bluuebunny/crossref_metadata_2025_split huggingface dataset:
Endoscope-assisted trigeminal schwannoma resection without extensive skull-base drilling
Authors: Berker Berk Burak , Güngör Abuzer , Doğruel Yücel , Rahmanov Serdar , Türe Hatice , Türe Ugur 
Published: December 2024

Abstract

OBJECTIVE
The objective of this study was to demonstrate that trigeminal schwannomas located in different cranial fossae can be resected entirely through Meckel’s cave without extensive skull-base drilling by taking either an endoscope-assisted pterional epidural approach (EA-PEA) or an endoscope-assisted lateral suboccipital retrosigmoid approach (EA-LSRA). Additionally, we describe a modified classification based on Jefferson’s system to determine the surgical approach.
METHODS
This is a retrospective study of 19 patients with trigeminal schwannomas in different cranial fossae who underwent EA-PEA or EA-LSRA .According to the proposed system, lesions in the middle fossa are classified as type A, those in the posterior fossa are type B, and lesions in both fossae are type C, the same as in Jefferson’s classification. Our modifications begin by classifying lesions extending into different fossae. Those located primarily in the middle cranial fossa are denoted type C1, whereas one predominantly occupying the posterior cranial fossa is type C2. Lesions with extracranial extensions are classified as type D. Patients with type A, type C1, and type D lesions underwent EA-PEA, while those with type B and C2 lesions were treated through EA-LSRA.
RESULTS
Thirteen patients (68.4%) underwent EA-PEA and 6 (31.6%) underwent EA-LSRA. Gross total resection was accomplished in 16 patients (84.2%). No surgery-related complications were observed.
CONCLUSION
Our study demonstrates that EA-PEA and EA-LSRA can lead to gross total resection in patients with complex trigeminal schwannomas. Endoscope assistance helps avoid the extensive skull-base approaches. The proposed classification system is a guide for determining the surgical approach.
TNFRSF18+ Tregs Impair Immunotherapy Efficacy in Immunosuppressed Colon Cancer Patients
Authors: Dai Kangfu , Lin，MM Songbin , Wang Jianping , Chen Lin , Jin Zhekang 
Published: December 2024

Abstract

Immunotherapy shows limited effectiveness in immunosuppressed colon cancer (CC), highlighting the need for a reliable biomarker to identify eligible patients. In this study, we characterized patient immunophenotypes as Immunity-High and Immunity-Low using ssGSEA scores from the TCGA-COAD database, revealing high expression of survival-inhibiting markers in the Immunity-Low group. Single-cell analysis localized these markers, which were validated through immunofluorescence and survival analyses in an immunotherapy cohort. Our findings indicate that the immunophenotype effectively differentiates patient groups with distinct immune cell infiltration patterns and significant survival differences (p = 0.038). Notably, elevated TNFRSF18 expression in the Immunity-Low group was linked to poorer prognosis (p = 0.030), with predominant expression found in Tregs. Increased TNFRSF18+ Treg infiltration correlated with shorter disease-free and overall survival post-immunotherapy (p = 0.041 and p = 0.007, respectively). Additionally, TNFRSF18-low organoids were responsive to anti-PD-1 treatment, unlike TNFRSF18-high organoids. This study is the first to identify TNFRSF18+ Tregs as prognostic markers and predictors of immunotherapy response in immunosuppressed CC, suggesting that TNFRSF18 agonists could enhance anti-PD-1 therapy in these patients.
Anterosuperior Mediastinal Paraganglioma in a 42-Year-Old Woman: A Diagnostic and Therapeutic Challenge - A Case Report
Authors: Wang Zheng , Zong Wenkang , Liang Shuo , Zhou Fang , Lu Xike , Sun Daqiang 
Published: December 2024

Abstract

Background: Paragangliomas are rare neuroendocrine tumors predominantly located within the adrenal gland. Extra-adrenal paragangliomas, particularly those in the anterosuperior mediastinum, are exceedingly rare and pose significant diagnostic and therapeutic challenges due to their complex anatomical location.
Case Description: A 42-year-old woman was found to have an anterosuperior mediastinal mass during a routine health screening. Enhanced chest computed tomography (CT) revealed an ovoid, low-density mass intricately associated with major vascular structures including the superior vena cava, brachiocephalic trunk, left common carotid artery, aortic arch, right anonymous vein, and right subclavian artery. Despite significant intraoperative blood loss of 2000 ml, the mass was successfully excised with meticulous surgical technique and effective hemostasis. Histopathological examination showed a classic Zellballen pattern with chief cells and sustentacular cells embedded in a vascular-rich stroma. Immunohistochemistry confirmed the tumor’s chromaffin nature, with chief cells testing positive for CD56, Synaptophysin, and Chromogranin A, and sustentacular cells positive for S100 protein, consistent with a diagnosis of paraganglioma. The patient’s postoperative recovery was uneventful, and she was discharged one week after surgery.
Conclusions: This case highlights the essential role of comprehensive preoperative imaging and the necessity for interdisciplinary surgical expertise in managing complex mediastinal paragangliomas. Advanced surgical techniques and careful intraoperative management are paramount to achieving successful outcomes. Appropriate imaging modalities and auxiliary laboratory tests are crucial for early detection of recurrences in these rare tumors.
Clinical Efficacy and Diagnostic Value of Metagenomic Next-Generation Sequencing (mNGS) in Hospital-Acquired Pneumonia: A Stratified Retrospective Study of Responders and Non- Responders
Authors: Zhang Bin , Wang Jianjun , Li Qing , Ge Jingyi , Zhang Chenxi , Zhou Ting , Guo Haiming , Yang Bo , Jiang Hongying 
Published: December 2024

Abstract

Background:Hospital-acquired pneumonia (HAP) presents significant diagnostic challenges, exacerbated by the limitations of traditional culture-based methods. This study evaluates the clinical efficacy and diagnostic value of metagenomic next-generation sequencing (mNGS) in the detection of pathogens in HAP patients, providing new insights into infection prevention and control in healthcare settings.
Methods: We conducted a retrospective analysis of clinical and laboratory data from 300 adult HAP patients at Beijing Rehabilitation Hospital, China. Bronchoalveolar lavage fluid samples were collected for DNA extraction, library construction, and sequencing using the Illumina platform.
Results: The results revealed that mNGS identified pathogens in 92% of the samples, compared to 72% by traditional cultures. Specifically, mNGS detected a broader range of bacteria, viruses, and fungi, including Pseudomonas, Klebsiella, and Aspergillus, which were often missed by traditional methods. mNGS identified polymicrobial infections in 28% of the cases and antibiotic resistance genes in 30% of the samples where traditional methods failed. These findings led to changes in treatment for 26% of the patients based solely on mNGS data, with specific treatment adjustments driven by the detection of rare or resistant pathogens in 18% of these cases.
Conclusions: Our findings advocate for the integration of mNGS in routine clinical practice to enhance diagnostic accuracy and enable more informed decision-making in the management of HAP. Despite its higher cost and technical requirements, mNGS holds promise for more accurate and timely diagnostics in complex infection cases.
Language Concordance and Interpreter Use in Primary Care: Perspectives from Spanish-preferring Patients
Authors: Predmore Zachary , Qureshi Nabeel , Slaughter Mary E. , Walsh Shannon , Diaz Yareliz , Talamantes Efrain , Curiel Yesenia , Garcia Rosa Elena , Quigley Denise D. 
Published: December 2024

Abstract

Background. Healthcare provided by bilingual providers or with assistance from qualified interpreters is intended to improve patient-provider communication. Despite federal laws requiring healthcare facilities to provide access to appropriate interpretation language assistance services for patients not proficient in English, many Spanish-preferring patients receive primary care from providers not fluent in Spanish or who regularly use formal interpreters.
Methods. Partnering with two urban SafetyNet providers in Southern California, we conducted focus groups in Spanish with Spanish-preferring patients who received care from providers who: 1) were Spanish-qualified, 2) used formal interpreters, and 3) used informal interpreters or other communication strategies. We coded transcripts to identify themes and compared patient experiences across provider types.
Subjects. 62 adult Spanish-preferring primary care patients.
Results. Spanish-preferring patients reported preference for continuity with their English-speaking providers despite language barriers because of established rapport. Patients receiving care from Spanish-qualified providers reported greater trust, more comprehensive care (i.e., covered more issues with minimal detail), yet with many interactions rushed. Formal interpreters facilitated better understanding and professional communication, however, impersonalized patient-provider interactions. Informal interpreters or ad-hoc strategies led to mixed experiences, often dependent on patient or provider ability to accurately convey medical information.
Conclusion. Spanish-preferring patient experiences highlighted the necessity for healthcare systems to support robust language and interpretation services that enhance direct communication, ensure interpreter quality, and maintain long-term patient-provider relationships. Improvements in policy and practice are needed to optimize healthcare communication for Spanish-preferring patients, since patient-provider communication is critical for high-quality health outcomes and experiences in multilingual settings.
The Role of the Insulin Resistance Marker TyG-WHtR in Chronic Diarrhea: Evidence from NHANES 2005--2010
Authors: Qiao Xiyun , Hu Jiayan , Wang Yuxi , Lv Mi , Wang Xiaokang , Liu Xin , Wang Yang , Wang Fengyun 
Published: December 2024

Abstract

Background
Research has revealed a link between metabolic conditions and the occurrence of diarrhea. Nevertheless, the association between insulin resistance (IR) and persistent diarrhea is still unclear. This study was conducted to determine whether the triglyceride glucose‒waist height ratio (TyG‒WHtR), an innovative measure for evaluating IR, might be involved in the occurrence of diarrhea.
Methods
This research used health and illness data sourced from the National Health and Nutrition Examination Survey (NHANES). We employed a range of statistical methods to evaluate the association between TyG-WHtR and chronic diarrhea. Initially, we conducted a preliminary test via multifactor regression. We subsequently confirmed the association by analyzing various subgroups and ultimately utilized smooth curve fitting to visualize the relationship.
Results
This research included 5,989 participants, of whom 7.4% had chronic diarrhea. According to the fully adjusted models, the TyG-WHtR was positively associated with chronic diarrhea (OR > 1, 95% CI > 1, P < 0.05). Additionally, the RCS further demonstrated a positive linear relationship between the two research variables. (P overall = 0.003, P nonlinear > 0.05).
Conclusions
The TyG-WHtR is positively correlated with chronic diarrhea, and this relationship is linear and relatively stable. In the future, it is essential to verify causal links through prospective research and clarify the underlying mechanisms.
Environmental Regulations and BRICS Export Flows: An Empirical Test of the Porter Hypothesis
Authors: Wahab Bashir Adelowo Adelowo 
Published: December 2024

Abstract

While Governments around the world have taken a proactive response by implementing environmental regulations to cut emissions and make production more environmentally friendly, there is a growing debate that stringent environmental regulations may have both inhibiting and promoting effects on trade flows. On this basis, this study examines the impact of environmental regulations on intra- and extra-BRICS export flows and tests the validity of the Porter hypothesis for the Bloc. Within the framework of the gravity model, this study utilizes a comprehensive panel dataset on the five BRICS countries for intra-BRICS trade analysis and 15 trading partners for extra-BRICS trade analysis at the bilateral level. Three categories of bilateral exports (‘aggregate’, ‘dirty’, and ‘footloose’ exports) were analyzed for the period 2010–2021. The study employs appropriate methodological approaches and alternative measures of environmental regulations to ensure the robustness of the findings. Specifically, the fixed and random effect model estimators were used for intra-BRICS trade flows analysis to address the heterogeneity and endogeneity issues, while the one-step system GMM (SGMM) was employed for extra-BRICS trade flows analysis to address the endogeneity and simultaneity issues and ensure the validity and reliability of the analysis conducted and the results. Using the environmental policy stringency (EPS) index, the results show that environmental policy standards in the exporting countries have a promoting effect, while those in the importing countries have an inhibiting effect on intra-BRICS aggregate exports and its components (dirty and footloose exports). Further, the promoting effect of environmental standards in the exporting countries is lower relative to the inhibiting effect of those in the importing countries. This implies that the Porter hypothesis for intra-BRICS export flows is invalid if the diverse effects of environmental regulations in both exporting and importing countries on exports are taken into consideration. For extra-BRICS export analysis, the Porter hypothesis is valid. With these findings, this study provides a robust understanding of the complex relationship between environmental regulations and international trade dynamics. Policy recommendations are provided in the conclusion section.
A Regional Measurement of China's Processing Trade from the Perspective of Vertical Specialization: 2012-2017
Authors: Ren Jia 
Published: December 2024

Abstract

Since the 2010s, the proportion of processing trade in total trade in China has declined year by year. Meanwhile, given the different stages of economic development across regions in China, the situation of processing trade might vary by region. This paper analyzes the realities of processing trade in different regions of China based on the regional input-output tables of 28 provinces, cities, and autonomous regions, measuring the Vertical Specialization (VS) index. The analysis reveals that the VS index levels in the eastern regions are higher compared to the central and western regions. From 2012 to 2017, the VS index in the eastern regions showed a declining trend, while in the central and western regions, many areas experienced an increase. Secondly, decreasing reliance on import inputs from processing exports was observed in the results of a newly proposed indicator. At last, the analysis of the VS index and per capita GDP shows that although the VS index rises with increases in per capita GDP, once per capita GDP surpasses a certain level, the VS index may shift from increasing to decreasing.
Industrial Energy Consumption and Carbon Emission Decoupling Study and Driving Factor Analysis: A Case Study of Sichuan Province, China
Authors: Lv Yuanyuan , Tang Weiguo , Ding Yi 
Published: December 2024

Abstract

Background
The carbon emission of industrial energy consumption has an important impact on a region's carbon emission reduction and optimization of carbon emission path. Based on the STIRPAT model and the TAPIO decoupling model, this study analyzes the driving factors and decoupling relationship between carbon emissions from industrial energy consumption and economic growth in Sichuan Province.
Results
(1) The industrial carbon emissions in Sichuan Province are increasing first and then decreasing, with an increase of 18.78% from 2005 to 2022, and the carbon emission intensity has decreased from 1.94 tons/10,000 yuan to 0.29 tons/10,000 yuan; (2) The decoupling relationship between industrial carbon emissions and economic growth in Sichuan Province presents three development periods, mainly strong decoupling and weak decoupling. According to the decomposition factors, the decoupling relationship between industrial carbon emissions and economic development is mainly affected by the decoupling coefficient of value creation and emission reduction; (3) The proportion of secondary industry, the number of industrial enterprises, and the total industrial assets are the main carbon promoting factors of industrial carbon emission in Sichuan Province, with elastic coefficients of 0.097, 0.057 and 0.040 respectively; population size is a carbon reduction factor with an elastic coefficient of -0.087.
Conclusions
(1) The overall carbon emissions from industrial consumption in Sichuan Province have shown an upward trend followed by a downward trend. From 2005 to 2022, industrial energy consumption mainly consisted of coal, oil, and natural gas, with energy consumption showing a downward trend; (2) The carbon emissions from industrial energy consumption and economic development in Sichuan Province from 2006 to 2022 are mainly in a state of strong decoupling and weak decoupling, showing three distinct development periods overall; (3) Among the driving factors of carbon emissions from industrial energy consumption in Sichuan Province, the proportion of the secondary industry, the number of industrial enterprises, and the total industrial assets are the main carbon promoting factors, with elasticity coefficients of 0.097, 0.057, and 0.040, respectively. The proportion of the secondary industry has the greatest impact factor. Based on this, the paper proposes to create a new green and low-carbon industrial model with low energy consumption, low pollution, and low emissions characteristics, enhance economic resilience, improve economic development resilience, formulate a reasonable development scale that coordinates industrial development with environmental protection, and steadily promote policy recommendations for energy conservation and emission reduction.
Comparison of Surgical Approaches to the Hippocampal Formation with Artificial Intelligence
Authors: Dundar Tolga Turan , Pehlivanoglu Meltem Kurt , Eker Ayse Gul , Albayrak Nur Banu , Mutluer Ahmet Serdar , Yurtsever Ismail , Dogan Ihsan , Duru Nevcihan , Ture Ugur 
Published: December 2024

Abstract

Objective
The relatively complex functional anatomy of the mediobasal temporal region is what makes surgical approaches to this area challenging. Various approaches, along with their combinations and modifications, have been described in the literature. Some of these surgical approaches have been compared using artificial intelligence-based approaches that can be predicted, classified, and analyzed for complex data.
Methods
Several approaches were selected for comparison: anterior transsylvian, trans-superior temporal sulcus, trans-middle temporal gyrus, subtemporal–transparahippocampal, presigmoid-retrolabyrinthine, supratentorial-infraoccipital, and paramedian supracerebellar-transtentorial. Magnetic resonance images were taken according to the criteria specified by the department of radiology. With an open-source software tool, volumetric data from cranial magnetic resonance images were segmented, and anatomical structures in the main regions were reconstructed. The Q-learning algorithm was used to find pathways similar to these standard surgical pathways.
Results
The Q-learning scores among the selected pathways are as follows: anterior transsylvian (Q_A) = 31.01, trans-superior temporal sulcus (Q_B) = 25.00, trans-middle temporal gyrus (Q_C) = 28.92, subtemporal-transparahippocampal (Q_D) = 23.51, presigmoid- retrolabyrinthine (Q_E) = 27.54, supratentorial-infraoccipital (Q_F) = 27.2, and paramedian supracerebellar-transtentorial (Q _G) = 21.04. The Q-value score for the supracerebellar transtentorial approach was the highest among the examined approaches and therefore optimal. A difference was also found between the total risk score of all points with pathways drawn by clinicians and the total risk scores of the pathways formed and followed by Q-learning.
Conclusions
Artificial intelligence-based approaches may significantly contribute to the success of the surgical approaches examined. Furthermore, artificial intelligence can contribute to clinical outcomes in both preoperative surgical planning and intraoperative technical equipment-assisted neurosurgery. However, further studies with more detailed data are needed for more sensitive results.
Comparative Analysis of Deep Learning Models for Plant Disease Detection
Authors: T Bhageerathi , M Anagha , S Pushpa T 
Published: December 2024

Abstract

The detection of plant diseases through deep learning models repre- sents a significant advancement in agricultural management. This study pro- vides a comprehensive accuracy comparison of four prominent deep learning models—Convolutional Neural Networks (CNN), AlexNet, DenseNet, and VGG16—for identifying plant diseases from leaf images. Leveraging the PlantVillage dataset, which includes over 11,254 images of healthy and dis- eased leaves, the research investigates the strengths and limitations of each model in terms of accuracy, feature extraction, and classification performance. DenseNet's densely connected architecture and VGG16's deep layers are high- lighted for their superior ability to handle complex patterns in diseased leaves. The study demonstrates that DenseNet achieves the highest accuracy, making it a viable solution for real-time disease detection in precision agriculture. By comparing these models, the research aims to guide the selection of the most effective deep learning approach for improving plant health monitoring.
A Meta-Analysis of Reading Interventions for Students with Emotional/Behavioral Disorders
Authors: Chitiyo Argnue , Sciuchetti Maria , Finch Holmes W , Dzenga Goodson 
Published: December 2024

Abstract

Students identified with Emotional/Behavioral Disorders (EBD) often exhibit behavioral challenges that negatively affect their academic performance. One of their weaker areas of academic achievement lies in reading. Although numerous research on interventions to improve their reading outcomes has been conducted, some students continue to lag behind. The use of instructional practices not supported by strong empirical evidence may deter students’ reading outcomes from improving. To address the reading performance gap, educators are encouraged to use evidence-based practices (EBP) supported by strong empirical research. Meta analyses play an important role in identifying and disseminating EBP. This meta-analysis evaluated reading intervention studies (n = 27) for students with emotional and behavioral disorders (EBD) using the Between Case Hedges’ g effect size. A random effects meta-analysis of 27 studies indicated that, overall, reading interventions increased reading outcomes of students with EBD by a large margin [g = .747, SE = .102, CI (0.547, 0.947), p < .05]. A meta-regression analysis consisting of six moderators resulted in statistically significant effects of study design, intervention agent, and type of dependent variable. Implications of study findings and suggestions for future research are discussed.