bluuebunny/crossref_metadata_2025_split huggingface dataset:
CNN-based Clinical Diagnosis and Decision Support System for Chest X-ray
Authors: Magar Bipin Thapa , Shrestha Kumar , Rahman Md. Asadur 
Published: April 2024

Abstract
Chest radiographs are popularly used as a first-line diagnostic tool for various chest diseases. However, the correct interpretation of information while reading a radiograph is a major challenge. We aim to develop a suitable convolutional neural network (CNN) framework for the automatic detection of disease in chest radiographs. We have designed a 15-layered CNN architecture with 3 output classes: covid, normal, and pneumonia. This architecture was trained with 10,011 images. To avoid the risk of over-fitting, data augmentation techniques were implemented on training samples while dropout layers were implemented in CNN architecture. During training, we were able to obtain 98.24% accuracy on the training dataset. On the other hand, the experimental results of the test dataset indicate that the classification accuracy is 95.8%, precision is 95.83%, recall is 95.77% and the f1-score is 95.79% on average which is comparatively superior to several existing research works.
CNN application for automated determination of the patient’s size to obtain the size-specific dose estimated in CT
Authors: Hernández-Dávila Erik R , Torres-García Eugenio , Aranda-Lara Liliana , Roldan-Valadez Ernesto , Isaac-Olivé Keila , Flores-Reyes Mario 
Published: April 2024

Abstract

Introduction. The currently available dosimetry techniques in computed tomography can be inaccurate which overestimate the absorbed dose. Therefore, we aimed to provide an automated and fast methodology to more accurately calculate the SSDE using

D

w

obtained by using CNN from thorax and abdominal CT study images. Methods. The SSDE was determined from the 200 records files. For that purpose, patients’ size was measured in two ways: (a) by developing an algorithm following the AAPM Report No. 204 methodology; and (b) using a CNN according to AAPM Report No. 220. Results. The patient’s size measured by the in-house software in the region of thorax and abdomen was 27.63 ± 3.23 cm and 28.66 ± 3.37 cm, while CNN was 18.90 ± 2.6 cm and 21.77 ± 2.45 cm. The SSDE in thorax according to 204 and 220 reports were 17.26 ± 2.81 mGy and 23.70 ± 2.96 mGy for women and 17.08 ± 2.09 mGy and 23.47 ± 2.34 mGy for men. In abdomen was 18.54 ± 2.25 mGy and 23.40 ± 1.88 mGy in women and 18.37 ± 2.31 mGy and 23.84 ± 2.36 mGy in men. Conclusions. Implementing CNN-based automated methodologies can contribute to fast and accurate dose calculations, thereby improving patient-specific radiation safety in clinical practice.
Virtual and bound states in low-energy positron scattering by atoms and molecules via modified effective range theory
Authors: Fedus Kamil , Karwasz Grzegorz 
Published: April 2024

Abstract
Modified effective range theory is applied as a tool to determine bound and virtual state energies in low-energy positron elastic scattering by atoms and molecules. This is achieved by the S-matrix continuation into the complex momentum plane, allowing to identify poles related to shallow energy states. The influence of the long-range polarization potential (∼r
−4) on the bound and virtual-state pole positions is analyzed for noble gases and nonpolar molecules such as H2, N2, and CH4. The quantitative relations between the S-matrix poles and the s-wave scattering length accounting for dipole polarization are introduced.
The potential role of airborne and floating wind in the North Sea region
Authors: Vos Hidde , Lombardi Francesco , Joshi Rishikesh , Schmehl Roland , Pfenninger Stefan 
Published: April 2024

Abstract
Novel wind technologies, in particular airborne wind energy (AWE) and floating offshore wind turbines, have the potential to unlock untapped wind resources and contribute to power system stability in unique ways. So far, the techno-economic potential of both technologies has only been investigated at a small scale, whereas the most significant benefits will likely play out on a system scale. Given the urgency of the energy transition, the possible contribution of these novel technologies should be addressed. Therefore, we investigate the main system-level trade-offs in integrating AWE systems and floating wind turbines into a highly renewable future energy system. To do so, we develop a modelling workflow that integrates wind resource assessment and future cost and performance estimations into a large-scale energy system model, which finds cost-optimal system designs that are operationally feasible with hourly temporal resolution across ten countries in the North Sea region. Acknowledging the uncertainty on AWE systems’ future costs and performance and floating wind turbines, we examine a broad range of cost and technology development scenarios and identify which insights are consistent across different possible futures. We find that onshore AWE outperforms conventional onshore wind regarding system-wide benefits due to higher wind resource availability and distinctive hourly generation profiles, which are sometimes complementary to conventional onshore turbines. The achievable power density per ground surface area is the main limiting factor in large-scale onshore AWE deployment. Offshore AWE, in contrast, provides system benefits similar to those of offshore wind alternatives. Therefore, deployment is primarily driven by cost competitiveness. Floating wind turbines achieve higher performance than conventional wind turbines, so they can cost more and remain competitive. AWE, in particular, might be able to play a significant role in a climate-neutral European energy supply and thus warrants further study.
An Instrumentalist Theory of Political Legitimacy
Authors: Brinkmann Matthias 
Published: April 2024

Abstract
This book defends instrumentalism, the claim that political legitimacy rests on promoting justice. This entails that power can be permissibly exercised without consent, democracy, or public justification. In the book’s first part, a revisionary understanding of the problem of legitimacy is defended. Legitimacy is defined as the permissibility of exercising power. This entails that the problem of legitimacy is separate from the problem of justifying political obligations. Furthermore, legitimacy can exist without political authority. Instrumentalism is described and defended in the book’s second part. The view is based on a hybrid theory of justice that recognizes both aims and constraints. The importance of justice is defended against competitor views which prioritize stability or perfection. A series of suggestions is made how instrumentalism should be formulated, in particular, that it should take a sophisticated two-level structure. The third part of the book argues against three competing theories. It is argued that consent is not necessary for legitimacy, and that strong, moral rights can be made compatible with the instrumentalist view. Proceduralist views which ground legitimacy on democracy are also rejected, but the possibility that democracy is a ‘secondary value’ within instrumentalism is explored. Lastly, it is shown that legitimacy does not rely on justifiability to reasonable people, but that legitimate governments can nonetheless accommodate disagreement in natural ways.
Theories of Legitimacy
Authors: Brinkmann Matthias 
Published: April 2024

Abstract
This chapter surveys major theories of legitimacy, classifying them into voluntarist, relational, anti-moralist, and rationalist families, as well as hybrid combinations of these. Voluntarism is subdivided into explicit and implicit consent theories, consent ‘light’ approaches, democratic theories, as well as hypothetical-consent and public-justification views. Fair-play and associative theories together constitute the family of relational views, while self-interest and realist theories form the anti-moralist family. Natural-duty approaches, Raz’s normal justification thesis, consequentialism, and instrumentalism are classed as versions of rationalism. Strengths and weaknesses of all approaches are discussed, with the first three families of theories found wanting.
The Importance of Justice
Authors: Brinkmann Matthias 
Published: April 2024

Abstract
This chapter argues for the priority of justice over other values, specifically when it comes to judging the legitimacy of political institutions. The justice-based instrumentalist theory of legitimacy is contrasted with two families of competitors. Minimalist theories claim that legitimacy is based on promoting stability, peace, or some similar value, with justice deemed too demanding a goal. Maximalist theories claim that justice is not enough and that legitimate institutions must be assessed against their promotion of welfare or human perfection. The chapter argues against both competitors, coming to the result that justice enjoys greater weight than competing values, although probably not in the form of lexical priority.
Democracy as a Secondary Value
Authors: Brinkmann Matthias 
Published: April 2024

Abstract
This chapter argues that democracy possesses secondary value: we should, in many cases, value democratic procedures for their own sake, but they are normally less important than the outcomes they bring about. The secondary-value view occupies an intermediate position between the radical claim that democracy has merely instrumental value and the mainstream view that it has intrinsic and primary value. Three versions of the secondary-value view are discussed. First, democracy might be a weak aim, in the sense that it possesses inferior weight when compared to other aims. Second, the value of democracy might be conditional. Third, democracy might be a constraint, but a lenient one that restricts few practical choices.
Legitimacy without Public Justification
Authors: Brinkmann Matthias 
Published: April 2024

Abstract
This chapter argues that legitimacy does not require power to be justifiable to reasonable people, and that an instrumentalist view can accommodate reasonable disagreement in several natural ways. The justificatory position is outlined, and its appeal located in its supposed sensitivity to reasonable disagreement in pluralistic societies. The position is rejected on the basis of five objections. Then the chapter answers the objection that instrumentalism cannot deal with reasonable disagreement by describing five strategies how the view can accommodate disagreement. The chapter ends with some reflections on the role of truth in politics and the moral tragedy of being wrong on normative issues.
Closing Reflections
Authors: Brinkmann Matthias 
Published: April 2024

Abstract
This chapter recapitulates themes from the book in six separate reflections, revisiting and expanding on questions discussed throughout the book. (I) Does instrumentalism provide us with any hints about which moral relations obtain between rulers and ruled? (II) What is the foundational argument for instrumentalism, and where might we resist it? (III) Where do the different ways to formulate instrumentalism leave us, and do they provide us with any insights? (IV) Have we successfully argued against all competitor views to instrumentalism, and which alternative remains the strongest? (V) In which ways is instrumentalism based on preservationist and revisionist methodological impulses? (VI) What does instrumentalism mean in practice?
The ‘Existential Fabric’ of War: Explaining the Phrase of War in the Laws of War
Authors: Lukin Annabelle , García Marrugo Alexandra 
Published: April 2024

Abstract
Across the texts constituting the laws of war, the word war is one of the most frequent lexical items, its dominant lexicogrammatical environment being in the phrase of war. While this combination seems unremarkable, given the durability of organized violence and the significance of this register for attempts to regulate the violence of war, the paper explores the ideological work of this phrase, including both the effects of the dominant pattern and its lexicogrammatical ‘opportunity cost’. The paper argues that the patterning of war in the laws of war shows a naturalizing of war in which the category is taken for granted, despite its context being the construction of law. In addition, the patterning reveals a paradoxical aversion to putting war at the centre of the laws of war. We argue this ‘decentring’ of war in the laws of war is a token of Malešević’s ‘ontological dissonance’ at the heart of modernity, a profound inability to reconcile our abhorrence of violence with the killing that is tolerated and defended as the ‘legitimate’ price of war.
Clinical evaluation of the efficacy of limbus artificial intelligence software to augment contouring for prostate and nodes radiotherapy
Authors: Starke Alison , Poxon Jacqueline , Patel Kishen , Wells Paula , Morris Max , Rudd Pandora , Tipples Karen , MacDougall Niall 
Published: April 2024

Abstract

Objectives
To determine if Limbus, an artificial intelligence (AI) auto-contouring software, can offer meaningful time savings for prostate radiotherapy treatment planning.

Methods
Three clinical oncologists recorded the time taken to contour prostate and seminal vesicles, lymph nodes, bladder, rectum, bowel, and femoral heads on CT scans for 30 prostate patients (15 prostate, 15 prostate and nodes). Limbus 1.6.0 was used to generate these contours on the 30 CT scans. The time taken by the oncologists to modify individual Limbus contours was noted and compared with manual contouring times. The geometric similarity of Limbus and expert contours was assessed using the Dice Similarity Coefficient (DSC), and the dosimetric impact of using un-edited Limbus organs at risk contours was studied.

Results
Limbus reduced the time to produce clinically acceptable contours by 26 minutes for prostate and nodes patients and by 13 minutes for the prostate only patients. DSC values of greater than 0.7 were calculated for all contours, demonstrating good initial agreement. A dosimetric study showed that 5 of the 20 plans optimized using unmodified AI structures required unnecessary compromise of PTV coverage, highlighting the importance of expert review.

Conclusions
Limbus offers significant time saving and has become an essential part of our clinical practice.

Advances in knowledge
This article is the first to include bowel and lymph nodes when assessing potential time savings using Limbus software. It demonstrates that Limbus can be used as an aid for prostate and node radiotherapy treatment planning.
Deciphering three predominant biopsy-proven phenotypes of IgG4-associated kidney disease: a retrospective study
Authors: Luo Sulin , Guo Luying , Yang Zhenzhen , Shen Rongfang , Zhang Tianlu , Wang Meifang , Zhou Qin , Wang Huiping , Li Xiayu , Chen Jianghua , Wang Rending 
Published: April 2024

ABSTRACT

Background
IgG4-associated kidney disease (IgG4-RKD) encompasses a spectrum of disorders, predominantly featuring tubulointerstitial nephritis (TIN) and membranous glomerulonephropathy (MGN). The limited understanding of the co-occurrence of IgG4-RD-TIN with anti-neutrophil cytoplasmic antibodies (ANCA)-associated vasculitis (AAV) poses a diagnostic and therapeutic challenge.

Methods
We examined 49 cases, comprising 21 cases of IgG4-RD-TIN (group A), 10 cases of IgG4-RD-TIN accompanied with MGN (group B), and 18 cases of IgG4-RD-TIN concurrent with AAV (group C), at the First Affiliated Hospital of Zhejiang University, China, from June 2015 to December 2022.

Results
The mean age and gender of the three IgG4-RKD subtypes were not statistically significant. IgG4-RD-TIN exhibited higher serum creatinine and a higher incidence of hypocomplementemia (group A 47.6%, group B 30%, group C 16.7%). IgG4-RD-TIN-MGN was characterized by proteinuria (group A 0.3 g/d, group B 4.0 g/d, group C 0.8 g/d, P &lt; 0.001) and hypoalbuminemia. IgG4-RD-TIN-AAV exhibited hypohemoglobinemia (group A 103.45 g/l, group B 119.60 g/l, group C 87.94 g/l, P &lt; 0.001) and a high level of urine erythrocytes. The primary treatment for IgG4-RD-TIN was steroids alone, whereas IgG4-RD-TIN-MGN and IgG4-RD-TIN-AAV necessitated combination therapy. Group A experienced two relapses, whereas groups B and C had no relapses. There was no significant difference in patient survival among the three groups, and only two cases in group C suffered sudden death.

Conclusions
This study provides valuable insights into clinical manifestations, auxiliary examination features, pathological characteristics, and prognosis of IgG4-RD-TIN, IgG4-RD-TIN-MGN, and IgG4-RD-TIN concurrent AAV. Large-scale studies are required to validate these findings.
Mast cells: a novel therapeutic avenue for cardiovascular diseases?
Authors: Poto Remo , Marone Gianni , Galli Stephen J , Varricchi Gilda 
Published: April 2024

AbstractMast cells are tissue-resident immune cells strategically located in different compartments of the normal human heart (the myocardium, pericardium, aortic valve, and close to nerves) as well as in atherosclerotic plaques. Cardiac mast cells produce a broad spectrum of vasoactive and proinflammatory mediators, which have potential roles in inflammation, angiogenesis, lymphangiogenesis, tissue remodelling, and fibrosis. Mast cells release preformed mediators (e.g. histamine, tryptase, and chymase) and de novo synthesized mediators (e.g. cysteinyl leukotriene C4 and prostaglandin D2), as well as cytokines and chemokines, which can activate different resident immune cells (e.g. macrophages) and structural cells (e.g. fibroblasts and endothelial cells) in the human heart and aorta. The transcriptional profiles of various mast cell populations highlight their potential heterogeneity and distinct gene and proteome expression. Mast cell plasticity and heterogeneity enable these cells the potential for performing different, even opposite, functions in response to changing tissue contexts. Human cardiac mast cells display significant differences compared with mast cells isolated from other organs. These characteristics make cardiac mast cells intriguing, given their dichotomous potential roles of inducing or protecting against cardiovascular diseases. Identification of cardiac mast cell subpopulations represents a prerequisite for understanding their potential multifaceted roles in health and disease. Several new drugs specifically targeting human mast cell activation are under development or in clinical trials. Mast cells and/or their subpopulations can potentially represent novel therapeutic targets for cardiovascular disorders.
Ncf1 knockout in smooth muscle cells exacerbates angiotensin II–induced aortic aneurysm and dissection by activating the STING pathway
Authors: Liu Hao , Yang Peiwen , Chen Shu , Wang Shilin , Jiang Lang , Xiao Xiaoyue , Le Sheng , Chen Shanshan , Chen Xinzhong , Ye Ping , Xia Jiahong 
Published: April 2024

Abstract

Aims
Aortic aneurysm and dissection (AAD) is caused by the progressive loss of aortic smooth muscle cells (SMCs) and is associated with a high mortality rate. Identifying the mechanisms underlying SMC apoptosis is crucial for preventing AAD. Neutrophil cytoplasmic factor 1 (Ncf1) is essential in reactive oxygen species production and SMC apoptosis; Ncf1 absence leads to autoimmune diseases and chronic inflammation. Here, the role of Ncf1 in angiotensin II (Ang II)–induced AAD was investigated.

Methods and results
Ncf1 expression increased in injured SMCs. Bioinformatic analysis identified Ncf1 as a mediator of AAD-associated SMC damage. Ncf1 expression is positively correlated with DNA replication and repair in SMCs of AAD aortas. AAD incidence increased in Ang II–challenged Sm22CreNcf1fl mice. Transcriptomics showed that Ncf1 knockout activated the stimulator of interferon genes (STING) and cell death pathways. The effects of Ncf1 on SMC death and the STING pathway in vitro were examined. Ncf1 regulated the hydrogen peroxide–mediated activation of the STING pathway and inhibited SMC apoptosis. Mechanistically, Ncf1 knockout promoted the ubiquitination of nuclear factor erythroid 2-related factor 2 (NRF2), thereby inhibiting the negative regulatory effect of NRF2 on the stability of STING mRNA and ultimately promoting STING expression. Additionally, the pharmacological inhibition of STING activation prevented AAD progression.

Conclusion
Ncf1 deficiency in SMCs exacerbated Ang II–induced AAD by promoting NRF2 ubiquitination and degradation and activating the STING pathway. These data suggest that Ncf1 may be a potential therapeutic target for AAD treatment.
Spontaneous coronary artery dissection outcomes among pregnant vs. non-pregnant women
Authors: Krittanawong Chayakrit , Patel Neelkumar , Bandyopadhyay Dhrubajyoti , Maitra Neil Sagar , Khawaja Muzamil , Wang Zhen , Alam Mahboob , Shani Jacob , Frankel Robert , Sharma Samin , Jneid Hani 
Published: April 2024

Abstract

Aims
Spontaneous coronary artery dissection (SCAD) has become increasingly recognized. It accounts for &lt;1-4% of acute coronary syndrome presentations. Overall, however, it makes up over 40% of pregnancy-associated myocardial infarction. Furthermore, pregnancy-associated spontaneous coronary artery dissection (P-SCAD) is described to have a greater degree of clinical manifestations, including left ventricular dysfunction, shock, and left main or multivessel involvement. The findings are disconcerting, though many studies evaluating P-SCAD are based on case series data or are single centre studies.

Methods and results
The aim of this study was to evaluate a larger national dataset to evaluate the outcomes of SCAD and specifically P-SCAD in an attempt to better characterize the severity and clinical nature of this condition. To conduct this study, we analysed the National Readmission Database from January 2016 to December 2020. Propensity matching was done using the Greedy 1:1 method. Multivariate logistics and time-to-event Cox regression analysis models were built by including all confounders significantly associated with the outcome on univariable analysis with a cut-off P-value of 0.2. In multivariate regression analysis, P-SCAD patients had a non-propensity matched odds ratio (OR) of 0.21 (0.3-1.54, P = 0.123) of dying and a propensity matched OR of 0.11 (0.02-0.61, P = 0.012) of dying. Thirty-day readmission rate for P-SCAD was 15.8% (n = 93) and for non-pregnant spontaneous coronary artery dissection (NP-SCAD) was 11.2% (n = 2286); non-propensity matched OR for readmission for PSCAD patients was 1.68 (1.24-2.29, P = 0.001) and propensity matched OR was 3.39 (1.93-5.97, P &lt; 0.001).

Conclusion
Among hospitalized patient, P–SCAD was associated with similar clinical outcomes and reduced incidence of death when compared with NP–SCAD, though had higher rates of 30–day readmission. Larger–scale observational data will be needed to ascertain the true incidence of cardiovascular complications as it relates to P–SCAD.