bluuebunny/crossref_metadata_2025_split huggingface dataset:
The “Arabic” Stole of Vatopediou Monastery: Traces of Islamic Material Culture in Late Byzantium
Authors: Vryzidis Nikolaos 
Published: May 2021

Abstract
In the collection of Vatopediou Monastery (Mount Athos) there is a Late Byzantine vestment called by the monks the “Arabic stole” (arabikon ōmophorion). This quite unique vestment probably owes its name to two bands of embroidered Arabic inscriptions on the lower part of each end. It is one of the very few known Byzantine religious objects to feature legible Arabic inscriptions, a visible symbol of Islamic otherness juxtaposed with the standard Christian iconography. Apart from bringing into the spotlight a medieval vestment that has been overlooked by scholars, this article traces possible sources of artistic transfer through a discussion of texts and extant objects. Finally, it aims at expanding our understanding of the reception of Islamic art in Late Byzantium, a time of both political decline and cultural renewal.
Forestry control in the Brazilian Amazon II: charcoal anatomy of 21 species
Authors: Braga Júnior Marcelo Mendes , de Souza Fernanda Ilkiu Borges , de Lima Melo Luiz Eduardo 
Published: May 2021

Abstract
The production of illegal charcoal, associated with other local human practices, is responsible for the degradation of native forests, especially in the Brazilian Amazon. The need for market control and charcoal production is accompanied by the lack of comparative charcoal materials from the Amazon. Here, we describe charcoal samples of 21 Brazilian species and provide SEM images that can facilitate the charcoal identification. It is possible to distinguish the species on the basis of anatomy. Features such as vessel groupings, vessel–ray pitting, perforation plates, axial parenchyma, ray cellular composition, storied structure and secretory elements were chosen as primary diagnostic features for the identification of species. We highlight vessel groupings, axial parenchyma type and in some cases even perforation plates, which were easily observed in low magnification SEM images and can assist in the supervision by government agents. From our descriptions, evaluations and photomicrographs, it will be possible to compare charcoal from commercial species from the Amazon.
Calibration of the SPEARpesticides bioindicator for cost-effective pesticide monitoring in East African streams
Authors: Ganatra Akbar A. , Kandie Faith Jebiwot , Fillinger Ulrike , McOdimba Francis , Torto Baldwyn , Brack Werner , Liess Matthias , Hollert Henner , Becker Jeremias M. 
Published: May 2021

Abstract
Background
Pesticides are washed from agricultural fields into adjacent streams, where even short-term exposure causes long-term ecological damage. Detecting pesticide pollution in streams thus requires the expensive monitoring of peak concentrations during run-off events. Alternatively, exposure and ecological effects can be assessed using the SPEARpesticides bioindicator that quantifies pesticide-related changes in the macroinvertebrate community composition. SPEARpesticides has been developed in Central Europe and validated in other parts of Europe, Australia and South America; here we investigated its performance in East African streams.

Results
With minimal adaptations of the SPEARpesticdes index, we successfully characterized pesticide pollution in 13 streams located in Western Kenya. The East African SPEARpesticides index correlated well with the overall toxicity of 30 pesticides (maximum toxic unit = maximum environmental vs. median lethal concentration) measured in stream water (R2 = 0.53). Similarly, the SPEARpesticides index correlated with the risk of surface run-off from agricultural fields (as identified based on ground slope in the catchment area and the width of protective riparian strips, R2 = 0.45). Unlike other bioindicators designed to indicate general water pollution, SPEARpesticides was independent of organic pollution and highly specific to pesticides. In 23% of the streams, pesticides exceeded concentrations considered environmentally safe based on European first tiered risk assessment.

Conclusions
Increasing contamination was associated with considerable changes in the macroinvertebrate community composition. We conclude that pesticides need to be better regulated also in developing countries. SPEARpesticides provides a straightforward and cost-efficient tool for the required monitoring of pesticide exposure in small to medium streams.
RETRACTED ARTICLE: Routine point-of-care ultrasound (POCUS) assessment of gastric antral content in traumatic emergency surgical patients for prevention of aspiration pneumonitis: an observational clinical trial
Authors: Shorbagy Mohamed S. , Kasem Amr A. , Gamal Eldin Ahmed A. , Mahrose Ramy 
Published: May 2021

Abstract
Background
Polytrauma patients are at a higher risk of delayed gastric emptying. To assess the gastric volume, a reliable diagnostic tool is needed to prevent the occurrence of aspiration pneumonia, which remains a serious complication associated with anesthesia. Gastric antral ultrasound can provide reliable information about the size of the gastric antrum in traumatized patients undergoing emergency surgery.

Methods
A prospective observational study of 45 polytrauma patients undergoing emergency surgery under general anesthesia was carried out. Prior to induction of anesthesia in the emergency department, gastric ultrasound was performed for qualitative and quantitative assessment of the gastric antrum in a supine position and right lateral decubitus (RLD) position. This was followed by routine placement of the nasogastric tube to aspirate and calculate the volume of the stomach contents.

Results
Of the 45 polytrauma patients, the risk assessment of aspiration and the anesthesia technique changed in 14 patients (31.1%) after the gastric ultrasound examination.
A very good relationship existed between the expected stomach volume at the RLD position and the suction volume in the nasogastric tube. In all cases, no aspirations were documented.

Conclusion
Ultrasound examination of the stomach in polytrauma patients allows assessing the size and type of stomach contents. The data obtained can influence the choice of anesthesia technique and reduce the risk of aspiration pneumonia.

Trial registration
This trial was registered at ClinicalTrials.gov. registry number: NCT04083677 on September 6, 2019.
Significances of viable synergistic autophagy-associated cathepsin B and cathepsin D (CTSB/CTSD) as potential biomarkers for sudden cardiac death
Authors: Dai Jialin , Zhang Qiong , Wan Changwu , Liu Jiangjin , Zhang Qiaojun , Yu Yanni , Wang Jie 
Published: May 2021

Abstract
Background
The Cathepsins family, including cathepsin B and cathepsin D, potentially affects the entire processes involved in atherosclerosis. Although coronary heart disease (CHD) has been widely studied as the basis of Sudden Cardiac Death (SCD), the relationship between CHD and CTSB/D remains unclear.

Methods
We screened for differentially expressed proteins (DEPs) associated with autophagy by limma package in R. For the genes corresponding to the DEPs after screening, we used various databases to carry out functional enrichment of related DEGs to explore their possible influence on a specific aspect of the disease. Functional enrichment analysis of DEGs was performed by DAVID, Metascape and GSEA. STRING and Cytoscape were obtained the hub genes, the analysis of interaction networks through the GENMANIA and Networkanalyst. Western Blot was used to validate the protein expression level of target genes. TF and miRNA prediction were performed using Networkanalyst and visualized using Cytoscape.

Results
The expression levels of members of the cathepsin family were up regulated in CHD tissues compared with the control. GO and KEGG revealed that cathepsin was markedly enriched in endopeptidase activities, immune responses, lysosome pathways, et al. The correlation analysis showed that in patients with CHD, the CTSB/CTSD expression were negatively correlated with ATG4D and BNIP3, but positively with BCL2L1, CAPNS1, and TP53. In the TF-mRNA-miRNA network, has-miR-24-3p and has-miR-128-3p had higher degrees, CTSB/CTSD could be targeted by them.

Conclusions
Our findings elucidated the expression and regulatory role of cathepsins in coronary heart disease induced SCD and might further explore the potential mechanisms of autophagy in CHD.
Primary squamous cell carcinoma of the pancreas with a large pseudocyst of the pancreas as the first manifestation: a rare case report and literature review
Authors: Qiu Xia , Meng Yajie , Lu Meiqin , Tian Chuan , Wang Min , Zhang Junwen 
Published: May 2021

Abstract
Background
Primary squamous cell carcinoma (SCC) of the pancreas with pseudocysts, especially diagnosed by endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA), is extremely rare.

Case presentation
A 64-year-old man was admitted to our department for abdominal distension. Two months ago, he experienced abdominal pain for 1 day and was diagnosed with acute pancreatitis in another hospital. After admission, laboratory tests showed the following: amylase 400 U/L, lipase 403 U/L, and carbohydrate antigen 19–9 (CA19-9) 347 U/mL. Abdominal computed tomography (CT) revealed pancreatitis with a pseudocyst with a diameter measuring 7 cm. During linear EUS, a large pseudocyst (5.4 × 5.2 cm) was observed in the pancreatic body. EUS-FNA was performed. We obtained specimens for histopathology and placed a plastic stent through the pancreas and stomach to drain the pseudocyst. Puncture fluid examination revealed the following: CA19-9 > 12,000 U/mL carcinoembryonic antigen (CEA) 7097.42 ng/ml, amylase 27,145.3 U/L, and lipase > 6000 U/L. Cytopathology revealed an abnormal cell mass, and cancer was suspected. Furthermore, with the result of immunohistochemistry on cell mass (CK ( +), P40 ( +), p63 ( +), CK7 (−) and Ki-67 (30%)), the patient was examined as squamous cell carcinoma (SCC). However, the patient refused surgery, radiotherapy and chemotherapy. After drainage, the cyst shrank, but the patient died 3 months after diagnosis due to liver metastasis and multiple organ failure.

Conclusion
For patients with primary pancreatic pseudocysts with elevated serum CEA and CA19-9 levels, we should not rule out pancreatic cancer, which may also be a manifestation of primary pancreatic SCC. EUS-FNA is helpful for obtaining histopathology and cytology and thus improving diagnostic accuracy.
A case of endobronchial actinomycosis as a challenging cause of lung atelectasis
Authors: Golfi Nicoletta , Mastriforti Roberta , Guidelli Luca , Scala Raffaele 
Published: May 2021

Abstract
Background
Primary endobronchial actinomycosis is exceptionally uncommon and can be misdiagnosed as unresolving pneumonia, endobronchial lipoma, bronchogenic carcinoma or foreign body. Predisposing factors are immunosuppressive conditions, chronic lung diseases, poor oral hygiene or foreign body aspiration.

Case presentation
We reported a case of 88-year old woman with a 4 days history of mild exertional dyspnea, productive cough with purulent sputum and fever up to 37.8 °C, who developed left sided endobronchial actinomycosis in absence of any pre-existent risk conditions; endobronchial de-obstruction and specific antibiotic treatment were performed with success, achieving a full resolution of the disease, with bronchoscopy playing a key role in the diagnosticand therapeutic pathways.

Conclusions
This case raises the necessity for increased awareness in the management of endobronchial lesions and in cases of suspected endobronchial actinomycosis; bronchoscopy plays a key role in the diagnostic and therapeutic process; prompt recognition of this entity can expedite proper treatment and recovery.
Deep learning-based segmentation of the lung in MR-images acquired by a stack-of-spirals trajectory at ultra-short echo-times
Authors: Weng Andreas M. , Heidenreich Julius F. , Metz Corona , Veldhoen Simon , Bley Thorsten A. , Wech Tobias 
Published: May 2021

Abstract
Background
Functional lung MRI techniques are usually associated with time-consuming post-processing, where manual lung segmentation represents the most cumbersome part. The aim of this study was to investigate whether deep learning-based segmentation of lung images which were scanned by a fast UTE sequence exploiting the stack-of-spirals trajectory can provide sufficiently good accuracy for the calculation of functional parameters.

Methods
In this study, lung images were acquired in 20 patients suffering from cystic fibrosis (CF) and 33 healthy volunteers, by a fast UTE sequence with a stack-of-spirals trajectory and a minimum echo-time of 0.05 ms. A convolutional neural network was then trained for semantic lung segmentation using 17,713 2D coronal slices, each paired with a label obtained from manual segmentation. Subsequently, the network was applied to 4920 independent 2D test images and results were compared to a manual segmentation using the Sørensen–Dice similarity coefficient (DSC) and the Hausdorff distance (HD). Obtained lung volumes and fractional ventilation values calculated from both segmentations were compared using Pearson’s correlation coefficient and Bland Altman analysis.
To investigate generalizability to patients outside the CF collective, in particular to those exhibiting larger consolidations inside the lung, the network was additionally applied to UTE images from four patients with pneumonia and one with lung cancer.

Results
The overall DSC for lung tissue was 0.967 ± 0.076 (mean ± standard deviation) and HD was 4.1 ± 4.4 mm. Lung volumes derived from manual and deep learning based segmentations as well as values for fractional ventilation exhibited a high overall correlation (Pearson’s correlation coefficent = 0.99 and 1.00). For the additional cohort with unseen pathologies / consolidations, mean DSC was 0.930 ± 0.083, HD = 12.9 ± 16.2 mm and the mean difference in lung volume was 0.032 ± 0.048 L.

Conclusions
Deep learning-based image segmentation in stack-of-spirals based lung MRI allows for accurate estimation of lung volumes and fractional ventilation values and promises to replace the time-consuming step of manual image segmentation in the future.
Combining weakly and strongly supervised learning improves strong supervision in Gleason pattern classification
Authors: Otálora Sebastian , Marini Niccolò , Müller Henning , Atzori Manfredo 
Published: May 2021

Abstract
Background
One challenge to train deep convolutional neural network (CNNs) models with whole slide images (WSIs) is providing the required large number of costly, manually annotated image regions. Strategies to alleviate the scarcity of annotated data include: using transfer learning, data augmentation and training the models with less expensive image-level annotations (weakly-supervised learning). However, it is not clear how to combine the use of transfer learning in a CNN model when different data sources are available for training or how to leverage from the combination of large amounts of weakly annotated images with a set of local region annotations. This paper aims to evaluate CNN training strategies based on transfer learning to leverage the combination of weak and strong annotations in heterogeneous data sources. The trade-off between classification performance and annotation effort is explored by evaluating a CNN that learns from strong labels (region annotations) and is later fine-tuned on a dataset with less expensive weak (image-level) labels.

Results
As expected, the model performance on strongly annotated data steadily increases as the percentage of strong annotations that are used increases, reaching a performance comparable to pathologists ($$\kappa = 0.691 \pm 0.02$$

κ
=
0.691
±
0.02

). Nevertheless, the performance sharply decreases when applied for the WSI classification scenario with $$\kappa = 0.307 \pm 0.133$$

κ
=
0.307
±
0.133

. Moreover, it only provides a lower performance regardless of the number of annotations used. The model performance increases when fine-tuning the model for the task of Gleason scoring with the weak WSI labels $$\kappa = 0.528 \pm 0.05$$

κ
=
0.528
±
0.05

.

Conclusion
Combining weak and strong supervision improves strong supervision in classification of Gleason patterns using tissue microarrays (TMA) and WSI regions. Our results contribute very good strategies for training CNN models combining few annotated data and heterogeneous data sources. The performance increases in the controlled TMA scenario with the number of annotations used to train the model. Nevertheless, the performance is hindered when the trained TMA model is applied directly to the more challenging WSI classification problem. This demonstrates that a good pre-trained model for prostate cancer TMA image classification may lead to the best downstream model if fine-tuned on the WSI target dataset. We have made available the source code repository for reproducing the experiments in the paper: https://github.com/ilmaro8/Digital_Pathology_Transfer_Learning
The clinical significance of remnant thyroid tissue in thyroidectomized differentiated thyroid cancer patients on 131I-SPECT/CT
Authors: Wang Feng , Nie Hui , Li Wei , Zhang Rusen , Li Wen 
Published: May 2021

Abstract
Background
To explore the 131I-SPECT/CT characteristics of remnant thyroid tissue (RTT) in differentiated thyroid cancer (DTC), further assess the risk factors and clinical significance.

Methods
52 DTC patients after total thyroidectomy had undergone neck 131I-SPECT/CT before 131I ablation. The diagnosis of RTT was based on SPECT/CT and follow-up at least 3 months. The anatomic locations and features of SPECT/CT of RTT were assessed by reviewers. The risk factors of RTT with CT positive were analyzed by the chi-square test.

Results
A total of 80 lesions of RTT were diagnosed in this study, most of them were mainly located in the regions adjacent to trachea cartilage (37/80) or lamina of thyroid cartilage (17/80). On SPECT/CT of RTT, low, moderate and high uptake were respectively noted in 10, 24 and 46 lesions, definite positive, suspected positive and negative CT findings were respectively noted in 10, 21 and 49. The RTT lesions with definite positive CT findings were mainly located adjacent to lamina of thyroid cartilage (5/10). Primary thyroid tumor (P = 0.029) and T stage (P = 0.000) were the effective risk factors of CT positive RTT.

Conclusions
RTT has certain characteristic distribution and appearances on SPECT/CT. Most of RTT with definite CT abnormalities located adjacent to lamina of thyroid cartilage, which suggest surgeons should strengthen the careful removal in this region, especially primary thyroid tumor involving bilateral and T4 stage. This study can provide a certain value for the improvement of thyroidectomy quality in DTC patients.
Risk factors related balance disorder for patients with dizziness/vertigo
Authors: Cao Zhentang , Zhu Cuiting , Zhou Yanan , Wang Yan , Chen Meimei , Ju Yi , Zhao Xingquan 
Published: May 2021

AbstractBackgroundWhen dizziness/vertigo patients presented with balance disorder, it will bring severe morbidity. There is currently lack of research to explore risk factor related balance disorder in dizziness patients, especially in those who walk independently.AimTo investigate risk factors related balance disorder in dizziness/vertigo patients who walk independently.MethodsMedical data of 1002 dizziness/vertigo patients registered in vertigo/balance disorder registration database were reviewed. The demographic data, medical history, and risk factors for atherosclerosis (AS) were collected. Enrolled dizziness/vertigo patients could walk independently, completed Romberg test, videonystagmography (VNG), and limits of stability (LOS). The subjective imbalance was patient complained of postural symptom when performing Romberg test. Multivariable logistic regression analyzed risk factors related balance disorder. The receiver operating characteristic (ROC) curve evaluated the utility of regression model.ResultsFive hundred fifty-three dizziness/vertigo patients who walk independently were included in the final analysis. According to LOS, patients were divided into 334 (60%) normal balance and 219 (40%) balance disorder. Compared with normal balance, patients with balance disorder were older (P = 0.045) and had more risk factors for AS (P<0.0001). The regression showed that risk factors for AS (OR 1.494, 95% CI 1.198–1.863), subjective imbalance (OR 4.835, 95% CI 3.047–7.673), and abnormality of optokinetic nystagmus (OR 8.308, 95% CI 1.576–43.789) were related to balance disorder. The sensitivity and specificity of model were 71 and 63% (P<0.0001). The area under the curve (AUC) was 0.721.ConclusionsRisk factors for AS, subjective imbalance, and abnormality of optokinetic nystagmus were predictors for balance disorder in patients with dizziness/vertigo who walk independently.
Fetal weight estimation by automated three-dimensional limb volume model in late third trimester compared to two-dimensional model: a cross-sectional prospective observational study
Authors: Wu Xining , Niu Zihan , Xu Zhonghui , Jiang Yuxin , Zhang Yixiu , Meng Hua , Ouyang Yunshu 
Published: May 2021

Abstract
Background
Accurate estimation of fetal weight is important for prenatal care and for detection of fetal growth abnormalities. Prediction of fetal weight entails the indirect measurement of fetal biometry by ultrasound that is then introduced into formulae to calculate the estimated fetal weight. The aim of our study was to evaluate the accuracy of fetal weight estimation of Chinese fetuses in the third trimester using an automated three-dimensional (3D) fractional limb volume model, and to compare this model with the traditional two-dimensional (2D) model.

Methods
Prospective 2D and 3D ultrasonography were performed among women with singleton pregnancies 7 days before delivery to obtain 2D data, including fetal biparietal diameter, abdominal circumference and femur length, as well as 3D data, including the fractional arm volume (AVol) and fractional thigh volume (TVol). The fetal weight was estimated using the 2D model and the 3D fractional limb volume model respectively. Percentage error was defined as (estimated fetal weight - actual birth weight) divided by actual birth weight and multiplied by 100. Systematic errors (accuracy) were evaluated as the mean percentage error (MPE). Random errors (precision) were calculated as ±1 SD of percentage error. The intraclass correlation coefficient (ICC) was used to analyze the inter-observer reliability of the 3D ultrasound measurements of fractional limb volume.

Results
Ultrasound examination was performed on 56 fetuses at 39.6 ± 1.4 weeks’ gestation. The average birth weight of the newborns was 3393 ± 530 g. The average fetal weight estimated by the 2D model was 3478 ± 467 g, and the MPE was 3.2 ± 8.9. The average fetal weights estimated by AVol and TVol of the 3D model were 3268 ± 467 g and 3250 ± 485 g, respectively, and the MPEs were − 3.3 ± 6.6 and − 3.9 ± 6.1, respectively. For the 3D TVol model, the proportion of fetuses with estimated error ≤ 5% was significantly higher than that of the 2D model (55.4% vs. 33.9%, p < 0.05). For fetuses with a birth weight < 3500 g, the accuracy of the AVol and TVol models were better than the 2D model (− 0.8 vs. 7.0 and − 2.8 vs. 7.0, both p < 0.05). Moreover, for these fetuses, the proportions of estimated error ≤ 5% of the AVol and TVol models were 58.1 and 64.5%, respectively, significantly higher than that of the 2D model (19.4%) (both p < 0.05). The inter-observer reliability of measuring fetal AVol and TVol were high, with the ICCs of 0.921 and 0.963, respectively.

Conclusion
In this cohort, the automated 3D fractional limb volume model improves the accuracy of weight estimation in most third-trimester fetuses. Prediction accuracy of the 3D model for neonatal BW, particularly < 3500 g was higher than that of the traditional 2D model.