bluuebunny/crossref_metadata_2025_split huggingface dataset:
Computer-aided diagnosis system for grading brain tumor using histopathology images based on color and texture features
Authors: Elazab Naira , Gab Allah Wael , Elmogy Mohammed 
Published: July 2024

Abstract
Background
Cancer pathology shows disease development and associated molecular features. It provides extensive phenotypic information that is cancer-predictive and has potential implications for planning treatment. Based on the exceptional performance of computational approaches in the field of digital pathogenic, the use of rich phenotypic information in digital pathology images has enabled us to identify low-level gliomas (LGG) from high-grade gliomas (HGG). Because the differences between the textures are so slight, utilizing just one feature or a small number of features produces poor categorization results.

Methods
In this work, multiple feature extraction methods that can extract distinct features from the texture of histopathology image data are used to compare the classification outcomes. The successful feature extraction algorithms GLCM, LBP, multi-LBGLCM, GLRLM, color moment features, and RSHD have been chosen in this paper. LBP and GLCM algorithms are combined to create LBGLCM. The LBGLCM feature extraction approach is extended in this study to multiple scales using an image pyramid, which is defined by sampling the image both in space and scale. The preprocessing stage is first used to enhance the contrast of the images and remove noise and illumination effects. The feature extraction stage is then carried out to extract several important features (texture and color) from histopathology images. Third, the feature fusion and reduction step is put into practice to decrease the number of features that are processed, reducing the computation time of the suggested system. The classification stage is created at the end to categorize various brain cancer grades. We performed our analysis on the 821 whole-slide pathology images from glioma patients in the Cancer Genome Atlas (TCGA) dataset. Two types of brain cancer are included in the dataset: GBM and LGG (grades II and III). 506 GBM images and 315 LGG images are included in our analysis, guaranteeing representation of various tumor grades and histopathological features.

Results
The fusion of textural and color characteristics was validated in the glioma patients using the 10-fold cross-validation technique with an accuracy equals to 95.8%, sensitivity equals to 96.4%, DSC equals to 96.7%, and specificity equals to 97.1%. The combination of the color and texture characteristics produced significantly better accuracy, which supported their synergistic significance in the predictive model. The result indicates that the textural characteristics can be an objective, accurate, and comprehensive glioma prediction when paired with conventional imagery.

Conclusion
The results outperform current approaches for identifying LGG from HGG and provide competitive performance in classifying four categories of glioma in the literature. The proposed model can help stratify patients in clinical studies, choose patients for targeted therapy, and customize specific treatment schedules.
Definitive chemoradiotherapy with paclitaxel for locally advanced esophageal squamous cell carcinoma in older patients (PARADISE-1): a phase I trial
Authors: Hirata Kenro , Yoshida Kayo , Katada Chikatoshi , Watanabe Akinori , Tsushima Takahiro , Yamaguchi Toshifumi , Yamamoto Sachiko , Ishikawa Hideki , Sato Yasunori , Imamura Chiyo K. , Tanigawara Yusuke , Ito Yoshinori , Kato Ken , Kitagawa Yuko , Hamamoto Yasuo 
Published: July 2024

Abstract
Background
In older patients, esophageal squamous cell carcinoma (ESCC) is difficult to treat using standard therapies, including surgery and cisplatin-based chemoradiotherapy. Paclitaxel (PTX) has radiosensitizing activity. We conducted a phase I trial of PTX combined with radiotherapy to establish a standard therapy for locally advanced ESCC in older patients.

Methods
Enrollment was conducted at six centers in Japan from April 2016 to September 2019. The participants were aged ≥ 70 years, had locally advanced ESCC, and were intolerant to surgery or unwilling. A fixed 60-Gy radiation dose was administered in 30 fractions. PTX dosing levels started at 30 mg/m2 weekly for 6 weeks. Depending on the number of DLTs, the dose was set to be increased by 10 mg/m2 or switched to biweekly. A geriatric assessment was performed before treatment using the Geriatric-8 screening tool. The primary endpoint was dose-limiting toxicity (DLT).

Results
We enrolled 24 patients (6 per group); DLT was observed in one (grade 4 hypokalemia), one (grade 3 aspiration), two (grade 3 radiodermatitis, grade 3 esophageal hemorrhage), and two (grade 3 anorexia, grade 5 pneumonitis) patients in the weekly PTX 30, 40, 50, and 60 mg/m2 groups, respectively. All adverse events, except death in the 60 mg/m2 group, showed reversible improvement, and the safety profile was considered acceptable. The 2-year survival and complete response rates were 40.0% and 54.2%, respectively. There was a significant difference in survival between favorable and unfavorable Geriatric-8 scores.

Conclusions
The recommended PTX dose with concomitant radiation was determined to be 50 mg/m2 weekly. Phase II trials at this dose are underway.
Normative data and correlation parameters for vessel density measured by 6 × 6-mm optical coherence tomography angiography in a large chinese urban healthy elderly population: date from the Beichen eye study
Authors: Xu Shuzhan , Gao Fei , Luan Rong , Liu Yuqing , Li Xiaorong , Liu Juping ,   the Beichen Eye Study Group
Published: July 2024

Abstract
Background
To establish a normative database for macular vessel density (VD) measured by optical coherence tomography angiography (OCTA) and explore the parameters related to the VD.

Methods
An observational study in epidemiology. 5840 healthy elderly participants in Beichen district, Tianjin, China underwent detailed ophthalmic and systemic examinations. OCTA was performed in all subjects using a 6 × 6-mm line scan mode centered on the macula and the built-in software was used to quantify VD and stratify the retina.

Results
One thousand four hundred sixty-one healthy elderly citizens (30.4% men) were included, with a median age of 60.0 years (8.0 years) and an age range of 50 to 87 years.VDs in the different plexuses: superficial capillary plexus (SCP) 43.9% (3.2%), deep capillary plexus (DCP) 44.3% (2.8%), outer capillary plexus (OCP) 21.9% (5.9%), choriocapillaris (CC) 52.1% (1.4%). 90% medical reference range of the VDs at different plexuses was reported. Age was correlated with the VDs of each capillary plexus. Sex was correlated with the VDs of DCP and OCP, and the VDs of DCP (p < 0.001) and OCP (p = 0.015) in women were higher than that in men. After age and sex adjustment, choroid average thickness was positively correlated with VDs of SCP (R = 0.067, p = 0.010) and DCP (R = 0.108, p < 0.001), ganglion cell layer (GCL) average thickness (R = 0.072, p = 0.006) was positively correlated with the VD of OCP, best-corrected visual acuity (BCVA) (R = 0.082, p = 0.002) was positively correlated with the VD of CC.

Conclusions
In this study, the normative VD database of the Chinese urban healthy elderly population measured by the OCTA was established, and parameters related to the VD of each capillary plexus were analyzed, providing new ideas for the future study of the relationship between macular VD and disease.

Trial registration
The Beichen Eye Study had been registered on the Chinese Clinical Trial Registry website (registry number: ChiCTR2000032280) on April 25, 2020.
91-month follow-up of solitary punctate chorioretinitis in a Chinese patient
Authors: Liu Chu , Liu Mengke , Lan Xinyue , Zhu Junjie , Zhang Zhengwei 
Published: July 2024

Abstract
Background
Solitary Punctate Chorioretinitis (SPC) is a recently identified form of punctate inner choroidopathy (PIC) characterized by a single lesion in the fovea of the macula. Previous studies with a maximum follow-up of 48 months were insufficient. Our review uncovered a case sustained for 91 months.

Case presentation
A 28-year-old young woman experienced with sudden visual loss in her right eye. Comprehensive examinations, including assessment of best-corrected visual acuity (BCVA), slit-lamp biomicroscopy, noncontact tonometry, fundus fluorescein angiography (FFA), fundus autofluorescence (FAF), optical coherence tomography angiography (OCTA), perimetry, and microperimetry, were conducted. Over 91 months, the lesion slightly enlarged, remained yellow-white and punctate, and stayed in the central macula of the posterior pole. OCT images depicted subsidence in the inner nuclear layer (INL), the outer plexiform layer (OPL), photoreceptor layer, and disruption of the external limiting membrane (ELM), ellipsoid zone, and retinal pigment epithelium (RPE)/Bruch’s membrane complex. Retinal herniation, focal choroidal excavation (FCE), and abnormal vessels in the choriocapillaris were noted. At the slab of the choriocapillaris, OCTA demonstrated that the lesion resembled a linear vascular structure, distinct from the structure of normal choriocapillaris. This confirmed the lesion as an abnormal vascular formation. FAF revealed a punctate hypo-autofluorescence lesion and abnormal hyper-autofluorescence near the optic disc and macula. FFA demonstrated a punctate hyper-fluorescent lesion inferotemporal to the fovea. The vascular structure remained stable without fluid exudation on OCT images, hence anti-vascular endothelial growth factor (anti-VEGF) treatment was not administered. Visual acuity improved from counting fingers to 0.07 in 52 days, reached 0.6 after 15 months, remained at 0.6 from 56 to 80 months, and returned to 0.8 after 91 months, although accompanied by local scotomas. The lesion pattern slightly enlarged without scarring.

Conclusions
Throughout long-term follow-up, we had long suspected the presence of choroidal neovascularization (CNV) and found the FCE in the last visit. Eventually, we concluded that SPC could potentially constitute a distinct subtype of PIC. The patient received no treatment, and vision recovered to 0.8. If CNV is suspected in SPC, anti-VEGF treatment may not be necessary without activity on OCT, but close monitoring is essential.
Changes in the epidemiological characteristics of influenza in children in Zhengzhou, China, in the post-COVID-19 era
Authors: Jia Wanyu , Zhang Xue , Sun Ruiyang , Li Peng , Zhen Xinggang , Li Yu , Wang Daobin , Li Changqing , Song Chunlan 
Published: July 2024

Abstract
Background
Influenza is a contagious respiratory disease posing a huge burden of disease for children around the world. The purpose of this study was to investigate the epidemiologic changes in childhood influenza in Zhengzhou, China, before, during, and after the COVID-19 outbreak. The aim of this study was to determine the impact of the COVID-19 outbreak and related prevention and control policies on the children’s influenza epidemiological trend.

Methods
All influenza report card data from the Children’s Hospital Affiliated with Zhengzhou University’s Disease Surveillance Reporting Management System were collected and analyzed monthly from January 2018 to December 2023. The period of the study was divided into three phases for comparison: the pre-pandemic period, the pandemic period, and the post-pandemic period.

Results
Between January 2018 and December 2023, a total of 82,030 children with influenza were diagnosed at our hospital, including 46,453 males and 35,577 females. A total of 11,833 of them had to be hospitalized for influenza, and 321 of them were brought to the ICU. Influenza showed low-level epidemiologic status during the COVID-19 pandemic, and there was a substantial rise in influenza and a surge in the number of cases after the COVID-19 pandemic period. The year 2023 will had the most influenza cases (40,785). The peak incidence of influenza changes in 2022, from July to October, and in 2023, from February to April and from October to December. During the post-pandemic period, the proportion of new-borns and young children among influenza patients decreased, while the proportion of school-age children increased significantly, and the proportion of influenza patients hospitalized and the proportion of ICU admissions decreased.

Conclusion
Influenza showed low-level epidemiologic status during the COVID-19 pandemic. In the post-pandemic period, there is a large increase in influenza incidence, with a double peak in influenza incidence. The proportion of school-age children with influenza has also increased. As a result, we recommend that influenza vaccination for key populations, particularly school-age children, be completed by October of each year in Henan Province, and that the government and schools increase education about nonpharmacological influenza prevention approaches.
Recurrent spontaneous pneumothorax secondary to lung cystic lesions in a case of convalescent COVID-19: a case report and literature review
Authors: Song Yangzi , Jin Jianmin , Wang Xuechen , Zhang Jinguo , Li Zuojun 
Published: July 2024

Abstract
Background
While spontaneous pneumothorax has been documented in COVID-19 patients, reports on recurrent spontaneous pneumothorax due to cystic lesions in convalescent COVID-19 patients are scarce. The progression of these lung cystic lesions remains inadequately explored.

Case presentation and literature review
An 81-year-old male, a non-smoker with a history of rheumatoid arthritis, presented with fever, cough, and expectoration for 14 days. Initially diagnosed with moderate COVID-19, he deteriorated to severe COVID-19 despite adherence to local treatment guidelines. Successive identification of three cystic lesions termed “bulla” or “pneumatocele”, and one cystic lesion with air-fluid level, referred to as “pneumo-hamatocele” (PHC), occurred in his lungs. Gradual improvement followed anti-inflammatory therapy and optimal supportive care. However, on day 42, sudden worsening dyspnea prompted a computed tomography (CT) scan, confirming a right spontaneous pneumothorax and subcutaneous emphysema, likely due to PHC rupture. Discharge followed chest tube implementation for pneumothorax resolution. On day 116, he returned to the hospital with mild exertional dyspnea. Chest CT revealed recurrent right pneumothorax from a remaining cyst in the right lung. Apart from our patient, literature retrieval identified 22 COVID-19 patients with spontaneous pneumothorax due to cystic lesions, with a male predominance (95.6%; 22/23). Diagnosis of pneumothorax and lung cystic lesions occurred around day 29.5 (range: 18–35) and day 26.4 (± 9.8) since symptom onset, respectively. Except for one patient whose pneumothorax occurred on day seven of illness, all patients eventually recovered.

Conclusions
Recurrent spontaneous pneumothorax secondary to lung cystic lesions may manifest in convalescent COVID-19 patients, particularly males with COVID-19 pneumonia. Chest CT around 2 to 3 weeks post-symptom onset may be prudent to detect cystic lesion development and anticipate spontaneous pneumothorax.
Resistant C. albicans implicated in recurrent vulvovaginal candidiasis (RVVC) among women in a tertiary healthcare facility in Kumasi, Ghana
Authors: Sarpong Abena Kyeraa , Odoi Hayford , Boakye Yaw Duah , Boamah Vivian Etsiapa , Agyare Christian 
Published: July 2024

Abstract
Background
Vulvovaginal candidiasis is a common fungal infection that affects the female lower genital tract. This study determined the major risk factors associated with vulvovaginal infection (VVI) in the Ashanti region of Ghana and also determined the antifungal resistance patterns of Candida albicans isolates to some antifungals.

Methods
Three hundred and fifty (350) high vaginal swab (HVS) samples were collected from women who presented with signs and symptoms of VVI. A structured questionnaire was administered to one hundred and seventy-two (172) of the women. HVS samples were cultured on Sabouraud dextrose agar with 2% chloramphenicol. The polymerase chain reaction was employed to confirm C. albicans. Antifungal susceptibility testing was performed and the susceptibility of C. albicans isolates to fluconazole, clotrimazole, amphotericin B, nystatin, miconazole and 5-flurocytosine were assessed.

Results
Vaginal infection was most prevalent amongst females in their reproductive age (21 to 30 years; 63.0%). The study found a significant association between vaginal infections and some risk factors such as sexual practices (p < 0.001), antibiotic misuse (p < 0.05), poor personal hygiene (p < 0.005) and birth control methods (p < 0.049). Out of the 350 HVS samples collected, 112 yielded yeast cells with 65 (58%) identified as C. albicans. The C. albicans isolates were resistant to 5’ flucytosine (100%), fluconazole (70%), voriconazole (69.2%), miconazole (58.5%) and nystatin (49.2%). C. albicans isolates were more susceptible to amphotericin B (53.8%) and clotrimazole (45.1%), although an appreciable number of isolates showed resistance (46.1% and 52.3%, respectively).

Conclusion
There should be nationwide education on all associated risk factors of VVI. Also, use of the various antifungal agents in vaginal candidiasis should proceed after antifungal susceptibility testing to ensure efficacious use of these agents.
Knowledge, attitudes, and practices of gouty arthritis in the general population aged > 30
Authors: Zhao Min , Jian Jie , Yang Dong , Sun Honggang , Liu Ling , Yan Zhiyuan , Ma Yun , Zhao Yugang 
Published: July 2024

Abstract
Background
A knowledge of gouty arthritis could help in the primary prevention of the disease development and lead to an early diagnosis if it occurs. This study investigated the knowledge, attitudes, and practices (KAP) toward gouty arthritis in the general population > 30 years old.

Methods
This web-based cross-sectional study was conducted among the general population > 30 years old between January and March 2023 in Chengdu, Sichuan. The questionnaire was designed by the investigators based on the available guidelines (Cronbach’s α = 0.846). A score above 70% indicated good knowledge, a positive attitude, and proactive practice. Multivariable and structural equation modeling (SEM) analyses were performed to analyze the factors influencing KAP.

Results
A total of 537 questionnaires were included. The knowledge, attitudes, and practices scores were 13.12 ± 6.41, 25.28 ± 3.97, and 45.25 ± 5.77, respectively. Female (OR = 0.47, 95%CI: 0.31–0.71, P < 0.001), suburban living (OR = 0.18, 95%CI: 0.04–0.78, P = 0.022), heads of institution/organization and professional and technical staff (OR = 2.04, 95%CI: 1.23–3.39, P = 0.006), and an income of < 2,000 yuan (OR = 0.35, 95%CI: 0.14–0.85, P = 0.021) were independently associated with knowledge. Female (OR = 2.17, 95%CI: 1.43–3.30, P < 0.001), age (OR = 1.03, 95%CI: 1.01–1.05, P = 0.001), college and above education (OR = 2.26, 95%CI: 1.16–4.41, P = 0.017), an income of 5,000–10,000 yuan (OR = 2.05, 95%CI: 1.27–3.31, P = 0.003), and an income of > 10,000 yuan (OR = 2.07, 95%CI: 1.12–3.81, P = 0.020) were independently associated with attitudes. Attitude (OR = 1.31, 95%CI: 1.23–1.40, P < 0.001), female (OR = 1.62, 95%CI: 1.01–2.58, P = 0.044), and age (OR = 1.02, 95%CI: 1.00-1.04, P = 0.016) were independently associated with practices. The structural equation modeling analysis showed that knowledge directly influenced attitude (β=-0.10, P < 0.001) and indirectly influenced practice (β=-0.07, P < 0.001), and attitude directly influenced practice (β = 0.68, P < 0.001).

Conclusion
The general population over 30 years old had inadequate knowledge, unfavorable attitudes, and less proactive practices toward gouty arthritis. Targeted interventions should focus on enhancing knowledge about gout and promoting positive attitudes toward its management.
Impact of group work on the hidden curriculum that induces students’ unprofessional behavior toward faculty
Authors: Nakamura Aoba , Kasai Hajime , Asahina Mayumi , Kamata Yu , Shikino Kiyoshi , Shimizu Ikuo , Onodera Misaki , Kimura Yasuhiko , Tajima Hiroshi , Yamauchi Kazuyo , Ito Shoichi 
Published: July 2024

Abstract
Background
Hidden curriculum (HC) can limit the effects of professionalism education. However, the research on how HC triggers unprofessional behavior among medical students is scant. Furthermore, there is no established approach for how faculty members may create a context, such as an educational environment and education system, that prevents students’ unprofessional behavior. This study aimed to develop an educational approach to prevent unprofessional behavior and clarify how faculty members consider HC that triggers students’ unprofessional behavior.

Methods
The study sample comprised 44 faculty members and eight medical students from the Chiba University School of Medicine. The participants were divided into groups and asked the following question: “What attitudes, statements, and behaviors of senior students, physicians, and faculty members trigger medical students’ unprofessional behavior?” The responses were collected using the affinity diagram method. The group members discussed the causes and countermeasures for the selected attitudes, statements, and behaviors of senior students, physicians, and faculty members based on the affinity diagram. The impact of the group work on the faculty members was surveyed using questionnaires immediately after its completion and six months later. Furthermore, the cards in the group work were analyzed using content analysis.

Results
The responses to the questionnaire on group work indicated that some faculty members (43.8%) improved HC, while others suggested conducting group work with more participants. The content analysis revealed six categories – inappropriate attitude/behavior, behavior encouraging unprofessional behavior, lack of compliance with regulations, harassment of other medical staff, inappropriate educational environment/supervisor, and inappropriate self-control – and 46 subcategories.

Conclusions
The HC that triggers students’ unprofessional behavior includes the words and actions of the educator, organizational culture, and educational environment. Group work makes faculty members aware of the HC that triggers unprofessional behavior, and induces behavioral change for HC improvement in the educational activities. Educators should refrain from using words and actions that encourage unprofessional behavior, such as personal anecdotes, as they reduce students’ learning motivation.