bluuebunny/crossref_metadata_2025_split huggingface dataset:
Hypo-Segmented Heterogeneous Boron Distribution Application in Boron Neutron Capture Therapy
Authors: Teng Yi-Chiao , Chen Jiang , Zhong Wan-Bing , Liu Yuan-Hao 
Published: October 2024

Abstract

Heterogeneous boron concentration distribution is the primary determinant that must be considered in boron neutron capture therapy (BNCT) dose calculations. However, taking into account the slip in BNCT dose calculation and assessment come from fusion of different image modalities and the partial volume effect of image voxel differences, it is necessary to reduce these errors when building a highly realistic computational model in order to provide high-confidence dose results. This article uses hypo-segmented heterogeneous boron distribution dose calculation to apply to brain tumor and head and neck cancer cases to evaluate dose cold spots in tumor and hot spots in organs at risk. Using hyper-segmented boron distribution dose results as a reference benchmark to compare with hypo-segmentation results, the mean tumor dose difference between the two is within 1.6%, and the D80 difference is within 2.3%. Significant differences in maximum and minimum doses to the region of interest are expected between hyper- and hypo-segmentation methods, but the dose-volume histogram for both are close to each other. Then, post-BNCT follow-up images were compared with dose maps of hyper- and hypo-segmented boron distribution. The dose distribution echoes clinical response, indicating that the hypo-segmented boron distribution method has evaluation properties.
Monitoring anti-factor Xa activity in patients with chronic thromboembolic pulmonary hypertension treated with factor Xa inhibitors
Authors: Nakano Yoshihisa , Adachi Shiro , Hirose Miku , Adachi Takeshi , Nishiyama Itsumure , Yasuda Kenichiro , Yoshida Masahiro , Kondo Takahisa , Murohara Toyoaki 
Published: October 2024

Abstract

Direct oral anticoagulants (DOACs) have been used clinically in patients with chronic thromboembolic pulmonary hypertension (CTEPH) for secondary prevention after acute venous thromboembolism, although the data is limited. We evaluated the effects of DOACs—especially factor Xa (FXa) inhibitors—by measuring anti-factor Xa activity (AXA). Fifty consecutive CTEPH patients treated with either rivaroxaban, apixaban, or edoxaban were enrolled. Heparin-calibrated AXA was measured at both peak and trough. The median peak heparin-calibrated AXA across all 50 patients was 1.90 IU/mL and was comparable among the three FXa inhibitors. At trough, heparin-calibrated AXA was significantly higher in apixaban treated patients (median 0.70 IU/mL) than in those with rivaroxaban (median 0.11 IU/mL) or edoxaban (median 0.11 IU/mL, p <.001). Peak heparin-calibrated AXA was significantly lower with reduced-dose FXa inhibitor (edoxaban 30 mg/day) than with the reference dose (edoxaban 60 mg/day, apixaban 10 mg/day, or rivaroxaban 15 mg/day, p =.01). The heparin-calibrated AXA of both rivaroxaban and apixaban was strongly significantly correlated with the plasma concentration of each drug. The cumulative rate of major and clinically relevant non-major bleeding was significantly higher in patients with peak heparin-calibrated AXA ≥2.09 IU/mL. Heparin-calibrated AXA could provide useful information when treating CTEPH patients with FXa inhibitors.
Construction and Validation of a Clinical Prediction Model for Sepsis Based on Peripheral Perfusion Index: In-Hospital and 28-Day Mortality Risk Prediction
Authors: Guo Qirui , Li Wenbo , Wang Jie , Wang Guangjian , Deng Qingyu , Lian Hui , Wang Xiaoting 
Published: October 2024

Abstract

Background
Sepsis is a clinical syndrome caused by infection, leading to organ dysfunction due to a dysregulated host response. In recent years, its high mortality rate has made it a significant cause of death and disability worldwide. The pathophysiological process of sepsis is related to the body's dysregulated response to infection, with microcirculatory changes serving as early warning signals that guide clinical treatment. The Peripheral Perfusion Index (PI), as an indicator of peripheral microcirculation, can effectively evaluate patient prognosis. This study aims to develop two new prediction models using PI and other common clinical indicators to assess the mortality risk of sepsis patients during hospitalization and within 28 days post-ICU admission.
Methods
This retrospective study analyzed data from sepsis patients treated in the Intensive Care Unit of Peking Union Medical College Hospital between December 2019 and June 2023, ultimately including 645 patients. LASSO regression and logistic regression analyses were used to select predictive factors from 35 clinical indicators, and two clinical prediction models were constructed to predict in-hospital mortality and 28-day mortality. The models' performance was then evaluated using ROC curve, calibration curve, and decision curve analyses.
Results
The two prediction models performed excellently in distinguishing patient mortality risk. The AUC for the in-hospital mortality prediction model was 0.82 in the training set and 0.73 in the validation set; for the 28-day mortality prediction model, the AUC was 0.79 in the training set and 0.73 in the validation set. The calibration curves closely aligned with the ideal line, indicating consistency between predicted and actual outcomes. Decision curve analysis also demonstrated high net benefits for the clinical utility of both models.
Conclusion
The study shows that these two prediction models not only perform excellently statistically but also hold high practical value in clinical applications. The models can help physicians accurately assess the mortality risk of sepsis patients, providing a scientific basis for personalized treatment.
Multitemporal monitoring of forest indicator species using UAV and machine learning image recognition
Authors: Niwa Hideyuki 
Published: October 2024

Abstract

In natural restoration, it is important to improve the efficiency of monitoring. Remote sensing using unmanned aerial vehicle (UAV) platforms plays a major role in improving monitoring efficiency. UAV platforms are particularly suited for monitoring long-term, multitemporal changes. The objectives of this study were to develop a standard protocol for monitoring multitemporal changes in forest indicator species using a UAV platform, to evaluate multitemporal changes, and to examine the factors contributing to these changes. The study site was a forest located within Takaragaike Park (Sakyo-ku, Kyoto, Japan), and Rhododendron reticulatum was selected as the study species. The distribution of R. reticulatum flowers was identified from 2019 to 2023 using image recognition with artificial intelligence. A mesh was used as a spatial unit, and standardized values (Z values) were tabulated to evaluate the abundance and changes in the number of R. reticulatum flowers over time. The method used in this study showed very high accuracy in image recognition at multitemporal periods, indicating that it is useful for long-term monitoring. It was also able to detect the effects of forest management and the impact of vegetation succession. The new method is expected to become one of the standard protocols for understanding multitemporal changes in forest indicator species.
Construction of Common Harmonic Waves on Major Depressive Disorder-A New Approach for Morphological Brain Network Analyses
Authors: Xu Kai , Haoxuan Lu , Zhang Ang , Sun Xin , Zhao Zhenghuan , Zheng Dong , Li Ke , Ye Jiajun 
Published: October 2024

Abstract

Objective
To observe the changes in morphological brain networks of patients with major depressive disorder (MDD) based on harmonic waves analysis.
Methods
A cohort of 55 MDD patients and 46 normal controls (NC) were enrolled in the study. All participants underwent scanning with a 3.0T ultra-high-field MR scanner to acquire high-resolution three-dimensional T1-weighted image data. Utilizing the Freesurfer 5.3.0 tool, we derived nine morphological features, such as the number of vertices, gray matter volume, Gaussian curvature, and more, to construct brain networks. Common harmonic waves were extracted through eigenvalue decomposition of the Laplacian matrix. We subsequently calculated Fisher's J score, representing the ratio of between-class mean to within-class variance, to assess the harmonic energy between MDD subjects and healthy controls, aiming to identify significant differences in the harmonic energy of morphological features between MDD and NC within each harmonic wave.
Results
We found no statistically significant difference in the total harmonic energy of the nine morphological features between the MDD and NC groups. However, specific harmonic energy levels varied significantly from the NC group, including 1) the number of vertices in harmonic waves 2, 6, 15, 44, and 57; 2) surface area in harmonic waves 2, 6, 16, and 57; 3) gray matter volume in harmonic waves 2, 12, 13, 15, and 57; 4) mean cortical thickness in harmonic waves 2, 19, 35, 36, and 44; 5) standard deviation of cortical thickness in harmonic waves 8, 21, and 42; 6) mean curvature in harmonic waves 26 and 57; 7) Gaussian curvature in harmonic waves 34, 40, 54, and 57; 8) fold index in harmonic waves 5, 16, and 21; 9) curvature index in harmonic waves 25, 32, 33, and 37 (P < 0.05).
Conclusion
Our findings indicate that MDD patients exhibit more pronounced fluctuations in harmonic energy, both in lower and higher segments, revealing distinctive abnormal brain harmonics in MDD patients. This offers a fresh perspective for gaining a different understanding of the morphological brain network in MDD patients.
Chinese Community-dwelling Older Adults’ Expectations regarding the Delivery of Integrated Care through Case Managers: A Mixed Methods Study Protocol
Authors: Zhao Yuanyuan , Tu Yuehua , Zhu Hua 
Published: October 2024

Abstract

Background
The rising prevalence of chronic diseases among older adults in China calls for a more robust and efficient healthcare system. The current system, being fragmented and insufficient, fails to deliver comprehensive care for chronic diseases. There is a pressing need for tailored and integrated care solutions for older adults, which would facilitate resource sharing, improve access to advanced facilities, provide expert guidance, and ensure safe and effective care for those with multiple comorbidities.
Methods
Employing the PRISMA model recommended by the World Health Organization, this study suggests the use of a case manager to improve the delivery of publicly funded healthcare in the community. An exploratory sequential mixed methods approach will be implemented to investigate the acceptability of the PRISMA integrated care model and to identify the realistic needs, expectations, and associated sociodemographic characteristics of Chinese community-dwelling older adults respectively. An evidence-based integrated care model will be captured that can optimise healthcare delivery.
Discussion
By incorporating elements from the PRISMA model and considering the specific expectations of older adults, this study strives to promote integrated care through a centralised point of access managed by a case manager. This approach addresses significant gaps in the current healthcare provision and aims to improve the quality, accessibility, and efficiency of services, thereby improving care for the community. The findings of this study have the potential to inform policy decisions, guide the implementation of integrated care delivery, and ultimately improve health outcomes and the quality of life for older adults in China.
Protocol Registration:
The study protocol has been registered on osf.io
(Registration DOI: https://doi.org/10.17605/OSF.IO/825AH).
Significant Upregulationof the HMGA1 and HMGA2 genes in Iranian patients suffering from gastric cancer
Authors: Nadafi Mohammad Amin , Golbashirzadeh Moteza , Moradzadegan Atousa 
Published: October 2024

Abstract

Background Gastric cancer, a prevalent malignancy worldwide, is associated with high mortality rates. The HMGA family, comprising regulatory chromatin proteins, plays a pivotal role in tumorigenesis. This study investigates alterations in HMGA protein expression within the affected population of Khuzestan, Iran.Materials and Methods Sixty tissue samples—thirty gastric cancer tumors and thirty non-tumor margins—were collected from the cancer institute in Tehran. RNA extraction, nanodrop quantification, and agarose gel electrophoresis were performed. Real-time PCR assessed the expression of HMGA1 and HMGA2 genes. Statistical analysis employed GraphPad Prism 9.2.0.332, including t-tests and ANOVAResults The study observed a substantial increase in the relative expression of the HMGA1 gene (17-fold) and the HMGA2 gene (15-fold) in tumor samples compared to non-tumor samples (P-values: HMGA1 = 0.0001, HMGA2 = 0.0038).Conclusion The elevated expression of HMGA1 and HMGA2 genes in cancer cells within the affected population in Khuzestan, Iran highlights their potential significance. Investigating the underlying mechanisms could aid in early diagnosis and risk prediction. Further research is recommended to explore the roles of these genes in-depth.
Fire Risk of Electrical Installations: A Fuzzy Petri Net Approach Applied to the National Museum of Brazil
Authors: Rocha Gustavo S. da , Rodrigues João Paulo C. , Gazzana Daniel da Silva 
Published: October 2024

Abstract

Over time, electrical fires have been recurring disasters around the world. As a common preventive strategy, the use of a standard checklist has become a traditional technique widely adopted today. However, this procedure might not capture the full spectrum of risk levels or address interconnected issues, thus potentially compromising effective risk management. Conversely, allowing for prioritization and immediate remediation of fire hazards, the incorporation of expert knowledge and data-driven insights to gauge risk factors is noteworthy. In this context, the approach proposed, rooted in fuzzy Petri nets, optimizes resource allocation by focusing on the highest-risk elements, leading to a more substantial risk reduction. In this paper, an enhanced methodology, which surpasses the absence of statistical data in real-life assessments, was implemented, considering the pre-fire conditions at the Brazilian National Museum. Simulation results indicate that simple corrections in the electrical installation could have significantly reduced the fire risk, possibly preventing the tragedy. These findings underscore the method's effectiveness, emphasizing the importance of thorough electrical risk management. It suggests that the catastrophe might have been avoided had the risks been appropriately addressed. The model emerges as an essential instrument for enhancing risk assessment and strategic resource allocation, especially vital in resource-constrained environments characteristic of developing countries like Brazil.
Single-cell RNA-seq of myasthenia gravis reveals transcriptional heterogenity and dysfunction of immune cell populations
Authors: Zou Lihui , Wu Qingjun , Guo Yingyu , Tian Yi , Yu Hanbo , Zhou Ting , Yin Siyuan 
Published: October 2024

Abstract

The immune system imbalance and immune cell dysfunction of myasthenia gravis (MG) have been thoroughly studied, but the composition and function of immune cell subsets at single cell level in thymus and peripheral blood remain unclear. Here, we performed single-cell RNA sequencing with 9701 and 23846 cells respectively originated from the peripheral blood and thymus samples of MG patients, and 6 930 cells from the peripheral blood of healthy controls, and identified 4 major cell populations of T cells, B cells, myeloid cells, and NK cells, as well as their 15 cell subpopulations. We found an absolute predominance of T cells in the thymus and peripheral blood of MG patients, and the proportions of memory B cells in both plasma and thymus are significantly increased while the number of naïve B cells is significantly reduced in MG patients compared to healthy controls. Besides, the plasma cells in the peripheral blood of MG patients had the strongest interactions with other cells, while monocytes in the thymic tissue had the strongest interactions with other cells. On the whole, our research clarify the cellular heterogeneity in the pathogenesis of MG, and characterize the immune microenvironment of thymic tissues in MG patients.
CHK2 immunohistochemical expression in prostatic carcinoma of Egyptian patients
Authors: El-Rebey Hala Said , Hola Ayat Shawky Abo , Kora Mona Abdelhamid , Alagizy Hagar , Hassanin Rania Abdallah 
Published: October 2024

Abstract

Background: Prostatic carcinoma (PCa) is a diverse disease with a complex molecular landscape that evolves throughout disease progression. There is a great need for novel biomarkers that are more effective at predicting PCa outcomes. CHK2 is a tumor suppressor gene and is considered a prospective target for prognostic and therapeutic applications. This study aims to investigate the immunohistochemical expression of CHK2 in PCa patients and to correlate its expression with the studied clinicopathological parameters, including survival data.
Material and Methods:
CHK2 expression was detected via immunohistochemistry in 71 biopsies from PCa patients and 34 biopsies from patients with nodular prostatic hyperplasia (NPH). CHK2 reactivity (positive vs negative) together with the total percentage of positive cells and H score were estimated in both studied groups.
Results: CHK2 immunoexpression was significantly greater in PCa patients than in NPH patients in terms of reactivity and H score (P= 0.036 and P= 0.018, respectively). PCa patients with high-grade PIN foci presented significantly lower total CHK2 expression (P=0.04). Univariate overall survival (OS) and progression-free survival (PFS) analyses revealed no significant differences according to CHK2 reactivity or total percent expression.
Conclusion: Our findings validated the importance of CHK2 in the mechanism of neoplastic transformation of the prostate.
Impact of age on surgical outcomes for World Federation of Neurosurgical Societies grade I and II aneurysmal subarachnoid haemorrhage: a novel prognostic model using recursive partitioning analysis
Authors: Umekawa Motoyuki , Yoshikawa Gakushi 
Published: October 2024

Abstract

Objective
This study aimed to evaluate age as a prognostic factor and develop a comprehensive prognostic model for patients undergoing clipping surgery for World Federation of Neurosurgical Societies (WFNS) grade I/II aneurysmal subarachnoid haemorrhage (SAH).
Methods
We retrospectively investigated 188 patients with WFNS grade I/II SAH who underwent microsurgical clipping at our institute between December 2010 and January 2020. The data of 176 patients (75 with grade I and 101 with grade II) were analysed. Data on patient demographics, aneurysm characteristics, SAH factors, surgical details, and clinical outcomes were collected. Prognostic factors were assessed using bivariate and multivariable logistic regression analyses, and recursive partitioning analysis.
Results
Favourable outcomes (mRS 0–2) were observed in 76% of patients. Age, a significant negative prognostic factor in multivariable analysis (odds ratio 0.55, 95% confidence interval 0.40–0.76, p < 0.001), was cutoff at 70 years by the receiver operating characteristic curve. Patients aged ≤ 70 years had significantly better outcomes than those aged > 70 years (84% vs. 46%, respectively; p < 0.001). Epileptic seizures were significantly associated with poor outcomes in older adults (p < 0.001). A prognostic model (favourable, intermediate, and poor) based on age and postoperative adverse events showed significantly different outcomes between age groups (p < 0.001).
Conclusions
Age was a stronger prognostic factor than WFNS grading for patients with grade I/II SAH undergoing microsurgical clipping. For patients aged ≤ 70 years, precise microsurgeries with fewer complications were associated with favourable outcomes beyond WFNS grade. For older patients, postoperative intensive seizure management may prevent poor outcomes.
Belumosudil for the Treatment of Chronic Graft-versus-Host Disease: A Single Center Real-World Experience
Authors: Salhotra Amandeep , Modi Badri , Ngo Dat , Chen Jason , Yang Dongyun , Shan Hayoue , Sandhu Karamjeet , Nashid Rahid , Amanam Idoroenyi , Otoukesh Salman , Nakamura Ryotaro , Ali Haris 
Published: October 2024

Abstract

Chronic graft-versus host disease (cGVHD) remains a major complication post-allogeneic stem cell transplantation (HCT). Belumosudil, a ROCK2 inhibitor was approved for cGVHD with 2–5 prior lines of therapy. We retrospectively analyzed 45 patients who received belumosudil at City of Hope Medical Center. Prior to belumosudil, the median age was 59 yrs with 3 prior lines of therapy (range 1–6). GVHD severity was predominantly moderate (37.8%) and severe (46.7%). Many patients had a prior history of ruxolitinib (71.1%), with concurrent use of belumosudil occurring in 51.1% of patients. ORR at 6-months and 12 months were 31.1% and 33.4% respectively. The best ORR at any point during belumosudil was 46.7% (CR 6.7% + PR 40%) and median FFS was 11.2 months. Infection occurred in 42% of patients, with 27% of patients requiring hospitalization to manage infection. Patients with concurrent ruxolitinib had higher infection rates (60.9% vs. 22;7%, p = 0.0156) and hospitalization (47.8% vs. 4.5%, p = 0.0017). Most infections were viral and considered mild requiring no hospitalization to manage the infection. Real-world experience with belumosudil supports the use in the treatment of cGVHD based on the ORR, promising FFS, and good tolerability in patients who have progressed on multiple prior lines of therapy.