bluuebunny/crossref_metadata_2025_split huggingface dataset:
CDKN2A/B deletions are strongly associated with meningioma progression: a meta-analysis of individual patient data
Authors: Wach Johannes , Basaran Alim Emre , Arlt Felix , Vychopen Martin , Seidel Clemens , Barrantes-Freer Alonso , Müller Wolf , Gaunitz Frank , Güresir Erdem 
Published: November 2023

AbstractHomozygous CDKN2A/B deletion has been associated with an increased risk of recurrence in meningiomas. However, the evidence is confined to a limited number of studies, and the importance of heterozygous CDKN2A/B deletions remains insufficiently investigated. Hence, the present meta-analysis reconstructs individual patient data (IPD) and reconstructs the probabilities of progression-free survival (PFS) stratified by CDKN2A/B status. IPD of PFS rates were extracted from published Kaplan–Meier plots using the R package IPDfromKM in R studio (RStudio, Boston, MA, USA). Reconstructed Kaplan–Meier Plots of the pooled IPD data were created. One-stage and two-stage meta-analyses were performed. Hazard ratios (HR) were used as effective measures. Of 181 records screened, four articles with 2521 participants were included. The prevalence of homozygous CDKN2A/B deletions in the included studies was 0.049 (95% CI 0.040–0.057), with higher tumor grades associated with a significantly greater proportion of CDKN2A/B deletions. The reconstructed PFS curves for the pooled cohort showed that the median PFS time of patients with a CDKN2A/B wild-type status, heterozygous or homozygous CDKN2A/B deletion was 180.0 (95% CI 145.7–214.3), 26.1 (95% CI 23.3–29.0), and 11.00 (95% CI 8.6–13.3) months, respectively (p < 0.0001). Both hetero- or homozygous CDKN2A/B deletions were significantly associated with shortened time to meningioma progression. One-stage meta-analysis showed that hetero- (HR: 5.5, 95% CI 4.0–7.6, p < 0.00001) and homozygous CDKN2A/B deletions (HR: 8.4, 95% CI 6.4–11.0, p < 0.00001) are significantly associated with shortened time to meningioma progression. Multivariable Cox regression analysis of progression in a subgroup with available covariates (age, sex, WHO grade, and TERT status) and also two-stage meta-analysis confirmed and validated the results of the one-stage analysis that both heterozygous and homozygous CDKN2A/B deletions are of prognostic importance. Further large-scale studies of WHO grade 2 and 3 meningiomas are needed to validate the importance of heterozygous CDKN2A/B deletions with consideration of established factors.
A quantitative evaluation model of ancient military defense efficiency based on spatial strength—take Zhejiang of the Ming Dynasty as an example
Authors: Wang Yinggang , Tan Lifeng , Zhang Zao , Liu Huanjie , Liu Jiayi , Zhang Yukun , Mu Mengqi 
Published: November 2023

Abstract
In the study of the defense capacity of ancient military settlements, most existing studies have evaluated the defense capacity of citadels qualitatively from a historiographical perspective. There are fewer quantitative studies on defense efficiency in a specific regional context. This paper takes the coastal defense citadels system of Zhejiang in the Ming Dynasty of China as the research object. It adopts a combination of digital historical data mining and quantitative research to study the defense efficiency of the military defense area in Zhejiang in the Ming Dynasty. This paper first analyzes the defense pattern of Zhejiang's sea defense citadels system in the Ming Dynasty. It determines the control points of defense groups, quantifies the defense group area with a Voronoi diagram, and classifies and assigns the entropy value to the deployment data of guard forts in historical data. Finally, the assigned forces are superimposed on the defense area to obtain the quantified defense efficiency of each defense group, and the defense results are verified. This paper innovatively proposes an "area-force" perspective. It introduces spatial segmentation and quantitative research methods to study the defense efficiency of a specific regional defense group system in ancient times. It proves that this method is feasible and can be applied to the study of other ancient military defense areas. It also expands the scientific perspective of ancient military fortification systems, which can contribute to systematically preserving ancient military settlement heritage on a larger scale.
Multiple angiosarcomas of both breasts: a case report
Authors: Matsuda Ryota , Saimura Michiyo , Anan Keisei , Katsuyama Kento , Tahara Yuki , Kurata Kanako , Horioka Kohei , Nakamoto Mitsuhiro , Koga Kenichiro , Mitsuyama Shoshu , Sato Eiichi , Wakamatsu Shinichi , Tamiya Sadafumi 
Published: November 2023

Abstract
Background
Primary angiosarcomas of the breast are rare and highly aggressive. We herein report a rare case of multiple angiosarcomas detected concurrently in both breasts.

Case presentation
A 49-year-old woman visited a doctor after noticing a lump in her right breast. At that time, mammography and ultrasonography revealed no abnormal findings in either breast. She was referred to our hospital 5 months later, because screening mammography had revealed a focal asymmetric density in her right breast. Ultrasonography showed ill-defined hyper- and hypo-echoic lesions in both breasts. Magnetic resonance imaging disclosed five heterogeneously enhanced masses (5.8 cm in maximum diameter) in the right breast and six enhanced masses (approximately 1–3 cm in diameter) in the left breast. Histological examination of core needle biopsies revealed proliferation of irregularly shaped vascular channels lined by atypical endothelial cells throughout the adipose tissue and lobules of the breasts, leading to a diagnosis of well-differentiated angiosarcoma. The lesions were assumed to be primary angiosarcomas, because she had neither a history of breast surgery nor of radiation therapy. She underwent bilateral mastectomies and postoperative chest wall irradiation. Computed tomography 11 weeks after the surgery revealed multiple, small, subcutaneous nodules in the chest wall that were suspected of being angiosarcoma metastases. We started chemotherapy (weekly paclitaxel 80 mg/m2), which achieved shrinkage of these nodules within 2 months.

Conclusions
Early diagnosis, immediate initiation of local and systemic therapies, and intensive follow-up are important in improving the prognosis of angiosarcomas.
Nutritional status of flexitarians compared to vegans and omnivores - a cross-sectional pilot study
Authors: Bruns Anja , Nebl Josefine , Jonas Wiebke , Hahn Andreas , Schuchardt Jan Philipp 
Published: November 2023

Abstract
Background
In the Western world, there has been a notable rise in the popularity of plant-based, meat-reduced flexitarian diets. Nevertheless, there is insufficient data on the nutritional status of individuals following this dietary pattern. The aim of this study was to investigate the intake and endogenous status of various nutrients in a healthy German adult study population consisting of flexitarians (FXs), vegans (Vs) and omnivores (OMNs).

Methods
In this cross-sectional study, dietary intake of 94 non-smoking adults (32 FXs, 33 Vs, 29 OMNs) between 25 and 45 years of age was assessed using 3-day dietary records. In addition, blood samples were collected to determine different endogenous nutrient status markers.

Results
32%, 82% and 24% of the FXs, Vs, and OMNs respectively reported using dietary supplements. In the FXs, intake of total energy as well as macronutrients and most micronutrients were within the reference range. FXs had higher intakes of fiber, retinol-equ., ascorbic acid, folate-equ., tocopherol-equ., calcium, and magnesium compared to OMNs. However, cobalamin intake in FXs (2.12 µg/d) was below the reference (4 µg/d). Based on 4cB12, 13% of FXs showed a cobalamin undersupply [< -0.5 to -2.5] compared to 10% of OMNs, and 9% of Vs. The median 25(OH)D serum concentrations in FXs, Vs and OMNs were 46.6, 55.6, and 59.6 nmol/L. The prevalence of an insufficient/deficient vitamin-D status [< 49.9 nmol 25(OH)D/L] was highest in FXs (53%), followed by Vs (34%) and OMNs (27%). In FXs and Vs, the supplement takers had better cobalamin and vitamin-D status than non-supplement takers. Anemia and depleted iron stores were found only occasionally in all groups. In women, the prevalence of pre-latent iron deficiency and iron deficiency was highest in FXs (67%) compared to Vs (61%) and OMNs (54%).

Conclusion
Our findings indicated that all three diets delivered sufficient amounts of most macro- and micronutrients. However, deficiencies in cobalamin, vitamin-D, and iron status were common across all diets. Further studies are needed to investigate the nutrient supply status and health consequences of meat-reduced plant-based diets. The study was registered in the German Clinical Trial Register (number: DRKS 00019887, data: 08.01.2020).
Individual and community level factors for modern contraceptives utilization among reproductive aged women in Amhara region, Mixed effect multi-level modeling, Data from Mini-EDHS, 2019
Authors: Bizuneh Fassikaw Kebede , Bizuneh Tsehay Kebede , Masresha Seteamlak Adane , Yayeh Berihun Mulu 
Published: November 2023

Abstract
Background
Modern contraceptive has been identified as a key strategy to control unintended pregnancy, protect the health of the mother and child, and promote women wellbeing. Despite this and increasingly wider availability of modern contraceptives, however, there are still high levels of unmet need for birth interspacing and contraceptive use in Amhara regions. This study aimed to identify factors associated with the enhancing of modern contraceptives utilization among reproductive aged women in Amhara region, using a mixed effects multilevel modeling data from mini-EDHS 2019.

Methods
A community-based cross-sectional study was conducted among 711(wt = 100%) samples of reproductive-aged women. The data were interviewed by trained data collectors using a semi-structured questionnaire for the final mini-EDHS 2019 data set. A multilevel binary logistic regression model was fitted to identify the enhancing factors for modern contraceptive utilization Adjusted Odds Ratio (AOR) with 95% Confidence Intervals (CI) was used to identify factors associated with utilization.

Result
The median age of the participants was 31 with (IQR ± 13) years. The overall modern contraceptive utilization was 42.3% (95%CI: 38.7; 46.1). Individual and community factors accounted for 21.4% of the variation in modern contraceptive utilization at the cluster level. Being age 25 years (AOR = 12.99; 95%CI: 4.5–37.2), 26–35 years (AOR = 8.8, 95%CI: 3.25- 24), 36–45 years (AOR = 5.6, 95%CI: 2.2–16.2), being married (AOR = 4.2, 95%CI: 2.21–6.97), educated women (AOR = 11.6, 95%CI: 3.22–40.4), and being middle-economic class (AOR = 3.03; 95%CI: 1.87–4.91) were identified as individual enhancing factors. Whereas, being urban resident (AOR = 5.19; 95%CI: 5.19: 41.7) and having media exposure (AOR = 1.5; 95%CI: 1.58–3.7) were community-level enhancing factors for modern contraceptive utilization.

Conclusion
Compared to earlier studies, in Amhara region, a lower prevalence rate of modern contraceptive utilization was reported. The variation in utilization at the cluster level, 21.4%, was attributed to individual and community-level factors. Healthcare providers should prioritize raising awareness about contraceptive side effects to encourage new users and decrease the number of individuals who discontinue contraceptive methods.
Impact of tardive dyskinesia on patients and caregivers: a survey of caregivers in the United States
Authors: Jain Rakesh , Ayyagari Rajeev , Goldschmidt Debbie , Zhou Mo , Finkbeiner Stacy , Leo Sam 
Published: November 2023

Abstract
Background
Tardive dyskinesia (TD) has a multidimensional impact on patients with TD and, as importantly, their caregivers. An online survey was developed and administered to assess patient and caregiver burden of TD. Survey participants were unpaid caregivers for patients with diagnoses of TD and schizophrenia, bipolar disorder, and/or major depressive disorder. Overall, 162 caregivers rated the 7-day impact of TD on the physical, psychological, and social functioning of patients and the impact of TD on these domains in their own lives and in their professional lives.

Results
Across physical, psychological, and social domains, most caregivers (82.7%) reported that TD had severe impact on the cared-for patients, and 23.5% reported severe impact of TD in their own lives. Caregivers experienced 46.4% activity impairment, and caregivers who were employed (n = 136) experienced 49.5% overall work impairment because of TD-related caregiving.

Conclusions
These results suggest that TD imposes substantial burden for both caregivers and patients.
Research Note Showing That the Rural Mortality Penalty Varies by Region, Race, and Ethnicity in the United States, 1999–2016
Authors: Rhubart Danielle , Santos Alexis 
Published: November 2023

Abstract
This research note presents a new perspective on the rural mortality penalty in the United States. While previous work has documented a growing rural mortality penalty, there has been a lack of attention to heterogeneity in trends at the intersection of region, race, and ethnicity. We use age-adjusted mortality rates from the Centers for Disease Control and Prevention to examine the rural mortality penalty by region, race, and ethnicity for 1999–2016 (N = 44,792,050 deaths) and stratify by 2006 National Center for Health Statistics metropolitan–nonmetropolitan classifications. We find substantial variation at the intersection of region, race, and ethnicity, revealing heterogeneity in the rural penalty and—in some cases—a rural mortality advantage. For the Black/African American population, the rural mortality penalty is observed only in the South. On the other hand, for Hispanic/Latino populations, a small but persistent rural mortality penalty is present only in the South and the West. There is a rural mortality penalty in all regions for White and American Indian/Alaska Native populations. However, for the latter, there is substantial variation in the magnitude of the penalty by region of residence. This research documents heterogeneous patterns when the rural mortality penalty is analyzed by region, race, and ethnicity in the United States.
The implication of interleukin-2 on the expression of CD56bright, CD56dim, and interferon-γ in patients with systemic lupus erythematosus
Authors: Soelistyoningsih Dwi , Susianti Hani , Kalim Handono , Handono Kusworini , Fajar Jonny Karunia 
Published: November 2023

Background: Interleukin-2 (IL-2) stimulation had been reported as having a beneficial impact to the expression of CD56bright, CD56dim, and interferon-γ (IFN-γ) in the case of immunological dysfunction diseases. However, in the case of systemic lupus erythematosus (SLE), the role of IL-2 had never been investigated. The objective of this study was to assess the impact of IL-2 on the expression of CD56bright, CD56dim, and IFN-γ in SLE patients. Methods: An experimental study was conducted by involving peripheral blood mononuclear cells isolated from six SLE patients. The study consisted of four groups based on IL-2 stimulation: D0 (0U/ml), D1 (50U/ml), D2 (150U/ml), and D3 (250U/ml); and they were then cultured for 72 hours. The levels of CD56bright and CD56dim were measured by FACSMelodyTM, while the levels of IFN-γ were measured using ELISA. Results: In group D0, D1, D2, and D3; the levels of CD56bright were 57.27±37.27, 241.16±64.41, 256.94±50.95, and 259.37±36.44 x1000 cells/mm3 respectively. Moreover, the levels of CD56dim were 812.85±167.37, 631.98±129.90, 616.42±157.97, and 615.90±155.57 x1000 cells/mm3 respectively. On the other hand, the levels of IFN-γ were 24.01±2.56, 26.09±4.79, 30.11±5.34, and 32.43±7.14 pg/ml respectively. Our analysis elucidated that the administration of IL-2 provided potential impact to the levels of CD56bright, but not to the levels of CD56dim and IFN-γ. Our findings indicated that the increased dosage of IL-2 resulted in a more significant impact on CD56bright. Conclusions: Our study clarifies that IL-2 provides a beneficial impact on CD56bright expression in SLE patients.
Evolutionary Algorithm on General Cover with Theoretically Guaranteed Approximation Ratio
Authors: Zhang Yaoyao , Zhu Chaojie , Tang Shaojie , Ran Yingli , Du Ding-Zhu , Zhang Zhao 
Published: November 2023

Theoretical studies on evolutionary algorithms have developed vigorously in recent years. Many such algorithms have theoretical guarantees in both running time and approximation ratio. Some approximation mechanism seems to be inherently embedded in many evolutionary algorithms. In this paper, we identify such a relation by proposing a unified analysis framework for a global simple multiobjective evolutionary algorithm (GSEMO) and apply it on a minimum weight general cover problem, which is general enough to subsume many important problems including the minimum submodular cover problem in which the submodular function is real-valued, and the minimum connected dominating set problem for which the potential function is nonsubmodular. We show that GSEMO yields theoretically guaranteed approximation ratios matching those achievable by a greedy algorithm in expected polynomial time when the potential function g is polynomial in the input size and the minimum gap between different g-values is a constant. History: Accepted by Erwin Pesch, Area Editor for Heuristic Search & Approximation Algorithms. Funding: This work was supported by National Natural Science Foundation of China [11771013, U20A2068]; Zhejiang Provincial Natural Science Foundation of China [LD19A010001].
Financing Innovative Activity and the Endogeneity of Patenting
Authors: Marquez Robert , Nguyen Thành , Yavuz M. Deniz 
Published: November 2023

It is common for lenders to require innovative firms to report all innovations and take actions, such as patenting, to protect their value. However, many future innovations are difficult to verify, making enforcement of such requirements difficult. This creates a tension for firms between protecting their innovations through patenting and creating assets that can be liquidated by a lender when not fully repaid. We show that the endogeneity of the patenting decision introduces an upper bound on the long-term payments that can be credibly promised to a lender, affecting the feasibility of obtaining financing and the terms of financial contracts. This paper was accepted by David Sraer, finance.
Stochastic Liquidity as a Proxy for Nonlinear Price Impact
Authors: Muhle-Karbe Johannes , Wang Zexin , Webster Kevin 
Published: November 2023

For the “In This Issue” column: Trading costs play a central role in designing and implementing quantitative trading strategies. To quantify trading costs, optimal execution and trading algorithms rely on price impact models, such as the propagator model. Empirically, price impact is concave in trade sizes, leading to nonlinear models for which optimization problems are intractable and even qualitative properties, such as price manipulation, are poorly understood. This paper shows that, in the diffusion limit of small and frequent orders, the nonlinear model converges to a tractable linear model. In this high-frequency limit, a stochastic liquidity parameter approximates the original impact function’s nonlinearity. This allows us to derive simple formulas for optimal trading strategies and sharp conditions on market volumes to rule out price manipulation. A detailed empirical study using high-frequency limit-order data illustrates the practical performance of the theoretical results.
Computational and dark-field ghost imaging with ultraviolet light
Authors: Song Jiaqi , Liu Baolei , Wang Yao , Chen Chaohao , Shan Xuchen , Zhong Xiaolan , Wu Ling-An , Wang Fan 
Published: November 2023

Ultraviolet (UV) imaging enables a diverse array of applications, such as material composition analysis, biological fluorescence imaging, and detecting defects in semiconductor manufacturing. However, scientific-grade UV cameras with high quantum efficiency are expensive and include complex thermoelectric cooling systems. Here, we demonstrate a UV computational ghost imaging (UV-CGI) method to provide a cost-effective UV imaging and detection strategy. By applying spatial–temporal illumination patterns and using a 325 nm laser source, a single-pixel detector is enough to reconstruct the images of objects. We use UV-CGI to distinguish four UV-sensitive sunscreen areas with different densities on a sample. Furthermore, we demonstrate dark-field UV-CGI in both transmission and reflection schemes. By only collecting the scattered light from objects, we can detect the edges of pure phase objects and small scratches on a compact disc. Our results showcase a feasible low-cost solution for nondestructive UV imaging and detection. By combining it with other imaging techniques, such as hyperspectral imaging or time-resolved imaging, a compact and versatile UV computational imaging platform may be realized for future applications.
Surgery with locking plate or hemiarthroplasty versus nonoperative treatment of 3–4-part proximal humerus fractures in older patients (NITEP): An open-label randomized trial
Authors: Launonen Antti P. , Sumrein Bakir O. , Reito Aleksi , Lepola Vesa , Paloneva Juha , Berg Hans E. , Felländer-Tsai Li , Kask Kristo , Rahnel Timo , Tootsi Kaspar , Märtson Aare , Jonsson Kenneth B. , Wolf Olof , Ström Peter , Døssing Kaj , Østergaard Helle K. , Mechlenburg Inger , Mattila Ville M. , Laitinen Minna K. 
Published: November 2023

Background
Proximal humerus fractures (PHFs) are common fractures, especially in older female patients. These fractures are commonly treated surgically, but the consensus on the best treatment is still lacking.

Methods and findings
The primary aim of this multicenter, randomized 3-arm superiority, open-label trial was to assess the results of nonoperative treatment and operative treatment either with locking plate (LP) or hemiarthroplasty (HA) of 3- and 4-part PHF with the primary outcome of Disabilities of the Arm, Shoulder, and Hand (DASH) at 2-year follow-up.
Between February 2011 and December 2019, 160 patients 60 years and older with 3- and 4-part PHFs were randomly assigned in 1:1:1 fashion in block size of 10 to undergo nonoperative treatment (control) or operative intervention with LP or HA. In total, 54 patients were assigned to the nonoperative group, 52 to the LP group, and 54 to the HA group. Five patients assigned to the LP group were reassigned to the HA group perioperatively due to high comminution, and all of these patients had 4-part fractures. In the intention-to-treat analysis, there were 42 patients in the nonoperative group, 44 in the LP group, and 37 in the HA group. The outcome assessors were blinded to the study group.
The mean DASH score at 2-year follow-up was 30.4 (standard error (SE) 3.25), 31.4 (SE 3.11), and 26.6 (SE 3.23) points for the nonoperative, LP, and HA groups, respectively. At 2 years, the between-group differences were 1.07 points (95% CI [−9.5,11.7]; p = 0.97) between nonoperative and LP, 3.78 points (95% CI [−7.0,14.6]; p = 0.69) between nonoperative and HA, and 4.84 points (95% CI [−5.7,15.4]; p = 0.53) between LP and HA. No significant differences in primary or secondary outcomes were seen in stratified age groups (60 to 70 years and 71 years and over).
At 2 years, we found 30 complications (3/52, 5.8% in nonoperative; 22/49, 45% in LP; and 5/49, 10% in HA group, p = 0.0004) and 16 severe pain-related adverse events. There was a revision rate of 22% in the LP group.
The limitation of the trial was that the recruitment period was longer than expected due to a high number of exclusions after the assessment of eligibility and a larger exclusion rate than anticipated toward the end of the trial. Therefore, the trial was ended prematurely.

Conclusions
In this study, no benefit was observed between operative treatment with LP or HA and nonoperative treatment in displaced 3- and 4-part PHFs in patients aged 60 years and older. Further, we observed a high rate of complications related to operative treatments.

Trial Registration
ClinicalTrials.gov NCT01246167.