bluuebunny/crossref_metadata_2025_split huggingface dataset:
Treatment of de novo Bone-Only Oligometastatic Breast Cancer
Authors: Fernandez Joseff Karl , Beith Jane , McNeil Catriona , Kumar Sanjeev , Tse Regina , Morarji Kavita , O’Connor Chelsie , Leow Boon Yang  Jerome , Gupta Karan , Harris Georgia , Hui Mun 
Published: November 2024

Abstract

Introduction
It is estimated that 10–25% of breast cancer patients have metastatic disease upon diagnosis with roughly 20% having limited metastatic sites. The optimal management of patients with de novo bone-only oligometastatic breast cancer (OMBC), particularly curative-intent approaches, continues to evolve given extremely limited evidence in survival outcomes with this strategy.
Methods
This was a single-center retrospective review of the survival outcomes and details of treatment of patients with de novo OMBC who received tri-modality treatment with systemic therapy (chemotherapy with or without endocrine treatment and/or HER2-directed therapy), surgery, and radiotherapy to local and metastatic site/s. Progression-free survival (PFS) was defined as the time from initiation of treatment (either surgery, or neoadjuvant systemic therapy) to date of clinical or radiologic progression.
Results
From January 2014-March 2024, we identified 10 women who fit the inclusion criteria. Seven had isolated bone metastasis, and none had more than 3 metastatic sites. The included cohort had a mean age of 44.2 years. Nine had hormone receptor-positive disease, and 5 were HER2-positive. All patients were discussed in a multidisciplinary meeting. Median PFS by Kaplan-Meier analysis was 40.2 months. Nine patients were still alive at the time of analysis, and 6 of them remain disease free with a median follow-up duration of 30.8 months.
Conclusion
Patients with de novo bone-only oligometastatic breast cancer seem to benefit from the standard curative-intent tri-modality approach with the addition of ablative radiation to metastatic sites. These patients have a long median PFS and can be rendered disease-free for many years.
New Insights into Human Dermal Microvasculature: A Study Based on Intravascular Perfusion and Immunofluorescence Staining
Authors: Rui Shu , Cao Zilong , Wang Yunzhang , Liu Liqiang 
Published: November 2024

Abstract

Skin microcirculation offers critical insights into systemic health and disease mechanisms. Despite this importance, specific characteristics and distribution patterns of dermal microarterioles and microvenules have been insufficiently explored. This study aimed to analyze their structural differences and distribution using an innovative intravascular dual perfusion technique combined with immunofluorescence staining to distinguish microvessel types within the dermis. Utilizing two post-mortem cadaver specimens, the study employed lead oxide-gelatin perfusion for microarterioles and latex for microvenules. Subsequent tissue sections underwent H&E and immunofluorescence staining, with CD31 used as a general vascular marker and MCT1 tested as a venule-specific marker. Analysis revealed significant structural differences between dermal layers: vessels in the deep dermis exhibited larger diameters and thicker walls than those in the superficial layer, while microvessel density was higher in the superficial dermis. These findings demonstrate distinct patterns and significant differences in microvessel distribution between the superficial and deep dermal layers, reflecting the layer-specific functional demands. Moreover, MCT1 was identified as a marker for microvenules and introduced a novel approach using immunofluorescent staining with CD31 and MCT1 to distinguish between dermal microarterioles and microvenules. These results offering implications for surgical planning, skin grafting, and diagnostics in microcirculation-related conditions.
Correlation of circulating T lymphocytes with response to neoadjuvant chemoimmunotherapy in operable esophageal squamous cell carcinoma
Authors: Li Kunzhi , Wang Kangning , Huang Yixuan , Yang Mu , Wei Xing , Han Yongtao , Miao Yan , Fang Qiang 
Published: November 2024

Abstract

Purpose: This study aimed to investigate the correlation of the circulating T lymphocytes with response to neoadjuvant chemotherapy combined immune-oncology therapy (neoCTIO) in operable esophageal squamous cell carcinoma (ESCC) and explore the predictive markers.
Methods: ESCC patients staged cT2N1-2M0 or cT3-4aN0-2M0 were enrolled. All patients received two cycles of neoCTIO of each 21-day cycle. Minimally invasive esophagectomy (MIE) was performed 4-8 weeks after neoCTIO. Peripheral blood lymphocytes subsets and effector cytokines were detected before and after neoCTIO by using flow cytometry. The primary endpoints were the advanced change of subsets, effector cytokines in T lymphocytes, and pathological complete response (pCR). The secondary endpoints included major pathological response (MPR).
Results: A total of 33 patients with ESCC were enrolled. 96.7% (32/33) received MIE with R0 resection and 10 (10/32, 31.3%) achieved MPR, including 6 (6/32, 18.8%) patients with pCR. The ORR was 43.8% (14/32). The number of Effector Memory CD8+ T lymphocytes was elevated after neoadjuvant therapy (P = 0.002). In the responders, CD8+ T lymphocytes showed higher IFNγ and TNFα co-expression (P=0.010). Responders exhibited higher numbers of effector subsets (P = 0.029) and lower numbers of naive subsets (P = 0.006). No statistical difference was found in the cell frequency of CD4+T lymphocyte subsets between the responders and the non- responders.
Conclusion: The baseline numbers of effector subsets and co-expression of IFN-γ and TNF-α in circulating CD8+ T lymphocytes were positive predictors while the baseline frequency of naive subsets was a negative predictive marker of the response to therapy.
Huazhi Rougan Granule Alleviates Liver and Intestinal Damage in Non-Alcoholic Fatty Liver Disease by Regulating miR-122 Expression and TLR4/MyD88/NF-κB Pathway Activation
Authors: Xie Ping , Jin Xiaowei , Li Chan , Lv Kun , Deng Ming 
Published: November 2024

Purpose:
miR-122 is upregulated in non-alcoholic fatty liver disease (NAFLD) liver
tissue, and knockdown of miR-122 protects hepatocytes from lipid metabolism disorders. This
study aimed to investigate whether Huazhi Rougan Granule (HRG) alleviates NAFLD liver and
intestinal injury by regulating the miR-122-mediated TLR4/MyD88/NF-κB pathway.

Methods:
Rats with NAFLD were constructed by high-fat feeding. Serum levels of total cholesterol
(TC), triglycerides (TG), aspartate aminotransferase (AST), and alanine aminotransferase
(ALT) were measured using a fully automated biochemical instrument. Histopathological
changes in the liver and small intestine were observed by HE staining. QRT-PCR detected the
expression level of miR-122 in the liver tissues. The protein expression of TLR4, MyD88, NF-
κB p65, and p-p65 in liver tissues was detected by western blotting.

Results:
HRG slowed down the weight gain of NAFLD rats, decreased (P<0.05) the levels of
TC, TG, ALT, AST, TNF-α, IL-1β, IL-6, LPS, and Hpt, improved the pathological status of liver
and small intestine tissues, upregulated (P<0.05) the expression of ZO-1 and Occludin, downregulated
(P<0.05) the protein expression of TLR4, MyD88, and p-p65, and inhibited (P<0.05)
the expression of miR-122.

Conclusion:
HRG may alleviate hepatic and intestinal injuries in rats with NAFLD by regulating
the miR-122-mediated TLR4/MyD88/NF-κB pathway.

result:
HRG slowed down the weight gain of NAFLD rats, decreased the levels of TC, TG, ALT, AST, TNF-α, IL-1β, IL-6, LPS and Hpt, improved the pathological status of liver and small intestine tissues, up-regulated the expression of ZO-1 and Occludin, down-regulated the protein expression of TLR4, MyD88 and p-p65, and inhibited the expression of miR-122.
Performance of a Full-Coverage Cervical Cancer Screening Program Using on an Artificial Intelligence– and Cloud-Based Diagnostic System: Observational Study of an Ultralarge Population
Authors: Ji Lu , Yao Yifan , Yu Dandan , Chen Wen , Yin Shanshan , Fu Yun , Tang Shangfeng , Yao Lan 
Published: November 2024

Background
The World Health Organization has set a global strategy to eliminate cervical cancer, emphasizing the need for cervical cancer screening coverage to reach 70%. In response, China has developed an action plan to accelerate the elimination of cervical cancer, with Hubei province implementing China’s first provincial full-coverage screening program using an artificial intelligence (AI) and cloud-based diagnostic system.

Objective
This study aimed to evaluate the performance of AI technology in this full-coverage screening program. The evaluation indicators included accessibility, screening efficiency, diagnostic quality, and program cost.

Methods
Characteristics of 1,704,461 individuals screened from July 2022 to January 2023 were used to analyze accessibility and AI screening efficiency. A random sample of 220 individuals was used for external diagnostic quality control. The costs of different participating screening institutions were assessed.

Results
Cervical cancer screening services were extended to all administrative districts, especially in rural areas. Rural women had the highest participation rate at 67.54% (1,147,839/1,699,591). Approximately 1.7 million individuals were screened, achieving a cumulative coverage of 13.45% in about 6 months. Full-coverage programs could be achieved by AI technology in approximately 1 year, which was 87.5 times more efficient than the manual reading of slides. The sample compliance rate was as high as 99.1%, and compliance rates for positive, negative, and pathology biopsy reviews exceeded 96%. The cost of this program was CN ¥49 (the average exchange rate in 2022 is as follows: US $1=CN ¥6.7261) per person, with the primary screening institution and the third-party testing institute receiving CN ¥19 and ¥27, respectively.

Conclusions
AI-assisted diagnosis has proven to be accessible, efficient, reliable, and low cost, which could support the implementation of full-coverage screening programs, especially in areas with insufficient health resources. AI technology served as a crucial tool for rapidly and effectively increasing screening coverage, which would accelerate the achievement of the World Health Organization’s goals of eliminating cervical cancer.
A Mixed Reality–Based Telesupervised Ultrasound Education Platform on 5G Network Compared to Direct Supervision: Prospective Randomized Pilot Trial
Authors: Kim Minha , Son Meong Hi , Moon Suhyeon , Cha Won Chul , Jo Ik Joon , Yoon Hee 
Published: November 2024

Abstract

Background
Ultrasound education is transitioning from in-person training to remote methods using mixed reality (MR) and 5G networks. Previous studies are mainly experimental, lacking randomized controlled trials in direct training scenarios.

Objective
This study aimed to compare an MR-based telesupervised ultrasound education platform on private 5G networks with traditional in-person training for novice doctors.

Methods
Conducted at a tertiary academic hospital from November to December 2023, the prospective unblinded randomized controlled pilot study assigned doctors without prior abdominal ultrasound education experience to either the telesupervision group (TG; n=20) or direct supervision group (DG; n=20). Participants received a 15-minute video lecture, conducted ultrasound on a phantom, and had 18 images scored by 2 blinded experts. Additionally, the TG received 5 minutes of training on the basic operation of a head-mounted display. Communication between doctors in the TG and supervisors was facilitated through a head-mounted display, whereas those in the DG interacted directly with supervisors. Primary outcomes were image quality scores, while secondary outcomes included procedure time, number of supervisor interventions, user experience using National Aeronautics and Space Administration-Task Load Index (NASA-TLX), System Usability Scale (SUS), and self-confidence through pre- and postsurveys.

Results
Image quality scores and procedure times showed no significant differences between the groups (TG: 66.8 [SD 10.3] vs DG: 66.8 [SD 10.4], P=.84; TG: 23.8 [SD 8.0] min vs DG: 24.0 [SD 8.1] min, P=.95, respectively). However, the TG engaged in more educational interventions (TG: 4.0 [SD 2.5] vs DG: 0.8 [SD 1.1], P<.001), reflecting a more interactive training environment. TG participants reported lower NASA-TLX scores for mental demand (43.8 [SD 24.8] vs 60.6 [SD 22.4], P=.03), effort (43.1 [SD 22.9] vs 67.9 [SD 17], P<.001), and frustration (26.9 [SD 20.3] vs 45.2 [SD 27.8], P=.02), indicating a reduced cognitive load compared to the DG. The mean SUS score was also higher in the TG (66.6 [SD 9.1] vs 60.2 [SD 10.4], P=.046), suggesting better usability. Both groups showed significant improvements in confidence, with the TG showing notably greater improvement in abdominal ultrasound proficiency (pre-education TG: 1.6 [SD 0.9] vs DG: 1.7 [SD 0.9], P=.73; post-education TG: 3.8 [SD 0.9] vs DG: 2.8 [SD 1.0], P=.006).

Conclusions
Although no significant differences in image quality scores were observed between groups, considerable differences in positive educational interactions, workload, and usability were evident. These findings emphasize the platform’s potential to enhance the ultrasound training experience, suggesting more interactive and efficient learning.
Comparative Evaluation of Consumer Wearable Devices for Atrial Fibrillation Detection: Validation Study
Authors: Wouters Femke , Gruwez Henri , Smeets Christophe , Pijalovic Anessa , Wilms Wouter , Vranken Julie , Pieters Zoë , Van Herendael Hugo , Nuyens Dieter , Rivero-Ayerza Maximo , Vandervoort Pieter , Haemers Peter , Pison Laurent 
Published: November 2024

Abstract

Background
Consumer-oriented wearable devices (CWDs) such as smartphones and smartwatches have gained prominence for their ability to detect atrial fibrillation (AF) through proprietary algorithms using electrocardiography or photoplethysmography (PPG)–based digital recordings. Despite numerous individual validation studies, a direct comparison of interdevice performance is lacking.

Objective
This study aimed to evaluate and compare the ability of CWDs to distinguish between sinus rhythm and AF.

Methods
Patients exhibiting sinus rhythm or AF were enrolled through a cardiology outpatient clinic. The participants were instructed to perform heart rhythm measurements using a handheld 6-lead electrocardiogram (ECG) device (KardiaMobile 6L), a smartwatch-derived single-lead ECG (Apple Watch), and two PPG-based smartphone apps (FibriCheck and Preventicus) in a random sequence, with simultaneous 12-lead reference ECG as the gold standard.

Results
A total of 122 participants were included in the study: median age 69 (IQR 61-77) years, 63.9% (n=78) men, 25% (n=30) with AF, 9.8% (n=12) without prior smartphone experience, and 73% (n=89) without experience in using a smartwatch. The sensitivity to detect AF was 100% for all devices. The specificity to detect sinus rhythm was 96.4% (95% CI 89.5%-98.8%) for KardiaMobile 6L, 97.8% (95% CI 91.6%‐99.5%) for Apple Watch, 98.9% (95% CI 92.5%‐99.8%) for FibriCheck, and 97.8% (95% CI 91.5%‐99.4%) for Preventicus (P=.50). Insufficient quality measurements were observed in 10.7% (95% CI 6.3%-17.5%) of cases for both KardiaMobile 6L and Apple Watch, 7.4% (95% CI 3.9%‐13.6%) for FibriCheck, and 14.8% (95% CI 9.5%‐22.2%) for Preventicus (P=.21). Participants preferred Apple Watch over the other devices to monitor their heart rhythm.

Conclusions
In this study population, the discrimination between sinus rhythm and AF using CWDs based on ECG or PPG was highly accurate, with no significant variations in performance across the examined devices.
Employers Perspectives of Caregiver-Friendly Workplace Policy for Caregiver-Employees' Caring for Older Adults in Hong Kong (Preprint)
Authors: Lee Maggie Man-sin , Yeoh Eng-Kiong , Wong Eliza Lai-Yi 
Published: November 2024

BACKGROUND

Hong Kong is experiencing a rapidly ageing population, s0 caregiver- employees in the workplace are not uncommon. However, awareness of such employees is low and caregiver-specific workplace policies are generally unknown. This study is the first in the literature to attempt to capture employers' perspectives on such policies and also their needs in future implementation.

OBJECTIVE

The objectives of this study are to identify the support currently provided or could be provided to Caregiver-Employees (CEs) caring for older adults in Hong Kong and the challenges and facilitative support for employers to adopt Caregiver-Friendly Workplace Policies (CFWP) in the specific context of Hong Kong.

METHODS

A qualitative research design with semi-structured individual in-depth interviews with seventeen employers from private, public, and non-governmental organization sectors in Hong Kong was adopted for this study. Thematic framework analysis was used to evaluate the data collected during the interviews.

RESULTS

Seventeen employers and managers comprising four males (24%) and 13 females (76%) from eight major industries in Hong Kong were interviewed. Four main themes were identified: (1) current support and potential support for CEs, (2) challenges in adopting CFWP, (3) facilitating support for adopting CFWP, and (4) incentives for adopting CFWP. The informants rated information and resources for CEs, bereavement leave, flexible working hours, and caregiver-inclusive corporate culture as the essential CFWP for CEs in Hong Kong.

CONCLUSIONS

While several studies have reported the types of CFWP and their impact on CEs, stakeholders' perspectives on CFWPs are rarely investigated. This study finds that although employers consider CFWP necessary and see it as a catalyst for a long-term win-win situation, the current support for CEs is discretionary and industry-specific. Government leadership is critical for formulating, piloting, and implementing CFWP to create a friendly environment that encourages disclosure with trust and respect across industry sectors in Hong Kong.
Derechos Humanos y estándares de investigación: una mirada desde la intervención de las comunicaciones en el proceso penal cubano.
Authors: González Rodríguez Yenisey 
Published: November 2024

The purpose of the article is to argue, from a look at the human rights of privacy and the secrecy of communications, the significance of the principles of legality, proportionality and strict necessity, as investigative standards, which inform the intervention of communications in the Cuban criminal process and the role that the Prosecutor plays in this to guarantee the legality of such investigative acts, based on the challenges imposed by Law 143 of 2021 “On criminal proceedings”. It is posed as a research problem: what are the research standards on which the interventions of communications in the Cuban criminal process must be based, which guarantee the exercise of the rights of privacy and the secrecy of communications? As a hypothesis, the existence of investigative standards in the interventions of communications in the Cuban criminal process is stated, which would guarantee the exercise of the rights of privacy and the secrecy of communications. The research methods of analysis-synthesis, historical-legal and exegetical analysis were used, as well as document review, which allowed us to offer final considerations on the topic.
Electron source model responsible for low power beam losses of 1 W/m along the entire PolFEL superconducting electron linear accelerator
Authors: Wasilewski Adam 
Published: November 2024

Abstract
The National Centre for Nuclear Research is planning to build a facility based on a free-electron laser (FEL) photon source. It is the first center to build this kind of facility in Eastern Europe. The laser radiation source relies on a superconducting linear electron accelerator. Ultimately, electrons are to be accelerated to energies of 72 MeV, 187 MeV and 280 MeV. To safely operate such kind of accelerator, the design of a shielding bunker is required, capable of attenuating the secondary radiation generated by electrons lost from the beam. This paper proposes a model for the energy and spatial distribution of such electrons. The proposed model will be used in subsequent calculations of the distribution of secondary radiation emitted by both the beamline and some devices essential for the operation of the PolFEL accelerator, such as superconducting niobium accelerating cavities, titanium liquid helium tanks filled with liquid helium, surrounded by μ-metal steel cryomodules containing a steel tube filled with liquid nitrogen, mirrors reflecting the resulting laser beams based on copper blocks, and electron beam deflecting electromagnets made of iron and copper. It was calculated that to reproduce a complex beam loss of 1 W/m, the total lost electron flux as a source of secondary radiation should be 1.7991 × 1013 e/s for 72 MeV, 1.1537 × 1013 e/s for 187 MeV and 1.1012 × 1013 e/s for 280 MeV. Preliminary Monte Carlo calculations of the designed source were performed, obtaining the energy and spatial distributions of the lost electrons.
New chamber stapes prosthesis: Effect of ionizing radiation on material and functional properties
Authors: Kwacz Monika , Sadło Jarosław , Walo Marta 
Published: November 2024

Abstract
New chamber stapes prosthesis (ChSP) is a middle-ear prosthesis intended for use in ear surgery for restoring the patient's middle ear function. As the prosthesis is an implantable medical device, it must be sterilized before use. However, possible alterations in the material and the functional properties following the sterilization process can influence the safety aspects while using the prosthesis. The purpose of this paper was to determine the effects of ionizing radiation (IR) on the physicochemical and biological properties of the new chamber prosthesis by utilizing EPR spectroscopy, mechanical testing, and cytotoxicity studies. Our research shows that the radiation treatment increases the hardness and the elastic modulus of the polymer, decreases the stiffness of the prosthesis membrane, and does not cause chemical changes in the polymers that may result in cytotoxicity. Furthermore, new ChSPs were successfully tested in preclinical in vitro tests. The test results justify the undertaking of further work, including in vivo biocompatibility tests and clinical trials, which would eventually lead to the increased use of the prosthesis in clinical practice.