bluuebunny/crossref_metadata_2025_split huggingface dataset:
A deep learning model to enhance the classification of primary bone tumors based on incomplete multimodal images in X-ray, CT, and MRI
Authors: Song Liwen , Li Chuanpu , Tan Lilian , Wang Menghong , Chen Xiaqing , Ye Qiang , Li Shisi , Zhang Rui , Zeng Qinghai , Xie Zhuoyao , Yang Wei , Zhao Yinghua 
Published: October 2024

Abstract
Background
Accurately classifying primary bone tumors is crucial for guiding therapeutic decisions. The National Comprehensive Cancer Network guidelines recommend multimodal images to provide different perspectives for the comprehensive evaluation of primary bone tumors. However, in clinical practice, most patients’ medical multimodal images are often incomplete. This study aimed to build a deep learning model using patients’ incomplete multimodal images from X-ray, CT, and MRI alongside clinical characteristics to classify primary bone tumors as benign, intermediate, or malignant.

Methods
In this retrospective study, a total of 1305 patients with histopathologically confirmed primary bone tumors (internal dataset, n = 1043; external dataset, n = 262) were included from two centers between January 2010 and December 2022. We proposed a Primary Bone Tumor Classification Transformer Network (PBTC-TransNet) fusion model to classify primary bone tumors. Areas under the receiver operating characteristic curve (AUC), accuracy, sensitivity, and specificity were calculated to evaluate the model’s classification performance.

Results
The PBTC-TransNet fusion model achieved satisfactory micro-average AUCs of 0.847 (95% CI: 0.832, 0.862) and 0.782 (95% CI: 0.749, 0.817) on the internal and external test sets. For the classification of benign, intermediate, and malignant primary bone tumors, the model respectively achieved AUCs of 0.827/0.727, 0.740/0.662, and 0.815/0.745 on the internal/external test sets. Furthermore, across all patient subgroups stratified by the distribution of imaging modalities, the PBTC-TransNet fusion model gained micro-average AUCs ranging from 0.700 to 0.909 and 0.640 to 0.847 on the internal and external test sets, respectively. The model showed the highest micro-average AUC of 0.909, accuracy of 84.3%, micro-average sensitivity of 84.3%, and micro-average specificity of 92.1% in those with only X-rays on the internal test set. On the external test set, the PBTC-TransNet fusion model gained the highest micro-average AUC of 0.847 for patients with X-ray + CT.

Conclusions
We successfully developed and externally validated the transformer-based PBTC-Transnet fusion model for the effective classification of primary bone tumors. This model, rooted in incomplete multimodal images and clinical characteristics, effectively mirrors real-life clinical scenarios, thus enhancing its strong clinical practicability.
Prophylactic regimens for the prevention of pseudophakic cystoid macular edema: systematic review and meta-analysis
Authors: Alqahtani Abdullah S. , Hersi Reem M. , Homsi Jumana J. , Alamoudi Loujen O. , Alghamdi Sara , Alrajhi Rawan K. , AlJehani Reham A. 
Published: October 2024

Abstract
Background
Pseudophakic cystoid macular edema (PCME) is a known complication of cataract surgery that contributes to decreased visual acuity. Mechanical manipulation associated with the release of inflammatory mediators is the leading hypothesis for PCME. To date, no standardized prophylactic protocol has been established to effectively reduce the incidence of PCME. This study assessed the efficacy and safety of nonsteroidal anti-inflammatory drops (NSAIDs) and corticosteroids for the prevention of PCME.

Method
We searched the following databases MEDLINE, EMBASE, and Cochrane Central. Register of Controlled Trials and included randomized controlled trials (RCTs) that studied the efficacy of NSAID vs. placebo, NSAID vs. steroid, or NSAID + steroid vs. placebo, reporting the incidence of PCME, macular thickness, and best-corrected visual acuity. The risk ratio (RR) with a 95% confidence interval (CI) and a random-effects model was used. The risk of bias was assessed using the revised Cochrane risk-of-bias tool.

Results
A total of 18 RCTs were included in this study (n = 2959). Nine RCT showed low risk of bias, 7 RCT showed unclear risk of bias, and 2 RCT had high risk of bias. The incidence of cystoid macular edema among patients treated with NSAIDs was significantly lower (RR = 0.33, P < 0.001). Subgroup analysis revealed a statistically significant low risk of edema among patients treated with NSAIDs alone (P < 0.001) compared to others. NSAIDs were associated with significantly low mean corrected visual acuity values using LogMar (P < 0.001).

Conclusion
NSAID alone or in combination with steroids showed its efficacy in reducing the incidence of PCME post-operatively. Future double-blind randomized controlled trials are required to standardize the protocol for different patient population.
The effect of postfire regeneration pattern on soil respiration in the boreal forest of China
Authors: Yang Lixue , Shan Chengfeng , Zhou Siyu , Yang Yuchun , Liu Huifeng , Shen Fangyuan 
Published: October 2024

Abstract
Background
As the second largest carbon flux between the atmosphere and terrestrial ecosystems, soil respiration involves multiple components of ecosystem production. Revealing soil respiration in forests with different postfire regeneration patterns is critical for determining appropriate restoration strategies in response to increasing wildfire disturbances. Here, we examined the influence of five postfire regeneration patterns (L: Larix gmelinii monocultures, LB: L. gmelinii and Betula platyphylla mixed plantations, P: Pinus sylvestris var. mongolica monocultures, PB: P. sylvestris var. mongolica and B. platyphylla mixed plantations, N: naturally regenerated forests) on soil heterotrophic respiration (Rh) and total respiration (Rs).

Methods
Trenching was implemented to monitor soil heterotrophic respiration. We used partial least squares path modeling methods to estimate the different environmental factors regulating soil respiration across forest types.

Results
The results showed that forest type and season had significant effects on Rs and Rh. Rh was the dominant part of Rs for all forest types (68.84 ~ 90.20%). Compared to naturally regenerated forests, Rs and Rh under L, LB, and PB had higher rates (P < 0.05), while Rs and Rh under P had lower rates (P < 0.05). The temperature sensitivities of Rs under different forest types were 2.316 (L), 1.840 (LB), 1.716 (P), 1.665 (PB), and 2.096 (N).

Conclusions
Forests regenerated with artificial participation established their plant communities visibly faster than naturally regenerated forests. Mixed species plantation regeneration demonstrated an improvement in soil respiration compared to naturally regenerated forests but had a lower temperature sensitivity of soil respiration than their respective monocultures. Soil temperature and moisture dominated the influence factors on soil respiration throughout the broader seasonal shifts. However, for a single season, forest productivity and soil properties have a greater impact on soil respiration. This study extends our knowledge of the interaction mechanism between soil respiration and environmental variables in boreal forests and contributes to improving confidence in global carbon cycling model predictions.
Consumer skepticism towards organic beauty products Cross-country research
Authors: Kifaya Raja 
Published: October 2024

AbstractBased on the attitude–behaviour–context (ABC) theory, the present study addressed consumer skepticism as one of the inhibitors of organic purchasing behaviour. More specifically, it investigated the role of environmental concern and environmental knowledge as a mediator, in the organic cosmetics background. Data gathered from consumers in Tunisia (N = 736), Italy (N = 720) and France (N = 715) and analysed using a structural equation modelling approach. The findings revealed that green skepticism is a strong inhibitor towards adoption of organic cosmetic products among consumers in the three countries. On the other hand, findings revealed that environmental knowledge and environmental concern fully mediate the relationship between green skepticism and organic purchasing behaviour. The ultimate goal is to provide valuable insights for business leaders, policymakers and marketers fully understand consumers’ resistance to organic cosmetic products. Further, it offers a comprehensive framework to support strategies to reduce consumers’ skepticism towards organic products, in different market segments.
Pathways regulating intestinal stem cells and potential therapeutic targets for radiation enteropathy
Authors: Chen Si-Min , Guo Bing-Jie , Feng An-Qiang , Wang Xue-Lian , Zhang Sai-Long , Miao Chao-Yu 
Published: October 2024

AbstractRadiotherapy is a pivotal intervention for cancer patients, significantly impacting their treatment outcomes and survival prospects. Nevertheless, in the course of treating those with abdominal, pelvic, or retroperitoneal malignant tumors, the procedure inadvertently exposes adjacent intestinal tissues to radiation, posing risks of radiation-induced enteropathy upon reaching threshold doses. Stem cells within the intestinal crypts, through their controlled proliferation and differentiation, support the critical functions of the intestinal epithelium, ensuring efficient nutrient absorption while upholding its protective barrier properties. Intestinal stem cells (ISCs) regulation is intricately orchestrated by diverse signaling pathways, among which are the WNT, BMP, NOTCH, EGF, Hippo, Hedgehog and NF-κB, each contributing to the complex control of these cells' behavior. Complementing these pathways are additional regulators such as nutrient metabolic states, and the intestinal microbiota, all of which contribute to the fine-tuning of ISCs behavior in the intestinal crypts. It is the harmonious interplay among these signaling cascades and modulating elements that preserves the homeostasis of intestinal epithelial cells (IECs), thereby ensuring the gut's overall health and function. This review delves into the molecular underpinnings of how stem cells respond in the context of radiation enteropathy, aiming to illuminate potential biological targets for therapeutic intervention. Furthermore, we have compiled a summary of several current treatment methodologies. By unraveling these mechanisms and treatment methods, we aspire to furnish a roadmap for the development of novel therapeutics, advancing our capabilities in mitigating radiation-induced intestinal damage.
Clinical and Genomic Characterization of
ERBB2
-Altered Gallbladder Cancer: Exploring Differences Between an American and a Chilean Cohort
Authors: Mondaca Sebastián , Walch Henry , Sepúlveda Santiago , Schultz Nikolaus , Muñoz Gonzalo , Yaqubie Amin , Macanas Patricia , Pareja Claudia , Garcia Patricia , Chatila Walid , Nervi Bruno , Li Bob , Harding James J. , Viviani Paola , Roa Juan Carlos , Abou-Alfa Ghassan K. 
Published: October 2024

PURPOSE

Gallbladder cancer (GBC) is a biliary tract malignancy characterized by its high lethality. Although the incidence of GBC is low in most countries, specific areas such as Chile display a high incidence. Our collaborative study sought to compare clinical and molecular features of GBC cohorts from Chile and the United States with a focus on
ERBB2
alterations.

METHODS
Patients were accrued at Memorial Sloan Kettering Cancer Center (MSK) or the Pontificia Universidad Católica de Chile (PUC). Clinical information was retrieved from medical records. Genomic analysis was performed by the next-generation sequencing platform MSK-Integrated Mutation Profiling of Actionable Cancer Targets.

RESULTS

A total of 260 patients with GBC were included, 237 from MSK and 23 from PUC. There were no significant differences in the clinical characteristics between the patients identified at MSK and at PUC except in terms of lithiasis prevalence which was significantly higher in the PUC cohort (85%
v
44%;
P
= .0003). The prevalence of
ERBB2
alterations was comparable between the two cohorts (15%
v
9%;
P
= .42). Overall,
ERBB2
alterations were present in 14% of patients (8% with
ERBB2
amplification, 4%
ERBB2
mutation, 1.5% concurrent amplification and mutation, and 0.4%
ERBB2
fusion). Notably, patients with GBC that harbored
ERBB2
alterations had better overall survival (OS) versus their
ERBB2
-wild type counterparts (22.3 months
v
11.8 months;
P
= .024).

CONCLUSION

The prevalence of lithiasis seems to be higher in Chilean versus US patients with GBC. A similar prevalence of
ERBB2
alterations of overall 14% and better OS suggests that a proportion of them could benefit from human epidermal growth factor receptor type 2–targeted therapies. The smaller cohort of Chile, where the disease prevalence is higher, is a reminder and invitation for the need of more robust next-generation sequencing analyses globally.
Percentage area reduction as surrogate for complete healing of hard-to-heal wounds: a review of clinical trials
Authors: Lammert Angela , Kiehlmeier Sandra , Dissemond Joachim , Münter Karl-Christian , Schnorpfeil Willi , Pohl Juliane 
Published: October 2024

Objective: Hard-to-heal (chronic) wounds are treated differently at varying healing stages and often require long periods of time to heal completely. Therefore, it is often very difficult to achieve this primary endpoint in clinical trials with wound products which are used temporarily. Thus, it seems reasonable to use valid wound healing parameters determined at an early stage, such as the percentage (wound) area reduction (PAR), as surrogates for predicting complete wound healing. Method: To identify studies on the association between potential surrogate endpoints and complete wound healing, a systematic literature search in MEDLINE, Embase and the Cochrane Library databases was performed. The findings of the studies were summarised qualitatively. Results: A total of 23 publications with a focus on hard-to-heal wounds (n=10 diabetic foot ulcers (DFUs), n=10 venous leg ulcers (VLUs), n=3 other ulcers) and various wound care regimens were identified. All studies showed a high bias potential. The available clinical evidence confirmed that the PAR at week 4 showed a good discriminatory capacity to predict which wounds would eventually heal and which would not. The chance to achieve complete wound healing was significantly higher for wounds achieving a PAR of ≥40% (VLU) or ≥50% (DFU) at week 4. Conclusion: The PAR thresholds of 40% (VLU) and 50% (DFU) can be used to identify the proportion of the wounds that will heal, and those that will not heal, to compare the efficacy of different wound dressings as early as week 4 in the setting of clinical trials. The available evidence may be limited by a potential risk of bias.
Experiences of patients with hard-to-heal wounds: insights from a pilot survey
Authors: Wahab Naz , Forsyth R Allyn 
Published: October 2024

Objective: To learn about the experiences of people who seek treatment for hard-to-heal wounds, we distributed a nationwide pilot survey, asking questions about the nature of their wound, how it shaped their daily lives, pathways to receiving care and experiences with treatment. The long-term objective is to quantify the journey of patients with hard-to-heal wounds to identify ideal intervention points that will lead to the best outcomes. This article summarises the findings, implications, limitations and suggestions for future research. Method: Qualitative data were self-reported from patients with hard-to-heal wounds (open for ≥4 weeks) in a pilot chatbot survey, (Wound Expert Survey (WES)) provided online in the US on Meta platforms (Facebook and Instagram) between 2021 and 2022. Results: The US national pilot survey attracted responses from 780 patients, 27 of whom provided a video testimonial. Some 57% of patients delayed treatment because they believed their wound would heal on its own, and only 4% saw a wound care specialist. Respondents reported the cost of care as the most frequent reason for not following all of a doctor's treatment recommendations. Queries regarding quality of life (QoL) revealed that more than half (65%) said they have negative thoughts associated with their wound at least every few days. Some 19% of respondents said their wound had an odour and, of them, 34% said odour had a major or severe negative impact on their self-confidence. Economically, nearly one-quarter of respondents said having a wound led to a drop in their total household income and 17% said their wound led to a change in their employment status. Conclusion: A national pilot survey of patients with hard-to-heal wounds revealed that many delay seeking professional assistance and only a small minority see a wound care specialist. Experiencing an ulcer, even for a few months, can have significant negative effects on a patient's QoL. Patients frequently had negative thoughts associated with their wound, and odour compounded these negative effects, leading to major or severe negative impacts on self-confidence. Households experienced a decline in income, due to both the direct reduction or loss of patient employment and the additional time spent by family members assisting in patient recovery. Thus, a variety of factors contribute to poor outcomes for patients with hard-to-heal wounds. To validate and extend these preliminary results, future surveys of patients with hard-to-heal wounds should focus on additional reasons patients do not seek professional help sooner. To improve health outcomes and QoL, assessment of patient socioeconomic variables should occur whenever wound closure stalls.
Prognostic value of stress perfusion cardiac magnetic resonance in patients with prediabetes and suspected coronary artery disease
Authors: Leungratanamart Norapat , Wanitchung Kasinee , Prechawuttidech Sumet , Karaketklang Khemajira , Kaolawanich Yodying 
Published: October 2024

Background
Stress perfusion cardiac magnetic resonance (CMR) is an accurate and comprehensive modality for evaluating patients with suspected coronary artery disease (CAD), but its prognostic value in prediabetic patients is uncertain.

Methods
This retrospective study included 452 consecutive prediabetic patients without prior diagnoses of CAD who underwent adenosine stress perfusion CMR. The primary endpoint was major adverse cardiovascular events (MACE), defined as cardiovascular death, nonfatal myocardial infarction (MI), hospitalization for heart failure, ischemic stroke, and late coronary revascularization (>90 days post-CMR). The secondary endpoint was a composite of cardiovascular death, nonfatal MI, and hospitalization for heart failure.

Results
The mean age was 68±11 years (49% male). Over a median follow-up time of 8.1 (IQR 5.7, 10.4) years, 55 patients experienced MACE, and 24 met the secondary endpoint. Patients with inducible ischemia had significantly greater annualized event rates for MACE (5.7% vs. 0.7%, p<0.001) and for the secondary endpoint (2.0% vs. 0.3%, p<0.001) than those without ischemia. Multivariable analysis revealed inducible ischemia as a consistent predictor for MACE (HR 3.36, 95%CI 1.90–5.94, p<0.001) and for the secondary endpoint (HR 2.89, 95%CI 1.22–6.80, p = 0.01). Late gadolinium enhancement (LGE) was an independent predictor of the secondary endpoint (HR 3.56, 95%CI 1.25–10.13; p = 0.02). Incorporating inducible ischemia and LGE data significantly improved the model’s ability to discriminate MACE risk (C-statistic increase from 0.77 to 0.83; net reclassification improvement 0.42; integrated discrimination improvement 0.05).

Conclusion
Stress perfusion CMR offers substantial independent prognostic value and effectively aids in reclassifying cardiovascular risk among prediabetic patients with suspected CAD.
Combined Heart and Liver Transplantation in Delayed-Onset Propionic Acidemia
Authors: White Mattie K. , Sims Omar T. , Eng Jason , Modaresi Esfeh Jamak 
Published: October 2024

ABSTRACT
Amish patients with propionic acidemia can have delayed presentations with rapid onset, severe cardiac decompensation despite metabolic control. Medical management is limited to strict low protein diet and correction of underlying catabolic triggers. Liver transplantation is indicated in pediatric patients with recurrent metabolic decompensation. There are limited reports of pediatric combined liver and heart transplantation. We present the first case of combined liver and heart transplantation in an Amish adult with newly diagnosed propionic acidemia and severe nonischemic dilated cardiomyopathy on advanced cardiac life support. Special considerations were necessary for close metabolic status monitoring and prevention of catabolic states.
Movimento lógico-histórico dos conceitos de Área e Perímetro
Authors: Borba Bruno Tizzo , Marco Fabiana Fiorezi de 
Published: October 2024

Neste artigo, recorte de uma tese, temos como objetivo apresentar um estudo do movimento lógico-histórico dos conceitos de área e perímetro, destacando-se os nexos conceituais evidenciados em historiografias estudadas. Para tanto, buscou-se na literatura autores que se fundamentam nos pressupostos do Materialismo Histórico-Dialético, bem como necessidades de grupos distintos e suas diversas práticas culturais. Os resultados indicam que os conceitos de área e perímetro são mais amplos do que os nexos externos tratados nas escolas da Educação Básica, como o cálculo de perímetro e de área por meio de fórmulas e representações das formas geométricas.
Non-canonical quantification in Old Persian: the adverb vasai̯
Authors: Coenen Pascal 
Published: October 2024

Abstract
In this paper, I conduct a synchronic investigation of the Old Persian adverb vasai̯. In some cases, this adverb functions as a degree intensifier whereas in others it appears to quantify over an argument NP. By drawing on analyses of adverbs like French beaucoup, English completely and German größtenteils, I will argue that a unified semantic analysis can be applied to all attestations of vasai̯. I will argue that in all attestations, vasai̯ indicates a high position on a scale. What differs in the respective passages is the nature of the scale. It can be an intensity scale specified by the predicate or a volume scale specified by an argument of the predicate. The latter case yields an interpretation that can be paraphrased by using an adnominal quantifier like much. In addition to the semantic analysis, I will argue that, contrary to the assumption made by several scholars, vasai̯ is always to be interpreted as an adverb and does not function as an uninflected noun or adjective.
Comprehensive approach to clinical decision-making strategy, illustrated by the Gulf War
Authors: Vučemilović Ante , Volf Mirela 
Published: October 2024

Abstract
Throughout the history of medicine, clinical decision-making strategies have largely been dependent on the implementation of novel technologies. Artificial intelligence (AI) has not only made a leap into a new dimension of medical measures & decisions’ shaping but has also served as a strategic backup of medical practice. Due to its nature, and military technologies in use, the Gulf War (1990–1991) is considered to be the verge of the contemporary warfare era. Soldiers had been engaged into a highly complex military operation theatre contaminated with both chemical and radiological noxious agents, and burdened with side-effects of prophylactic measurements. The aim of this review is to present a comprehensive approach to clinical decision-making strategy using the Gulf War veterans’ syndrome as an example. The model is based on the processing of all data coming from the military operation theatre and their unification with medical data, so as to obtain the final product, i.e., the decision needed for a personalised therapeutic approach. Due to the complexity and a huge amount of data gathered at a given location in a given time, the functioning of this model unanimously calls for the interlace between military system AI and that of the medical sector.