bluuebunny/crossref_metadata_2025_split huggingface dataset:
Treatment Pattern and Outcome of Locally Advanced Rectal Cancer in Resource-Constrained Countries: Experience at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia
Authors: Hailu Elias Amare , Woldetsadik Edom Seife , Tadesse Biruk Legesse , Dibaba Abdi Dandena , Zingeta Girum Tessema , Kelemu Hidagewoin Frew , Zewde Yonas Alemayehu , Aytehgeza Ruth Shimeles , Begna Kebede H. 
Published: January 2025

PURPOSE
Management of locally advanced rectal cancer (LARC) includes neoadjuvant chemoradiotherapy (NACRT) followed by total mesorectal excision. Recently, total neoadjuvant treatment (TNT) has gained attention. In developing countries, patients with rectal cancer often present at advanced stages. This study assesses treatment patterns and outcomes in LARC at a largest referral center in Ethiopia.

MATERIALS AND METHODS
A cross-sectional study was conducted on 100 patients with LARC treated at Tikur Anbessa Specialized Hospital from January 2020 to September 2022.

RESULTS
The median age at diagnosis was 45.5 years (range, 20-86), with 51% male. Of the patients, 81% had no previous oncologic treatment and 75.3% was discussed in a multidisciplinary tumor board. Up-front surgery was planned for 44.4% of patients, whereas 22.2% and 8.6% were assigned to TNT and NACRT, respectively. Among 81 treatment-naïve patients, 79 were triaged for surgery, but only 47 (59.5%) underwent surgery, achieving an 89.9% R0 resection rate. Of 36 up-front planned surgeries, 35 proceeded as planned, whereas only 12 of 43 (28%) planned after neoadjuvant treatment underwent surgery. Neoadjuvant chemotherapy (NACT) was given to 37% of patients, with 16.7% (5 of 30) undergoing subsequent surgery. Radiotherapy was given to 24.2% of participants, with 56.25% undergoing surgery. Short-course radiotherapy (SCRT) was given to two patients. Only 14.8% completed all planned treatments, with radiation waiting time (median, 10 months) being the main impediment.

CONCLUSION
Timely administration of neoadjuvant treatment is not possible in most resource-limited settings. Because of better treatment completion, up-front surgery looks a more viable option than NACT in these situations. Extended waiting time for radiotherapy can be mitigated by opting for alternatives like SCRT in selected patients.
Revisiting the matrix elements of the position operator in the crystal momentum representation
Authors: Si M. S. , Zhang G. P. 
Published: January 2025

Abstract
Fewer operators are more fundamental than the position operator in a crystal. But since it is not translationally invariant in crystal momentum representation (CMR), how to properly represent it is nontrivial. Over half a century, various methods have been proposed, but they often lead to either highly singular derivatives or extremely arcane expressions. Here we propose a resolution to this problem by directly computing their matrix elements between two Bloch states. We show that the position operator is a full matrix in CMR, where the off-diagonal elements in crystal momentum

only appear along the direction of the position vector. Our formalism, free of singular derivative and degeneracy difficulties, can describe an array of physical properties, from intraband transitions, polarization with or without spin-orbit coupling, orbital angular momentum, to susceptibilities.
The Captopril Challenge Test Predicts Cardiac Structure and Dysfunction in Primary Aldosteronism
Authors: Chen Uei-Lin , Liao Che-Wei , Wang Shuo-Meng , Lai Tai-Shuan , Huang Kuo-How , Chang Chin-Chen , Lee Bo-Ching , Lu Ching-Chu , Chang Yi-Ru , Chen Zheng-Wei , Chang Yi-Yao , Hung Chi-Sheng , Chueh Jeff S , Wu Vin-Cent , Tsai Cheng-Hsuan , Vaidya Anand , Lin Yen-Hung 
Published: January 2025

Abstract

Context
The captopril challenge test (CCT) is a commonly used confirmation test that identifies the magnitude of renin- and angiotensin II-independent aldosterone production and thus the presence and severity of primary aldosteronism (PA).

Objective
This study investigated the association between the post-CCT plasma aldosterone concentration (PAC) and cardiovascular remodeling and diastolic dysfunction.

Methods
A total of 540 PA patients with complete CCT and echocardiographic data were retrospectively analyzed. Clinical and echocardiographic parameters were assessed at baseline and 1 year after PA-targeted treatment.

Results
The post-CCT PAC showed a significant linear association with both left ventricular mass index (LVMI) and the ratio of early diastolic transmitral and myocardial velocity on tissue Doppler imaging (E/e′) in restricted cubic spline analyses, indicating a continuum of risk linked to postcaptopril aldosterone levels. In linear regression analyses, post-CCT PAC was significantly associated with baseline LVMI, E/e′, and left atrial volume index (LAVI), regardless of multiple model adjustments. One year after PA-targeted treatment, patients with higher post-CCT PAC experienced the greatest improvements in LVMI, E/e′, and LAVI. In contrast, baseline aldosterone levels were associated only with baseline LVMI and its improvement after treatment but not with the baseline or improvement of E/e′ or LAVI.

Conclusion
Higher post-CCT PAC was significantly associated with worse left ventricular remodeling and diastolic dysfunction but also greater improvements in cardiac structure and dysfunction following targeted treatment. These findings highlight the prognostic and therapeutic values of the CCT that the post-CCT PAC predicts the severity of cardiac disease and also the potential for therapeutic benefits in PA.
What Are “Nonphysician Obligations” Anyway? A Survey Study Exploring Their Impact on Anesthesiology Resident Education and Developing a Conceptual Framework
Authors: Cormier Nicholas R. , Kinney Daniel A. , Gaiser Robert R. 
Published: January 2025

BACKGROUND:
The Accreditation Council for Graduate Medical Education defines “nonphysician obligations” as “duties performed by nursing and allied health professionals, transport services, or clerical staff.” How anesthesiology trainees understand the concept of “nonphysician obligations” and are impacted by these obligations is incompletely understood. The objective of the study was to identify how anesthesiology trainees define “nonphysician obligations,” which obligations impact trainee education, and what attitudes trainees hold.

METHODS:
A survey was administered to Anesthesiology residents (N = 86) at a large academic hospital in 2023. Respondents defined “nonphysician obligations,” listed obligations that impacted their education, and indicated the frequency of these obligations. Respondents scored their agreement with statements appraising attitudes toward the clarity and consistency of the term and classified anesthesiology tasks as physician/nonphysician. The authors developed a conceptual framework defining “nonphysician obligations” using grounded theory and categorized the participants’ responses based on this framework. Tallies assessed which obligations and attitudes were most prominent.

RESULTS:
The response rate was 82.6% (n = 71). Respondents defined nonphysician obligations with either a patient-centered or physician-centered framework. Tasks spanning nursing, patient transport, anesthesia technicians, certified registered nurse anesthetists, and care coordinators impacted education most. Outlier definitions and obligations emerged, including personal and household obligations. Fifty-seven percent of trainees disagreed that the definition of nonphysician obligations was clear. Forty-seven percent agreed definitions held by anesthesiology trainees were aligned. Sixty-two percent felt that different medical specialties did not share a common definition. Classification of typical anesthesiology tasks as physician/ nonphysician was heterogenous.

CONCLUSIONS:
“Nonphysician obligations” are defined by a new, nuanced, specialty-specific explanatory framework, and those that impact education are summarized in distinct classes. Trainee definitions and attitudes expose possible faults in how nonphysician obligations are currently evaluated.
A master regulatory loop that activates genes in a temporally coordinated manner in muscle cells of ascidian embryos
Authors: Oda Izumi , Satou Yutaka 
Published: January 2025

ABSTRACT
Ascidian larval muscle cells present a classic example of autonomous development. A regulatory mechanism for these cells has been extensively investigated, and the regulatory gene circuit has been documented from maternal factors to a muscle-specific gene. In the present study, we comprehensively identified genes expressed specifically in ascidian muscle cells, and found that all of them are under control of a positive regulatory loop of Tbx6-r.b and Mrf, the core circuit identified previously. We also found that several transcription factors under control of the Tbx6-r.b/Mrf regulatory loop exhibited various temporal expression profiles, which are probably important for creating functional muscle cells. These results, together with results of previous studies, provide an exhaustive view of the regulatory system enabling autonomous development of ascidian larval muscle cells. It shows that the Tbx6-r.b/Mrf regulatory loop, but not a single gene, serves a ‘master’ regulatory function. This master regulatory loop not only controls spatial gene expression patterns, but also governs temporal expression patterns in ascidian muscle cells.
Cell migration signaling through the EGFR-VAV2-Rac1 pathway is sustained in endosomes
Authors: Pinilla-Macua Itziar , Surve Sachin , Sorkin Alexander 
Published: January 2025

ABSTRACT
Ligand binding to EGFR activates Rho family GTPases, triggering actin cytoskeleton reorganization, cell migration and invasion. Activated EGFR is also rapidly endocytosed but the role of EGFR endocytosis in cell motility is poorly understood. Hence, we used live-cell microscopy imaging to demonstrate that endogenous fluorescently labeled VAV2, a guanine nucleotide exchange factor for Rho GTPases, is co-endocytosed with EGFR in genome-edited human oral squamous cell carcinoma (HSC3) cells, an in vitro model for head-and-neck cancer where VAV2 is known to promote metastasis and is associated with poor prognosis. Chemotactic migration of HSC3 cells toward an EGF gradient is found to require both VAV2 and clathrin-mediated endocytosis. Moreover, sustained activation of Rac1, a Rho family GTPase promoting cell migration and a major substrate of VAV2, also depends on clathrin. Endogenous fluorescently labeled Rac1 localizes to EGFR-containing endosomes. Altogether, our findings suggest that signaling through the EGFR-VAV2-Rac1 pathway persists in endosomes and that this endosomal signaling is required for EGFR-driven cell migration.
Five-Ce:Nd:YAG-rod solar laser approach with TEM00-mode collection efficiency of 51.7  W/m2
Authors: Matos Ana , Liang Dawei , Costa Hugo , Tibúrcio Bruno D. , Almeida Joana 
Published: January 2025

One of the major goals of solar-pumped lasers is to improve TEM00-mode collection and conversion efficiencies. Several studies have explored multi-rod designs with the aim of enhancing laser output and thermal management by distributing the absorbed solar energy across multiple rods. In this work, we introduced a concept comprising four Fresnel lenses with a total collection area of 3.14m2 and four aspherical lenses, which concentrated the sunlight into a water-flooded cylindrical cavity housing five side-pumped Ce:Nd:YAG rods. A beam-merging scheme was also proposed to generate a single output beam. Simulations performed with Zemax and LASCAD demonstrated that this configuration could produce a total TEM00-mode laser output of 162.3 W. The corresponding collection efficiency reached 51.7W/m2, with a solar-to-laser power conversion efficiency of 5.44%, representing improvements of 3.13 and 2.64 times, respectively, compared to the record experimental results from a system using a single Ce:Nd:YAG crystal and a Fresnel lens. Moreover, even when compared to a more complex seven-rod configuration, both efficiencies exhibited a 1.50 times increase.
Prognostic significance of total choline on in-vivo proton MR spectroscopy for prediction of late recurrence in patients with hormone receptor-positive, HER2-negative early breast cancer
Authors: Kim Hyunjik , Park Heungkyu , Chun Yongsoon , Kim Hagjun , Baek Hyeonman , Kim Yunyeong 
Published: January 2025

Purpose
In-vivo proton magnetic resonance spectroscopy (MRS) is a non-invasive method of analyzing choline metabolism that has been used to predict breast cancer prognosis. A strong choline peak may be a surrogate for aggressive tumor biology but its clinical relevance is unclear. The present study assessed whether total choline (tCho), as measured by proton MRS, can predict late recurrence in patients with hormone receptor (HR)-positive, HER2-negative early breast cancer.

Methods
The study cohort included 261 HR+/HER2- breast cancer patients who underwent diagnostic single-voxel proton MRS (3.0T scanner) prior to first-line surgery from March 2011 to July 2014. The relationships between tCho compound peak integral (tChoi) values and others prognostic factor were analyzed, as were the effects of tChoi on 10-year disease-free survival (DFS) and overall survival (OS). The clinical significance of tChoi was also analyzed using Harrell’s C-index.

Results
Mean tChoi in HR+/HER2- study group was 15.47 and we set the cut-off for tChoi at 15 for survival analysis. 10-year DFS differed significantly between tChoi <15 and ≥15 (p = 0.017), with differences differing significantly for late (5–10 years; p = 0.02) but not early (0–5 years; p = 0.323) recurrence. Cox regression analysis showed that tChoi was significantly predictive of 10-year DFS (p = 0.046, OR 2.69) and tended to be predictive of late recurrence (HR 4.36, p = 0.066). Harrell’s C-index showed that the Ki-67 index (AUC = 0.597) and lymphovascular invasion (AUC = 0.545) were also predictive of survival, with the addition of normalized tChoi improving the AUC to 0.622 (p = 0.014), indicating better predictive power.

Conclusion
tChoi determined by in vivo MRS was predictive of prognosis in patients with HR+/HER2- early breast cancer. This parameter may serve as a valuable, non-invasive tool to predict prognosis when combined with other known prognostic factors.
Comparison of core temperature using tracheal thermometer and pulmonary artery catheter in adult patients undergoing coronary artery bypass graft surgery
Authors: Park Seyeon , Kim Hee Young , Kim Hye-Jin , Jung Jieun , Hong Seo-Ho , Jung Yeon-Soo , Ha Dong-Hyeon , Park Da-Eun , Yoon Ji-Uk 
Published: January 2025

Background
Monitoring core temperature is important for patients under anesthesia. Esophageal and pulmonary artery blood temperatures can be used for measuring core temperature during general anesthesia. However, these methods pose challenges, especially when the placement of an esophageal thermometer and pulmonary artery catheter (PAC) is either impractical or not the preferred approach. An endotracheal tube (ETT) with a thermometer on the cuff allows for the measurement of tracheal temperature, providing a suitable alternative to core temperature measurement. This study aimed to assess the clinical reliability and accuracy of the thermometer in the ETT in comparison to the core temperature measured using a PAC.

Methods
Eleven patients who underwent coronary artery bypass graft (CABG) surgery were enrolled in this study. The patients were intubated using an ETT equipped with a thermometer on the cuff, and a PAC was inserted. Temperature measurements of both the trachea and pulmonary artery blood were recorded at 5-minute intervals for 1 hour before starting cardiopulmonary bypass. The agreement between the two temperature measurement methods was investigated using the Bland-Altman plot with multiple measurements per subject, and the correlation was evaluated using the concordance correlation coefficient (CCC).

Results
Eleven patients with a total of 143 pairs of data were included for analysis. The mean difference between the tracheal and pulmonary artery temperatures was −0.10°C. The 95% limit of agreement (LoA), calculated as ± 1.96 standard deviation, ranged from −0.35°C to 0.15°C. The 95% confidence interval for the lower and upper LoA was −0.51°C to −0.27°C and 0.07°C to 0.31°C, respectively. The maximum allowed difference (Δ) was set at 0.5°C. The majority of temperature differences fell within the LoA and were well below the maximum allowed difference. The CCC was 0.95, which indicates a substantial strength of agreement.

Conclusions
The agreement between the tracheal and pulmonary artery temperature measurements using the ETT thermometer and pulmonary artery catheter, respectively, was found to be clinically reliable and accurate. Therefore, the tracheal temperature measurement can effectively represent the core temperature of the patients. Employing an ETT equipped with a thermometer on the cuff can serve as a reliable and independent method for measuring core temperature.

Trial registration
Clinical trial registration number: NCT05595616.
Racial/ethnic differences in mental health treatment received among people with comorbid cardiometabolic and depressive symptomology: National Health and Nutrition Examination Survey, 2017 to March 2020 Pre-Pandemic
Authors: Dark Tyra , Harris Rachel , Burns Desiree , Chernicky Jacob , Reid-Marks Laura , Rust George 
Published: January 2025

Background
Individuals with chronic physical conditions and comorbid mental illness have increased probability of adverse health outcomes. As minority populations have limited access to both medical care and culturally appropriate mental health services, having a comorbid mental health condition can further impede their ability to manage chronic conditions and widen racial disparities in health outcomes. Further, racial/ethnic disparities in treatment patterns are likely to exacerbate disparities in adverse health outcomes.

Objective
To identify the racial/ethnic mental health treatment patterns among individuals with cardiometabolic and depressive symptomology co-occurrence.

Methods
This study utilized National Health and Nutrition Examination Survey data, 2017 to March 2020 Pre-Pandemic. The primary analysis was an adjusted linear logistic regression analysis of race/ethnicity, comorbidity status and mental health treatment type. Regression models were estimated to determine the likelihood of receiving counseling and medication therapy, and to determine if the likelihood is associated with race/ethnicity.

Results
Primary findings indicate that depressive symptomology only was the most common designation and fewer than half of persons received any mental health treatment. Across all racial/ethnic groups, receiving no mental health treatment was the most common designation. Sixty-one percent of Non-Hispanic White persons and more than three out of four Hispanic and Non-Hispanic Black persons with only depressive symptoms received no mental health treatment. Adjusted regression analyses revealed that participants with comorbid cardiometabolic and depressive symptomology have 28% lower odds of receiving combined mental health professional and medication therapy than participants with depressive symptomology only.

Conclusions
Simultaneously treating both mental illness and cardiometabolic symptoms properly is complicated, but there may be untapped synergies in treating both concurrently. Therefore, to achieve favorable health outcomes, policy should be implemented to optimize clinical treatment by addressing aspects of both conditions in an integrated approach and may need to be culturally tailored to be effective.
Association between the triglyceride-glucose index and its combined obesity indicators and the risk of hypertension in middle-aged and older Chinese adults: A nationwide cross-sectional study
Authors: Zheng Huoping , Xu Meiling , Yang Jing , Xu Mingjun 
Published: January 2025

Objective
This study aimed to explore the association between the triglyceride-Glucose Index (TyG) and its combination with obesity indicators in relation to the risk of hypertension among middle-aged and elderly individuals in China.

Methods
A total of 9,248 participants aged 45 and above were selected from the 2015 China Health and Retirement Longitudinal Study. Data on basic demographics, behavioral habits, medical history, physical examination results, and blood indicators were collected. The TyG and its obesity-related indicators, including TyG-BMI, TyG-WC, and TyG-WHtR were analyzed. These indicators were categorized into four groups based on quartiles, and the prevalence of hypertension within each group was assessed. Logistic regression analysis was conducted to evaluate the association between different TyG indices and obesity-related indicators with the risk of hypertension. Additionally, a restricted cubic spline model was employed to investigate the dose-response relationship between the TyG index, its combined obesity indicators, and the risk of hypertension. The receiver operating characteristic curve was utilized to determine the optimal predictive index for diagnosis.

Results
This study included a total of 9,248 middle-aged and elderly individuals aged 45 and above, comprising 4,274 males (46.21%), with an average age of 61.38 ± 9.28 years. The prevalence of hypertension exhibited an increasing trend as the quartiles of TyG, TyG-BMI, TyG-WC, and TyG-WHtR rose. After fully adjusting for covariates, comparisons between the first quartile (Q1) and the fourth quartile (Q4) of TyG, TyG-BMI, TyG-WC, and TyG-WHtR revealed that all these metrics at Q4 level were associated with an increased prevalence of hypertension. The odds ratios were as follows: TyG: OR = 1.80 (95% CI: 1.48–2.19); TyG-BMI: OR = 5.09 (95% CI: 4.33–5.98); TyG-WC: OR = 3.96 (95% CI: 3.38–4.65); TyG-WHtR: OR = 3.91 (95% CI: 3.33–4.60). A linear correlation was observed between TyG and the risk of hypertension (P for non-linearity = 0.2267), while non-linear correlations were noted between TyG-BMI, TyG-WC, and TyG-WHtR with the risk of hypertension (P for non-linearity < 0.001). The receiver operating characteristic curve indicated that TyG-WC demonstrated the highest diagnostic performance for hypertension, with an area under the curve of 0.642 (95% CI: 0.631–0.654).

Conclusion
As the levels of TyG, TyG-BMI, TyG-WC, and TyG-WHtR increased, the risk of hypertension among middle-aged and elderly individuals aged 45 and above in my country rises significantly. Among them, TyG-WC can be a predictor of hypertension in middle-aged and elderly people.