bluuebunny/crossref_metadata_2025_split huggingface dataset:
Renal tumor segmentation, visualization, and segmentation confidence using ensembles of neural networks in patients undergoing surgical resection
Authors: Bachanek Sophie , Wuerzberg Paul , Biggemann Lorenz , Janssen Tanja Yani , Nietert Manuel , Lotz Joachim , Zeuschner Philip , Maßmann Alexander , Uhlig Annemarie , Uhlig Johannes 
Published: August 2024

Abstract
Objectives
To develop an automatic segmentation model for solid renal tumors on contrast-enhanced CTs and to visualize segmentation with associated confidence to promote clinical applicability.

Materials and methods
The training dataset included solid renal tumor patients from two tertiary centers undergoing surgical resection and receiving CT in the corticomedullary or nephrogenic contrast media (CM) phase. Manual tumor segmentation was performed on all axial CT slices serving as reference standard for automatic segmentations. Independent testing was performed on the publicly available KiTS 2019 dataset. Ensembles of neural networks (ENN, DeepLabV3) were used for automatic renal tumor segmentation, and their performance was quantified with DICE score. ENN average foreground entropy measured segmentation confidence (binary: successful segmentation with DICE score > 0.8 versus inadequate segmentation ≤ 0.8).

Results
N = 639/n = 210 patients were included in the training and independent test dataset. Datasets were comparable regarding age and sex (p > 0.05), while renal tumors in the training dataset were larger and more frequently benign (p < 0.01). In the internal test dataset, the ENN model yielded a median DICE score = 0.84 (IQR: 0.62–0.97, corticomedullary) and 0.86 (IQR: 0.77–0.96, nephrogenic CM phase), and the segmentation confidence an AUC = 0.89 (sensitivity = 0.86; specificity = 0.77). In the independent test dataset, the ENN model achieved a median DICE score = 0.84 (IQR: 0.71–0.97, corticomedullary CM phase); and segmentation confidence an accuracy = 0.84 (sensitivity = 0.86 and specificity = 0.81). ENN segmentations were visualized with color-coded voxelwise tumor probabilities and thresholds superimposed on clinical CT images.

Conclusions
ENN-based renal tumor segmentation robustly performs in external test data and might aid in renal tumor classification and treatment planning.

Clinical relevance statement
Ensembles of neural networks (ENN) models could automatically segment renal tumors on routine CTs, enabling and standardizing downstream image analyses and treatment planning. Providing confidence measures and segmentation overlays on images can lower the threshold for clinical ENN implementation.

Key Points

Ensembles of neural networks (ENN) segmentation is visualized by color-coded voxelwise tumor probabilities and thresholds.

ENN provided a high segmentation accuracy in internal testing and in an independent external test dataset.

ENN models provide measures of segmentation confidence which can robustly discriminate between successful and inadequate segmentations.
A New Abscisic Acid Conjugate, ABA-L-Glutamate, Determined in Different Plant Species by Combined Immunoaffinity Chromatography-Tandem Mass Spectrometry
Authors: Turečková Veronika , Oklestková Jana , Žukauskaitė Asta , Eyer Luděk , Novák Ondřej , Strnad Miroslav 
Published: August 2024

AbstractAbscisic acid (ABA) is a phytohormone that occurs in plants at very low concentration (pmol/g fresh weight) and regulates multiple biological processes, including stomatal closure, seed germination, and responses to environmental stresses. In the present study, isolation of ABA, ABA glucosyl ester, and 11 ABA amino acid conjugates from minute quantities of plant tissue (less than 20 mg fresh weight) was achieved using a purification method based on the combination of an Oasis HLB column and an immunoaffinity sorbent. New monoclonal antibodies raised against (+)-cis,trans-ABA conjugated to BSA through its carboxyl group (C1) were characterised by enzyme-linked immunosorbent assay (ELISA) and used for immunoaffinity chromatography (IAC) gel preparation. The use of immunoaffinity purification significantly reduced matrix effects and increased the selectivity and sensitivity of subsequent UHPLC-MS/MS analysis. In addition to (+)-cis,trans-ABA and its glucosyl ester, a new abscisic acid conjugate, ABA-L-glutamate, was isolated by IAC and identified by tandem mass spectrometry in pea (Pisum sativum L.), Lepidium sativum L. and wheat (Triticum aestivum L.) seedlings. However, it was not found in 10-day-old seedlings of Arabidopsis thaliana or water-stressed tobacco (Nicotiana tabacum L.) leaves. Here, the identification of an ABA conjugate with glutamic acid in plants is described for the first time.
Force-Based Modeling of Heterogeneous Roles in the Coordinated Behavior of a Triad
Authors: Ichikawa Jun , Fujii Keisuke 
Published: August 2024

AbstractGroup coordination is defined as interactions with other members to implement a task that is difficult to do alone or to achieve higher performance than an individual. Meanwhile, the adjustment process in coordination is not uniquely determined because each individual has many degrees of freedom. It is more difficult to explain and model complex and dynamic coordination, such as nonverbal behavior of three or more members than pair or verbal interaction. Hence, we previously introduced a coordinated drawing task and conducted the behavioral experiment. The triads operated reels to change the tensions of threads connected to a pen, shared three heterogeneous roles (pulling, relaxing, and adjusting), and moved the pen to draw an equilateral triangle. The results indicated that the adjusting role was related to high task performance by helping resiliently without disturbing the pen’s smooth movement while avoiding great pen deviation. However, this experiment alone cannot explain details of the adjustment process of tension. To supplement these findings, this study formulated the three roles using equations of motion. The multi-agent simulation results showed that the adjusting role might use the degree of pen deviation reflected by the others’ motor information, such as the operating procedures and forces, to change the tension and draw at least three sides. Although it is necessary to consider that we used the experimental task, our study contributes to the fundamental understanding of resilient adjustment in coordination by sharing heterogeneous roles as the first step.
Predictability of the early summer surface air temperature over Western South Asia
Authors: Rashid Irfan Ur , Abid Muhammad Adnan , Osman Marisol , Kucharski Fred , Ashfaq Moetasim , Weisheimer Antje , Almazroui Mansour , Torres-Alavez José Abraham , Afzaal Muhammad 
Published: August 2024

AbstractVariability of the Surface Air Temperature (SAT) over the Western South Asia (WSA) region leads to frequent heatwaves during the early summer (May-June) season. The present study uses the European Centre for Medium-Range Weather Forecast’s fifth-generation seasonal prediction system, SEAS5, from 1981 to 2022 based on April initial conditions (1-month lead) to assess the SAT predictability during early summer season. The goal is to evaluate the SEAS5’s ability to predict the El Niño-Southern Oscillation (ENSO) related interannual variability and predictability of the SAT over WSA, which is mediated through upper-level (200-hPa) geopotential height anomalies. This teleconnection leads to anomalously warm surface conditions over the region during the negative ENSO phase, as observed in the reanalysis and SEAS5. We evaluate SEAS5 prediction skill against two observations and three reanalyses datasets. The SEAS5 SAT prediction skill is higher with high spatial resolution observations and reanalysis datasets compared to the ones with low-resolution. Overall, SEAS5 shows reasonable skill in predicting SAT and its variability over the WSA region. Moreover, the predictability of SAT during La Niña is comparable to El Niño years over the WSA region.
German version of the engagement of a person with dementia scale: translation and initial application experiences
Authors: Seibert Kathrin , Domhoff Dominik , Fricke Jacob , Wolf-Ostermann Karin 
Published: August 2024

Abstract

Background
Assessment tools for engagement in people with dementia often rely on self-reported measures which restricts their use in people with severe cognitive limitations. The Engagement of a Person with Dementia Scale (EPWDS) is a valid and reliable tool to assess behavioral and emotional expressions and responses of engagement in people with dementia through observation; however, the EPWDS is not yet available in the German language.

Objectives
1) Translation and cross-culturally adaptation of the original English version of the EPWDS into the German language (EPWDS-GER) and 2) to gain insights into assessing data with the newly developed instrument.

Material and methods
International recommendations were followed to cross-culturally adapt the English original version of the EPWDS into the German language in 5 steps: translation by three independent translators, synthesis, back translation, expert committee review (N = 10) and test of the prefinal version in nursing practice (N = 22) on a 5-point Likert scale to assess comprehensibility, practicability and suitability of the EPWDS-GER.

Results
The EPWDS-GER achieved high ratings for the five subscales on ease of understanding, ease of answering and importance of single items for assessing engagement. Average agreement for all items ranged from 3.86 to 4.43 (SD = 0.68–1.29). Overall rating of EPWDS-GER resulted in a mean agreement of 4.18 (SD = 0.73) for suitability and of 4.09 (SD = 0.81) for practicability.

Conclusion
The EPWDS-GER is an easy to use tool for measuring behavioral and emotional expressions and responses of engagement of a person with dementia and can now be utilized in clinical practice and research.
Health-related quality of life in vibrant soundbridge patients: generic and specific measures, short-term and long-term outcomes
Authors: Muigg Franz , Zelger Philipp , Rossi Sonja , Kühn Heike , Schmutzhard Joachim , Graf Simone , Weichbold Viktor 
Published: August 2024

Abstract
Objective
The goal of the study was to determine the short- and long-term outcome of health-related quality of life (HRQoL) in adults implanted with a Vibrant Soundbridge (VSB).

Methods
Twenty-one adults (8 females, 13 males; mean age at implantation: 57 ±10 years) who received a unilateral VSB for combined or conductive hearing loss, were administered two questionnaires: the Nijmegen Cochlear Implant Questionnaire (NCIQ) as a measure of hearing-specific HRQoL, and the Health Utility Index 3 (HUI 3) as a measure of generic HRQoL. The questionnaires were administered before implantation and three, six, 12 and 24 months after processor activation.

Results
The NCIQ total score raised significantly from 62 points before implantation to 76 points at three months after processor activation (p < 0.005). Thereafter, no significant increases occurred anymore. The HUI 3 multi-attribute score (MAUS) increased from 0.59 before implantation to 0.70 at three months and at six months after processor activation and then declined slightly to 0.68 at 24 months after processor activation. Similar values were observed with the HUI 3 single-attribute score (SAUS) of Hearing. The increases of the HUI 3 scores were not statistically significant, but all pre-post-implantation differences were clinically relevant.

Discussion
VSB recipients experienced a quick improvement of their HRQoL. After just three months of device use, a significant improvement of hearing-specific HRQoL and a clinically relevant improvement of generic HRQoL were seen. After three months, no essential changes of HRQoL occurred in our sample, suggesting that the achieved level of HRQoL may remain stable in the long term.
Muscular tension in ear surgeons during cochlear implantations: does a new microscope improve musculoskeletal complaints?
Authors: Lakomek Antonia , Eichler Theda , Meyer Moritz , Höing Benedikt , Dudda Marcel , Lang Stephan , Arweiler-Harbeck Diana 
Published: August 2024

Abstract

Purpose
Musculoskeletal complaints and fatigue are commonly described symptoms in daily work of ear nose and throat surgeons using a microscope. Long ear surgical procedures are associated with prolonged microscope use, which can lead to unconsciously tense and uncomfortable body posture. The digital microscope RoboticScope® allows visualization of surgical site through a Head-Mounted Display, independent from camera head and is therefore much easier on the back, as the sitting position can be adjusted flexibly. Aim of the prospective study was to investigate to what extent the use of a RoboticScope® changes the tension of neck and shoulder muscles of the surgeons in comparison to a conventional tripod microscope.

Methods
For this purpose, the electric activity of neck and shoulder muscles of surgeons was recorded using surface electromyography during cochlear implantations. Electrical potentials were derived via electrodes on neck and shoulder muscles. The basic tension of those muscles was measured in relaxed position before and after surgery. During microscope use the tension was continued to be measured. A questionnaire recorded parameters such as level of difficulty of operation as well as patient data.

Results
Results from 58 operations, 33 of which were performed using a conventional microscope and 25 using a Head-Mounted Display, show a significant reduction in muscular tension during surgery by 40% (p < 0.001) in experienced ear surgeons when using a RoboticScope®, regardless of the surgeon.

Conclusion
Our results are in line with the relevance of preventive measures to avoid acute and chronic work-related illnesses/symptoms described in literature.
Enhancing exercise performance and recovery through sodium bicarbonate supplementation: introducing the ingestion recovery framework
Authors: Gurton William H. , King David G. , Ranchordas Mayur K. , Siegler Jason C. , Gough Lewis A. 
Published: August 2024

AbstractSodium bicarbonate (SB) supplementation is an ergogenic strategy for athletes competing in high-intensity exercise, but the efficacy of SB for accelerating recovery from exercise and thus improving performance during repeated bouts of exercise is not fully understood. In a similar fashion to using SB as a pre-exercise buffer, it is possible accelerated restoration of blood pH and bicarbonate following an exercise bout mechanistically underpins the use of SB as a recovery aid. Physiological mechanisms contributing to beneficial effects for SB during repeated bout exercise could be more far-reaching however, as alterations in strong ion difference (SID) and attenuated cellular stress response might also contribute to accelerated recovery from exercise. From inspection of existing literature, ingestion of 0.3 g kg−1 body mass SB ~60–90 min pre-exercise seems to be the most common dosage strategy, but there is evidence emerging for the potential application of post-exercise supplementation timing, gradual SB doses throughout a competition day, or even ingestion during exercise. Based on this review of literature, an SB ingestion recovery framework is proposed to guide athletes and practitioners on the use of SB to enhance performance for multiple bouts of exercise.
Variation in vessel traits of northern red oak (Quercus rubra L.) provenances revealed high phenotypic plasticity to prevailing environmental conditions
Authors: Kormann Jonathan M. , van der Maaten-Theunissen Marieke , Unterholzner Lucrezia , Liesebach Mirko , Liepe Katharina J. , van der Maaten Ernst 
Published: August 2024

Abstract
Key message
Red oak provenances responded with high plasticity and intra-annual variability in vessel traits to studied climatic conditions, indicating weak signals of local adaptation and providing opportunities for forest management.
The climate change-induced increase in frequency and severity of extreme events has revealed a high vulnerability of various major tree species in Europe, stressing the need for selecting climate-resilient species for forest management. In this context, adaptive strategies of northern red oak (Quercus rubra L.) were examined, using wood anatomical data derived from a provenance trial. We investigated the interannual variation in vessel traits of red oak provenances planted at three sites along a precipitation gradient in Germany. We compared the climate sensitivity of German provenances with those from North America to analyze plasticity and to identify signals of local adaptation in vessel traits. The results revealed variations in vessel traits between all sites, pointing to site-specific responses to prevailing environmental conditions. Differences between provenances were prevalent for vessel size-related traits, with site-specific higher values for German provenances at wet sites. Climate signals, which varied between traits, were strongest for vessel density and the relative conductive area. Vessel traits were found to depend both on previous-year conditions as and on spring climate conditions during the onset of vessel formation. The site-specific response in extreme years deviate significantly between drought and frost events. A trade-off between resistance to extremes and vessel diameter could not be demonstrated, and provenances with larger vessel diameters showed higher frost resistance. The observed high plasticity in vessel traits and the site-specific variation to climate influences point to an adjustment in vessel formation to the prevailing environmental conditions.
Evolutionary variational inference for Bayesian generalized nonlinear models
Authors: Sommerfelt Philip Sebastian Hauglie , Hubin Aliaksandr 
Published: August 2024

AbstractIn the exploration of recently developed Bayesian Generalized Nonlinear Models (BGNLM), this paper proposes a pragmatic scalable approximation for computing posterior distributions. Traditional Markov chain Monte Carlo within the populations of the Genetically Modified Mode Jumping Markov Chain Monte Carlo (GMJMCMC) algorithm is an NP-hard search problem. To linearize them, we suggest using instead variational Bayes, employing either mean-field approximation or normalizing flows for simplicity and scalability. This results in an evolutionary variational Bayes algorithm as a more scalable alternative to GMJMCMC. Through practical applications including inference on Bayesian linear models, Bayesian fractional polynomials, and full BGNLM, we demonstrate the effectiveness of our method, delivering accurate predictions, transparency and interpretations, and accessible measures of uncertainty, while improving the scalability of BGNLM inference through on the one hand using a novel variational Bayes method, but, on the other hand, enabling the use of GPUs for computations.
Stereotactic radio-neurosurgery for jugular foramen schwannomas
Authors: Bourhila Camil , Cotrutz Cristian , Daniel Roy Thomas , George Mercy , Schiappacasse Luis , Patin David , Levivier Marc , Tuleasca Constantin 
Published: August 2024

Abstract

Background
Stereotactic radiosurgery (SRS) represents a minimally invasive and valuable alternative for jugular foramen schwannomas (JFS), both as upfront and/or adjuvant treatment (in hybrid approaches).

Methods
We conducted a retrospective review of our cases treated at the Lausanne University Hospital (CHUV) from June 2010 to October 2023. Eleven patients underwent SRS, among whom three had prior surgery, two in our center in the frame of a planned combined approach and one in another center. Two patients received "volume-staged" SRS. The mean age at SRS was 60 years (median 68; range 29–83). Cranial nerve (CN) symptoms were present in six patients, while five were asymptomatic. The mean tumor volume at SRS was 2.1 cc (median 1.2; range 0.068–7.3 cc), with a 12 Gy marginal dose prescribed in all cases.

Results
The mean follow-up period was 3.9 years (median 2, range 1–7). Cranial nerve function improved after SRS in six patients, while five remained stable. At the last follow-up, all tumors showed a decrease in volume, except for one patient, who underwent surgery at 18 months after SRS, for volumetric increase at 6 and 12 months, with further XII−th CN palsy and medulla oblongata compression. Although tumor decreased at 18 months, such patient needed microsurgical resection for symptom persistence and was further controlled. The mean tumor volume at 1 year post-SRS was 1.6 cc (median 0.55; range 0.028–7.77 cc), at 2 years was 1.31 cc (median 0.76; range 0.19–5), and at 3 years was 1.32 cc (median 0.59; range 0.23–4.8). No adverse radiation events were observed.

Conclusions
Stereotactic radiosurgery is considered a safe and effective treatment for jugular foramen schwannomas, ensuring high rates of tumor control in all patients over the long term. The cranial nerve function improved after SRS in the 6 patients who had deficits and the other 5 patients who had no deficits remained asymptomatic. For larger tumors, combined/hybrid approaches can be a valuable alternative, to obtain tumor control and to preserve neurological function.
Individuelle MS-Therapie
Authors: Heschl Bettina 
Published: August 2024

ZusammenfassungZur Behandlung der multiplen Sklerose zeigte sich in den letzten Jahren ein stetiger Zuwachs neuer Therapieoptionen und es steht derzeit eine Vielzahl von Medikamenten zur Verfügung. Um für unsere Patient:innen die individuell richtige Therapie zu finden, müssen neben einer sicheren Diagnose sowie der Krankheitsaktivität auch Wirkungsweise und Nebenwirkungen der einzelnen Medikamente in die Therapieentscheidung miteinfließen.Ich berichte über eine junge Patientin mit einer komplexen Vorgeschichte und werde anhand der Medikamentenwirkweise sowie potenziellen Nebenwirkungen Entscheidungen diskutieren und Problemlösungen besprechen.
Oncological similarities between large type 3 and type 4 tumors in patients with resectable gastric cancer: a propensity score-matched analysis of a multi-institutional dataset
Authors: Nakanishi Koki , Kanda Mitsuro , Ito Seiji , Mochizuki Yoshinari , Teramoto Hitoshi , Ishigure Kiyoshi , Murai Toshifumi , Asada Takahiro , Ishiyama Akiharu , Matsushita Hidenobu , Shimizu Dai , Tanaka Chie , Fujiwara Michitaka , Murotani Kenta , Kodera Yasuhiro 
Published: August 2024

Abstract
Background
Large type 3 (diameter ≥ 8 cm) and type 4 gastric cancers have been arbitrarily combined in Japan as a single entity. However, whether these two types are oncologically similar remain unclear. This study aimed to clarify this issue.

Methods
In this retrospective study, we analyzed a database of 3,575 patients from nine institutions who underwent gastrectomy between 2010 and 2014. Using propensity scores to balance significant variables, we compared prognoses and tumor recurrences.

Results
Of patients with clinical T3/T4 who underwent R0 resection, 75 and 73 had large type 3 and 4 tumors, respectively. Patients with type 4 tumors had significantly lower overall survival rates than those of patients with large type 3 tumors (hazard ratio [HR] 1.77; 95% confidence interval [CI] 1.14–2.74). However, among the large type 3 tumors, a remarkable difference in prognosis was observed between the differentiated and undifferentiated histological types. A comparison was made between large type 3 with undifferentiated phenotype and type 4, each with 39 patients after propensity score matching. Outcomes in both groups were similar in terms of overall survival (HR 1.28; 95% CI 0.73–2.25) and relapse-free survival (HR 1.34; 95% CI 0.80–2.27). No statistically significant differences were observed in the incidence of peritoneal recurrence (35.9% vs. 46.1%, P = 0.36) and lymph node recurrence (25.6% vs. 12.8%, P = 0.15).

Conclusions
Large type 3 tumors with undifferentiated phenotype and type 4 tumors were oncologically similar. This subgroup could be considered as a new entity for future clinical trials.