bluuebunny/crossref_metadata_2025_split huggingface dataset:
Applying optimized YOLOv8 for heritage conservation: enhanced object detection in Jiangnan traditional private gardens
Authors: Gao Chan , Zhang Qingzhu , Tan Zheyu , Zhao Genfeng , Gao Sen , Kim Eunyoung , Shen Tao 
Published: January 2024

Abstract
This study aims to promote the protection and inheritance of cultural heritage in private gardens in the Jiangnan area of China. By establishing a precise visual labeling system and accelerating the construction of a database for private garden features, we deepen the understanding of garden design philosophy. To this end, we propose an improved Jiangnan private garden recognition model based on You Only Look Once (YOLO) v8. This model is particularly suitable for processing garden environments with characteristics such as single or complex structures, rich depth of field, and cluttered targets, effectively enhancing the accuracy and efficiency of object recognition. This design integrates the Diverse Branch Block (DBB), Bidirectional Feature Pyramid Network (BiFPN), and Dynamic Head modules (DyHead) to optimize model accuracy, feature fusion, and object detection representational capability, respectively. The enhancements elevated the model's accuracy by 8.7%, achieving a mean average precision (mAP@0.5) value of 57.1%. A specialized dataset, comprising 4890 images and encapsulating various angles and lighting conditions of Jiangnan private gardens, was constructed to realize this. Following manual annotation and the application of diverse data augmentation strategies, the dataset bolsters the generalization and robustness of the model. Experimental outcomes reveal that, compared to its predecessor, the improved model has witnessed increments of 15.16%, 3.25%, and 11.88% in precision, mAP0.5, and mAP0.5:0.95 metrics, respectively, demonstrating exemplary performance in the accuracy and real-time recognition of garden target elements. This research not only furnishes robust technical support for the digitization and intelligent research of Jiangnan private gardens but also provides a potent methodological reference for object detection and classification research in analogous domains.
The onset of motor learning impairments in Parkinson’s disease: a computational investigation
Authors: Gigi Ilaria , Senatore Rosa , Marcelli Angelo 
Published: January 2024

AbstractThe basal ganglia (BG) is part of a basic feedback circuit regulating cortical function, such as voluntary movements control, via their influence on thalamocortical projections. BG disorders, namely Parkinson’s disease (PD), characterized by the loss of neurons in the substantia nigra, involve the progressive loss of motor functions. At the present, PD is incurable. Converging evidences suggest the onset of PD-specific pathology prior to the appearance of classical motor signs. This latent phase of neurodegeneration in PD is of particular relevance in developing more effective therapies by intervening at the earliest stages of the disease. Therefore, a key challenge in PD research is to identify and validate markers for the preclinical and prodromal stages of the illness. We propose a mechanistic neurocomputational model of the BG at a mesoscopic scale to investigate the behavior of the simulated neural system after several degrees of lesion of the substantia nigra, with the aim of possibly evaluating which is the smallest lesion compromising motor learning. In other words, we developed a working framework for the analysis of theoretical early-stage PD. While simulations in healthy conditions confirm the key role of dopamine in learning, in pathological conditions the network predicts that there may exist abnormalities of the motor learning process, for physiological alterations in the BG, that do not yet involve the presence of symptoms typical of the clinical diagnosis.
Can the FIB-4 score predict the severity of acute pancreatitis in NAFLD?
Authors: Kirdok Kutay , Yogurtcu Özge , Buran Tahir , Kasap Elmas 
Published: January 2024

Abstract
Background
Non-alcoholic fatty liver disease (NAFLD) is a liver pathology. NAFLD’s prevalence is increasing in the world and because of the increase non-invasive methods are gaining importance in diagnosis. The Fibrosis 4 (FIB-4) score is one of the most commonly used non-invasive scoring methods for diagnosing NAFLD today. Acute pancreatitis is a disease with inflammation and high morbidity. There are studies indicating that acute pancreatitis progresses more severely in patients with NAFLD. In our study, it was aimed to define the possible relationship between the FIB-4 score and the severity of acute pancreatitis, which has not been investigated before and contribute to the literature.

Methods
Our study was conducted by retrospectively scanning 124 patients diagnosed with acute pancreatitis between 2018 and 2020. The patients were compared with the presence of NAFLD and the FIB-4 score results in those with NAFLD.

Results
The 48th-hour Ranson score was found to be statistically significantly higher in patients with NAFLD compared to those without NAFLD. In patients with NAFLD, the total billurbin, direct billurbin, AST, ALT, ALP, GGT, and Ranson scores were found to be statistically significantly higher in those with FIB-4 score ≥ 2.67.

Conclusıon
As liver fibrosis increases in patients with NAFLD, it is suggested that liver damage accompanying acute pancreatitis increases, and the prognosis of acute pancreatitis worsens. There is a need for further studies to be conducted while centering more on this subject, which has not been investigated before in the literature.
Hyperkalemia in the tropics: multiple causes and a not so common presentation—a case report
Authors: Ittyachen Abraham M. , Sukumaran Anjely , Peter Ancy , Baby Binitha , Anthony Dawn 
Published: January 2024

Abstract
Background
Hyperkalemia is an electrolyte abnormality with potentially life-threatening consequences. But all cases of hyperkalemia need not be symptomatic either. The feared consequence of hyperkalemia is that on the heart, it can induce fatal arrhythmias; rarely, it can present with neuromuscular signs. Most cases of hyperkalemia can be attributed to a single cause. Rarely, it can be multifactorial.

Case presentation
From the province of Kerala in India, we describe an elderly gentleman with severe hyperkalemia, who presented with quadriparesis. He had ECG changes consistent with hyperkalemia. Diverse causes were involved at the same time for the hyperkalemia. An uncommon cause observed was a diet rich in tropical fruits. As he did not respond to conservative (medications) measures, he had to be dialyzed. With dialysis, there was a rapid neurological recovery, and the potassium levels had improved.

Conclusions
In patients presenting with ascending paralysis, especially old people with morbidities, one differential diagnosis to be considered is hyperkalemia. Once hyperkalemia is confirmed, in addition to medications and illnesses, the preceding diet should also be enquired, especially the intake of fruits. In all, a good history in such a case is without a doubt imperative.
The lack of agency becoming part of the self
Authors: Szalai Judit 
Published: January 2024

SUMMARYThis brief commentary on Greenberg's article ‘When the illness speaks’ addresses the problem of agency in mental disorder. Complementing the perspective of the article, it advocates an approach that does not see the causal mechanism of disorder-related behaviour in terms of an exclusive disjunction between the effects of the individual patient's own agency or manifestations of the illness. When reduced agency becomes part of the person's self-conception, passivity no longer means behaviour that is alien to their ‘genuine self’. Relatedly, the requirement that the patient's self-conception be validated raises some questions regarding its therapeutic constraints.
A study of the association between enzalutamide blood concentrations and adverse events in patients with castration-resistant prostate cancer.
Authors: Iguchi Taro , Kato MInoru , Hirayama Yukiyoshi , Yamasaki Takeshi , Yasuda Sayaka , Morita Nobuyo , Chikazawa Ippei , Fukushima Wakaba , Tamada Satoshi , Miyazawa Katsuhito 
Published: January 2024

102 Background: Enzalutamide (ENZA) is effective in castration-resistant prostate cancer (CRPC), but subjective adverse events (AEs) such as fatigue and decreased appetite may make it difficult to continue ENZA due to AEs despite its effectiveness. Owing to AEs, half of the patients required a dose reduction to 120 mg, thereby eliminating the AEs and enabling patients to continue taking ENZA. We hypothesized that a dose reduction to 120 mg of ENZA would reduce AEs in patients while keeping serum concentrations in the therapeutic range. Methods: Patients with CRPC were treated with ENZA from 2015 to 2020 at Osaka City University Hospital and their serum was stored at least twice with written consent. All patients were treated with an initial dose of 160 mg of ENZA, and the dose was reduced to 120 mg if they complained of AEs. In the full dose group (no AEs with 160 mg of ENZA), serum concentrations of ENZA and its active metabolite (N-desmethyl enzalutamide: M2) were measured at 1, 3, and 6 months. In the reduced dose group, serum concentrations were measured before and after dose reduction. To clarify the relationship between AEs and the serum ENZA and M2 concentrations, the serum ENZA and M2 concentrations in patients with/without AEs and before/after dose reduction were compared. To examine whether dose reductions affect the efficacy of ENZA, PSA progression free survival, and the overall survival were compared between the full dose group and the reduced dose group. Results: Serum ENZA and M2 concentrations were measured in 246 samples from 84 patients and mean effective serum concentrations of ENZA + M2 were 28.0, 30.4, and 29.2 μg/mL in the full dose group at 1, 3, and 6 months, respectively; and 29.1 and 24.1 μg/mL at a dose of 160 mg and 120 mg, respectively, in the reduced dose group. Most of AEs were resolved by dose reduction and there was no statistically significant difference in PSA progression free survival (HR: 0.86, 95% CI: 0.44-1.68) or overall survival (HR: 0.60, 95% CI: 0.26-1.40) between the full dose group and the reduced dose group. Conclusions: A correlation between the ENZA dose and serum ENZA + M2 concentration was observed, but no association between AE and serum ENZA or M2 concentration was observed. Dose reduction to 120 mg reduced serum ENZA and M2 concentrations of the patients with AEs and resolved the AEs but did not affect the efficacy of ENZA. These results suggest that patients with AEs at 160 mg of ENZA can have their AEs resolved by reducing the dose to 120 mg without loss of efficacy.
Toxicity-benefit analysis of advanced prostate cancer trials using weighted toxicity scoring.
Authors: Gill Jaspreet Kaur , Sperandio Rubens Copia , Nguyen Tuan Hoang , Emmenegger Urban 
Published: January 2024

110 Background: The weighted toxicity score (WTS) is a metric suitable for comparing the toxicity burden in experimental versus control arms of randomized controlled trials (RCTs). When compared against clinical endpoints, the WTS can be used to evaluate the cost versus benefit of anti-cancer agents. This study sought to apply the WTS to prostate cancer (PC) clinical trials. Methods: Select phase 3 PC RCTs with reported adverse event (AE) data were compiled. The WTS was computed for each trial arm and compared to reported hazard ratios (HRs) of primary and/or secondary endpoints (i.e., overall survival (OS) and progression-free survival (PFS)). Average WTSs for the experimental versus control arms were used to calculate the toxicity differential between treatment arms. Average HRs for OS and PFS were used to compare efficacy. Results: Sixteen RCTs were analyzed (investigational agents: androgen-receptor signaling inhibitors (ARSi) [n = 4], poly (ADP-ribose) polymerase inhibitors (PARPi) monotherapy [n = 3], ARSi + PARPi as well as ARSi + ARSi combination therapies [n = 3 each], and triple therapy [n=3]). The median number of distinct reported AEs across all studies was 18 (range, 9-61). Overall, toxicity and efficacy were greater among experimental than control arms (6.62 versus 4.00 median WTS; median HR for OS 0.71, median HR for PFS 0.61). The triple therapy studies observed the lowest increase in toxicity by adding an ARSi to control therapy (10.4%), associated with 52% lower risk of progression, and 29% lower risk of death. Comparably, the ARSi + PARPi trials noted the highest increase in toxicity (79.7%), with 32% lower risk of progression and 12% lower risk of death. The PARPi monotherapy, ARSi monotherapy, and ARSi + ARSi combination therapy studies reported increased toxicity due to experimental therapy in descending order (Table). Conclusions: The WTS enables toxicity versus benefit assessment for anti-cancer regimens. Clinical application of this metric may facilitate individualized treatment planning in advanced PC management. [Table: see text]
Comparative health-related quality of life (QoL) in metastatic castration-sensitive prostate cancer (mCSPC): A living systematic review.
Authors: Garza Morales Rodolfo , Naqvi Syed Arsalan Ahmed , Ayaz Ahsan , Khakwani Kaneez Zahra Rubab , Riaz Zaryab Bin , Raina Ammad , Ravi Praful , Childs Daniel S , Andrews Jack R. , Orme Jacob , Cobran Ewan Kemar , Singh Parminder , Riaz Irbaz Bin , Bryce Alan Haruo 
Published: January 2024

111 Background: Comparative evidence of quality of life (QoL) outcomes regarding life-prolonging treatments for the management of first-line treatment of metastatic castration sensitive prostate cancer (mCSPC) is not known. Methods: This systematic review uses the living interactive evidence synthesis framework (PMID: 36862387). Phase III randomized controlled trials assessing contemporary systemic treatments in mCSPC were included. Small sample size adjusted standardized mean differences (SMD; Hedges’ g) with 95% confidence intervals (CI) were computed for global QoL at 3, 6, 12, and 24 mo. Positive SMD indicated better health-related QoL, with zero indicating a null effect. Mixed treatment comparisons were made using a network meta-analysis. P-scores were computed; a higher score indicated better QoL. Results: Of 10 clinical trials initially included, eight trials (15 references) reported QoL. At 3mo global QoL was improved with abiraterone (AAP)+ADT compared to D+ADT (SMD: 0.26; 95% CI: 0.13-0.39), enzalutamide (E)+ADT (0.18; 0.03-0.33), and ADT (0.14; 0.02-0.27). At 6mo, AAP+ADT significantly improved global QoL compared to D+ADT (0.74; 0.62-0.87), E+ADT (1.74; 1.56-1.92), and ADT (1.79; 1.65-1.93). D+ADT also improved global QoL at 6mo compared to ADT (1.05; 0.93-1.16) but not when compared to E+ADT. At 12mo, AAP+ADT improved global QoL compared to E+ADT (0.20; 0.05-0.34) and ADT (0.19; 0.07-0.31) but not compared to D+ADT (0.05; -0.07-0.17). D+ADT also improved global QoL at 12mo compared to ADT (0.14; 0.03-0.24) (Table). Global QoL has not been reported for ARASENS trial at this time. These results are available on the Living interactive website. Conclusions: The totality of evidence suggests improved global QoL with androgen-pathway inhibitors (API) doublet therapy. D+ADT may offer better QoL at longer 6 and 12 months of follow-up. QoL data for triplet therapy is still emerging and will be incorporated in the living review as soon as it becomes available. [Table: see text]
Adverse outcomes (AOs) in patients (pts) with metastatic castration-sensitive prostate cancer (mCSPC) treated with intensified androgen deprivation therapy (ADT+).
Authors: Mir Nabiel Ali , Akmal Waqaas , Imam Maaz , Giurcanu Mihai , Szmulewitz Russell Zelig , Stadler Walter Michael 
Published: January 2024

113 Background: mCSPC pts experience adverse outcomes (AOs) with intensified androgen deprivation, resulting in treatment discontinuation; however, there is limited data to identify those at risk. The IRONMAN registry is a global initiative to enroll advanced prostate cancer patients worldwide, and survey data on AOs, patient-reported outcomes (PROs), and clinico-epidemiologic (demographic, cancer, and treatment) details. We report the prevalence and predictors of AOs from baseline demographic, clinical, and PRO information with the onset of AOs and present a risk prediction model for clinical use. Methods: We analyzed data from 553 mCSPC patients in the IRONMAN registry from inception to March 2023 who received ADT+ alone (Abiraterone 47.6%, Enzalutamide 26.9%, Apalutamide 22.6%, Darolutamide 2.9%) and had completed baseline PROs. We defined AOs, reported by 60 global sites, as non-progression-related clinically significant serious adverse events (csSAE), treatment discontinuation, and dose reductions (DR/DC), delineated as a composite outcome based on first event. We processed baseline variable groups: Demographics (race, ethnicity, marital status, study site), Clinical Factors (age, ECOG score, metastatic sites, ADT+, concurrent medications, labs [ALP, Hb, LDH, and PSA]), Concurrent therapies (steroid use within 30 days [d] & steroid dose, radiation/surgery prior or planned in 6months) and PROs (EORTC QLQ-C30 and EPIC-23). We developed a multifactorial logistic regression model to predict adverse outcomes (AOs) within two years of initiating ADT+ therapy. All variables with less than 25-30% missing data were included. Variable selection was conducted in two layers: intra-group stepwise selection followed by an inter-group selection of variables retained from the first layer. The model's discriminatory ability was evaluated using the area under curve (AUC). Results: 553 pts met inclusion (51.6% North America, 72% White, mean age: 71 years [range, 40 to 96 years], and 62.9% confirmed bone-metastatic mCSPC). 119 pts (21.5%) developed AOs (61 csSAEs [18 dead; Median: 140 d; IQR 81-360 d], 58 DR/DC [Median: 122 d; IQR 43-262 d]). <5% went off study. The multifactorial model (n=314 pts) performed well at predicting AOs (AUC 0.77 [0.70-0.84]), with significant factors being more self-reported pain, greater urinary frequency, prednisone>5mg within 30d, more self-reported weakness and poor sexual function within 3 months of ADT+ initiation. Conclusions: 1 in 5 mCSPC patients on ADT+ experienced non-progression-related AOs at 2 years. Significant, easily assessed predictive factors are identified and may be utilized in their clinical management. A novel multifactorial model is presented to predict AOs at 2 years. Further validation, assessment of missingness bias, and imputation are planned.
Trop-2: A promising new therapeutic target in penile squamous cell carcinoma.
Authors: Weiten Richard , Kessler Carolina , Spohn Hanna Elisa , Storz Enno , Pfister David A. , Nestler Tim , Tolkach Yuri , Wirtz Ralph M. , von Brandenstein Melanie , Krausewitz Philipp , Heidenreich Axel 
Published: January 2024

12 Background: Penile squamous cell carcinoma (PSCC) is an infrequent yet progressively prevalent malignancy. Despite ongoing advancements in personalized and immunotherapeutic approaches, patients grappling with the diagnosis of locally advanced or metastasized PSCC still confront a limited therapeutic arsenal, leading to an unfavorable prognosis. Consequently, an imperative mandate arises to explore alternative therapeutic modalities, particularly antibody-drug-conjugates (ADCs), which have demonstrated significant clinical efficacy in the context of metastatic solid tumor pathologies. Our aim was to ascertain the potential utility of ADCs targeting Trop-2 in both localized PSCC (PRIM) and patient-matched distant metastases (MET). Methods: Immunohistochemical analysis of Trop-2 expression was conducted in PRIM ( N=40) and their corresponding METs ( N=9, including lymph node and lung metastases). We assessed overall survival (OS) by stratifying patients into subgroups based on Trop-2 expression: weak (H-score 15-99) versus moderate/strong (H-score 100-300). Additionally, we explored the relationship between Trop-2 and HPV-dependency. Furthermore, Trop-2 mRNA expression levels were quantified via qRT-PCR, and an enzyme-linked immunosorbent assay was employed to measure Trop-2 in serum samples derived from PRIM ( N=40) and a healthy control group ( N=10). Results: We found a statistically significant increase in Trop-2 mRNA expression levels in individuals afflicted with PSCC compared to healthy controls ( p<0.0001). Moreover, a notable elevation in Trop-2 protein expression was observed in the serum specimens obtained from PSCC patients ( p<0.01). The majority of patients exhibited moderate to strong Trop-2 expression, indicative of a robust median H-score of 280 (interquartile range: 210-300). Subgroup analysis revealed a correlation between Trop-2 expression and HPV status ( p<0.01), demonstrating discernible associations with more favorable clinical outcomes, as evidenced by the log-rank (Mantel-Cox) test ( p<0.05). Conclusions: Trop-2 protein expression in PSCC holds prognostic significance. Furthermore, the elevated Trop-2 levels in both PRIM and PSCC metastases suggest that the Trop-2-targeted ADC, Sacituzumab govitecan, may emerge as a promising novel therapeutic intervention for these patients.
Post hoc analysis of rPFS and OS from the TALAPRO-2 (TP-2) study: Genomic subgroups based on likelihood of BRCA or HRR gene alteration status.
Authors: Shore Neal D. , Agarwal Neeraj , Azad Arun , Carles Joan , Fay Andre P. , Matsubara Nobuaki , De Giorgi Ugo , Joung Jae Young , Fong Peter C.C. , Voog Eric , Jones Robert J , Dunshee Curtis , Zschaebitz Stefanie , Oldenburg Jan , Lin Xun , Healy Cynthia G. , Di Santo Nicola , Laird Douglas , Zohren Fabian , Fizazi Karim 
Published: January 2024

136 Background: Prior to randomization in TP-2, patients (pts) (N=805; all-comers) were prospectively assessed for HRR gene alterations in tumor tissue and/or ctDNA using FoundationOne CDx and/or FoundationOne Liquid CDx. In the all-comers cohort, talazoparib (TALA) + enzalutamide (ENZA) as first-line treatment for pts with mCRPC significantly improved rPFS vs ENZA (HR 0.63; 95% CI 0.51–0.78). To investigate if ITT results for TP-2 all-comers were driven by unidentified biomarker-positive pts, we assessed the correlation between rPFS/OS outcomes and pt BRCA or HRR alteration status. Methods: Within each analysis by BRCA or HRR alteration status, three exploratory subgroups based on the likelihood of BRCA/HRR alterations were defined using all available FoundationOne records from prospective and retrospective exploratory testing. BRCA1/2 mutated ( BRCAm; 10% ITT) or HRR mutated (HRRm; 33% ITT): pts were identified via a positive test result in either ctDNA and/or tumor tissue testing. Undetermined BRCAm (38% ITT) or undetermined HRRm (28% ITT): pts with one negative BRCAm/HRRm test result not confirmed by the other test, or for whom the results of both tests were indeterminate. Non- BRCAm (51% ITT) or non-HRRm (39% ITT): pts with negative BRCAm or HRRm status confirmed by both ctDNA and tumor tissue testing. Results: A benefit in rPFS was demonstrated in the non- BRCAm and non-HRRm subgroups (Table) with a non- BRCAm median rPFS of 33.1 vs 22.1 months favoring TALA + ENZA (HR 0.71; 95% CI 0.52–0.96). A trend towards improved OS was also observed in the non- BRCAm and non-HRRm subgroups. OS data in the undetermined HRRm (36%) and undetermined BRCAm (39%) groups were least mature. For both rPFS and OS for undetermined BRCAm and undetermined HRRm, HRs were higher than those for BRCAm, non- BRCAm, HRRm, or non-HRRm; the reasons for this are unclear. Conclusions: The statistically significant rPFS improvement in the TP-2 all-comer ITT population did not seem to be attributable to pts with undetected BRCA/HRR alterations. There was evidence of rPFS benefit in the non- BRCAm and non-HRRm subgroups in favor of TALA + ENZA. While the OS data are still maturing, there is a clear benefit for pts with BRCAm and no detrimental impact for pts negative for BRCAm or HRRm by both tumor and ctDNA. Clinical trial information: NCT03395197 . [Table: see text]