bluuebunny/crossref_metadata_2025_split huggingface dataset:
Consecutive Cytokeratin Immunochemistry-Supervised Algorithm for Predicting Tumor Areas in Ki67 Breast Cancer Images
Authors: Wu Chien-Hui , Chang Min-Hsiang , Tsai Hsin-Hsiu , Yang Mei-Lin , Peng Yi-Ting 
Published: March 2024

Abstract
Automatic Ki67 index (KI) assessment has become popular in breast cancer research; however, the results are easily influenced by non-tumor cells. This can be addressed by using neural networks to predict tumor areas. Compared to human annotation, cytokeratin immunostaining can more accurately highlight epithelial regions and provide reliable ground truth. We built an immunohistochemistry (IHC)-supervised neural network using the ground truth extracted from consecutive cytokeratin-stained slides, which could predict the tumor area in Ki67 images of breast cancer. The effect of masks on KI quantification was evaluated in 20 patients with breast carcinoma. Set A (three cases) was used to measure the similarity of adjacent whole-slide images (WSIs). A UNet++ (with an EfficientNet-b7 backbone) model was built using Set B (67 cases) for tumor area prediction. The KI in Set C (20 cases) was quantified with and without the application of tumor-area masks, and the KI difference was computed. The mean intersection over union of the epithelial masks extracted from adjacent cytokeratin sections was 0.72 (0.68–0.76). After training and validating in 49 cases, the intersection over union in the test set was 0.44–0.73. At the tile image-level, KI difference was − 42.5–41.7%. Images with the highest difference usually contained numerous lymphocytes or vessels, and the masks prevented disguised cells from being counted. At the WSI-level, the hotspot location changed in 18/20 cases, but hotspot KI changed insignificantly (− 1.0% on average). The global KI changed less (0.9% on average). Thus, consecutive IHC staining provides substantial, precise, and reliable ground truths that trained the algorithm efficiently. This IHC-supervised training workflow can be applied to other targets by replacing IHC antibodies. Furthermore, the virtual tumor areas improved Ki67 counting by excluding the non-tumor areas at the tile image-level, although the effect on the WSI-level was insignificant.
PMNBARL: Enhancing Efficiency of Privacy Management in Digital Networks through Blockchain and Adaptive Reinforcement Learning
Authors: Research Hiralal Solunke , Bhaladhare Pawan , Potgantwar Amol 
Published: March 2024

Abstract
The urgent need for advanced privacy mechanisms in the digital era is underscored by the growing concerns over data breaches and privacy invasions. Traditional privacy management methods often fall short in addressing these challenges, primarily due to their static nature and limited adaptability to evolving cyber threats. This work presents an efficient method to privacy management by integrating blockchain technology with adaptive privacy mechanisms, leveraging the power of machine learning (ML) and deep learning (DL) algorithms. Existing privacy management systems are predominantly rigid, offering limited scope for dynamic adaptation to changing network conditions and user behaviors. Such systems are increasingly inadequate in handling the complexities of modern data environments, often leading to compromised data confidentiality and higher instances of unauthorized data access or policy violations for different use cases. In response, this paper introduces an innovative model that employs smart contracts on the blockchain for privacy policy enforcement operations. These smart contracts ensure secure, transparent, and immutable privacy management, markedly enhancing data confidentiality and reducing policy violations under different attacks. Furthermore, the application of Reinforcement Learning (RL), enables dynamic privacy policy management operations. RL's ability to learn and adjust policies adaptively in response to environmental feedback ensures improved responsiveness and efficiency in privacy settings. A novel aspect of this work is the integration of Anomaly Detection using Deep Neural Networks (DNNs) with blockchain technology for self-adaptive security. DNNs' proficiency in identifying complex patterns in large datasets allows for the early detection of privacy breaches, enhancing the overall security performance levels. Additionally, the implementation of Differential Privacy in Federated Learning addresses the challenge of preserving data privacy during collective model training, thus ensuring robust privacy protection operations. The proposed methods were tested on various real-time simulation datasets, showcasing superior performance over existing methods in terms of energy efficiency, speed, throughput, consistency, and packet delivery ratio sets. This work not only presents a significant advancement in privacy management but also sets a new standard for future research in the field of data privacy and security levels.
Acquisition of clinical reasoning skills by undergraduate nursing students in Malawi; towards development of a middle-range theory : A qualitative study
Authors: Mwale Omero. G. , Mukwato Patricia. K. , makukula Marjorie .k. 
Published: March 2024

Abstract
Introduction: Acquisition of clinical reasoning skills is essential in nursing for patient safety. Lack of clinical reasoning skills in nursing can impose harmful consequences on the patient. However, teaching and learning clinical reasoning skills is not easy due to its complexity. Without a model, clinical reasoning is taught intuitively. Therefore, this study aimed at investigating how undergraduate nursing students acquire clinical reasoning skills, towards development of a middle-range theory.
Methods: This study employed Grounded theory of systematic design underpinned by a social constructivism paradigm. The participants were undergraduate nursing students and nurse educators. Purposive sampling was used to sample the participants. Data were collected in six months using numerous methods of interviews, observations, and document review Twelve individual in-depth interviews and six focus group discussions were conducted. Data collection and initial data analysis occurred concurrently using a coding process, with comparative analysis.
Results: The study revealed that undergraduate nursing students acquired clinical reasoning skills through automation while utilizing the nursing process. Through the themes, a new theory called ‘a middle-range theory for the acquisition of clinical reasoning skills’, was generated in this current study. The associated concepts were environmental setting, type of curriculum, anchors and expected outcomes which included individual and health care system indicators.
Conclusion: Teaching undergraduate nursing students how to reason clinically will develop nurses who can adjust and solve problems in changing patient’s situations. Based on the findings of this study, it is recommended that nursing students be equipped with adequate clinical reasoning skills before they graduate. Therefore, implementing the new model called ‘a middle range theory for the acquisition of clinical reasoning skills’ could foster the development of clinical reasoning skills from the start of the nursing training program.
Intraoperative virtual reality for older patients undergoing total knee arthroplasty: study protocol for a randomized clinical trial
Authors: Espinosa-Leon Juan P. , Mathura Ryan , Chen Guanqing , Joseph Melisa , Sadhwani Trishna , Beydoun Najla , Hernandez Edjay R. , Riley Tyler , Kunze Lisa J. , Goodspeed Valerie , O'Gara Brian P. 
Published: March 2024

Abstract

Background:
In an aging surgical patient population, preventing complications such as oversedation has taken increasing priority in perioperative care. Intraoperative use of Virtual Reality (VR) may decrease sedative requirements. We hypothesize that the use of immersive VR during total knee arthroplasty (TKA) will lead to decreased propofol requirements, improved patient-reported satisfaction, and reduced postoperative opioid requirements compared to active and usual care controls.
Methods:
This is a single center, randomized clinical trial of older (age > 60) patients undergoing TKA. Participants will be randomized into three groups (2:2:1): VR immersion, music, and sham VR plus usual care. All patients will receive a regional block and spinal anesthesia. Patients in the immersive VR and music groups will use Patient Controlled Sedation (PCS) with propofol, while those in the sham VR group will act as the standard of care control group and will receive Monitored Anesthesia Care (MAC) with propofol infusion.
Statistical Analysis:
Analyses will be conducted using IBM SPSS Statistics Version 25, considering a two-sided p-value < 0.05 to be statistically significant. The primary outcome is the intraoperative dose of propofol (mg kg− 1 min− 1). Secondary outcomes include patient satisfaction, post-anesthesia care unit (PACU) length of stay, postoperative pain scores and analgesic requirements, functional outcomes, postoperative delirium, and postoperative neurocognition.
Discussion:
VR used as a non-pharmacological adjunct to regional and spinal anesthesia during TKA may reduce sedative requirements while maintaining patient satisfaction. If true, this approach to minimizing sedation may impact clinical outcomes including perioperative complications and length of stay for older patients, while maintaining a high degree of patient satisfaction.
Trial Registration:
This trial was registered on clinicaltrials.gov on January 29, 2021. The registration number is NCT04748549.
https://clinicaltrials.gov/ct2/show/NCT04748549
Sintilimab plus GemOx is an effective salvage therapy in patients with refractory⁄relapsing nodal peripheral T cell lymphomas
Authors: Xiao Xibin , Hu Mengmeng , Jiang Huawei , Chen Panpan , Lei Huyi 
Published: March 2024

Abstract
Peripheral T-cell lymphomas (PTCLs) are a heterogeneous group of rare malignancies. Once relapse or progression after front-line therapy, treatment options are minimal. We designed a retrospective study to explore the effectiveness and safety of chemoimmunotherapy in relapse or refractory nodal PTCLs. 31 patients with r/r nodal PTCLs were enrolled, including 23 PTCL-NOS, 4 AITL, and 4 ALCL. 21 (67.7%) patients received at least two lines of therapy. 71.0% (95% CI, 53.4%-83.9%) of patients documented objective response of 2–4 cycles of sintilimab plus GemOx therapy, including 9 complete response and 13 partial response. 21 (67.7%) patients received consolidation therapy, including 5 autologous stem-cell transplantation and 12 histone deacetylase inhibitors. After a median 25.6 months follow-up, the median PFS was 22.0 (95% CI,11.8–24.7) months, and the median OS was 26.2 (95% CI, 24.4 –NA) months. 29 (93.5%) patients experienced at least one adverse event, and 26 (83.9% patients only had mild (grade 1–2) AEs.Univariable Cox regression showed the progression risk of AITL is 22.7 (3.9–131.0, p < 0.01) times of PTCL-NOS, while the HR of ALCL was 1.14 (0.33–3.96,p = 0.833). Sintilimab plus GemOx showed encouraging activity and manageable toxicity for patients with r/r PTCL, warranting further investigations.
Incidence of In-Hospital Mortality and Its Determinants among Intensive Care Unit Patients with Acute Respiratory Distress Syndrome in Ethiopian: A multilevel analysis
Authors: Abate Semagn Mekonnen , Kebede Melkamu , Hailu Seyoum , Adamu Yayeh , Mantefardo Bahru , Meno Abinet , Lafebo Lakew 
Published: March 2024

Abstract
Purpose
Acute respiratory distress syndrome (ARDS) is a heterogeneous syndrome with substantial morbidity and mortality globally. Body of evidence revealed that the epidemiologic estimates are currently disproportional due to differences in patient populations, risk factors, resources, and practice protocols around the world, and the rate of mortality and its predictors are uncertain in Ethiopia.
Method
A multi-centre longitudinal study was conducted in Ethiopia from January 2018 to June 2023. After receiving ethical clearance from the Institutional Review Board (IRB) of Dilla University College of Health Science and Medicine, 356 ARDS patients’ records were retrieved with a systematic random sampling technique. A multilevel multivariate analysis was used to control the effect of clustering. A P < 0.05 was taken as statistically significant.
Results
This study demonstrated that the cumulative mortality rate of patients with ARDS was 59% (95% CI: 53.5 to 63.9). The multilevel multivariable model analysis showed that GCS < 8 (AOR = 7.4; 95% CI: 2.79, 19.75), severe form of ARDS (AOR 4.7 95% CI 1.64, 13.36), invasive ventilation (AOR 3.2, 95% CI 1.56, 6.42), and respiratory comorbidity (AOR 4.9, 95% CI 1.71, 14.32) were independent predictors of in-hospital mortality among patients with ARDS.
Conclusion
The study revealed that the hospital mortality rate was substantially higher than that of developed nations. The study also highlighted various risk factors that independently predicted in-hospital mortality.The findings of this study call for mitigating strategies to improve ICU care for ARDS patients.
An ultra-sensitive dopamine electrochemical sensor based on PVP/rGO-MWCNT composites
Authors: Jiang Yixuan , Luo Dandan , Liu Saiwen , Zhang Jin , Meng Wei , Chen Chao 
Published: March 2024

Abstract
Dopamine (DA) is a neurotransmitter secreted by the brain that plays a variety of roles in the central nervous system. An imbalance in dopamine can cause a range of disease symptoms and negative effects, such as Parkinson's disease and arrhythmia. Detecting DA accurately and rapidly is therefore crucial for medical diagnosis and disease prevention. In this study, PVP and rGO-MWCNT were encapsulated using a hydrothermal method to form a composite material. The composite was then characterized using scanning electron microscopy (SEM). The three materials were combined, and based on this, a new DA electrochemical sensor was constructed. It is worth noting that the high specific surface area and high conductivity of rGO-MWCNT cooperate with the amphiphilic and stable dispersion of PVP, which further improves the electrochemical performance of the sensor for DA. Under optimal conditions, DA content is detected within a wide range and with a low detection limit which is explained by the electrochemical redox process of the sensor. In addition, the sensor shows satisfactory recovery and accuracy in detecting DA content in real human serum samples using the standard addition method.
Los olvidados: Non-BRCA variants associated with Hereditary breast cancer in Mexican population
Authors: Aguilar Dione , Garza-Rodríguez María Lourdes , Muñiz-Garza Carolina Elizabeth , Villarreal-Garza Cynthia Mayte , Vidal-Gutiérrez Oscar , Pérez-Ibave Diana Cristina , Burciaga-Flores Carlos Horacio 
Published: March 2024

Abstract

Background: Hereditary predisposition to breast and ovarian cancer syndrome (HBOC) is a pathological condition with increased cancer risk, including breast (BC), ovarian cancer (OC), and others. HBOC pathogenesis is caused mainly by germline pathogenic variants (GPV) in BRCA1 and BRCA2 genes. However, other relevant genes are related to this syndrome diagnosis, prognosis, and treatment, including TP53, PALB2, CHEK2, ATM, etc. This study aimed to identify the prevalence of non-BRCA genes in HBOC patients of Northeast Mexico.
Methods: This multicentric study included 1285 patients with HBOC diagnosis from four oncologic centers in northeast Mexico from 2016 to 2023. Genomic and clinical data were analyzed based on multi-gene panel results and electronic records of the medical geneticist consultation. For the data analysis of qualitative and quantitative variants JASP statistical software (version 0.18.1) was used, taking p<0.05 as a significant results.
Results: We found that 32.7% of the patients had at least one GPV in non-BRCA genes. The five most frequent non-BRCA genes were CHEK2, PALB2, MUTYH, CDKN2A, and ATM. Among the group of non-BRCA genes, six are involved in the homologous repair pathway (HR), and three are related to DNA damage repair (DDR) pathways. In the analysis of GPVs in molecular pathways, DDR GPVs had a higher risk of developing BC and having cancer between 41-50 years.
Conclusion: Multi-gene testing implementation improves the detection of often overlooked genes related to HBOC pathogenesis and treatment. Non-BRCA GPVs in Northern Mexico correspond to one-third of the HBOC cases, including HR and DDR pathways genes that would be misdiagnosed if not tested. HR patient carriers are potential targets of iPARP therapies. The optimal approach to cancer treatment for non-BRCA mutation carriers warrants further investigation to develop newer therapies.
Transition from endogenous to exogenous feeding in longfin yellowtail Seriola rivoliana larvae under simultaneous effects of daily temperature fluctuation and enrichment of the rotifer Brachionus rotundiformis
Authors: Pacheco-Carlón Nairoby , Dios Marco A. Hernández-de , Nolasco-Soria Hector , Tovar-Ramírez Dariel , Maldonado-García Minerva , Maldonado-García Deneb 
Published: March 2024

Abstract

The most sensitive period in fish larva culture occurs when larvae must make the transition from endogenous to exogenous feeding, where temperature and nutrition are suggested as the primary factors affecting development and survival. However, little is known about its simultaneous impact during this period. This study aimed to determine the effect of two temperature regimes and rotifer enrichment at the first feeding of longfin yellowtail Seriola rivoliana. Eggs were subjected to a constant 24°C (CTE) and a daily temperature fluctuation (DTF) between 22.8–25.2°C until oil droplet exhaustion, 5.5 days after hatching. Inside the temperature treatments, the impact of three rotifer enrichment products (Ori-green, S.presso, and a Domestic emulsion) for the euryhaline Brachionus rotundiformis was evaluated. Results showed that larval survival was higher and larvae were bigger at DTF compared to CTE at oil droplet exhaustion. At the same stage, larval size from rotifer enrichments resulted bigger at Domestic emulsion compared to Ori-green. The relative expression of trypsin gen in larvae aged 3.7 DAH was higher at Domestic emulsion compared to S.presso emulsion and Ori-green. This study indicates that daily temperature fluctuation and Domestic emulsion can improve larval performance at first feeding. Domestic emulsion is probably a potential rotifer-enricher for longfin yellowtail larvae.
A city under siege: Time-series analysis of shootouts and the association with health and living conditions in Rio de Janeiro, Brazil, 2017-2022
Authors: Cunha Ana Paula , Mota Jurema Corrêa da , Bastos Francisco I 
Published: March 2024

Abstract
Armed violence is characterized by episodes of conflicts with the use of firearms and occasionally knives and other sharp objects. Ecological time series study applying the joinpoint model based on data on shootouts in the city of Rio de Janeiro, Brazil, from 2017 to 2022. We analyzed the possible association between shootouts and living conditions based on linear and polynomial regressions. Decreases were observed in the number of shootouts in the city of Rio de Janeiro from 2017 to 2022, although current levels of violence are still far above those defined by international agencies as desirable or even acceptable. The statistically significant associations between indicators of living and health conditions and episodes of shootouts were nonlinear (SPI: -2747.9 [(-4973.8; -522.0]; SDI: -2987.4 [(-537.1; -437.6)]). A decrease was observed in episodes of armed violence. The relationship with living conditions points to a complex association, not reducible to a possible linear relationship between violence and living conditions. The findings suggest that complex phenomena should be analyzed with state-of-the-art models, whether for diagnosis or to inform truly structural interventions.
How can equity, diversity, and inclusion (EDI) principles be incorporated into research excellence with industry and community partners? Lessons learnt from Canada andAustralia
Authors: Hung Lillian , Wong Karen Lok Yi , Rasekaba Tshepo , Ren Haopu , Blackberry Irene 
Published: March 2024

Abstract

Background
The rapid advancement of gerontechnology, technologies for older adults, needs a collaborative approach, integrating the efforts of researchers, industry and community partners. Multisectoral collaboration fosters a holistic view, merging industry expertise, academic rigour, and the lived experiences of older adults and caregivers. This paper explores the role of Equity, Diversity, and Inclusion (EDI) perspectives in such collaboration.
Methods
We present two case studies from Canada and Australia. Study one involves a Dementia Television project, and study two an innovative rural dementia care project. Data sources included case studies’ focus group transcripts, research meeting notes, or publications between 2021–2023 and 2016–2024, respectively. Utilizing Rofel’s reflective model, we reflected on lessons learned regarding challenges, strategies, and their implications for future research. Our analysis focused on two questions: 1) What were the common challenges we encountered in partnering with industry and community in the research process? And 2) How can EDI be applied to help overcome those challenges?
Results
Thematic analysis identified five common themes of challenges and ten practical strategies. The challenges are (1) implicit bias, (2) underrepresentation, (3) communication gaps, (4) mistrust and (5) power dynamics. Based on the lessons learned, we identified ten practical strategies through EDI principles: (1) diverse representation, (2) establish transparent agreements, (3) inclusive language and cultural sensitivity, (4) apply flexibility to learn and adapt, (5) embed team reflection (6) take time to build trust and relationships, (7) meaningful engagement, (8) equitable recognition (9) foster a respectful environment for shared learning, and (10) cultivate a long-term sustained relationship.
Conclusion
The older population is diverse, and their needs are complex. EDI considerations contribute to fostering research excellence and maximizing the potential to develop aging technologies that truly meet the diverse needs of older adults for societal impact. Multisector collaboration requires clear communication and intentional efforts to build trust. EDI considerations should be embedded at every stage of the research process. This paper outlined common challenges, strategies, and implications as practical tips for future research and practice.