bluuebunny/crossref_metadata_2025_split huggingface dataset:
Value evaluation model (VEM) of ancient Chinese military settlement heritage: a case study of Liaoxi Corridor in the Ming Dynasty
Authors: Fan Xixuan , Wang Zhen , Li Shifen 
Published: March 2024

Abstract
The Ming Great Wall Military Defense System is the most complete ancient military cultural heritage in China, which is of great significance to the study of China’s ancient military defense mechanism and pattern. Military settlement is an important carrier of this mechanism. The estimation and in-depth understanding of its value can further excavate the profound connotation of the military defense system and the Great Wall spatial pattern in the Ming Dynasty. This paper adopts the AHP-CRITIC weighting approach to determine the weights of the historical value, scientific value, social value, cultural value and artistic value of the settlement heritage, so as to construct the value evaluation model of military settlements, and takes 34 Ming Great Wall military settlements in the Liaoxi Corridor as an example for evaluation. The results of the evaluation identified the priority settlements for conservation and development, and also explored their relationship with historical status, urbanization processes and official policies. The evaluation model constructed in this paper has a certain universality, and can also be followed in the evaluation of other military settlements in the Ming Great Wall Defense System, so as to obtain the overall cognition of the settlement system.
Reinforcement learning for intensive care medicine: actionable clinical insights from novel approaches to reward shaping and off-policy model evaluation
Authors: Roggeveen Luca F. , Hassouni Ali el , de Grooth Harm-Jan , Girbes Armand R. J. , Hoogendoorn Mark , Elbers Paul W. G. ,   the Dutch ICU Data Sharing Against COVID-19 Collaborators
Published: March 2024

Abstract
Background
Reinforcement learning (RL) holds great promise for intensive care medicine given the abundant availability of data and frequent sequential decision-making. But despite the emergence of promising algorithms, RL driven bedside clinical decision support is still far from reality. Major challenges include trust and safety. To help address these issues, we introduce cross off-policy evaluation and policy restriction and show how detailed policy analysis may increase clinical interpretability. As an example, we apply these in the setting of RL to optimise ventilator settings in intubated covid-19 patients.

Methods
With data from the Dutch ICU Data Warehouse and using an exhaustive hyperparameter grid search, we identified an optimal set of Dueling Double-Deep Q Network RL models. The state space comprised ventilator, medication, and clinical data. The action space focused on positive end-expiratory pressure (peep) and fraction of inspired oxygen (FiO2) concentration. We used gas exchange indices as interim rewards, and mortality and state duration as final rewards. We designed a novel evaluation method called cross off-policy evaluation (OPE) to assess the efficacy of models under varying weightings between the interim and terminal reward components. In addition, we implemented policy restriction to prevent potentially hazardous model actions. We introduce delta-Q to compare physician versus policy action quality and in-depth policy inspection using visualisations.

Results
We created trajectories for 1118 intensive care unit (ICU) admissions and trained 69,120 models using 8 model architectures with 128 hyperparameter combinations. For each model, policy restrictions were applied. In the first evaluation step, 17,182/138,240 policies had good performance, but cross-OPE revealed suboptimal performance for 44% of those by varying the reward function used for evaluation. Clinical policy inspection facilitated assessment of action decisions for individual patients, including identification of action space regions that may benefit most from optimisation.

Conclusion
Cross-OPE can serve as a robust evaluation framework for safe RL model implementation by identifying policies with good generalisability. Policy restriction helps prevent potentially unsafe model recommendations. Finally, the novel delta-Q metric can be used to operationalise RL models in clinical practice. Our findings offer a promising pathway towards application of RL in intensive care medicine and beyond.
Impact of the Kuroshio large meander on local atmospheric circulation and precipitation in winter
Authors: Sasaki Yoshi N. , Ito Ryunosuke 
Published: March 2024

AbstractThe Kuroshio, which flows to the south of Japan, typically takes two paths on decadal timescales; the straight path and the large meander path, or the so-called Kuroshio large meander. This phenomenon is characterized by the presence of the cyclonic cold-core eddy located south of Japan, which leads to both negative and positive sea surface temperature (SST) anomalies along the southeastern coast of Japan. To clarify the atmospheric response to these SST anomalies in winter, we conducted a control experiment employing a regional atmospheric model with observed SSTs and two sensitivity experiments in which the SST boundary conditions were substituted with those corresponding to the periods of for the Kuroshio large meander and the straight path. The differences in these two sensitivity experiments showed that the surface wind response to the SST anomalies associated with the Kuroshio large meander was not only characterized by wind divergence over the cyclonic cold-core eddy, as reported previously but also wind convergence along the southeastern coast of Japan. Interestingly, this wind anomaly blew into the positive SST anomaly along the east coast of Japan at around 36°N. Similar wind anomalies along the east coast of Japan were observed in a reanalysis product. The results of the model simulation and the reanalysis product showed that during the Kuroshio large meander period, the number of rainy days increased significantly over the warm SST anomaly, while the precipitation and the number of rainy days decreased over the cyclonic cold-core eddy. Moisture budget analysis revealed that the observed decrease in precipitation was attributed to the disparity between the reduced evaporation and the anomalous horizontal moisture convergence in a region where the surface winds were divergent. This moisture convergence was mainly induced by a decrease in specific humidity, implying this change in specific humidity effectively mitigated the variation in precipitation.
A case of giant nipple adenoma
Authors: Ono Shuko , Tanaka Masumi , Yoshinaga Yasuteru , Satou Toshihiko , Aoki Mikiko 
Published: March 2024

Abstract
Background
Nipple adenoma is a relatively rare benign disease. Clinically, it often presents with nipple erosions, and it should be differentiated from Paget’s disease.

Case presentation
The patient was a 63-year-old woman who complained of a lump in her left nipple for more than 30 years. Computed tomography performed for screening congestive heart failure suggested a left nipple mass of 40 mm in size. Needle biopsy revealed nipple adenoma, and skin biopsy was also performed to confirm the diagnosis. Nipple tumor resection was performed under local anesthesia, and we confirmed that the final diagnosis was nipple adenoma with negative margins. The patient has been free from recurrence for 2 years since the surgery.

Conclusions
We have reported our experience of a case of giant nipple adenoma.
Powerpenia Should be Considered a Biomarker of Healthy Aging
Authors: Freitas Sandro R. , Cruz-Montecinos Carlos , Ratel Sébastien , Pinto Ronei S. 
Published: March 2024

AbstractTo identify biomarkers that precede the decline of human function and independence during the lifespan, two important concepts have been introduced in recent decades: sarcopenia and dynapenia. While the former is originally focused on skeletal muscle loss, the latter is on maximal strength loss. Although the dynapenia concept implies the inclusion of skeletal muscle power, in practical terms, this has not been specifically addressed. For instance, only 2 out of 220 studies published between 2008 and 2023 have directly measured muscle power to classify individuals with dynapenia. As previous studies have shown a greater relevance of skeletal muscle power in healthy aging, we hereby propose the introduction of the term “powerpenia” to specifically reflect the loss of skeletal muscle power along lifespan, but also with disease and/or physical inactivity. Together with sarcopenia and dynapenia, we contend that powerpenia should be considered a biomarker of healthy aging.
Dermatological side effects of dipeptidyl Peptidase-4 inhibitors in diabetes management: a comprehensive review
Authors: Zaresharifi Shirin , Niroomand Mahtab , Borran Sarina , Dadkhahfar Sahar 
Published: March 2024

AbstractDipeptidyl peptidase-4 (DPP-4) inhibitors are a class of drugs that enhance the incretin-insulin pathway and offer effective glycemic control in type 2 diabetes mellitus. However, these drugs may be associated with various dermatological side effects, ranging from mild to severe. This review article summarizes the current literature on the dermatological side effects of DPP-4 inhibitors, including bullous pemphigoid, severe cutaneous adverse drug reactions, fixed drug eruptions, and other mucocutaneous reactions. The review also discusses the possible mechanisms, risk factors, diagnosis, and management of these side effects. This review aims to increase the awareness and vigilance of healthcare providers in recognizing and managing the dermatological side effects of DPP-4 inhibitors and to emphasize the need for further research and surveillance to optimize diabetes care and patient safety.
Towards equitable representation in long-term residential care: widening the circle to ensure “essential voices” in research teams
Authors: Hande Mary Jean , Owusu Prince , Aubrecht Katie , Cloutier Denise , Estabrooks Carole , Keefe Janice 
Published: March 2024

AbstractThe COVID-19 pandemic exposed long-standing inequities in Canada’s long-term residential care (LTRC) sector with life-threatening consequences. People from marginalized groups are overrepresented among those who live in, and work in LTRC facilities, yet their voices are generally silenced in LTRC research. Concerns about these silenced voices have sparked debate around ways to change LTRC policy to better address long-standing inequities and enhance the conditions that foster dignity for those who live and work in LTRC. Weaving an analysis of historical and cultural attitudes about LTRC, and promising strategies for engaging people with lived experience, we argue that the voices of people with lived experience of life and work (paid and unpaid) in LTRC are essential for ethically and effectively shifting long-standing inequities. Lessons from a 4-year, national, multi-disciplinary research study, known as the Seniors Adding Life to Years (SALTY) project, suggest that resident-determined quality of life can be prioritized by centring the perspectives of residents, their family/friends, direct care workers, volunteers, and people living with dementia in the research process. Accordingly, we highlight strategies to include these voices so that meaningful and impactful system change can be realized.
Simultaneous use of Beauveria bassiana and Bacillus subtilis-based biopesticides contributed to dual control of Trialeurodes vaporariorum (Hemiptera: Aleyrodidae) and tomato powdery mildew without antagonistic interactions
Authors: Komagata Yasuyuki , Sekine Takayuki , Oe Takaho , Kakui Shogo , Yamanaka Satoshi 
Published: March 2024

Abstract
Background
Implementing pest and disease control techniques that have low environmental impact is important for sustainable agriculture. Microbial biopesticides are an effective approach due to their low environmental impact and low risk of resistance development. Because it is not usually possible to control multiple pests and diseases with a single microbial biopesticide, it is essential to investigate the potential for combining microbial biopesticides with varying control spectrums effectively. Many biopesticides have antimicrobial activity and may therefore interact negatively in combination.

Results
This study demonstrated that a mixture of Beauveria bassiana and Bacillus subtilis formulations proved potential for simultaneous control of greenhouse whitefly (Trialeurodes vaporariorum Westwood) and tomato powdery mildew (Oidium neolycopersici). Three greenhouse experiments were conducted to assess the efficacy of mixed and single-use treatments. A laboratory experiment comparing the insecticidal effect of each treatment was also conducted. In all greenhouse experiments, the combined treatment controlled the greenhouse whitefly (78.9–88.3%) and tomato powdery mildew (47.2–81.0%) compared to untreated controls, which was as well as each treatment alone. In some greenhouse and laboratory experiments, the mixed treatment showed an approximately 1.32 to 1.78 times higher insecticidal effect compared to single-use treatments. Regarding the control efficacy against the pest and disease, negative effects of microbial agents on each other were not observed.

Conclusions
These results demonstrated the effectiveness of concurrent use of two microbial pesticides examined on dual control of pest and disease and showed potential for improved control of certain pests. The knowledge of this work could suggest the possibility of more environmentally friendly pest control systems with the use of microbial pesticides.
Syntaxin 1A gene polymorphism in multiple sclerosis: a case–control study
Authors: Oraby Mohammed I. , Soliman Rasha H. , Abdel Kader Noha A. , Abdul Galil Esraa M. , Masoud Mohammed M. 
Published: March 2024

Abstract
Background
Syntaxin 1A is a member of a membrane-integrated nervous system-specific protein superfamily involved in the neuromediator release from synaptic vesicles and one of the proteins included in axonal integrity. Studies that discussed the role of Syntaxin 1A in multiple sclerosis are few and limited. Gene studying sometimes shows unexpected results in different populations. The aim of this work was to investigate Syntaxin 1A genetic polymorphism (rs1569061) in a sample of Egyptian patients with MS and the relation between Syntaxin 1A gene polymorphism and disease course and disability. A case–control study included 150 subjects; 75 Egyptian MS patients of different clinical courses and 75 age and sex matched healthy controls. Patients were subjected to clinical evaluation, assessment of disability, and cognition. Both patient and control groups were subjected to Syntaxin 1A genotyping.

Results
There was no significant difference between different genotypes distribution for Syntaxin 1A (rs 1569061) between MS patients and controls.
No significant difference was found between genotypes and allele distribution for Syntaxin 1A (rs 1569061) among cases of MS regarding EDSS or results of BICAMS). There was no statistically significant difference between syntaxin genotypes among cases of MS regarding demographic or clinical characteristics of the disease.

Conclusion
Here we show no statistically significant difference between MS patients and control regarding Syntaxin 1A genotypes and different alleles. Syntaxin 1A genotypes have no impact on clinical characteristics of the disease, disability, or cognition. These negative findings open the floor for the study of other MS related genes in Egypt.
Immunochemistry-based quantification of tumor-infiltrating lymphocytes and immunoscore as prognostic biomarkers in bladder cancer
Authors: Rejeb Sarra Ben , Elfekih Sirine , Kouki Nadia , Boulma Rami , Khouni Hassen 
Published: March 2024

Abstract
Background
Tumor-infiltrating lymphocytes (TILs) and the derived immunoscore (IS) have gained considerable attention over the last decade as prognostic markers in many solid cancers. However, in bladder cancer (BC), their prognostic value is not clearly established.

Methods
The present study aimed to quantify the TILs rates in BC, assess the derived immunoscore, and investigate their prognostic value. An immunochemistry-based quantification of the different subtypes of TILS was performed on paraffin-embedded blocks from patients with invasive urothelial carcinoma of the bladder. We have assessed the rates of TILs, respectively, on peri-tumoral (PT) and intra-tumoral (IT) areas and calculated for each case the corresponding IS which is the index: CD8+/CD3+ TILs. The IS was then classified as low (I0, I1) or high (I2, I3, I4). We included 30 cases in the analysis.

Results
The median age of patients was 65 years with a sex ratio of 9. TILs densities and distribution were significantly variable between IT and PT areas CD3+ (p = 0.03) and CD8+ (p = 0.004) with the highest rates on the PT areas. In univariate analysis, a low density of CD8+ TILs was significantly associated with an advanced age (p = 0.05), with the presence of lympho-vascular invasion (p = 0.02) and with the absence of specific histological subtype (p = 0.05). A low immunoscore was significantly associated with the presence of lympho-vascular invasion (p = 0.004). No significant association was found between TILs subpopulations, the IS, and the other clinicopathological and survival data. The overall survival (OS) and disease-free survival (DFS) medians were slightly superior in highly T (CD3+/CD8+)-cell infiltrated tumors as well as tumors with a high IS densities. However, the univariate analysis showed that TILs and immunoscore did not impact overall survival (OS) and disease-free survival (DFS).

Conclusion
TILs and immunoscore might be effective prognostic tools in BC. However, standardized quantification methods and further investigation on larger samples are highly recommended to definitively attest the prognostic value of TILs and IS in BC.
Can the abbreviated MRI protocol replace the standard full protocol in the detection and characterization of breast non-mass enhancement?
Authors: Hassan Alzahraa Sayed , Aboelhamd Eman , Yousef Hazem Abu Zeid , Moubark Mahmoud , Hassanein Sara , Ali Abeer Houssein 
Published: March 2024

Abstract
Background
Breast MRI full diagnostic protocol (FDP) showed great value in detecting and characterizing non-mass enhancement (NME); however, it is costly and time-consuming. MRI abbreviated protocol (AP) showed comparable accuracy to FDP in various indications but has not been specifically tested in NME. Our study purpose is to assess the accuracy of the AP in the detection and characterization of breast NME in comparison with the FDP and to perform time analysis of the AP.

Methods
Patients who demonstrated NME in dynamic contrast-enhanced MRI were included to be assessed using AP and FDP. Image analysis was performed blindly and independently. Firstly, reconstructed images from the pre- and first post-contrast T1WI (first maximum intensity projection and subtraction) were made available as AP. Later, the time/signal intensity curve and remaining images of the FDP were added to the assessment. Both protocols were compared regarding acquisition time, interpretation time, BI-RADS scores and accuracy in the detection and characterization of NME in correlation to histopathology and/or follow-up. Validity statistics, Cohen-Kappa and ROC curve were used.

Results
Fifty-nine NME lesions were identified. AP acquisition and interpretation times were significantly shorter than those of the FDP (3.3 vs. 35 min) and (45 “25–75 s” vs. 108 “80–150 s”) (P < 0.001), respectively. There was almost perfect agreement between the two protocols in the BIRADS grading of NME (k = 0.950, P < 0.001). In ROC curve analysis, the FDP was insignificantly more accurate than the AP (84.8% vs. 81.4%, P = 0.144).

Conclusions
Breast MRI–AP is comparable to the FDP in the detection and characterization of breast NME with advantageous time saving.
Co-designing strategies to implement long-acting injectable PrEP for sexual minority men in Chicago: a study protocol for an innovation tournament and implementation mapping
Authors: Van Pelt Amelia E. , Casline Elizabeth , Phillips Gregory , Cestou Jorge , Mustanski Brian , Cook Grace , Beidas Rinad S. 
Published: March 2024

Abstract
Background
Participatory design approaches can improve successful selection and tailoring of implementation strategies by centering the voices of key constituents. To reduce incidence of the human immunodeficiency virus (HIV) in the USA, co-design of implementation strategies is needed for long-acting injectable cabotegravir (CAB-LA), a new form of HIV pre-exposure prophylaxis, among the disproportionately impacted population of sexual minority men (SMM). This manuscript describes the protocol for participatory design approaches (i.e., innovation tournament and implementation mapping) to inform implementation of CAB-LA among SMM (≥ 12 years), particularly Black and Latino populations, in Chicago.

Methods
This research incorporates innovative methods to accomplish two objectives: (1) to crowdsource ideas for the design of implementation strategies for CAB-LA through a virtual innovation tournament and (2) to leverage the ideas from the innovation tournament to operationalize implementation strategies for CAB-LA thorough the systematic process of implementation mapping. A committee of constituents with diverse expertise and perspectives (e.g., SMM, implementation scientists, HIV clinicians, public health leadership, and community partners) will provide input throughout the design process.

Discussion
This research will produce a menu of co-designed implementation strategies, which can guide plans for CAB-LA integration in Chicago and provide insights for other EHE regions. Further, as the first innovation tournament focused on HIV prevention, this research can provide a framework for participatory approaches across the care continuum. Given that the co-design of implementation strategies often does not involve the participation of individuals with lived experiences, this work will center the voices of those who will benefit most.
Narrative review of the role of intravenous fluid in critically sick patients
Authors: Stoltzfus Mason , Kohli Aditya , Shah Priyanshi , Anamika Fnu , Kanagala Sai Gautham , Gupta Vasu , Patel Meet A. , Jain Rohit 
Published: March 2024

Abstract
Background
Intravenous fluid administration is regarded as a universal therapy in critical care. It is the mainstay of treatment in patients with dehydration, blood loss, sepsis, electrolyte imbalance, and shock. Crystalloids (for example, normal saline, lactated Ringer’s, Hartmann’s, Normosol, Isolyte, and PlasmaLyte solutions) and colloids (for example, albumin, or synthetic dextrans, gelatins, and starches) are the two types of commonly used IV fluids.

Main text
Resuscitation, replacement, and maintenance are the three main indications for intravenous fluid administration. Despite their widespread use, there is no standard therapeutic dose for IV fluids and clinicians are less familiar with the indications to stop IV fluid administration. Appropriate fluid management to maintain tissue perfusion while avoiding potentially harmful effects of IV fluid administration such as fluid overloading, metabolic acidosis, acute kidney injury, and electrolyte imbalance should be the core principle of treatment.

Conclusion
This review will focus on the role of different types of intravenous fluid in critically ill patients, including their side effects and applications in various types of shock.