bluuebunny/crossref_metadata_2025_split huggingface dataset:
Direct Dose Prediction With Deep Learning for Postoperative Cervical Cancer Underwent Volumetric Modulated Arc Therapy
Authors: Yu Wenliang , Xiao Chengjian , Xu Jiayi , Jin Juebin , Jin Xiance , Shen Lanxiao 
Published: March 2023

Purpose To predict the voxel-based dose distribution for postoperative cervical cancer patients underwent volumetric modulated arc therapy using deep learning models. Method A total of 254 patients with cervical cancer received volumetric modulated arc therapy in authors’ hospital from January 2018 to September 2021 were enrolled in this retrospective study. Two deep learning networks (3D deep residual neural network and 3DUnet) were adapted to train (203 cases) and test (51 cases) the feasibility and effectiveness of the prediction method. The performance of deep learning models was evaluated by comparing the results with those of treatment planning system according to metrics of dose-volume histogram of target volumes and organs at risk. Results The dose distributions predicted by deep learning models were clinically acceptable. The automatic dose prediction time was around 5 to 10 min, which was about one-eighth to one-tenth of the manual optimization time. The maximum dose difference was observed in D98 of rectum with a | δD| of 5.00 ± 3.40% and 4.88 ± 3.99% for Unet3D and ResUnet3D, respectively. The minimum difference was observed in the D2 of clinical target volume with a |δD| of 0.53 ± 0.45% and 0.83 ± 0.45% for ResUnet3D and Unet3D, respectively. Conclusion The 2 deep learning models adapted in the study showed the feasibility and reasonable accuracy in the voxel-based dose prediction for postoperative cervical cancer underwent volumetric modulated arc therapy. Automatic dose distribution prediction of volumetric modulated arc therapy with deep learning models is of clinical significance for the postoperative management of patients with cervical cancer.
Ruptured Pancreaticoduodenal Artery Aneurysm in a Patient With Celiac Artery Dissection: A Case Report
Authors: Shin Jiyoung , Hong Hyun Pyo , Kim Young-Wook 
Published: March 2023

Unlike other visceral artery aneurysms, pancreaticoduodenal artery aneurysms (PDAAs) should be treated regardless of their size. There are no reports on PDAA associated with celiac artery (CA) dissection. We, here, report the case of a patient with a ruptured PDAA with concomitant CA dissection. A 44-year-old Korean man presented to the emergency room of another hospital 29 days ago due to a sudden onset of abdominal pain. Contrast-enhanced abdominal computed tomography (CT) revealed a large right retroperitoneal hematoma and CA dissection. Subsequently, aortography revealed no specific bleeding focus. He underwent conservative treatment for 16 days, including a transfusion, and then was referred to us. His abdominal CT angiography revealed a diminishing retroperitoneal hematoma, a 7 mm × 8 mm PDAA at the anterior inferior pancreaticoduodenal artery aneurysm (PDA), and CA dissection. Selective celiac angiography revealed sluggish and diminished blood flow to the true lumen of the CA, and the hepatic, gastroduodenal, and splenic arteries were supplied by collaterals arising from the superior mesenteric artery (SMA). We performed elective coil embolization of the anterior PDA using the right femoral approach. We believe that postprocedural surveillance is required after CA dissection because of the potential risk of recurrent PDAA. Additionally, we suggest that hidden PDAA rupture should be considered for spontaneous retroperitoneal bleeding.
Endovascular thrombectomy for distal vessel occlusion stroke: Single-center experience
Authors: Matsoukas Stavros , Paz Santiago Gomez , Kellner Christopher P , De Leacy Reade , Fifi Johanna T , Mocco J , Majidi Shahram 
Published: March 2023

Background The safety and efficacy of endovascular thrombectomy (EVT) in distal vessel occlusion (DVO) are not well described. We aimed to evaluate the technical feasibility and safety of EVT in patients with DVO. Methods We performed a retrospective analysis of consecutive DVOs (defined as M3/M4, A1/A2, and P1/P2 occlusion) who underwent EVT within 24 h since last known well. The primary efficacy outcome was successful reperfusion (mTICI ≥ 2B). Secondary outcomes included successful recanalization with ≤3 passes. The safety outcome measures included the rate of subarachnoid hemorrhage (SAH), all intracerebral hemorrhage (ICH), and symptomatic ICH (sICH). Results A total of 72 patients with DVO was identified: 39 (54%) with M3/M4, 13 (18%) with A1/A2, and 20 (28%) with P1/P2 occlusions. Admission NIHSS score median (IQR) was 12 (11), and 90% of the patients had baseline mRS ≤ 2. Thirty-six percent of the patients received intravenous thrombolytic therapy. Successful recanalization was achieved in 90% of the patients. The median number of passes was 2, with successful recanalization achieved with ≤3 passes in 83% of the patients. ICH was seen in 16% of the patients, including three SAHs. However, only one patient (1.4%) had sICH. Among 48 patients in whom 90-day outcome data were available, 33 (53.2%) had favorable clinical outcome (mRS ≤ 3). In a multivariable logistic regression, only baseline NIHSS was identified as an independent predictor of poor outcome. Conclusion This single-center real-world experience demonstrates that EVT in patients with DVO stroke is safe and feasible and may lead to improved clinical outcome.
Neutrophil-to-lymphocyte ratio for predicting postoperative recurrence in Crohn’s disease patients with isolated anastomotic lesions
Authors: Chen Rirong , Li Chao , Chao Kang , Tie Yizhe , Zheng Jieqi , Guo Huili , Zeng Zhirong , Li Li , Chen Minhu , Zhang Shenghong 
Published: March 2023

Background: Patients with isolated anastomotic lesions (iAL) are common in postoperative Crohn’s disease (CD) and have heterogeneous prognosis. Objectives: To investigate the prognostic value of neutrophil-to-lymphocyte ratio (NLR) in CD patients with iAL. Design: A bicenter retrospective cohort study. Methods: CD patients who received ileocolonic resection from 2013 and 2020 and had a modified Rutgeerts score of i2a were recruited. NLR was determined within 1 week around the initial endoscopy after ileocolectomy. The primary outcome was clinical recurrence. Kaplan–Meier method and Cox hazard regression analysis were utilized to assess the association between candidate variables and outcomes of interest. Results: In total, 411 postoperative CD patients were preliminarily reviewed and 83 patients were eligible. In total, 36 (48.6%) patients experienced clinical recurrence with a median follow-up time of 16.3 (interquartile range, 9.7–26.3) months. NLR > 2.45 and age at surgery >45 years had higher cumulative incidence of clinical recurrence in the Kaplan–Meier analysis. After adjusted for potential confounders, NLR > 2.45 was the only independent risk factor for clinical recurrence, with an adjusted hazard ratio (HR) of 2.88 [95% confidence interval (CI), 1.39–6.00; p = 0.005]. Furthermore, a risk score based on NLR and age at surgery were built to further stratify patients. Compared to those who scored 0, patients with a score of 1 and 2 had an adjusted HR of 2.48 (95% CI, 1.22–5.02) and 6.97 (95% CI, 2.19–22.16) for developing clinical recurrence, respectively. Conclusions: NLR is a promising prognostic biomarker for CD patients with iAL. The utilization of NLR and the risk score to stratify patients may facilitate the personalized management in patients with iAL.
Glycemic Risk Index Profiles and Predictors Among Diverse Adults With Type 1 Diabetes
Authors: Hoogendoorn Claire J. , Hernandez Raymond , Schneider Stefan , Harmel Mark , Pham Loree T. , Crespo-Ramos Gladys , Agarwal Shivani , Crandall Jill , Peters Anne L. , Spruijt-Metz Donna , Gonzalez Jeffrey S. , Pyatak Elizabeth A. 
Published: March 2023

Background: The Glycemia Risk Index (GRI) was introduced as a single value derived from the ambulatory glucose profile that identifies patients who need attention. This study describes participants in each of the five GRI zones and examines the percentage of variation in GRI scores that is explained by sociodemographic and clinical variables among diverse adults with type 1 diabetes. Methods: A total of 159 participants provided blinded continuous glucose monitoring (CGM) data over 14 days (mean age [SD] = 41.4 [14.5] years; female = 54.1%, Hispanic = 41.5%). Glycemia Risk Index zones were compared on CGM, sociodemographic, and clinical variables. Shapley value analysis examined the percentage of variation in GRI scores explained by different variables. Receiver operating characteristic curves examined GRI cutoffs for those more likely to have experienced ketoacidosis or severe hypoglycemia. Results: Mean glucose and variability, time in range, and percentage of time in high, and very high, glucose ranges differed across the five GRI zones ( P values < .001). Multiple sociodemographic indices also differed across zones, including education level, race/ethnicity, age, and insurance status. Sociodemographic and clinical variables collectively explained 62.2% of variance in GRI scores. A GRI score ≥84.5 reflected greater likelihood of ketoacidosis (area under the curve [AUC] = 0.848), and scores ≥58.2 reflected greater likelihood of severe hypoglycemia (AUC = 0.729) over the previous six months. Conclusions: Results support the use of the GRI, with GRI zones identifying those in need of clinical attention. Findings highlight the need to address health inequities. Treatment differences associated with the GRI also suggest behavioral and clinical interventions including starting individuals on CGM or automated insulin delivery systems.
Assessment of microbial bioburden on portable medical equipment in a hospital setting
Authors: Chatterjee Piyali , Coppin John David , Martel Julie Ann , Williams Marjory D , Choi Hosoon , Stibich Mark , Simmons Sarah , Passey Deborah , Allton Yonhui , Jinadatha Chetan 
Published: March 2023

Objectives: Although routine disinfection of portable medical equipment is required in most hospitals, frontline staff may not be able to disinfect portable medical equipment at a rate that adequately maintains low bioburden on high-use equipment. This study quantified bioburden over an extended time period for two types of portable medical equipment, workstations on wheels and vitals machines, across three hospital wards. Methods: Bioburden was quantified via press plate samples taken from high touch surfaces on 10 workstations on wheels and 5 vitals machines on each of 3 medical surgical units. The samples were taken at three timepoints each day over a 4-week period, with random rotation of timepoints and portable medical equipment, such that frontline staff were not aware at which timepoint their portable medical equipment would be sampled. The mean bioburden from the different locations and portable medical equipment was estimated and compared with Bayesian multilevel negative binomial regression models. Results: Model estimated mean colony counts (95% credible interval) were 14.4 (7.7–26.7) for vitals machines and 29.2 (16.1–51.1) for workstations on wheels. For the workstations on wheel, colony counts were lower on the mouse, 0.22 (0.16–0.29), tray, 0.29 (0.22, 0.38), and keyboard, 0.43 (0.32–0.55), when compared to the arm, as assessed by incident rate ratios. Conclusions: Although routine disinfection is required, bioburden is still present across portable medical equipment on a variety of surfaces. The difference in bioburden levels among surfaces likely reflects differences in touch patterns for the different portable medical equipment and surfaces on the portable medical equipment. Although the association of portable medical equipment bioburden to healthcare-associated infection transmission was not assessed, this study provides evidence for the potential of portable medical equipment as a vector for healthcare-associated infection transmission despite hospital disinfection requirements.
Relationship Between Quadriceps Strength and Knee Joint Power During Jumping After ACLR
Authors: Graham Megan C. , Reeves Kelsey A. , Johnson Darren L. , Noehren Brian 
Published: March 2023

Background: Knee joint power is significantly impaired during the propulsive phase of jumping after anterior cruciate ligament reconstruction (ACLR); however, it is currently unknown how quadriceps strength influences knee joint power. Purpose: To (1) evaluate the relationship between quadriceps strength, joint power, and the percentage contribution of the hip, knee, and ankle joints to total limb power during the propulsive phase of jumping and (2) establish a quadriceps strength cutoff value for maximizing the likelihood of having knee joint power characteristics similar to healthy participants. Study Design: Cross-sectional study; Level of evidence, 3. Methods: A total of 75 participants were included in this study—40 patients who underwent ACLR 6 months before (18 females; mean age, 19.3 ± 5.7 years) and 35 healthy controls (HC) (20 females; mean age, 21.5 ± 4.5 years). Participants performed a drop vertical jump and underwent isometric quadriceps strength testing. The peak joint power was calculated as the product of the internal joint moment and joint angular velocity. Pearson product-moment correlations were used to assess the relationship between quadriceps strength and knee joint power. Paired samples t tests were used to quantify differences between limbs. Receiver operating characteristic (ROC) curve analysis was used to determine a quadriceps strength cutoff. Results: The involved limbs of the ACLR cohort (INV) had significantly lower peak knee joint power and percentage contribution from the knee joint during jumping compared with the uninvolved limbs (NON) and limbs of the controls (INV, 2.5 ± 1.2 W/kg; NON, 4.4 ± 1.5 W/kg; HC, 4.3 ± 1.7 W/kg [ P < .0001]). Quadriceps strength was associated with knee joint power in involved limbs and limbs of controls (INV, r = 0.50; HC, r = 0.60). A quadriceps strength cutoff value of 2.07 N·m/kg had an area under the ROC curve of 0.842, indicating good predictive accuracy. Conclusion: Athletes at 6 months after ACLR demonstrated knee-avoidant jumping mechanics and had significant reductions in knee joint power on the involved limb. A quadriceps strength cutoff value of 2.07 N·m/kg can help predict which athletes will display knee joint power characteristics similar to those of healthy controls.
Antenatal Care Dropout and Associated Factors in Ethiopia: A Systematic Review and Meta-Analysis
Authors: Sisay Gizaw , Mulat Tsion 
Published: March 2023

Background The prevalence and determinants of antenatal care (ANC) dropout in Ethiopia were studied. However, the results were inconsistent and showed considerable variation. Hence, this meta-analysis aimed at estimating the overall prevalence of ANC dropout and its predictors in Ethiopia. Methods A comprehensive search of published studies was done using different international databases such as such as PubMed, DOJA, Embase, Cochrane Library, Google Scholar, and the institutional repository of Ethiopian universities were used to search for relevant studies. Data were extracted using Microsoft Excel spreadsheet, and exported to STATA v17 for analysis. A random effect model was used to estimate the overall national prevalence of ANC dropout. Fixed effects model were used to compute the pooled adjusted odd ratios (AOR) with the corresponding 95% confidence intervals (CIs). I2 test was used to assess heterogeneity of the included studies. Egger's tests was used to check for the presence of publication bias. Results A total of 7 studies were included in this systematic review and meta-analysis with 11,839 study participants. The overall pooled prevalence of ANC in Ethiopia was found to be 41.37% (95% CI =35.04, 47.70). Distance from the health care facility (AOR = 2.93, 95% CI = 2.75, 3.11), pregnancy complication signs (AOR = 2.97, 95% CI = 2.77, 3.16), place of residence (AOR =  1.79, 95% CI = 1.31, 2.26), educational level (AOR = 1.79, 95%CI = 1.37, 2.21), and age group (30-49) (AOR = 0.61, 95% CI = 0.45, 0.78) were significantly associated with ANC dropout. Conclusion Based on this review and meta-analysis, 41% of Ethiopian women dropped out of ANC visits before the minimum recommended visit (4 times). Hence, to reduce the number of ANC dropouts, it is important to counsel and educate women during their first prenatal care. Issues of urban–rural disparities and noted hotspot areas for ANC dropout should be given further attention.
The role of size effects in moderating the benefits of sustainable investing
Authors: Ferrat Yann , Daty Frédéric , Burlacu Radu 
Published: March 2023

Using an extensive sample of environmental, social, and governance (ESG) ratings, we reexamine the corporate social responsibility (CSR) factor premium in the developed equity markets between 2007 and 2019 and show that its extent is contingent upon size effects. Consistent with the novel market equilibrium, we contend that the exponential growth of socially responsible investment (SRI) has rendered the risk-adjusted returns of large CSR-leading firms in line with or even below their lagging counterparts. In line with the neglected effect, greater market segmentation, lower market efficiency, and lower investor awareness of CSR enable us to observe the former market equilibrium in the smaller corporation partition, where CSR-lagging firms exhibit lower returns than leading ones. We thus theorize a two-stage CSP–CFP relationship, where size effects are considered a relevant moderator. This contention is robust to portfolio and panel regression settings. However, our partly contradicting results with the existent literature emphasize the divergence in ESG ratings across rating agencies. JEL Classification M14; G11; G15
Effect of Training Program on Knowledge and Practice of Breast feeding Women During COVID-19
Authors: Harthi Amnah M. , Harthi Abeer M. , Hendy Abdelaziz 
Published: March 2023

Aim Evaluate the effect of the training program on knowledge and practice of breastfeeding women during coronavirus disease 2019 (COVID-19). Methods One-group pretest/post-test quasiexperimental research design was utilized to accomplish the aim of this study. The study was carried out at the primary health care units Ad Dar Al Baida 1, Ad Dar Al Baida 2, Al Aziziyah at Riyadh Province of Saudi Arabia. The study included a convenience sample of 100 breastfeeding women. Tool A structured interviewing questionnaire sheet was used for data collection that included three parts knowledge, reported practice, and demographic characteristics. Results More than one-quarter (30%) and (28%) of studied women had satisfactory knowledge-related causes, risk factor and signs, symptoms of COVID-19 at preintervention, while the majority 85% and 86% of them had satisfactory knowledge postintervention at p-value <.01**. In addition, less than one-fifth (17%) and (16%) of studied women had satisfactory knowledge about Breastfeeding guidelines during COVID-19 and care of breastfeeding women during COVID-19, compared with most of them (89%) and (92%) postintervention at p-value <.01**. Conclusion Based on our current study, it was concluded that the educational program effectively improves breastfeeding women's knowledge and practices. There was a highly statistically significant positive linear correlation between the breastfeeding women's knowledge and reported practices regarding COVID-19 infection before and after the implementation of the educational program at p < .0.
Typical Complications After Cartilage Repair of the Ankle Using Autologous Matrix-Induced Chondrogenesis (AMIC)
Authors: Waltenspül Manuel , Meisterhans Michel , Ackermann Jakob , Wirth Stephan 
Published: March 2023

Background: Autologous matrix-induced chondrogenesis (AMIC) for the treatment of osteochondral lesions of the talus (OLT) results in favorable clinical outcomes, yet high reoperation rates. The aim of this study was to report and analyze typical complications and their risk factors after AMIC for OLT. Methods: A total of 127 consecutive patients with 130 AMIC procedures for OLT were retrospectively assessed. All AMIC procedures were performed in an open fashion with 106 (81.5%) cases requiring a malleolar osteotomy (OT) to access the OLT. Seventy-one patients (54.6%) underwent subsequent surgery. These cases were evaluated at a mean follow-up of 3.1 years (±2.5) for complications reviewing postoperative imaging and intraoperative findings during revision surgery. Six patients (8.5%) were lost to follow-up. Regression model analysis was conducted to identify factors that were associated with AMIC-related complications. Results: Among the 65 (50%) patients who required revision surgery, 18 patients (28%) demonstrated AMIC-related complications with deep fissuring (83%) and thinning (17%) of the AMIC graft. Conversely, 47 patients (72%) underwent subsequent surgery due to AMIC-unrelated reasons including isolated removal of symptomatic hardware (n = 17) and surgery addressing concomitant pathologies with (n = 25) and without hardware removal (n = 5). Previous prior cartilage repair surgery was significantly associated with AMIC graft-associated complications in patients undergoing revision surgery ( P = .0023). Among age, body mass index, defect size, smoking, and bone grafting, smoking was the only factor showing statistical significance with an odds ratio of 3.7 (95% CI 1.24, 10.9; P = .019) to undergo revision surgery due to graft-related complications, when adjusted for previous cartilage repair surgery. Conclusion: The majority of revision surgeries after AMIC for OLT are unrelated to the performed AMIC graft but frequently address symptomatic hardware and concomitant pathologies. Both smoking and previous cartilage repair surgery seem to significantly increase the risk of undergoing revision surgery due to AMIC-related complications. Level of evidence: Level IV, case series.
Genomic diversity of aquaporins across genus Oryza provides a rich genetic resource for development of climate resilient rice cultivars
Authors: Raza Qasim , Rashid Muhammad Abdul Rehman , Waqas Muhammad , Ali Zulfiqar , Rana Iqrar Ahmad , Khan Sultan Habibullah , Khan Iqrar Ahmad , Atif Rana Muhammad 
Published: March 2023

Abstract
Background
Plant aquaporins are critical genetic players performing multiple biological functions, especially climate resilience and water-use efficiency. Their genomic diversity across genus Oryza is yet to be explored.

Results
This study identified 369 aquaporin-encoding genes from 11 cultivated and wild rice species and further categorized these into four major subfamilies, among which small basic intrinsic proteins are speculated to be ancestral to all land plant aquaporins. Evolutionarily conserved motifs in peptides of aquaporins participate in transmembrane transport of materials and their relatively complex gene structures provide an evolutionary playground for regulation of genome structure and transcription. Duplication and evolution analyses revealed higher genetic conservation among Oryza aquaporins and strong purifying selections are assisting in conserving the climate resilience associated functions. Promoter analysis highlighted enrichment of gene upstream regions with cis-acting regulatory elements involved in diverse biological processes, whereas miRNA target site prediction analysis unveiled substantial involvement of osa-miR2102-3p, osa-miR2927 and osa-miR5075 in post-transcriptional regulation of gene expression patterns. Moreover, expression patterns of japonica aquaporins were significantly perturbed in response to different treatment levels of six phytohormones and four abiotic stresses, suggesting their multifarious roles in plants survival under stressed environments. Furthermore, superior haplotypes of seven conserved orthologous aquaporins for higher thousand-grain weight are reported from a gold mine of 3,010 sequenced rice pangenomes.

Conclusions
This study unveils the complete genomic atlas of aquaporins across genus Oryza and provides a comprehensive genetic resource for genomics-assisted development of climate-resilient rice cultivars.