bluuebunny/crossref_metadata_2025_split huggingface dataset:
Hypofractionated wholebreast irradiation with sequential or simultaneous integrated boost for early breast cancer after-surgery treatment
Authors: Dong Shi , Lin Honghua , Qiu Enyi , zhang Hao , Jin Wenqi , Xu Yajing , Han Ruozhen 
Published: April 2024

Abstract

Background
This study aimed to compare dosimetry of the target region and organ at risk (OAR) according to two different radiation plans for patients after breast-conserving surgery (BCS), hypofractionated whole breast irradiation (HFWBI) combined with an additional sequential boost (SEQ) versus simultaneous integrated boost (SIB), and further explore better radiotherapy after breast-conserving surgery.
Methods
We included 56 patients with early-stage left-sided breast cancer. Hybrid volumetric modulated arc therapy (H-VMAT) plus sentinel lymph node biopsy was given to all participants. The following SIB and SEQ treatments were planned for each patient. The radiation doses delivered to OAR and dose-volume histogram were analyzed. The comparison of the max dose (Dmax), the mean dose (Dmean), the min dose (Dmin), and the volume of each organ that received x Gy (Vx) was accomplished.
Results
The V5, V10, and V20 of the heart and the ipsilateral lung were lower in the SIB plan than SEQ, while among patients receiving the SIB plan, the V5 and V10 of the right and the left ventricle were lower. The Dmean for the heart, left anterior descending (LAD), right ventricle, left ventricle and the ipsilateral lung was lower for the SIB plan (heart: 5.24 ± 0.75 Gy vs. 6.92 ± 0.92Gy, p < 0.001; lad: 9.27 ± 1.07Gy vs. 11.86 ± 1.40Gy, p < 0.001; right ventricle 6.39 ± 1.54Gy vs. 8.39 ± 1.88Gy, left ventricle 6.10 ± 1.33Gy vs. 8.54 ± 1.80Gy, p < 0.001; lung: 9.28 ± 1.07Gy vs. 11.86 ± 1.41Gy, p < 0.001).
Conclusions
Regarding the dosimetry among the heart, LAD, ventricle, and left lung, SIB radiotherapy achieved better results, suggesting that the SIB plan might be more suitable for postoperative radiotherapy after BCS for early-stage breast cancer patients. We also witnessed that large daily radiation doses could be safe and effective when combined with the radiobiology of breast cancer.
Windsock Mitral Valve After Prior Aortic Valve Endocarditis
Authors: Kang Augustine , Wang Hanjay , Liebert Diane , Berry Gerald J. , Boyd Jack H. 
Published: April 2024

Abstract

Background: Windsock deformities, though rare, represent a severe form of valvular aneurysm distinguished by localized balloon-like protrusions of the leaflet body. Here, we present a compelling case of windsock mitral valve (MV) formation subsequent to incompletely managed aortic valve (AV) endocarditis. The case is illustrated through radiographic, intraoperative, and histopathologic images.
Case Presentation: We present the case of a 44 year old male patient who presented with symptoms suggestive of infective endocarditis. Despite initiation of appropriate antimicrobial therapy and surgical intervention for AV involvement, the patient developed progressive valvular dysfunction. Subsequent imaging studies revealed the emergence of windsock deformity in the mitral valve apparatus. Intraoperative assessment confirmed the presence of this rare valvular anomaly, which was further corroborated by histopathologic examination.
Conclusions: We provide, for the first time in the literature, a clear intraoperative view and example of windsock mitral valve (MV) developing after incompletely treated aortic valve (AV) endocarditis.
Context explains much of patient-perceived physician empathy in general practice
Authors: Lelorain Sophie , Descamps Axel , Grignoli Nicola , Pruvost Thomas , Dhelft Antoine , Rouhier Marie-Anne , Lallemant Elise , Sebbah Alissa , Pinçon Claire 
Published: April 2024

Abstract

Background.
Patient-perceived physician empathy (PPPE) is associated with numerous positive outcomes for patients, quality of care and health expenditure. Research into the factors that explain PPPE is therefore crucial, but the focus has often been placed on physician-related predictors of PPPE. In general practice, however, many barriers to empathy may be contextual, such as lack of time, or patient-related, such as multimorbidity. Consequently, our aim was to explore the effect of these variables on PPPE in general practice.
Methods.
In a cross-sectional design, 50 randomly recruited physicians were compelled to include 20 consecutive adult patients with one or more chronic disease(s). The characteristics of the doctors and their work environment were collected (e.g. gender, age, peer-group participation or lack of participation, urban or rural area, working alone or with other colleagues, caseload, etc.). Physicians filled in patients’ diseases, and patients filled in validated questionnaires on their health, emotional skills (i.e their ability to identify, express and regulate emotions) and their perception of physician empathy (CARE scale). Multilevel linear regressions were performed using SAS.
Results.
The median PPPE was 45 (n = 762), with higher rates in patients who had had seven or more consultations with the physicians in the last 12 months and lower in patients with genitourinary and upper gastrointestinal diseases. In consultations ≤ 20 minutes, the length of consultation was associated with higher PPPE in interaction with patients’ emotional skills: the positive effect of longer consultations on PPPE was stronger in patients with low emotional skills, whereas patients with high emotional skills were able to perceive high empathy even in very short consultations of 5–10 minutes. Among the 11 physician-related candidate variables, only physician age had a significant effect.
Conclusions.
Patient-related and, especially, contextual variables explained PPPE much more than physician-related variables. Consultations with infrequently seen patients and patients with low emotional skills should ideally last at least 20 minutes to allow the empathic process to unfold. Patients with genitourinary and upper-gastrointestinal diseases should be given special consideration, as they may encounter intimate issues or specific needs requiring more attention.
Recognizing Multiple Ingredients in Food Images Using a Single-Ingredient Classification Model
Authors: Fu Kun , Ｄａｉ Ｙｉｎｇ 
Published: April 2024

Abstract

Recognizing food images presents unique challenges due to the variable spatial layout and shape changes of ingredients with different cooking and cutting methods. This study introduces an advanced approach for recognizing multiple ingredients segmented from food images. The method localizes the candidate regions of the ingredients using the locating and sliding window techniques. Then, these regions are assigned into ingredient classes using a convolutional neural network (CNN)-based single-ingredient classification model trained on a dataset of single-ingredient images. To address the challenge of processing speed in multi-ingredient recognition, a novel model pruning method is proposed to enhances the efficiency of the classification model. Subsequently, the multi-ingredient identification is achieved through a decision-making scheme, incorporating a novel top n algorithm with integrating the classification results from various candidate regions to improve the ingredient recognition accuracy. The single-ingredient image dataset, designed in accordance with the “New Food Ingredients List FOODS 2021”, encompasses 9,982 images across 110 diverse categories, emphasizing variety in ingredient shapes. In addition, a multi-ingredient image dataset is developed to rigorously evaluate the performance of our approach. Experimental results validate the effectiveness and efficiency of our method, particularly highlighting its competitive capability in recognizing multiple ingredients to SOTA methods. Furthermore, it is found that the CNN-based pruned model enhances the ingredient segmentation accuracy of food images. This marks a significant advancement in the field of food image analysis.
Docosahexaenoic acid (DHA); a driving force regulating gene expression in bluefin tuna (Thunnus thynnus) larvae development
Authors: Koven William , Yanowski Eran , Gardner Luke , Nixon Oriya , Block Barbara 
Published: April 2024

Abstract

This study elucidated the role of DHA-modulated genes in the development and growth of Atlantic bluefin tuna (Thunnus thynnus) larvae ingesting increasing levels of DHA in their rotifer prey. The effect of feeding low, medium, and high rotifer (Brachionus rotundiformis) DHA levels (2.0, 3.6 and 10.9 mg DHA g− 1 DW, respectively) was tested on 2–15 days post hatching (dph) bluefin tuna larvae. Larval DHA content markedly (P < 0.05) increased in a DHA dose-dependent manner (1.5, 3.9, 6.1 mg DHA g− 1 DW larva, respectively), that was positively correlated with larval prey consumption, and growth (P < 0.05). Gene ontology enrichment analyses of DEGs demonstrated dietary DHA significantly (P < 0.05) affected different genes and biological processes at different developmental ages. The number of DHA up-regulated DEGs was highest in 10 dph larvae (408), compared to 5 (11) and 15 dph fish (34), and were mainly involved in neural and synaptic development in the brain and spinal cord. In contrast, DHA in older 15 dph larvae elicited fewer DEGs but played critical roles over a wider range of developing organs. The emerging picture underscores the importance of DHA-modulated gene expression as a driving force in bluefin tuna larval development and growth.
How does the prevalence of alcohol use and associations with psychological distress differ across ethnic groups in England: A cross-sectional analysis of eight national surveys
Authors: Puddephatt Jo-Anne , Onwumere Juliana , Gage Suzanne H. , Coomber Ross , Das-Munshi Jayati , Goodwin Laura 
Published: April 2024

Abstract

Purpose Differences in patterns of alcohol and mental health across ethnic groups are not well-understood. Using multiple secondary datasets and across ethnic groups, this study aimed to examine the prevalence and associations of i)alcohol use and binge-drinking, ii)alcohol use and binge-drinking with psychological distress, and iii)pooled prevalence and associations for i)and ii)across multiple data sources. Methods A secondary analysis of eight representative surveys in England was conducted (N = 112,831). Alcohol was assessed using validated measures and categorised as i)non-,ii)low-risk,iii)increased-risk, and iv)binge-drinker. Psychological distress was assessed using validated measures. Ethnicity was categorised using the most specific categories available. Multinomial and logistic regression models were conducted to address aims one and two. A meta-analysis was conducted to address aim three. Results Minority ethnic groups were more likely to be non-drinkers, and less likely to be increased-risk or binge-drinkers, compared to White British groups. Among those experiencing psychological distress, White British groups were more likely to be a non-drinker (OR = 1.46,95%CI = 1.34–1.59), Indian groups were more likely to be an increased-risk drinker (OR = 1.43,95%CI = 1.05–1.96), Black African and White British groups were more likely to be binge-drinkers (OR = 1.98,95%CI = 1.00-3.92;OR = 1.14, 95%CI = 1.08–1.20), compared to those of the same ethnicity but without psychological distress. Conclusion There were differences in the level of alcohol use between specific ethnic groups despite minority ethnic groups often being combined. Ethnic groups with the overall highest levels of drinking did not have the higher odds of increased-risk drinking when individuals experienced psychological distress. There is a need to better understand the reasons for drinking among minority ethnic groups experiencing psychological distress.
Cohort multiple Randomized Controlled trial in pediatric asthma to assess the long- and short-term effects of eHealth interventions: protocol of the CIRCUS study
Authors: Ruuls Tamara , Sprengers Romi , Hengeveld Vera , Thio Boony , Tabak Monique , Zagers Deborah , Palen Job van der , Kamp Mattiènne van der 
Published: April 2024

Abstract

Background
Asthma is one of childhood's most prevalent chronic conditions that significantly impact the quality of life. Current asthma management lacks real-time, objective, and longitudinal monitoring reflected by a high prevalence of uncontrolled asthma (46–60%). Long-term (home) monitoring holds promise to establish new clinical endpoints for timely anticipation. Also, the integration of eHealth interventions holds promise for timely and appropriate medical anticipation for controlling symptoms and preventing asthma exacerbations. This study aims to provide a pragmatic study design for gaining insight into longitudinal monitoring, assessing, and comparing eHealth interventions' short- and long-term effects on improving pediatric asthma care.
Methods
For this cohort multiple randomized controlled trial (cmRCT), we establish a dynamic cohort of 300 pediatric asthma patients at Medisch Spectrum Twente (Enschede, the Netherlands), referred to as the CIRCUS cohort. The CIRCUS study gathers observational and patient-reported measurements at set moments, including patient characteristics, asthma outcomes, clinical outcomes, healthcare utilization, and environmental outcomes. We randomly appoint eligible participants to the intervention or control group. The effects of the eHealth interventions are assessed and compared to the control group, deploying the CIRCUS outcomes. The participants continue in the CIRCUS cohort after completing the intervention and its follow-up. This process repeats for every intervention, allowing re-approaching participants.
Discussion
The CIRCUS study results can provide a rich and unique data set that can improve insight into risk factors of asthma exacerbations and yield new clinical endpoints. Furthermore, the effects of eHealth interventions can be assessed and compared with each other in both the short- and long-term. Additionally, patient groups within the patient population can be discerned which can be used to tailor eHealth interventions to the personalized needs to improve asthma management. In conclusion, CIRCUS can provide valuable clinical data to discern risk factors for asthma exacerbations, identify and compare effective scalable eHealth solutions, and improve pediatric asthma care.
Trial Registration
This study was ethically approved by the Medical Research Ethics Committee (NL85668.100.23) on February 15th, 2024. The study protocol is registered at ClinicalTrials.gov (NCT06278662).
Infectious intestinal diseases increase neurodegenerative disease risk: A nationwide population-based cohort study
Authors: Hsu Fang-Chin , Weng Zi-Xeng , Pu Ta-Wei , Jao Shu-Wen , Chen Chao-Yang , Hu Je-Ming , Chien Wu-Chien 
Published: April 2024

Abstract

Infectious intestinal diseases (IIDs) pose a significant health and economic burden worldwide. Recent observations at the Tri-Service General Hospital, Taiwan, suggest a potential association between IIDs and neurodegenerative diseases, prompting an investigation into this relationship. This study explored interactions between IIDs and neurodegenerative diseases. We conducted a population-based retrospective cohort analysis using data from the National Health Insurance Research Database (NHIRD) of Taiwan. Patients diagnosed with IIDs between 2000 and 2015 were identified along with a matched control group. Covariates, including demographics, comorbidities, and healthcare utilization were considered. The hazard ratios (HRs) of neurodegenerative diseases were assessed using a Cox proportional regression analysis. This study included 297,438 patients: 99,146 and 198,292 patients in the IID and control groups, respectively. Patients with IIDs showed a significantly higher overall risk of neurodegenerative diseases (adjusted hazard ratio [aHR] = 1.144, P < 0.001). Subgroup analyses revealed an elevated risk of Parkinson's disease, multiple sclerosis, and other neurodegeneration-associated disorders in the IID group. Additionally, a positive correlation was observed between the frequency of medical visits for IIDs and neurodegenerative disease risk. This study provides evidence for a significant association between IIDs and the neurodegenerative disease risk. Early detection and management of IIDs may have implications for long-term neurological health outcomes. Further research is required to elucidate underlying mechanisms and develop targeted interventions and preventive strategies.
Bone marrow involvement in solid tumors - a retrospective observational study
Authors: ZHANG BICHENG , JIN LAN , WU DANG , XU JING , GUO SIYU , LI JINGJING , WEI QICHUN , ZHANG TING 
Published: April 2024

Abstract
Background
Solid tumor patients with bone marrow involvement (BMI) typically have a poor prognosis. However, some patients still exhibit a relatively good prognosis following aggressive treatment. This study aimed to identify prognostic factors to stratify patients and screen those who may benefit from aggressive treatment.
Methods
A total of 41 consecutive patients diagnosed with a bone marrow biopsy were enrolled between January 1, 2016, and December 31, 2021. Then, their clinical features and laboratory data were assessed using the Chi-square test. Overall survival (OS) rates were plotted over time using the Kaplan-Meier method. Lastly, the survival time of solid tumor patients with BMI with distinct clinical symptoms, peripheral hematologic profiles, biochemical profiles, and coagulation function were analyzed using the Kaplan-Meier method.
Results
The median OS of the whole cohort was 23 days. Specifically, the median OS of patients (n = 40) receiving anti-tumor treatment (n = 12) and supportive care (n = 28) was 158 days and 13 days, respectively ( P < 0.001 ). Interestingly, the prognosis of patients with BMI and normal leukocyte count, platelet count, glutamic-pyruvic transaminase (GPT) level, and plasma prothrombin time (PT), as well as lactate dehydrogenase (LDH) level less than twice the normal upper limit and alkaline phosphatase (AKP) less than five times the normal upper limit, was relatively favorable. Conversely, elevated levels of LDH, AKP, GPT, prolonged PT, abnormal leukocyte count, and thrombocytopenia were associated with a poor prognosis.
Conclusions
Solid tumor patients with BMI can benefit from aggressive anti-tumor treatments. Additionally, early diagnosis of BMI in solid tumor patients, selection of patients with a potential good prognosis, and administering appropriate anti-tumor treatments are key factors in prolonging the survival time of BMI patients.
Influence of the Indian Ocean Dipole (IOD) on Hydro-climate variability in Dwangwa River Basin, Malawi
Authors: Chirwa Aubren C. , Ngongondo Cosmo , Vunain Ephraim 
Published: April 2024

Abstract
Large-scale climate processes such as the Indian Ocean Dipole (IOD) have significant roles in modulating rainfall and hydrological systems. Understanding such processes can inform adaptation measures for climate change and variability, as well as water resource management and planning. This study investigated the impact of IOD on rainfall and discharge variability in the Dwangwa River Basin (DRB) in Malawi, a key inflow to Lake Malawi. Specifically, the study analysed annual rainfall variability trends from 1985 to 2015 using the Coefficient of Variation (CV) and the annual Precipitation Concentration Index (PCI). The significance and direction of rainfall and discharge trends were quantified using the Mann-Kendall trend test at the α = 0.05 significance level. To evaluate the association between rainfall and IOD, the Pearson product moment used three IOD phases: positive, negative, and neutral. Simple linear regression was utilised to check the response of the river during the concerned IOD phases. The study found CVs below 30%, typical of climates with moderate monthly rainfall variability. The PCI ranged from 20–30%, suggesting a strongly seasonal and highly variable temporal intra-annual rainfall distribution in the DRB. Moreover, the Mann-Kendall test statistics showed insignificant annual rainfall trends. Further, the findings demonstrated an insignificant negative correlation between rainfall and positive IOD, with rainfall increases associated with negative IOD, whereas positive IOD is associated with decreased river discharge. Consequently, El Niño and a positive IOD could cause DRB to have low water availability.
1D Poiseuille Plane Channel Flow by Second Order Response Matrix
Authors: Ganapol Barry D. 
Published: April 2024

Abstract

With increasing miniaturization of diagnostic devices for more effective detection of blood-borne pathogens for example, Poiseuille molecular flow in micro channels has become increasingly relevant. Since continuum mechanics no longer applies for Poiseuille flow when the Knudson number is near or larger than unity, kinetic theory is required to capture the microscopic molecular scattering responsible for channel molecular flow and the velocity profile across a channel. Here, we apply a response matrix solution to the 1D Poiseuille flow with a BGK approximation featuring simplicity with precision by following a consistent numerical formulation leading to high precision, 8-place benchmarks.
Mathematics Subject Classification. 34K10, 34A05, 34A30, 82C40, 82C70, 86–08.
Deciphering seasonal depression variations and interplays between weather changes, physical activity, and depression severity in real-world settings: Learnings from RADAR-MDD longitudinal mobile health study
Authors: Zhang Yuezhou , Folarin Amos A. , Ranjan Yatharth , Cummins Nicholas , Rashid Zulqarnain , Conde Pauline , Stewart Callum , Sun Shaoxiong , Vairavan Srinivasan , Matcham Faith , Oetzmann Carolin , Siddi Sara , Lamers Femke , Simblett Sara , Wykes Til , Mohr David C. , Haro Josep Maria , Penninx Brenda W.J.H. , Narayan Vaibhav A. , Hotopf Matthew , Dobson Richard J.B. , Pratap Abhishek , consortium RADAR-CNS 
Published: April 2024

Abstract
Prior research has shown that changes in seasons and weather can have a significant impact on depression severity. However, findings are inconsistent across populations, and the interplay between weather, behavior, and depression has not been fully quantified. This study analyzed real-world data from 428 participants (a subset; 68.7% of the cohort) in the RADAR-MDD longitudinal mobile health study to investigate seasonal variations in depression (measured through a remote validated assessment - PHQ-8) and examine the potential interplay between dynamic weather changes, physical activity (monitored via wearables), and depression severity. The clustering of PHQ-8 scores identified four distinct seasonal variations in depression severity: one stable trend and three varying patterns where depression peaks in different seasons. Among these patterns, participants within the stable trend had the oldest average age (p = 0.002) and the lowest baseline PHQ-8 score (p = 0.003). Mediation analysis assessing the indirect effect of weather on physical activity and depression showed significant differences among participants with different affective responses to weather. Specifically, the temperature and day length significantly influenced depression severity, which in turn impacted physical activity levels (p < 0.001). For instance, among participants with a negative correlation between depression severity and temperature, a 10°C increase led to a total daily step count rise of 655.4, comprised of 461.7 steps directly due to the temperature itself and 193.7 steps because of decreased depressive severity (1.9 decrease in PHQ-8). In contrast, for those with a positive correlation, a 10°C rise directly led to a 262.3-step rise; however, it was offset by a 141.3-step decrease due to increased depression severity (2.1 increase in PHQ-8) from higher temperatures, culminating in an insignificant overall increase of 121 steps. These findings illustrate the heterogeneity in individuals' seasonal depression variations and responses to weather, underscoring the necessity for personalized approaches to help understand the impact of environmental factors on the real-world effectiveness of behavioral treatments.