bluuebunny/crossref_metadata_2025_split huggingface dataset:
Validation and interpretation of Pan-TRK immunohistochemistry: a practical approach and challenges with interpretation
Authors: Karakas Cansu , Giampoli Ellen J. , Love Tanzy , Hicks David G. , Velez Moises J. 
Published: January 2024

Abstract
Objectives
Actionable, solid tumor activating neurotrophic receptor tyrosine kinase (NTRK) fusions are best detected via nucleic acid-based assays, while Pan-TRK immunohistochemistry (IHC) serves as a reasonable screening modality. We describe a practical and cost-effective approach to validate pan-TRK and discuss challenges that may be encountered.

Methods
Pan-TRK Clone EPR17341 was validated in accordance with the 2014 consensus statements set forth by the College of American Pathologists. Confirmation of IHC results were guided by the European Society of Medical Oncology recommendations for standard methods to detect NTRK fusions.

Results
Within 36 samples, ETV6-NTRK3 (n = 8) and TPM4-NTRK3 (n = 1) fusions were confirmed. ETV6-NTRK3 fusion positive cases revealed cytoplasmic and nuclear staining. A TPM4-NTRK3 fusion positive high grade malignant peripheral nerve sheath tumor revealed diffuse cytoplasmic staining. A high grade ovarian serous carcinoma revealed focal punctate staining and revealed a non-actionable NTRK1 truncation at intron 2. Diffuse cytoplasmic staining was observed in a case of fusion-negative polymorphous adenocarcinoma. Wild-type expression of TRK in pulmonary meningothelial-like nodules was discovered following a false-positive IHC interpretation.

Conclusion
Pan-TRK IHC shows some utility as a diagnostic and surrogate marker for NTRK screening however, physiologic or non-specific expression may lead to false-positive results.
Ethnobotanical and ethnomedicinal research into medicinal plants in the Mt Stara Planina region (south-eastern Serbia, Western Balkans)
Authors: Jarić Snežana , Kostić Olga , Miletić Zorana , Marković Milica , Sekulić Dimitrije , Mitrović Miroslava , Pavlović Pavle 
Published: January 2024

AbstractBackgroundEthnobotanical research in Southeast Europe—one of the most important European hotspots for biocultural diversity—is significant for the acquisition of Traditional Ecological Knowledge related to plants as well as for encouraging the development of local environments. The current ethnobotanical research was conducted in the region of Mt Stara Planina (south-eastern Serbia), which is characterised by rich phytodiversity with a large number of endemic and relict plant species. The aim of the study was to document the diversity of uses of medicinal plants and of traditional knowledge on their therapeutic uses.MethodsEthnobotanical data was collected through both open and semi-structured interviews with locals. Fifty-one inhabitants were interviewed (26 men and 25 women), aged 30–91, and data was analysed by means of use reports, citation frequency, use values (UV), and the informant consensus factor (ICF).ResultsThe study identified 136 vascular medicinal plant taxa and one lichen species belonging to 53 families and 116 genera. Lamiaceae (19), Rosaceae (18), and Asteraceae (17) had the highest species diversity. The plant parts most commonly used to make a variety of herbal preparations were the aerial parts (54 citations), leaves (35 citations), fruits (20 citations), flowers (18 citations), and roots (16 citations), while the most common forms of preparation were teas (60.78%), consumption of fresh tubers, leaves, roots, and fructus (6.86%), compresses (5.88%), juices (5.39%), decoctions (3.92%), ‘travarica’ brandy (3.92%), and syrups (2.45%). Of the recorded species, 102 were administered orally, 17 topically, and 18 both orally and topically. The plants with a maximum use value (UV = 1) wereAllium sativum, Allium ursinum, Gentiana asclepiadea, Gentiana cruciata, Gentiana lutea, Hypericum perforatum, Thymus serpyllumandUrtica dioica. The highest ICF value (ICF = 0.95) was recorded in the categories of Skin and Blood, Blood Forming Organs, and Immune Mechanism.ConclusionsThis study shows that medicinal plants in the research area are an extremely important natural resource for the local population as they are an important component of their health culture and provide a better standard of living.
New midpoint-type inequalities in the context of the proportional Caputo-hybrid operator
Authors: Demir İzzettin , Tunç Tuba 
Published: January 2024

AbstractFractional calculus is a crucial foundation in mathematics and applied sciences, serving as an extremely valuable tool. Besides, the new hybrid fractional operator, which combines proportional and Caputo operators, offers better applications in numerous fields of mathematics and computer sciences. Due to its wide range of applications, we focus on the proportional Caputo-hybrid operator in this research article. Firstly, we begin by establishing a novel identity for this operator. Then, based on the newfound identity, we establish some integral inequalities that are relevant to the left-hand side of Hermite–Hadamard-type inequalities for the proportional Caputo-hybrid operator. Furthermore, we show how the results improve upon and refine many previous findings in the setting of integral inequalities. Later, we present specific examples together with their related graphs to offer a better understanding of the newly obtained inequalities. Our results not only extend previous studies but also provide valuable viewpoints and methods for tackling a wide range of mathematical and scientific problems.
Perspectives of clinical stakeholders and patients from four VA liver clinics to tailor practice facilitation for implementing evidence-based alcohol-related care
Authors: Soyer Elena M. , Frost Madeline C. , Fletcher Olivia V. , Ioannou George N. , Tsui Judith I. , Edelman E. Jennifer , Weiner Bryan J. , Bachrach Rachel L. , Chen Jessica A. , Williams Emily C. 
Published: January 2024

Abstract
Background
Unhealthy alcohol use (UAU) is particularly dangerous for people with chronic liver disease. Liver clinics may be an important setting in which to provide effective alcohol-related care by integrating evidence-based strategies, such as brief intervention and medications for alcohol use disorder. We conducted qualitative interviews with clinical stakeholders and patients at liver clinics in four Veterans Health Administration (VA) medical centers to understand barriers and facilitators of integrating alcohol-related care and to support tailoring of a practice facilitation implementation intervention.

Methods
Data collection and analysis were guided by the Consolidated Framework for Implementation Research (CFIR). Interviews were transcribed and qualitatively analyzed using a Rapid Assessment Process (RAP) guided by the CFIR.

Results
We interviewed 46 clinical stakeholders and 41 patient participants and analyzed findings based on the CFIR. Clinical stakeholders described barriers and facilitators that ranged from operations/clinic resource-based (e.g., time and capacity, desire for additional provider types, referral processes) to individual perspective and preference-based (e.g., supportiveness of leadership, individual experiences/beliefs). Patient participants shared barriers and facilitators that ranged from relationship-based (e.g., trusting the provider and feeling judged) to resource and education-based (e.g., connection to a range of treatment options, education about impact of alcohol). Many barriers and facilitators to integrating alcohol-related care in liver clinics were similar to those identified in other clinical settings (e.g., time, resources, role clarity, stigmatizing beliefs). However, some barriers (e.g., fellow-led care and lack of integration of liver clinics with addictions specialists) and facilitators (e.g., presence of quality improvement staff in clinics and integrated pharmacists and behavioral health specialists) were more unique to liver clinics.

Conclusions
These findings support the possibility of integrating alcohol-related care into liver clinics but highlight the importance of tailoring efforts to account for variation in provider beliefs and experiences and clinic resources. The barriers and facilitators identified in these interviews were used to tailor a practice facilitation implementation intervention in each clinic setting.
CNN-IKOA: convolutional neural network with improved Kepler optimization algorithm for image segmentation: experimental validation and numerical exploration
Authors: Abdel-Basset Mohamed , Mohamed Reda , Alrashdi Ibrahim , Sallam Karam M. , Hameed Ibrahim A. 
Published: January 2024

AbstractChest diseases, especially COVID-19, have quickly spread throughout the world and caused many deaths. Finding a rapid and accurate diagnostic tool was indispensable to combating these diseases. Therefore, scientists have thought of combining chest X-ray (CXR) images with deep learning techniques to rapidly detect people infected with COVID-19 or any other chest disease. Image segmentation as a preprocessing step has an essential role in improving the performance of these deep learning techniques, as it could separate the most relevant features to better train these techniques. Therefore, several approaches were proposed to tackle the image segmentation problem accurately. Among these methods, the multilevel thresholding-based image segmentation methods won significant interest due to their simplicity, accuracy, and relatively low storage requirements. However, with increasing threshold levels, the traditional methods have failed to achieve accurate segmented features in a reasonable amount of time. Therefore, researchers have recently used metaheuristic algorithms to tackle this problem, but the existing algorithms still suffer from slow convergence speed and stagnation into local minima as the number of threshold levels increases. Therefore, this study presents an alternative image segmentation technique based on an enhanced version of the Kepler optimization algorithm (KOA), namely IKOA, to better segment the CXR images at small, medium, and high threshold levels. Ten CXR images are used to assess the performance of IKOA at ten threshold levels (T-5, T-7, T-8, T-10, T-12, T-15, T-18, T-20, T-25, and T-30). To observe its effectiveness, it is compared to several metaheuristic algorithms in terms of several performance indicators. The experimental outcomes disclose the superiority of IKOA over all the compared algorithms. Furthermore, the IKOA-based segmented CXR images at eight different threshold levels are used to train a newly proposed CNN model called CNN-IKOA to find out the effectiveness of the segmentation step. Five performance indicators, namely overall accuracy, precision, recall, F1-score, and specificity, are used to disclose the CNN-IKOA’s effectiveness. CNN-IKOA, according to the experimental outcomes, could achieve outstanding outcomes for the images segmented at T-12, where it could reach 94.88% for overall accuracy, 96.57% for specificity, 95.40% for precision, and 95.40% for recall.
The size of the Hill Sachs defect increases during reduction of a first time shoulder dislocation in older adults: a pilot study in 20 cases
Authors: Ruiz Ibán Miguel Angel , Pérez Expósito Roque , Vicente Bártulos Agustina , Vega Rodriguez Rosa , Ruiz Díaz Raquel , Diaz Heredia Jorge 
Published: January 2024

AbstractPurposeTo evaluate if the size of Humeral Hill‐Sachs Defects (HSDs) increases during reduction in the emergency department (ED) in subjects that have a first‐time anterior shoulder dislocation.MethodsSubjects more than 18 years old presenting to the ED a first‐time anterior shoulder dislocation were included. A computed tomography was performed prior to any reduction attempt (Pre‐CT). The shoulder was reduced in the emergency room with intraarticular lidocaine; if two attempts failed, the shoulder was reduced under anaesthesia. A second CT was performed after reduction of the shoulder (Post‐CT).CT were evaluated using the Osirix software. A 3‐dimensional reconstruction of the humeral head was performed and the maximum width of the humeral defect, maximum depth of the humeral defect and total volume of the humeral defect were measured. The relative increase in size was calculated.ResultsTwenty subjects were included in the study. All subjects presented HSDs in the Pre‐CT that had a width of a median of 9.9(interquartile range:2.9)mm, a depth of 7.0(3.0]mm and a volume of 355(333)mm2. The HSD in the Post‐CT had a width of 10.9(3.0)mm (an increase of 7.23[8.5]%, significant differences, p = 0.0001) a depth of 7.2(2.7)mm (an increase of 9.93[20.7]%, significant differences, p < 0.0001) and a volume of 469(271) mm2 (an increase of 27.5[26.9]%, significant differences, p < 0.0001). There were size increases larger than 25% in 15/20 (75%) of subjects.ConclusionStandard reduction manoeuvres performed in a first‐time anterior shoulder dislocation increase the size of the HSD. This increase in size is larger than 25% in four out of five cases.Level of evidenceIV, prospective cases series study.
Skin sensory alteration and kneeling ability following cruciate retaining total knee arthroplasty are not affected by the incision position: A randomised controlled trial of simultaneous bilateral surgery
Authors: Barroso Rosa Sergio , Wilkinson Matthew , McEwen Peter , Morse Levi , Grant Andrea , Doma Kenji , Haward Charles , Rikard‐Bell Matthew 
Published: January 2024

AbstractPurposeThe purpose of this randomised controlled trial was to assess the impact of skin incision location on the patients’ ability to kneel.MethodsA total of 29 patients undergoing bilateral total knee arthroplasty (58 knees) were randomised to receive a lateral or midline incision, with the contralateral limb receiving the alternative option. Cruciate retaining implants were used in all cases by three experienced arthroplasty surgeons. The primary outcome measures assessed functional ability to kneel using an innovative five‐point kneeling scale, preferred knee to kneel on and the area of cutaneous sensory loss around the incision at 6 weeks, 6 months and 12 months. Secondary outcome measures were the OKS, KOOS JR, FJS and EQ5D patient reported outcome measures (PROMS), length of surgical scar, overall knee preference and range of motion (ROM).ResultsThere were no significant differences between the two groups for any primary or secondary outcome measures. Flexion range however, had a significant positive correlation with kneeling score (r = 0.335, p = 0.010). The kneeling score increased at each time point after surgery and was significantly greater at 12 months than preoperatively (2.7 v 3.5, p = 0.015). The area of sensory loss lateral to the incision was significantly less at 6 and 12 months than at 6 weeks (43.6cm2 and 40.1cm2 v 84.1cm2, p < 0.0001).ConclusionThe ability to kneel following cruciate retaining total knee arthroplasty is not affected by the incision position but by time and flexion range. TKA improves the ability to kneel by 12 months post‐surgery. Sensory loss lateral to the incision reduces with time.Level of evidenceTherapeutic Level 2.
The reimbursement system can influence the treatment choice and favor joint replacement versus other less invasive solutions in patients affected by osteoarthritis
Authors: De Marziani Luca , Boffa Angelo , Di Martino Alessandro , Andriolo Luca , Reale Davide , Bernasconi Alessio , Corbo Valentina Rita , de Caro Francesca , Delcogliano Marco , di Laura Frattura Giorgio , Di Vico Giovanni , Manunta Andrea Fabio , Russo Arcangelo , Filardo Giuseppe 
Published: January 2024

AbstractPurposeThe aim of this study was to assess how physicians perceive the role of the reimbursement system and its potential influence in affecting their treatment choice in the management of patients affected by osteoarthritis (OA).MethodsA survey was administered to 283 members of SIAGASCOT (Italian Society of Arthroscopy, Knee, Upper Limb, Sport, Cartilage and Orthopaedic Technologies), a National scientific orthopaedic society. The survey presented multiple choice questions on the access allowed by the current Diagnosis‐Related Groups (DRG) system to all necessary options to treat patients affected by OA and on the influence toward prosthetic solutions versus other less invasive options.ResultsAlmost 70% of the participants consider that the current DRG system does not allow access to all necessary options to best treat patients affected by OA. More than half of the participants thought that the current DRG system favors the choice of prosthetic solutions (55%) and that it can contribute to the increase in prosthetic implantation at the expense of less invasive solutions (54%). The sub‐analyses based on different age groups, professional roles, and places of work allowed to evaluate the response in each specific category, confirming the findings for all investigated aspects.ConclusionsThis survey documented that the majority of physicians consider that the reimbursement system can influence the treatment choice when managing OA patients. The current DRG system was perceived as unbalanced in favor of the choice of the prosthetic solution, which could contribute to the increase in prosthetic implantation at the expense of other less invasive options for OA management.
Pulmonary ligament rupture due to a bronchial artery aneurysm-induced hematoma: a case report
Authors: Tomioka Yasuaki , Yamada Eiji , Hyodo Tsuyoshi , Muro Masahiko 
Published: January 2024

Abstract
Background
Bronchial artery aneurysm (BAA) is a rare vascular anomaly with the potential for serious complications, such as rupture leading to hemothorax or hemoptysis. Although bronchial artery embolization (BAE) is recognized as an effective intervention for ruptured BAA, video-assisted thoracoscopic surgery (VATS) is a minimally invasive approach for the treatment of associated hemothorax.

Case presentation
A 73-year-old woman presented with a mediastinal hematoma from a ruptured BAA, causing bilateral hemothorax. Emergency angiography revealed a saccular BAA that was successfully embolized using a microcatheter and coil. Subsequent computed tomography revealed an expanding hemothorax managed by VATS, with 1400 mL of blood drained. During VATS, thoracoscopy revealed pulmonary ligament rupture, which was attributed to increased intramediastinal pressure. The patient was discharged eight days postoperatively with no complications. This case highlights the use of BAE and VATS in the management of mediastinal BAA rupture and massive hemothorax.

Conclusions
BAE proved to be an effective strategy for the management of ruptured mediastinal BAAs. VATS is a valuable standby procedure for hematoma removal, but the indication should be carefully determined because of the risk of BAA re-rupture.
Research collaboration with older people as a matter of scientific quality and ethics: a focus group study with researchers in ageing and health
Authors: Dahlin-Ivanoff Synneve , Berge Isak , Barenfeld Emmelie , Haak Maria , Lood Qarin 
Published: January 2024

Abstract
Background
Society is placing increasing demands on collaboration with actors outside the academia to be involved in the research process, and the responsibility for turning this into reality lies with the researchers. As research collaboration is a way to increase the societal relevance of research and since older people have the right to be actively involved in research that concerns them, this study is addressed to researchers who work with and for older people. The purpose of this article is to explore researchers’ experiences of research collaboration with the heterogeneous group of older people, from healthy to frail.

Methods
The focus group method was applied based on a qualitative approach that is based on a social constructivist research tradition. It differs from other qualitative methods, such as interviews, in that it encourages interaction between research participants and contributes to shedding light on a collective understanding of the world. A total of 14 researchers participated in four focus groups (three to five participants/group).

Results
The results provided support for the overall theme: “Good scientific quality and ethics are balanced against the needs and abilities of older people”. This means a balance between the researcher and the older people collaborating with them to receive the best possible scientific quality. This is highlighted in the core category “Positioning for research collaboration” with the subcategories “Involvement or not”, “Traditional or innovative thinking” and “Selectivity or representativeness”, and the core category “Research collaboration – an ethical issue of power” with the subcategories “Research collaboration a risk for freedom of research”, “Research collaboration a risk of abuse of power” and “Discriminatory academic power structures create ethical issues”.

Conclusions
Addressing the balancing act of collaborating with older people in research, the findings contribute with an understanding of the importance of researchers’ awareness of social and academic structures to minimise the risk of epistemic injustices in research on ageing and health. We want to highlight the researchers’ voice and clarify the role that researchers have in terms of the opportunities for older people to become part of the collective understanding of ageing and health and make their voices heard.
Virtual simulation in healthcare education: a multi-professional, pan-Canadian evaluation
Authors: Verkuyl Margaret , Violato Efrem , Harder Nicole , Southam Theresa , Lavoie-Tremblay Mélanie , Goldsworthy Sandra , Ellis Wendy , Campbell Suzanne H. , Atack Lynda 
Published: January 2024

Abstract
Background
As we experience a shortage of healthcare providers in Canada, it has become increasingly challenging for healthcare educators to secure quality clinical placements. We evaluated the impact of virtual simulations created for the virtual work-integrated learning (Virtu-WIL) program, a pan-Canadian project designed to develop, test, and offer virtual simulations to enrich healthcare clinical education in Canada. Evaluation was important since the virtual simulations are freely available through creative commons licensing, to the global healthcare community.

Methods
Students self-reported their experiences with the virtual simulations and the impact on their readiness for practice using a survey that included validated subscales. Open-ended items were included to provide insight into the students’ experiences.

Results
The evaluation included 1715 Nursing, Paramedicine and Medical Laboratory students enrolled in the Virtu-WIL program from 18 post-secondary universities, colleges, and institutions. Results showed most students found the virtual simulations engaging helped them learn and prepare for clinical practice. A key finding was that it is not sufficient to simply add virtual simulations to curriculum, careful planning and applying simulation pedagogy are essential.

Conclusion
Virtual simulation experiences are increasingly being used in healthcare education. Results from this rigorous, large-scale evaluation identified ways to enhance the quality of these experiences to increase learning and to potentially decrease the number of hours healthcare students need in clinical practice to meet professional competencies. Further research is needed regarding many aspects of virtual simulations and, in particular, curriculum integration and the timing or sequencing of virtual simulations to best prepare students for practice.