bluuebunny/crossref_metadata_2025_split huggingface dataset:
Object segmentation in cluttered environment based on gaze tracing and gaze blinking
Authors: Ratsamee Photchara , Mae Yasushi , Kamiyama Kazuto , Horade Mitsuhiro , Kojima Masaru , Arai Tatsuo 
Published: December 2021

AbstractPeople with disabilities, such as patients with motor paralysis conditions, lack independence and cannot move most parts of their bodies except for their eyes. Supportive robot technology is highly beneficial in supporting these types of patients. We propose a gaze-informed location-based (or gaze-based) object segmentation, which is a core module of successful patient-robot interaction in an object-search task (i.e., a situation when a robot has to search for and deliver a target object to the patient). We have introduced the concepts of gaze tracing (GT) and gaze blinking (GB), which are integrated into our proposed object segmentation technique, to yield the benefit of an accurate visual segmentation of unknown objects in a complex scene. Gaze tracing information can be used as a clue as to where the target object is located in a scene. Then, gaze blinking can be used to confirm the position of the target object. The effectiveness of our proposed method has been demonstrated using a humanoid robot in experiments with different types of highly cluttered scenes. Based on the limited gaze guidance from the user, we achieved an 85% F-score of unknown object segmentation in an unknown environment.
Toward an Optimized Staging System for Pancreatic Ductal Adenocarcinoma: A Clinically Interpretable, Artificial Intelligence–Based Model
Authors: Bertsimas Dimitris , Margonis Georgios Antonios , Huang Yifei , Andreatos Nikolaos , Wiberg Holly , Ma Yu , Mcintyre Caitlin , Pulvirenti Alessandra , Wagner Doris , van Dam J. L. , Gavazzi Francesca , Buettner Stefan , Imai Katsunori , Stasinos Georgios , He Jin , Kamphues Carsten , Beyer Katharina , Seeliger Hendrik , Weiss Matthew J. , Kreis Martin , Cameron John L. , Wei Alice C. , Kornprat Peter , Baba Hideo , Koerkamp Bas Groot , Zerbi Alessandro , D'Angelica Michael , Wolfgang Christopher L. 
Published: December 2021

PURPOSE The American Joint Committee on Cancer (AJCC) eighth edition schema for pancreatic ductal adenocarcinoma treats T and N stage as independent factors and uses positive lymph nodes (PLNs) to define N stage, despite data favoring lymph node ratio (LNR). We used artificial intelligence–based techniques to compare PLN with LNR and investigate interactions between tumor size and nodal status. METHODS Patients who underwent pancreatic ductal adenocarcinoma resection between 2000 and 2017 at six institutions were identified. LNR and PLN were compared through shapley additive explanations (SHAP) analysis, with the best predictor used to define nodal status. We trained optimal classification trees (OCTs) to predict 1-year and 3-year risk of death, incorporating only tumor size and nodal status as variables. The OCTs were compared with the AJCC schema and similarly trained XGBoost models. Variable interactions were explored via SHAP. RESULTS Two thousand eight hundred seventy-four patients comprised the derivation and 1,231 the validation cohort. SHAP identified LNR as a superior predictor. The OCTs outperformed the AJCC schema in the derivation and validation cohorts (1-year area under the curve: 0.681 v 0.603; 0.638 v 0.586, 3-year area under the curve: 0.682 v 0.639; 0.675 v 0.647, respectively) and performed comparably with the XGBoost models. We identified interactions between LNR and tumor size, suggesting that a negative prognostic factor partially overrides the effect of a concurrent favorable factor. CONCLUSION Our findings highlight the superiority of LNR and the importance of interactions between tumor size and nodal status. These results and the potential of the OCT methodology to combine them into a powerful, visually interpretable model can help inform future staging systems.
Accuracy of Smartphone Images of the Cervix After Acetic Acid Application for Diagnosing Cervical Intraepithelial Neoplasia Grade 2 or Greater in Women With Positive Cervical Screening: A Systematic Review and Meta-Analysis
Authors: Allanson Emma R. , Phoolcharoen Natacha , Salcedo Mila P. , Fellman Bryan , Schmeler Kathleen M. 
Published: December 2021

PURPOSE Smartphones are used in cervical screening for visual inspection after acetic acid or Lugol's iodine (VIA/VILI) application to capture and share images to improve the sensitivity and interobserver variability of VIA/VILI. We undertook a systematic review and meta-analysis assessing the diagnostic accuracy of smartphone images of the cervix at the time of VIA/VILI (termed S-VIA) in the detection of precancerous lesions in women undergoing cervical screening. METHODS This systematic review was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Studies from January 1, 2010, to June 30, 2020, were assessed. MEDLINE/PubMed, Embase, CINAHL, Cochrane, and LILACS were searched. Cohort and cross-sectional studies were considered. S-VIA was compared with the reference standard of histopathology. We excluded studies where additional technology was added to the smartphone including artificial intelligence, enhanced visual assessment, and other algorithms to automatically diagnose precancerous lesions. The primary outcome was the accuracy of S-VIA for the diagnosis of cervical intraepithelial neoplasia grade 2 or greater (CIN 2+). Data were extracted, and we plotted the sensitivity, specificity, negative predictive value, and positive predictive value of S-VIA using forest plots. This study was prospectively registered with The International Prospective Register of Systematic Reviews:CRD42020204024. RESULTS Six thousand three studies were screened, 71 full texts assessed, and eight studies met criteria for inclusion, with six included in the final meta-analysis. The sensitivity of S-VIA for the diagnosis of CIN 2+ was 74.56% (95% CI, 70.16 to 78.95; I2 61.30%), specificity was 61.75% (95% CI, 56.35 to 67.15; I2 95.00%), negative predictive value was 93.71% (95% CI, 92.81 to 94.61; I2 0%), and positive predictive value was 26.97% (95% CI, 24.13 to 29.81; I2 61.3%). CONCLUSION Our results suggest that S-VIA has accuracy in the detection of CIN 2+ and may provide additional support to health care providers delivering care in low-resource settings.
Management of Stage III Non–Small-Cell Lung Cancer: ASCO Guideline
Authors: Daly Megan E. , Singh Navneet , Ismaila Nofisat , Antonoff Mara B. , Arenberg Douglas A. , Bradley Jeffrey , David Elizabeth , Detterbeck Frank , Früh Martin , Gubens Matthew A. , Moore Amy C. , Padda Sukhmani K. , Patel Jyoti D. , Phillips Tanyanika , Qin Angel , Robinson Clifford , Simone Charles B. 
Published: December 2021

PURPOSE To provide evidence-based recommendations to practicing clinicians on management of patients with stage III non–small-cell lung cancer (NSCLC). METHODS An Expert Panel of medical oncology, thoracic surgery, radiation oncology, pulmonary oncology, community oncology, research methodology, and advocacy experts was convened to conduct a literature search, which included systematic reviews, meta-analyses, and randomized controlled trials published from 1990 through 2021. Outcomes of interest included survival, disease-free or recurrence-free survival, and quality of life. Expert Panel members used available evidence and informal consensus to develop evidence-based guideline recommendations. RESULTS The literature search identified 127 relevant studies to inform the evidence base for this guideline. RECOMMENDATIONS Evidence-based recommendations were developed to address evaluation and staging workup of patients with suspected stage III NSCLC, surgical management, neoadjuvant and adjuvant approaches, and management of patients with unresectable stage III NSCLC. Additional information is available at www.asco.org/thoracic-cancer-guidelines .
Utility of Continuous Glucose Monitoring vs Meal Study in Detecting Hypoglycemia After Gastric Bypass
Authors: Honka Henri , Chuang Janet , D’Alessio David , Salehi Marzieh 
Published: December 2021

AbstractContextGastric bypass (GB) increases postprandial glucose excursion, which in turn can predispose to the late complication of hypoglycemia. Diagnosis remains challenging and requires documentation of symptoms associated with low glucose and relief of symptom when glucose is normalized (Whipple triad).ObjectiveTo compare the yield of mixed meal test (MMT) and continuous glucose monitoring system (CGMS) in detecting hypoglycemia after GB.SettingThe study was conducted at General Clinical Research Unit, Cincinnati Children’s Hospital (Cincinnati, OH, USA).MethodsGlucose profiles were evaluated in 15 patients with documented recurrent clinical hypoglycemia after GB, 8 matched asymptomatic GB subjects, and 9 healthy weight-matched nonoperated controls using MMT in a control setting and CGMS under free-living conditions.ResultsPatients with prior GB had larger glucose variability during both MMT and CGMS when compared with nonsurgical controls regardless of their hypoglycemic status. Sensitivity (71 vs 47%) and specificity (100 vs 88%) of MMT in detecting hypoglycemia was superior to CGMS.ConclusionsOur findings indicate that a fixed carbohydrate ingestion during MMT is a more reliable test to diagnose GB-related hypoglycemia compared with CGMS during free-living state.
Temozolomide Nonresponsiveness in Aggressive Prolactinomas and Carcinomas: Management and Outcomes
Authors: Das Liza , Rai Ashutosh , Salunke Pravin , Ahuja Chirag Kamal , Sood Ashwani , Radotra Bishan Dass , Sood Ridhi , Korbonits Márta , Dutta Pinaki 
Published: December 2021

Abstract

Context
Temozolomide (TMZ) is endorsed as the treatment of choice in aggressive or malignant pituitary adenomas.

Objective
Herein we describe a case of an aggressive prolactinoma that was resistant to TMZ. We performed a literature review of similar nonresponsive, aggressive prolactinomas.

Methods
A 40-year-old woman presented with a giant prolactinoma that required cabergoline, transsphenoidal surgery, and radiotherapy to achieve near-normal prolactin and apparently no residual tumor. A year later, she presented with multiple cranial nerve involvement due to a recurrent tumor extending to the infratemporal fossa. She underwent transfrontal surgery, second radiotherapy, and was started on TMZ. Despite 8 cycles of temozolomide (200 mg/m2, 5/28-day cycle), she had progressive disease and ultimately succumbed to the disease. PubMed/MEDLINE, Google Scholar, and prior review articles were searched for manuscripts about patients with aggressive prolactinomas who had been treated with TMZ. Data on demography, duration of therapy, and management outcomes were analyzed in those with progressive disease.

Results
We identified 94 cases of patients with aggressive/malignant prolactinomas in the literature who had received TMZ. Progressive disease despite TMZ was present in 36 cases (38%). There was a male preponderance (65%) among these and 40% had aggressive prolactinomas, whereas the rest had carcinomas. Patients received a median of 8 cycles (interquartile range, 3.5-11.5) of TMZ. O6-methylguanine-DNA-methyltransferase (MGMT) immunostaining was negative in 35%. Overall mortality at the time of publication was 40%, at a duration varying from 2 to 20 years from diagnosis.

Conclusion
TMZ resistance in aggressive/malignant prolactinomas is challenging. Progressive disease on optimal TMZ treatment entails the use of newer agents.
Increased Gray Matter Density in the Right Mesencephalic Tegmentum Is Associated With Better Engel Classes I and II After Radiosurgery for Hypothalamic Hamartomas
Authors: Tuleasca Constantin , Hamdi Hussein , Daquin Géraldine , Villeneuve Nathalie , Chauvel Patrick , Lepine Anne , Bartolomei Fabrice , Régis Jean 
Published: December 2021

BACKGROUND:Hypothalamic hamartomas (HHs) are disabling congenital lesions, responsible for gelastic seizures frequently associated with catastrophic epilepsies, epileptogenic encephalopathy, and cognitive and psychiatric severe comorbidities. Stereotactic radiosurgery (SRS) is a well-established minimally invasive therapeutic approach.OBJECTIVE:To assess whether pretherapeutic gray matter density (GMD) correlates with seizure outcome.METHODS:We used voxel-based morphometry at whole-brain level, as depicted on pretherapeutic standard structural magnetic resonance neuroimaging. We examined 24 patients (10 male patients, 14 female patients; mean age, 12.7 yr; median, 9; range, 5.9-50) treated in Marseille University Hospital, France, between May 2001 and August 2018.RESULTS:Most relevant anatomic area predicting postoperative Engel classes I and II vs III and IV after SRS for HHs was mesencephalic tegmentum. Higher pretherapeutic GMD in this area was associated with better outcomes for seizure cessation. The only other statistically significant clusters were right cerebellar lobule VIIIb and VIIIa. Lower pretherapeutic GMD in both clusters correlated with better Engel class outcomes. GMD decreased with age in the left mediodorsal thalamus.CONCLUSION:Seizure cessation after SRS for HHs was associated with higher GMD in mesencephalic tegmental area, acknowledged to be involved in the neural control of explosive vocal behavior in animals. This area is connected by the mamillotegmental bundle to the lateral tuberal nucleus area of the hypothalamus, where HHs are known to rise. In the future, the detection of more gray matter in this “laugh” tegmental area based on pretherapeutic routine structural neuroimaging might help in patient selection for minimally invasive radiosurgery for HH.
Spine Surgery Under Spinal vs General Anesthesia: Prospective Analysis of Quality of Life, Fatigue, and Cognition
Authors: De Biase Gaetano , Gruenbaum Shaun E. , Quiñones-Hinojosa Alfredo , Abode-Iyamah Kingsley O. 
Published: December 2021

BACKGROUND:
There has recently been increasing interest in the use of spinal anesthesia (SA) for spine surgery. The literature that compared spine surgery under SA vs general anesthesia (GA) focused on safety, perioperative outcomes, and costs.

OBJECTIVE:
To test if SA is associated with less postoperative fatigue, cognitive dysfunction, and better quality of life in patients undergoing lumbar spine surgery compared with GA.

METHODS:
We conducted a prospective nonrandomized study in patients undergoing elective lumbar spine surgery under SA or GA by a single surgeon. Fatigue was assessed with the fatigue visual analog scale scale (0-10) and Chalder Fatigue Scale, quality of life with Medical Outcomes Study 12-item Short Form (SF-12), and differences in cognition with Mini-Mental State Examination. Patients were baselined before surgery and assessed again 1 mo after surgery.

RESULTS:
Fifty patients completed the study, 25 underwent surgery under SA and 25 under GA. The groups were homogeneous for baseline clinical characteristics, with no differences in preoperative fatigue, quality of life, and cognition. At 1 mo after surgery, SA compared with GA had better fatigue scores: fatigue visual analog scale (2.9 ± 1.5 vs 5.9 ± 2.3 [P < .0001]) and Chalder Fatigue Scale (11.2 ± 3.1 vs 16.9 ± 3.9 [P < .0001]). One month postoperatively, we observed a significant difference in the SF-12 physical component, with SA having 38.8 ± 8.9 vs 29.4 ± 10.3 (P = .002). We did not observe significant postoperative differences in the SF-12 mental component or Mini-Mental State Examination.

CONCLUSION:
Our study demonstrates that SA offers unique patient-centered advantages to GA for elective spine surgery. One month after surgery, patients who received SA had less postoperative fatigue and better quality of life.
Preoperative Duration of Symptoms Does Not Affect Outcomes of Anterior Lumbar Interbody Fusion
Authors: Cha Elliot D. K. , Lynch Conor P. , Patel Madhav R. , Jacob Kevin C. , Geoghegan Cara E. , Jadczak Caroline N. , Mohan Shruthi , Singh Kern 
Published: December 2021

BACKGROUND:
Previous studies have examined the impact of preoperative duration of symptoms (DOS) on lumbar spinal surgery outcomes although this has not been explored for anterior lumbar interbody fusion (ALIF).

OBJECTIVE:
To assess the impact of preoperative DOS on patient-reported outcome measures (PROMs) of ALIF with posterior instrumentation.

METHODS:
A database was retrospectively reviewed for ALIFs with posterior instrumentation. PROMs recorded at preoperative, 6-wk, 12-wk, 6-mo, and 1-yr postoperative timepoints included Visual Analog Scale back and leg, Oswestry Disability Index, 12-Item Short-Form Physical Component Score (SF-12 PCS), and PROM Information System physical function. Achievement of minimum clinically important difference (MCID) was determined by comparing differences in postoperative PROMs from baseline to established values. Patients were grouped based on preoperative DOS into <1-yr and ≥1-yr groups. Differences in PROMs were compared using a t-test, whereas MCID achievement used a χ2 test.

RESULTS:
Fifty-three patients were included, with 20 in the <1-yr group and 33 in the ≥1-yr group. The most common diagnosis was isthmic spondylolisthesis. No significant preoperative differences were observed in any PROM. DOS groups demonstrated significantly different scores for SF-12 PCS at 6 wk (P = .049). No significant differences in MCID achievement were observed between groups for any PROM.

CONCLUSION:
ALIF patients demonstrated similar levels of pain, disability, and physical function regardless of preoperative DOS, except for back pain and physical function at intermittent timepoints. MCID achievement did not differ based on DOS for all outcome measures.
Does Pre-existing Anticoagulation or Antiplatelet Therapy Increase the Risk of Traumatic Subarachnoid Hemorrhage Progression?
Authors: Harland Tessa A. , Prabhala Tarun , Nardolillo AnneMarie , Dalfino John C. , Adamo Matthew A. , Paul Alexandra R. , Boulos Alan S. , Entezami Pouya 
Published: December 2021

BACKGROUND:
Isolated traumatic subarachnoid hemorrhage (tSAH) is a common finding in mild traumatic brain injury that often results in transfer to a tertiary center. Patients prescribed blood-thinning medications (BTs) are believed to be at higher risk of clinical or radiographic worsening.

OBJECTIVE:
To compare the rates of radiographic progression and need for neurosurgical intervention in patients with tSAH who are on anticoagulation (AC) and antiplatelet (AP) therapies with those who are not.

METHODS:
Analysis using a retrospective cohort design identified patients older than 18 years with isolated tSAH and a Glasgow Coma Scale of 15 on admission. Clinical information including use of BTs, administration of reversal agents, radiographic progression, and need for neurosurgical intervention was collected. Patients on BTs were divided into AP, AC, and AP/AC groups based on drug type.

RESULTS:
Three hundred eighty-four patients were included with 203 in the non-BT group and 181 in the BT group. Overall, 2.1% had worsening scans, and none required operative intervention. There was no difference in radiographic worsening between the non-BT and BT groups (2.4% vs 1.6%; P = 1.00). Crosswise comparison revealed no difference between the non-BT group and each BT subtype (AP, AP/AC, or AC). The non-BT group was more likely to have radiographic improvement than the BT group (45.8% vs 30.9%; P = .002).

CONCLUSION:
Neurologically intact patients on BTs with isolated tSAH are not at increased risk of radiographic progression or neurosurgical intervention. The presence of BTs should not influence management decisions for increased surveillance.
Volumetric 3-Dimensional Analysis of the Supraorbital vs Pterional Approach to Paramedian Vascular Structures: Comprehensive Assessment of Surgical Maneuverability
Authors: Houlihan Lena Mary , Abramov Irakliy , Loymak Thanapong , Jubran Jubran H. , Staudinger Knoll Ann J. , Farhadi Dara S. , Naughton David , Howshar Jacob T. , O'Sullivan Michael G. J. , Lawton Michael T. , Preul Mark C. 
Published: December 2021

BACKGROUND:
Both the pterional and supraorbital approaches have been proposed as optimal access corridors to deep and paramedian anatomy.

OBJECTIVE:
To assess key intracranial structures accessed through the surgical approaches using the angle of attack (AOA) and the volume of surgical freedom (VSF) methodologies.

METHODS:
Ten pterional and 10 supraorbital craniotomies were completed. Data points were measured using a neuronavigation system. A comparative analysis of the craniocaudal AOA, mediolateral AOA, and VSF of the ipsilateral paraclinoid internal carotid artery (ICA), terminal ICA, and anterior communicating artery (ACoA) complex was completed.

RESULTS:
For the paraclinoid ICA, the pterional approach produced larger craniocaudal AOA, mediolateral AOA, and VSF than the supraorbital approach (28.06° vs 10.52°, 33.76° vs 23.95°, and 68.73 vs 22.59 mm3 normalized unit [NU], respectively; P < .001). The terminal ICA showed similar superiority of the pterional approach in all quantitative parameters (27.43° vs 11.65°, 30.62° vs 25.31°, and 57.41 vs 17.36 mm3 NU; P < .05). For the ACoA, there were statistically significant differences between the results obtained using the pterional and supraorbital approaches (18.45° vs 10.11°, 29.68° vs 21.01°, and 26.81 vs 16.53 mm3 NU; P < .005).

CONCLUSION:
The pterional craniotomy was significantly superior in all instrument maneuverability parameters for approaching the ipsilateral paraclinoid ICA, terminal ICA, and ACoA. This global evaluation of 2-dimensional and 3-dimensional surgical freedom and instrument maneuverability by amalgamating the craniocaudal AOA, mediolateral AOA, and VSF produces a comprehensive assessment while generating spatially and anatomically accurate corridor models that provide improved visual depiction for preoperative planning and surgical decision-making.
Dynamic shapes of the zygote and two-cell mouse and human
Authors: Graham Chris F. , Windsor Shane , Ajduk Anna , Trinh Thanh , Vincent Anna , Jones Celine , Coward Kevin , Kalsi Dilraj , Zernicka-Goetz Magdalena , Swann Karl , Thomas Adrian L. R. 
Published: December 2021

ABSTRACT
Mouse zygote morphokinetics were measured during interphase, the mitotic period, cytokinesis, and two-cell stage. Sequences of rounder–distorted–rounder shapes were revealed, as were changing patterns of cross section area. A calcium chelator and an actin-disrupting agent inhibited the area changes that occurred between pronuclear envelope breakdown and cytokinesis. During cell division, two vortices developed in each nascent cell and they rotated in opposite directions at each end of the cell, a pattern that sometimes persisted for up to 10 h. Exchange with the environment may have been promoted by these shape and area cycles and persisting circulation in the cytoplasm may have a similar function between a cell's interior and periphery. Some of these movements were sporadically also seen in human zygotes with abnormal numbers of pronuclei and the two-cell stages that developed from these compromised human zygotes.
Hollow Core-satellite ZIF-8/PDA/AgNPs Nanocomplexes: Fabrication, Structure and Antibacterial Activity
Authors: Xu Xiaoyi , Liu Qiqi , Hui Shuhan , Jiang Shan 
Published: December 2021

Abstract
A hollow core-satellite ZIF-8/PDA/AgNPs was established and studied as an antibacterial agent. Polydopamine (PDA) was coated on ZIF-8 surface to form a hollow structure because ZIF-8 core was etched by the chelation of PDA and Zn2+. Then AgNPs were homogeneously decorated on the surface of ZIF-8/PDA by in situ reduction of Ag+ to avoid their aggregation. ZIF-8/PDA/AgNPs have good antibacterial activity, and they can totally inhibit bacterial growth at the concentration of 16 µg mL−1.