bluuebunny/crossref_metadata_2025_split huggingface dataset:
Integrating fMRI spatial network dynamics and EEG spectral power: insights into resting state connectivity
Authors: Phadikar Souvik , Pusuluri Krishna , Iraji Armin , Calhoun Vince D. 
Published: January 2025

IntroductionThe Integration of functional magnetic resonance imaging (fMRI) and electroencephalography (EEG) has allowed for a novel exploration of the brain’s spatial–temporal resolution. While functional brain networks show variations in both spatial and temporal dimensions, most studies focus on fixed spatial networks that change together over time.MethodsIn this study, for the first time, we link spatially dynamic brain networks with EEG spectral properties recorded simultaneously, which allows us to concurrently capture high spatial and temporal resolutions offered by these complementary imaging modalities. We estimated time-resolved brain networks using sliding window-based spatially constrained independent component analysis (scICA), producing resting brain networks that evolved over time at the voxel level. Next, we assessed their coupling with four time-varying EEG spectral power (delta, theta, alpha, and beta).ResultsOur analysis demonstrated how the networks’ volumes and their voxel-level activities vary over time and revealed significant correlations with time-varying EEG spectral power. For instance, we found a strong association between increasing volume of the primary visual network and alpha band power, consistent with our hypothesis for eyes open resting state scan. Similarly, the alpha, theta, and delta power of the Pz electrode were localized to voxel-level activities of primary visual, cerebellum, and temporal networks, respectively. We also identified a strong correlation between the primary motor network and alpha (mu rhythm) and beta activity. This is consistent with motor tasks during rest, though this remains to be tested directly.DiscussionThese association between space and frequency observed during rest offer insights into the brain’s spatial–temporal characteristics and enhance our understanding of both spatially varying fMRI networks and EEG band power.
Dietary addition of compound organic acids improves the growth performance, carcass trait, and body health of broilers
Authors: Cai Fang , Huang Meiping , Liu Wei , Wan Xiaoling , Qiu Kai , Xu Xiao 
Published: January 2025

IntroductionThe poultry industry constantly seeks strategies to enhance broiler growth performance and overall health. Organic acidifiers, including L-lactic acid, L-malic acid, and acetic acid, have gained attention as potential feed additives to improve animal production by modulating gut health, enhancing nutrient absorption, and supporting immune function. Despite their promising effects in other animal species, the impact of this novel compound organic acidifier on broiler performance, metabolism, and immune response has not been fully elucidated. This study aims to evaluate the effects of this compound acidifier on growth performance, serum lipid profile, antioxidant status, and immune parameters in broilers, providing insights into its potential benefits as a dietary supplement for broiler health and productivity.MethodsA total of 240 broilers were randomly divided into four groups: a control group and three treatment groups receiving 0.25%, 0.5%, or 1.0% acidifier, with six replicates of ten birds each. Over a 6-week period, various parameters were measured, including serum triglycerides, high-density lipoproteins, lysozyme, immunoglobulins (IgA, IgM), superoxide dismutase (SOD) activity, IL-2, TNF-α, and gene expressions related to lipid metabolism.ResultsOver a 6-week period, the acidifier decreased serum triglycerides and high-density lipoproteins while also enhancing growth performance. Additionally, it raised the serum levels of lysozyme, IgA, IgM, and the SOD. Additionally, IL-2 and TNF-α concentrations in the jejunum mucosa decreased. The acidifier upregulated PPARα, AMPK, FABP1 and MTTP expressions, and downregulated APOB100. Overall, the acidifier effectively improved broiler growth performance during the early development phase primarily by enhancing hepatic lipid metabolism, antioxidant capacity, and immune function.ConclusionThese results suggest that the acidifier may accelerate liver lipid metabolism in broilers by modulating the gene expression profiles involved in lipid metabolism.
The necessity of gestational vitamin D supplementation depends on ambient temperature: concern for infant vitamin D status
Authors: Yin Wanjun , Zhang Lei , Zhu Peng 
Published: January 2025

BackgroundGiven the ease of access to ambient temperature, it may be a more practical guide than the UVB index. However, the association between gestational temperature and vitamin D level in newborns remains unclear. Our study aims to explore this association and the necessity of maternal vitamin D supplementation when ambient temperature is less than a specific value.MethodsBased on a birth cohort study, we measured cord blood concentrations of 25(OH)D in 1419 neonates from January to September 2008 in Hefei, a new first-tier city in China. The daily mean temperature of Hefei was obtained from the China Meteorological Data Sharing Service System. Individual information on sociodemographic characteristics, perinatal health status, lifestyle, and birth outcomes was collected prospectively.ResultsThe best-fit relationship was observed in the regression model using a quadratic function to describe the association between the ambient temperature of the eighth gestational month (29–32 gestational weeks) and cord blood 25(OH)D concentrations (R2 = 0.358, p &lt; 0.001). Ambient temperatures of 10 and 24.5°C were linked to the cutoff of vitamin D inadequacy (&lt;50 nmol/L) and deficiency (&lt;30 nmol/L) in cord blood, respectively. For maternal exposure to an ambient temperature of ≥24.5°C in the eighth gestational month, vitamin D supplementation during pregnancy failed to significantly enhance neonatal vitamin D concentrations. In contrast, for maternal exposure to ambient temperature of &lt;10°C, maternal vitamin D supplementation was significantly associated with elevated 25(OH)D concentrations in cord blood.ConclusionGestational ambient temperature may be an ideal predictor for infant vitamin D status screening. Maternal exposure to an ambient temperature of less than 10°C is a critical index in the eighth gestational month, which may determine the onset of vitamin D supplementation.
High Ki67 expression, HER2 overexpression, and low progesterone receptor levels in high-grade DCIS: significant associations with clinical practice implications
Authors: Schandiz Hossein , Farkas Lorant , Park Daehoon , Liu Yan , Andersen Solveig N. , Sauer Torill , Geisler Jürgen 
Published: January 2025

Simple summaryWe investigated the role of Ki67, a ubiquitous marker in cancer, within the context of ductal carcinoma in situ (DCIS), a precursor of invasive breast cancer. Through rigorous analysis of histopathological and immunopathological samples from a substantial cohort, this study revealed robust correlations between heightened Ki67 expression, diminished progesterone (PR) levels, and HER2 overexpression, indicative of aggressive DCIS phenotypes. These findings offer novel insights into the surrogate immunomolecular subtyping landscape of DCIS, potentially refining risk stratification and therapeutic approaches. This elucidation underscores the translational significance of Ki67 as a prognostic and predictive biomarker in DCIS, with implications for personalized treatment paradigms and patient outcomes.BackgroundThe Ki67 proliferation index is widely used in various tumors, including invasive breast carcinoma (IBC). However, its prognostic utility is often constrained by technical complexity. Its diagnostic and clinical significance in ductal carcinoma in situ (DCIS) remains uncertain. We studied Ki67 immunohistochemistry interobserver diagnostic agreement at different cutoff values in high-grade DCIS. Additionally, we investigated the associations between Ki67 expression, PR levels, and human epidermal growth factor receptor 2 (HER2) in high-grade DCIS among various subtypes (Luminal (Lum) A, LumB HER2-, LumB HER2+, HER2-enriched, and triple-negative)).MethodsUsing histopathological specimens from 484 patients diagnosed with DCIS between 1996 and 2018, we implemented the 2013 St. Gallen recommendations for surrogate immunomolecular subtyping of IBC. Subtypes were classified, and the Ki67 interobserver diagnostic agreement between Counting Pathologist 1 (CP1) and CP2 was calculated using Cohen’s kappa coefficient at various cutoff values.ResultsThe Cohen’s kappa coefficient for interobserver agreement between CP1 and CP2 was κ = 0.586, indicating moderate agreement. Ki67 levels varied significantly among subtypes (p &lt; 0.0001), with a median Ki67% being higher in cases with invasive components (p = 0.0351). Low PR combined with high Ki67% was significantly associated with HER2 overexpression (p = 0.0107).ConclusionsInterobserver agreement for the Ki67 count was moderate. Ki67 expression showed considerable variability in high-grade DCIS. Low PR levels combined with high Ki67 expression were linked to HER2 overexpression, showing possible clinical implications for identifying high-risk DCIS.
Multi-scale channel attention U-Net: a novel framework for automated gallbladder segmentation in medical imaging
Authors: Zhou Yiming , Wen Xiaobo , Fu Kang , Li Meina , Sun Lin , Hu Xiao 
Published: January 2025

ObjectivesTo develop a novel automatic delineation model, the Multi-Scale Channel Attention U-Net (MCAU-Net) model, for gallbladder segmentation on CT images of patients with liver cancer.MethodsWe retrospectively collected the CT images from 120 patients with liver cancer, based on which ground truth was manually delineated by physicians. The images and ground truth constitute a dataset, which was proportionally divided into a training set (54%), a validation set (6%), and a test set (40%). Data augmentation was performed on the training set. Our proposed MCAU-Net model was employed for gallbladder segmentation and its performance was evaluated using Dice Similarity Coefficient (DSC), Jaccard Similarity Coefficient (JSC), Positive Predictive Value (PPV), Sensitivity (SE), Hausdorff Distance (HD), Relative Volume Difference (RVD), and Volumetric Overlap Error (VOE) metrics.ResultsOn the test set, MCAU-Net achieved DSC, JSC, PPV, SE, HD, RVD, and VOE values of 0.85 ± 0.22, 0.79 ± 0.23, 0.92 ± 0.14, 0.84 ± 0.23, 2.75 ± 0.98, 0.18 ± 0.48, and 0.22 ± 0.42, respectively. Compared to the control models, U-Net, SEU-Net and TransUNet, the MCAU-Net improved DSC 0.06, 0.04 and 0.06, JSC by 0.09, 0.06 and 0.09, PPV by 0.08, 0.08 and 0.05, SE by 0.05,0.05 and 0.07, and reduced HD by 0.45, 0.28 and 0.41, RVD by 0.07, 0.03 and 0.07, VOE by 0.04, 0.02 and 0.08 respectively. Qualitative results revealed that MCAU-Net produced smoother and more accurate boundaries, closer to the expert delineation, with less over-segmentation and under-segmentation and improved robustness.ConclusionsThe MCAU-Net model significantly improves gallbladder segmentation on CT images. It satisfies clinical requirements and enhances the efficiency of physicians, particularly in segmenting complex anatomical structures.
Therapeutic drug monitoring and neutralizing anti-drug antibody detection to optimize TNF-alpha inhibitor treatment for uveitis
Authors: Chen Howard C. , Shunyakova Jenny , Reddy Amit K. , Pandiri Srujay , Hassman Lynn 
Published: January 2025

BackgroundAdalimumab taken every other week is an effective treatment in patients with chronic refractory uveitis. Patients who have a suboptimal response to this treatment may suffer from recurrent inflammation and vision loss. Here, we investigated the use of therapeutic drug monitoring and neutralizing anti-drug antibody detection as a strategy to optimize tumor necrosis factor (TNF)-alpha inhibitor treatment in patients who have a suboptimal response to the initial dosing of adalimumab.MethodRetrospective cohort study performed in two tertiary referral uveitis services in the United States between 2015 to 2023. Patients with non-infectious uveitis who had a suboptimal response to every two-week dosing of adalimumab and underwent serum adalimumab level with reflex to anti-drug antibody testing were followed. Patients were considered to have neutralizing drug antibodies when serum drug levels were low (less than or equal to 6 mcg/mL) and anti-adalimumab antibodies were present on reflex testing. Treatment adjustment was made by clinicians with the knowledge of serum adalimumab level and the presence or absence of neutralizing drug antibodies. Every two-week dosing of adalimumab was either escalated to weekly dosing or switched to infliximab, an alternate TNF-alpha inhibitor, based on these findings. The primary outcome was success or failure at 12 months, as determined by disease inactivity on steroid-sparing therapy.Results32 patients with suboptimal response to the initial dosing of adalimumab were included. 31.2% (n=10) of patients were found to have neutralizing drug antibodies. All patients with neutralizing drug antibodies underwent a medication switch to infliximab with a remission rate of 40% at 12 months. Patients without neutralizing drug antibodies (n=22) underwent dose escalation (77.3%; n=17) or medication switch (22.7%; n=5) and achieved a remission rate of 68.2% at 12 months. Altogether, treatment adjustment based on therapeutic drug monitoring and neutralizing drug antibody detection, in our cohort, resulted in a remission rate of 62.5%.ConclusionsFor patients with uveitis experiencing suboptimal therapeutic response to adalimumab dosed every two weeks, therapeutic drug monitoring and neutralizing drug antibody detection may help clinicians optimize TNF-alpha inhibitor treatment.
Harmful newborn cord care practices and associated factors among mothers who gave birth in the last six months in Chencha town, Southern Ethiopia: a mixed-methods study
Authors: Seifu Misgana , Hassen Sultan , Kassa Mekdim , Haile Yosef , Girma Zeleke , Toma Temesgen Mohammed , Ashole Agune , Gujo Mintesinot Melka , Dema Wondimagegn Taye , Mekuriya Aleme , Shibru Endashaw 
Published: January 2025

BackgroundHarmful substance-related infections that cause neonatal deaths on the umbilical stump continue to be a major cause of worry, accounting for a large portion of the yearly mortality toll in developing nations such as Ethiopia. In our study region, there is, however, little data regarding these issues. In Chencha town, Southern Ethiopia, mothers who gave birth in the last six months were the subjects of this study.MethodsA community-based cross-sectional mixed study design was conducted among mothers who gave birth within the past six months, from April to May 2023. Quantitative data was collected through structured interview questionnaires from 312 randomly selected mothers. The collected data was coded, cleaned, and entered into Epi-info version 7.2.5.0, and analyzed using SPSS version 26. Binary logistic regression analysis was used to identify associated factors, and the strength of association was measured by odds ratios with a 95% confidence interval at a p-value of &lt;0.05. The audio-recorded qualitative data were transcribed in Amharic language and then translated into English and entered into Open Code software version 3.6.2 for analysis using the thematic content analysis method.ResultsHarmful newborn cord care practice was prevalent among 55.8% (95% CI: 50.1, 61.4) of the mothers. Factors such as husband's educational status (AOR = 3.09, 95% CI: 1.11, 8.67), communication on cord care within the community (AOR = 10.24, 95% CI: 5.44, 19.28), and discussions with health workers regarding cord care (AOR = 7.26, 95% CI: 3.59, 14.64) demonstrated significant associations with harmful newborn cord care practice (p &lt; 0.05). In the qualitative analysis, four themes emerged such as substance applied (butter, Vaseline, and ointment). The reasons for application were moisturizing the cord, facilitating its separation, and promoting its healing. The sources of advice on cord care were relatives, neighbors, and HCW.ConclusionThis study revealed that harmful newborn cord care practice was prevalent among 55.8% [95% CI (50.1, 61.4)] of mothers who gave birth in the last six months. The present study identified husbands' educational status, exposure to cord care messages through interpersonal communication in the community, and mothers who didn't ever engage in discussion with health workers about cord care as significant factors.
Molecular genetic diagnosis and surgical management in a cohort of children with 46,XY disorders/differences of sex development
Authors: Wong Yuenshan Sammi , Luk Ho Ming , Yau Ho Chung , Wong Lap Ming , Poon Sarah Wing Yiu , Tung Joanna Yuet Ling , Tam Yuk Him 
Published: January 2025

ObjectiveA firm diagnosis revealing the etiology of disorders/differences of sex development (DSD) is most helpful in guiding clinical management. The aim of this study is to investigate molecular genetic diagnoses and surgical treatment in a cohort of children with 46,XY DSD.MethodsA retrospective study was conducted on children with 46,XY DSD. They were referred to a tertiary surgical center during the period between 2011 and 2022 and were found to have genetic alterations, which were considered etiologies for their DSD. Data on clinical presentations, sex of rearing, genetic findings, surgical treatment, and comorbidities were collected and reviewed.ResultsA total of 21 patients were included in the study: 11 and 10 were reared as male and female, respectively. Genetic alterations were found as the causes for androgen insensitivity syndrome (n = 4), 5-alpha reductase type II deficiency (n = 5), 17-beta hydroxysteroid dehydrogenase III deficiency (n = 1), 17-alpha hydroxylase deficiency (n = 1), and gonadal dysgenesis (n = 10). Of those with gonadal dysgenesis, the genetic alterations were NR5A1 mutation/deletion (n = 3), DMRT1 deletion (n = 4), WT1 mutation (n = 2), and DAX1 duplication (n = 1). A total of 20/21 patients underwent one or more surgical procedures including hypospadias repair (n = 10), gonadectomy (n = 11), gonadal biopsy (n = 4), hernia repair (n = 4), orchidopexy (n = 1), and feminizing genitoplasty (n = 1). A total of 5/21 had germ cell neoplasms in one or both gonads. A total of 8/10 patients with gonadal dysgenesis had comorbidities involving other systems. Of the whole group, seven patients were found to inherit genetic alterations from their parents.ConclusionsMolecular genetic diagnosis enhances the understanding of etiology, improves diagnostic accuracy, and provides precise guidance in the counseling and surgical management of children with 46,XY DSD.
Comparison of ultrasonographic features between two types of hepatic echinococcosis and hepatoblastoma in children
Authors: Tao Yi , Kong Hanqing , Li Jiawu , Tan Zhizhi , Wang Jun , Luo Yan 
Published: January 2025

IntroductionThe prevalence of hepatic alveolar echinococcosis (AE) and cystic echinococcosis (CE) is notably high among children in western China, with the mortality rate for untreated children potentially reaching up to 90%. Meanwhile, hepatoblastoma is the most common malignant liver tumor in children, yet its treatment differs significantly from that of hepatic echinococcosis. This study aimed to compare and analyze the ultrasonographic and contrast-enhanced ultrasound (CEUS) characteristics of hepatic CE, AE, and hepatoblastoma in children, providing more imaging evidence for accurate clinical diagnosis.MethodsA retrospective analysis was conducted on preoperative data from children with pathologically confirmed hepatic echinococcosis in our hospital between 2012 and 2024. Furthermore, children consecutively diagnosed with hepatoblastoma between 2020 and 2024, confirmed by histopathological examination, were selected as the control group. Clinical data, conventional ultrasound images, and CEUS characteristics of hepatic echinococcosis and hepatoblastoma were analyzed and compared.ResultsThe mean ages of 22 children with hepatic CE and nine children with hepatic AE were 11.6 ± 2.8 years and 11.8 ± 3.6 years, respectively. The mean age of 36 children with hepatoblastoma was 2.9 ± 3.0 years. Significant differences were observed in age and history of residence or travel to endemic areas among children with hepatic echinococcosis and hepatoblastoma (P &lt; 0.001). Hepatic CE and hepatoblastoma showed a higher proportion of cystic degeneration [≥50% (54.5%, 12/22), and between 0% and &lt;50% (47.2%, 17/36, respectively)], while hepatic AE predominantly showed no cystic degeneration (88.9%, 8/9). Clear boundaries were most commonly seen in hepatic CE lesions (95.5%, 21/22), while unclear boundaries were more frequent in hepatic AE lesions (88.9%, 8/9) (P &lt; 0.05). Calcification was more prevalent in hepatic AE compared to hepatic CE and hepatoblastoma (P &lt; 0.05). Hepatoblastoma exhibited richer color Doppler signals (94.4%, 34/36) compared to hepatic CE and AE (P &lt; 0.05). CEUS was performed on two hepatic echinococcosis and nine hepatoblastoma lesions. On CEUS, one hepatic AE lesion showed peripheral hyperenhancement in the arterial phase, while one hepatic CE lesion showed no significant enhancement. In hepatoblastoma, nine lesions demonstrated hyperenhancement in the arterial phase and hypoenhancement in the late phase.ConclusionThis study demonstrates the value of ultrasound in differentiating hepatic echinococcosis from hepatoblastoma in children. Hepatic CE typically manifests as a well-defined cystic or cystic-solid mass, while hepatic AE often presents as an ill-defined cystic-solid or solid mass with diffuse calcifications. Conversely, hepatoblastoma appears as a partially well-defined cystic-solid or solid mass with abundant color Doppler signals within and around the lesion.
Secondary neoplasms in survivors of pediatric acute lymphoblastic leukemia and lymphoblastic lymphoma: a single-center, retrospective study
Authors: Ushida Eri , Toyoda Hidemi , Kohso Atsushi , Okumura Yosuke , Niwa Kaori , Ito Takahiro , Morimoto Mari , Hanaki Ryo , Amano Keishiro , Iwamoto Shotaro , Deguchi Takao , Hori Hiroki , Hirayama Masahiro 
Published: January 2025

BackgroundAcute lymphoblastic leukemia (ALL)-based therapeutic regimens have markedly improved the survival of children with ALL and lymphoblastic lymphoma (LBL). However, survivors are at risk of secondary neoplasms. Few studies on such secondary neoplasms have been conducted outside of Europe and the United States. The aim of this study was to evaluate the incidence of, risk factors for, and outcomes of secondary neoplasms in long-term survivors of ALL and LBL at a tertiary pediatric oncology center in Mie prefecture, Japan.ProcedureWe retrospectively reviewed 188 patients with ALL and LBL who were treated with an ALL-based therapeutic regimen at Mie University Hospital from January 1, 1977 to December 31, 2022 and followed up.ResultsTen patients developed secondary neoplasms, with 10-year and 20-year cumulative incidences of 2.9% [standard error (SE) = 1.5%] and 5.5% (SE = 2.3%), respectively. The median interval between the primary-cancer diagnosis and secondary-neoplasm diagnosis was 18.5 years (range: 7.8–41.7 years). All 10 secondary neoplasms were central nervous system (CNS) tumors (6 meningiomas and 4 high-grade gliomas). Radiotherapy (p = 0.007) and CNS involvement in the primary cancer (p &lt; 0.001) increased the risk of secondary neoplasms among long-term survivors. Gliomas occurred significantly earlier than meningiomas (p = 0.047), and three patients died of secondary neoplasms (all gliomas).ConclusionsAs secondary gliomas occurred earlier than meningiomas and are associated with poor outcomes, physicians should take great pains to minimize their risk to improve long-term survival and quality of life.