bluuebunny/crossref_metadata_2025_split huggingface dataset:
Multi-omics-based prognostic prediction for locally advanced hypopharyngeal cancer treated with surgery and postoperative chemoradiotherapy: a dual-center study
Authors: Dong Sixue , Yao Zian , Zhang Zhiyuan , Wang Jiazhou , Ying Guo , Tao Lei , Ou Xiaomin , Hu Weigang , Hu Chaosu 
Published: November 2024

Abstract

Purpose
This study aimed to predict the progression-free survival (PFS) of the patients who were diagnosed with hypopharyngeal cancer and received postoperative chemoradiotherapy by using multi-omics method which integrating clinical factors, dosimetric and radiomic features.
Materials and methods
This study retrospectively collected the pretreatment T1-weighted MR imaging data of 88 hypopharyngeal cancer patients with postoperative chemoradiotherapy, including 56 cases from one center (training and testing cohorts) and 32 cases from another center (external validation cohort), and the gross tumor volumes (GTV) were countered for all cases. A Python-based library, pyradiomics was used to extract the radiomics features from each GTV. Least absolute shrinkage and selection operator (LASSO) regression was used to identify the most important features for classifier establishment. On the other hand, complete radiotherapy data are retained for 48 patients among them, and the planning tumor volumes (PTV) were countered for radiotherapy planning. The dose distribution features extracted by using pyradiomics and the dosimetric parameters were combined with the radiomics features to establish the classifiers. The probabilities of positive sample calculated from the best classifier, the radiomics and multi-omics signatures were obtained for establish the Cox proportional hazards models.
Results
The ensemble learning (EL) model was selected as the superior model with the higher area under the receiver operating characteristic curve (AUC) values than other classifier during the radiomics-only analysis, and the EL model with stacking technique showed the best performance, yielding AUC values of 0.93, 0.79, and 0.78 for the training, testing, and external validation cohorts, respectively. Furthermore, the multi-omics analysis integrating radiomics and dosiomics improved the effectiveness of the EL model with AUC values of 0.98 and 0.88 for the training and testing cohorts, respectively. Furthermore, the C-index of the Cox proportional hazards models resulted in a 0.099 improvement in the testing cohort when employing the multi-omics signature versus the radiomics signature.
Conclusion
Regarding the patients with hypopharyngeal cancer receiving postoperative chemoradiotherapy, the multi-omics-based prognostic prediction could achieve a more robust predictive capability than the radiomics-only study. This approach warrants further validation through prospective studies.
Comparing Pixel-and Object-Based Approaches for Classifying Benthic Habitats
Authors: Simmons Henry O. J. , Dalby Oli , Ierodiaconou Daniel , Young Mary A. 
Published: November 2024

Abstract

Context
Benthic habitat mapping is crucial for effective marine spatial planning. Despite advancements in multibeam echosounder (MBES) technology, selecting appropriate classification methods to accurately map seafloor habitats remains a challenge.
Objectives
This study aims to provide novel comparisons of large spatial scale habitat classifications using pixel-based (PB) and object-based image analysis (OBIA) methods, applied within a hierarchical random forest framework, to classify benthic biotopes in the northern section of Apollo Marine Park and the adjacent Cape Otway coastline, Victoria, Australia.
Methods
We utilised high-resolution MBES-derived data, implementing a hierarchical random forests algorithm to classify benthic habitats. The PB method treated each pixel independently, allowing for high spatial detail, while the OBIA method grouped pixels into meaningful segments for classification. Prior to segmentation, backscatter data from two different MBES systems were harmonised using a bulk shift method (Misiuk et al., 2020) to ensure consistency across datasets. We then applied the Supercells segmentation technique (Nowosad 2022) to the harmonised backscatter data, forming the foundation for the OBIA-based classification. Both methods were evaluated using accuracy, F1 scores, and uncertainty maps were generated to assess classification reliability.
Results
Both classification methods demonstrated strong performance, with no statistically significant differences in overall accuracy. However, the complexity of the habitat maps varied: the PB approach excelled in capturing fine-scale habitat details, beneficial for management and conservation efforts requiring high detail. Conversely, the OBIA method produced more interpretable and less complex maps, suitable for general spatial analyses, though it resulted in the omission of some minority classes.
Conclusion
This study emphasises the importance of defining the desired level of complexity in habitat maps before analysis, ensuring that chosen methods yield maps suitable for specific applications—particularly in datasets with strong class imbalances. Future advancements in machine learning and emerging technologies have the potential to further refine habitat mapping techniques and enhance classification accuracy.
A National Cross-Sectional Study on the Prevalence of Burnout in Filipino Neurosurgery Residents
Authors: Mercado Charlene Mary , Torres Genevieve Mae , Sih Ibet Marie 
Published: November 2024

Abstract

INTRODUCTION: Burnout is an occupational hazard affecting service-oriented professionals, including healthcare workers. Physicians experiencing burnout are at risk of suboptimal performance which negatively impacts patient care. Neurosurgery residents are particularly vulnerable to burnout, as the work demands are high and control over working conditions are low. This study is the first in the country to determine the prevalence of burnout in this population.
METHODS: We surveyed 77 Filipino neurosurgery residents. The Maslach Burnout Inventory (MBI-HSS) was filled out by the respondents. The questionnaire included demographic data. Bivariate analysis among the variables were done using analysis of variance.
RESULTS: Fifty-six residents (72.3%) responded to our survey. Thirty residents (53.6%) are experiencing burnout in at least one dimension. There was no significant difference in mean burnout scores across institution type, sex, year level and number of on-duty days per week. Residents younger than 30 years had lower PA scores compared to those aged 35 and above (p=0.041). Married residents had higher PA scores compared to single residents (p=0.019).
CONCLUSION: The overall prevalence of burnout in Filipino neurosurgery residents is 53.6% (95% CI 40.8 to 65.98%). Training programs should strengthen mentorship programs and conduct a regular assessment of burnout in residents to facilitate timely intervention and improve the working conditions for the next generation of Filipino neurosurgeons.
Bilateral Choroidal Folds in Thyroid-Associated Ophthalmopathy Without Compressive Optic Neuropathy: A Case Report
Authors: Lin Xintong , Shu Wenjun , Chen Haifeng , Gan Lu , Zhang Rong , Xu Binbin , Li Xiaofeng , Yue Han , Guo Jie , Qian Jiang , Xue Kang , Ma Ruiqi 
Published: November 2024

Abstract

Background
This case presents a rare form of thyroid-associated ophthalmopathy with idiopathic choroidal folds, unlinked to optic neuropathy—an unusual finding in thyroid-related eye disease. Instead, bilateral nuclear cataracts and lens dislocation were identified as the primary causes of vision loss, emphasizing the importance of considering multiple, less common contributors in such cases. The decision to begin with cataract surgery exemplifies a tailored, effective approach to multifactorial vision loss, offering insights for cases with overlapping ocular issues. Given recent associations between COVID-19 vaccination and ocular symptoms like choroidal folds and scleritis, posterior scleritis was considered a possible explanation. This underscores the need for further investigation into atypical presentations of thyroid-associated eye disease.
Case presentation:
A 54-year-old male developed bilateral vision loss and choroidal folds one year following COVID-19 vaccination. Initially diagnosed with thyroid-associated ophthalmopathy, he underwent an adequate course of steroid pulse therapy with no visual improvement. Further assessment revealed bilateral cataracts and lens dislocation. Computed tomography identified mild extraocular muscle thickening but no orbital apex crowding, ruling out compressive optic neuropathy. Lens surgery subsequently restored his vision and normalized his visual fields. However, two months postoperatively, he experienced recurrent blurred vision and restricted movement in the right eye. Magnetic resonance imaging confirmed extraocular muscle enlargement, leading to a diagnosis of compressive optic neuropathy, and tocilizumab therapy was initiated. Following treatment, the patient demonstrated improved vision, reduced muscle thickness, and enhanced motility.
Conclusions
This case suggests that initial choroidal folds may be due to a combination of vaccine-related side effects and elevated orbital pressure, underscoring the potential for COVID-19 vaccination to cause atypical ocular symptoms.
Clinical long-term oncologic outcomes of endoscopic noncurative resection for superficial esophageal squamous cell carcinoma: A single-center retrospective study
Authors: Yu Zipu , Shao Liming , Zhu Chunpeng 
Published: November 2024

Abstract

Background: The aim of this retrospective cohort study was to analyze clinical long-term oncologic outcomes for patients with endoscopic submucosal dissection (ESD) treatment for early squamous cell carcinoma of the esophagus (SCCE). The efficacy of adjuvant therapy including surgical resection, chemoradiotherapy (CRT), radiotherapy or chemotherapy after endoscopic noncurative resection of superficial esophageal squamous cell carcinoma (SESCC) was unknown.
Methods: Forty-three patients with SESCC who underwentendoscopic submucosal dissection (ESD) were consecutively enrolled in the retrospective cohort study. There were 40 patients whose follow-up time continued until May 2023 in study. The characters of primary tumors, tumor-related mortality, 5-year survival rate, tumor recurrence or metastasis were analyzed in post-ESD SESCC patients. The median follow-up time was 48 months (range, 8 to 64 months).
Results: During the cohort, the tumor size was 33±19.8 mm. The invasion depth was as followed: epithelial (62.7%, 27/43), lamina propria mucosa (16.3%, 7/43), muscularis mucosa (6.9%, 3/43) and submucosa (13.8%, 6/43). Nine patients with muscularis mucosa and submucosa invasion received additional treatments. 2 patients experienced esophagectomy, 1 patient underwent CRT, 4 patients underwent radiotherapy, and 2 patients accepted chemotherapy. The tumor-related mortality was 0% for the 43 patients, and 5-year survival rate was 97.5%. No tumor recurrence or metastasis was observed during 48 months follow-up.
Conclusion: ESD indicates a satisfactory cure rate for SESCC patients. Additional treatments such as esophagectomy or chemotherapy, or CRT for post-ESD SESCC patients with muscularis mucosa and submucosa invasion were favorable.
The association between fetal head malrotation and labor analgesia: a propensity score-matched analysis
Authors: Tamura Nami , Takeda Jun , Uchiyama Saki , Nojiri Shuko , Itakura Atsuo 
Published: November 2024

Abstract

Background
Fetal head malrotation is associated with prolonged labor, instrumental delivery, and perinatal complications. Previous studies have suggested an association between malrotation and labor analgesia, but this remains controversial. This study aimed to clarify whether malrotation increases with the use of labor analgesia.
Methods
This retrospective cohort study using propensity score matching. Medical records from January 2020 to January 2023 were reviewed. The study subjects were full-term pregnant women with singleton cephalic fetuses whose cervixes were fully dilated. The group without labor analgesia (Group C) was matched with the labor analgesia group (Group A) by propensity score matching. The primary outcome was the occurrence of malrotation. Secondary outcomes included rates of normal vaginal delivery, instrumental delivery, cesarean section, and success rate of attempted manual rotation. Pearson’s chi-square test was used to assess the association between the use of labor analgesia and outcomes.
Results
During the study period, 3868 women were included, 1164 cases were excluded due to the exclusion criteria, and 971 cases were further excluded due to missing data. Of 1735 eligible women, 88.4% received labor analgesia. After propensity score matching, 804 women were included, of whom 75% received labor analgesia (Group A) and 25% did not (Group C). The rate of malrotation was significantly higher in Group A compared to that in Group C (11.6% vs. 6.5%, p = 0.03). The rate of instrumental delivery was significantly higher in Group A (25.7% vs. 14.9%, p = 0.001). The distribution of the instrumental deliveries in Group A was as follows: Naegele forceps delivery was used in 87.1% of the cases, Kielland forceps in 5.2%, and vacuum extraction in 7.7%. There was no significant difference in the rate of vaginal delivery. Manual rotation was attempted in 84.3% of malrotation cases in Group A with a 64.4% success rate, with no significant difference of the success rate between the two groups.
Conclusions
Labor analgesia is associated with an increased rate of malrotation and instrumental delivery. However, it does not seem to decrease the rate of vaginal delivery, given the high attempt and success rates of manual rotation and the availability of Kielland forceps delivery.
LC-MS analysis of serum lipidomic and metabolomic signatures in pediatric patients with acute lymphoblastic leukemia
Authors: Yan Feiyu , Wang Shengnan , Wang Yilin , Sun Yan , Yang Jing , Sun Lirong , Zaytseva Yekaterina Y. , Deng Pan , Wang Lingzhen 
Published: November 2024

Abstract

Background
Acute lymphoblastic leukemia (ALL) is a prevalent hematologic malignancy that primarily affects children. The diagnosis and treatment of pediatric ALL remain challenging. This study aimed to identify differential lipids and metabolites that may hold potential for improving ALL diagnosis.
Methods
Serum lipidome and metabolome alterations of ALL were analyzed by comparing pediatric patients with ALL with healthy controls based on liquid chromatography high-resolution mass spectrometry analysis of serum lipidomic and metabolomic signatures.
Results
We identified 2,298 lipid features in the serum. Among them, 72 (3.13%) differed significantly in pediatric patients with ALL compared to healthy controls. Notably, sphingolipids (ceramide and sphingomyelin) and phospholipids exhibited the most pronounced changes. Targeted analysis of ceramides revealed significantly elevated levels of Cer 18:0 and Cer 20:0 in the serum of pediatric patients with ALL. Additionally, gut microbial-related lipids (such as sulfonolipids and fatty acid esters of hydroxy fatty acids) showed significant alterations. Metabolomic analysis identified 15 differential metabolites, indicating disrupted nucleotide and amino acid metabolism. Furthermore, the dysregulated lipids and metabolites correlated with various blood indicators, with ceramide and nucleosides positively associated with white blood cell count but negatively correlated with hemoglobin and platelet.
Conclusion
These findings shed light on abnormal molecular signatures contributing to pediatric ALL and may serve as potential biomarker panel for diagnosis and therapy of ALL.
Center Volume Not Associated with Survival Benefit of Inter-hospital Transfer for Pediatric Cardiac Surgery
Authors: Chauhan Dhaval , Mehaffey J. Hunter , Hayanga J. W. Awori , Verhoeven Pieter Alex , Mathewson Margaret , Godsey Veronica , Fazi Alyssa , Udassi Jai P. , Badhwar Vinay , Mascio Christopher E. 
Published: November 2024

Abstract

Objective
To evaluate the relationship between center volume and inpatient mortality after inter-hospital transfer among patients undergoing pediatric cardiac surgery using contemporary real-world data.
Methods
The Kids’ Inpatient Database (KID) was queried for cardiopulmonary bypass (CPB) cases (CPB) for years 2016 and 2019. Hospitals were divided into three groups based on terciles of volume: “low”: ≤103 cases/year, “mid”:104–194 cases/year, and “high”: >194 cases/year. Multilevel regression models were created to evaluate the association of volume and inpatient mortality for transferred patients for the entire cohort as well as high-complexity cases. (Risk Stratification for Congenital Heart Surgery (RACHS-2) categories 3,4 and 5)
Results
Of 25,749 patients undergoing cases on CPB, 3,511 (13.6%) were preoperative inpatient transfers between hospitals. Compared to direct admissions, unadjusted mortality for patients who were transferred was higher in all groups: 1.7% vs. 5.6% (low-volume), 1.1% vs. 4.6% (mid-volume) and 1.1% vs. 4.9% (high-volume). Compared to low-volume hospitals, inpatient mortality for patients admitted on transfer was not significantly different in mid-volume (OR = 0.85, 95% CI 0.54–1.34, p = 0.483) and high-volume centers (OR = 0.7, 95% CI 0.45–1.12, p = 0.127) for the entire cohort. There was no significant difference in risk-adjusted inpatient mortality for high-complexity cases performed at mid-volume (OR 1.06, p = 0.845, 95% CI (0.62–1.85)) or high-volume hospitals (OR 0.82, p = 0.482, 95% CI (0.48–1.45)).
Conclusion
Annual CPB case volume may not accurately predict risk-adjusted inpatient mortality for children transferred for heart surgery. Annual case volume alone should not dictate transfer practices in pediatric heart surgery.
The effectiveness of the family medicine curriculum in the Sudan Medical Specialization Board in the improvement of skills and knowledge of family medicine residents 2024: A quantitative and qualitative survey
Authors: Abdelgadir Hiba Salah , Ahmed Nasreldin M 
Published: November 2024

Abstract

Introduction:
Family medicine was identified in Sudan in 2006 after the first family medicine master's degree program was established. The objective of this study was to evaluate the effectiveness of the family medicine curriculum in the Sudan Medical Specialization Board (SMSB) and provide baseline and updated data on the strengths and weaknesses of the family medicine training program.
Methods:
A cross-sectional quantitative and qualitative descriptive survey was conducted from February to October 2024. Data was collected through a pretested, pre-coded online questionnaire. Semi-structured, in-depth interviews were conducted with the family medicine specialists and trainers in the SMSB. All data were summarized numerically (mean, standard deviation, median) and graphically (frequency tables). Qualitative data was recorded, transcribed, coded, and then analyzed using a content analysis approach.
Results:
A total of 100 family medicine doctors participated in the study. Most of the participants (82%) were females. Regarding the job title (76%) of the participants were residents and the rest (24%) were specialists. More than half of the participants (66%) were from Khartoum. Most participants (87%) reported satisfaction with the family medicine training curriculum in the SMSB and its effectiveness in improving knowledge and practices. Some of the interviewed residents (30%) complained of dissatisfaction with the research methodology course, and about half of them reported that the course was ineffective and not improving their knowledge and skills in research. Furthermore, residents reported the family medicine research committee in the SMSB had unclear requirements which was reflected in a high rejection rate of the research proposals submitted by residents.
Conclusion:
The SMSB family medicine curriculum is a comprehensive training-based curriculum that increases residents’ satisfaction, knowledge, skills, and patients’ respect.
Clinical and Pathological Features of the Cured Severe COVID-19 Patient Who Received Successful Lung Transplantation
Authors: Guo Wei , Liu Yan , Ge Minghuan , Ding Xiangchao , Wang Bo , Xu Jian , Chu Xiaoying , Chen Ying , Tian Sufang , Lin Huiqing 
Published: November 2024

Abstract

Background: During the pandemic of COVID-19, lots of features of this disease have been discovered. However, the lung pathology and the correlated clinical features of the patients who recovered from the severe state of COVID-19 are still largely unknown. Especially for those who underwent diffuse alveolar damage (DAD), most of the morphological data were obtained from the autopsy specimens or biopsy samples.
Case presentation: In the present report, the pathologic changes in the lungs of a patient who had successfully received lung transplantation at the recovery stage of severe COVID-19 were described. Diffuse alveolar damage, hyperplasia of interstitial fibroblast and alveolar type II epithelial cells, and the filling of macrophages in alveoli were observed. Hyperemia and thickening of blood vessels and interstitial lymphocytic inflammation were also prominent. SARS-COV-2 nuclear capsid was detected spotty in the alveolar epithelial after several times’ negative nucleic acid results from his pharyngeal swab specimens. Evidence of combined virus infection, such as Cytomegalovirus,could also be found. A few eosinophils were found in the parenchymal of the lung, which combined with the elevated eosinophils in the blood, might indicate a recovery of this patient.
Discussion and Conclusions: This rare case provides a chance for us to observe the pathological changes in the diffuse fibrosis stage of severe COVID-19, which might help us to further understand how pulmonary fibrosis forms after severe pathogen infection.
Hybrid modelling framework for ozonation and biological activated carbon in tertiary wastewater treatment
Authors: Angula Shalongo T. , Okedi John , Harding Theo , Bellandi Giacomo , Ikumi David S. 
Published: November 2024

ABSTRACT

Despite water being a significant output of water and resource recovery facilities (WRRFs), tertiary wastewater treatment processes are often underrepresented in integrated WRRF models. This study critically reviews the approaches used in comprehensive models for ozone (O3) and biological activated carbon (BAC) operation units for wastewater tertiary treatment systems. The current models are characterised by limitations in the mechanisms that describe O3 disinfection and disinfection by-product formation, and BAC adsorption in multi-component solutes. Drawing from the insights from the current O3, BAC, and WRRF modelling approaches, we propose an integrated O3–BAC model suitable for simulating dissolved organic carbon (DOC) and micropollutants removal in the O3–BAC systems. We recommend a hybrid modelling approach in which data-driven models can be integrated to compensate for structural limitations in mechanistic models. The model is developed within the activated sludge model (ASM) framework for flexibility in coupling with other WRRF models and hence facilitates developing system-wide WRRF models for wastewater reclamation and reuse systems.