bluuebunny/crossref_metadata_2025_split huggingface dataset:
A novel immune-related risk-scoring system associated with the prognosis and response of cervical cancer patients treated with radiation therapy
Authors: Wu Zhuna , Lin Qiuya , Sheng Liying , Chen Weihong , Liang Meili , Wu Danni , Ke Yumin 
Published: November 2023

Objective: The tumor microenvironment plays a critical role in the radiotherapy and immunotherapy response of cervical squamous cell carcinoma and endocervical adenocarcinoma (CESC). Radioresistance is a key factor in treatment failure among patients who receive radical radiotherapy. Thus, new immune-related biomarkers associated with radiotherapy response in CESC are needed.Methods: In this study, the CIBERSORT and ESTIMATE methods were applied to determine the percentage of tumor-infiltrating cells and the number of immune components in 103 CESCs treated with radiotherapy from The Cancer Genome Atlas (TCGA) database. The main dysregulated genes were subjected to multivariate and univariate analyses. The prognostic value of this system was studied via receiver operating characteristic curve and survival analysis. For further confirmation, the biomarkers’ expression levels and predictive value were validated by immunohistochemistry (IHC) and qRT-PCR. The CIBERSORT algorithm was used to calculate the compositional patterns of 22 types of immune cells in cervical cancer patients treated with radiation therapy.Results: Data for 17 radioresistant and 86 radiosensitive tumors were obtained from the The Cancer Genome Atlas database. 53 immune-related DEGs were identified. GO and KEGG analyses revealed that the DEGs were enriched in protein kinase B signaling, growth factors in cytokines, the MAPK pathway and the PI3K-Akt pathway. Then, 14 key immune-related genes built a risk scoring model were deemed prognostic in CESC with radiotherapy. The area under the curve (AUC) of the model was 0.723, and the high-risk group presented worse outcomes than the low-risk group. In addition, the high-risk group tended to have persistent tumors (p = 0.001). The high expression of WT1 and SPOUYT4 were associated with relapse, the high expression of Angiotensinogen and MIEN1 were associated with nonrelapse. Analysis of the immune microenvironment indicated that M0 macrophages, M2 macrophages, activated mast cells and resting memory CD4+ T cells were positively correlated with the risk score (p &lt; 0.05).Conclusion: The novel immune-related risk scoring system has some advantages in predicting the prognosis and treatment response of cervical cancer patients treated with radiotherapy. Moreover, it might provide novel clues for providing targeted immune therapy to these patients.
Peg-in-hole assembly skill imitation learning method based on ProMPs under task geometric representation
Authors: Zang Yajing , Wang Pengfei , Zha Fusheng , Guo Wei , Zheng Chao , Sun Lining 
Published: November 2023

IntroductionBehavioral Cloning (BC) is a common imitation learning method which utilizes neural networks to approximate the demonstration action samples for task manipulation skill learning. However, in the real world, the demonstration trajectories from human are often sparse and imperfect, which makes it challenging to comprehensively learn directly from the demonstration action samples. Therefore, in this paper, we proposes a streamlined imitation learning method under the terse geometric representation to take good advantage of the demonstration data, and then realize the manipulation skill learning of assembly tasks.MethodsWe map the demonstration trajectories into the geometric feature space. Then we align the demonstration trajectories by Dynamic Time Warping (DTW) method to get the unified data sequence so we can segment them into several time stages. The Probability Movement Primitives (ProMPs) of the demonstration trajectories are then extracted, so we can generate a lot of task trajectories to be the global strategy action samples for training the neural networks. Notalby, we regard the current state of the assembly task as the via point of the ProMPs model to get the generated trajectories, while the time point of the via point is calculated according to the probability model of the different time stages. And we get the action of the current state according to the target position of the next time state. Finally, we train the neural network to obtain the global assembly strategy by Behavioral Cloning.ResultsWe applied the proposed method to the peg-in-hole assembly task in the simulation environment based on Pybullet + Gym to test its task skill learning performance. And the learned assembly strategy was also executed on a real robotic platform to verify the feasibility of the method further.DiscussionAccording to the result of the experiment, the proposed method achieves higher success rates compared to traditional imitation learning methods while exhibiting reasonable generalization capabilities. It shows that the ProMPs under geometric representation can help the BC method make better use of the demonstration trajectory and thus better learn the task skills.
Appropriate use of antiplatelet medications following transient ischemic attacks and stroke: a 9-year study from the Middle East
Authors: Naveed Hiba , Akhtar Naveed , Al-Jerdi Salman , Uy Ryan Ty , Joseph Sujatha , Morgan Deborah , Babu Blessy , Shanthi Shobana , Shuaib Ashfaq 
Published: November 2023

Background and purposeGuidelines recommend that patients with high-risk TIAs and minor strokes presenting within 1–3 days from onset should be offered dual antiplatelet therapy (DAPT). There are little data on real-world adherence to these recommendations. We evaluated the appropriateness of DAPT use in TIA and stroke patients in a prospective database.MethodsThe Qatar Stroke Database began the enrollment of patients with TIAs and acute stroke in 2014 and currently has ~16,000 patients. For this study, we evaluated the rates of guideline-adherent use of antiplatelet treatment at the time of discharge in patients with TIAs and stroke. TIAs were considered high-risk with an ABCD2 score of 4, and a minor stroke was defined as an NIHSS of 3. Patient demographics, clinical features, risk factors, previous medications, imaging and laboratory investigations, final diagnosis, discharge medications, and discharge and 90-day modified Rankin Scale (mRS) were analyzed.ResultsAfter excluding patients with ICH, mimics, and rare secondary causes, 8,082 patients were available for final analysis (TIAs: 1,357 and stroke: 6,725). In high-risk TIAs, 282 of 666 (42.3%) patients were discharged on DAPT. In patients with minor strokes, 1,207 of 3,572 (33.8%) patients were discharged on DAPT. DAPT was inappropriately offered to 238 of 691 (34.4%) low-risk TIAs and 809 of 3,153 (25.7%) non-minor stroke patients.ConclusionThis large database of prospectively collected patients with TIAs and stroke shows that, unfortunately, despite several guidelines, a large majority of patients with TIAs and stroke are receiving inappropriate antiplatelet treatment at discharge from the hospital. This requires urgent attention and further investigation.
Regression models for partially localized fMRI connectivity analyses
Authors: Smith Bonnie B. , Zhao Yi , Lindquist Martin A. , Caffo Brian 
Published: November 2023

BackgroundBrain functional connectivity analysis of resting-state functional magnetic resonance imaging (fMRI) data is typically performed in a standardized template space assuming consistency of connections across subjects. Analysis methods can come in the form of one-edge-at-a-time analyses or dimension reduction/decomposition methods. Common to these approaches is an assumption that brain regions are functionally aligned across subjects; however, it is known that this functional alignment assumption is often violated.MethodsIn this paper, we use subject-level regression models to explain intra-subject variability in connectivity. Covariates can include factors such as geographic distance between two pairs of brain regions, whether the two regions are symmetrically opposite (homotopic), and whether the two regions are members of the same functional network. Additionally, a covariate for each brain region can be included, to account for the possibility that some regions have consistently higher or lower connectivity. This style of analysis allows us to characterize the fraction of variation explained by each type of covariate. Additionally, comparisons across subjects can then be made using the fitted connectivity regression models, offering a more parsimonious alternative to edge-at-a-time approaches.ResultsWe apply our approach to Human Connectome Project data on 268 regions of interest (ROIs), grouped into eight functional networks. We find that a high proportion of variation is explained by region covariates and network membership covariates, while geographic distance and homotopy have high relative importance after adjusting for the number of predictors. We also find that the degree of data repeatability using our connectivity regression model—which uses only partial location information about pairs of ROI's—is comparably as high as the repeatability obtained using full location information.DiscussionWhile our analysis uses data that have been transformed into a common template-space, we also envision the method being useful in multi-atlas registration settings, where subject data remains in its own geometry and templates are warped instead. These results suggest the tantalizing possibility that fMRI connectivity analysis can be performed in subject-space, using less aggressive registration, such as simple affine transformations, multi-atlas subject-space registration, or perhaps even no registration whatsoever.
Outcomes of cochlear implantation in 75 patients with auditory neuropathy
Authors: Wu Jie , Chen Jiyue , Ding Zhiwei , Fan Jialin , Wang Qiuquan , Dai Pu , Han Dongyi 
Published: November 2023

BackgroundCochlear implantation (CI) outcomes in patients with auditory neuropathy (AN) are variable, which hampers patients’ decisions on CI.ObjectiveThis study aims to assess the outcomes of CI in individuals diagnosed with AN and to examine the various factors that may influence the effectiveness of this intervention.MethodsA total of 75 patients diagnosed with AN were included in the study. The hearing threshold, the score of categories of auditory performance (CAP), speech intelligibility rating (SIR), and speech audiometry were tested. Genetic testing was conducted by medical exome sequencing in 46 patients.ResultsAfter CI, the average aided hearing threshold for patients with prelingual and post-lingual onset was 38.25 ± 6.63 dB and 32.58 ± 9.26 dB, respectively; CAP score improved to 5.52 ± 1.64 (p &lt; 0.001) and 6.00 ± 0.96 (p &lt; 0.001), respectively; SIR score increased to 3.57 ± 1.22 (p &lt; 0.001) and 4.15 ± 0.95 (p &lt; 0.001), respectively. Maximum speech recognition ranged from 58 to 93% for prelingual onset patients and 43 to 98% for those with post-lingual onset. Speech outcomes of CI in cases with cochlear nerve (CN) deficiency were significantly poorer (p = 0.008). Molecular etiologies, including TWIST1, ACTG1, m.A7445G, and a copy-number variant (CNV) carrying ACTB, were related to AN here.ConclusionCI is a viable therapy option for patients with AN; CN deficiency might impact outcomes of CI.
The diagnostic value of quantitative bone SPECT/CT in solitary undetermined bone lesions
Authors: Du Fen , Wumener Xieraili , Zhang Yarong , Liu Ming , Li Taichuang , Huang Size , Zhang Maoqun , Wu Rongliang , Liang Ying 
Published: November 2023

ObjectiveTo investigate the diagnostic value of the maximum standard uptake value (SUVmax) of quantitative single-photon emission computed tomography/computed tomography (SPECT/CT) in solitary undetermined bone lesions.MethodsIn Part I, retrospective study, 167 untreated patients with extra-skeletal malignant tumors by pathology were consecutively enrolled for staging with Tc-99m methyl-diphosphonate (99mTc-MDP) whole-body bone scan (WBS) and quantitative SPECT/CT, and a total of 396 bone lesions with abnormal radioactivity concentration in 167 patients were included from April 2019 to September 2020. The differences in SUVmax among the benign bone lesions, malignant bone lesions, and normal vertebrae were analyzed. The receiver operating characteristic (ROC) curve and cutoff value of SUVmax were obtained. Part II, prospective study, 49 solitary undetermined bone lesions in SPECT/CT in 49 untreated patients with extra-skeletal malignant tumors were enrolled from October 2020 to August 2022. The diagnostic efficacy of SUVmax in solitary undetermined bone lesions was assessed. The final diagnosis was based on follow-up imaging (CT, MRI, or 2-deoxy-2-[18F]fluoro-D-glucose-positron emission tomography/computed tomography) for at least 12 months.ResultsIn Part I, a total of 156 malignant and 240 benign bone lesions was determined; the SUVmax of malignant lesions (26.49 ± 12.63) was significantly higher than those of benign lesions (13.92 ± 7.16) and normal vertebrae (6.97 ± 1.52) (P = 0.00). The diagnostic efficiency of the SUVmax of quantitative SPECT/CT revealed a sensitivity of 75.00% and a specificity of 81.70% at a cutoff value of 18.07. In Part II, 17 malignant and 32 benign lesions were determined. Using SUVmax ≥18.07 as a diagnostic criterion of malignancy, it has a sensitivity of 82.35%, a specificity of 93.75%, and an accuracy of 89.80%.ConclusionThe SUVmax of quantitative SPECT/CT is valuable in evaluating solitary undetermined bone lesions. Using a cutoff SUVmax value of 18.07, quantitative SPECT/CT demonstrated high sensitivity, specificity, and accuracy in differentiating malignant from benign bone lesions.
Genetic variation and response to selection of photosynthetic and forage characteristics in Kentucky bluegrass (Poa pratensis L.) ecotypes under drought conditions
Authors: Shariatipour Nikwan , Shams Zahra , Heidari Bahram , Richards Christopher 
Published: November 2023

IntroductionEvaluation of the effects of water-limited conditions on the photosynthetic characteristics and forage yield is important for enhancing the forage productivity and drought tolerance in Kentucky bluegrass (Poa pratensis L.).MethodsIn the present study, 100 P. pratensis ecotypes collected from different geographical areas in Iran were assessed under well-watered and drought stress conditions. Genetic variation and response to selection for the photosynthetic characteristics [i.e., net photosynthesis rate (A), stomatal conductance (gs), transpiration rate (Tr), chlorophyll content (Chl), and photochemical efficiency (Fv/Fm)] and forage yield [fresh forage yield (FY) and dry forage yield (Dy)] traits were analyzed during the 2018 and 2019 growing seasons.Results and discussionDrought stress had negative effects on evaluated photosynthesis parameters and significantly reduced dry and fresh forage yields. On average, FY with a 45% decrease and gs with a 326% decrease under drought stress conditions showed the highest reduction rate among forage yield and photosynthesis traits, respectively. Genotypic coefficients of variation (GCV) for FY were lower under drought stress. The estimates of heritability, genetic advance, and genetic advance as percentage of mean showed the predominance of additive gene action for the traits. Overall, the results showed that “Ciakhor”, “Damavand”, “Karvandan”, “Basmenj”, “Abr2”, “Abrumand”, “Borhan”, “Hezarkanian”, “LasemCheshmeh”, “Torshab”, and “DoSar” have higher forage yield production with little change between two irrigation regimes, which makes them promising candidates for developing high-yielding drought-tolerant varieties through breeding programs.
Piloting a mental health intervention for young adults in poverty enrolled in post-secondary education in post-conflict regions in Colombia: a study protocol
Authors: Zimmerman Annie , García Durán María Camila , Araya Ricardo , Avendano Mauricio , Hessel Philipp , Díaz Yadira , Peña Niño Omar Dario , Donetto Sara , Escobar Lux Martha , Idrobo Fabio 
Published: November 2023

BackgroundColombia has endured more than five decades of internal armed conflict, which led to substantial costs for human capital and mental health. There is currently little evidence about the impact of incorporating a mental health intervention within an existing public cash transfer program to address poverty, and this project aims to develop and pilot a mental health support intervention embedded within the human capital program to achieve better outcomes among beneficiaries, especially those displaced by conflict and the most socioeconomically vulnerable.MethodsThe study will consist of three phases: semi-structured one-to-one interviews, co-design and adaptations of the proposed intervention with participants and pilot of the digital intervention based on cognitive behavioral therapy and transdiagnostic techniques to determine its feasibility, acceptability, efficacy, and usefulness in ‘real settings’. Results will inform if the intervention improves clinical, educational and employment prospects among those who use it.ResultsKnowledge will be generated on whether the mental health intervention could potentially improve young people’s mental health and human capital in conflict-affected areas? We will evaluate of the impact of potential mental health improvements on human capital outcomes, including educational and employment outcomes.ConclusionFindings will help to make conclusions about the feasibility and acceptability of the intervention, and it will assess its effectiveness to improve the mental health and human capital outcomes of beneficiaries. This will enable the identification of strategies to address mental health problems among socioeconomically vulnerable young people that can be adapted to different contexts in in low and middle-income countries.
Effectiveness and impact of community-based health insurance on health service utilization in northwest Ethiopia: a quasi-experimental evaluation
Authors: Fetene Samrawit Mihret , Mengistu Mezgebu Yitayal , Aschalew Andualem Yalew 
Published: November 2023

BackgroundAddressing the health challenges of lower socioeconomic groups in Ethiopia is still a huge problem. In that regard, the government piloted the community-based health insurance (CBHI) in 2011 in a few districts and subsequently scaled up. However, the effectiveness of the program on the utilization of health services and its impact was not well explored. Thus, we aimed to evaluate the effectiveness of CBHI toward health services’ utilization and its impact in northwest Ethiopia.MethodsA quasi-experimental matched comparison group evaluation design with sequential explanatory mixed methods was employed. To evaluate the CBHI program, the effectiveness and impact dimensions from the Organization for Economic Cooperation and Development framework were used. A multistage sampling technique was used to select a total of 332 households enrolled in the CBHI program; 341 comparison households who did not enroll in the program were also randomly selected. A structured interviewer-administrated questionnaire was used to evaluate the effectiveness and impact of CBHI on health service utilization. The Propensity score matching model was employed for the estimation of the effect of the CBHI program on health service utilization. Challenges for program achievement toward health service utilization were explained through qualitative data and these were then analyzed thematically.ResultsThe evaluation showed 1.3 visits per capita per year of health service utilization among CBHI members. Households enrolled in CBHI increased health service utilization by 6.9 percentage points (ATT = 0.069; 95% CI: 0.034, 0.114). There was an improvement in health service utilization after the introduction of CBHI, however, there are challenges: (i) shortage of human resources, (ii) out-of-stock of drugs and medical supplies, and (iii) long waiting times for service and reimbursement claims. These issues limit the success of the program toward health service utilization.ConclusionThe CBHI program contributed to health service utilization improvement among CBHI members. However, the utilization rate of health services among CBHI members is still less than the target stated for the program and also the WHO recommendation. Therefore, the findings of this evaluation can be used by program implementers, policy makers, and other stakeholders to overcome the identified challenges and to increase the success of the program.
Impact of the COVID-19 pandemic on acute mental health admissions in Croatia
Authors: Kalanj Karolina , Ćurković Marko , Peček Mirta , Orešković Stjepan , Orbanić Ante , Marshall Rick 
Published: November 2023

BackgroundThe pandemic of COVID-19 had a profound impact on our community and healthcare system. This study aims to assess the impact of COVID-19 on psychiatric care in Croatia by comparing the number of acute psychiatric cases before coronavirus disease (2017–2019) and during the pandemic (2020–2022).Materials and methodsThe paper is a retrospective, comparative analyzes of the hospital admission rate in Diagnosis Related Group (DRG) classes related to mental diseases, and organic mental disorders caused by alcohol and drug use. This study used DRG data from all acute hospitals in Croatia accredited to provide mental health care services and relevant publicly available data from the Croatian Institute of Public Health (CIPH) and the Croatian Health Insurance Fund (CHIF). All hospital admissions for acute psychiatric patients in Croatia were tracked during both periods under study.ResultsDuring the pandemic, the average number of all such cases decreased by 28% in secondary and tertiary hospitals, and by 11% in specialist psychiatric hospitals. It was also found that during COVID-19, there was a decrease in case numbers in DRG classes related to major affective disorders and anxiety, alcohol, and drug intoxication (31, 48, 34 and 45%, respectively). However, the same period saw an increase in hospital activity for eating disorders and for involuntary admissions related to schizophrenia and paranoia (30, 34 and 39% respectively). There were no changes in the admission rate for cases related to opioid use.ConclusionThe COVID-19 pandemic resulted in both a steep decrease in the overall number of psychiatric cases inpatient treatment at mental health facilities and their DRG casemix. Increasing our understanding of how pandemics and isolation affect demand for psychiatric care will help us better plan for future crises and provide more targeted care to this vulnerable group.