bluuebunny/crossref_metadata_2025_split huggingface dataset:
Regional Inequalities in the Allocation of Specialist Doctors Within the Portuguese NHS
Authors: de Melo William , Ferreira Ana Sofia 
Published: February 2025

ABSTRACTThis paper addresses regional disparities in the allocation of medical professionals within the Portuguese National Health Service (NHS) and its policy implications, drawing recommendations to address these inequalities. In a country with a universal and comprehensive healthcare system, ensuring equitable geographical distribution of healthcare professionals is crucial for the effectiveness and equity of the health system. The analysis uses data from the NHS payroll system (RHV), covering the period from 2017 to 2023, and focuses on active medical workers, including those on duty and retired but still in service, distributed among the five Regional Health Administrations that then existed. The analysis is based on Full‐Time Equivalents to provide a more realistic picture of the healthcare workforce. Population data comes from the official source. The Dissimilarity Index is used to measure regional disparities, focusing on the medical workforce (specialist doctors). The study aims to identify disparities in the distribution of these healthcare professionals throughout the five regions within the NHS and inform evidence‐based policies to address such inequalities in resource allocation of the healthcare workforce. The findings reveal that while the overall density of NHS healthcare workers per 1000 inhabitants grew, and global disparities in the allocation of NHS workers slightly diminished, some regional disparities have worsened, as it was the case of the distribution of specialist doctors among the territory. The Dissimilarity Index indicates increasing inequality among the allocation of the medical workforce in the national territory, with statistically significant growth in disparity over time. The study underscores the urgent need for targeted policies to address these growing inequalities in allocating specialist doctors within the NHS.
Prognostic impact of primary surgery in human papillomavirus‐independent, advanced or metastatic endocervical adenocarcinoma: A bi‐institutional retrospective study
Authors: Seo Jun‐Hyeong , Yang Tyan‐Shin , Kim Hyun‐Soo , Cho Won Kyung , Lai Yen‐Ling , Chen Jung , Chen Yu‐Li , Lee Yoo‐Young 
Published: February 2025

AbstractObjectiveTo evaluate the prognostic impact of primary surgery on patients with HPV‐independent, advanced or metastatic endocervical adenocarcinoma (EAC) who typically exhibit poor survival outcomes and resistance to conventional therapies such as chemoradiotherapy.MethodsA bi‐institutional retrospective study was conducted at Samsung Medical Center and Taiwan National University Hospital. Between 2001 and 2023, 92 patients with HPV‐independent advanced or metastatic EAC were included. Patients were divided into two groups: 54 (58.7%) underwent primary surgery and 38 (41.3%) received non‐surgical treatments, including definitive radiotherapy or palliative chemotherapy. Kaplan–Meier analysis was used to compare progression‐free survival (PFS) and overall survival (OS) between groups. Multivariate analysis was performed to identify independent prognostic factors.ResultsThe surgery group demonstrated significantly improved outcomes, with a median PFS of 19.2 months, compared with 10.0 months in the non‐surgery group (P < 0.001). Median OS was not reached in the surgery group, whereas it was 24.1 months in the non‐surgery group (P = 0.002). Multivariate analysis showed that non‐surgical treatment was an independent predictor of poor PFS (hazard ratio [HR] 2.25; 95% confidence interval [CI] 1.18–4.29; P = 0.013) and OS (HR 3.25; 95% CI 1.37–7.73; P = 0.008). Additionally, the recurrence rate was significantly lower in the surgery group (55.6%) than in the non‐surgery group (84.2%; P = 0.006).ConclusionPrimary surgery significantly improves survival outcomes in patients with HPV‐independent advanced or metastatic EAC. These findings suggest that surgery should be considered as part of a multimodal treatment strategy for this aggressive subtype, highlighting the need for individualized therapeutic approaches beyond standard chemoradiotherapy protocols.
Gas vector and surface tension reducer to enhance biofuel production through syngas fermentation with Clostridium carboxidivorans
Authors: Correa Mariana Mattos Pereira do Nascimento , Gonçalves Robson Corrêa , Benevenuti Carolina Santos Jordani , Ferreira Tatiana Felix , Amaral Priscilla Filomena Fonseca 
Published: February 2025

AbstractBackgroundSyngas fermentation using acetogenic bacteria as biocatalysts has emerged as an alternative for a carbon‐neutral economy. One of the major challenges in syngas fermentation is gas–liquid mass transfer. In this work, the surfactant Tween®80 (0.15%) and perfluorodecalin (PFC, 20% v/v) – a gas vector—were added to the fermentation medium with Clostridium carboxidivorans to increase acetic acid, ethanol, and butanol production through gas–liquid mass transfer improvement. The production of biofuels and biochemicals was evaluated in heterotrophic (non‐syngas) and mixotrophic (with syngas) fermentations.ResultsAlthough higher biomass was achieved in heterotrophy, mixotrophic fermentation resulted in 27% higher ethanol production, and in presence of butanol, which was not detected in the first condition. Acetic acid concentration was not affected. Gaseous fermentation in serum flasks with Tween®80 and PFC increased the production of butanol and acetic acid by 1.3‐fold compared with syngas fermentation without these compounds. Ethanol production was similar in both conditions. In the bioreactor, the productivity of the total metabolites was 3.3‐fold higher with Tween®80 and PFC.ConclusionsThe combination of Tween® 80 and PFC enhances metabolite production even without syngas and improves gas–liquid mass transfer during syngas fermentation, offering a promising solution to overcome mass transfer challenges in this process. © 2025 Society of Chemical Industry (SCI).
Performance of electronic medical record tool in predicting 6‐month mortality in hospitalized patients with cancer
Authors: Kulkarni Nita S. , Landler Matthew P. , Cohen Elaine R. , Wayne Diane B. , Szmuilowicz Eytan 
Published: February 2025

AbstractBackgroundA systematic tool to identify hospitalized patients with high mortality risk may be beneficial for targeting palliative care to those in greatest need.ObjectiveEvaluate the performance of the End‐of‐life Index (EOLI; Epic Systems Corporation) in identifying patients at the highest 6‐month mortality risk among hospitalized patients with cancer.MethodsWe conducted a retrospective study of adults with cancer admitted to oncology services in a 959‐bed hospital between July 1 and December 31, 2023. We evaluated EOLI score performance in determining mortality risk using the area under the receiver operating characteristic curve (AUC). The primary outcome was 6‐month mortality for patients with an EOLI score above and below the optimal threshold value. Secondary outcomes included in‐hospital mortality, 30‐day mortality, length of stay, intensive care unit (ICU) utilization, palliative care consultation, do‐not‐resuscitate status on discharge, and discharge disposition.ResultsThe EOLI score had moderate accuracy in identifying patients at higher risk of 6‐month mortality (AUC: 0.71) with an optimal threshold value of 40. For patients with EOLI > 40 and < 40, the 6‐month mortality was 45.9% and 16.3%, respectively (p < .001). Patients with EOLI > 40 had higher ICU utilization (12.4% vs. 6.5%, p = .002) and were more likely to be discharged to a location other than home (13.5% vs. 5.3%; p < .001).ConclusionsFor hospitalized patients with cancer, the EOLI shows moderate accuracy in identifying patients with a high risk of 6‐month mortality. As a screening tool, the EOLI can be used to identify patients who may benefit from timely palliative care.
Effect of Application of Bone Marrow Mesenchymal Stem Cells After Subglottic Injury: Animal Study
Authors: Ibrahim Ezzeldin , Gaafar Alaa Hazem , Mehanna Radwa Ali , El Achy Samar , Taha Ashraf Hamza 
Published: February 2025

ABSTRACTObjectiveAcquired laryngotracheal stenosis (LTS) is notorious for recurrence and the need for repeated procedures to achieve a satisfactory outcome. This limitation is, at least partly, due to the suboptimal healing process of the airway following trauma. Consequently, innovative interventions are required to improve wound healing, which would reflect on improving the outcome of the management of LTS. The objective of this study is to examine the effect of the application of BM‐MSCs in preventing subglottic acute stenosis following trauma.MethodsTwenty‐four Sprague–Dawley rats were divided into three equal groups (n = 8): two intervention groups and one control group. Subglottic trauma was performed in the three groups. In the intervention groups, bone marrow‐derived mesenchymal stem cells (BM‐MSCs) were applied either systemically (TS group) or via local injection (TL group). Subglottic specimens from the three groups were compared by histopathological appearance, lamina propria (LP) thickness, and luminal anteroposterior (AP) diameter.ResultsAn intense inflammatory reaction was observed in the control specimens, while a mild inflammatory reaction was detected in the two intervention groups. The LP thickness and the AP diameter were significantly different between the control group and the two intervention groups.ConclusionsIn the present animal model, stem cell application, either systemic or local application, can mitigate subglottic inflammation and stenosis after trauma.
Deep Learning for Chromatic Optimization in Dual‐Color Mini‐LEDs for Aircraft Displays
Authors: Gao Fengyun , Zhang Nan , Bai Zelong , Lu Yijun , Chen Zhong , Guo Weijie 
Published: February 2025

AbstractGaN‐based miniaturized light‐emitting diodes (mini‐LEDs) have emerged as highly promising light sources for high‐performance aircraft cockpit displays. Among these diodes, vertically stacked blue‒green dual‐color mini‐LEDs are fabricated and show excellent color‐tunable properties. When packaged with K2SiF6:Mn4+, an impressive color gamut area ratio of 113.63% NTSC is demonstrated. However, vertical optical crosstalk originates from the photoluminescence (PL) effect of the green epitaxial layer when the blue mini‐LED is powered on, making precise chromatic characteristics difficult to obtain. To address this problem, a deep neural network (DNN) is proposed, which combines forward modeling and inverse design in a tandem architecture. This DNN supports a current modulation scheme that enables precise control of chromaticity coordinates, achieving a Δu′v′ of 0.003. These advancements in materials and device strategies pave the way for developing low color difference, high‐resolution display systems for aircraft cockpits.
Cellulose Based Aerogels Derived From Rice Agro Wastes with Enhanced Antifungal Activity for Topical Management of Vulvovaginal Candidiasis
Authors: Ranjan Rahul , Bhatt Smruti B , Rai Rohit , Kumari Shabnam , Tilak Ragini , Dhar Prodyut 
Published: February 2025

AbstractWith the increased cultivation of rice crop, the problem of accumulating waste biomass after harvesting is becoming a huge challenge, disposal of which through land filling and burning leads to global warming. In this work, abundantly available rice straw waste is strategically functionalized through delignification‐cum‐phosphorylation route to produce smart‐responsive and ultra‐light weight aerogels for topical management of vulvovaginal candidiasis. The prepared aerogels show low density (0.028 g cm−3), high water absorption capacity ∼2381.71%, and charge content (1850 mmol kg−1) of phosphate groups covalently linked to cellulose backbone as evident from XPS and FTIR spectroscopy studies. The aerogels with porous morphology also show cyclic mechanical compressibility and thermal stability due to presence of phosphate groups as evident from high char content (28.5% at 700 °C). The negatively charged aerogels show prolonged storage and release profile of clotrimazole with synergistically strong antifungal response against several Candida species with lowered MIC of ∼0.02µg ml−1. Interestingly, post‐phosphorylation the functionalized aerogels show improved biodegradation of ∼83% within 92 days under soil conditions. This study proposes a low‐cost, facile, eco‐friendly, sustainable approach to convert waste rice biomass into functionalized high‐performance aerogels for potential treatment of vaginal infections improving female reproductive health.
Intraguild Predation and Competitions of Two Stage‐Structured Species in a Seasonal Patchy Model
Authors: Wang Feng‐Bin , Cheng Chang‐Yuan 
Published: February 2025

ABSTRACTSome creatures interact with not only the same species but also different species by competing resources and even develop intraguild predation (IGP) to improve their survival. Individuals also react for survival according to spatial heterogeneity and seasonal variation of the environment. However, all these creatures' behaviors may change in their different life stages because of varied physiological structures. Considering these concerns, we propose a two‐patch model with environmental seasonality and individuals' two life stages and incorporate intraspecific and interspecific competitions and IGP between two species. We begin by analyzing single‐species models to establish threshold dynamics. This analysis shows that a species will eventually go extinct or exhibit oscillatory population dynamics across both patches, attracting all nonnegative solutions. Next, we explore two‐species models, without and with IGP, and formulate the invasion indices for both species in each scenario. In both cases, we demonstrate that the population tends to die out if the invasion indices are less than one while remaining persistent if the invasion indices exceed one. Finally, we conduct numerical examples to verify the criterion for threshold dynamics and observe some interesting results, including IGP can reverse the competition outcome, IGP can induce ecological diversity, seasonality can facilitate species survival, and prey species can adapt their maturation time against IGP.
Whole liver phase‐based R2 mapping in liver iron overload within a breath‐hold
Authors: Tamada Daiki , Navaratna Ruvini , Weaver Jayse Merle , Hernando Diego , Reeder Scott B. 
Published: February 2025

AbstractPurposeDiagnosis and treatment monitoring of iron overload increasingly relies on non‐invasive MRI‐based measurement of liver iron concentration (LIC). Liver R2 mapping is known to correlate well with LIC. However, traditional spin‐echo based R2 mapping methods have drawbacks such as long acquisition times and limited volumetric coverage. In this work, we present an optimized phase‐based R2 mapping method to quantify whole‐liver R2 in iron overload patients within a single breathhold.Theory and MethodsA recently developed phase‐based R2 mapping method is optimized in this study to improve estimation of high R2 values using reduced TR, spatial averaging, and R1 correction. Using Bloch equation simulations, the proposed optimization method was evaluated. Furthermore, the impact of fat on R2 bias was investigated through simulations. The feasibility of the optimized phase‐based R2 method was assessed in healthy volunteers and patients with iron overload and compared to reference STEAM‐MRS R2 measurements.ResultsSimulations demonstrate that a shorter TR extends the dynamic range of R2 estimation to higher values and that averaging of signal phase before R2 estimation is necessary when R2 is high. Phantom experiments also demonstrate reduced phase‐based R2 bias using R1 correction. Good agreement (1.5 T: r2 = 0.76, 3.0 T: r2 = 0.70) between the modified phase‐based R2 method and reference STEAM R2 was found in healthy volunteers and iron overload patients over a wide range of LIC values.ConclusionThis study demonstrates the feasibility of the proposed phase‐based R2 method to accurately measure whole‐liver R2 mapping in severe iron overloaded patients during a single breathhold.
An evaluation of the coax monopole antenna as a transmit array element for head imaging at 14 T
Authors: Budé Lyanne M. I. , Vat Koen , Voogt Ingmar J. , Zivkovic Irena , Raaijmakers Alexander J. E. 
Published: February 2025

AbstractPurposeIn comparison to dipole antennas, the coax monopole antenna (CMA) diminishes the possibility of cable‐coil coupling. This greatly facilitates cable routing in spatially restricted environments, such as head coil arrays. With the outlook of a 14T MRI system being installed at the Donders Center in Nijmegen, the Netherlands, this study aims to optimize the CMA for an eight‐channel head array at 14 T and compare its performance with an array of fractionated dipole antennas.MethodsBoth antenna designs were optimized for head imaging at 14 T using single‐channel finite‐difference time‐domain (FDTD) simulations at 596 MHz. Eight‐channel simulations were then used on a human model to evaluate and specific absorption rate (SAR) distributions. For both antenna types, prototype arrays were built by placing eight elements on a 26‐cm‐diameter cylindrical holder. These prototype arrays were used for S11 and S12 evaluation.ResultsThe optimal dimensions of the CMA were a length of 20 cm and a gap position of 4 cm. The fractionated dipole was optimal for a length of 25 cm. Evaluation of 100 000 random shims revealed that the CMA performs with lower SAR efficiency, although the SAR efficiencies are similar in CP mode. Measured S11 and S12 levels were both lower for the CMA.ConclusionThe coax monopole would be an excellent candidate for head coil arrays at 14T MRI. Although the CMA is expected to perform with lower SAR efficiency than the fractionated dipole, its single‐ended design will facilitate elements placement and cable‐routing, especially in a spatially restricted environment.
Improving ungated steady‐state cardiac perfusion using transition bands
Authors: Mendes Jason K. , Le Johnathan V. , Arai Andrew E. , Ranjan Ravi , DiBella Edward V. R. , Adluru Ganesh 
Published: February 2025

AbstractPurposeAlthough gated first‐pass contrast‐enhanced sequences are the clinical standard for cardiovascular MR perfusion, some patient conditions necessitate using ungated steady‐state sequences. However, through‐plane cardiac motion and blood flow into the left ventricle can disrupt the magnetization steady state of the tissue, and perfusion quantification based on a steady‐state assumption will contain errors. The tissue magnetization steady‐state disruption can be eliminated with a proposed sequence modification that simultaneously excites transition bands with no change in the sequence resolution or timing parameters.Theory and MethodsThe proposed sequence modification simultaneously excites two transition bands adjacent to the imaged region. The transition bands experience the same consistent excitation history as the imaged slices. Thus, any tissue that moves into an imaged slice location from a transition band location will not disrupt the magnetization steady state. Gradient dephasing and radiofrequency spoiling are used to null the transition band signal so that it does not contribute to the reconstructed images. Transition bands were added to a two‐dimensional ungated steady‐state radial FLASH (fast low‐angle shot) sequence with simultaneous multiband imaging on a PRISMA 3T MRI scanner. Phantom, normal canine, and human subject data are presented.ResultsTransition bands reduce the amount of tissue magnetization disruption to the steady state without adding artifacts to the imaged slices. Myocardial blood flow maps from a selected normal canine study and a normal human subject show good uniformity and consistency to literature values for all slices. Perfusion estimates with the proposed method also demonstrate good consistency with saturation‐recovery methods commonly used for myocardial perfusion imaging.ConclusionWe have demonstrated that the proposed transition bands can reduce quantification errors resulting from blood flow into the left ventricle and through‐plane cardiac and respiratory motion. There is no loss of image‐acquisition efficiency, and temporal resolution is unchanged with this technique.
Communication of Voice‐Related Complications in Thyroidectomy: A Qualitative Analysis
Authors: Kao Derek D. , Jensen Catherine B. , Bacon Elizabeth , Hogikyan Norman D. , Roman Benjamin R. , Pitt Susan C. 
Published: February 2025

AbstractObjectiveThis study aims to characterize patient–surgeon discussions of voice‐related complications during thyroidectomy for low‐risk thyroid cancer.Study DesignA qualitative study.SettingThree academic medical centers.MethodsPre‐operative clinic visits between 14 surgeons (6 otolaryngologists and 8 endocrine surgeons) and 49 patients with low‐risk (cT1‐2, N0) thyroid cancer were audio‐recorded and transcribed. Qualitative analysis was used to evaluate surgeon counseling strategies and patient concerns related to voice.ResultsPatients aged from 20 to 77 years old were predominantly female (77.6%) and white (89.9%). Surgeons presented risk with negative framing and numerical percentages (1%‐4%) and/or qualified the risk as “low” or “small” for a lobectomy, but a “much bigger deal” for bilateral nerve injury in total thyroidectomy. At a minimum, surgeons referred to voice dysfunction as “voice change.” Some further described “hoarseness” or the “inability to project voice.” Other surgeons imitated what voice dysfunction would sound like. A few surgeons probed the importance of voice to a patient's life. One surgeon imparted that having a voice‐related complication “can be really emotional.” Patients responded with varying degrees of concern about voice changes after surgery, from feeling “super concerned … about losing [their] voice” to feeling “ok” with it “as long as [they're] around to deal with it.”ConclusionSignificant variability exists in how surgeons describe and set expectations about voice‐related complications. The degree to which patients value voice‐related outcomes differed based on their occupation and hobbies, but this was tempered by their cancer diagnosis. Further research is needed to identify optimal disclosure of voice‐related risks and expectations.
Normal‐Weight Offspring of Parents With Diet‐Induced Obesity Display Altered Gene Expression Profiles
Authors: Czechowski Paul , Hoffmann Anne , Dommel Sebastian , Jais Alexander , Blüher Matthias , Klöting Nora 
Published: February 2025

ABSTRACTObjectiveA Western diet is associated with obesity, and the link between parental and offsprings' obesity is unclear. Among mice, this study examined how parents' Western diets affect their male offspring's obesity risk. This study further explored whether early exposure to obesogenic diets from either parent influences offsprings' long‐term weight gain.MethodsThree‐week‐old C57BL6/NTac mice were assigned to a Western diet (WD) or control diet (CD), given from six to 14 weeks old. Adults from these dietary groups were then mated to create four breeding combinations: CD/CD, CD/WD, WD/CD, and WD/WD. Weight gain trajectories were studied in parents (P) and offspring (F1), along with gene expression in four tissues of male offspring. Non‐linear mixed effect modeling and q‐mode PCA were used to assess the influence of sex, litter size, and parental diet on gene expression, before describing gene expression in more detail.ResultsOffsprings' weight gain was mainly influenced by sex and litter size, with no significant impact from parental diet. At the same time, gene expression differences among offspring, particularly between WD/WD and CD/CD offspring, were linked to genes associated with inflammation, stress response, and other obesity‐relevant processes.ConclusionsObegenesic diet of two parents with obesity, rather than only one, likely alters the risks of metabolic disease in male mice even at normal weights.