bluuebunny/crossref_metadata_2025_split huggingface dataset:
Oncologic Outcome in Advanced Oral Squamous Cell Carcinoma After Refusal of Recommended Adjuvant Therapy
Authors: Mrosk Friedrich , Doll Christian , Scheer Julia , Neumann Felix , Hofmann Elena , Kreutzer Kilian , Voss Jan , Rubarth Kerstin , Beck Marcus , Heiland Max , Koerdt Steffen 
Published: October 2023

ImportanceClinicians may be confronted with patients refusing recommended adjuvant therapy (AT) after the primary resection of an advanced oral squamous cell carcinoma (OSCC). However, for this tumor entity, data are lacking regarding the oncological outcomes and associated factors after refusal of AT.ObjectiveTo evaluate the difference in survival and disease recurrence for patients with and without recommended AT after resection of advanced OSCC.Design, Setting, and ParticipantsIn this single-center retrospective matched cohort study, patients with advanced OSCC who refused recommended AT between January 2010 and December 2021 were matched 1:1 according to Union for International Cancer Control tumor staging with patients who completed AT.ExposuresPatients with advanced OSCC who refused or completed recommended AT between 2010 and 2021.Main Outcomes and MeasuresThe primary outcome of this study was the comparison of overall survival (OS) and recurrence-free survival (RFS) between the 2 study groups.ResultsA total of 82 patients (mean [SD] age at time of surgery, 68.0 [11.3] years; 38 [46.3%] female, 44 [53.7%] male) with and without AT (41 per study group) were included in the analysis. Patients refusing AT developed more frequent disease recurrence than patients who completed AT (61.0% vs 26.8%; difference, 34.2%; odds ratio, 4.26; 95% CI, 1.68-10.84). In addition, patients who refused AT presented with lower 2-year OS (72.7% vs 88.6%; difference, 15.9%; 95% CI, 8.6%-40.6%) and much lower 2-year RFS (39.1% vs 74.2%; difference, 35.1%; 95% CI, 0.2%-70.5%). In the patient cohort who rejected AT, a worse OS was associated with female sex (48.6% vs 90.5%; difference, 41.9%; 95% CI, 0.6%-84.4%), pT1-2 category (57.1% vs 92.3%; difference, 35.2%; 95% CI, 3.3%-73.6%), and pN1 or higher category (61.2% vs 82.6%; difference, 21.4%; 95% CI, 14.1%-56.8%). Lower RFS was associated with female sex (37.9% vs 90.9%; difference, 53.0%; 95% CI, 8.0%-97.9%), advanced T category (pT3-4, 35.3% vs 80.0%; difference, 44.7%; 95% CI, 6.4%-95.3%), lymph node yield of 20 or greater (31.4% vs 80.6%; difference, 49.2%; 95% CI, 4.9%-93.4%), and lymph node ratio of less than 4.6% (36.6% vs 84.4%; difference, 47.8%; 95% CI, 1.8%-93.1%).Conclusions and RelevanceIn this cohort study of patients with advanced OSCC, refusal of AT was associated with worse oncological outcomes. The prevalence of disease recurrence during follow-up was 34% higher in patients who refused AT than in patients who completed AT. The results from this study may assist clinicians in guiding patients who are considering refusal of or withdrawal from AT.
Risk of Carcinoma in Pleomorphic Adenomas of the Parotid
Authors: Levyn Helena , Subramanian Tejas , Eagan Alana , Katabi Nora , Lin Oscar , Badillo NatalieDeana Dizon , Martinez German , Scholfield Daniel W. , Wong Richard J. , Shah Jatin P. , Givi Babak , Morris Luc G. T. , Ganly Ian , Patel Snehal G. 
Published: October 2023

ImportanceSurgery is the mainstay of treatment for pleomorphic adenomas (PAs) of the parotid to prevent further growth and potential future malignant transformation. While historical case series have reported transformation rates as high as 10%, there is a lack of contemporary methodologically sound data.ObjectiveTo examine the rate of carcinoma ex pleomorphic adenoma (CXPA) detection in untreated PAs and investigate factors associated with malignant neoplasm.Design, Setting, and ParticipantsThis cohort study reviewed all cases of primary PAs managed at a quaternary referral center between December 1990 and January 2015. Patients whose clinical presentation was compatible with a primary benign PA and whose history indicated tumor duration of over 1 year were included. Data were analyzed from January to April 2023.ExposureUntreated PA.Main Outcomes and MeasuresRate of CXPA detection among untreated PAs and association of tumor duration with rates of CXPA detection. Pathology slides of patients who underwent surgery were reviewed by a single expert pathologist for the presence of CXPA. Univariable logistic regression was performed to evaluate possible factors associated with CXPA.ResultsA total of 260 patients (median age, 47 years [IQR, 38-60 years]; 174 [66.9%] female) had a median tumor duration of 3.2 years (range, 1-30 years; mean [SD], 5.7 [5.5] years). Patients were divided into 4 groups by tumor duration: 1 to 4 years (158 [60.7%]), 5 to 9 years (47 [18.1%]), 10 to 14 years (27 [10.4%]), and 15 to 30 years (28 [10.8%]). In 156 of 170 patients who underwent preoperative fine-needle aspiration (91.8%), a benign tumor was diagnosed; 5 of these patients (3.2%; 95% CI, 1.4%-7.3%) were later diagnosed with CXPA on pathology after eventual excision, and the rate of high grade CXPA was 1.3%. None of the patients had permanent facial nerve paralysis. Tumor size at presentation (odds ratio [OR], 1.66; 95% CI, 1.22-2.24) and incremental (per year) increase in age (OR, 1.04; 95% CI, 1.01-1.08) were found to be associated with CXPA, whereas tumor duration was not (OR, 1.00; 95% CI, 1.00-1.01).Conclusions and RelevanceIn this study, the rate of malignant neoplasm detection among initially untreated PA was 3.2%. The results suggest that tumor size and older age are associated with the development of CXPA, while tumor duration is not. Observation of PA for longer periods was not associated with serious permanent complications.
Historical determinants of street connectivity in Japanese cities: Relationship between Japanese castle town formation, war damage, and space syntax integration value
Authors: Watanabe Reo , Hanibuchi Tomoya , Yamamoto Ryoko , Nakaya Tomoki 
Published: October 2023

AbstractAre street networks today dependent on history? This question is significant when considering the determinants of street connectivity and the potential for intervention toward walkable street networks. This study investigates the associations of two historical events—castle town origination and war damage during World War II (WWII)—with the street connectivity of 803 Japanese cities. We used the space syntax theory to measure street connectivity and conducted multiple linear regression analyses to determine the aforementioned associations. The results showed that street connectivity today tends to be low in cities that originated from castle towns and high in cities that suffered heavy damage during WWII. This may be due to complicated street networks that were constructed intentionally in castle towns to defend their territory from invasion. The remaining irregular layouts may have directly and indirectly influenced today's street networks. Furthermore, in the cities that suffered heavy war damage, the “postwar reconstruction city plan” was enforced to reconstruct affected areas, which may have improved street connectivity. These findings highlight the significance of historical events in the consideration of street connectivity determinants and the development of interventions to enhance them.
Unsupervised deep learning registration model for multimodal brain images
Authors: Abbasi Samaneh , Mehdizadeh Alireza , Boveiri Hamid Reza , Mosleh Shirazi Mohammad Amin , Javidan Reza , Khayami Raouf , Tavakoli Meysam 
Published: October 2023

AbstractMultimodal image registration is a key for many clinical image‐guided interventions. However, it is a challenging task because of complicated and unknown relationships between different modalities. Currently, deep supervised learning is the state‐of‐theart method at which the registration is conducted in end‐to‐end manner and one‐shot. Therefore, a huge ground‐truth data is required to improve the results of deep neural networks for registration. Moreover, supervised methods may yield models that bias towards annotated structures. Here, to deal with above challenges, an alternative approach is using unsupervised learning models. In this study, we have designed a novel deep unsupervised Convolutional Neural Network (CNN)‐based model based on computer tomography/magnetic resonance (CT/MR) co‐registration of brain images in an affine manner. For this purpose, we created a dataset consisting of 1100 pairs of CT/MR slices from the brain of 110 neuropsychic patients with/without tumor. At the next step, 12 landmarks were selected by a well‐experienced radiologist and annotated on each slice resulting in the computation of series of metrics evaluation, target registration error (TRE), Dice similarity, Hausdorff, and Jaccard coefficients. The proposed method could register the multimodal images with TRE 9.89, Dice similarity 0.79, Hausdorff 7.15, and Jaccard 0.75 that are appreciable for clinical applications. Moreover, the approach registered the images in an acceptable time 203 ms and can be appreciable for clinical usage due to the short registration time and high accuracy. Here, the results illustrated that our proposed method achieved competitive performance against other related approaches from both reasonable computation time and the metrics evaluation.
Non‐contrast based approach for liver function quantification using Bayesian‐based intravoxel incoherent motion diffusion weighted imaging: A pilot study
Authors: Phonlakrai Monchai , Ramadan Saadallah , Simpson John , Skehan Kate , Goodwin Jonathan , Trada Yuvnik , Martin Jarad , Sridharan Swetha , Gan Lay Theng , Siddique Sabbir Hossain , Greer Peter 
Published: October 2023

AbstractPurposeLiver cirrhosis disrupts liver function and tissue perfusion, detectable by magnetic resonance imaging (MRI). Assessing liver function at the voxel level with 13‐b value intravoxel incoherent motion diffusion‐weighted imaging (IVIM‐DWI) could aid in radiation therapy liver‐sparing treatment for patients with early impairment. This study aimed to evaluate the feasibility of IVIM‐DWI for liver function assessment and correlate it with other multiparametric (mp) MRI methods at the voxel level.MethodThis study investigates the variability of apparent diffusion coefficient (ADC) derived from 13‐b value IVIM‐DWI and B1‐corrected dual flip angle (DFA) T1 mapping. Experiments were conducted in‐vitro with QIBA and NIST phantoms and in 10 healthy volunteers for IVIM‐DWI. Additionally, 12 patients underwent an mp‐MRI examination. The imaging protocol included a 13‐b value IVIM‐DWI sequence for generating IVIM parametric maps. B1‐corrected DFA T1 pulse sequence was used for generating T1 maps, and Gadoxatate low temporal resolution dynamic contrast‐enhanced (LTR‐DCE) MRI was used for generating the Hepatic extraction fraction (HEF) map. The Mann‐Whitney U test was employed to compare IVIM‐DWI parameters (Pure Diffusion, Dslow; Pseudo diffusion, Dfast; and Perfusion Fraction, Fp) between the healthy volunteer and patient groups. Furthermore, in the patient group, statistical correlations were assessed at a voxel level between LTR‐DCE MRI‐derived HEF, T1 post‐Gadoxetate administration, ΔT1%, and various IVIM parameters using Pearson correlation.ResultsFor‐vitro measurements, the maximum coefficient of variation of the ADC and T1 parameters was 12.4% and 16.1%, respectively. The results also showed that Fp and Dfast were able to distinguish between healthy liver function and mild liver function impairment at the global level, with p = 0.002 for Fp and p < 0.001 for Dfast. Within the patient group, these parameters also exhibited a moderate correlation with HEF at the voxel level.ConclusionOverall, the study highlighted the potential of Dfast and Fp for detecting liver function impairment at both global and pixel levels.
Detection of prions in the urine of patients affected by sporadic Creutzfeldt–Jakob disease
Authors: Pritzkow Sandra , Ramirez Frank , Lyon Adam , Schulz Paul E. , Appleby Brian , Moda Fabio , Ramirez Santiago , Notari Silvio , Gambetti Pierluigi , Soto Claudio 
Published: October 2023

AbstractObjectiveCurrently, it is unknown whether infectious prions are present in peripheral tissues and biological fluids of patients affected by sporadic Creutzfeldt–Jakob disease (sCJD), the most common prion disorder in humans. This represents a potential risk for inter‐individual prion infection. The main goal of this study was to evaluate the presence of prions in urine of patients suffering from the major subtypes of sCJD.MethodsUrine samples from sCJD patients spanning the six major subtypes were tested. As controls, we used urine samples from people affected by other neurological or neurodegenerative diseases as well as healthy controls. These samples were analyzed blinded. The presence of prions was detected by a modified version of the PMCA technology, specifically optimized for high sensitive detection of sCJD prions.ResultsThe PMCA assay was first optimized to detect low quantities of prions in diluted brain homogenates from patients affected by all subtypes of sCJD spiked into healthy urine. Twenty‐nine of the 81 patients affected by sCJD analyzed in this study were positive by PMCA testing, whereas none of the 160 controls showed any signal. These results indicate a 36% sensitivity and 100% specificity. The subtypes with the highest positivity rate were VV1 and VV2, which combined account for about 15–20% of all sCJD cases, and no detection was observed in MV1 and MM2.InterpretationOur findings indicate that potentially infectious prions are secreted in urine of some sCJD patients, suggesting a possible risk for inter‐individual transmission. Prion detection in urine might be used as a noninvasive preliminary screening test to detect sCJD.
Comparison of two corticosteroid regimens on brain volumetrics in patients with Duchenne muscular dystrophy
Authors: Geuens Sam , Van Dessel Jeroen , Govaarts Rosanne , Ikelaar Nadine A. , Meijer Onno C. , Kan Hermien E. , Niks Erik H. , Goemans Nathalie , Lemiere Jurgen , Doorenweerd Nathalie , De Waele Liesbeth 
Published: October 2023

AbstractObjectiveDuchenne muscular dystrophy (DMD) is a neuromuscular disorder in which many patients also have neurobehavioral problems. Corticosteroids, the primary pharmacological treatment for DMD, have been shown to affect brain morphology in other conditions, but data in DMD are lacking. This study aimed to investigate the impact of two corticosteroid regimens on brain volumetrics in DMD using magnetic resonance imaging (MRI).MethodsIn a cross‐sectional, two‐center study, T1‐weighted MRI scans were obtained from three age‐matched groups (9–18 years): DMD patients treated daily with deflazacort (DMDd, n = 20, scan site: Leuven), DMD patients treated intermittently with prednisone (DMDi, n = 20, scan site: Leiden), and healthy controls (n = 40, both scan sites). FSL was used to perform voxel‐based morphometry analyses and to calculate intracranial, total brain, gray matter, white matter, and cerebrospinal fluid volumes. A MANCOVA was employed to compare global volumetrics between groups, with site as covariate.ResultsBoth patient groups displayed regional differences in gray matter volumes compared to the control group. The DMDd group showed a wider extent of brain regions affected and a greater difference overall. This was substantiated by the global volume quantification: the DMDd group, but not the DMDi group, showed significant differences in gray matter, white matter, and cerebrospinal fluid volumes compared to the control group, after correction for intracranial volume.InterpretationVolumetric differences in the brain are considered part of the DMD phenotype. This study suggests an additional impact of corticosteroid treatment showing a contrast between pronounced alterations seen in patients receiving daily corticosteroid treatment and more subtle differences in those treated intermittently.
Fixed‐time fuzzy adaptive robust H∞ control for nonstrict‐feedback nonlinear systems with input saturation and output constraints
Authors: Toodeshki Mojtaba Hosseini , Yao Qijia 
Published: October 2023

SummaryThis paper focuses on the design of fixed‐time fuzzy adaptive robust control of nonlinear systems in a nonstrict‐feedback form that includes output constraints, input saturation, and external disturbance. Fuzzy systems have been utilized to deal with uncertainties and non‐linearity in the system dynamic model. By introducing novel control and adaptive rules, there is no need to approximate the input saturation function with the hyperbolic tangent function. A Barrier Lyapunov Function (BLF) ensures that systems outputs do not violate the defined constraints. By combining the backstepping and BLF method, asymptotic convergence of tracking error signal to zero in fixed‐time is proved. At the same time, index is also met in dealing with the disturbance effects. Finally, the simulation results of the proposed control method in two examples confirm its effectiveness.
Robust state and sensor fault estimation for switched nonlinear systems based on asynchronous switched fuzzy observers
Authors: Tabbi Ibtissam , Jabri Dalel , Chekakta Issam , Belkhiat Djamel E. C. 
Published: October 2023

SummaryThis article aims to address state and sensor fault estimation issue for a class of continuous‐time nonlinear switched systems, modelled as Takagi‐Sugeno (T‐S) models with nonlinear consequent parts and subject to norm bounded disturbances. This modelling approach helps to prevent Unmeasured Premise Variables (UPVs) problem. The primary contribution of this study consists of proposing robust asynchronous switched observers to simultaneously estimate state and sensor faults under state‐dependent switching. Based on a candidate multiple Lyapunov function, the design of the proposed observer is formulated in terms of Linear Matrix Inequalities (LMIs) conditions. These conditions are dwell‐time‐independent and less conservative compared with similar previous studies, thanks to some usual relaxation techniques and the incremental quadratic constraints applied on unmeasured nonlinear consequent parts. Another contribution consists to perform the estimation of the attraction domain of the estimation error using an optimization procedure. In order to illustrate the effectiveness of the proposed design approach, two simulation examples are considered. The first one concerns the conservatism reduction brought by our proposal compared with previous studies, while the second one is dedicated to show through an illustrative example the performance of the proposed switched T‐S observers under mismatching switching laws.
Dissipative fault detection for time‐delay nonlinear Markov jump systems with measurement outliers under stochastic communication protocol
Authors: Wu Zhihui , Ma Siteng , Feng Lichao , Chen Dongyan , Hu Tiantian 
Published: October 2023

SummaryThis article investigates the dissipative fault detection (FD) problem for time‐delay nonlinear Markov jump systems with measurement outliers in the case of partially unknown transition probabilities. The stochastic communication protocol is utilized to save network bandwidth, where the scheduling model is described via a Markov chain. An outlier‐resistant FD filter is constructed with the help of adaptive saturation function technology. The sufficient conditions are derived to ensure that the FD system satisfies the stochastic stability and stochastic strict dissipativity. In addition, an FD filter without saturation constraint is also designed to compare with the outlier‐resistant FD filter, which verifies that the outlier‐resistant FD filter weakens the influence of measurement outliers effectively. Finally, two examples are provided to demonstrate the feasibility and effectiveness of the designed FD scheme.
Strategies for Making High‐Performance Artificial Spider Silk Fibers
Authors: Schmuck Benjamin , Greco Gabriele , Pessatti Tomas Bohn , Sonavane Sumalata , Langwallner Viktoria , Arndt Tina , Rising Anna 
Published: October 2023

AbstractArtificial spider silk is an attractive material for many technical applications since it is a biobased fiber that can be produced under ambient conditions but still outcompetes synthetic fibers (e.g., Kevlar) in terms of toughness. Industrial use of this material requires bulk‐scale production of recombinant spider silk proteins in heterologous host and replication of the pristine fiber's mechanical properties. High molecular weight spider silk proteins can be spun into fibers with impressive mechanical properties, but the production levels are too low to allow commercialization of the material. Small spider silk proteins, on the other hand, can be produced at yields that are compatible with industrial use, but the mechanical properties of such fibers need to be improved. Here, the literature on wet‐spinning of artificial spider silk fibers is summarized and analyzed with a focus on mechanical performance. Furthermore, several strategies for how to improve the properties of such fibers, including optimized protein composition, smarter spinning setups, innovative protein engineering, chemical and physical crosslinking as well as the incorporation of nanomaterials in composite fibers, are outlined and discussed.
Formulation and Evaluation of PVA/Gelatin/Carrageenan Inks for 3D Printing and Development of Tissue‐Engineered Heart Valves
Authors: Jafari Arman , Vahid Niknezhad Seyyed , Kaviani Maryam , Saleh Wael , Wong Nicholas , Van Vliet Patrick Piet , Moraes Christopher , Ajji Abdellah , Kadem Lyes , Azarpira Negar , Andelfinger Gregor , Savoji Houman 
Published: October 2023

AbstractCongenital and acquired valvular heart diseases (VHDs) are significant causes of mortality worldwide. With valve replacement being the primary solution for VHD, current options display shortcomings, including calcification, thrombogenicity, and hemodynamic alteration, leading to repetitive surgeries. Tissue engineering, however, has shown great potential for fabricating heart valves (HVs) with fewer complications. Here, a series of inks are developed, combining poly(vinyl alcohol), gelatin, and carrageenan for 3D printing of tissue‐engineered heart valves (TEHVs). The inks/hydrogels are investigated to characterize their physico‐chemical, morphological, mechanical, and rheological characteristics. In vitro and in vivo biocompatibility, immune response, hemolysis, and thrombogenicity of the inks/hydrogels are also evaluated. Moreover, in vitro hydrodynamics of the TEHVs under physiological conditions are reported. Inks demonstrate mechanical characteristics comparable to native leaflets. Subcutaneous implantation reveals that the hydrogels do not induce chronic inflammation and can undergo remodeling. In vitro hemocompatibility assessments of the hydrogels show minimal hemolysis with low thrombogenicity. Different sizes and types of HVs are successfully printed with high fidelity in the air. In vitro hydrodynamic assessment confirms that the TEHVs can withstand aortic conditions. Altogether, the 3D‐printed TEHVs can be a promising alternative for valve replacement to solve the problems associated with the current options.