bluuebunny/crossref_metadata_2025_split huggingface dataset:
Let this be a safe place: a qualitative study into midwifery care for forcibly displaced women in the Netherlands
Authors: Tankink J. B. , Verschuuren A. E. H. , de Graaf J. P. , Feijen-de Jong E. I. , van der Lans P. J. A. , van den Muijsenbergh M. E. T. C. , Franx A. , Goodarzi B. 
Published: November 2024

Abstract
Background
Forcibly displaced women in the Netherlands face increased chances of perinatal mortality and other adverse pregnancy and childbirth outcomes compared to the resident country population, which has been linked to suboptimal care. This study was conducted to gain insights from the experiences of Dutch midwives to inform and enhance the provision of tailored and equitable care for forcibly displaced women.

Methods
We conducted a qualitative study using semistructured interviews with community midwives who provide care for forcibly displaced women (asylum seekers and recognized refugees) in the Netherlands. Through thematic analysis, we identified the barriers midwives encounter in providing care and explored their strategies for navigating these barriers, aiming to inform recommendations that advance equitable care provision.

Results
Interviews with eleven midwives revealed barriers across three thematic levels: (1) the interactional level, where barriers related to language and interpreters, cultural differences, and building trust impeded positive interactions between midwives and forcibly displaced women; (2) the organizational level, where barriers concerning relocations of asylum seekers, delays in accessing care, and interdisciplinary collaboration impeded optimal care; and (3) the contextual level, where barriers related to women’s housing conditions, the resettlement process and the mental health of forcibly displaced women impeded midwives’ to respond to clients’ needs. These levels of barriers culminated in a core theme of imbalance between midwives’ expanded responsibilities and the limited resources and strategies available to them in care for forcibly displaced women. This imbalance forced midwives into multiple roles, increased both the practical and emotional burden on them, and undermined their ability to provide optimal, equitable care.

Conclusions
To enhance the provision of equitable pregnancy and childbirth care for forcibly displaced women in the Netherlands, it is crucial to target the imbalance between the responsibilities that midwives bear and the resources available to them. This requires dismantling barriers at the interactional, organizational and contextual level of care through targeted policy interventions. Structural determinants that perpetuate the imbalance in midwives’ work and restrict their scope of influence, such as restrictive migration policies that contribute to socioeconomic marginalization and poor housing conditions, need to be addressed. Ultimately, midwives themselves require more support and education to recognize and combat injustices in pregnancy and childbirth care for forcibly displaced women.
Concordance between immunohistochemistry and MSI analysis for detection of MMR/MSI status in colorectal cancer patients
Authors: Faizee Muhammad Ishaque , Talib NorLelawati A. , Hamdan Asmah Hanim Bt. , Abdullah Nor Zamzila Bt. , Rahimi Bilal Ahmad , Haidary Ahmed Maseh , Saadaat Ramin , Hanifi Ahmed Nasir 
Published: November 2024

Abstract
Background
Recently, screening of colorectal cancer (CRC) patients for mismatch repair/microsatellite instability (MMR/MSI) status is widely practiced due to its potential predictive and prognostic roles and a screening tool to reveal Lynch Syndrome (LS). The purpose of the study was to evaluate concordance between immunohistochemistry (IHC) and MSI analysis methods for detection of MMR/MSI status in colorectal cancer patients in Kuantan, Pahang.

Methods
Fifty selected CRC cases of deficient mismatch repair (dMMR) and proficient mismatch repair (pMMR) which were identified immunohistochemically in the previous study were subjected to MSI analysis. MSI Analysis System 1.2 (Promega) was utilized.

Results
The results of MSI analysis method showed MSI-High: 26% (13/50), MSI-Low: 6% (3/50), and Microsatellite Stable: 68% (34/50). The concordance was perfect (0.896, Kappa value) between MSI analysis and IHC methods for the assessment of MMR/MSI status in CRC patients. The discordance was only 4% (2/50). MSI analysis identified all dMMR cases determined by IHC except one case. The obtained frequency of dMMR and pMMR patients was 11.4% (14/123) and 88.6% (109/123) by IHC method, respectively.

Conclusion
Our findings support the universal practice of evaluating the MMR/MSI status in all newly diagnosed CRC patients. Based on the perfect concordance of two methods, the method of choice is based on the availability of expertise and equipments. IHC is highly appreciable method due to its feasibility and reproducibility.
The development for emerging biomarkers of lymphangioleiomyomatosis
Authors: Huang Liting , Xiao Ying , Yang Lulu , Ren Siying 
Published: November 2024

Abstract 抽象Lymphangioleiomyomatosis (LAM) is a rare, slowly progressing, low-grade metastatic tumor primarily affecting women. Currently, vascular endothelial growth factor–D (VEGF-D) is the only validated diagnostic biomarker, enabling diagnosis of LAM without the need for lung biopsy in appropriate clinical settings. However, VEGF-D concentrations are normal in about 30% of patients, rendering it insufficient for diagnosing all cases of LAM. There remains a need to identify more non-invasive, safe, sensitive, and specific biomarkers associated with LAM. Therefore, it is imperative to explore novel non-invasive, safe, and specific diagnostic methods for LAM. This article aims to review biomarkers associated with LAM, including potential biomarkers newly discovered or showing advancements in classical biomarkers widely used in LAM, and discuss their application in LAM diagnosis, assessment of disease severity, prediction of treatment response, and prognosis.淋巴管平滑肌瘤病 （LAM） 是一种罕见的、进展缓慢的低级别转移性肿瘤，主要影响女性。目前，血管内皮生长因子-D （VEGF-D） 是唯一经过验证的诊断生物标志物，无需在适当的临床环境中进行肺活检即可诊断 LAM。然而，约 30% 患者的 VEGF-D 浓度正常，不足以诊断所有 LAM 病例。仍然需要确定与 LAM 相关的更多无创、安全、敏感和特异性的生物标志物。因此，当务之急是探索新型无创、安全和特异性的 LAM 诊断方法。本文旨在回顾与 LAM 相关的生物标志物，包括新发现的潜在生物标志物或显示出 LAM 中广泛使用的经典生物标志物的进展，并讨论它们在 LAM 诊断、疾病严重程度评估、治疗反应预测和预后中的应用。
Differential effects of thiamine and ascorbic acid in clusters of septic patients identified by latent variable analysis
Authors: Legouis David , Monard Céline , Ourahmoune Aimad , Sgardello Sebastian , Quintard Hervé , Criton Gilles , Sangla Frederic , Schneider Antoine 
Published: November 2024

Abstract
Background
Thiamine and ascorbic acid have been proposed to mitigate the devastating consequences of sepsis and septic shock. To date, randomized controlled trials have failed to demonstrate a benefit of these therapies and heterogeneity of treatment effect is suspected. In this study, we aimed at assessing the heterogeneity of treatment effect of thiamine (B1) and the combination of B1 plus ascorbic acid (AA + B1) in critically ill patients with sepsis.

Methods
We conducted a bi-centric retrospective cohort study. All adult patients admitted to the ICU with sepsis or septic shock between January 2012 and August 2022 were included. Patient clusters were identified using latent variable analysis based on demographics and physiological variables obtained within 24 h of admission. Within each cluster and using inverse probability weighted Cox models, we compared in-hospital mortality between patients who received standard treatment (control), standard treatment plus B1 (B1 group), and standard treatment plus a combination of thiamine and ascorbic acid (AA + B1 group).

Results
A total of 3465 septic patients were included, 2183, 1054 and 228 in the standard, B1 and AA + B1 groups respectively. Five clusters of patients were identified in an unsupervised manner. The “Cluster Severe” included the most severely ill patients, the “Cluster Resp” patients presented with predominantly respiratory failure, the “Cluster Old” included elderly patients with multiple comorbidities, the “Cluster Fit” patients were young, healthy with low severity indices and “Cluster Liver” included patients with predominant liver failure. B1 treatment was associated with different outcomes across the five clusters. It was associated with a lower in-hospital mortality in the “Cluster Severe” and “Cluster Resp”. On the other hand, the combination of thiamine and ascorbic acid was not associated with reduced mortality in any cluster but an increased mortality in”Cluster Old”.

Conclusions
These results reinforce the lack of efficacy of the combination of AA + B1 reported in recent trials and even raise concerns about potential harm in older patients with comorbidities. On the contrary, we reported improved ICU survival associated with B1 supplementation in the most severe patients and those with predominant respiratory failure, supporting the need for further trials in this specific population.
Socio-affective communication in Tph2-deficient rat pups: communal nesting aggravates growth retardation despite ameliorating maternal affiliation deficits
Authors: Wang Tianhua , Homberg Judith R. , Boreggio Laura , Samina Marta C. F. , Castro Rogério C. R. , Kolk Sharon M. , Alenina Natalia , Bader Michael , Dai Jinye , Wöhr Markus 
Published: November 2024

Abstract
Background
A lack of serotonin (also known as 5-hydroxytryptamine, 5-HT) in the brain due to deficiency of the rate-limiting enzyme in 5-HT synthesis, tryptophan hydroxylase 2 (TPH2), was recently reported to result in impaired maternal affiliation across species, including mice, rats, and monkeys. In rodents, this was reflected in a lack of preference for maternal odors and reduced levels of isolation-induced ultrasonic vocalizations (USV), possibly contributing to a severe growth retardation phenotype.

Methods
Here, we tested whether growth retardation, maternal affiliation deficits, and/or impairments in socio-affective communication caused by Tph2 deficiency can be rescued through early social enrichment in rats. To this aim, we compared male and female Tph2−/− knockout and Tph2+/− heterozygous rat pups to Tph2+/+ wildtype littermate controls, with litters being randomly assigned to standard nesting (SN; one mother with her litter) or communal nesting (CN; two mothers with their two litters).

Results
Our results show that Tph2 deficiency causes severe growth retardation, together with moderate impairments in somatosensory reflexes and thermoregulatory capabilities, partially aggravated by CN. Tph2 deficiency further led to deficits in socio-affective communication, as evidenced by reduced emission of isolation-induced USV, associated with changes in acoustic features, clustering of subtypes, and temporal organization. Although CN did not rescue the impairments in socio-affective communication, CN ameliorated the maternal affiliation deficit caused by Tph2 deficiency in the homing test. To close the communicative loop between mother and pup, we assessed maternal preference and showed that mothers display a preference for Tph2+/+ controls over Tph2−/− pups, particularly under CN conditions. This is consistent with the aggravated growth phenotype in Tph2−/− pups exposed to the more competitive CN environment.

Conclusion
Together, this indicates that CN aggravates growth retardation despite ameliorating maternal affiliation deficits in Tph2-deficient rat pups, possibly due to reduced and acoustically altered isolation-induced USV, hindering efficient socio-affective communication between mother and pup.
Contrast-enhanced US Bosniak Classification: intra- and inter-rater agreement, confounding features, and diagnostic performance
Authors: Jin Dong-dong , Zhuang Bo-wen , Lin Ke , Zhang Nan , Qiao Bin , Xie Xiao-yan , Xie Xiao-hua , Wang Yan 
Published: November 2024

Abstract
Background
The contrast-enhanced US (CEUS) Bosniak classification, proposed by the European Federation for Ultrasound in Medicine and Biology (EFSUMB) in 2020, predicts malignancy in cystic renal masses (CRMs). However, intra- and inter-rater reproducibility for CEUS features has not been well investigated.

Purpose
To explore intra- and inter-rater agreement for US features, identify confounding features, and assess the diagnostic performance of CEUS Bosniak classification.

Materials and methods
This retrospective study included patients with complex CRMs who underwent CEUS examination from January 2013 to August 2023. Radiologists (3 experts and 3 novices) evaluated calcification, echogenic content, wall, septa, and internal nodules of CRMs using CEUS Bosniak classification. Intra- and inter-rater agreements were assessed using the Gwet agreement coefficient (Gwet’s AC). Linear regression identified features associated with discrepancies in Bosniak category assignment. Diagnostic performance was evaluated using the area under the receiver operating characteristic curve (AUC).

Results
A total of 103 complex CRMs were analyzed in 103 patients (mean age, 50 ± 15 years; 66 males). Intra-rater agreement for the Bosniak category was substantial to almost perfect (Gwet’s AC 0.73–0.87). Inter-rater agreement was substantial for the Bosniak category (Gwet’s AC 0.75) and moderate to almost perfect for US features (Gwet’s AC 0.44–0.94). Nodule variation (i.e., absence vs. obtuse margin vs. acute margin) explained 84% of the variability in the Bosniak category assignment. CEUS Bosniak classification showed good diagnostic performance, with AUCs ranging from 0.78 to 0.90 for each rater.

Conclusions
CEUS Bosniak classification demonstrated substantial intra- and inter-rater reproducibility and good diagnostic performance in predicting the malignancy potential of CRMs. Nodule variations significantly predicted differences in Bosniak category assignments.

Critical relevance statement
Contrast-enhanced US Bosniak classification reliably predicts malignancy in cystic renal masses, demonstrating substantial reproducibility and diagnostic accuracy. This improves clinical decision-making and patient management.

Key Points

Intra- and inter-rater reproducibility for contrast-enhance US features for Bosniak classification have not been well investigated.

Substantial inter-rater agreements for the Bosniak category and variable agreements for determining imaging features were found.

Contrast-enhanced US Bosniak classification is reproducible and has good diagnostic performance for predicting malignancy in cystic renal masses.

Graphical Abstract
Ultra-high gradient performance 3-Tesla MRI for super-fast and high-quality prostate imaging: initial experience
Authors: Bischoff Leon M. , Endler Christoph , Krausewitz Philipp , Ellinger Joerg , Klümper Niklas , Isaak Alexander , Mesropyan Narine , Kravchenko Dmitrij , Nowak Sebastian , Kuetting Daniel , Sprinkart Alois M. , Mürtz Petra , Pieper Claus C. , Attenberger Ulrike , Luetkens Julian A. 
Published: November 2024

Abstract
Objectives
To implement and evaluate a super-fast and high-quality biparametric MRI (bpMRI) protocol for prostate imaging acquired at a new ultra-high gradient 3.0-T MRI system.

Methods
Participants with clinically suspected prostate cancer prospectively underwent a multiparametric MRI (mpMRI) on a new 3.0-T MRI scanner (maximum gradient strength: 200 mT/m, maximum slew rate: 200 T/m/s). The bpMRI protocol was extracted from the full mpMRI protocol, including axial T2-weighted and diffusion-weighted (DWI) sequences (b0/800, b1500). Overall image quality was rated by two readers on a five-point Likert scale from (1) non-diagnostic to (5) excellent. PI-RADS 2.1 scores were assessed by three readers separately for the bpMRI and mpMRI protocols. Cohen’s and Fleiss’ κ were calculated for PI-RADS agreement between protocols and interrater reliability between readers, respectively.

Results
Seventy-seven male participants (mean age, 66 ± 8 years) were included. Acquisition time of the bpMRI protocol was reduced by 62% (bpMRI: 5 min, 33 ± 21 s; mpMRI: 14 min, 50 ± 42 s). The bpMRI protocol showed excellent overall image quality for both the T2-weighted (median score both readers: 5 [IQR: 4–5]) and DWI (b1500) sequence (median score reader 1: 4 [IQR: 4–5]; reader 2: 4 [IQR: 4–4]). PI-RADS score agreement between protocols was excellent (Cohen’s κ range: 0.91–0.95 [95% CI: 0.89, 0.99]) with an overall good interrater reliability (Fleiss’ κ, 0.86 [95% CI: 0.80, 0.92]).

Conclusion
Ultra-high gradient MRI allows the establishment of a high-quality and rapidly acquired bpMRI with high PI-RADS agreement to a full mpMRI protocol.

Trials registration
Clinicaltrials.gov, NCT06244680, Registered 06 February 2024, retrospectively registered, https://classic.clinicaltrials.gov/ct2/show/NCT06244680.

Critical relevance statement
A novel 3.0-Tesla MRI system with an ultra-high gradient performance enabled high-quality biparametric prostate MRI in 5.5 min while achieving excellent PI-RADS agreement with a standard multiparametric protocol.

Key Points

Multi- and biparametric prostate MRIs were prospectively acquired utilizing a maximum gradient of 200 mT/m.

Super-fast biparametric MRIs showed excellent image quality and had high PI-RADS agreement with multiparametric MRIs.

Implementation of high gradient MRI in clinical routine allows accelerated and high-quality biparametric prostate examinations.

Graphical Abstract
Impact of uncertainty quantification through conformal prediction on volume assessment from deep learning-based MRI prostate segmentation
Authors: Gade Marius , Nguyen Kevin Mekhaphan , Gedde Sol , Fernandez-Quilez Alvaro 
Published: November 2024

Abstract
Objectives
To estimate the uncertainty of a deep learning (DL)-based prostate segmentation algorithm through conformal prediction (CP) and to assess its effect on the calculation of the prostate volume (PV) in patients at risk of prostate cancer (PC).

Methods
Three-hundred seventy-seven multi-center 3-Tesla axial T2-weighted exams from biopsied males (66.64 $$\pm$$
±
7.47 years) at risk of PC were retrospectively included in the study. Assessment of PV based on PI-RADS 2.1 ellipsoid formula ($${{{\rm{PV}}}}_{{ref}}$$

PV

r
e
f

) was available for included patients. Prostate segmentations were obtained from a DL model and used to calculate the PV ($${{{\rm{PV}}}}_{{DL}}$$

PV

D
L

). CP was applied at a confidence level of 85% to flag unreliable pixel segmentations of the DL model. Subsequently, the PV ($${{{\rm{PV}}}}_{{CP}}$$

PV

C
P

) was calculated when disregarding uncertain pixel segmentations. Agreement between $${{{\rm{PV}}}}_{{DL}}$$

PV

D
L

and $${{{\rm{PV}}}}_{{CP}}$$

PV

C
P

was evaluated against the reference standard $${{{\rm{PV}}}}_{{ref}}$$

PV

r
e
f

. Intraclass correlation coefficient (ICC) and Bland–Altman plots were used to assess the agreement. The relative volume difference (RVD) was used to evaluate the PV calculation accuracy, and the Wilcoxon Signed-Rank Test was used to assess statistical differences. A p-value < 0.05 was considered statistically significant.

Results
Conformal prediction significantly reduced RVD when compared to the DL algorithm (RVD = − 2.81 $$\pm$$
±
8.85 and RVD = −8.01 $$\pm$$
±
11.50). $${{{\rm{PV}}}}_{{CP}}$$

PV

C
P

showed a significantly larger agreement than $${{{\rm{PV}}}}_{{DL}}$$

PV

D
L

when using the reference standard $${{{\rm{PV}}}}_{{ref}}$$

PV

r
e
f

(mean difference (95% limits of agreement) $${{{\rm{PV}}}}_{{CP}}$$

PV

C
P

: 1.27 mL (− 13.64; 16.17 mL) $${{{\rm{PV}}}}_{{DL}}$$

PV

D
L

: 6.07 mL (− 14.29; 26.42 mL)), with an excellent ICC ($${{{\rm{PV}}}}_{{CP}}$$

PV

C
P

: 0.97 (95% CI: 0.97 to 0.98)).

Conclusion
Uncertainty quantification through CP increases the accuracy and reliability of DL-based PV assessment in patients at risk of PC.

Critical relevance statement
Conformal prediction can flag uncertain pixel predictions of DL-based prostate MRI segmentation at a desired confidence level, increasing the reliability and safety of prostate volume assessment in patients at risk of prostate cancer.

Key Points

Conformal prediction can flag uncertain pixel predictions of prostate segmentations at a user-defined confidence level.

Deep learning with conformal prediction shows high accuracy in prostate volumetric assessment.

Agreement between automatic and ellipsoid-derived volume was significantly larger with conformal prediction.

Graphical Abstract
Post-traumatic intraosseous sheath development of the extensor carpi radials brevis tendon: a case report
Authors: Hinrichs Seela , Snellings Rich , Scholte Ryan 
Published: November 2024

Abstract
Background
Complications from closed treatment in children are rare but can include growth disturbances and deformities. This case report presents a unique, post-traumatic growth deformity in the distal radius, where the extensor carpi radialis brevis tendon developed an interosseous course.

Case presentation
A 49-year-old Caucasian male presented with chronic, dull pain in the radiodorsal aspect of the right wrist, worsened by weightbearing and terminal flexion and extension. The patient had a history of a distal radius fracture from a motor vehicle accident in adolescence, which was treated nonsurgically. Current X-rays showed a lucent process along the distal lateral radius without aggressive features. Magnetic resonance imaging revealed the extensor carpi radialis brevis tendon in an interosseous position within the distal dorsal lateral radius, with a longitudinal tear of the tendon. A noncontrast computed tomography scan confirmed a complete bone bridge along the tendon’s interosseous component, limiting potential surgical access. The patient, found to have a positive Antinuclear Antibody (ANA), was treated with prednisone and later with methotrexate and folic acid, which alleviated symptoms.

Conclusions
This case highlights a rare post-traumatic deformity following a distal radius fracture, where the extensor carpi radialis brevis tendon formed an intraosseous sheath. It underscores the importance of considering unique anatomical changes when planning surgical interventions. This is the first reported case of an interosseous tendon sheath development around a tendon postdistal radius fracture, expanding the spectrum of known complications.