bluuebunny/crossref_metadata_2025_split huggingface dataset:
Identification of Luminal A breast cancer by using deep learning analysis based on multi-modal images
Authors: Liu Menghan , Zhang Shuai , Du Yanan , Zhang Xiaodong , Wang Dawei , Ren Wanqing , Sun Jingxiang , Yang Shiwei , Zhang Guang 
Published: November 2023

PurposeTo evaluate the diagnostic performance of a deep learning model based on multi-modal images in identifying molecular subtype of breast cancer.Materials and methodsA total of 158 breast cancer patients (170 lesions, median age, 50.8 ± 11.0 years), including 78 Luminal A subtype and 92 non-Luminal A subtype lesions, were retrospectively analyzed and divided into a training set (n = 100), test set (n = 45), and validation set (n = 25). Mammography (MG) and magnetic resonance imaging (MRI) images were used. Five single-mode models, i.e., MG, T2-weighted imaging (T2WI), diffusion weighting imaging (DWI), axial apparent dispersion coefficient (ADC), and dynamic contrast-enhanced MRI (DCE-MRI), were selected. The deep learning network ResNet50 was used as the basic feature extraction and classification network to construct the molecular subtype identification model. The receiver operating characteristic curve were used to evaluate the prediction efficiency of each model.ResultsThe accuracy, sensitivity and specificity of a multi-modal tool for identifying Luminal A subtype were 0.711, 0.889, and 0.593, respectively, and the area under the curve (AUC) was 0.802 (95% CI, 0.657- 0.906); the accuracy, sensitivity, and AUC were higher than those of any single-modal model, but the specificity was slightly lower than that of DCE-MRI model. The AUC value of MG, T2WI, DWI, ADC, and DCE-MRI model was 0.593 (95%CI, 0.436-0.737), 0.700 (95%CI, 0.545-0.827), 0.564 (95%CI, 0.408-0.711), 0.679 (95%CI, 0.523-0.810), and 0.553 (95%CI, 0.398-0.702), respectively.ConclusionThe combination of deep learning and multi-modal imaging is of great significance for diagnosing breast cancer subtypes and selecting personalized treatment plans for doctors.
Incidence and associated factors of developing second pelvic malignant neoplasms among prostate cancer patients treated with radiotherapy
Authors: Wang Youbiao , Chen Ru , Deng Xinxi , Jiang Xinghua 
Published: November 2023

ObjectiveTo identify risk factors of secondary pelvic malignant neoplasms (SPMNs) among prostate cancer (PCa) patients treated with radiotherapy. Simultaneously, population-based data were used to validate the high risk of SPMNs in PCa patients with radiotherapy.Materials and methodsWe identified male patients diagnosed with PCa (localized and regional) as the first primary cancer and pelvic malignant neoplasm (including bladder and rectal cancer) as secondary cancer from Surveillance, Epidemiology, and End Results database (1975-2020). An external validation cohort was obtained from the First Affiliated Hospital of Nanchang University. The Fine-Gray competing risk regression and Poisson regression were utilized to evaluate the risk of SPMNs development. Poisson regression was also performed to calculate the standardized incidence ratio (SIR). The Kaplan-Meier method was used to assess the overall survival (OS) of patients with SPMNs.Results89397 PCa patients treated with radiotherapy were enrolled. We identified associated factors of SPMNs, including age at diagnosis, race, year of diagnosis, marital status, radiation strategy and latency. In the multivariable competing risk regression model and Poisson regression model, a significantly higher risk of SPMNs development was observed in patients over 50 years(P&lt;0.05), white patients(P&lt;0.001), unmarried patients and treated with brachytherapy combined with external beam radiotherapy or brachytherapy(P&lt;0.05). Patients treated with radiotherapy had a higher bladder and rectal cancer incidence than the general population. Patients who developed SPMNs showed poorer OS.ConclusionWe identified several risk factors associated with SPMNs and confirmed a relatively higher incidence of bladder and rectal cancer among PCa patients with radiotherapy. These results help tailor treatment and surveillance strategies.
Lymphovascular invasion is an independent prognostic factor in breast cancer irrespective of axillary node metastasis and molecular subtypes
Authors: Lee Suk Jun , Go Jieon , Ahn Byung Soo , Ahn Jee Hyun , Kim Jee Ye , Park Hyung Seok , Kim Seung Il , Park Byeong-Woo , Park Seho 
Published: November 2023

PurposeLymphovascular invasion (LVI) is a well-known poor prognostic factor for early breast cancer. However, the effect of LVI on breast cancer subtype and node status remains unknown. In this study, we aimed to evaluate the clinical significance of LVI on the recurrence and long-term survival of patients with early breast cancer by comparing groups according to the subtype and node status.MethodsWe retrospectively reviewed the medical records of 4554 patients with breast cancer who underwent breast cancer surgery between January 2010 and December 2017. The primary endpoints were disease-free survival (DFS) and overall survival (OS). Univariate and multivariate analyses were performed to identify prognostic factors related to the DFS and OS according to the nodal status and breast cancer subtype.ResultsDuring a follow-up period of 94 months, the median OS and DFS were 92 and 90 months, respectively. The LVI expression rate was 8.4%. LVI had a negative impact on the DFS and OS, regardless of the lymph node status. LVI was associated with higher recurrence and lower survival in the luminal A, human epidermal growth factor receptor 2-positive, and triple-negative breast cancer subtypes. The Cox proportional hazards model showed that LVI was a significant prognostic factor for both DFS and OS. No correlation has been observed between LVI and the Oncotype Dx results in terms of prognostic value in early breast cancer.ConclusionLVI is an independent poor prognostic factor in patients with early breast cancer, regardless of the node status and molecular subtype. Therefore, the LVI status should be considered when making treatment decisions for patients with early stage breast cancer; however, further prospective studies are warranted.
Identifying clinical features and molecular characteristics of the endometrial clear cell carcinoma
Authors: Cai Yuhan , Han Qin , Guo Hongyan 
Published: November 2023

ObjectiveThe aim of this study was to verify TCGA subtypes in endometrial clear cell carcinoma (ECCC) and determine their clinical and molecular characteristics.MethodsWe summarized and compared the clinical features of 28 clear cell carcinoma and 112 endometrioid carcinoma patients. Of the 28 ECCCs, 19 underwent TCGA classification, and other markers (ER, PR, ARID1A, ARIB1B, TAF1, and HER-2) were also detected by IHC, and outcomes were assessed.ResultsCompared to endometrioid carcinoma, ECCC had an older age of onset (median age, 64.5 years, range 31–81 years), higher rate of myometrial invasion (42.8% vs. 21.5% in endometrioid carcinoma), LVSI (33% vs. 16%), and more advanced FIGO stage. Among the ECCCs, LVSI was a poor prognostic factor. TCGA classification was performed for 19 ECCCs: two POLEmut cases (10.5%), three MMRd (15.8%), 11 p53wt (57.9%), and three p53abn (15.8%). Of the 19 ECCCs, six (31.6%) showed HER-2 positive expression, and eight (42.1%) had TAF1 expression loss. ECCCs possessed HER-2 and TAF1 expression had worse outcomes.ConclusionOur study summarized the clinical features of ECCC. The outcomes of patients with ECCC with TCGA subtypes differed from those of patients with endometrioid carcinoma. HER-2 and TAF1 may be new prognostic factors.
Quantitative melanoma diagnosis using spectral phasor analysis of hyperspectral imaging from label-free slices
Authors: Schuty Bruno , Martínez Sofía , Guerra Analía , Lecumberry Federico , Magliano Julio , Malacrida Leonel 
Published: November 2023

IntroductionMelanoma diagnosis traditionally relies on microscopic examination of hematoxylin and eosin (H&amp;E) slides by dermatopathologists to search for specific architectural and cytological features. Unfortunately, no single molecular marker exists to reliably differentiate melanoma from benign lesions such as nevi. This study explored the potential of autofluorescent molecules within tissues to provide molecular fingerprints indicative of degenerated melanocytes in melanoma.MethodsUsing hyperspectral imaging (HSI) and spectral phasor analysis, we investigated autofluorescence patterns in melanoma compared to intradermal nevi. Using UV excitation and a commercial spectral confocal microscope, we acquired label-free HSI data from the whole-slice samples. ResultsOur findings revealed distinct spectral phasor distributions between melanoma and intradermal nevi, with melanoma displaying a broader phasor phase distribution, signifying a more heterogeneous autofluorescence pattern. Notably, longer wavelengths associated with larger phases correlated with regions identified as melanoma by expert dermatopathologists using H&amp;E staining. Quantitative analysis of phase and modulation histograms within the phasor clusters of five melanomas (with Breslow thicknesses ranging from 0.5 mm to 6 mm) and five intradermal nevi consistently highlighted differences between the two groups. We further demonstrated the potential for the discrimination of several melanocytic lesions using center-of-mass comparisons of phase and modulation variables. Remarkably, modulation versus phase center of mass comparisons revealed strong statistical significance among the groups. Additionally, we identified the molecular endogenous markers responsible for tissue autofluorescence, including collagen, elastin, NADH, FAD, and melanin. In melanoma, autofluorescence is characterized by a higher phase contribution, indicating an increase in FAD and melanin in melanocyte nests. In contrast, NADH, elastin, and collagen dominate the autofluorescence of the nevus.DiscussionThis work underscores the potential of autofluorescence and HSI-phasor analysis as valuable tools for quantifying tissue molecular fingerprints, thereby supporting more effective and quantitative melanoma diagnosis.
Evaluation of a steroid delivery system to mitigate the severity of proliferative vitreoretinopathy in a minipig model
Authors: Wong Chee Wai , Cheung Ning , Howden James S. , Busoy Joanna Marie Fianza , Sim Shaun , Lim Joshua , Ho Candice , Veluchamy Amutha Barathi , Storm Gert , Wong Tina T. 
Published: November 2023

PurposeTo investigate the efficacy of liposomal prednisolone phosphate to mitigate the severity of proliferative vitreoretinopathy (PVR) in a minipig model of PVR.MethodsA total of 18 eyes of 9 minipigs underwent PVR induction surgically. Eyes were randomized equally into three groups: intravitreal injection of liposomal prednisolone phosphate (LPP), triamcinolone acetonide (TA), and controls. PVR severity was graded on fundoscopic examination using a modified version of the Silicon Study Classification System. Severe PVR was defined as grade 2-5 on this classification, and the proportion of eyes with retinal detachment from severe PVR, defined as retinal re-detachment, i.e., PVR grade 2-5, was compared between treatment and control groups.ResultsOn day 28, five eyes (83.3%) in the control group were observed to have severe PVR. Within the LPP group, one (16.7%) eye developed retinal detachment due to severe PVR. Grade 0 PVR was observed in four (66.7%) eyes, grade 1 in one (16.7%) eye, and grade 5 in one (16.7%) eye. Within the TA group, grade 0 PVR was observed in four eyes (66.7%), grade 1 in two eyes (16.6%), and grade 5 in one (16.7%) eye. The difference in the proportion of eyes with severe PVR was significantly lower in the LPP group compared to controls at day 28 (16.7% vs 83.3%, p=0.02). There was no significant difference in the rate of severe PVR or median PVR grade between the liposomal prednisolone phosphate and triamcinolone acetonide groups.ConclusionLiposomal prednisolone phosphate reduces the severity of PVR in a minipig model of PVR.
Ophthalmological impairment in patients with congenital cytomegalovirus infection
Authors: Salomè Serena , Ciampa Nicola , Giordano Mariapaola , Raimondi Raffaele , Capone Eleonora , Grieco Claudia , Coppola Clara , Capasso Letizia , Raimondi Francesco 
Published: November 2023

BackgroundCongenital cytomegalovirus (cCMV) infection is a frequent cause of neurosensory impairment. Ocular abnormalities and visual impairment have been reported in a high percentage of symptomatic infants, whereas they are considered uncommon in asymptomatic ones. The paucity of data has made difficult to reach clear recommendations on the ophthalmological follow-up that should be provided.Methods250 patients with cCMV infection (123 symptomatic) were enrolled and underwent a series of age-appropriate ophthalmologic, audiologic, and neurodevelopmental examinations from 2002 to 2022.ResultsFunduscopic abnormalities were identified at onset in 16/123 (13%) symptomatic infants and in none of the asymptomatic ones (p &lt; 0.001). Chorioretinitis lesions were the most common findings (10/16 cases), while the others showed retinal scars. Lesions were bilateral in 4 patients. No later onset retinal lesions were detected, nor in symptomatic or in asymptomatic children. Five of the 16 (31.5%) symptomatic and none of the asymptomatic subjects showed visual impairment al the last evaluation (p &lt; 0.001). All patients with unfavorable outcome had also neurological impairment. Among symptomatic patients, ocular lesions were associated with central nervous system (CNS) pathological findings in prenatal ultrasonography (p 0.05) and with clinical signs of CNS involvement at birth (p 0.046). No correlation was found with the type of maternal infection and pathological neuroimaging.ConclusionsChorioretinal lesions are a fairly common finding at birth in neonates with symptomatic cCMV, often associated with long term visual impairment. Asymptomatic infants do not show ophthalmological abnormalities in the short or long term. This information is relevant both to parental counseling and to cost-effective patient management.
Preterm infants with positive conjunctival swab culture: risk factors and association with late-onset sepsis–a retrospective cohort study
Authors: Gad Ashraf , Khalil Amr , Halil Muhammed , Chandra Prem , Soliman Aly , Rahman E’mar Abdel , Ibrahim Marwa , Al Khzzam Fadi , AlHendawi Talal , Hamed Manal , Bayoumi Mohammad A. A. , Petkar Hawabibee 
Published: November 2023

IntroductionPurulent conjunctival discharge in hospitalized preterm infants may indicate conjunctivitis and warrant treatment. The purpose of this study was to examine the relationship between positive conjunctival swab (CS) culture and late-onset sepsis (LOS) in preterm infants.MethodsA retrospective cohort study was conducted to determine the relationship between positive CS culture growth results (CSP) obtained in preterm infants ≤34 weeks' gestation and the development of LOS within 120 h of obtaining CS compared with those who had negative CS culture results (CSN). Electronic medical records were reviewed from January 2015 until December 2019 for preterm infants presenting with purulent conjunctival discharge and underwent CS culture testing due to suspected conjunctivitis.ResultsOf the 234 CS cultures obtained during the study period, 145 (61.9%) were CSP compared to 89 (38.1%) CSN cultures. Gram-negative organisms accounted for 70% of all CSP cultures, with the remaining 30% being Gram-positive. Patients with CSP were smaller, younger, had lower 1-minute APGAR scores, and required respiratory support more frequently than those with CSN. Infants with CSP received antibiotics for longer periods, both topically and systemically. Infants who developed LOS were more likely to require invasive ventilation (adjusted odds ratio, 33.5; 95% CI, 2.52–446.5, p = 0.008). The incidence of LOS between the two groups was similar, with 6.2% observed in the CSP group compared to 3.4% in the CSN group (p = 0.543). Similarly, the rates of bacteremia were similar in both groups. Of the CSP patients who were presented with bacteremia, four out of seven (57%) exhibited bacteremia caused by the same organism found in their CS cultures. Similarly, within the entire cohort, respiratory cultures were performed on nine intubated patients within two weeks of obtaining CS cultures. Of these, in the CSP group, five out of six (83%) showed an organism identical to that found in the CS cultures.ConclusionThe study found a significant proportion of positive CS cultures in preterm infants, with distinct patient characteristics and treatment compared to negative cultures. While the incidence of LOS was not significantly different between the two groups, some CSP patients demonstrated bacteremia with the same CS organism, suggesting a possible connection between conjunctival or respiratory colonization and bacteremia.
The relationship between tolerance for uncertainty and academic adjustment: the mediating role of students’ psychological flexibility during COVID-19
Authors: Daşcı Esma , Salihoğlu Kübra , Daşcı Esra 
Published: November 2023

IntroductionUniversity students are among the groups most adversely affected by COVID-19 in terms of their psychological and academic wellbeing, particularly given the pandemic’s uncertainty. However, little is known about their psychological flexibility to deal with this uncertain nature of pandemic. This study aimed to examine the mediating role of psychological flexibility (PF) in the relationship between university students’ intolerance of uncertainty (IU) and their academic adjustment to the online learning process during COVID-19.MethodsData was collected from 388 university students from Türkiye (18–34 (Mage = 21.43, SD = 2.04) who completed five questionnaires – Intolerance of Uncertainty Scale, Acceptance and Action Questionnaire II, Academic Self Efficacy Scale, Educational Stress Scale, and Online Self-Regulatory Learning Scale. Additionally, as indicators of students’ academic adjustment, perceived academic performance – ranging 1 to 10, and their last academic grade point average before and during the pandemic were also collected.ResultsThe results indicated that PF and IU had a significant effect on the academic adjustment of students during the pandemic. PF had a complete mediating role between the IU and academic adjustment. Results also revealed that online self-regulation, a sub-dimension of academic adjustment, did not show a significant relationship with any other variable in the model.DiscussionResearch findings showed that psychological flexibility is a very important strength for university students to maintain their academic adjustment in stressful times. The results were discussed in light of the relevant research, and recommendations for further research and implications were provided.
Relationships between COVID-19 healthcare outcomes and county characteristics in the U.S. for Delta (B.1.617.2) and Omicron (B.1.1.529 and BA.1.1) variants
Authors: Bruckhaus Alexander A. , Zhang Yujia , Salehi Sana , Abedi Aidin , Duncan Dominique 
Published: November 2023

BackgroundCOVID-19 is constantly evolving, and highly populated communities consist of many different characteristics that may contribute to COVID-19 health outcomes. Therefore, we aimed to (1) quantify the relationships between county characteristics and severe and non-severe county-level health outcomes related to COVID-19. We also aimed to (2) compare these relationships across time periods where the Delta (B.1.617.2) and Omicron (B.1.1.529 and BA.1.1) variants were dominant in the U.S.MethodsWe used multiple regression to measure the strength of relationships between healthcare outcomes and county characteristics in the 50 most populous U.S. counties.ResultsWe found many different significant predictors including the proportion of a population vaccinated, median household income, population density, and the proportion of residents aged 65+, but mainly found that socioeconomic factors and the proportion of a population vaccinated play a large role in the dynamics of the spread and severity of COVID-19 in communities with high populations.DiscussionThe present study shines light on the associations between public health outcomes and county characteristics and how these relationships change throughout Delta and Omicron’s dominance. It is important to understand factors underlying COVID-19 health outcomes to prepare for future health crises.
Examining the relationship between sleep quality and depressive symptoms in Korean women engaged in soccer during the coronavirus pandemic
Authors: Kim Young-Jae , Lee Da-Som , Kim E-Sack 
Published: November 2023

IntroductionThe COVID-19 pandemic has caused sudden changes to daily lives, such as self-isolation and social distancing, and has negatively affected sleep quality and patterns. The resulting psychological discomfort has caused many Korean women to experience depressive moods. Vigorous physical activity is considered effective in improving sleep quality and alleviating depressive symptoms. As a form of vigorous physical activity, soccer could be used to improve women's mental health. This study aimed to ascertain the effects of playing soccer on sleep quality and depressive symptoms in women.MethodsNon-face-to-face questionnaires were administered using Pittsburgh Sleep Quality Index to measure sleep quality and Patient Health Questionnaire-9 to measure depressive symptoms, targeting 200 of 297 soccer-playing Korean women aged 20–50 years, from October 13, 2022, to January 15, 2023. A total of 172 questionnaires administered to soccer participants were used, while 28 with insincere and double or no-responses were excluded. Additionally, 124 samples of non-exercise participants were collected, with the help of “EMBRAIN,” a Korean research and survey company. This study analyzed differences in sleep quality and depressive symptoms, and correlations and multiple regression analysis were performed.ResultsThe soccer group was shown to have a high quality of sleep. In relation to the effect of sleep quality on depressive symptoms, subjective sleep quality, sleep latency, sleep disturbance, use of sleeping pills, and daytime functional disorder had a significant effect. In the relation to the effect of sleep quality on depressive symptoms, significant effect was found in subjective sleep quality, sleep latency, sleep disturbance, and daytime functional disorder of soccer participants, and non-exercise participants displayed significant effect in subjective sleep quality, sleep disturbance, and the use of sleeping pills.DiscussionThis study examined the effect of soccer participation on sleep quality and depressive symptoms among women. Soccer, which requires high activity and teamwork levels, improves sociability in women by enhancing their sense of belonging, self-confidence, and team spirit.