bluuebunny/crossref_metadata_2025_split huggingface dataset:
Reducing risk of CO2 storage in regional aquifers – plume migration in flat layer
Authors: Vulin Domagoj , Močilac Iva Kolenković , Jukić Lucija , Logarušić Božo 
Published: September 2024

Abstract

In order to show that in certain circumstances the presence of a structural trap is not required for CO2 storage, a set of conceptual models for CO2 injection in a deep saline aquifer represented by a horizontal, laterally infinite layer, i.e., without structural or stratigraphic trap, was developed. This is theoretically supported by the assumed gravitational migration of a CO2 plume towards cap-rock. The hypothesis was tested by varying injection depths and rock permeability to analyse the influence of these parameters on time and radius of CO2 plume lateral spreading. After running 30 simulation cases, an analytical term has been proposed and it was found that a logarithmic function is satisfactory for describing the relationship between time and maximum spreading radius from the injection well. Subsequently, a generalized analytical multi-parameter correlation was found to describe CO2 plume movement with time within the spread radius. After establishing such a fitted correlation, it is possible to predict the extent of the CO2 saturation zone, justifying less frequent 4D seismic measurements.
Establishing an animal model for post-inflammatory hyperpigmentation following fractional CO2 laser application
Authors: Feng Jiangfeng , Song Xiuzu , Zhang Beilei , Xiang Wenzhong 
Published: September 2024

Abstract

Background
Post-inflammatory hyperpigmentation (PIH) is a common cosmetic concern, often leading to significant psychological distress for the patients. With the widespread application of lasers including ablative fractional resurfacing (AFR) with a 10,600 nm CO2 laser, PIH caused by lasers is becoming increasingly common. But due to the absence of an appropriate animal research model, our understanding of pathophysiological mechanisms and preventive strategies for PIH remains limited.
Methods
This study aimed to establish an animal model to investigate PIH following AFR CO2 laser application, focusing on the dynamic changes in melanin, inflammatory cytokines, growth factors, and skin structures as PIH developed. We employed pigmented guinea pigs as our experimental subjects and conducted our research in two phases. In the first phase, we utilized three modalities of AFR CO2 laser, namely Active FX, Deep FX, and Total FX, to identify which laser mode could induce PIH by monitoring dynamic melanin changes. In the second phase, we used the Total FX mode to re-establish the PIH model. Pathophysiological changes during PIH progression were investigated through histopathological observations, real-time quantitative polymerase chain reaction, and two-photon microscopy.
Results
We successfully established a replicable animal model for PIH following AFR CO2 laser intervention. Following intervention with Total FX, we observed a significant increase in inflammatory cytokines and growth factors within the skin tissue by the second week, with stable pigmentation becoming apparent by the third week.
Conclusions
Our research provides a promising animal model for understanding and further studying the mechanisms of PIH after laser procedures.
EBM Level:
V (animal study)
A Quantitative Study on Quality of Physical Infrastructure, WASH practices, Preschool Education and Safety in Anganwadi Centers, Government Preschools and Private Preschools in Delhi
Authors: Tabassum Zeba , Khalid Kainat , Neyazi Sumayya , Ahmed Ebtisham 
Published: September 2024

Abstract

As the foundation of all learning depends upon early childhood experiences, which consist of the pre-schooling age of a child’s life, i.e., 3 to 6 years, preschools have a significant role in all learning. Enhanced cognitive, social, language capabilities and even a higher level of school readiness can be achieved through the quality of preschool programs. So, this study is undertaken to understand the quality of various modes of preschools, i.e., Anganwadi centers, government preschools, and private preschools, regarding their physical infrastructure, WASH practices, preschool education, and safety, that run in Delhi. 45 preschoolers were taken, 15 from each mode, and a descriptive research design was used for comparing the quality of different modes. The findings show that government preschools and private preschools are working at good quality in terms of physical infrastructure, safety of the children, and classroom process, though government preschools are performing slightly better than private preschools. On the other hand, Anganwadi centers are working mostly at average quality in all variables. All three modes of preschool should extensively work on the WASH practices and preschool education, especially in curriculum transaction and a child-friendly environment, as they require attention.
Is there a comparable Mp-MRI for incidental prostate uptake on 18F-FDG PET/CT?
Authors: Özdemir Merve Şam , Kaya Nurullah , Savun Metin , Keskin Emin Taha , Yüzkan Sabahattin , Omak Özgür , Özdemir Harun 
Published: September 2024

Abstract

Purpose: Although 18F-FDG-PET/CT is helpful in defining many types of cancer, localized prostate cancer should not be treated with this technique. In this study, accidental 18F-FDG uptake in the prostate is described using multi-parametric MRI (mpMRI).
Methods and Materials: While 18F-FDG-PET/CT is useful for characterizing a variety of cancers, it is not advised for prostate cancer that is localized. This work investigates the use of mpMRI to describe incidental 18F-FDG uptake in the prostate.mpMRI included T2-weighted (T2W), dynamic contrast enhancement (DCE), and apparent diffusion coefficient (ADC) sequences. Patients were classified according to PI-RADS (Prostate Imaging Reporting and Data System) version 2.1 by an experienced uroradiologist, and 18F-FDG-PET was evaluated to determine whether the area of involvement on CT had a counterpart in mpMRI. A biopsy was performed on 30 of the 92 patients.These patients' maximum standardized uptake values (SUVmax) 6 < and ≥ 6, PS(PSA) density 0.15< and ≥ 0.15, PSA level, uptake pattern (focal involvement/diffuse involvement), and PI-RADS scores were compared. P < 0.05 was considered statistically significant.
Results: In the study, 92 patients with incidental 18F-FDG-PET/CT prostate uptake were examined. Median age was 66, PSA median was 3.6 ng/ml (range: 0-3198 ng/ml). Notably, in 70.6% of cases, PET/CT uptake didn't correlate with mp-MRI findings. Among PI-RADS 3-4-5 patients (29.3%), there was a correlation. Biopsies in 30 patients revealed 43.3% benign, 56.7% malignant. Significant differences between benign and malignant cases were observed in PSA density, PI-RADS scores, and PSA levels (p < 0.05), while SUVmax and uptake pattern were not significant.
Conclusions: Our study showed that incidental 18F-FDG-PET/CT prostate uptake was detected and that high PSA density values, PI-RADS scores, and PSA values, such as in routine patients, and not PET-CT findings such as SUVmax and uptake pattern, were more predictive of malignancy.
Pedal to the Metal: Accelerating Intracerebral Hemorrhage Treatment with Robotic-Assisted Surgery. A systematic review &amp; meta-analysis of clinical effectiveness
Authors: Łajczak Paweł , Łajczak Anna 
Published: September 2024

Abstract

Introduction
Intracerebral hemorrhage (ICH) is a severe condition in vascular neurological surgery, often leading to high mortality and severe disability. Recent advancements in robotic-assisted (RA) systems, including ROSA, Remebot, and CAS-R-2, have shown promise in enhancing surgical precision and outcomes. This study aims to evaluate the effectiveness of RA systems in ICH drainage compared to conventional methods.
Materials and Methods
This systematic review followed PRISMA 2020 guidelines. The inclusion criteria were peer-reviewed English language articles reporting on the use of RA systems for ICH surgery in humans. Data extraction focused on surgical time, mortality rates, neurological outcomes, complication rates, and economic effectiveness. Meta-analyses were performed using R software, employing a random effects model to account for variations between studies.
Results
Fifteen studies were included in the systematic review, with eleven qualifying for the meta-analysis. The results demonstrated that RA systems significantly reduced surgery time (MD -94.94 minutes, 95% CI: -149.85 to -40.03, p <.01) and mortality at last follow-up (OR 0.37, 95% CI: 0.15 to 0.92, p = .032). RA systems also improved neurological outcomes, with lower mean modified Rankin Scale (mRS) scores (MD -0.81, 95% CI: -1.08 to -0.53, p <.01) and higher Glasgow Outcome Scale (GOS) scores (MD 0.68, 95% CI: 0.16 to 1.20, p <.01). Complications such as rebleeding, pulmonary infections, and intracranial infections were significantly reduced. Economic analysis showed lower overall treatment costs due to reduced hospital stays and fewer complications.
Conclusions
Robotic-assisted systems offer substantial benefits in the surgical management of ICH, including reduced surgery times, lower mortality rates, improved neurological outcomes, and fewer complications. Despite these promising results, further large-scale, multi-center randomized controlled trials are needed to validate these findings and standardize protocols for the use of RA systems in neurosurgery.
Prognostic value of NPR and CLR-based nomogram modeling in elderly patients with Acinetobacter baumannii sepsis
Authors: Lai Shaoqin , Li Xiaojun , Cai Donghao , Mei Chuangchuang 
Published: September 2024

Abstract

Background
Acinetobacter baumannii (A. baumannii) is one of the main pathogens that causes sepsis in elderly patients, with high morbidity and mortality rates once infected; new inflammatory indicators, such as the neutrophil–lymphocyte ratio (NLR) and platelet–lymphocyte ratio (PLR), have been proposed in recent years, and the prognostic effects of these new inflammatory indicators have not yet been adequately investigated in A. baumannii sepsis in elderly patients. Therefore, we verified the effects of these inflammatory indicators on A. baumannii sepsis prognosis in elderly patients by constructing a nomogram model.
Methods
The clinical data of 126 elderly patients with A. baumannii sepsis were retrospectively analyzed, and they were divided into a survival group (87 patients) and a death group (39 patients) according to survival status 28 days after infection. The prognostic risk factors were screened by univariate and multivariate Cox regression analyses and LASSO regression, and a predictive model was constructed and evaluated to analyze the predictive value of continuous variables for prognosis.
RESULTS
Out of 126 patients, 39 died, for a mortality rate of 31.0%. A high NLR (hazard ratio [HR] of 35.948, 95% confidence interval [CI], 6.890–187.548) and a high C-reactive protein (CRP)-to-lymphocyte ratio (CLR) (HR, 1.004; 95% CI, 1.002–1.006) are independent risk factors for death in elderly patients with Acinetobacter baumannii sepsis. The nomogram model predicted the highest discriminatory 7-day prognosis of A. baumannii sepsis in elderly patients, with an area under the working curve (AUC) of 0.821 for subjects, 0.778 and 0.784 for 14 and 28 days, respectively, and a standardized model with good agreement. The clinical decision curve revealed that the model provided good net benefit, ranging from 20%-100%.
Conclusion
The NPR and CLR are closely associated with the prognosis of A. baumannii sepsis in elderly patients, and in clinical practice, a focus should be placed on these new indicators of inflammation, especially the NPR and CLR, to help physicians better assess the prognosis of A. baumannii sepsis in elderly patients and to develop a more effective therapeutic regimen to improve the survival rate of patients.
Dosimetric Effects of Bladder Volume Changes in MR-Guided Radiotherapy for Cervical Cancer
Authors: Zhou Kaiwen , Zhao Junfeng , Chen Jinhu , An Xingwei , Yin Yong , Li Zhenjiang 
Published: September 2024

Abstract

Purpose
This study aims to assess the dosimetric impact of variable bladder volume on CTV and OAR in cervical cancer patients undergoing radiotherapy.
Method
A total of 27 cervical cancer patients were included in this study: 12 received radical radiotherapy, and 15 underwent postoperative radiotherapy. All patients were treated with the Elekta Unity MR-linac system. The dose requirement was 95–100% of the prescribed dose to the PTV(45 Gy/25 sessions/5 weeks). Daily images were acquired at the time of treatment using the MR-linac. For this study, MR images from the first three treatments of each patient were selected to contour the CTV and OAR (bladder, small bowel, rectum, right and left lateral femoral heads), and the treatment plan was recalculated using the Monaco TPS. The dosimetric effects of bladder volume changes on the CTV and OAR were analyzed by SPSS.
Result
Regarding the dosimetric effects on the CTV, in the postoperative radiotherapy group, D98 and D95 of the CTV decreased as the bladder filled, with D95 decreasing from 5175.5 cGy to 5000.7 cGy. In contrast, for patients undergoing radical radiotherapy, the mean dose of the CTV increased from 5143.4 cGy to 5368.1 cGy as the bladder filled (ρ = 0.306, P = 0.035). For the dosimetric effects on the bladder, in the postoperative radiotherapy group, V30 and V20 of the bladder decreased as the bladder filled. In the radical radiotherapy group, the minimum dose of the bladder decreased with increasing bladder volume, but the maximum dose increased from 5103.3 cGy to 5794.7 cGy (ρ = 0.451, P = 0.006). For the rectum and small bowel, in the postoperative radiotherapy group, changes in bladder volume did not significantly affect the dose of the small bowel and rectum (p > 0.05). However, in the radical radiotherapy group, the minimum and mean doses to the rectum and the D2 of the small bowel decreased with bladder filling.
Conclusion
This study assessed the dosimetric and volumetric effects of bladder filling on the CTV and OAR using daily MR images from the MR-linac. Bladder filling influences the dose distribution to CTV and OAR.
A Consortium of Fecal Microbes that Decolonizes Antibiotic-resistant Enteric Pathogens: A Potential Alternative to Fecal Microbiota Transplantation
Authors: Yoon Mi Young , Jeong Uk Jin , Cho Soo Yoon , Jung Hee Yong , Kim Erin , Rho Mina , Han Min , Lee Eun Hwa , Kim Jung Ho , Lee Seung Soon , Chung Youn Wook , Ryu Ji-Hwan , Choi Jun Yong , Yoon Sang Sun 
Published: September 2024

Abstract

Fecal microbiota transplantation (FMT) has proven effective in decolonizing carbapenemase-producing Enterobacteriaceae (CPE) and vancomycin-resistant Enterococci (VRE). However, its efficacy varies among patients, and frequent implementation poses challenges. Through microbiome analysis of fecal samples from both FMT responders and non-responders, we identified a consortium of four gut commensal species, termed BM111. In an antibiotic-pretreated mouse infection model, BM111 effectively decolonized a VRE strain, demonstrating its therapeutic potential. Additionally, in a humanized mouse model with feces from CPE-infected patients transplanted into germ-free mice, BM111 significantly cleared CPE strains. In animals treated with the BM111 consortium, their microbiome diversity increased post-treatment, correlating with BM111-induced positive outcomes. Further informatic analysis of cohorts from 11 countries confirmed the high prevalence and abundance of these four species in healthy individuals, supporting their potential to restore microbiome balance in patients with infection-induced dysbiosis. The BM111 consortium presents a promising, safe, and effective alternative to FMT for combating antibiotic-resistant enteric infections, warranting further clinical research and development.
Behavioral and Social Drivers of Routine Childhood Immunization in Selected Low Coverage Areas in the Philippines
Authors: Dalisay Soledad Natalia , Landicho Madilene , Lota Maria Margarita , Fujimori Yoshiki , Claro Paulyn Jean , Roxas Evalyn , Abeleda Alvin , Rosuello Jan Zarlyn , Dato Micaella , Vogt Florian , Danchin Margaret , Kaufman Jessica 
Published: September 2024

Abstract

Background
Routine childhood vaccination coverage under the National Immunization Program of the Philippines is well below the target of 95% with a high number of zero-dose children. Declining immunization rates led to outbreaks of vaccine preventable diseases such as measles, polio, and pertussis. This study aimed to identify the factors affecting childhood vaccine uptake by exploring the perspectives of community members, program managers, and coordinators.
Methodology:
Three regions with low vaccine coverage in the Philippines were selected as study sites. We conducted focus groups with adult caregivers of vaccinated and unvaccinated children aged 0–11 years recruited by barangay (community) health workers. Key informant interviews were also conducted with immunization program managers and coordinators from different administrative levels. Focus group and interview guides were informed by the World Health Organization’s Behavioural and Social Drivers (BeSD) of Vaccination framework, which include the following domains influencing vaccine uptake: “Thinking and feeling”, “Social processes'', “Motivation”, and “Practical issues''. Transcripts were analyzed by themes and deductive axial coding was used to categorize themes into BeSD domains and socioecological levels.
Results
Twelve focus groups (n = 143) and 57 key informant interviews were done. Under the ‘Thinking and feeling’ domain of the BeSD, at the intrapersonal level, the perception of benefits and negative side effects of routine vaccines were clear drivers of vaccination. In the ‘Social processes’ domain, factors at multiple socioecological levels such as influence of family, barangay health workers, and community leaders were identified. Incentives such as candies and hygiene kits were also a driver to vaccination. Practical issues such as the availability of vaccines and accessibility of vaccination sites remain a barrier to vaccination despite implementation of strategies such as outreach vaccination activities and house-to-house visits by health center personnel.
Conclusions
Availability of routine vaccines and accessibility to vaccination sites are major challenges in the Philippines. Acceptability of routine vaccines continue to be affected by previous controversies around the Dengue vaccine and the recent COVID-19 pandemic. Enhancing training for health care workers on health promotion education regarding vaccination may contribute to increased vaccine uptake. Integration of immunization with other population-based health programs could be explored.
A Comparative Analysis of Robotic versus Laparoscopic Total Pancreatectomy: Insights from the National Cancer Database
Authors: Baytar Doga Kahramangil , Charles Angel , Parrish Austin , Voskamp Sarah , Novikov Aleksey , McKean Jordan , Hughes Steven , Sahin Ilyas , George Thomas , Paniccia Alessandro , Nassour Ibrahim 
Published: September 2024

Abstract

Background
Total pancreatectomy is a complex procedure used in the management of pancreatic cancer. While minimally invasive techniques have been increasingly adopted, limited data exists comparing robotic total pancreatectomy (RTP) and laparoscopic total pancreatectomy (LTP). This study evaluates the utilization, short- and long-term outcomes of RTP and LTP using the National Cancer Database.
Methods
Patients with stages I-III pancreatic adenocarcinoma who underwent RTP or LTP between 2010 and 2019 were identified. Patient demographics, treatment characteristics, pathologic outcomes, postoperative outcomes, and overall survival were compared. Multivariable logistic regression and Cox proportional hazards models were used to assess the association of surgical approach with outcomes.
Results
Of the 995 patients included, 188 (19%) underwent RTP and 807 (81%) underwent LTP. The utilization of minimally invasive techniques increased over time, with RTP accounting for 24% of cases in 2019. RTP had lower conversion rates than LTP (16% vs. 24%, p = 0.031), but this difference was not significant after adjusting for confounders. Postoperative outcomes, including length of stay, 30-day readmission, and 30- and 90-day mortality, were similar between RTP and LTP. The median overall survival was 22.3 months for RTP and 23.6 months for LTP (p = 0.647).
Conclusion
RTP and LTP demonstrate comparable perioperative, pathological, and oncological outcomes for the management of pancreatic adenocarcinoma. Despite the increasing adoption of minimally invasive total pancreatectomy, it remains a rare operation and should be performed in experienced centers to optimize outcomes.
Comparison of intracerebrospinal fluid methotrexate by Ommaya reservoir versus lumbar puncture in leptomeningeal carcinomatosis with hydrocephalus: a retrospective cohort study
Authors: Hong Kun , Liu Chang , Zhang Yu , Li Yi , Li Qing , He Junying , Bu Hui 
Published: September 2024

Abstract

Objective
The aim of this study was to investigate the clinical efficacy and long-term outcome of different routes of intracerebrospinal fluid (intra-CSF) methotrexate administration in the treatment of leptomeningeal carcinomatosis (LC) with hydrocephalus.
Methods
A total of 36 patients were included in this retrospective study. 15 patients were enrolled in the Ommaya reservoir (OR) group and 21 in the lumbar punctures (LP) group. Overall survival (OS) was estimated using the Kaplane-Meier method. Prognostic models were constructed using Cox proportional hazards models.
Results
Of the 36 patients, most primary cancers were non-small cell lung cancer (69.4%) and breast cancer (13.9%). Compared with the LP group, the OR group had higher overall response rate (p = 0.016) and clinical response rate (p = 0.002). Further, the OR group provided better control of intracranial pressure (p = 0.042). All side effects, due to procedure-related complications and drug toxicities, were reported in 4 and 2 patients, respectively. Median OS was 54.7 weeks, in the OR versus 44.1 weeks in the LP group. No statistical difference was observed in the survival of the two groups (p = 0.53). Significant prognostic factors associated with poorer outcome on multivariate analysis were extraneural metastasis (p = 0.01), non-targeted therapy (p < 0.001), and ineffective response after intra-CSF chemotherapy (p = 0.041) .
Conclusions
Compared with intra-CSF methotrexate administration via LP, OR adminstration did not prolong the OS in LC patients with hydrocephalus. But it was more effective in relieving clinical symptoms and did not increase adverse events. Concomitant targeted therapy and effective response may improve the survival.