bluuebunny/crossref_metadata_2025_split huggingface dataset:
Descriptive Analysis of Therapeutic Outcomes between Thoracoscopic and Transsternal Thymectomy in Myasthenia Gravis Patients from 2011 to 2021
Authors: Lashkarizadeh Mahdiye , Haghollahi Vahid , Nezhad Nazanin Zeinali , Lashkarizadeh Mohammadreza , Shahpar Amirhossein 
Published: May 2024

Abstract

Background
Myasthenia gravis is an autoimmune disease with high prevalence of thymus disorders, in which, thymectomy is considered one of the therapeutic approaches in improving the patients’ clinical outcomes. Today, thoracoscopic thymectomy has received significant attention than the classic transsternal approach due to fewer complication. Therefore, this study was designed with the aim of investigating the therapeutic outcomes of thymectomy in patients with myasthenia gravis in the Afzalipour Hospital of Kerman between 2011–2021.
Methods
The current study is a descriptive analytical study on patients with myasthenia gravis who underwent surgical thymectomy within 2011–2021. Demographic and clinical characteristics of patients from the time of operation to three years of follow-up were extracted and recorded from clinical records or by phone calls. Data were analyzed using SPSS software.
Results
The data of 70 patients who underwent surgical thymectomy were analyzed. Thymectomy caused a significant reduction in the severity of the disease according to the Osserman classification (P = 0.001). It also significantly reduced the use of corticosteroids (P = 0.001) and IVIG (P = 0.015) compared to the time before the surgery. 78.57% of patients needed to take less medicine than before surgery. Left VATS was associated with less post-operative severity of the disease (P = 0.023). There were only two deaths during the follow-up period.
Conclusion
Overall, the findings of the present study demonstrated that thoracoscopic thymectomy is a useful surgical approach that leads to faster recovery, reducing the severity of the disease, need for medication, and complications in patients with myasthenia gravis, In comparison with the transsternal approach.
Visual acuity screening by school teachers in Far West Nepal: A randomized trial of alternate screening models.
Authors: Awasthi Suresh , Reddy Priya Adhisesha , Bassett Ken L. 
Published: May 2024

Abstract

Background: School vision screening programs are more effective and less costly in comparison to primary eye care model. However, studies have not examined alternate school visual acuity screening methods in Nepal in terms of accuracy and cost. This study was conducted to validate recent evidence from India of the effectiveness and cost of alternate school visual acuity screening models involving all class teachers (ACTs) versus a few selected teachers (STs) from schools in Far West Nepal.
Methods: Nine schools in Far West Nepal were randomly selected for the ACTs which is the intervention arm or STs which is the standard arm. Teachers from both arms were trained to identify children aged 6 years and above with visual acuity 6/9 or worse in either eye as well as obvious ocular abnormalities and refer them to an ophthalmic team from Geta Eye Hospital who visited the schools to examine all children regardless of initial screening. Mean values were compared using student t and Wilcoxon rank sum tests, and proportions were compared between study groups using chi square statistics.
Results: A total of 3793 children in 5 ACTs schools and 2144 children in 4 STs schools were included. ACTs (80 teachers) screened 3713 children and STs (9 teachers) screened 2064 children aged 6 to 15 years. ACTs had better sensitivity (95.1% [95% CI: 91.9- 98.2]) and specificity (92.8% [95% CI: 92.0%-93.6%]) compared to STs: sensitivity (73.2% [95% CI: 64.4- 82.0]) and specificity (85.3% [95% CI: 83.8-86.7]). More children from ACTs than STs reached the Geta Eye Hospital for further investigation within 3 months (n= 10/30 [33.3%] versus n= 5/18 [27.7%]) for ACTs and STs respectively but the difference was not statistically significant. The cost of screening per child with refractive error and or other ocular abnormalities was $3.05 for ACTs and $ 5.29 for STs.
Conclusion: A school vision screening program involving ACTs in Nepal was more accurate than ST screening in identifying refractive error and or other ocular abnormalities at approximately 60% of the cost.
Validation of in vivo dose using EPID combined with fan-beam CT guidance in post-breast-conserving radiotherapy for early-stage breast cancer
Authors: zhu wanli , Fang Jia , Dai Chunyan , Liao Can , Zhao Fei , Wang Yu , Mo Zijie , Zhang Yi , Chen Meiqin , Zhang Hongzhi , Ding Shubo 
Published: May 2024

Abstract

Objective
To explore the application of in vivo dose validation during post-breast-conserving radiotherapy for early breast cancer and the impact of image guidance on validation outcomes, as well as to examine the influence of inter- and intra-fractional variances on dose distribution.
Methods
Twenty-six patients undergoing post-breast-conserving radiotherapy for early-stage breast cancer were selected for in-treatment in vivo dose validation. The retrospective analysis examined the results of in vivo dose validation across different image-guided modalities. Utilizing the image-guided images, the target area and organs at risk were redefined to quantitatively assess the effect of inter- and intra-fractional differences on the dose distribution.
Results
The 3mm3%/3mm5% 2Dγ-pass (gamma pass) rates in the image-guided radiotherapy(IGRT) group were significantly higher than those in the non-IGRT(N-IGRT) group for both left and right breast cancer (p<0.05). Additionally, the 3mm 5% 2Dγ-pass rate of fan beam CT(FBCT) group was higher than that of IGRT group, and was statistically significant (p<0.05). The inter-fractional differences in the left breast cancer patients mainly affected the target area parameters primary gross tumor volume(PGTV) D95, PGTV D2, planning target volume(PTV) D95, PTV D90, heart Dmean and V5, lung V5, and were statistically significant (p<0.05). The effects of intra-fractional differences on dose distribution were statistically significant except for cardiac Dmean (p<0.05). Similarly, inter-fractional differences in right breast cancer patients significantly affected the dose distribution of parameters such as PGTV D95, PGTV D2, PTV D95, PTV D90, Heart Dmean, Lung V5, and were statistically significant (p<0.05), while the effect of intra-fractional differences on dose distribution was statistically significant for all parameters (p<0.05).
Conclusion
Electronic portal imaging device (EPID) in vivo dose validation combined with fan-beam CT image guidance offers an accurate assessment of real-time dose delivery in breast cancer radiotherapy patients. This approach provides a foundation for implementing respiratory motion management and adaptive radiotherapy strategies for breast cancer treatment.
Impact of malnutrition on the clinical evolution of very elderly patients undergoing emergency surgery for abdominal pathology
Authors: Villajos-Guijarro María , Ramírez-Martín Raquel , Mauleón-Ladrero Coro , González Victoria Déniz , Torres Alexander Forero , Nisa Francisca Garcia-Moreno , González-Montalvo Juan Ignacio 
Published: May 2024

Abstract

Purpose: Analyse the influence of nutritional status on postoperative complications, as well as on mortality and mean length of hospital stay, of very elderly patients undergoing emergency abdominal surgery.
Methods: We performed a longitudinal observational study including patients older than 80 years who underwent emergency surgery by the general surgery service for abdominal pathology, who were followed by the geriatrics service between September 2018 and May 2021. Global Leadership Initiative on Malnutrition criteria were used for the diagnosis of malnutrition, classifying patients as malnourished or normonourished. A comprehensive geriatric assessment was performed on the patients, and postoperative complications, mean length of hospital stay and in-hospital and 1-year mortality were recorded.
Results: Of the 131 patients included, 84 were malnourished and 47 normonourished. The average age was 86±4.7 years. Compared with normonourished patients, malnourished patients had a higher incidence of atrial fibrillation debut (22.4% vs. 4.5%, p<0.05; odds ratio [OR] 6.1 [1.33-27.6]), urinary tract infection (18.4% vs 4.5%, p<0.05; OR 4.72 [1.02-21.95]) and bacteraemia (26% vs 9.1%, p<0.05; OR 3.51 [1.14-11.1]). Surgical complications were more frequent in malnourished patients (51.2% vs 23.9%, p<0.05; OR 3.34 [1.5-7.44]). The mean length of hospital stay was 22.6 (±14.1) days in the malnourished patients compared with 15.3 (±11.9) days in the normonourished (p<0.005).
Conclusion: Malnutrition in very old patients undergoing emergency abdominal surgery is associated with a poorer clinical course; thus, it must be considered in the evaluation and follow-up of these patients.
On Indian Summer Monsoon Droughts and their Causal Mechanisms Over the Past Millennium
Authors: Sinha Ashish , Steiger Nathan , Li Hanying , Kathayat Gayatri , Tan Liangcheng , Cheng Hai 
Published: May 2024

Abstract

Historical documentary accounts from the Indian subcontinent document several decade-to-multidecade clusters of severe Indian summer monsoon (ISM) droughts over the past millennium. Many of these putative droughts have no counterparts in the observational period, but an objective assessment of the severity, duration, frequency, and spatial extent of these droughts and their causal mechanisms remains uncertain. Here, we use the Paleo Hydrodynamics Data Assimilation (PHYDA) product to bridge this gap. PHYDA reproduces historical intervals of increased drought frequency with high fidelity and reveals multiple instances of multi-year “black swan” droughts that are in line with historical accounts. We find that droughts, as well as extended periods of dryness, occurred under both El Niño and non-El Niño conditions, with El Niño explaining ~ 49% of all drought instances. A large portion (~40%) of non-El Niño type droughts were likely forced by cooler extratropical SST anomalies in the North Atlantic region. The remaining droughts, however, cannot be accounted for by any other modes of SST, implying a substantial role of ISM internal stochastic variability in driving droughts. While El Niño was an important driver, its association with droughts varied considerably, accounting for between 15-80% of droughts depending on the century. The millennial length perspective afforded by PHYDA supports expanding the El Niño-centric paradigm of ISM droughts into a framework that includes extratropical teleconnections.
Implementation of a nurse-delivered, community-based liver screening and assessment program for people with non-alcoholic fatty liver disease (LOCATE-NAFLD trial)
Authors: Allen Michelle J. , Tulleners Ruth , Brain David , O’Beirne James , Powell Elizabeth E. , Barnett Adrian , Valery Patricia C. , Kularatna Sanjeewa , Hickman Ingrid J. 
Published: May 2024

Abstract

Background With the high burden of Non-Alcoholic Fatty Liver Disease (NAFLD) in the community, current models of care that require specialist review for disease risk stratification overwhelm hospital clinic capacity and create inefficiencies in care. The LOCal Assessment and Triage Evaluation of Non-Alcoholic Fatty Liver Disease (LOCATE-NAFLD) randomised trial compared usual care to a community-based nurse delivered liver risk assessment. This study evaluates the implementation strategy of LOCATE-NAFLD. Methods The evaluation used multiple methods (quantitative trial data and qualitative framework analysis of semi-structured interviews) to explore the general practitioner (GP) and patient perspectives of acceptability (Acceptability Framework), and factors associated with reach, effectiveness, adoption, implementation, and maintenance (RE-AIM framework) of the LOCATE model of care. Results LOCATE-NAFLD was considered highly acceptable by both patients and GPs. The model of care achieved appropriate reach across the participating health services, reaching high-risk patients faster than usual care and with predominantly positive patient experiences. A notable reduction in anxiety and stress was experienced in the intervention group due to the shorter waiting times between referral and assessment. There was an overall perception of confidence in nursing staff capability to perform the community-based screening and GPs indicated confidence in managing low-risk NAFLD without the need for specialist review. Challenges to implementation, adoption and maintenance included variable prioritisation of liver disease assessment in complex cases, the need for further GP training in NAFLD assessment and treatment pathways, available funding and referral pathways for community screening, and accessibility of effective diet and exercise professional support. Conclusion Nurse delivered community-based liver screening is highly acceptable to GPs and patients and has shown to be an effective mechanism to identify high risk patients. Adoption and maintenance of the model of care faces significant challenges related to affordable access to screening, prioritisation of liver disease in complex patient cohorts, and unresolved difficulties in prescribing effective strategies for sustained lifestyle intervention in the primary care setting. Trial registration The trial was registered on 30 January 2020 and can be found via Australian New Zealand Clinical Trials Registry (ANZCTR) – ACTRN12620000158965.
Role of 3D ultrasound in the treatment of stress urinary incontinence with polyacrylamide hydrogel (Bulkamid®) – a pilot study
Authors: Ugianskiene Aiste , Juhl Caroline Sollberger , Glavind Karin 
Published: May 2024

Abstract

Introduction and Hypothesis
Polyacrylamide hydrogel (PAHG) is a bulking agent used in treatment of stress urinary incontinence (SUI) in women. Some women experience an improvement or cure in stress urinary incontinence (SUI) symptoms lasting only a few weeks after the injection of the bulking agent. The aim of this study was to use three-dimensional ultrasound (3DUS) to describe the changes in volume, number of deposits and echogenicity of the bulking agent 3 months after PAHG injection.
Methods
Prospective cohort study of fourteen women with SUI or mixed primarily SUI, who underwent an injection of PAHG. The subjective outcome was evaluated with Patient Global Impression of Improvement questionnaire. 3DUS was performed in all patients immediately after injection of PAHG and again at 3 months follow-up.
Results
The study found a mean 36.5% loss in bulking agent volume during the study period. A total of 53 PAHG deposits were found by ultrasound immediately after injection. At 3 months follow-up 41 PAHG deposits were left. All deposits were hypoechogenic immediately after injection and only 24% of demonstrated PAHG collections had a hypoechoic echogenicity at 3 months follow-up.
Conclusions
More than 1/3 of volume of injected PAHG and 23% of deposits could not be found by 3DUS at 3 months follow-up. Only 24% of PAHG injections in our patients had hypo-echoic echogenicity at 3 months follow-up. Larger 3DUS studies with longer follow-up and focus on exact location of the PAHG injections are important future studies.
Visual Information Facilitation Scene Text Retrieval
Authors: Luo Hailong , Ibrayim Mayire , Hamdulla Askar , Deng Qilin 
Published: May 2024

Abstract

Given a query text and a database of images to be queried, a scene text retrieval system can output the addresses of images containing this query word, as well as the location of the query word in the images. The current state-of-the-art method matches the visual features of query embedding and text instance embedding. This approach effectively mitigates the heterogeneity differences between the two modalities, but it disrupts the visual structure of the query images. In this paper, we optimize this method. First, we directly convert the entire query text into an image, thereby maximally preserving the visual information of the original text image. Then, we devised a Coarse-Grained Feature Rectification (CGFR) module, which facilitates visual alignment. Finally, we propose Adaptive Edit Distance (AED) and improve the main loss function. With the promotion of the above scheme, our method has reached the state-of-the-art level on multiple benchmark datasets. Particularly, this method is suitable for multilingual retrieval tasks, with a 16.98% improvement in mAP score compared to the current state-of-the-art method.
Increased Risk of Genitourinary Cancer in Kidney Transplant Recipients: A Large-Scale National Cohort Study and its Clinical Implications
Authors: Kim Hyunho , Chae Kyung-Hee , Choi Arum , Kim Mi-hyeong , Hong Ji Hyung , Choi Bum Soon , Kim Sukil , Ban Tae Hyun 
Published: May 2024

Abstract

Purpose
To investigate the risk of genitourinary (GU) cancer in kidney transplant recipients (KTRs) compared to that in the general population, focusing on potential risk factors and clinical implications.
Methods
Using a national cohort of approximately 360,000 individuals, including 31,542 KTRs, we conducted a retrospective analysis of the data from 2007 to 2018. Propensity score matching was used to compare KTRs with a healthy population, adjusting for age, sex, diabetes, hypertension, and hypercholesterolemia.
Results
We identified a significantly increased risk of GU cancers, particularly bladder and kidney cancers, in KTRs. Multivariate analysis revealed a higher risk of GU cancer associated with kidney transplantation (hazard ratio [HR]: 2.133, 95% confidence interval [CI]: 1.641–2.772) and hypercholesterolemia (HR: 1.725, 95% CI: 1.227–2.425), with older age and male sex also being significant risk factors. Conversely, no significant increase in prostate cancer risk was observed in KTRs compared to the general population.
Conclusion
This national cohort-based study indicated an increased risk of GU cancer in KTRs, underscoring the need for targeted cancer surveillance and pre- and post-transplant counseling. These findings provide valuable insights for the development of cancer surveillance programs for KTRs and highlight the necessity for further research in this field.
β-glucan primed and DYDGP microparticles treatment induces trained immunity against mycobacterium tuberculosis infected human macrophage: an in-vitro/in-vivo studies
Authors: Ahmad Firoz , Ahmad Shad , Upadhyay Tarun Kumar , Jain Parul , Saeed Mohd , Ahmad Irfan , Al-Keridis Lamya Ahmed , Khubaib Mohd , Sharma Rolee 
Published: May 2024

Abstract

Background
Tuberculosis (TB) remains a persistent global health challenge, prompting the exploration of innovative strategies to enhance prevention and treatment outcomes. Host-directed therapies have emerged as a promising avenue in TB management, potentially reshaping current treatment paradigms. This study investigates the efficacy of β-glucans as immune-training agents to strengthen the host's defense mechanisms against Mycobacterium tuberculosis infection.
Methods
Our investigation focuses on DYDGP-treated, trained cells to elucidate the effects of β-glucans on immune training. We assessed the integrity of trained macrophage cell membranes and their enhanced phagocytic uptake compared to untrained cells. Additionally, we examined the activation of crucial cellular signalling pathways, enhanced oxidative reactive oxygen species (ROS) production, and acidic vesicular organelles formation within infected and trained macrophage cells at the 24-hour mark. In-vivo and in-vitro phagocytosis uptake assays were conducted to evaluate the impact of training on phagocytic activity, while lysotracker staining data provided insights into macrophage immune responses and pathogen clearance. Furthermore, we investigated the modulatory effects of DYDGP-treated β-glucans on functional characteristics, such as enhanced mycobacterial control at 24 hours, confirmed by colony-forming unit (CFU) assays.
Results
Our findings demonstrate promising outcomes, with trained macrophage cells exhibiting intact cell membranes and enhanced phagocytic uptake compared to untrained cells. β-glucans effectively activate crucial cellular signalling pathways, leading to enhanced oxidative ROS production and acidic vesicular organelles formation within infected and trained macrophage cells at 24 hours. In vivo and in vitro assays reveal that training enhances phagocytosis of particles and induces a potent immune response, resulting in enhanced phago-lysosomal maturation and pathogen clearance within infected and trained macrophage cells at 24 hours. Additionally, DYDGP-treated β-glucans exhibit modulatory effects on functional characteristics, including enhanced mycobacterial control at 24 hours.
Conclusions
These results underscore the potential of β-glucans as adjunctive therapies in TB management. However, further research is needed to comprehensively elucidate the observed effects and optimize their therapeutic application. This study lays the groundwork for future investigations aimed at harnessing the immunomodulatory properties of β-glucans to combat TB effectively.
Identification and Validation of a Prognostic Model Based on Three TLS- Related Genes in Oral Squamous Cell Carcinoma
Authors: Sun Bincan , Gan Chengwen , Tang Yan , Xu Qian , Wang Kai , Zhu Feiya 
Published: May 2024

Abstract

Background: The tertiary lymphoid structures (TLSs) have an immunomodulatory function and have a positive impact on the survival outcomes of patients with oral squamous cell carcinoma (OSCC). However, there is a lack of standard approaches for quantifying TLSs and prognostic models using TLS-related genes (TLSRGs). These limitations limit the widespread use of TLSs in clinical practice.
Methods: A convolutional neural network was used to automatically detect and quantify TLSs in HE-stained whole slide images. By employing bioinformatics and diverse statistical methods, this research created a prognostic model using TCGA cohorts, and explored the connection between this model and immune infiltration. The expression levels of three TLSRGs in clinical specimens were detected by immunohistochemistry.
Results: TLSs were found to be an independent predictor of both overall survival (OS) and disease-free survival in OSCC patients. A larger proportion of the TLSs area represented a better prognosis. After analysis, we identified 69 differentially expressed TLSRGs, and selected three pivotal TLSRGs to construct the risk score model. This model emerged as a standalone predictor for OS and exhibited close associations with CD4+ T cells, CD8+ T cells, and macrophages. Immunohistochemistry revealed high expression levels of CCR7 and CXCR5 in TLS+OSCC samples, while CD86 was highly expressed in TLS-OSCC samples.
Conclusions: This is the first prognostic model based on TLSRGs, that can effectively predict survival outcomes and contribute to individual treatment strategies for OSCC patients.