bluuebunny/crossref_metadata_2025_split huggingface dataset:
Long‐Term Outcomes of Reduced‐Toxicity Conditioning Using 8‐Gray Total Body Irradiation, Fludarabine, and Cyclophosphamide in Children, Adolescents, and Young Adults With Hematological Malignancies
Authors: Morokawa Hirokazu , Hirabayashi Koichi , Furui Yu , Okura Eri , Saito Shoji , Nakazawa Yozo 
Published: December 2024

ABSTRACTRecent studies have indicated that total body irradiation (TBI)‐based reduced‐toxicity conditioning (RTC) may be a potential treatment modality, especially in adults with leukemia. However, its efficacy and safety in children with hematological malignancies remain unclear. To investigate the long‐term outcomes and safety of allogeneic hematopoietic stem cell transplantation (allo‐HSCT) using an 8‐Gray (Gy) TBI/fludarabine (FLU)/cyclophosphamide (CY) RTC in children with hematological malignancies. We included 66 consecutive patients with leukemia, lymphoma, or myelodysplastic syndrome in this retrospective cohort study. Participants were < 25 years old and received an 8‐Gy TBI/FLU/CY RTC regimen followed by the first allo‐HSCT at Shinshu University Hospital between March 2004 and March 2021. The 5‐year overall and relapse‐free survival probabilities were 88.2% and 76.5%, respectively, in the lymphoid malignancy group. The myeloid malignancy group had probabilities of 72.4% and 58.6%, respectively. The 5‐year cumulative incidences of relapse and non‐relapse mortality were 20.6% and 2.9%, respectively, in the lymphoid malignancy group. These incidences were 37.9% and 3.4%, respectively, in the myeloid malignancy group. All patients had engraftment without early relapse and none developed grade 5 regimen‐related toxicity within 28 days after allo‐HSCT. Nonetheless, two patients had congenital abnormalities caused by chromosomal aberrations and died without relapse. 8‐Gy TBI/FLU/CY RTC was safe in children with hematological malignancies, regardless of the donor source. However, safety concerns were noted in cases of chromosomal aberration‐induced congenital abnormalities. Additionally, patients in the lymphoid and myeloid malignancy groups had favorable prognoses.
Karst Hydrologic Memory Supplements Streamflow During Dry Periods in Snow‐Dominated, Mountainous Watersheds
Authors: Tennant Hyrum , Neilson Bethany T. , Hill Devon , Newell Dennis L. , Evans James P. , Choi Seohye , McNamara James P. , Ashmead Nathaniel , Xu Tianfang 
Published: December 2024

ABSTRACTAnalysis of PRISM and SNOTEL station data paired with USGS streamflow gage data in the western United States shows that, in snow‐dominated mountainous watersheds, streamflow regimes differ between watersheds with karst geology and their non‐karst neighbours. These carbonate aquifers exhibit a spectrum of flow paths encompassing karst conduits, including large fractures or voids that transmit water readily to springs and other surface waters, and matrix flow paths through soils, highly fractured bedrock, or porous media bedrock grains. A well‐connected karst aquifer will discharge a large portion of its accumulated precipitation to surface water via springs and other groundwater flow paths on an annual scale, exhibiting a lagged response to precipitation presenting as a “memory effect” in hydrograph time series. These patterns were observed in the hydrologic records of gaged watersheds with exposed or near‐surface carbonate layers accounting for > 30% of their drainage area. In western snow‐dominated watersheds, where paired streamflow and SNOTEL data are available, analysis of the precipitation and flow time series shows low‐flow volume is strongly related to karst aquifer conditions and winter precipitation when compared to low‐flow volumes present in non‐karst watersheds, which have a complex relationship to multiple driving metrics. Analysis of normalised streamflow and cumulative precipitation in karst watersheds show that low‐flow conditions are highly dependent on the preceding winter precipitation and streamflow in both wet and dry periods. In non‐karst watersheds, increased precipitation primarily impacts high‐flow, spring runoff volumes with no clear relationship to low‐flow periods. When comparing cumulative streamflow and precipitation volumes within each water year and over longer timescales, karst watersheds show the potential filling and draining of large amounts of karst storage, whereas non‐karst watersheds demonstrate a more stable storage regime. Communities in many western US watersheds are dependent on snow‐dominated karst watersheds for their water supply. This analysis, using widely available hydrologic data, can provide insight into the recharge and storage processes within these watersheds, improve our ability to assess current flow regimes, anticipate the impacts of climate change on water availability, and help manage water supplies.
Long‐term risk and characteristics of cerebrovascular events after upper body radiotherapy among childhood cancer survivors in the DCCSS‐LATER cohort
Authors: Verbruggen Lisanne C. , Kok Judith L. , Kremer Leontien C. M. , Janssens Geert O. , Nederkoorn Paul J. , Penson Adriaan , Versluijs A. Birgitta , de Vries Andrica C. H. , Reedijk Ardine M. J. , Bresters Dorine , Hoving Eelco W. , van Dulmen‐den Broeder Eline , Loonen Jacqueline J. , de Bont Judith , Wilbers Joyce , Louwerens Marloes , van der Heiden‐van der Loo Margriet , van den Heuvel‐Eibrink Marry M. , Pluijm Saskia M. F. , Neggers Sebastian J. C. M. M. , Tissing Wim J. E. , Roos Yvo B. W. E. M. , Ronckers Cécile M. , Teepen Jop C. , van der Pal Helena J. H. ,   the DCCSS‐LATER consortium
Published: December 2024

AbstractCerebrovascular events (CVEs) are serious late adverse events among childhood cancer survivors. We estimated the incidence and risk factors of symptomatic CVEs and described the clinical characteristics among childhood cancer survivors after upper body radiotherapy. The Dutch Childhood Cancer Survivor Study LATER cohort study includes 5‐year childhood cancer survivors diagnosed <age 18 years in the period 1963–2001. Data about CVEs were retrieved from medical records of survivors treated with upper body radiotherapy (n = 1633). Multivariable Cox and logistic regression models were used to identify potential risk factors for developing a symptomatic CVE. In 107 survivors with upper body radiotherapy, a CVE emerged, at a median age of 35.5 years. Cumulative incidence 40 years after diagnosis was 9.1% (95% CI: 7.2%–11.6%). A cranial radiotherapy prescription dose >50 Gy was associated with 6‐fold increased risk, compared to upper body radiotherapy not involving the cranium (hazard ratio = 6.3, 95%CI: 3.3–12.1). In a subgroup with available data on lifestyle and comorbidities, hypertension (odds ratio[OR] = 6.2, 95%CI: 1.6–23.8) and obesity (BMI≥30 vs. <30 = 2.95, 95%CI: 1.1–8.0) significantly increased CVE risk. During CVE episode, 17 (16%) had a life‐threatening situation, and two (2%) others died. In 28%, a second CVE developed during follow‐up. At end of follow‐up, 29% were deceased, and 40% of those alive were unable to carry out normal activities/active work. Childhood cancer survivors treated with higher doses of cranial radiotherapy are at highest risk for developing CVEs. CVEs occur at a young age and cause a high morbidity. Studies to investigate risk‐reducing secondary preventive interventions are warranted.
A Three‐Step Automated Segmentation Method for Early Cervical Cancer MRI Images Based on Deep Learning
Authors: Xiong Liu , Chen Chunxia , Lin Yongping , Song Zhiyu , Su Jialin 
Published: December 2024

ABSTRACTTumor detection and segmentation are essential for cervical cancer (CC) treatment and diagnosis. This study presents a model that segmented the tumor, uterus, and vagina based on deep learning automatically on magnetic resonance imaging (MRI) images of patients with CC. The tumor detection dataset consists of 68 CC patients' diffusion‐weighted magnetic resonance imaging (DWI) images. The segmented dataset consists of 73 CC patients' T2‐weighted imaging (T2WI) images. First, the three clear images of the patient's DWI images are detected using a single‐shot multibox detector (SSD). Second, the serial number of the clearest image is obtained by scores, while the corresponding T2WI image with the same serial number is selected. Third, the selected images are segmented by employing the semantic segmentation (U‐Net) model with the squeeze‐and‐excitation (SE) block and attention gate (SE‐ATT‐Unet). Three segmentation models are implemented to automatically segment the tumor, uterus, and vagina separately by adding different attention mechanisms at different locations. The target detection accuracy of the model is 92.32%, and the selection accuracy is 90.9%. The dice similarity coefficient (DSC) on the tumor is 92.20%, pixel accuracy (PA) is 93.08%, and the mean Hausdorff distance (HD) is 3.41 mm. The DSC on the uterus is 93.63%, PA is 91.75%, and the mean HD is 9.79 mm. The DSC on the vagina is 75.70%, PA is 85.46%, and the mean HD is 10.52 mm. The results show that the proposed method accurately selects images for segmentation, and the SE‐ATT‐Unet is effective in segmenting different regions on MRI images.
Semi‐Supervised Medical Image Segmentation Based on Feature Similarity and Multi‐Level Information Fusion Consistency
Authors: Long Jianwu , Liu Jiayin , Yang Chengxin 
Published: December 2024

ABSTRACTSemantic segmentation is a key task in computer vision, with medical image segmentation as a prominent downstream application that has seen significant advancements in recent years. However, the challenge of requiring extensive annotations in medical image segmentation remains exceedingly difficult. In addressing this issue, semi‐supervised semantic segmentation has emerged as a new approach to mitigate annotation burdens. Nonetheless, existing methods in semi‐supervised medical image segmentation still face challenges in fully exploiting unlabeled data and efficiently integrating labeled and unlabeled data. Therefore, this paper proposes a novel network model—feature similarity multilevel information fusion network (FSMIFNet). First, the feature similarity module is introduced to harness deep feature similarity among unlabeled images, predicting true label constraints and guiding segmentation features with deep feature relationships. This approach fully exploits deep feature information from unlabeled data. Second, the multilevel information fusion framework integrates labeled and unlabeled data to enhance segmentation quality in unlabeled images, ensuring consistency between original and feature maps for comprehensive optimization of detail and global information. In the ACDC dataset, our method achieves an mDice of 0.684 with 5% labeled data, 0.873 with 10%, 0.884 with 20%, and 0.897 with 50%. Experimental results demonstrate the effectiveness of FSMIFNet in semi‐supervised semantic segmentation of medical images, outperforming existing methods on public benchmark datasets. The code and models are available at https://github.com/liujiayin12/FSMIFNet.git.
Effect of a pharmacy‐driven rapid bacteremia response program on outcomes in adult patients with extended‐spectrum beta‐lactamase bacteremia: A retrospective, quasi‐experimental study
Authors: Swingler Elena A. , Clark Madison , Moore Sarah E. , Song Matthew , Montes de Oca Jamison , Furmanek Stephen , Chandler Thomas , Wilde Ashley M. 
Published: December 2024

AbstractIntroductionRapid diagnostic technology can improve patient outcomes, particularly when combined with Antimicrobial Stewardship Program (ASP) intervention. Bacteremic patients due to drug‐resistant organisms are most likely to benefit from rapid diagnostic technologies as they are more likely to be prescribed inadequate empiric therapy. The purpose of this study was to analyze the impact of a pharmacy‐driven Rapid Bacteremia Response Program (RBRP) on the process and clinical outcomes of patients with bacteremia due to an extended‐spectrum beta‐lactamase (ESBL)‐producing organism.MethodsA retrospective, quasi‐experimental study was conducted at a large healthcare system. The RBRP was implemented in 2017 to expedite antimicrobial therapy for bacteremia based on Gram stain and Verigene® system (Luminex Corp, Austin, TX, USA) results. Adults hospitalized with ESBL bacteremia were evaluated pre‐intervention and post‐intervention (utilizing the RBRP). The primary outcome was time to active therapy. Secondary outcomes included in‐hospital and 30‐day mortality, length of hospital and intensive care unit (ICU) stay, and factors associated with mortality.ResultsA total of 200 patients were included: 100 patients in the pre‐intervention and 100 patients in the post‐intervention group. The post‐intervention group resulted in 6.4 h faster time to active therapy from blood culture collection (median 22.8 h pre‐intervention vs. 16.4 h post‐intervention, p = 0.001). No statistical difference was identified for the length of hospital or ICU stay and in‐hospital or 30‐day mortality between groups. Multivariable analysis identified age, male sex, quick Pitt bacteremia score, and hospital‐acquired infection to be significantly associated with 30‐day mortality.ConclusionThe pharmacy‐driven RBRP resulted in decreased time to active therapy for patients with ESBL bacteremia.
Monitoring concentration and lipid signature of plasma extracellular vesicles from HR+ metastatic breast cancer patients under CDK4/6 inhibitors treatment
Authors: Richard Mathilde , Moreau Rosalie , Croyal Mikaël , Mathiot Laurent , Frénel Jean‐Sébastien , Campone Mario , Dupont Aurélien , Gavard Julie , André‐Grégoire Gwennan , Guével Laëtitia 
Published: December 2024

AbstractExtracellular vesicles (EVs) are cell‐derived small membrane structures that transport various molecules. They have emerged as potential circulating biomarkers for monitoring responses to cancer therapies. This study aimed to comprehensively characterize plasma‐carried EVs in hormone receptor‐positive (HR+) metastatic breast cancer (MBC) patients treated with first‐line CDK4/6 inhibitors (iCDK4/6) combined with endocrine therapy. MBC patients were classified into three groups based on their response to therapy: resistant, intermediate or sensitive. In a prospective cohort, we monitored the concentration of circulating EVs, analyzed their lipid signature and correlated these factors with treatment response. To facilitate the translation of EV research to clinical practice, we established a three‐step procedure: (1) EVs were isolated from plasma using semi‐automatized size exclusion chromatography (SEC); (2) EV concentration, termed vesiclemia, was determined by drop counting via interferometric light microscopy (ILM); and (3) EV lipid composition was analyzed by mass spectrometry. ILM‐based vesiclemia values were highly fluctuating upon iCDK4/6 treatment, while early increase associated with accelerated progression. Of note, vesiclemia remained a steady parameter over a 1‐year period in age‐matched healthy women. Additionally, analysis of the EV cargo unveiled a distinct sphingolipid profile, characterized by increased levels of ceramides and sphingomyelins in resistant patients within the first 2 months of treatment. Based on 16 sphingolipid species, sensitive and resistant patients were correctly classified with an overall accuracy of 82%. This specific sphingolipid pattern was exclusively discernible within EVs, and not in plasma, highlighting the significance of EVs in the early prediction of individual responses to iCDK4/6 and disease progression. Overall, this study provides insights of the longitudinal characterization of plasma‐borne EVs in both a healthy group and HR+ MBC patients under iCDK4/6 therapies. Combined vesiclemia and EV sphingolipid profile emphasize the promising potential of EVs as non‐invasive biomarkers for monitoring early treatment response.
Aggressive Versus Moderate Fluid Replacement for Acute Pancreatitis: An Updated Systematic Review and Meta‐Analysis
Authors: Ehsan Muhammad , Ahmad Aamna Badar , Javed Haseeba , Zahid Afra , Aamir Hafiz Sheheryar , Cheema Huzaifa Ahmad , Ayyan Muhammad , Mustafa Biah , Shahid Abia , Ilyas Muhammad Abdullah , Kandel Kamal , Awan Rehmat Ullah , Iqbal Sana 
Published: December 2024

ABSTRACTBackgroundA conservative strategy is the primary modality of treatment for acute pancreatitis of which fluid replacement is an important component. Since the results regarding early aggressive versus moderate fluid replenishment for acute pancreatitis are inconsistent, we sought to compare outcomes between the two resuscitation strategies in our meta‐analysis.MethodsWe searched MEDLINE (PubMed), Embase, the Cochrane Library, and ClinicalTrials.gov for all available randomized controlled trials (RCTs) assessing outcomes for patients treated with aggressive fluid replacement compared to moderate fluid replacement. Our primary outcome was all‐cause mortality.ResultsOur meta‐analysis included 6 RCTs involving a total of 632 patients. Our results showed that aggressive fluid resuscitation increased the risk of all‐cause mortality as compared to moderate fluid replacement (RR 2.40, CI: 1.38–4.19). For all of our secondary outcomes which included the development of organ failure, severe pancreatitis, pancreatic necrosis, clinical improvement, development of SIRS, persistent SIRS, and length of hospital stay, the results indicate that there was no significant difference between the two groups.ConclusionsAggressive fluid resuscitation is associated with higher mortality as compared to moderate fluid replacement in patients with acute pancreatitis. RCTs with larger sample sizes are needed to provide greater statistical power and establish more definitive conclusions.
Epidemiological, Clinical, and Genomic Traits of PIV in Hospitalized Children After the COVID‐19 Pandemic in Wuhan, China
Authors: Huang Jiaming , Li Ying , Chen Hebin , Liu Haizhou , Li Wenqing , Isiaka Ismaila Damilare , Du Hui , Noman Muhammad , Rizwan Muhammad Arif , Du Qing , Li Yang , Lin Yaxin , Liu Yuehu , Lu Xiaoxia , Liu Di , Yan Yi 
Published: December 2024

ABSTRACTHuman parainfluenza virus (PIV) is a main cause of acute lower respiratory tract infections (ALRTIs), which contributes to childrens' mortality worldwide; however, the epidemiology of PIVs following the SARS‐CoV‐2 pandemic is still not clarified, and poses risks of potential outbreaks. Herein, we conducted a retrospective observational study from September 26, 2020 to September 30, 2023 to assess PIV epidemiology in Wuhan, China, as well as the clinical characteristics of PIV infections. In total, 14,065 inpatients with ALRTIs were enrolled, of which 936 were identified to have PIV infection. We also obtained 69 PIV3 RNA to reveal its molecular traits. An alteration in PIV season pattern away from spring and summer prevalence was noted, as well as a progressive rise in its detection rate. PIV‐related ALRTIs were more prevalent in male patients. PIV3 was the dominant PIV type in recent years. In comparison with the phase before the cancellation of Dynamic Zero‐COVID Policy in December 2022, symptoms after its repeal were milder. All Wuhan strains were classified with C3f lineage and possibly evolved from native strains in China. Additionally, some mutations, such as Q499P in protein hemagglutinin‐neuraminidase, should be given further attention. In summary, our study demonstrates the clinical characteristics of PIVs and genomic traits of PIV3 in Wuhan, China, thus holds importance for the diagnosis and control of PIV infections in the post‐pandemic era.
An Open‐Source Tool for Investigation of Differential RNA Expression Between Spinal Cord Cells of Male and Female Mice
Authors: Bellavance Justin , David Laurence S. , Hildebrand Michael E. 
Published: December 2024

ABSTRACTChronic pain is a highly debilitating condition that differs by type, prevalence, and severity between men and women. To uncover the molecular underpinnings of these differences, it is critical to analyze the transcriptomes of spinal cord pain‐processing networks for both sexes. Despite several recently published single‐nucleus RNA‐sequencing (snRNA‐seq) studies on the function and composition of the mouse spinal cord, a gene expression analysis investigating the differences between males and females has yet to be performed. Here, we combined data from three different large‐scale snRNA‐seq studies, which used sex‐identified adult mice. Using SeqSeek, we classified more than 37,000 unique viable cells within predicted cell types with the use of machine learning. We then utilized DESeq2 to identify significant differentially expressed genes (DEGs) between males and females in a variety of cell populations, including superficial dorsal horn (SDH) neurons. We found a large number of DEGs between males and females in all cells, in neurons, and in SDH neurons of the mouse spinal cord, with a greater level of differential expression in inhibitory SDH neurons compared to excitatory SDH neurons. The results of these analyses are available on an open‐source web‐app: https://justinbellavance.shinyapps.io/snRNA_Visualization/. Lastly, we used gene set enrichment analysis to identify sex‐enriched pathways from our previously identified DEGs. Through this, we have identified specific genetic players within the rodent spinal cord that diverge between males and females, which may underlie reported sex differences in spinal nociceptive mechanisms and pain processing.
Exploring the association between moral injury and posttraumatic stress symptoms among Canadian public safety personnel
Authors: D'Alessandro‐Lowe Andrea M. , Scott Andrew M. , Patel Herry , Easterbrook Bethany , Ritchie Kimberly , Brown Andrea , Pichtikova Mina , Karram Mauda , Sullo Emily , Mirabelli James , Schielke Hygge , Malain Ann , O'Connor Charlene , Remers Shannon , Lanius Ruth , McCabe Randi E. , McKinnon Margaret C. 
Published: December 2024

AbstractPublic safety personnel (PSP), such as police officers, firefighters, correctional workers, and paramedics, routinely face work stressors that increase their risk of developing posttraumatic stress disorder (PTSD). PSP may additionally face moral transgressions in the workplace (e.g., witnessing human suffering, working within broken systems), heightening the risk of moral injury (MI) in this population. Research among military personnel and health care workers shows an association between MI and PTSD; however, less is known about the association between these constructs among PSP. Canadian PSP completed an online survey between June 2022 and June 2023, including a demographic questionnaire and measures of PTSD, MI, dissociation, depression, anxiety, stress, and childhood adversity. Latent variable structural equation modeling (SEM) was performed to ascertain the impact of a latent MI construct (i.e., shame, trust violation, functional impairment) on a latent PTSD construct (i.e., intrusions, avoidance, negative alterations in cognition and mood, hyperreactivity, depersonalization, derealization). Sex, age, depression, anxiety, stress, and childhood adversity were included as covariates. A total of 314 PSP were included in the data analysis. A latent variable SEM regressing PTSD onto MI and including covariates accounted for 83.7% of the variance in PTSD. MI was the strongest predictor compared to all covariates and was significantly associated with PTSD symptoms, β = .506, p < .001, above and beyond the impacts of sex, age, depression, anxiety, stress, and childhood adversity. These findings are consistent with research among military members and health care providers and highlight the importance of further exploring MI among PSP.