bluuebunny/crossref_metadata_2025_split huggingface dataset:
Auto-segmentation of neck nodal metastases using self-distilled masked image transformer on longitudinal MR images
Authors: Paudyal Ramesh , Jiang Jue , Han James , Diplas Bill H , Riaz Nadeem , Hatzoglou Vaios , Lee Nancy , Deasy Joseph O , Veeraraghavan Harini , Shukla-Dave Amita 
Published: March 2024

Abstract

Objectives
Auto-segmentation promises greater speed and lower inter-reader variability than manual segmentations in radiation oncology clinical practice. This study aims to implement and evaluate the accuracy of the auto-segmentation algorithm, “Masked Image modeling using the vision Transformers (SMIT),” for neck nodal metastases on longitudinal T2-weighted (T2w) MR images in oropharyngeal squamous cell carcinoma (OPSCC) patients.

Methods
This prospective clinical trial study included 123 human papillomaviruses (HPV-positive [+]) related OSPCC patients who received concurrent chemoradiotherapy. T2w MR images were acquired on 3 T at pre-treatment (Tx), week 0, and intra-Tx weeks (1-3). Manual delineations of metastatic neck nodes from 123 OPSCC patients were used for the SMIT auto-segmentation, and total tumor volumes were calculated. Standard statistical analyses compared contour volumes from SMIT vs manual segmentation (Wilcoxon signed-rank test [WSRT]), and Spearman’s rank correlation coefficients (ρ) were computed. Segmentation accuracy was evaluated on the test data set using the dice similarity coefficient (DSC) metric value. P-values &lt;0.05 were considered significant.

Results
No significant difference in manual and SMIT delineated tumor volume at pre-Tx (8.68 ± 7.15 vs 8.38 ± 7.01 cm3, P = 0.26 [WSRT]), and the Bland-Altman method established the limits of agreement as –1.71 to 2.31 cm3, with a mean difference of 0.30 cm3. SMIT model and manually delineated tumor volume estimates were highly correlated (ρ = 0.84-0.96, P &lt; 0.001). The mean DSC metric values were 0.86, 0.85, 0.77, and 0.79 at the pre-Tx and intra-Tx weeks (1-3), respectively.

Conclusions
The SMIT algorithm provides sufficient segmentation accuracy for oncological applications in HPV+ OPSCC.

Advances in knowledge
First evaluation of auto-segmentation with SMIT using longitudinal T2w MRI in HPV+ OPSCC.
Interspecific insect relationships on Terminalia argentea (Myrtales: Combretaceae) trees in the Cerrado biome
Authors: Leite Germano Leão Demolin , Teixeira David Lopes , Silva Carlos Alberto Domingues da , Lemes Pedro Guilherme , Tavares Wagner de Souza , Serrão José Eduardo , Zanuncio José Cola , Zanetti Ronald 
Published: March 2024

Abstract
Terminalia argentea Mart. (Combretaceae), native to Brazil, is used in habitat restoration programs. Arthropods are bioindicators because their populations reflect changes in the environment. We evaluated the recovery of a degraded area by using ecological indices and analyzing arthropod interactions on T. argentea plants. The richness and diversity of sap-sucking Hemiptera and the abundance of tending ants and Sternorrhyncha predators increased with the number of T. argentea leaves. The correlation of the abundance of tending ants and Sternorrhyncha predators was positive with that of the sap-sucking Hemiptera, and the abundance of Sternorrhyncha predators was negative with that of tending ants and sap-sucking Hemiptera. The positive correlation between the abundance, richness, and diversity of insect groups and numbers of T. argentea leaves is an example of the bottom-up regulation mechanism, with the population dynamics of the lower trophic levels dictating those of higher trophic levels. The contribution of T. argentea, a host plant of many arthropods, to the recovery of ecological relationships between organisms in degraded ecosystems is important.
The genomic signatures of evolutionary stasis
Authors: Brownstein Chase D , MacGuigan Daniel J , Kim Daemin , Orr Oliver , Yang Liandong , David Solomon R , Kreiser Brian , Near Thomas J 
Published: March 2024

Abstract
Evolutionary stasis characterizes lineages that seldom speciate and show little phenotypic change over long stretches of geological time. Although lineages that appear to exhibit evolutionary stasis are often called living fossils, no single mechanism is thought to be responsible for their slow rates of morphological evolution and low species diversity. Some analyses of molecular evolutionary rates in a handful of living fossil lineages have indicated that these clades exhibit slow rates of genomic change. Here, we investigate mechanisms of evolutionary stasis using a dataset of 1,105 exons for 481 vertebrate species. We demonstrate that two ancient clades of ray-finned fishes classically called living fossils, gars and sturgeons, exhibit the lowest rates of molecular substitution in protein-coding genes among all jawed vertebrates. Comparably low rates of evolution are observed at fourfold degenerate sites in gars and sturgeons, implying a mechanism of stasis decoupled from selection that we speculate is linked to a highly effective DNA repair apparatus. We show that two gar species last sharing common ancestry over 100 million years ago produce morphologically intermediate and fertile hybrids in the wild. This makes gars the oldest naturally hybridizing divergence among eukaryotes and supports a theoretical prediction that slow rates of nucleotide substitution across the genome slow the accumulation of genetic incompatibilities, enabling hybridization across deeply divergent lineages and slowing the rate of speciation over geological timescales. Our results help establish molecular stasis as a barrier to speciation and phenotypic innovation and provide a mechanism to explain the low species diversity in living fossil lineages.
Surviving the serenade: how conflicting selection pressures shape the early stages of sexual signal diversification
Authors: Gallagher James H , Broder E Dale , Wikle Aaron W , O’Toole Hannah , Durso Catherine , Tinghitella Robin M 
Published: March 2024

Abstract
Understanding how the early stages of sexual signal diversification proceed is critically important because these microevolutionary dynamics directly shape species trajectories and impact macroevolutionary patterns. Unfortunately, studying this is challenging because signals involve complex interactions between behavior, morphology, and physiology, much of which can only be measured in real-time. In Hawaii, male Pacific field cricket song attracts both females and a deadly parasitoid fly. Over the past two decades, there has been a marked increase in signal variation in Hawaiian populations of these crickets, including novel male morphs with distinct mating songs. We capitalize on this rare opportunity to track changes in morph composition over time in a population with three novel morphs, investigating how mate and parasitoid attraction (components of sexual and natural selection) may shape signal evolution. We find dramatic fluctuation in morph proportions over the three years of the study, including the arrival and rapid increase of one novel morph. Natural and sexual selection pressures act differently among morphs, with some more attractive to mates and others more protected from parasitism. Collectively, our results suggest that differential protection from parasitism among morphs, rather than mate attraction, aligns with recent patterns of phenotypic change in the wild.
Predictors of Urinary and Fecal Incontinence in Prefrail and Frail Older Adults: A Cross-Sectional Study of the FRAGSALUD Project
Authors: Corral-Pérez Juan , Ávila-Cabeza-de-Vaca Laura , Valero-Cantero Inmaculada , González-Mariscal Andrea , Ponce-Gonzalez Jesus G , Vázquez-Sánchez María Ángeles , Casals Cristina 
Published: March 2024

Abstract

Background
Frailty is associated with urinary and fecal incontinence, which are common geriatric syndromes. This study aims to identify health factors associated with incontinence in prefrail or frail older adults living in the community.

Methods
This multicenter cross-sectional study included 225 older adults (75.0 ± 6.4 years) with prefrailty or frailty based on the 5-component Fried phenotype. Physical function was assessed using the Short Physical Performance Battery (SPPB). Physical activity, inactivity, and sleep were estimated using a wrist-worn accelerometer. Urinary or fecal incontinence was registered using the Barthel scale (urine and bowel items). Multivariable logistic regression analyses, with age as a covariate, were conducted to identify associations of incontinence.

Results
In our participants, 27% presented urinary or fecal incontinence with no sex differences (p = .266). Our results showed that age, daily medication count, and number of falls in the previous year independently predicted incontinence in frail and prefrail older adults (p &lt; .05). Some Fried’s criteria, including self-reported exhaustion, gait speed, and handgrip strength, were associated with the presence of incontinence (p &lt; .05), but not Fried’s classification. The SPPB total score and its isolated variables were significantly associated with the urinary and fecal incontinence (p &lt; .05). However, none of the accelerometer outcomes showed significant associations with incontinence status.

Conclusions
According to this study, age, number of medications, and falls (but not sex) are linked to urinary and fecal incontinence in frail or prefrail older adults living in the community, recommending the assessment of physical function using the SPPB rather than estimating daily physical activity, inactivity, or sleep.
The Ukraine War and nuclear sharing in NATO
Authors: von Hlatky Stéfanie , Lambert-Deslandes Émile 
Published: March 2024

Abstract
Russian nuclear sabre-rattling following the 2022 invasion of Ukraine has reinvigorated debates over NATO deterrence. One of its key components—nuclear sharing—has been in place since September 1954, but support for it within the alliance has varied over time. Indeed, although Belgium, Germany, Italy, the Netherlands and Turkey host American gravity bombs on their territory, there were fears during the 2010s that some of them would follow Canada, Greece and the United Kingdom's example and withdraw from the scheme. By examining why and how NATO's nuclear-sharing arrangements have changed since inception, we argue that they consistently serve deterrence, signalling, alliance cohesion and burden-sharing goals, which make them hard to dismantle. However, we also demonstrate, through our survey of post-Cold War policies, official statements and public debates, that there is more room in a low threat environment for political contestation within host states. Accordingly, nuclear sharing requires a high threat environment to escape domestic opposition, which effectively returned in 2022, cementing the nuclear status quo.
Injury Pattern Analysis to Optimize Burn Injury Prevention in the Unhoused Community
Authors: Ross Erin E , Speiser Noah , Donohue Sean , Yenikomshian Haig A 
Published: March 2024

Abstract
Unhoused patients are an overrepresented group in burn injury, and are a uniquely vulnerable population. Current research focuses on the consequences of homelessness on burn outcomes, with little known about the specific circumstances and behaviors leading to burn injury that may represent specific targets for injury prevention efforts. The burn registry at an urban regional burn center was queried for burn admissions in unhoused adults from 2019 to 2022. Registry data pulled included demographics, urine toxicology, mechanism of injury, and injury subjective history. Subjective injury history was reviewed to determine more specific injury circumstances and activities during which accidental burns occurred. Demographic and mechanistic trends in burn admissions were explored via descriptive statistics. Among 254 admissions for burns from the unhoused community, 58.1% of patients were positive for stimulants on admission. Among accidental injuries (69.7%), common circumstances included preparing food or beverages, cooking or using methamphetamine, smoking cannabis or tobacco, bonfires, and candles. A specific common circumstance was lighting a cigarette while handling accelerants (6.7%). Interventions for stimulant abuse, as well as outreach efforts to educate unhoused patients about situational awareness, safe handling of accelerants, safe smoking practices, and safe cooking practices, may be effective tools in reducing burn admissions in this vulnerable population.
Diel flight activity in response to attractants in the predatory beetle, Cathartus quadricollis (Coleoptera: Silvanidae) in macadamia nut in Hawaii
Authors: Acebes-Doria Angelita , Hamilton Lindsey J , Follett Peter A 
Published: March 2024

Abstract
The diel flight activity in Cathartus quadricollis (Guerin-Meneville) (Coleoptera: Silvanidae), a predator of two important pests in Hawaii, coffee berry borer, Hypothenemus hampei (Ferrari) and tropical nut borer, Hypothenemus obscurus (F.) (Coleoptera: Curculionidae: Scolytinae) was studied in a macadamia nut orchard using yellow sticky traps baited with pheromone and fungal volatile attractants. The study was conducted at different months throughout the year and at different times during the lunar cycle (new moon and full moon). Flight activity peaked in the late hours of the photophase into the early hours of the scotophase, between 1830 and 2000 h; flight activity also occurred but to a lesser extent in the early morning hours between 0700 and 1030 h. Numbers of captured C. quadricollis during periods of flight activity were negatively correlated with wind speed. The implications of these findings for the development of optimal pest management strategies including biological control are discussed.
A-Bomb for the People? When Leaders Cue the Public in Nuclear Decision-Making
Authors: Gibbons Rebecca Davis , Petrovics Ariel 
Published: March 2024

Abstract
In building indigenous nuclear weapon programs, leaders have incentives to keep their plans secret, and several have. Domestic populations may limit the flexibility of the program, and international scrutiny could lead to sanctions or even military strikes. And yet, many leaders have cued the public to their nuclear ambitions. Why do leaders cue these audiences to their nuclear intentions when doing so could lead to both internal and external constraints from public awareness and foreign pressure? Using qualitative evidence from past cases of elite cueing, this article offers a theoretical examination of why some leaders choose to involve the public despite—or sometimes because of—the constraints that attention can impose. We describe six types of cueing logics based on the level of development of the nuclear program and the intended audience. Understanding the rationales behind such cues is not just of historical significance; these cues remain relevant as several states continue to pursue nuclear technologies—capabilities that can be used for peaceful purposes or repurposed for nuclear weapons. In other words, nuclear cueing is an important and overlooked aspect of research on nuclear proliferation.
How proton therapy fits into the management of adult intracranial tumors
Authors: Kotecha Rupesh , La Rosa Alonso , Mehta Minesh P 
Published: March 2024

Abstract
Intracranial tumors include a challenging array of primary and secondary parenchymal and extra-axial tumors which cause neurologic morbidity consequential to location, disease extent, and proximity to critical neurologic structures. Radiotherapy can be used in the definitive, adjuvant, or salvage setting either with curative or palliative intent. Proton therapy (PT) is a promising advance due to dosimetric advantages compared to conventional photon radiotherapy with regards to normal tissue sparing, as well as distinct physical properties, which yield radiobiologic benefits. In this review, the principles of efficacy and safety of PT for a variety of intracranial tumors are discussed, drawing upon case series, retrospective and prospective cohort studies, and randomized clinical trials. This manuscript explores the potential advantages of PT, including reduced acute and late treatment-related side effects and improved quality of life. The objective is to provide a comprehensive review of the current evidence and clinical outcomes of PT. Given the lack of consensus and directives for its utilization in patients with intracranial tumors, we aim to provide a guide for its judicious use in clinical practice.
Evolving concepts in margin strategies and adaptive radiotherapy for glioblastoma: A new future is on the horizon
Authors: Tseng Chia-Lin , Zeng K Liang , Mellon Eric A , Soltys Scott G , Ruschin Mark , Lau Angus Z , Lutsik Natalia S , Chan Rachel W , Detsky Jay , Stewart James , Maralani Pejman J , Sahgal Arjun 
Published: March 2024

Abstract
Chemoradiotherapy is the standard treatment after maximal safe resection for glioblastoma (GBM). Despite advances in molecular profiling, surgical techniques, and neuro-imaging, there have been no major breakthroughs in radiotherapy (RT) volumes in decades. Although the majority of recurrences occur within the original gross tumor volume (GTV), treatment of a clinical target volume (CTV) ranging from 1.5 to 3.0 cm beyond the GTV remains the standard of care. Over the past 15 years, the incorporation of standard and functional MRI sequences into the treatment workflow has become a routine practice with increasing adoption of MR simulators, and new integrated MR-Linac technologies allowing for daily pre-, intra- and post-treatment MR imaging. There is now unprecedented ability to understand the tumor dynamics and biology of GBM during RT, and safe CTV margin reduction is being investigated with the goal of improving the therapeutic ratio. The purpose of this review is to discuss margin strategies and the potential for adaptive RT for GBM, with a focus on the challenges and opportunities associated with both online and offline adaptive workflows. Lastly, opportunities to biologically guide adaptive RT using non-invasive imaging biomarkers and the potential to define appropriate volumes for dose modification will be discussed.
A Lesbian's Miscarriage
Authors: Chinloy Soraya 
Published: March 2024

ABSTRACT:
In my experience of caring for a lesbian couple suffering a miscarriage, I disengaged my bias about their sexual orientation and compassionately cared for their needs. After praying with the couple, I felt a deep connection with them and a palpable peace. Joy shone on their faces and they verbally expressed gratitude. God used me as a caring presence. Christian nurses are vessels for God's love to bring peace and healing.
Tailoring African American Faith Community-Based Diabetes Self-Management Education
Authors: Weeks Christine E. , Waldrop Julee , Jessup Ann 
Published: March 2024

ABSTRACT:
African Americans (AA) experience a disparate effect of type II diabetes (T2D). For this nurse-led pilot study, a pre-validated 6-week diabetes self-management education (DSME) program was implemented in a faith community setting and tailored to the participants' faith and culture by using short scriptural lessons, prayers, and individual sharing. Participants demonstrated improvements in fasting blood glucose (p = .042), diabetes knowledge (p = .002), and psychosocial self-efficacy (p = .001). Although generalizability of findings is limited, the structure and methods used in tailoring this DSME program could be transferable to other faith-based settings.
Christian Ethical Foundations of Modern Nursing in China
Authors: Chou Chuan Chiang , Wang Shu-Yi 
Published: March 2024

ABSTRACT:
The influence of Western Christian missionary nurses has been recorded in the history and development of nursing in China. The purpose of this study was to investigate the influence of Christianity on Chinese nursing ethics. This documentary research used content analysis to investigate Christian value trends over 13 years (1920-1932) as reflected in a major bilingual Chinese nursing journal.
Steroid responsiveness in alcohol-associated hepatitis is linked to glucocorticoid metabolism, mitochondrial repair, and heat shock proteins
Authors: Hardesty Josiah , Hawthorne Meghan , Day Le , Warner Jeffrey , Warner Dennis , Gritsenko Marina , Asghar Aliya , Stolz Andrew , Morgan Timothy , McClain Craig , Jacobs Jon , Kirpich Irina A. 
Published: March 2024

Background:
Alcohol-associated hepatitis (AH) is one of the clinical presentations of alcohol-associated liver disease. AH has poor prognosis, and corticosteroids remain the mainstay of drug therapy. However, ~40% of patients do not respond to this treatment, and the mechanisms underlying the altered response to corticosteroids are not understood. The current study aimed to identify changes in hepatic protein expression associated with responsiveness to corticosteroids and prognosis in patients with AH.

Methods:
Patients with AH were enrolled based on the National Institute on Alcohol Abuse and Alcoholism inclusion criteria for acute AH and further confirmed by a diagnostic liver biopsy. Proteomic analysis was conducted on liver samples acquired from patients with AH grouped as nonresponders (AH-NR, n = 7) and responders (AH-R, n = 14) to corticosteroids, and nonalcohol-associated liver disease controls (n = 10). The definition of responders was based on the clinical prognostic model, the Lille Score, where a score < 0.45 classified patients as AH-R and a score > 0.45 as AH-NR. Primary outcomes used to assess steroid response were Lille Score (eg, improved liver function) and survival at 24 weeks.

Results:
Reduced levels of the glucocorticoid receptor and its transcriptional co-activator, glucocorticoid modulatory element-binding protein 2, were observed in the hepatic proteome of AH-NR versus AH-R. The corticosteroid metabolizing enzyme, 11-beta-hydroxysteroid dehydrogenase 1, was increased in AH-NR versus AH-R along with elevated mitochondrial DNA repair enzymes, while several proteins of the heat shock pathway were reduced. Analysis of differentially expressed proteins in AH-NR who survived 24 weeks relative to AH-NR nonsurvivors revealed several protein expression changes, including increased levels of acute phase proteins, elevated coagulation factors, and reduced mast cell markers.

Conclusions:
This study identified hepatic proteomic changes that may predict responsiveness to corticosteroids and mortality in patients with AH.
Congenital Generalized Lipodystrophy in a Division 1 Female Sprinter
Authors: Schleich Kevin T. , Novakofski Kira D. , Thomsen Timothy W. , Woodroffe Lisa , Slayman Tyler G. 
Published: March 2024

Abstract:
A 21-year-old African American Division 1 female sprinter presented with 3-weeks history of right great toe and forefoot pain, fatigue, and a 30-day continuous menstrual cycle despite implanted etonogestrel (Nexplanon) inserted 3 years prior. An magnetic resonance imagine (MRI) identified likely stress fracture of the second metatarsal base with a diffusely low T1 signal indicating hyperactive red marrow. Due to persistent pain, a follow-up MRI was ordered 6 months later and indicated serous atrophy of the bone marrow, prompting a further metabolic workup notable for triglycerides exceeding 4000 mg/dL and a hemoglobin A1c of 10.9%. This case highlights the manifestation of a rare congenital lipodystrophy that initially presented as a relatively classic stress fracture and metrorrhagia in a female athlete.