bluuebunny/crossref_metadata_2025_split huggingface dataset:
Coefficient of variation and texture analysis of 18F-FDG PET/CT images for the prediction of outcome in patients with multiple myeloma
Authors: Pellegrino Sara , Origlia Davide , Di Donna Erica , Lamagna Martina , Della Pepa Roberta , Pane Fabrizio , Del Vecchio Silvana , Fonti Rosa 
Published: July 2024

AbstractIn multiple myeloma (MM) bone marrow infiltration by monoclonal plasma cells can occur in both focal and diffuse manner, making staging and prognosis rather difficult. The aim of our study was to test whether texture analysis of 18 F-2-deoxy-d-glucose positron emission tomography/computed tomography (18F-FDG PET/CT) images can predict survival in MM patients. Forty-six patients underwent 18 F-FDG-PET/CT before treatment. We used an automated contouring program for segmenting the hottest focal lesion (FL) and a lumbar vertebra for assessing diffuse bone marrow involvement (DI). Maximum standardized uptake value (SUVmax), mean standardized uptake value (SUVmean) and texture features such as Coefficient of variation (CoV), were obtained from 46 FL and 46 DI. After a mean follow-up of 51 months, 24 patients died of myeloma and were compared to the 22 survivors. At univariate analysis, FL SUVmax (p = 0.0453), FL SUVmean (p = 0.0463), FL CoV (p = 0.0211) and DI SUVmax (p = 0.0538) predicted overall survival (OS). At multivariate analysis only FL CoV and DI SUVmax were retained in the model (p = 0.0154). By Kaplan-Meier method and log-rank testing, patients with FL CoV below the cut-off had significantly better OS than those with FL CoV above the cut-off (p = 0.0003), as well as patients with DI SUVmax below the threshold versus those with DI SUVmax above the threshold (p = 0.0006). Combining FL CoV and DI SUVmax by using their respective cut-off values, a statistically significant difference was found between the resulting four survival curves (p = 0.0001). Indeed, patients with both FL CoV and DI SUVmax below their respective cut-off values showed the best prognosis. Conventional and texture parameters derived from 18F-FDG PET/CT analysis can predict survival in MM patients by assessing the heterogeneity and aggressiveness of both focal and diffuse infiltration.
Interdecadal variability of winter and spring Eurasian snow depth and its impact on Eastern China precipitation
Authors: An Yingying , Meng Xianhong , Zhao Lin , Li Zhaoguo , Wang Chan , Chen Hao , Shang Lunyu , Wang Shaoying , Liu Yumeng , Zhu Hanhui 
Published: July 2024

AbstractEmpirical orthogonal function (EOF) and correlation analyses were employed to investigate the winter and spring snow depth in Eurasia and its relationship with Eastern China precipitation based on the observed and reanalyzed data from 1980 to 2016. The results show that the winter and spring snow cover in Eurasia not only highlights a decreasing trend due to global warming (the first EOF mode, its variance accounted for 24.4% and 22.6% of the total variance) but also exhibits notable interdecadal variation (the second EOF mode, its variance accounted for 10.2% and 11.5% of the total variance). The second EOF mode of winter snow depth in Eurasia is characterized by a west-east dipole pattern. It was observed that the spatial correlation pattern between the EOF2 of Eurasian snow depth and summer precipitation in China closely resembles the meridional quadrupole structure of the third EOF mode of summer precipitation in China. This pattern is characterized by excessive rainfall in Northeast China and the lower-middle reaches of the Yangtze River, and less rainfall over the Yellow River basin and southern China. The EOF mode of spring snow depth not only reflects the declining trend but also regulates precipitation in Eastern China. The possible mechanisms by which snow depth causes changes in soil moisture and subsequently affects atmospheric circulation are then explored from the perspective of the hydrological effects of snow cover. Decreased (Increased) snow depth in Eurasia during the winter and spring directly leads to diminished (increased) soil moisture while increasing (decreasing) net radiation and sensible heat flux at the surface. The meridional distribution of surface temperature also exhibits a dipole pattern, leading to enhanced subtropical westerly jet in the upper troposphere. The Eurasian snow cover anomalies pattern triggered an anomalous mid-latitude Eurasian wave train, which strengthened significantly in the Western Siberian Plain. It then splits into two branches, one continuing to propagate eastward at high latitudes and the other shifting towards East Asia, thereby impacting precipitation in Eastern China. This work indicates that the second EOF mode of Eurasian snow cover can impact the precipitation variability in Eastern China during the same period and in summer on an interdecadal scale.
The influence of Black Cohosh on hippocampal and hypothalamic gene expression profiles in ovariectomized rats and its potential to treat menopausal decrease in smell discrimination
Authors: Pavicic Elena , Rüst Katrin , Ehrentraut Stefan , von Wolff Michael , Stute Petra 
Published: July 2024

Abstract
Purpose
Menopause is associated with a decrease in smell discrimination ability. This study assessed the impact of black cohosh on hippocampal (HC) and hypothalamic (HT) gene expression profiles in rats, to understand, if herbal treatment has an impact on neurologic changes due to menopause and whether this could address a decrease in smell discrimination.

Methods
HC and HT tissues from female Sprague Dawley rats (total n = 19) were analyzed at three different life stages: intact tissues of the HC (n = 4) and the HT (n = 4), oophorectomized tissues 3 months after oophorectomy (OVX) of the HC (n = 4) and the HT (n = 3), and tissues after treatment with an isopropanolic extract (iCR) from the rhizomes of black cohosh (60 mg/kg) for 3 months after OVX of the HC (n = 2) and the HT (n = 2).

Main outcome measures
To reveal underlying biological processes a gene set enrichment analysis (GSEA) was performed.

Results
The GSEA revealed gene ontology terms that were significantly enriched, including several genes associated with the olfactory system, indicating biological processes regulated by treatment with iCR. Six olfactory receptor genes were further analyzed by another GSEA, demonstrating the possibility of iCR treatment to compensate for oophorectomy-induced changes.

Conclusion
Findings suggest that herbal treatment, such as iCR, has an esteeming impact on HC and HT genes that are changed through menopause. Further studies are needed to suggest black cohosh as a treatment option for decreased smell discrimination.
Feasibility evaluation of the Versius surgical system: robot-assisted hysterectomy for benign and malignant gynaecological lesions
Authors: Sadlecki Pawel , Walentowicz-Sadlecka Malgorzata 
Published: July 2024

Abstract
Introduction
The application of minimally invasive surgery allows for radical and precise removal of the gynaecological lesion while simultaneously reducing the side effects and complications associated with surgical treatment. This paper aims to share our direct experience with the implementation of the CMR Versius robotic platform in the treatment of benign and malignant gynaecological lesions.

Methods
This study included patients who underwent hysterectomy in the Department of Obstetrics, Gynaecology, and Gynaecologic Oncology at the Regional Polyclinical Hospital in Grudziadz, Poland. A total of 50 patients were included in the study: 29 underwent laparoscopic surgery and 21 underwent robot-assisted surgery using the CMR Versius system.

Results
It was found that in the case of non-radical hysterectomy, the duration of surgery differed significantly (96.5 vs. 134.6 min, p < 0.01) in the groups of patients undergoing laparoscopic and robotic surgery. There were also no statistically significant differences in loss of blood parameters, rate of complications and conversions to other type of surgery after the laparoscopic and robotic surgeries. Both groups did not differ significantly in terms of hospitalisation time after surgery.

Conclusion
Versius CMR surgical robot assistance provides safe and effective support for MIS procedures in gynaecology.
Reduced rate of force development under fatigued conditions is associated to the decline in force complexity in adult males
Authors: D’Emanuele Samuel , Boccia Gennaro , Angius Luca , Hayman Oliver , Goodall Stuart , Schena Federico , Tarperi Cantor 
Published: July 2024

Abstract
Purpose
This study aimed to verify whether the slowing of muscle contraction quickness, typically observed in states of fatigue, may worsen force control by decreasing the rate with which force fluctuations are modulated. Therefore, we investigated the relationship between rate of force development (RFD), and force fluctuations' magnitude (Coefficient of variation, CoV) and complexity (Approximate Entropy, ApEn; Detrended fluctuation analysis, DFAα).

Methods
Fourteen participants performed intermittent ballistic isometric contractions of the plantar dorsiflexors at 70% of maximal voluntary force until task failure (under 60% twice).

Results
Indices of RFD (RFDpeak, RFD50, RFD100, and RFD150) decreased over time by approximately 46, 32, 44, and 39%, respectively (p all ≤ 0.007). DFAα increased by 10% (p < 0.001), and CoV increased by 15% (p < 0.001), indicating decreased force complexity along with increased force fluctuations, respectively. ApEn decreased by just over a quarter (28%, p < 0.001). The linear hierarchical models showed negative associations between RFDpeak and DFAα (β =  − 3.6 10–4, p < 0.001), CoV (β =  − 1.8 10–3, p < 0.001), while ApEn showed a positive association (β = 8.2 × 10–5, p < 0.001).

Conclusion
The results suggest that exercise-induced reductions in contraction speed, lead to smoother force complexity and diminished force control due to slower adjustments around the target force. The fatigued state resulted in worsened force producing capacity and overall force control.
Evaluation of the relationship between intercostal muscle oxygenation measured by near-infrared spectroscopy and exercise capacity in group E COPD patients
Authors: Kerget Buğra , Çil Gizem , Aksakal Alperen 
Published: July 2024

AbstractNear-infrared spectroscopy (NIRS) can be used to demonstrate muscle metabolism and oxygenation. NIRS-based oximeters enable the noninvasive measurement of static and dynamic muscle oxygenation. This study aimed to evaluate the relationship between NIRS readings and exercise capacity in group E COPD patients. The prospective study included 40 patients with group E COPD who presented to our outpatient clinic between May 2021 and June 2022. The patients were evaluated with pulmonary function testing, 6-Minute Walk Test (6MWT), echocardiography, and dyspnea and quality of life assessments. NIRS muscle oxygen saturation (SmO2) levels at the start and end of the 6MWT were obtained. 6MWT distance was positively correlated with intercostal SmO2 and fingertip SO2 at the start (R = 0.679, p ≤ 0.001 and R = 0.321, p = 0.04, respectively) and end of the 6MWT (R = 0.693, p ≤ 0.001 and R = 0.635, p ≤ 0.001, respectively) and negatively correlated with the number of hospitalizations due to exacerbations in the last year and mean pulmonary arterial pressure (R =  − 0.648, p ≤ 0.001 and R =  − 0.676, p ≤ 0.001, respectively). SF-36 score was positively correlated with intercostal SmO2 at the beginning of the 6MWT (R = 0.336, p = 0.03). Intercostal SmO2 levels at the start of the 6MWT positively correlated with diffusing capacity of the lung for carbon dioxide (DLCO) (R = 0.388, p = 0.01) and ratio of DLCO to alveolar volume (DLCO/VA) levels (R = 0.379, p = 0.02), and these correlations persisted more strongly after the 6MWT (R = 0.524, p = 0.01; R = 0.500, p = 0.01, respectively). NIRS is a practical and noninvasive method for measuring muscle oxygenation and can be used as an alternative to 6MWT in the evaluation of exercise capacity in patients with group E COPD.
Noncrossing Partition Lattices from Planar Configurations
Authors: Cohen Stella , Dougherty Michael , Harsh Andrew D. , Martin Spencer Park 
Published: July 2024

AbstractThe lattice of noncrossing partitions is well-known for its wide variety of combinatorial appearances and properties. For example, the lattice is rank-symmetric and enumerated by the Catalan numbers. In this article, we introduce a large family of new noncrossing partition lattices with both of these properties, each parametrized by a configuration of n points in the plane.
The learning curve of laparoscopic splenectomy and esophagogastric devascularization for portal hypertension with 10-year follow-up
Authors: Wang Dong , Chen Xiao , Lv Ling , Yang Tao , Huang Bo , Cao Yanlong , Zhang Yong , Lu Jianguo , Yin Jikai 
Published: July 2024

Abstract
Introduction and objectives
Laparoscopic splenectomy and esophagogastric devascularization (LSED) are minimally invasive, effective, and safe in treating esophageal-fundic variceal bleeding with portal hypertension (PHT). The study aimed to assess the learning curve of LSED by cumulative summation (CUSUM) analysis. The 10-year follow-up data for LSED and open surgery were also examined.

Patients and methods
Five hundred and ninety-four patients were retrospectively analyzed. Operation time, intraoperative blood loss, open operation conversion, and postoperative complications were selected as the evaluation indicators of surgical ability. The learning curve of LESD was assessed by the CUSUM approach. Patient features, perioperative indices, and 10-year follow-up data were examined.

Results
Totally 236 patients underwent open surgery, and 358 underwent LSED. Patient characteristics were similar between groups. The LSED patients experienced less intraoperative blood loss, fewer complications, and faster recovery compared to the open surgery cohort. The learning curve of LESD was maximal for a case number of 50. Preoperative general characteristics were comparable for both stages. But the skilled stage had decreased operation time, reduced blood loss, less postoperative complications, and better recovery compared to the learning stage. The LSED group had higher recurrent hemorrhage-free survival rate and increased overall survival in comparison with cases administered open surgery in the 10-year follow-up. Free-liver cancer rates were similar between two groups.

Conclusions
About 50 cases are needed to master the LSED procedure. Compared to open surgery, LSED is a safer, feasible, and safe procedure for PHT patients, correlating with decreased rebleeding rate and better overall survival.
Reduced-port robotic pancreaticoduodenectomy with optimized surgical field deployment: early results of single-site plus-two ports method
Authors: Ninomiya Riki , Komagome Masahiko , Abe Satoru , Maruta Shohei , Matsudaira Shinichi , Okada Noriki , Mori Kazuhiro , Nagata Rihito , Chiyoda Takehiro , Kimura Akifumi , Takemura Nobuyuki , Maki Akira , Beck Yoshifumi , Hsieh Ching-Lung , Peng Cheng-Ming 
Published: July 2024

Abstract
Background
The adoption of Robotic Pancreaticoduodenectomy (RPD) is increasing globally. Meanwhile, reduced-port RPD (RPRPD) remains uncommon, requiring robot-specific techniques not possible with laparoscopy. We introduce a unique RPRPD technique optimizing surgical field exposure.

Methods
Our RPRPD utilizes a single-site plus-two ports technique, facilitated by a single-port platform through a 5-cm incision. The configuration of robotic arms (arm1, arm2, arm3, and arm4) were strategically designed for optimal procedural efficiency, with the arms2 and arm3, alongside the assistant trocar, mounted on the single-port platform, while the arms1 and arm4 were positioned laterally across the abdomen. Drainage was established via channels created at the arm1 and arm4 insertion sites. A “gooseneck traction” was principally employed with the robotic instrument to prop up the specimen rather than grasp, improving the surgical field’s visibility and access. Clinical outcomes of patients who underwent RPRPD performed between August 2020 and September 2023 by a single surgeon across two centers in Taiwan and Japan were reviewed.

Results
Fifty patients underwent RPRPD using the single-site plus-two ports technique. The gooseneck traction technique enabled goodsurgical field deployment and allowed for unrestricted movement of robotic arms with no collisions with the assistant instruments. The median operative time was 351 min (250–488 min), including 271 min (219–422 min) of console time and three minutes (2–10 min) of docking time. The median estimated blood loss was 80 mL (1–872 mL). All RPRPD procedures were successfully performed without the need for conversion to open surgery. Postoperative major morbidity (i.e., Clavien-Dindo grade ≥ IIIa) was observed in 6 (12%) patients and median postoperative hospital stay was 13 days.

Conclusions
The single-site plus-two ports RPRPD with the gooseneck traction proves to be a safe, feasible option, facilitating surgical field visibility and robotic arm maneuverability.

Graphical Abstract
Utility of the mFI-5 as a predictor of post-operative outcomes following gastrectomy for gastric cancer: an ACS-NSQIP analysis
Authors: Tran Ashley , Putnam Luke R. , Lipham John C. , Shiraga Sharon 
Published: July 2024

Abstract
Background
Gastric cancer is the 5th most common malignancy worldwide. Surgical treatment for the disease can often be highly morbid, especially in elderly patients. The modified 5-item frailty index (mFI-5), a recently developed tool for assessing patient frailty, has been shown to be an effective predictor of post-operative outcomes in various surgical fields. This study aims to assess the utility of the mFI-5 in predicting adverse postoperative outcomes following gastrectomy for gastric cancer.

Methods
The National Surgical Quality Improvement Program (NSQIP) database was queried for patients who underwent partial or total gastrectomy for gastric cancer between 2011 and 2021. The mFI-5 score was calculated based on the presence of hypertension, congestive heart failure, diabetes mellitus, chronic obstructive pulmonary disease, and partially or fully dependent functional status. Patients were stratified into 3 groups according to mFI-5 score (mFI-5 = 0, mFI-5 = 1, mFI-5 ≥ 2). Univariate analysis and multivariate logistic regression were used to evaluate the association between mFI-5 score and post-operative outcomes.

Results
7438 patients were identified (mFI-5 = 0: 3032, mFI-5 = 1: 2805, mFI-5 ≥ 2: 1601). mFI-5 ≥ 2 was an independent predictor of overall complications (OR 1.43, p < 0.001), serious complications (OR 1.42, p < 0.001), pneumonia (OR 1.43, p = 0.010), MI (OR 2.91, p = 0.005), and readmission within 30 days (OR 1.33, p = 0.008). Patients with higher frailty were more likely to experience unplanned intubation (OR 2.06, p < 0.001; OR 2.47, p < 0.001), failure to wean from the ventilator (OR 1.68, p = 0.003; OR 2.00, p < 0.001), acute renal failure (OR 3.25, p = 0.003; OR 3.27, p = 0.005), 30-day mortality (OR 1.73, p = 0.009; OR 1.94, p = 0.004), and non-home discharge (OR 1.34, p = 0.001; OR 1.74, p < 0.001) relative to non-frail patients.

Conclusion
Higher frailty, as indicated by an increased mFI-5 score, raises the risk of serious post-operative complications in patients with gastric cancer undergoing gastrectomy. The mFI-5 has the potential to help identify high-risk patients and enhance pre-operative discussions and optimization.

Graphical abstract
YouTube videos on lymphedema as an information source for Spanish speaking breast cancer survivors
Authors: Fernandez-Alvarez Maria del Mar , Cachero-Rodríguez Judit , Fu Mei Rosemary , Sánchez-Fernández Paula , Ureña-Lorenzo Amalia , Martin-Payo Ruben 
Published: July 2024

Abstract
Background
Breast cancer-related lymphedema in the upper limb remains one of the most distressful complications of breast cancer treatment. YouTube is considered a potential digital resource for population health and decision making. However, access to inadequate information or misinformation could have undesirable impacts. This cross-sectional study aimed to evaluate the reliability, quality and content of YouTube videos on lymphedema as an information source for Spanish-speaking breast cancer survivors.

Methods
A search of YouTube was conducted in January 2023 using the key words “breast cancer lymphedema” and “lymphedema arm breast cancer.” Reliability and quality of the videos were evaluated using the Discern tool, content, source of production, number of likes, comments, views, duration, Video Power Index, likes ratio, view ratio and age on the platform.

Results
Amongst the 300 Spanish language videos identified on YouTube, 35 were selected for analysis based on the inclusion and exclusion criteria. Of the 35 selected videos, 82.9% (n = 29) were developed by healthcare or academic professionals and 17.1% (n = 9) by others. Reliability (p < 0.017) and quality (p < 0.03) were higher in the videos made by professionals. The Discern total score (r = 0.476; p = 0.004), reliability (r = 0.472; p = 0.004) and quality (r = 0.469; p = 0.004) were positively correlated with the duration of the videos.

Conclusions
Our findings provide a strong rationale for educating breast cancer survivors seeking lymphedema information to select videos made by healthcare or academic professionals. Standardised evaluation prior to video publication is needed to ensure that the end-users receive accurate and quality information from YouTube.
Leveraging AutoEncoders and chaos theory to improve adversarial example detection
Authors: Pedraza Anibal , Deniz Oscar , Singh Harbinder , Bueno Gloria 
Published: July 2024

AbstractThe phenomenon of adversarial examples is one of the most attractive topics in machine learning research these days. These are particular cases that are able to mislead neural networks, with critical consequences. For this reason, different approaches are considered to tackle the problem. On the one side, defense mechanisms, such as AutoEncoder-based methods, are able to learn from the distribution of adversarial perturbations to detect them. On the other side, chaos theory and Lyapunov exponents (LEs) have also been shown to be useful to characterize them. This work proposes the combination of both domains. The proposed method employs these exponents to add more information to the loss function that is used during an AutoEncoder training process. As a result, this method achieves a general improvement in adversarial examples detection performance for a wide variety of attack methods.
Detecting diabetes in an ensemble model using a unique PSO-GWO hybrid approach to hyperparameter optimization
Authors: Ulutas Hasan , Günay Recep Batuhan , Sahin Muhammet Emin 
Published: July 2024

AbstractDiabetes is a chronic medical condition that disrupts the body's normal blood sugar levels. It is essential to detect this disease at an early stage in order to prevent organ and tissue injury. This study focuses on diagnosing diabetes by leveraging ensemble learning methods, which involve combining various machine learning techniques. The goal is to create an ensemble learning model that achieves the best classification performance by employing different classifiers and combining techniques. The study explores boosting, bagging, voting, and stacking ensemble learning methods, while also introducing an approach called PSO-GWO (Particle Swarm Optimization and Grey Wolf Optimization) hybrid method for optimizing the model's hyperparameters. The model consisting of combining various classifiers in the stacking ensemble learning method provided the highest classification performance in diagnosing diabetes. The 5-fold cross-validation method is used in the study. Within the scope of the study, the highest accuracy with (98.10%) is obtained with the random forest classifier. The results of the study are presented in comparison with other studies in the literature. These findings contribute to the field of diabetes diagnosis and highlight the potential for developing more accurate and reliable diagnostic systems in the future.