bluuebunny/crossref_metadata_2025_split huggingface dataset:
Differentiating between obstructive and non‐obstructive azoospermia: A machine learning‐based approach
Authors: Haghpanah Abdolreza , Ayareh Nazanin , Akbarzadeh Ashkan , Irani Dariush , Hosseini Fatemeh , Moghadam Farid Sabahi , Gilani Mohammad Ali Sadighi , Shamohammadi Iman 
Published: February 2025

AbstractBackgroundInfertility is a major global concern, with azoospermia, being the most severe form of male infertility. Distinguishing between obstructive azoospermia (OA) and non‐obstructive azoospermia (NOA) is crucial due to their differing treatment approaches. This study aimed to develop a machine learning model to predict azoospermia subtypes using clinical, ultrasonographic, semen and hormonal analysis data.MethodsThis retrospective study included all subjects diagnosed with azoospermia. All patients were evaluated by at least one urologist, had their semen sample assessed on at least two different occasions for diagnosis and underwent a testicular biopsy to determine the type of azoospermia, categorized into OA and NOA. Clinical factors, hormonal levels, semen parameters and testicular features were compared between the OA and NOA groups. Three machine learning models, including logistic regression, support vector machine and random forest, were evaluated for their accuracy in differentiating the two subtypes.ResultsThe study included a total of 427 patients with azoospermia, of which 326 had NOA and 101 had OA. The median age of the patients was 33.0 (IQR: 7.0) years. Our findings revealed that factors such as body mass index, testicular length, volume and longitudinal axis, semen parameters and hormonal levels differed significantly between the two groups. When these variables were input into the machine learning‐based models, logistic regression achieved the highest F1‐score and area under the curve value among the three models evaluated.ConclusionsThis study underscores the potential of machine learning to differentiate between azoospermia subtypes using readily available clinical data. However, further research is required to validate and refine the model before it can be applied clinically.
A systematic review of outcomes associated with patients admitted to hospital with emergency haematuria
Authors: Kerdegari Nikki , Varma Raghav , Ippoliti Simona , Alexander Cameron , Nathan Arjun , Gallagher Kevin , Khadhouri Sinan , Byrnes Kevin , Bhatt Nikita , Kasivisvanathan Veeru 
Published: February 2025

AbstractObjectiveUnscheduled admission for haematuria accounts for 15% of all urological emergencies with over 25 000 patients admitted each year in the UK. It is associated with prolonged admission and poor clinical outcomes. This systematic review aims to determine current management strategies and outcomes in these patients.MethodsA systematic search was performed in October 2023 across MEDLINE, EMBASE and Web of Science for randomised controlled trials and retrospective and prospective observational studies assessing the management of patients admitted as an emergency with haematuria. The primary outcome measure was the length of stay (LoS). Secondary outcomes included hospital readmission, mortality and health resource use.ResultsThree eligible publications with a total of 219 patients were identified. Mean length of stay was 5.8 days. The pooled mean age of unscheduled emergency haematuria was 74.8 years and 87.9% of patients were male. Bladder cancer was present in 17% of patients and, similarly, prostate cancer was present in 17% of patients.ConclusionsUnscheduled admission for haematuria is associated with long LoS. This systematic review has demonstrated a lack of data reporting outcomes of unscheduled haematuria and its management strategies. There is a need to perform large‐scale prospective studies to better understand this cohort of patients.
Hydrocortisone treatment is associated with early recovery from severe septic shock in patients with obstructive pyelonephritis due to upper urinary tract stone
Authors: Otsuka Isamu , Nishimoto Koshiro , Kozako Taichi , Kanemaru Katsuhiro , Yamashita Yasuhiro , Kamoto Toshiyuki , Sawada Atsuro 
Published: February 2025

AbstractObjectivesThe administration of hydrocortisone in patients with severe septic shock contributes to early recovery in intensive care. The purpose of this study was to evaluate the effect of hydrocortisone on early recovery from severe septic shock in patients with obstructive pyelonephritis due to upper urinary tract stone (stone pyelonephritis).MethodsFrom January 2018 to October 2023, of all patients admitted for treatment of stone pyelonephritis, 28 did not respond to initial fluid infusion and vasopressors for urosepsis. Among these 28 patients, 14 were administered hydrocortisone for recovery from early shock. Characteristics and noradrenaline administration time of patients treated or not treated with hydrocortisone were retrospectively analysed.ResultsIn patients with septic shock associated with stone pyelonephritis unresponsive to initial fluid and vasopressors, noradrenaline administration time in the hydrocortisone group (28.7 ± 17.5 h) was significantly shorter than in the non‐treated group (46.0 ± 12.8 h, p = 0.006). The factors diabetes, blood culture results, age, performance status, severity of vital signs and laboratory data on sepsis severity were not significantly associated with the duration of noradrenaline administration.ConclusionsOur findings suggest potential benefits of hydrocortisone administration for stone pyelonephritis unresponsive to initial fluid and vasopressors. Widespread adoption of hydrocortisone in the treatment of sepsis, which is common in intensive care, could become more important in urology.
Assessing Environmental Risks Factors in Anorectal Malformations: Case Report and Literature Review
Authors: Ortiz‐Fernandez Claudia , Campillo i López Ferran , Schneider Stephan Otto , Núñez Bernardo , Vidal Anton Foguet i 
Published: February 2025

ABSTRACTIntroductionAnorectal malformations are birth defects that affect 1 in 5000 live births. Despite the research, the cause is still unknown, but genetic and environmental factors have been described to contribute to its pathogenesis. We report the case of a child with an anterior ectopic anus in which prenatal environmental factors were systematically assessed using a screening evaluation interview, the Green Page, and a complete Pediatric Environmental History.CaseA first born of a 29 year old woman with a history of epilepsy treated with high doses of lamotrigine, levetiracetam, and clobazam, and a subclinical hypothyroidism treated with levothyroxine. Periconceptional supplementation with 400mcg of folic acid, maternal and paternal smoking habit, and some occupational exposures to chemical hazards. No personal or family history of congenital malformations.DiscussionSome previously related environmental factors were found, such as mother's epilepsy, high lamotrigine dose, tobacco exposure, air pollution, and in a lesser risk the use of levothyroxine. The Green Page and the Pediatric Environmental History could contribute to identifying and reducing environmental risks related to birth defects.
Hematoma, Perihematomal Edema, and Total Lesion Predict Outcome in Patients With Intracerebral Hemorrhage
Authors: Huang Qin , Wu Lin , Song Ziwei , Zhang Zhi , Kuang Hongla , Zhu Yuping , Zeng Chenying , Zhang Lanjiao , Zhang Hudie , Xu Zubing , Xu Wenyuan , Lin Jing 
Published: February 2025

ABSTRACTBackgroundThe present study aimed to evaluate the predictive abilities of hematoma volume, perihematomal edema (PHE) volume, and total lesion (hematoma + PHE) volume for poor outcome in patients with intracerebral hemorrhage (ICH).MethodsPatients admitted to our department between January 2015 and March 2023 were retrospectively enrolled according to the inclusion criteria and exclusion criteria. Demographic characteristics, clinical information, laboratory examinations, and imaging data were collected.ResultsWe included 510 patients with initial computerized tomography (CT) scan (342 [67.1%] male, median age = 62 years); 142 patients had CT scans at admission and 72 h post ICH, and 350 patients had CT scans at admission and 5–9 days after onset. Multivariate logistic regression analysis revealed that absolute hematoma, absolute PHE, and absolute total lesion at admission; absolute hematoma and absolute total lesion at 72 h after onset; absolute hematoma, absolute PHE, and absolute total lesion at 5–9 days post ICH were independently related to poor outcome (p < 0.05). Furthermore, receiver operating characteristic curves demonstrated that the total volume of hematoma and PHE at 5–9 days post ICH was a better indicator to predict poor outcome, compared to other risk factors in patients with ICH (area under curve = 0.778, 95%CI: 0.729–0.826).ConclusionThe total volume of hematoma and PHE at 5–9 days after onset had the highest ability in predicting poor outcome in patients with ICH.
Analysis of Ruddlesden‐Popper and Dion‐Jacobson 2D Lead Halide Perovskites Through Integrated Experimental and Computational Analysis
Authors: Akbar Basir , Chong Kil To , Tayara Hilal 
Published: February 2025

ABSTRACTTwo‐dimensional (2D) lead halide perovskites (LHPs) have captured a range of interest for the advancement of state‐of‐the‐art optoelectronic devices, highly efficient solar cells, next‐generation energy harvesting technologies owing to their hydrophobic nature, layered configuration, and remarkable chemical/environmental stabilities. These 2D LHPs have been categorized into the Dion‐Jacobson (DJ) and Ruddlesden‐Popper (RP) systems based on their layered configuration respectively. To efficiently classify the RP and DJ phases synthetically and reduce reliance on trial/error method, machine learning (ML) techniques needs to develop. Herein, this work effectively identifies RP and DJ phases of 2D LHPs by implementing various ML models. ML models were trained on 264 experimental data set using 10‐fold stratified cross‐validation, hyperparameter optimization with Optuna, and Shapley Additive Explanations (SHAP) were employed. The stacking classifier efficiently classified RP and DJ phases, demonstrating a minimal variation between the sensitivity and specificity and achieved a high Balance Accuracy (BA) of (0.83) on independent test data set. Our best model tested on 17 hybrid 2D LHPs and three experimental synthesized 2D LHPs aligns well experimental outcomes, a significant advance in cutting edge ML models. Thus, this proposed study has unlocked a new route toward the rational classification of RP and DJ phases of 2D LHPs.
The combination of oleic acid, linoleic acid, palmitoleic acid, and α‐linolenic acid promoted the expansion of NK‐92 cells in vitro
Authors: Zhang Shumin , Huang Huimin , Zhang Jingwei , Zhao Yuanyuan , Tan Wen‐song , Cai Haibo 
Published: February 2025

AbstractCell culture medium is an important factor affecting the expansion of NK cells in vitro. As an important component of cell culture medium, lipids participate in various complex physiological activities of cells and significantly affect the expansion of cells. Using NK‐92 cells as a model, the lipid metabolism of NK cells in vitro was analyzed, and combined with the kinetic relationship between lipid metabolism and NK cell expansion. Four fatty acids, oleic acid, linoleic acid, palmitoleic acid, and α‐linolenic acid, were preliminatively identified as the key lipid combinations. The combination was preliminarily verified on the self‐developed serum‐free medium. It was found that when the key lipid combination was added according to the concentration in the serum, NK‐92 cells expansion reached 188.03 ± 33.34‐folds, which was significantly higher than 105.28 ± 13.23‐folds in the basic medium. Additionally, NK‐92 cells expanded by adding key lipid combinations could maintain cell killing function. Overall, this research provides technical support for the development of NK cell serum‐free medium.
Imaging‐Based Prediction of Ki‐67 Expression in Hepatocellular Carcinoma: A Retrospective Study
Authors: Cai Chiyu , Wang Liancai , Tao Lianyuan , Zhu Hengli , Ren Yongnian , Li Deyu , Li Dongxiao 
Published: February 2025

ABSTRACTAimThis study aims to develop a non‐invasive, preoperative predictive model for Ki‐67 expression in HCC patients using enhanced computed tomography (CT) and clinical indicators to improve patient outcomes.MethodsThis retrospective study analyzed 595 post‐curative hepatectomy HCC patients. Patients were categorized into high (> 20%) and low (≤ 20%) Ki‐67 expression groups based on cellular proliferation levels. Radiomic features were extracted from enhanced CT scans and combined with clinical parameters to develop a predictive model for Ki‐67 expression.ResultsKey clinical factors impacting Ki‐67 expression in HCC included alpha‐fetoprotein (AFP), non‐smooth tumor margin, ill‐defined pseudo‐capsule, and peritumoral star node. From 1441 initially extracted radiomic features, 16 key features were selected using Lasso regression. These features were used to develop a radiomics model, which, when combined with clinical data, yielded an integrated predictive model with high accuracy. The combined model achieved an area under the curve (AUC) of 0.854 in the training group and 0.839 in the validation group. A nomogram based on this model was constructed, and its predictive accuracy was validated through calibration curves and decision curve analysis. A risk scorecard model was also constructed as a practical tool for clinicians to assess the risk level of high Ki‐67 expression, facilitating personalized treatment planning. Survival analysis demonstrated significant differences in 3‐year overall survival (OS) and progression‐free survival (PFS) rates between patients with high and low Ki‐67 expression, indicating the model's strong prognostic capability.ConclusionsThis study successfully developed a comprehensive model that integrates radiomic and clinical data for the preoperative prediction of Ki‐67 expression in HCC patients.
Significance of Gelsolin Superfamily Genes in Diagnosis, Prognosis and Immune Microenvironment Regulation for Endometrial Cancer
Authors: Jiang Senwei , Ye Minjuan , Wan Jing , Ye Qingjian , Qiu Suli , Yang Yuebo , Li Xiaomao 
Published: February 2025

ABSTRACTBackgroundPreviously, anti‐CTLA4 and anti‐PD‐1/PD‐L1 immunotherapies have shown limited efficacy in MSI‐H/MMR‐D endometrial cancer, leading to poor clinical outcomes. The gelsolin superfamily, which includes GSN, SCIN, VILL, VIL1, CAPG, AVIL, SVIL, and FLII, plays crucial roles in cell motility and gene regulation.AimsThe objective of this study is to explore the potential therapeutic and prognostic implications of the gelsolin superfamily in EC.Materials & MethodsData from TCGA, GEPIA, THPA, UALCAN, and Kaplan–Meier plotter databases were analyzed to investigate the expression and clinical relevance of gelsolin superfamily members. Co‐expression networks of the gelsolin superfamily were assessed using LinkedOmics, GeneMANIA, and NetworkAnalyst. The relationship between gelsolin superfamily and immune cell infiltration was investigated using TIMER, ImmuCellAI, and GEPIA.ResultsWe found that high expressions of CAPG, AVIL, and SVIL were associated with poor prognosis, while high expressions of GSN and FLII were linked to better outcomes in EC. Functional enrichment analysis indicated the involvement of gelsolin superfamily members in pathways related to estrogen response, MYC targets, epithelial–mesenchymal transition, TGF beta signaling, MTORC1 signaling, oxidative phosphorylation, inflammatory response, and IL6‐JAK‐STAT3 signaling. Furthermore, gelsolin superfamily members demonstrated strong correlations with the levels of monocytes, natural killer T, naive CD4+ T, follicular helper T, and central memory T in EC. In vitro studies showed that silencing CAPG and FLII could inhibit proliferation and metastasis in endometrial cancer cell lines.ConclusionThese findings indicate the significant association of gelsolin superfamily members with prognosis and immunological status in endometrial cancer.
Assessing the Economic Impact of Cancer Care: A Study on Out‐of‐Pocket Expenditures and Utilization in South Korea
Authors: Kim Do Hee , Kim Yejin , Park Jun Su , Lee Sang Gyu , Chang Hyuk‐Jae , Kim Tae Hyun 
Published: February 2025

ABSTRACTIntroductionCancer remains one of the leading causes of mortality and financial distress worldwide. In South Korea, the government introduced a benefit extension system in 2013 aimed at mitigating the financial strain associated with cancer treatment. However, cancer patients continue to bear significant out‐of‐pocket (OOP) expenses. This study aims to quantify the incremental healthcare utilization and OOP expenditures incurred by cancer patients in South Korea.MethodsUtilizing data from the 2019 Korean Health Panel (KHP), we assessed cancer‐related healthcare utilization and OOP expenditures. A generalized linear regression model, adjusted for demographic and socioeconomic variables, was employed. Healthcare utilization was measured by hospital admissions, outpatient visits, and emergency room (ER) visits, while OOP expenditures encompassed services including both covered and not covered by the National Health Insurance (NHI) system.ResultsCancer patients experienced 0.39 more hospitalizations, 4.91 additional outpatient visits, and 0.11 more ER visits annually compared to non‐cancer patients. Their incremental OOP expenses amounted to $482.8 per year, with $340.2 attributable to inpatient services. Notable variations in healthcare utilization and expenditures were observed across different cancer types.DiscussionDespite the implementation of the benefit extension system, cancer patients continue to face considerable OOP expenses, particularly for inpatient care. With cancer incidence expected to rise, there is a pressing need for more comprehensive healthcare policies that alleviate the financial burden and prioritize cost‐effective treatments for cancer patients.ConclusionThis study underscores the substantial economic impact of cancer on South Korean patients. Expanding the benefit extension system and promoting cost‐effective care strategies are critical to easing the growing financial pressures on cancer patients.
Parents' Challenges in Children's Psychotherapeutic Interventions: A Phenomenological Study
Authors: Chuah Hooi Mei , Sumari Melati 
Published: February 2025

ABSTRACTBackgroundParental engagement in a child's psychotherapeutic interventions for Emotional and Behavioural Difficulties (EBD) greatly influences the effectiveness of the treatment. However, various challenges can hinder parents' active participation in these interventions. Aim: To gain a deeper understanding of the challenges parents encounter while engaging in their child's psychotherapeutic interventions, this study explored the specific challenges faced by parents within the Malaysian context.Materials and MethodsA transcendental phenomenological approach was used in this study to provide an in‐depth understanding of the challenges faced by parents during their engagement with their child's mental health services. Applying Seidman's three‐interview series, empirical voices from seven parents (six mothers and one father) in peninsula Malaysia were collected. The Stevick–Colaizzi–Keen method was used to analyse data collected from individual interviews.ResultsThe parents' experiences of challenges in children's psychotherapeutic interventions uncovered three significant themes with seven subthemes. ‘Delivery of Therapy’ emerged as the first main theme, with cost of therapy, service accessibility and structure of therapy as subthemes. The second main theme was ‘Pre‐therapy Preparation’, with preparatory work before therapy and children's level of acceptance as subthemes. Finally, the third main theme was 'Therapist's Professionalism', with the therapist's credibility and working relationship with the therapist as the subthemes.DiscussionFindings highlight challenges that hinder timely and effective psychotherapeutic interventions, adding emotional strain for parents.ConclusionAddressing these challenges through comprehensive mental health policies could empower all stakeholders to deliver high‐quality services and foster parental engagement.
From Body Positivity and Beyond: Investigating Affective Aesthetic Atmospheres of Influencers
Authors: Anderson Kelley Cours , Wallach Karen Anne , Albinsson Pia A. , Tracy Ryann 
Published: February 2025

ABSTRACTHow do influencers create content on social media that shapes consumer experiences and discourse around beauty standards? While research recognizes the power of influencers to help motivate market‐level changes, limited research has investigated this performance, particularly related to content intended to resist existing aesthetic norms. This research explores how social media spaces are designed and modified within the wider discourse by leveraging critical video analysis of TikTok influencers within the context of the body positivity movement. Using findings from netnographic data, we introduce a conceptual framework that explains how influencers and various market actors co‐create an affective aesthetic atmosphere—a space offering aesthetic meanings with the subjective formation of an experience and its related emotional bricolage, herein aimed at resisting normative beauty standards. Implications address the impact on consumer well‐being, the beauty industry, and marketers.
Rapid Growth of a Hepatic Hydatid Cyst in a Pediatric Patient: A Case Report From Iran and Its Clinical Significance
Authors: Sayyahfar Shirin , Khamesipour Faham , Zarei Elham , Nasiri Javad 
Published: February 2025

ABSTRACTHepatic hydatid cysts in pediatric patients present unique diagnostic and therapeutic challenges due to their rapid growth and potential to mimic other pathologies. This case highlights the importance of considering hydatid disease in the differential diagnosis of hepatic cysts, especially in children from endemic regions. The unusual rapid growth rate observed in pediatric cases, influenced by age‐related immune and tissue dynamics, underscores the need for heightened vigilance even when prior imaging appears normal. Timely recognition and intervention are crucial to preventing complications such as cyst rupture, secondary infection, and compression of adjacent organs. This case also illustrates the utility of serological and radiological tools in confirming the diagnosis and the role of surgical and pharmacological therapies in ensuring favorable outcomes. Clinicians must remain alert to atypical presentations, ensuring comprehensive evaluation and prompt treatment to improve prognosis and reduce the burden of complications associated with hydatid disease.
Recurrent Inflammatory State due to Severe Periarticular Calcifications in a Patient on Hemodialysis: A Case Report
Authors: Timsans Janis , Vilpakka Mari , Lusila Niilo , Kauppi Markku 
Published: February 2025

ABSTRACTThis report highlights a severe manifestation of chronic kidney disease‐mineral and bone disorder (CKD‐MBD) in a hemodialysis patient: periarticular calcifications causing recurrent inflammation mimicking infection. Diagnostics excluded infections and autoimmune disorders, identifying CKD‐MBD as the cause. Low‐dose prednisolone effectively mitigated inflammation, reducing hospitalizations.