bluuebunny/crossref_metadata_2025_split huggingface dataset:
Annotation-efficient deep learning for breast cancer whole-slide image classification using Tumor Infiltrating Lymphocytes and slide-level labels
Authors: Perera Rashindrie , Savas Peter , Senanayake Damith , Salgado Roberto , Joensuu Heikki , O’Toole Sandra , Li Jason , Loi Sherene , Halgamuge Saman 
Published: December 2023

Abstract
Tumor-Infiltrating Lymphocytes (TILs) play a crucial role in the immune response against cancer cells. The existing deep learning methods for TIL analysis in whole-slide images (WSIs) require extensive annotations at the sub-image (patch) level, which often require time-consuming and labor-intensive specialist input. To address this, we propose a first-of-its-kind framework named annotation-efficient segmentation and attention-based classifier (ANSAC). ANSAC requires only slide-level labels to classify WSIs as having high vs. low TIL scores, with the binary classes divided by an expert-defined threshold. ANSAC automatically segments tumor and stroma regions relevant to TIL assessment, eliminating the need for extensive manual annotations. Additionally, it uses an attention model to generate an attention map that highlights the most pertinent regions in the WSI for the classification task. We evaluate ANSAC on four breast cancer WSI datasets and show significant improvements over three baseline methods in identifying TIL-relevant regions and up to 8% classification improvement on a held-out test dataset. Additionally, we propose a modification to the pre-processing step of a well-known method, enhancing its performance up to 6%.
Tear Fluid Cytokine Analysis: A Non-Invasive Approach for Assessing Retinopathy of Prematurity Severity
Authors: Baba Takashi , Uotani Ryu , Inata Kodai , Sasaki Shin-ichi , Shimizu Yumiko , Miura Mazumi , Inoue Yoshitsugu , Miyazaki Dai 
Published: December 2023

Abstract
Purpose: To determine whether there is a significant association between the inflammatory cytokines in the tear fluid and the severity of the Retinopathy of Prematurity Severity (ROP).
Study Design: Retrospective cohort study.
Methods: The cytokine levels in tear fluids were determined in 34 eyes with ROP and 18 eyes without ROP. There were 15 eyes with severe ROP requiring treatment and 19 eyes with mild ROP not requiring treatment. For severe ROP eyes, tear fluids were collected before treatment.
Results: Significantly higher levels of CCL2 and VEGF were detected in eyes with severe ROP compared to eyes with mild ROP and no ROP. When assessed for cytokine levels that discriminate each disease group, CCL2 showed a significant odds ratio of 1.76 for severity change (/quintile, P = 0.032, after adjusting for birth weight). Correlation analysis showed that birth weight correlated with IL-1α levels, and decreased weight gain increased IFN-γ levels. We next determined tear fluid cytokines which discriminate severe ROP using receiver operating characteristics analysis. We show combination of higher CCL2 levels, higher VEGF levels, and lower IFN-γ levels in the tear fluid had a stronger predictive value for the severe ROP (area under curve, 0.85).
Conclusion: The levels of CCL2, VEGF, and IFN-γ in tear fluid may serve as useful biomarkers for assessing the severity of ROP.
Generalized Eruption Forecasting Models using Machine Learning Trained on Seismic Data from 24 Volcanoes
Authors: Ardid Alberto , Dempsey David , Caudron Corentin , Cronin Shane , Kennedy Ben , Girona Társilo , Potter Sally , Lamb Oliver , Miller Craig , Cabrera Leoncio , Ruiz Sergio , Pacheco Javier , Mora Mauricio , Maranto Anto , Sabuncu Yesim Cubuk , De Angelis Silvio , Roman Diana 
Published: December 2023

Abstract

Seismic data collected before volcanic eruptions holds important clues for forecasting future eruptions. However, many volcanoes have short monitoring histories or have infrequent eruptions. Here, we aim to enhance volcanic eruption forecasting through machine learning, tackling challenges in generalizing eruption precursors across diverse volcanoes, including those with limited seismic data. Additionally, we investigate similarities and differences in pre-eruptive seismic activity. We combine records from 24 volcanoes to train machine learning (ML) models that recognize eruption precursors and tested the accuracy by forecasting on volcanoes whose data had been withheld during training. These forecasts had nearly the same accuracy as other models that were given the advantage of training on past eruptions at the target volcano. We find that numerous eruption precursors are applicable across various volcanoes, challenging the notion that volcanoes exhibit individualistic behaviour. The accuracy of the ML models is about 50 to 70% higher than traditional methods based on averaged seismic amplitude. Our ML models should be a tool for volcano observatories to provide timely probabilistic forecasts suitable to address volcanic risk, especially where prior eruption data is limited. This methodology and workflow can be applied to other hazard types that suffer from regional data-scarcity, e.g., wildfires and floods.
Gender differences in the proportion of Japanese parents meeting recommendations within 24- hour movement guidelines and associations with weight status
Authors: Tanaka Chiaki , Tremblay Mark S. , Tanaka Shigeho 
Published: December 2023

Abstract

Background
Canadian 24-h movement guidelines were developed to improve health of adults. Parents’ healthy behaviours are especially important because they are also role models for their children. The purpose of this study was to evaluate adherence to the three recommendations associated with health in the Canadian 24-h movement guidelines and their relationship with weight status (underweight or obesity) in Japanese parents.
Methods
This cross-sectional study included 425 mothers and 237 fathers who had children < 13 years of age. Weight status according to measured body mass index (BMI) was classified by < 18.5 kg/m2 and ≥ 25 kg/m2 as the cut-off for underweight and obesity, respectively. Meeting the 24-h movement guidelines was defined as: ≥150 min/week of moderate-to-vigorous physical activity (MVPA) (Canadian PA recommendation) or at least 60 min/day of MVPA (Japanese PA recommendation), ≤ 8 h/day of sedentary time which includes ≤ 3 hours of recreational screen time, and 7 to 9 h/night of sleep. MVPA and sedentary time were accelerometer-determined while and screen time and sleep duration were self-reported.
Results
The prevalence of mothers meeting all three recommendations was 30.6% using Canadian physical activity guidelines and 20.7% using Japanese physical activity guidelines, while that of fathers was 10.6% and 8.0%, respectively. Mothers not meeting the sedentary behaviour recommendation had a lower odds ratio and those not meeting Japanese PA recommendations had a higher odds ratio for underweight compared to mothers meeting the recommendations, adjusted for age and area socioeconomic status.
Conclusions
The screen time recommendation or Japanese PA recommendation were associated with underweight in mothers. None of the recommendations was associated with weight status in fathers. Further research is needed to understand the relationships among movement behaviours and weight status, particularly among Japanese women, whose routine behaviours may be misclassified as sedentary.
Period-doubling cascade route to chaos in an initially curved microbeam resonator exposed to fringing-field electrostatic actuation
Authors: Rashidi Zahra , Azizi Saber , Rahmani Omid 
Published: December 2023

Abstract

This paper explores the nonlinear dynamics of a piezoelectrically laminated microbeam resonator with an initial curvature, which is subjected to electrostatic actuation caused by fringing fields. The resonator is fully clamped at both of its ends and is coated with two piezoelectric layers, encompassing both the top and bottom surfaces. The fringing field electrostatic force is assessed through finite element modeling, and the resulting data is accurately fitted to a suitable hyperbolic function. The nonlinear motion equation accounts for the geometric nonlinearity and the nonlinear electrostatic force. The motion equation is discretized using Galerkin method and the reduced order system is numerically integrated over the time for the time response. The variation of the first three natural frequencies with respect to the applied electrostatic voltage is determined and the frequency response curve is determined. The bifurcation points have been examined and their types have been clarified based on the loci of the Floquet exponents on the complex plane. The period -doubled branches of the frequency response curves originating from the period doubling (PD) bifurcation points are stablished. It's demonstrated that the succession PD cascades leads to chaotic behavior. The chaotic behavior is identified qualitatively by constructing the corresponding Poincaré section and analyzing the response's associated frequency components. The chaotic response is regularized by applying an appropriate piezoelectric voltage which shifts the frequency response curve along the frequency axis.
Detection of hidden antibiotic resistance through real-time genomics
Authors: Urban Lara , Sauerborn Ela , Corredor Carolina , Reska Tim , Perlas Albert , Atum Samir Vargas da Fonseca , Goldman Nick , Wantia Nina , Costa Clarissa Prazeres da , Foster-Nyarko Ebenezer 
Published: December 2023

Abstract

Real-time genomics through nanopore sequencing holds the promise of fast antibiotic resistance prediction, but concerns remain about its accuracy. We here show that real-time genomics has the potential to improve clinical practice based on a multi-drug resistant Klebsiella pneumoniae bloodstream infection. In contrast to established diagnostics, real-time genomics can accurately identify complex antibiotic resistance patterns conferred through newly discovered low-abundance resistance genes, potentially significantly impacting clinical decision-making and patient outcome.
Workforce Estimate to Treat Mental Disorders in the Kingdom of Saudi Arabia
Authors: Lee Eileen , Bruckner Tim A. , Alluhidan Mohammad , Alamri Adwa , Alhabeeb Abdulhameed , Nakshabandi Ziad , Alqahtani Mohammed M.J. , Herbst Christopher , Hamza Mariam M. , Alazemi Nahar 
Published: December 2023

Abstract

Background: Mental, neurological, and substance abuse (MNS) disorders describe a range of conditions that affect the brain and cause distress or functional impairment. In the Middle East and North Africa (MENA), MNS disorders make up 10.88 percent of the burden of disease as measured in disability-adjusted life years. The Kingdom of Saudi Arabia (KSA) is one of the main providers of mental health services and one of the largest contributors to mental health research in the region. Within the past decade, mental health resources and services has increased.
Methods: We employ a needs-based workforce estimate to arrive at the total number of psychiatrists, nurses, and psychosocial care providers needed to meet the epidemiological need of mental health conditions of the population of KSA. Estimates for a potential mental health workforce gap were calculated using five steps: Step 1– Quantify target population for priority mental health conditions. Step 2 – Identify number of expected cases per year. Step 3 – Set target service coverage for each condition. Step 4 – Estimate cost-effective health care service resource utilization for each condition. Step 5 – Estimate service resources needed for each condition.
Results: There is an epidemiologic need for a total of 17,128 full-time-equivalent (FTE) health care providers to treat priority MNS disorders. KSA appears to have a need-based shortage of 10,402 health workers to treat mental disorders. A total of 114 psychiatrists, 5,729 nurses, and 4,559 psychosocial care providers would be additionally needed (that is, above and beyond current levels) to address the priority mental health conditions. The shortfall is particularly severe for nurses and psychosocial workers who make up 98.9 percent of the shortfall. This shortage is substantial when compared to other high-income countries. Overall, the workforce needed to treat MNS conditions translates to 49.2 health workers per 100,000 population.
Conclusion: Challenges to addressing the shortfall are Saudi specific which includes awareness of cultural customs and norms in the medical setting. These requisites are compounded by the lack of Saudi nationals in the mental health workforce. Saudis make up 29.5 percent of the physician workforce and 38.8 percent of the nursing workforce which means that foreign-trained staff must supplement the shortfall and be mindful of Saudi specific cultural considerations. Potential solutions to reducing the shortfall of mental health care workers includes nurse task shifting and training of general practitioners to screen for, and treat, a subset of MNS disorders.
Data Generation Using Generative Adversarial Network with Twin Normalization
Authors: Mao Xiuqing , Sun Lei , Kong Zhiyin , Zhao Min 
Published: December 2023

Abstract
Traditional generative adversarial networks require a large number of samples during training. When generating high-resolution images, it may suffer to mode collapse, resulting in lower quality outputs. This paper proposes a generative adversarial network data generation method (Twin-Norm-GAN) based on twin normalization, which is expected to relief the problem of mode collapse when generating high-resolution images with few samples. The method first normalizes the gradient of the discriminator, that is, imposes gradient norm constraints, which further prevents the phenomenon of mode collapse; then adds a normalized attention module to the generator and discriminator to suppress less significant weights, a weight sparsity penalty is applied to the attention module, which improves the quality of the generated images. Experiments are conducted using standard datasets such as FFHQ, Panda, and art paintings, and compared with the current state-of-the-art GAN model (FastGAN) for generating high-fidelity images with few samples through qualitative and IS, FID quantitative evaluation methods, the experiments show that compared with the contrast model, this method can generate higher quality images. And the classification experiments prove that the data generated by this method are available for the training of downstream task models.
Overt visual attention in the formation of preference between lottery options
Authors: Fan Xinhao , Elsey Jacob , Wyngaard Aurelien , Sampson Aaron , Yang Youping , Emeric Erik , Glickman Moshe , Usher Marius , Levy Dino , Stuphorn Veit , Niebur Ernst 
Published: December 2023

Abstract

Models of multi-attribute decision making vary on whether all or only part of the information available is being processed, as well as on whether preference formation is based on within-option or within-attribute processing. Here we carry out a combined empirical and computational study in which we rely on lottery-options with varying task complexities. We monitor eye-gaze during the decision formation to determine which decision-relevant information participants attend, and when. We then compare a large set of models, of different levels of complexity in their ability to account for the choices made by individual participants, and we find that two models outperform all others. The first is the two-layer 1 leaky-competing accumulator based on Prospect Theory (LCA-PT), which predicts human choices on simple tasks better than any other model. For complex tasks a new model based on older work in operations research performs best in the complex task, with both its performance as well as that of the second-ranked LCA-PT model significantly exceeding that of all other models. Both of these models use the sequence of observed eye movements for each participant to capture the allocation of attention to specific options and attributes during the decision process, but make different assumptions about the effect of attention on decision making. Our results suggest that, when faced with complex choice problems, people form preferences primarily based on attention-guided pairwise, within-attribute value-comparisons.
Attitude Towards Health Technology And Skills Required For Health Technology Developers: A Qualitative Study
Authors: Phaisawang Sranya , Nakorn Thanyaphong Na , Trivijitsilp Prasert , Srikiatkhach Anan 
Published: December 2023

Abstract

BACKGROUND
Throughout history, medical education has developed in response to societal changes and advances in biological research and technology. Health technology, encompassing devices, medicines, vaccines, and digital health systems, is transforming healthcare with increased effectiveness and efficiency. Thailand, a popular medical tourism destination, intends to shift its focus to high-quality healthcare services and advanced technologies for long-term economic sustainability. This study examines attitudes towards health technology and identifies necessary skills for health technology developers to help create an ecosystem for technology-driven healthcare and prepare human capital in the field.
METHODS
In-depth interviews with diverse stakeholders in the health and health technology industries were conducted for this qualitative study to investigate the role of health technology in future healthcare and the skills required for health technology developers. Qualitative Content Analysis was carried out, and participants included national health policy makers, university presidents, hospital directors, and health technology company administrators. The study utilized the electronic Delphi method for ranking skills through multiple interview rounds, ensuring thorough evaluation of significant topics.
RESULTS
This study involved interviews with sixteen stakeholders in health technology, focusing on its importance and impact on future healthcare. Participants discussed three major areas of technology: molecular technologies, biomedical engineering technologies, and health information technologies. Delocalization, personalization, and digitalization are key components of healthcare transformation. The challenges and skills needed for health technology developers were categorized into four domains including, Health Science, Health Technology, Product Development & Design and Marketing & Entrepreneurship.
CONCLUSION
Our qualitative research revealed the significance of technology in healthcare transformation. We also identified four skill categories that health technology developers must possess. (1) Health Science, (2) Health Technology, (3) Product Development & Design, and (4) Marketing & Entrepreneurship were among these domains. A systematic strategy for developing these skills is a crucial success factor in human capital preparation for future technology-driven healthcare.
Dynamics of HIV PrEP use and coverage during and after COVID-19 in Germany
Authors: Schmidt Daniel , Duport Yannick , Kollan Christian , Marcus Ulrich , Iannuzzi Sara , Kleist Max 
Published: December 2023

Abstract

Background
Pre-exposure prophylaxis (PrEP) with oral emtricitabine/tenofovir disoproxil (FTC/TDF) proved highly efficient in preventing HIV. Since 09/2019, FTC/TDF-PrEP is covered by health insurances in Germany, if prescribed by licensed specialists. However, methods to longitudinally monitor progress in PrEP implementation in Germany are lacking.
Methods
Utilizing anonymous FTC/TDF prescription data from 2017–2021, we developed a mathematical model to disentangle HIV-treatment from PrEP prescriptions, as well as to translate PrEP prescriptions into number of PrEP users. We used the model to estimate past- and future PrEP uptake dynamics, to predict coverage of PrEP needs and to quantify the impact of COVID-19 on PrEP uptake on a national and regional level.
Results
We identified significant (p < 0.01) decelerating effects of the first- and second COVID-19-lockdown on PrEP uptake in 04/2020 and 12/2020. We estimated 26,159 (CI: 25,751 − 26,571) PrEP users by 12/2021, corresponding to 33% PrEP coverage of people in need. We projected 64,794 (CI: 62,956 − 66,557) PrEP users by 12/2030, corresponding to 67% PrEP coverage. We identified profound regional differences, with high PrEP coverage and uptake in metropoles and low coverage in more rural regions.
Conclusions
Our approach presents a comprehensive solution to monitor and forecast PrEP implementation from anonymous data and highlighted that the COVID-19 pandemic significantly decelerated PrEP uptake in Germany. Moreover, slow PrEP uptake in rural areas indicate that structural barriers in PrEP care, education or information exist that may hamper the goal of ending the AIDS epidemic by 2030.
Struggling to Resume Childhood Vaccination During War in Myanmar: Evaluation of a Pilot Program
Authors: Poe April , (none) Emily , (none) Aurora , Aung Hein Tharu , Salreh Alfred , Grissom Brianna , Oo Cynthie Tin , Fishbein Daniel B. 
Published: December 2023

Abstract

Background. After the military coup in Myanmar in February 2021, the health system began to disintegrate when staff who called for the restoration of the democratic government resigned and fled to states controlled by ethnic minorities. The military retaliated by blocking the shipment of humanitarian aid, including vaccines, and attacked the ethnic states. After two years without vaccines for their children, parents urged a nurse-led civil society organization in an ethnic state to find a way to resume vaccination. The nurses developed a vaccination program, which we evaluated.
Methods. A retrospective cohort study and participatory evaluation were conducted. We interviewed the healthcare workers about vaccine acquisition, transportation, and administration and assessed compliance with WHO-recommended practices. We analyzed the participating children’s characteristics. We calculated the proportion of children vaccinated before and after the program. We calculated the probability children would become up-to-date after the program using inverse survival.
Results. Since United Nations agencies could not assist, private donations were raised to purchase, smuggle into Myanmar, and administer five vaccines. Cold chain standards were maintained. Compliance with other WHO-recommended vaccination practices was 74%. Of the 184 participating children, 145 (79%, median age five months [IQR 6.5]) were previously unvaccinated, and 71 (41%) were internally displaced. During five monthly sessions, the probability that age-eligible zero-dose children would receive the recommended number of doses of MMR was 92% (95% confidence interval [CI] 83%-100%), Penta 87% (95% CI 80%-94%); BCG 76% (95% CI 69%-83%); and OPV 68% (95% CI 59%-78%). Migration of internally displaced children and stockouts of vaccines were the primary factors responsible for decreased coverage.
Conclusions. This is the first study to describe the situation, barriers, and outcomes of a childhood vaccination program in one of the many conflict-affected states since the coup in Myanmar. Even though the proportion of previously unvaccinated children was large, the program was successful. While the target population was necessarily small, the program's success led to a donor-funded expansion to 2,000 children. Without renewed efforts, the proportion of unvaccinated children in other parts of Myanmar will approach 100%.