bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prognostic and predictive value of tertiary lymphoid structures in TURBT materials; Should it be seated in routine pathological examination and can it be used in deciding on the treatment method?
Authors: Yilmaz Fatih , Sagir Suleyman 
Published: February 2024

Abstract
Purpose: This study aims to reveal the importance of tertiary lymphoid structures (TLS) in TURBT materials with a practical and applicable method in which the effect of a certain threshold value on survival and treatment response can be implicated.
Methods: TURBT materials that had not previously received any treatment (chemotherapy, radiotherapy, or immunotherapy) and were diagnosed for the first time at Mardin Training and Research Hospital between 2014 and 2022 were included in the study. The maximum number of TLS per 4x magnification field (Field diameter: 4,5 mm) was recorded.Grouping and statistical analysis of the TLS number were performed using threshold values of “≥1”, “≥2” and “≥3”.
Results
TLSs were more frequently found in high-grade tumors (p=0,008) and showed a strong association with stage progression (p<0,001). It was also significantly associated with many adverse histopathological parameters. Conversely,high TLS (≥1, ≥2, and ≥3) appeared to be associated with fewer recurrences (p=0,032, p=0,001, and p=0,018, respectively), and cases with higher TLS showed longer recurrence-free survival (p=0,089, p=0,023, p=0,037, respectively). TLS≥3 was found to be an independent parameter associated with favoarable RFS (p=0,019, HR=0,401) and multifocality was found to be an independent risk factor for RFS (p=0,023, HR=2,302).
Conclusion
This study is the first to demonstrate the relationship between the presence and specific thresholds of TLS in TURBT materials with prognostic parameters. Including this information in the routine pathological examination of TURBT materials will allow a more accurate approach to treatment and follow-up, especially in patients with NMIBC.
Meta-analysis and Systematic Review of Medical Errors Across Specialties: Bridging the Gap with International Perspectives and Recommendations
Authors: Hemeda Mohamed S. , Ibrahim Mohamed Mohamed-Aly , Salim Almaza Ali , Abdelmola Omran Mohamed , Shemy Gamal Galal , Ahmed Samer S , Arafa Ibrahim Arafa Reyad , Saqr Yasser M , Abdelkhalek Hesham Hafez , Bastawisy Amir , Elazeem Mostafa A. , Rashed Khalid A. , Abdalla Hytham , Dawood Yahia Mohmmed Ahmed , Elawamry Mahmoud Ibrahim M , Elbahrawy Mahmoud Mohamed Mahmoud , Eid Gaber , Ali Emadeldeen , Elaziz Abd Elaziz Shokry Abd , Alsaid Aldosoky Abd Elaziz , Ahmed Nashwa , Elfadle Amr Abu , Mohamed Mohamed Hafez , Ramadan Alaa , Sawy Safwat Salama , Fayed Badr , Mohamed Refaat R. , Abdelrazzak Emad , Fakhry Mohamed , Elyamany Mona Ibrahim , Hassan Adel Ali , Abouzid Mohamed , Sayed Heba Youssef 
Published: February 2024

Abstract

Background
Medical errors refer to professional negligence or wrongdoing by healthcare providers that could harm patients. It can vary significantly across different specialties due to variations in patient populations, diagnostic challenges, treatment complexity, and procedural risks.
Methods
We conducted an electronic search of PubMed, Scopus, Web of Science, and Embase databases to identify all relevant published records till 11th August 2023. The analyses were carried out in R studio using the meta package. The mean difference (MD) was used to pool continuous outcomes, while the odds ratio (OR) was used to pool dichotomous outcomes, both with 95% confidence intervals (CI). We used the New Castle Ottawa (NOS) Scale for the observational studies.
Results
Encompassing diverse specialties, the 63 included studies with 376,574 participants, with a mean age of approximately 40.9 years. Conducted in various countries, the United States was the most reported location. The meta-analysis revealed pooled proportional effect estimates for medication errors in different specialties: neurosurgery 24%, orthopedic surgery 24%, cardiology 20%, general surgery 16%, OB/GYN 15%, internal medicine 12%, anesthesia 10%, cardiothoracic surgery 10%, urology 10%, otolaryngology 8%, pediatrics 8%, family medicine 5%, oncology 5%, ophthalmology 5%, chest 4%, neurology 4%, radiology 4%, dermatology 3%, vascular surgery 3%, gastroenterology 2%, endocrinology 1%, tropical medicine 1%, and rheumatology 0%.
Conclusion
The distribution of medical specialties exhibited diverse occurrence rates: ≥20% for neurosurgery, orthopedic surgery, and cardiology; <20% and ≥ 10% for general surgery, OB/GYN, internal medicine, anesthesia, cardiothoracic surgery, and urology. Further research is required to investigate the causative factors in different regions and specialties, particularly those with high medical error rates.
Mesenchymal Stromal Cell Transplantation Ameliorates Fibrosis and Dysregulated microRNA Signature Associated with Ischaemic Skeletal Muscle Damage.
Authors: Sanz-Nogués Clara , Keane Alan , Creane Michael , Hynes Sean , Chen Xizhe , Lyons Caomhán , Horan Emma , Elliman Stephen , Goljanek-Whysall Katarzyna , O'Brien Timothy 
Published: February 2024

Abstract
Peripheral arterial disease (PAD) is strongly associated with lower-extremity muscle wasting. Hallmark features of PAD associated skeletal muscle pathology include a loss of skeletal muscle mass, reduced strength and physical performance, as well as increased inflammation, fibrosis and adipocyte infiltration, among others. At a molecular level, skeletal muscle ischaemia has also been associated with gene and microRNA (miRNA) dysregulation. Mesenchymal stromal cells (MSCs) have been previously reported to enhance muscle regeneration and improve muscle function in a variety of skeletal muscle injuries. The aim of this study was to evaluate the effects of intramuscularly delivered human umbilical cord-derived MSCs (hUC-MSCs) on skeletal muscle regeneration in a preclinical model of acute skeletal muscle ischaemia. Herein, we report an hUC-MSC-mediated amelioration of ischaemia-induced skeletal muscle atrophy and function via enhancement of myofibre regeneration, reduction of tissue inflammation, adipocyte accumulation, and tissue fibrosis. These changes were observed in the absence of a cell-mediated enhancement of blood flow recovery measured by laser doppler imaging. Furthermore, the reduced tissue fibrosis in the cell-treated group was associated with an upregulation of miR-1, miR-133a and miR-29b and downregulation of targeted pro-fibrotic genes such as Col1a1 and Fn1. Our results support the use of hUC-MSC as a potential novel approach to reduce fibrosis and promote skeletal muscle regeneration after ischaemic injury in patients with PAD.
Epidemiology and outcomes of critically ill patients in the Emergency Department of a tertiary teaching hospital in Rwanda
Authors: B. Laurent Gamy Kamunga , Bearnot Courtney J , Martin Kyle D , Uwamahoro Doris L , Cattermole Giles N 
Published: February 2024

Abstract

Background
The introduction of Emergency Medicine in Rwanda in 2015 has been associated with a mortality reduction in patients presenting to Kigali University Teaching Hospital (KUTH). In the context of increasing numbers of critically ill patients presenting to EDs globally, the aim of this study was to describe the characteristics of critically ill patients, the critical care interventions performed, and the outcomes of critically ill patients presenting to the KUTH ED with the goal of informing future research into the root causes of mortality of critically ill ED patients and of identifying high yield topics for didactic and procedural training.
Methods
A descriptive prospective cohort pilot study analyzed all patients ≥15 years who presented to KUTH between April and June 2022 with modified South African Triage Scores of Red with alarm, Red without alarm, and Orange.
Results
Of 320 patients, 66.9% were male and median age was 40 years. Patients were triaged as Orange (65.3%), Red without alarm (22.8%), and Red with alarm (11.9%). Presentations were categorized as: medical emergencies (48.0%), traumatic injury (44.5%), and surgical emergencies (7.6%). Median length of stay was 31 hours (IQR 28, 56) and boarding was 23 hours (IQR 8, 48). Overall mortality was 12.2% and highest among medical emergencies (16.5%, p = 0.048) and increased significantly with triage color: Red with alarm (47.4%), Red without alarm (16.4%), and Orange (4.3%, p < 0.0001). Cardiopulmonary resuscitation (CPR) (10.3%), endotracheal intubation (8.8%), and vasopressor administration (3.1%) were the most frequent critical interventions performed. Survival after cardiac arrest was 9.1% and 32.1% after intubation. Mortality was associated with the following interventions: CPR, intubation, and use of vasopressors (p < 0.05).
Conclusions
This pilot study identified the most common critical care interventions performed and a high mortality among patients who required these interventions in the ED of a tertiary teaching hospital in Rwanda. These findings will inform didactics and procedural training for emergency care providers. Future research should focus on the root causes of mortality in these specific patient populations and identify areas of system strengthening to reduce mortality.
Tislelizumab plus concurrent chemoradiotherapy versus concurrent chemoradiotherapy for elderly patients with inoperable locally advanced esophageal squamous cell carcinoma: a multicenter, randomized, parallel-controlled, phase II clinical trial
Authors: Zhang Ke , Wang Qifeng , Cao Jianzhong , Fan Chengcheng , Shen Wenbin , Xiao Qin , Ge Xiaolin , Zhang Tian , Liu Xiao , Chen Xi , Dong Jie , Li Zewei , Zheng Zhunhao , Yan Cihui , Wang Ping , Pang Qingsong , Zhang Wencheng 
Published: February 2024

Abstract

Background
The standard treatment for elderly patients with unresectable locally advanced esophageal squamous cell carcinoma (ESCC) is definitive chemoradiotherapy based on S-1. However, 3-year overall survival (OS)is limited about 40%. Tislelizumab has been the first-line and second-line standard treatment for advanced ESCC with tolerable toxicity. In the study we aimed to explore a new curative strategy for locally advanced unresectable elderly ESCC by combining tislelizumab with chemoradiotherapy.
Methods
The study is an open label, multicenter, investigator-initiated phase II clinical trial in older patients with inoperable locally advanced ESCC evaluating tislelizumab plus concurrent chemoradiotherapy compared to concurrent chemoradiotherapy. The main inclusion criteria are pathological confirmation of locally advanced inoperable ESCC at clinical cT1N2-3M0 or cT2-4bN0-3M0(stage II–IVA), aged ≥ 70 years, without any previous systemic anti-tumor therapy, and adequate organ function. A total of 136 patients will be recruited from approximately 6 centers over a period of 1 year and randomized in a 1:1 ratio to receive tislelizumab in combination with concurrent chemoradiotherapy(tislelizumab + S-1 + radiotherapy) or concurrent chemoradiotherapy (S-1 + radiotherapy). The efficacy and safety of treatment will be evaluated during the therapy and follow-up period until disease progression or death or the end of the trial. The primary study endpoint is investigator-assessed progression free survival (PFS), and the secondary study endpoints are OS, objective response rate (ORR), duration of remission (DOR), and safety. Fresh or archival tumor tissues and peripheral blood samples will be used in the exploratory studies.
Discussion
The synergistic efficacies of combined definitive concurrent chemoradiotherapy with tislelizumab are expected to result in survival benefit for elderly patients with inoperable locally advanced ESCC. As S-1 plus concurrent radiotherapy is the standard treatment option for locally advanced ESCC older patients, the combination of definitive concurrent chemoradiotherapy and tislelizumab has the potential to change the standard ESCC therapeutic strategy with comparable safety.
Trial registration
ClinicalTrials.gov NCT06061146.Registered 9/10/2023
Interpretation of coefficients in segmented regression for interrupted time series analyses
Authors: Wang Yongzhe , Nonzee Narissa J. , Zhang Haonan , Ashing Kimlin T. , Song Gaole , Crespi Catherine M. 
Published: February 2024

Abstract
Background
Segmented regression, a common model for interrupted time series (ITS) analysis, primarily utilizes two equation parametrizations. Interpretations of coefficients vary between the two segmented regression parametrizations, leading to occasional user misinterpretations.
Methods
To illustrate differences in coefficient interpretation between two common parametrizations of segmented regression in ITS analysis, we derived analytical results and present an illustration evaluating the impact of a smoking regulation policy in Italy using a publicly accessible dataset. Estimated coefficients and their standard errors were obtained using two commonly used parametrizations for segmented regression with continuous outcomes. We clarified coefficient interpretations and intervention effect calculations.
Results
Our investigation revealed that both parametrizations represent the same model. However, due to differences in parametrization, the immediate effect of the intervention is estimated differently under the two approaches. The key difference lies in the interpretation of the coefficient related to the binary indicator for intervention implementation, impacting the calculation of the immediate effect.
Conclusions
Two common parametrizations of segmented regression represent the same model but have different interpretations of a key coefficient. Researchers employing either parametrization should exercise caution when interpreting coefficients and calculating intervention effects.
Analyzing the topological properties of resting-state brain function network connectivity based on graph theoretical methods in patients with high myopia
Authors: Wei Bin , Huang Xin , Ji Yu , Fu Wen-Wen , Cheng Qi , Shu Ben-Liang , Huang Qin-Yi , Chai Hua , Zhou Lin , Yuan Hao-Yu , Wu Xiao-Rong 
Published: February 2024

Abstract
Aim
Recent imaging studies have found significant abnormalities in the brain’s functional or structural connectivity among patients with high myopia (HM), indicating a heightened risk of cognitive impairment and other behavioral changes. However, there is a lack of research on the topological characteristics and connectivity changes of the functional networks in HM patients.In this study, we employed graph theoretical analysis to investigate the topological structure and regional connectivity of the brain function network in HM patients.
Methods
We conducted rs-fMRI scans on 82 individuals with HM and 59 healthy controls (HC), ensuring that the two groups were matched for age and education level. Through graph theoretical analysis, we studied the topological structure of whole-brain functional networks among participants, exploring the topological properties and differences between the two groups.
Results
In the range of 0.05 to 0.50 of sparsity, both groups demonstrated a small-world architecture of the brain network. Compared to the control group, HM patients showed significantly lower values of γ (P = 0.0101) and σ (P = 0.0168). Additionally, the HM group showed lower nodal centrality in the right Amygdala (P<0.001, Bonferroni-corrected). Notably, there is an increase in functional connectivity (FC) between the SN and SMN in the HM group, while the strength of FC between the basal ganglia is relatively weaker (P<0.01).
Conclusion
HM Patients exhibit reduced small-world characteristics in their brain networks, with significant drops in γ and σ values indicating weakened global interregional information transfer ability. Not only that, the topological properties of the amygdala nodes in HM patients significantly decline, indicating dysfunction within the brain network.In addition, there are abnormalities in the FC between the saliency network (SN) , Sensorimotor Network (SMN), and basal ganglia networks in HM patients , which is related to attention regulation, motor impairment, emotions, and cognitive performance. These findings may provide a new mechanism for central pathology in HM patients.

Currently, there is a lack of research on the integration of
graph theory analysis and functional magnetic resonance imaging to
investigate the changes in brain functional region connectivity in
high myopia.
In order to improve the diagnosis of high myopia and provide
timely prevention of neurological diseases caused by changes in
brain function.
To provide new perspectives for future research on the
pathological and physiological mechanisms of high myopia.
Multimodal anomaly detection for high-speed train control system based on attention mechanism
Authors: Kang Renwei , Pang Yanzhi , Cheng Jianfeng , Chen Jianqiu , Zhou Jingjing 
Published: February 2024

Abstract
Accurate and rapid anomaly detection of train control systems is an inevitable requirement for ensuring the safe and efficient operation of high-speed railways. Currently, the manual offline fault diagnosis has issues such as ineffectiveness in fault locating and a relatively large scope of fault impact. In response, an anomaly detection model based on multimodal learning with the attention mechanism is proposed. According to the interrelated relationship between text logs and visual images representing equipment working status, a language-vision fusion two-stream multimodal neural network learning architecture is designed. The entire network structure, centred on the attention mechanism, learns the mapping relationship between inputs and outputs, simultaneously processes log generation of multiple sub-equipment, and separately focuses on the context of the text and changes in indicator light display at specific positions on the visual images. At the final decision-making layer, the learning results of language and vision are organically fused through logical operations, producing a unified output indicating the anomalous state of the system. Experimental results on real train operation datasets demonstrate the model’s superior performance in terms of precision and recall compared to other methods, validating its effectiveness.
Participatory forest restoration for sustainable livelihood: A case study from Himalaya
Authors: Sreenivasa Kottapalli , Semwal Rajeev Lochan , Maletha Ajay , Nautiyal Sunil , Maikhuri Rakesh Kumar , Saxena Krishna 
Published: February 2024

Abstract

Forest restoration based on the concepts of integrated, adaptive and co-management with active community participation was attempted in a village in the temperate region of Indian Himalayan region. Mixed plantation of multipurpose broad-leaved trees, bamboo and medicinal herbs selected by the inhabitants based on pooled traditional and scientific knowledge was established, with an understanding that funding will be limited to inputs unaffordable by people and will be terminated after economic benefit/cost ratio is > 1. Stakeholders would voluntarily maintain and upscale/outscale it thereafter and analysis of socio-ecological outcomes would continue for at least next 20 years. Accordingly, the funding was terminated after 7 years when economic benefit/cost ratio crossed the mark of one. Voluntary planting of Alnus nepalensis in gaps arising from gregarious flowering induced mass mortality of bamboo two years after cessation of funding maintained progression of recovery. After 20 years, the restored area had 17% of aboveground and 75% of belowground carbon stocks, and 39% of flowering species as compared to intact forests. Further, restored forest after 20 years was monetarily the most efficient land use even though there were no payments for its regulating ecosystem services. People maintained but did not upscale/outscale the forest restoration trial as also cultivation of medicinal herbs having high biodiversity conservation on farm land triggered by it. In the study village abandonment of cropping in 39% of private farm area and leasing 24% of it to a pharmaceutical company were the land use changes between 8th and 20th year of restoration. Nullification of carbon sequestration by forest restoration by emission from agricultural abandonment resulted in no net sequestration at landscape (village) scale. Land use/cover changes resulted in change in flowering plant species diversity at ecosystem but not at village landscape scale. There is a need of tailoring forest restoration as an activity enhancing traditional knowledge, culture and income of people, ensuring its synergy with other land uses/non-land activities and determining financial support for contribution of farm-forest cultural landscape mosaics to biodiversity conservation and climate change mitigation around biodiversity hotspots in developing countries
Effect of Goat Weed Leaf Meal (Ageratum conyzoides) as a Partial Dietary Replacement for Maize in the diet of African Catfish (Clarias gariepinus) Juveniles
Authors: Irabor Arnold Ebuka , Sanubi Jovita Oghenenyerhovwo , Ozor Augustine Onyemaechi , Onwuka Maureen , Olele Flourence Nkeonyeasua , Pierre Hardin Aaron Jn , Khalil Muhammad Faisal 
Published: February 2024

Abstract
It is crucial to find ways to employ less expensive conventional materials in fish farming to lower production costs without adversely affecting the general performance of the fish. Consequently, certain neglected plants, such as goat weed leaves that have been reported to have the potential to serve as a partial substitute for maize (energy source) must be considered. Therefore, this research evaluated the effects of partially replacing maize with goat weed leaf meal (Ageratum conyzoides) (GWLM) on the growth, haematology, and serum enzyme indices of Clarias gariepinus juveniles. A 56-day feeding trial was conducted with a total of 500 juveniles with an average weight of 13.7 g. After sterilizing in a mixture of potassium permanganate and water to reduce stress, a one-week acclimatization period was ensured using commercial feed (2 mm). Subsequently, they were randomly stocked in quadruplets of 25 fish per culture tank measuring 1.2 m x 1.2 m x 0.9 m each (labeled Ai-iv, Bi-iv, Ci-iv, Di-iv, and Ei-iv) based on the diet to be fed. A total of five (5) different diets with varying levels of dietary inclusion (0%, 2%, 4%, 6%, and 8%) of goat weed leaf meal (GWLM) as a partial replacement for maize were formulated to contain a minimum crude protein level of 40%. The test diets were administered twice daily (7:00 hrs. and 18:00 hrs.) and the sampled fish were adequately fed (5% body weight) with proper follow-up to monitor feeding behavior. The data collected from the research were subjected to a one-way analysis of variance (ANOVA) using the SPSS version 23 analysis package. Furthermore, a Duncan multiple-range test was employed to separate the means. There were notable (p < 0.05) variations in various parameters (proximate composition, digestibility of nutrients, growth performance, haematological and serological profiles, and water quality) observed in all treatments as the inclusion of the test ingredient in the diet increased. However, as the inclusion levels of the test ingredient increased above 4%, a steady decline was observed between treatments. At a 4% dietary inclusion level, the best performance indices (weight gained (36.52g), feed conversion ratio (2.15), specific growth rate (2.31) and survival rate (95%)), and blood profile (haematology and serum enzyme indices) were observed. Therefore, a 4% replacement of maize using goat weed leaf meal (GWLM) in the diet is suitable for the optimum performance of African catfish.