bluuebunny/crossref_metadata_2025_split huggingface dataset:
The role of pelvic floor ultrasound correlated with pelvic organ prolapse quantification in the assessment of anterior and apical compartments of pelvic organ prolapse
Authors: El-Gohary Toqa , Hamed Soha T. , El-Azizi Hatem Mohamed , Haggag Hisham Mamdouh , Azzam Heba 
Published: March 2024

Abstract
Background
Pelvic organ prolapse (POP) is a gynecological disease significantly associated with older age. A higher prevalence of women with symptomatic POP showed physical and emotional distress, negatively affecting their quality of life (QoL). The most widespread tool used is the prolapse quantification system (POP-Q) of the International Continence Society (ICS). The aim of this study was to evaluate the role of ultrasound (U/S) compared to POP-Q for the detection and quantification of POP in the anterior (urinary bladder) and apical (cervix/vaginal vault) compartments of the pelvic floor in Egyptian women.

Results
The current study revealed that among 83 women, 53 had POP with a mean age of 50.83 years, 96.2% had anterior compartment prolapse (either alone or with apical compartment prolapse), 52% had apical compartment prolapse (either alone or with anterior compartment prolapse), 47.2% had anterior compartment prolapse only, and 3.7% had apical compartment prolapse only. There was a strong agreement (almost linear) between (POP-Q) and U/S in detecting significant pelvic organ prolapse in the anterior compartment (Kappa value 0.925, P < 0.001) and the apical compartment (Kappa value 0.945 and P < 0.001). With higher value of sensitivity and specificity, our study assigned significant anterior compartment prolapse using a cutoff value of 0 for point Ba of POP-Q and −11.5 for bladder neck descent at valsalva using U/S.

Conclusions
Pelvic floor ultrasound provides general and detailed anatomical overview of the pelvic floor as well as detection and assessment of the POP in anterior and middle compartments.
An automated fluorescent immunoassay for on-site screening of AFM1 in raw milk at the ppt level
Authors: Kou Jiaqian , Dou Leina , Mari Ghulam Mujtaba , Wu Weilin , Zhang Yingjie , Li Peipei , Wang Xiaonan , Zhang Suxia , Wen Kai , Chen Yiping , Yu Wenbo 
Published: March 2024

AbstractIn the dairy industry, the quality of raw milk as it is collected from dairy farmers must be strictly ensured. Therefore, when on-site screening of typical carcinogens in raw milk, this technology must simultaneously be convenient to operate and highly sensitive. Here, an automated and fluorescent immunoassay system for screening trace amounts of aflatoxin M1 (AFM1) in raw milk was developed. The whole immunoassay procedure can be processed in a true “sample-to-results” paradigm, avoiding the tedious manual operation of the traditional indirect competitive enzyme-linked immunosorbent assay (ic-ELISA) method. In addition, we designed an integrated fluorescent spectrometer that can quantitatively measure fluorescent signals with high sensitivity. The automated and fluorescent immunoassay system can screen AFM1 in raw milk samples with an ultra low limit of detection (4.7 pg/mL in raw milk). The half maximal inhibitory concentration (IC50) was 8.3 pg/mL, which is approximately 4-fold lower than that of traditional ic-ELISA. When the system was applied to screen actual raw milk samples, the recovery rates ranged from 79.4% to 104.6%, with a coefficient of variation ranging from 8.9% to 15.2%. Overall, we believe that the automated and fluorescent immunoassay system can provide a one-stop solution that is user-friendly and highly sensitive for screening trace AFM1 contaminants in raw milk.
Anti-CD19 Chimeric Antigen Receptor T-Cell Therapy for Richter Transformation: An International, Multicenter, Retrospective Study
Authors: Kittai Adam S. , Bond David , Huang Ying , Bhat Seema A. , Blyth Emily , Byrd John C. , Chavez Julio C. , Davids Matthew S. , Dela Cruz Jamie P. , Dowling Mark R. , Duffy Caitlyn , Ho Carrie , Jacobson Caron , Jaglowski Samantha , Jain Nitin , Lin Kevin H. , Miller Cecelia , McCarthy Christine , Omer Zulfa , Parry Erin , Rai Manoj , Rogers Kerry A. , Saha Aditi , Schachter Levanto , Scott Hamish , Senapati Jayastu , Shadman Mazyar , Siddiqi Tanya , Stephens Deborah M. , Vanguru Vinay , Wierda William , Woyach Jennifer A. , Thompson Philip A. 
Published: March 2024

PURPOSE Outcomes for Richter transformation (RT) are poor with current therapies. The efficacy and safety of anti-CD19 chimeric antigen receptor T-cell therapy (CAR-T) for RT are not established. METHODS We performed an international multicenter retrospective study of patients with RT who received CAR-T. Patient, disease, and treatment characteristics were summarized using descriptive statistics, and modeling analyses were used to determine association with progression-free survival (PFS) and overall survival (OS). PFS and OS were estimated from the date of CAR-T infusion. RESULTS Sixty-nine patients were identified. The median age at CAR-T infusion was 64 years (range, 27-80). Patients had a median of four (range, 1-15) previous lines of therapy for CLL and/or RT, including previous Bruton tyrosine kinase inhibitor and/or BCL2 inhibitor therapy in 58 (84%) patients. The CAR-T product administered was axicabtagene ciloleucel in 44 patients (64%), tisagenlecleucel in 17 patients (25%), lisocabtagene maraleucel in seven patients (10%), and brexucabtagene autoleucel in one patient (1%). Eleven patients (16%) and 25 patients (37%) experienced grade ≥3 cytokine release syndrome and immune effector cell–associated neurotoxicity syndrome, respectively. The overall response rate was 63%, with 46% attaining a complete response (CR). After a median follow-up of 24 months, the median PFS was 4.7 months (95% CI, 2.0 to 6.9); the 2-year PFS was 29% (95% CI, 18 to 41). The median OS was 8.5 months (95% CI, 5.1 to 25.4); the 2-year OS was 38% (95% CI, 26 to 50). The median duration of response was 27.6 months (95% CI, 14.5 to not reached) for patients achieving CR. CONCLUSION CAR-T demonstrates clinical efficacy for patients with RT.
Continuous Subcutaneous Delivery of rhPTH(1-84) and rhPTH(1-34) by Pump in Adults With Hypoparathyroidism
Authors: Charoenngam Nipith , Bove-Fenderson Erin , Wong Daniel , Cusano Natalie E , Mannstadt Michael 
Published: March 2024

Abstract

Context
Continuous subcutaneous infusion of recombinant parathyroid hormone (rhPTH) through a pump has been proposed as a therapeutic alternative for patients with chronic hypoparathyroidism who remain symptomatic or hypercalciuric on conventional treatment (calcium and active vitamin D) or daily injections of rhPTH(1-84) or rhPTH(1-34). However, the real-world evidence of the outcome of this novel therapy is limited.

Case Descriptions
We report the clinical and biochemical outcomes of 12 adults with hypoparathyroidism (11 women, age 30-70 years, and 1 man, age 30 years) from 3 different clinical sites in the United States who were transitioned from conventional therapy to daily injections of rhPTH(1-84) or rhPTH(1-34) and then switched to continuous administration of rhPTH(1-84)/rhPTH(1-34) via pump therapy. In most patients, mean serum calcium concentrations increased while on PTH pump therapy compared with both conventional therapy (in 11 patients) and single/multiple daily rhPTH injections (in 8 patients). Despite this, 10 patients had lower median 24-hour urinary calcium levels while on PTH pump therapy compared with prior therapy (mean ± SD difference: −130 ± 222 mg/24 hours). All patients reported a qualitative decrease in hypocalcemic symptoms while receiving pump therapy. Three patients had pod failure at least once, and 1 patient developed an infusion site reaction.

Conclusion
In this case series of 12 patients with chronic hypoparathyroidism treated with rhPTH(1-84)/rhPTH(1-34) administered via a pump, improvement in clinical and biochemical parameters were observed in the majority of the patients. Our observations indicate benefits of pump administration of rhPTH that warrant further investigation.
Not Only RET but NF1 and Chromosomal Instability Are Seen in Young Patients with Sporadic Medullary Thyroid Carcinoma
Authors: Castroneves Luciana Audi , Mangone Flavia Regina Rotea , Lerario Antonio Marcondes , da Cunha Mercante Ana Maria , Batista Rafael Loch , Barros Luciana Rodrigues Carvalho , Ferreira Carla Vaz , Farias Evelin Cavalcante , Vanderlei Felipe Augusto Brasileiro , Maia Ana Luiza , Nagai Maria Aparecida , Jorge Alexander Augusto Lima , Hoff Ana Oliveira 
Published: March 2024

Abstract

Context
Genetic analysis of sporadic medullary thyroid carcinoma (MTC) has revealed somatic variants in RET, RAS, and occasionally other genes. However, around 20% of patients with sporadic MTC lack a known genetic driver.

Objective
To uncover potential new somatic or germline drivers, we analyze a distinct cohort of patients with sporadic, very early–onset, and aggressive MTC.

Methods
Germline and somatic DNA exome sequencing was performed in 19 patients, previously tested negative for germline RET variants.

Results
Exome sequencing of 19 germline samples confirmed the absence of RET and identified an NF1 pathogenic variant in 1 patient. Somatic sequencing was successful in 15 tumors revealing RET variants in 80%, predominantly p.Met918Thr, which was associated with disease aggressiveness. In RET-negative tumors, pathogenic variants were found in HRAS and NF1. The NF1 germline and somatic variants were observed in a patient without a prior clinical diagnosis of neurofibromatosis type 1, demonstrating that the loss of heterozygosity of NF1 functions as a potential MTC driver. Somatic copy number alterations analysis revealed chromosomal alterations in 53.3% of tumors, predominantly in RET-positive cases, with losses in chromosomes 9 and 22 being the most prevalent.

Conclusion
This study reveals that within a cohort of early-onset nonhereditary MTC, RET remains the major driver gene. In RET-negative tumors, NF1 and RAS are drivers of sporadic MTC. In addition, in young patients without a RET germline mutation, a careful clinical evaluation with a consideration of germline NF1 gene analysis is ideal to exclude Neurofibromatosis type 1 (NF1).
Preoperative Mobile Health Data Improve Predictions of Recovery From Lumbar Spine Surgery
Authors: Greenberg Jacob K. , Frumkin Madelyn , Xu Ziqi , Zhang Jingwen , Javeed Saad , Zhang Justin K. , Benedict Braeden , Botterbush Kathleen , Yakdan Salim , Molina Camilo A. , Pennicooke Brenton H. , Hafez Daniel , Ogunlade John I. , Pallotta Nicholas , Gupta Munish C. , Buchowski Jacob M. , Neuman Brian , Steinmetz Michael , Ghogawala Zoher , Kelly Michael P. , Goodin Burel R. , Piccirillo Jay F. , Rodebaugh Thomas L. , Lu Chenyang , Ray Wilson Z. 
Published: March 2024

BACKGROUND AND OBJECTIVES:
Neurosurgeons and hospitals devote tremendous resources to improving recovery from lumbar spine surgery. Current efforts to predict surgical recovery rely on one-time patient report and health record information. However, longitudinal mobile health (mHealth) assessments integrating symptom dynamics from ecological momentary assessment (EMA) and wearable biometric data may capture important influences on recovery. Our objective was to evaluate whether a preoperative mHealth assessment integrating EMA with Fitbit monitoring improved predictions of spine surgery recovery.

METHODS:
Patients age 21–85 years undergoing lumbar surgery for degenerative disease between 2021 and 2023 were recruited. For up to 3 weeks preoperatively, participants completed EMAs up to 5 times daily asking about momentary pain, disability, depression, and catastrophizing. At the same time, they were passively monitored using Fitbit trackers. Study outcomes were good/excellent recovery on the Quality of Recovery-15 (QOR-15) and a clinically important change in Patient-Reported Outcomes Measurement Information System Pain Interference 1 month postoperatively. After feature engineering, several machine learning prediction models were tested. Prediction performance was measured using the c-statistic.

RESULTS:
A total of 133 participants were included, with a median (IQR) age of 62 (53, 68) years, and 56% were female. The median (IQR) number of preoperative EMAs completed was 78 (61, 95), and the median (IQR) number of days with usable Fitbit data was 17 (12, 21). 63 patients (48%) achieved a clinically meaningful improvement in Patient-Reported Outcomes Measurement Information System pain interference. Compared with traditional evaluations alone, mHealth evaluations led to a 34% improvement in predictions for pain interference (c = 0.82 vs c = 0.61). 49 patients (40%) had a good or excellent recovery based on the QOR-15. Including preoperative mHealth data led to a 30% improvement in predictions of QOR-15 (c = 0.70 vs c = 0.54).

CONCLUSION:
Multimodal mHealth evaluations improve predictions of lumbar surgery outcomes. These methods may be useful for informing patient selection and perioperative recovery strategies.
Preinjury Frailty Predicts 1-Year Mortality in Older Adults With Traumatic Spine Fractures
Authors: Fields Daryl P. , Varga Gregory , Alattar Ali , Shanahan Regan , Das Ashtah , Hamilton David K. , Okonkwo David O. , Kanter Adam S. , Forsythe Raquel M. , Weiner Debra K. 
Published: March 2024

BACKGROUND AND OBJECTIVES:
Nearly 30% of older adults presenting with isolated spine fractures will die within 1 year. Attempts to ameliorate this alarming statistic are hindered by our inability to identify relevant risk factors. The primary objective of this study was to develop a prediction model that identifies feasible targets to limit 1-year mortality.

METHODS:
This retrospective cohort study included 703 older adults (65 years or older) admitted to a level I trauma center with isolated spine fractures, without neural deficit, from January 2013 to January 2018. Multivariable analysis was used to select for independently significant patient demographics, frailty variables, injury metrics, and management decisions to incorporate into distinct logistic regression models predicting 1-year mortality. Variables were considered significant, if P < .05.

RESULTS:
Of the 703 older adults, 199 (28.3%) died after hospital discharge, but within 1 year of index trauma. Risk Analysis Index (RAI; odds ratio [OR]: 1.116; 95% CI: 1.087-1.149; P < .001) and ambulation requiring a cane (OR: 2.601; 95% CI: 1.151-5.799; P = .02) or walker (OR: 4.942; 95% CI: 2.698-9.196; P < .001), ie, frailty variables, were associated with increased odds of 1-year mortality. Spine trauma scales were not associated with 1-year mortality. Longer hospital stays (OR: 1.112; 95% CI: 1.034-1.196; P = .004) and nursing home discharge (OR: 3.881; 95% CI: 2.070-7.378; P < .001) were associated with increased odds, while discharge to rehab (OR: 0.361; 95% CI: 0.155-0.799; P = .014) decreased 1-year mortality odds. A “preinjury” regression model incorporating Risk Analysis Index and ambulation status resulted in an area under receiver operating characteristic curve (AUROCC) of 0.914 (95% CI: 0.863-0.965). A “postinjury” model incorporating Glasgow Coma Scale, hospital stay duration, and discharge disposition resulted in AUROCC of 0.746 (95% CI: 0.642-0.849). Combining elements of the preinjury and postinjury models into an “integrated model” produced an AUROCC of 0.908 (95% CI: 0.852-0.965).

CONCLUSION:
Preinjury frailty measures are most strongly associated with 1-year mortality outcomes in older adults with isolated spine fractures. Incorporating injury metrics or management decisions did not enhance predictive accuracy. Further work is needed to understand how targeting frailty may reduce mortality.
An Approximation to the Invariant Measure of the Limiting Diffusion of G/Ph/n + GI Queues in the Halfin–Whitt Regime and Related Asymptotics
Authors: Jin Xinghu , Pang Guodong , Xu Lihu , Xu Xin 
Published: March 2024

In this paper, we develop a stochastic algorithm based on the Euler–Maruyama scheme to approximate the invariant measure of the limiting multidimensional diffusion of [Formula: see text] queues in the Halfin–Whitt regime. Specifically, we prove a nonasymptotic error bound between the invariant measures of the approximate model from the algorithm and the limiting diffusion. To establish the error bound, we employ the recently developed Stein’s method for multidimensional diffusions, in which the regularity of Stein’s equation obtained by the partial differential equation (PDE) theory plays a crucial role. We further prove the central limit theorem (CLT) and the moderate deviation principle (MDP) for the occupation measures of the limiting diffusion of [Formula: see text] queues and its Euler–Maruyama scheme. In particular, the variances in the CLT and MDP associated with the limiting diffusion are determined by Stein’s equation and Malliavin calculus, in which properties of a mollified diffusion and an associated weighted occupation time play a crucial role. Funding: X. Jin is supported in part by the Fundamental Research Funds for the Central Universities [Grants JZ2022HGQA0148 and JZ2023HGTA0170]. G. Pang is supported in part by the U.S. National Science Foundation [Grants DMS-1715875 and DMS-2216765]. L. Xu is supported in part by the National Nature Science Foundation of China [Grant 12071499], Macao Special Administrative Region [Grant FDCT 0090/2019/A2], and the University of Macau [Grant MYRG2018-00133-FST]. This work was supported by U.S. National Science Foundation [Grant DMS-2108683].
Development of Green Engineered Cementitious Composite using Fly Ash and Nanosilica for 3D Printing
Authors: S. Anandaraj  , S. Sakthi Sowmya  , A. R. Krishnaraja  , T. Mithun  
Published: March 2024

The effects of adding Nanosilica (NS) to Engineered Cementitious Composites (ECC) for 3D Printing (3DP) applications were investigated in this study. The mechanical characteristics of 3DP ECC mortar with different NS contents were investigated. The basic components of the composite included fly ash, M-sand, polypropylene fibers, Ordinary Portland Cement, nanosilica and an accelerator. There were four different mix proportions of NS involving 0.05%, 0.1%, 0.15%, and 0.2%. After 3, 7, 14, and 28 days of curing, the following strengths, viz., pull-out strength, direct tensile strength, compressive strength, and flexural strength were assessed. Addition of NS improved the mechanical properties of ECC up to an ideal level of 0.15%, after which decreasing returns and adverse effects, including agglomeration, were observed. Insights into the ideal NS content for obtaining maximum performance of ECC obtained from the study provide knowledge for formulations in high-performance 3DP technologies.
Air Quality Prediction in Smart Environment using Lightweight Residual Network: Sustainable Light-AirNet Approach
Authors: P. Muthusamy  , V. Nandhini  , B. Karthikeyan  , K. Nithya  , S. Sabarunisha Begum  , K. Elangovan  
Published: March 2024

In densely populated places, air pollution prediction is crucial since it directly affects human health and the local governance. The main objective of this work is to analyze the spatial and temporal patterns of the concentration of the main air pollutants in Bangalore, India. In this paper, a lightweight residual network with an attention mechanism is created using a collection of residual concatenation blocks layered with recursive residual blocks. This aids in the adaptive extraction of useful features, the learning of more expressive spatial context information, and the efficient transfer of information through gradient flow in the network. A unique attention mechanism, known as the Two-Fold Attention Module, has been created with the purpose of enhancing the model’s ability to represent information. The Light-AirNet model was designed to provide hourly forecasts by using past pollution data and three measured weather variables were collected from weather stations. Light-AirNet is compared with existing approaches in terms of different metrics and it was found that it achieves 24.5% of root-mean-square error, 21.5% of mean square error, 12.59% of mean absolute error, and 97.45% of prediction accuracy.
Tunable fiber attenuator for electrically wet-driven micromirrors
Authors: Chen Tao , Yang Zhengxuan , Zhang Zhenqin , Zhao Zhen , Guan Jianfei , Chen Jing , Xu Rongqing 
Published: March 2024

Herein we report an electronically controlled tunable fiber-optic attenuator that leverages the microfluidic electro-wetting effect, which enables a fine-tuning of the solid-liquid interface wetting angle to control the micro-reflector, thus regulating the lens fiber coupling efficiency. Theoretical calculations indicated an optical attenuation regulation effect of 0–45.0 dB in the voltage range of 0–30.0 V. Experimental results align closely with theoretical calculations, demonstrating an attenuation range of 0.59–43.0 dB within a voltage variation range of 0–25.0 V, with control accuracy of 0.56 dB. Our study unveils the potential for designing fiber-optic attenuators with varying tuning accuracy by precisely adjusting the solid-liquid interface wetting angle.
Human resources challenges in the management of diabetes and hypertension in Mozambique
Authors: Madede Tavares , Mavume Mangunyane Elzier , Munguambe Khátia , Govo Valério , Beran David , Levitt Naomi , Damasceno Albertino 
Published: March 2024

Background
The major burden of non-communicable diseases (NCDs) globally occurs in low-and middle-income countries, where this trend is expected to increase dramatically over the coming years. The resultant change in demand for health care will imply significant adaptation in how NCD services are provided. This study aimed to explore self-reported training and competencies of healthcare providers, and the barriers they face in NCD services provision.

Methods
A qualitative design was used to conduct this study. Data was collected through semi-structured interviews with government officials within the Mozambican Ministry of Health, district health authorities, health facility managers, and health providers at urban and rural health facilities of Maputo, in Mozambique. The data was then analyzed under three domains: provider´s capacity building, health system structuring, and policy.

Results
A total of 24 interviews of the 26 planed with managers and healthcare providers at national, district, and health facility levels were completed. The domains analyzed enabled the identification and description of three themes. First, the majority of health training courses in Mozambique are oriented towards infectious diseases. Therefore, healthcare workers perceive that they need to consolidate and broaden their NCD-related knowledge or else have access to NCD-related in-service training to improve their capacity to manage patients with NCDs. Second, poor availability of diagnostic equipment, tools, supplies, and related medicines were identified as barriers to appropriate NCD care and management. Finally, insufficient NCD financing reflects the low level of prioritization felt by managers and healthcare providers.

Conclusion
There is a gap in human, financial, and material resources to respond to the country’s health needs, which is more significant for NCDs as they currently compete against major infectious disease programming, which is better funded by external partners. Healthcare workers at the primary health care level of Mozambique’s health system are inadequately skilled to provide NCD care and they lack the diagnostic equipment and tools to adequately provide such care. Any increase in global and national responses to the NCD challenge must include investments in human resources and appropriate equipment.