bluuebunny/crossref_metadata_2025_split huggingface dataset:
Outcomes of laparoscopic, robotic and open nephroureterectomy with bladder cuff excision in patients with T3T4 upper urinary tract urothelial carcinoma: a multi-center retrospective study
Authors: Fang Jen-Kai , Yeh Hsin-Chih , Lee Hsiang-Ying , Weng Han-Yu , Tai Ta-Yao , Huang Chao-Yuan , Hong Jian-Hua , Yu Chih-Chin , Wu Shu-Yu , Chung Shiu-Dong , Tsai Chung-You , Hsueh Thomas Y. , Chiu Allen W. , Jiang Yuan-Hong , Lee Yu Khun , Chen I-Hsuan Alan , Lin Jen-Tai , Chen Yung-Tai , Lin Chang-Min , Cheong Ian-Seng , Huang Hsu-Che , Lo Shih-Hsiu , Lin Wei-Yu , Tseng Jen-Shu , Wu Chia-Chang , Wang Shian-Shiang , Chang Yi-Huei , Chang Chao-Hsiang 
Published: March 2024

Abstract

Background
Nephroureterectomy with bladder cuff excision is the standard treatment for high-risk upper urinary tract urothelial carcinoma (UTUC). Minimally invasive surgery is the most common procedure in our experience, however previous prospective studies have reported inferior oncological outcomes of laparoscopic nephroureterectomy for locally advanced UTUC. The aim of this study was to compare the outcomes of open, laparoscopic and robotic surgery.
Methods
We retrospectively reviewed 705 patients with locally advanced UTUC from multiple institutions throughout Taiwan. Perioperative outcomes and oncological outcomes were compared between the open, laparoscopic and robotic groups.
Results
The minimally invasive group had better overall and cancer-specific survival (CSS) rates. The 5-year CSS rates of the open, laparoscopic and robotic groups were 51%, 69%, and 77% respectively (p < 0.001). The robotic group had similar outcomes to the laparoscopic group. More lymph node dissections were performed and more lymph nodes were harvested in the robotic group.
Conclusions
Laparoscopic or robotic surgery can lead to better perioperative and oncological results in patients with locally advanced UTUC.
Dynamic Prospective Average and Marginal Impact Factors from a Scenario-Based Method for the German Power System until 2070
Authors: Blanke Tobias , Döring Bernd , Göttsche Joachim , Frisch Jérôme , Treeck Christoph van 
Published: March 2024

Abstract
Background: Rising greenhouse gas concentrations, primarily carbon dioxide, are raising global temperatures. Germany aims to reduce emissions by 95 \% by 2045 compared to 1990 under the Climate Change Act 2021. This paper introduces two methodologies to determine hourly German electricity system values for this decarbonization period: crucial for life cycle assessment (LCA) and carbon accounting (CA). It examines methodologies, including a new electricity impact calculation model which accounts for storage construction's environmental impact.
Methods: To achieve the study's objectives, an electricity dataset with hourly resolution will be explained. Subsequently, the two methodologies will be elucidated and applied to this dataset for multiple LCA impact categories.
Results: According to the results, the new model, which considers the emissions from storage construction, produces higher emissions than the existing model. This increase is more pronounced in future scenarios where storages have a higher share of electricity and during hours when storage discharge is high. This trend is observed for most of the considered LCA impacts. The newly calculated emissions match the literature values.
Conclusions: Based on the analysis, the obtained outcomes can be inferred to be reasonable. Moreover, comparing the two electricity impact models revealed significant variations in the results as the electric grid storage capacity increased. Therefore, the newly proposed model is beneficial in scenarios with high storage system capacity.
Liquid-Film Flow Rate From Measurements of Disturbance Wave Characteristics for Applications in Thin Film Flow
Authors: Chan Jason , Morse Roman W. , Meissner Maggie A. , Dressler Kristofer M. , Hurlburt Evan T. , Nellis Gregory F. , Berson Arganthael 
Published: March 2024

Abstract

This paper discusses the development of a liquid-film thickness measurement technique using laser refractometry and the extension of this technique to enable the measurements of wave height, shape, frequency and velocity. The measurement technique is implemented in a falling water film facility for ease of method validation. The falling-film facility provides optical access to the film which allows the laser refractometry measurements to be compared to high-speed imaging of the waves directly. The total mass flow rate carried by the film (waves and base film) can be computed based on the laser refractometry measurement and compared to the actual liquid flow rate in the falling film facility in order to validate the technique without the complication of droplet entrainment that is typical in annular flow.
Assessing the Robustness of Randomized Controlled Trials on Neuromonitoring in Thyroid Surgery: Utilizing the Fragility and Reverse Fragility Index
Authors: Bollo-Arocena Elisabet , Gallego Lander , Carballo Laura , Galan Carlos Placer 
Published: March 2024

Abstract
Purpose
The Fragility Index (FI) and Reverse Fragility Index (RFI)) are novel metrics that have been developed to evaluate the robustness of RCTs. The aim of this study was to assess the robustness of RCTs, in the use of intraoperative neuromonitoring (IOMN) in the thyroid surgery field, using FI, RFI, and their respective fragility quotients.
Methods
A Systematic search was conducted based on the PRISMA which utilized MEDLINE, EMBASE, Cochrane Library, and Web of Science databases. Inclusion criteria included RCTs related to the IONM in the thyroid surgery with dichotomous outcome measures and 1:1 allocation. Fragile results were defined as those with an FI or RFI equal to or less than the number of patients lost to follow-up or those with an FI or RFI less than 3.
Results
There were 8 RCTs that met our criteria with 2473 patients with 4607 nerves at risk. Among them, 2 (25%) were positive RCTs (p < 0.05) and 6 (75%) were negative RCTs (p > 0.05). The median FI was 2 (IQR 0–2). The median RFI was 3.5 (IQR 1.6–6). Based on the relationship between an FI/RFI ratio of less than 3, two (25%) studies were considered fragile. Furthermore, based on the relationship between FI/RFI and the number of patients lost during follow-up, 4 (50%) studies were considered fragile.
Conclusions
Using the new metrics, FI and RFI, the RCTs that did not demonstrate superiority with the use of IONM in thyroid surgery were more robust than those that did show superiority. However, controversy regarding the utility of IONM is not closed
Dual Vision Transformer-DSUNET With Feature Fusion for Brain Tumor Segmentation
Authors: Zakariah Mohammed , Al-Razgan Muna , Alfakih Taha 
Published: March 2024

Abstract
Brain tumors are one of the leading causes of cancer death; screening early is the best strategy to diagnose and treat brain tumors. Magnetic Resonance Imaging (MRI) is extensively utilized for brain tumor diagnosis; nevertheless, achieving improved accuracy and performance, which is a critical challenge in most of the previously reported automated medical diagnostics, is a difficult problem. The study introduces the Dual Vision Transformer-DSUNET model, which incorporates feature fusion techniques to provide precise and efficient differentiation between brain tumors and other brain regions by leveraging multi-modal MRI data. The impetus for this study arises from the necessity of automating the segmentation process of brain tumors in medical imaging, a critical component in the realms of diagnosis and therapy strategy. To tackle this issue the BRATS 2020 dataset is employed, an extensively utilized dataset for the segmentation of brain tumors. This dataset encompasses multi-modal MRI images, including T1-weighted, T2-weighted, T1Gd (contrast-enhanced), and FLAIR modalities. The proposed model incorporates the dual vision idea to comprehensively capture the heterogeneous properties of brain tumors across several imaging modalities. Moreover, the utilization of feature fusion techniques is implemented to augment the amalgamation of data originating from several modalities, hence enhancing the accuracy and dependability of tumor segmentation. The evaluation of the Dual Vision Transformer-DSUNET model's performance is conducted by employing the Dice Coefficient as a prevalent metric for quantifying segmentation accuracy. The results obtained from the experiment exhibit remarkable performance, with Dice Coefficient values of 91.47% for enhanced tumors, 92.38% for core tumors, and 90.88% for edema. The cumulative Dice score for the entirety of the classes is 91.29%. In addition, the model has a high level of accuracy, roughly 99.93%, which underscores its durability and efficacy in the task of segmenting brain tumors. Experimental findings demonstrate the integrity of the suggested architecture, which has quickly improved the detection accuracy of many brain diseases.
Sociodemographic characteristics related to inequality in depression treatment in Peruvian adults: a concentration index decomposition approach
Authors: Intimayta-Escalante Claudio 
Published: March 2024

Abstract
Background Depressive symptoms affect a significant proportion of Peruvian population, between 13.8% and 15.1% since 2014 to 2018. However, only the 14.1% did not receive treatment, this gap in treatment is influenced for sociodemographic conditions. The study aim was assessing demographic characteristics related to inequalities in the depression treatment receiving in Peruvian adults.Methods Utilizing data from the 2017–2022 Demographic and Health Survey, we conducted an analytic cross-sectional study. Inequality in treatment receipt was evaluated using concentration curves for estimated Concentration Index (CI), and the Erreygers Concentration Index (ECI), with the wealth index serving as an equity stratified. Decomposition analysis was employed to examine disparities among sociodemographic characteristics, including sex, age, education, residence, health insurance, and ethnicity.Results Of the 35,925 Peruvian adults with depressive symptoms surveyed, only 10.82% received treatment. Our analysis revealed treatment recipients were concentrated in higher wealth quintiles (CI: 22.08, 95% CI: 20.16 to 24.01, p < 0.01). Disparities persisted across various demographic groups, with urban residency (ECI: 0.03, 95% CI: 0.02 to 0.03, p < 0.001), those without education (ECI: 0.05, 95% CI: 0.03 to 0.07, p < 0.001), Afro-Peruvians (ECI: 0.06, 95% CI: 0.04 to 0.08, p < 0.001), and women (ECI: 0.07, 95% CI: 0.06 to 0.08, p < 0.001) experiencing lower received treatment, influenced by wealth quintile.Conclusion Only one in ten Peruvian adults with depressive symptoms received treatment. Sociodemographic conditions such as living in rural areas, outside of the capital region, having low educational level, and identifying as Quechua or Aymara were the main components of inequality in the receipt of treatment for depressive symptoms.
MCT1-Mediated Endothelial Cell Lactate Shuttle as a Target for Promoting Axon Regeneration after Spinal Cord Injury
Authors: Shi Chaoran , Xu Jiaqi , Ding Yinghe , Yuan Feifei , Zhu Fengzhang , Wu Tianding , Duan Chunyue , Lu Hongbin , Hu Jianzhong , Jiang Liyuan 
Published: March 2024

Abstract
Vascular damage following spinal cord injury (SCI) precipitates ischemia and hypoxia at the injury site, leading to profound metabolic disturbances. The implications of these metabolic disorders on neural tissue remodeling and functional recovery remain poorly understood. Our study elucidates the consequences of the hypoxic environment induced by SCI, which significantly enhances glycolysis and lactate production at the injury's epicenter. And our findings revealed a marked decrease in the expression of Monocarboxylate Transporter 1 (MCT1), a crucial transporter facilitating lactate delivery to neurons and consequently supporting their energy metabolism, within vascular endothelial cells emerging after SCI. This decrease disrupts lactate transport to neurons, resulting in metabolic imbalances that impede axonal regeneration. Remarkably, our research demonstrates that targeted delivery of adeno-associated virus (AAV) injections to restore MCT1 expression in endothelial cells (ECs) promotes axonal regeneration and functional recovery in SCI mouse models. These findings reveal a previously unrecognized connection between lactate shuttling from ECs to neurons after SCI and neural functional recovery. Highlighting a novel metabolic pathway for intervention, our study opens new therapeutic avenues for the treatment of spinal cord injuries, suggesting that targeting lactate transport mechanisms may offer significant benefits in SCI recovery.
Exploring physiologic regulatory factors in traumatic brain injury (TBI) through Correlation Analysis and Graph Neural Network
Authors: A. Hasitha Kuruwita , Ng Shu Kay , Liew Alan Wee-Chung , Richards Brent , Haseler Luke , Kumar Kuldeep , Ross Kelvin , Zhang Ping 
Published: March 2024

Abstract
Purpose
Traumatic brain injury (TBI) is one of the most common cause of mortality and disability globally. Intensive care unit (ICU) management poses significant challenges for medical practitioners, primarily because of the complex interplay between biomarkers and hidden interactions. This study aimed to uncover subtle interconnections between biomarkers and identify the key factors contributing to TBI characteristics and ICU severity scores.
Methods
A total of 29 patients with TBI who were admitted to the ICU were selected and analysed using monitoring electrocardiography (ECG), vital signs, Glasgow Coma Scale (GCS) and electronic medical records. This study utilized a methodology that integrates correlation-based network analysis and graph neural network (GNN) techniques to uncover hidden relationships between various biomarkers and identify the most critical monitoring biomarkers for patients with TBI within the first 12 hours of ICU stay.
Results
The analysis revealed significant associations within the dataset. Specifically, MeanRR exhibited notable connections with alterations in systolic blood pressure and heart rate variations. Moreover, the final GCS showed a strong correlation, including long-term correlation with heart rate variability (HRV) feature alpha2, variability in atrial blood pressure means and diastolic blood pressure, gender, and age. Variability of diastolic blood pressure, GCS ICU scoring values, and pNN50 (an HRV measure) demonstrated strong association with other biomarkers during the first 12 hours following ICU admission.
Conclusion
HRV as an electronic biomarker and the variability in physiological variables during first 12 hours in the ICU are equally important factors for TBI severity assessment and can offer valuable insights into the patient's health prognosis.
Left atrioventricular valve regurgitation after complete atrioventricular septal defect repair
Authors: Kawase Takumi , Itatani Keiichi , Haibara Jiryo , Masaki Shota , Suda Hisao 
Published: March 2024

Abstract

Background:
Left ventricular outflow tract stenosis and atrioventricular valve regurgitation are often problems encountered in adulthood after complete atrioventricular septal defect repair.
The surgical approach and indications for managing long-term outcomes such as left atrioventricular valve regurgitation and left ventricular outflow tract stenosis after complete atrioventricular septal defect repair have been discussed.
Case presentation:
A 23-year-old woman with intellectual disability was diagnosed with complete atrioventricular septal defect and underwent two-patch repair without cleft closure in childhood. Follow-up examination in adulthood demonstrated moderate left-sided atrioventricular valve regurgitation and left ventricular outflow tract stenosis with a circumferential ridge (peak velocity, 3.7 m/s; pressure gradient, 54 mmHg). Intraoperative findings showed a circumferential ridge under the aortic valve, and we removed the ridge. In addition, a cleft was present at the anterior leaflet, and we completely closed the cleft. Anticoagulation therapy was not initiated, and no embolic complications occurred. Follow-up echocardiography demonstrated no ridge under the aortic valve and only mild-range left AVVR.
Conclusions:
We successfully performed surgical treatment without valve replacement or anticoagulation therapy in a patient with poor medical compliance. Delayed reoperation leads to degeneration of the valve structure and makes more difficult to repair. Clinicians must evaluate atrioventricular valve regurgitation in combination with the dilatation annulus, cleft size, and depth of the leaflet coaptation area.
Efficient Lightweight UAV Image Target Detection Model Based on YOLOv7
Authors: yin shuai , sun xiaobo 
Published: March 2024

Abstract
In the realm of UAV aerial imagery target recognition, detecting small objects presents substantial challenges due to their diminutive size, occlusions among targets, scarcity of distinctive features, and the complexity of backgrounds. To address these issues, this study introduces YOLOv7-PBLight, an innovative, high-precision, and efficient model designed to enhance the accuracy of small object detection in UAV imagery while balancing operational efficiency. Building on the YOLOv7 algorithm, our approach incorporates several key improvements to effectively tackle these challenges: By analyzing the roles of different detection heads, the model eliminates the second subsampling layer and the deepest detection head, thus reducing its receptive field to preserve fine-grained feature information critical for accurate detection of small objects. Furthermore, a Dual-Level Routing Attention (BRA) mechanism is integrated to augment the network's focus on small targets, thereby improving overall algorithm performance. A novel loss function that combines Normalized Gaussian Wasserstein Distance (NWD) with CIOU is introduced to diminish the sensitivity of small objects to positional inaccuracies. Finally, the YOLOv7 backbone is refined using the lightweight network ShuffleNetv2, reducing the model's parameter size and computational burden. Additionally, the utilization of deep separable convolution technology enhances the ELAN and MPConv modules, culminating in the development of YOLOv7-PBiKlight, a lightweight network that achieves a balance between precision and speed. Empirical validation demonstrates that the proposed method effectively resolves the challenges of aerial target detection, significantly improving detection precision with a 4.6% increase in mAP_0.5on the VisDrone2021, reducing the model's parameter size by 67%, and achieving competitive accuracy and speed compared to other algorithms in the field.
Overwintering at multiple life stages in Schizotetranychus shii (Acari: Tetranychidae), a specialist of evergreen chinquapin
Authors: Nagata Kohei , Negoro Yamato , Ito Katsura 
Published: March 2024

Abstract

Host availability in winter affects the overwintering strategies of herbivorous arthropods. Spider mites (Acari: Tetranychidae) overwinter as eggs or adult females, but some do so as multiple life stages on evergreen hosts. For example, in Schizotetranychus brevisetosus, adult females and their eggs stay on host leaves in mid-winter. However, few studies have focused on proximate factors generating such overwintering stages. Here, we investigated photoperiodic responses and life-stage compositions in winter in a population of Schizotetranychus shii, a specialist of Japanese chinquapin (Fagaceae). The proportion of non-ovipositing females at 20°C followed a sigmoid curve with increasing photoperiod, and the critical day length (CDL) was estimated as 11.8L, which corresponds to the environments from late September to early October. Although females grown under 10–11L conditions never oviposited within 7 days, 90–96% of them started oviposition within only 30 days without chilling (n = 23–31). In the field, all life stages were observed to occur throughout winter, but their proportions varied drastically. The proportion of eggs declined from early October (62%) to early December (12%), as predicted by CDL, but steeply increased toward late February (96%), during which only adult females and eggs remained. In summary, a short photoperiod in October arrests oviposition in emerging females, but they soon commence oviposition in November while immature stages are still growing, and individuals at all life stages (including a new generation) coexist until all immature stages mature in February. This novel pattern suggests that evergreen hosts allow spider mites to evolve overwintering strategies with little phylogenetic constraint.
Early Therapeutic Drug Monitoring Optimizes Teicoplanin Use in Patients with Hematological Malignancies
Authors: Wang Yu-Wen , Hou Hsin-An , Lin Chien-Chin , Lin Hsing-Yu , Chen Pin-Zi , Kuo Ching-Hua , Chiu Huai-Hsuan , Chuang Chia-Chi , Chen Yi-Jing , Lin Shu-Wen 
Published: March 2024

Abstract
Purpose
Teicoplanin is a time-dependent glycopeptide antibiotic. The trough concentration (Cmin) ≥ 15–20 mg/L between the fourth and sixth day has been suggested for severe infections or the management of febrile neutropenia (FN). Owing to no reports discussing the impact of early target attainment on treatment outcomes, this study aimed to evaluate the dose–Cmin relationship and clinical outcome and estimate the optimal early target Cmin for FN in patients with hematological malignancies
Methods
This single-center, prospective study enrolled hematological malignancy patients who were treated with teicoplanin either as an empirical antibiotic for FN or as definitive treatment for Gram-positive bacteria. Blood samples were collected on day three (48 hours) post-loading doses, day five (96 hours), and day eight (when applicable) and determined by ultra high pressure liquid chromatography-triple quadruple mass spectrometry. A two-tailed α value of 0.05 was considered as statistical significance.
Results
A total of 117 samples from 47 FN patients were consecutively analyzed. The mean Cmin at 48 hours, 96 hours, and on day eight were 23.4 mg/L, 21.4 mg/L, and 27.8 mg/L, respectively. The patients achieving Cmin ≥ 20 mg/L at 48 hours had a higher likelihood of treatment success. The areas under the receiver operating characteristic curves were 0.71 for clinical efficacy and the cut-off value of Cmin at 48 hours was 18.85 mg/L (95% confidence interval; 0.55–0.87; P = 0.018).
Conclusions
The Cmin of teicoplanin after completion of loading doses could predict the treatment response, with a target concentration ≥ 18.85 mg/L.