bluuebunny/crossref_metadata_2025_split huggingface dataset:
Oncological outcomes after attempted nerve‐sparing radical prostatectomy (NSRP) in patients with high‐risk prostate cancer are comparable to standard non‐NSRP: a longitudinal long‐term propensity‐matched single‐centre study
Authors: Furrer Marc A. , Sathianathen Niranjan , Gahl Brigitta , Corcoran Niall M. , Soliman Christopher , Rodriguez Calero Jose Antonio , Ineichen Gallus B. , Gahl Miriam , Kiss Bernhard , Thalmann George N. 
Published: August 2023

ObjectiveTo assess the long‐term safety of nerve‐sparing radical prostatectomy (NSRP) in men with high‐risk prostate cancer (PCa) by comparing survival outcomes, disease recurrence, the need for additional therapy, and perioperative outcomes of patients undergoing NSRP to those having non‐NSRP.Patients and methodsWe included consecutive patients at a single, academic centre who underwent open RP for high‐risk PCa, defined as preoperative prostate‐specific antigen level of > 20 ng/mL and/or postoperative International Society of Urological Pathology Grade Group 4 or 5 (i.e., Gleason score ≥ 8) and/or ≥pT3 and/or pN1 assessing the RP and lymph node specimen. We calculated a propensity score and used inverse probability of treatment weighting to match baseline characteristics of patients with high‐risk PCa who underwent NSRP vs non‐NSRP. We analysed oncological outcome as time‐to‐event and calculated hazard ratios (HRs).ResultsA total of 726 patients were included in this analysis of which 84% (n = 609) underwent NSRP. There was no evidence for the positive surgical margin rate being different between the NSRP and non‐NSRP groups (47% vs 49%, P = 0.64). Likewise, there was no evidence for the need for postoperative radiotherapy being different in men who underwent NSRP from those who underwent non‐NSRP (HR 0.78, 95% confidence interval [CI] 0.53–1.15). NSRP did not impact the risk of any recurrence (HR 0.99, 95% CI 0.73–1.34, P = 0.09) and there was no evidence for survival being different in men who underwent NSRP to those who underwent non‐NSRP (HR 0.65, 95% CI 0.39–1.08). There was also no evidence for the cancer‐specific survival (HR 0.56, 95% CI 0.29–1.11) or progression‐free survival (HR 0.99, 95% CI 0.73–1.34) being different between the groups.ConclusionIn patients with high‐risk PCa, NSRP can be attempted without compromising long‐term oncological outcomes provided a comprehensive assessment of objective (e.g., T Stage) and subjective (e.g., intraoperative appraisal of tissue planes) criteria are conducted.
Hands‐On: Investigating the role of physical manipulatives in spatial training
Authors: Gilligan‐Lee Katie A. , Hawes Zachary C. K. , Williams Ashley Y. , Farran Emily K. , Mix Kelly S. 
Published: August 2023

AbstractStudies show that spatial interventions lead to improvements in mathematics. However, outcomes vary based on whether physical manipulatives (embodied action) are used during training. This study compares the effects of embodied and non‐embodied spatial interventions on spatial and mathematics outcomes. The study has a randomized, controlled, pre‐post, follow‐up, training design (N = 182; mean age 8 years; 49% female; 83.5% White). We show that both embodied and non‐embodied spatial training approaches improve spatial skills compared to control. However, we conclude that embodied spatial training using physical manipulatives leads to larger, more consistent gains in mathematics and greater depth of spatial processing than non‐embodied training. These findings highlight the potential of spatial activities, particularly those that use physical materials, for improving children's mathematics skills.
Factors affecting operative morbidity and long‐term outcomes in patients undergoing surgery for presacral tumours: a multicentric cohort study from the Turkish Collaborative Group for Quality Improvement in Colorectal and Pelvic Surgery
Authors: Aytac Erman , Sokmen Selman , Aktas Melik Kagan , Colak Tahsin , Mentes Bulent , Balik Emre , Demirbas Sezai , Akyol Cihangir , Sungurtekin Ugur , Oncel Mustafa , Ozturk Ersin , Obuz Funda , Ucaroglu Basar , Leventoglu Sezai , Ozerhan Ismail Hakki , Baca Bilgi , Ozgen Utku , Haksal Mustafa , Tumay Volkan , Geçim Ethem , Bugra Dursun 
Published: August 2023

AbstractAimData regarding the operative management of presacral tumours present various dilemmas due to their rarity and heterogeneous nature. The aim of this study was to evaluate the management strategy, factors associated with operative morbidity and long‐term postoperative outcomes in a large group of patients undergoing surgery for presacral tumours.MethodThis study was designed as a multicentre retrospective cohort study. Records of patients who underwent surgery for presacral tumours at 10 tertiary colorectal centres between 1996 and 2017 were evaluated.ResultsOne hundred and twenty seven patients (44 men) with a mean age of 46 years and body mass index of 27 kg/m2 were included. Fifty eight per cent of the patients had low sacral lesions (below S3). The operative approaches were transabdominal (17%), transsacral (65%) and abdominosacral (17%). The postoperative morbidity was 19%. Thirty per cent of the patients had a malignant tumour. Longer duration of symptoms (p = 0.001), higher American Society of Anesthesiologists score (p = 0.01), abdominosacral operations (p = 0.0001) and presacral tumours located above S3 (p = 0.004) were associated with an increased risk of postoperative morbidity. Overall long‐term postoperative recurrence and mortality were 6% and 5%, respectively, within a 3‐year mean follow‐up period in patients with presacral malignant tumours.ConclusionReduced physical condition, omission of symptoms prior to surgery, combined resections and high sacral tumours are the risk factors associated with postoperative complications in patients undergoing surgery for presacral tumours. Meticulous planning of the operation and intensified perioperative care may improve the outcomes in high‐risk patients.
Sense and nonsense of yT‐staging on MRI after chemoradiotherapy in rectal cancer
Authors: El Khababi Najim , Beets‐Tan Regina G. H. , Tissier Renaud , Lahaye Max J. , Maas Monique , Curvo‐Semedo Luís , Dresen Raphaëla C. , Nougaret Stephanie , Beets Geerard L. , Lambregts Doenja M. J. ,   the Rectal MRI Study Group
Published: August 2023

AbstractAimThe aim of this work was to investigate the value of rectal cancer T‐staging on MRI after chemoradiotherapy (ymrT‐staging) in relation to the degree of fibrotic transformation of the tumour bed as assessed using the pathological tumour regression grade (pTRG) of Mandard as a standard of reference.MethodTwenty two radiologists, including five rectal MRI experts and 17 ‘nonexperts’ (general/abdominal radiologists), evaluated the ymrT stage on the restaging MRIs of 90 rectal cancer patients after chemoradiotherapy. The ymrT stage was compared with the final ypT stage at histopathology; the percentages of correct staging (ymrT = ypT), understaging (ymrT < ypT) and overstaging (ymrT > ypT) were calculated and compared between patients with predominant tumour at histopathology (pTRG4–5) and patients with predominant fibrosis (pTRG1–3). Interobserver agreement (IOA) was computed using Krippendorff's alpha.ResultsAverage ymrT/ypT stage concordance was 48% for the experts and 43% for the nonexperts; ymrT/ypT stage concordance was significantly higher in the pTRG4–5 subgroup (58% vs. 41% for the pTRG1–3 group; p = 0.01), with the best results for the MRI experts. Overstaging was the main source of error, especially in the pTRG1–3 subgroup (average overstaging rate 38%–44% vs. 13%–55% in the pTRG4–5 subgroup). IOA was higher for the expert versus nonexpert readers (α = 0.67 vs. α = 0.39).ConclusionsymrT‐staging is moderately accurate; accuracy is higher in poorly responding patients with predominant tumour but low in good responders with predominant fibrosis, resulting in significant overstaging. Radiologists should shift their focus from ymrT‐staging to detecting gross residual (and progressive) disease, and identifying potential candidates for organ preservation who would benefit from further clinical and endoscopic evaluation to guide final treatment planning.
Poor outcomes in patients with sepsis undergoing emergency laparotomy and laparoscopy are attenuated by faster time to care measures
Authors: Eiamampai Natthaya , Ramsay Euan A. , Soiza Roy L. , McDonald David A. , Moug Susan J. , Myint Phyo K. 
Published: August 2023

AbstractAimEmergency laparotomy and laparoscopy (EmLap) are amongst the commonest surgical procedures, with high prevalence of sepsis and hence poorer outcomes. However, whether time taken to receive care influences outcomes in patients requiring antibiotics for suspected infection remains largely unexplored. The aim of this work was to determine whether (1) time to care contributes to outcome differences between patients with and without suspected infection and (2) its impact on outcomes only amongst those with suspected infection.MethodClinical information was retrospectively obtained from the 2017–2018 Emergency Laparotomy and Laparoscopic Scottish Audit (ELLSA). Time to care referred to six temporal variables describing radiological investigation, anaesthetic triage and surgical management. Outcome measures [mortality, readmission, hospital death, postoperative destination and length of stay (LoS)] were compared using adjusted and unadjusted regression analyses to determine whether the outcome differences could be explained by faster or slower time to care.ResultsAmongst 2243 EmLap patients [median age 65 years (interquartile range 51–75 years), 51.1% female], 892 (39.77%) received antibiotics for suspected infection. Although patients with suspected infection had faster time to care (all p ≤ 0.001) and worse outcomes compared with those who did not, outcome differences were not statistically significant when accounted for time (all p > 0.050). Amongst those who received antibiotics, faster time to care was also associated with decreased risk of postoperative intensive care unit (ICU) stay and shorter LoS (all p < 0.050).ConclusionWorse outcomes associated with infection in EmLap patients were attenuated by faster time to care, which additionally reduced the LoS and ICU stay risk amongst those with suspected infection.
Social Expectations are Primarily Rooted in Reciprocity: An Investigation of Fairness, Cooperation, and Trustworthiness
Authors: Bogdan Paul C. , Dolcos Florin , Moore Matthew , Kuznietsov Illia , Culpepper Steven A. , Dolcos Sanda 
Published: August 2023

AbstractSocial expectations guide people's evaluations of others’ behaviors, but the origins of these expectations remain unclear. It is traditionally thought that people's expectations depend on their past observations of others’ behavior, and people harshly judge atypical behavior. Here, we considered that social expectations are also influenced by a drive for reciprocity, and people evaluate others’ actions by reflecting on their own decisions. To compare these views, we performed four studies. Study 1 used an Ultimatum Game task where participants alternated Responder and Proposer roles. Modeling participants’ expectations suggested they evaluated the fairness of received offers via comparisons to their own offers. Study 2 replicated these findings and showed that observing selfish behavior (lowball offers) only promoted acceptance of selfishness if observers started acting selfishly themselves. Study 3 generalized the findings, demonstrating that they also arise in the Public Goods Game, emerge cross‐culturally, and apply to antisocial punishment whereby selfish players punish generosity. Finally, Study 4 introduced the Trust Game and showed that participants trusted players who reciprocated their behavior, even if it was selfish, as much as they trusted generous players. Overall, this research shows that social expectations and evaluations are rooted in drives for reciprocity. This carries theoretical implications, speaking to a parallel in the mechanisms driving both decision‐making and social evaluations, along with practical importance for understanding and promoting cooperation.
Investigation of the non‐small cell lung cancer patients with bronchus involvements: A population‐based study
Authors: Wang Gang , Ye Yong‐Qiang , Xie Bao‐Long , Lai Xiang‐Min , Zhong Sheng‐Peng 
Published: August 2023

AbstractBackgroundWe aimed to explore the prognostic differences among T1‐4N0‐2M0 non‐small cell lung cancer (NSCLC) patients with bronchus involvements and to validate the T category of these patients in an external cohort.MethodsUnivariable and multivariable Cox analysis was performed to determine the prognostic factors. Kaplan–Meier method with a log‐rank test was used to compare overall survival differences between groups. Propensity score matching method was used to minimize the bias caused by the imbalanced covariates between groups.ResultsA total of 169 390 eligible T1‐4N0‐2M0 NSCLC cases were included. There were 2354, 3367, 1638, 75, 87 585, 42 056, 19 246, and 13 069 cases in the group of superficial tumors of any size with invasive component limited to bronchial wall (T1‐bronchus), tumors involving main stem bronchus ≥2 cm from carina (T2‐main bronchus [≥2 cm]), tumors involving main stem bronchus <2 cm from carina (T2‐main bronchus [<2 cm]), tumors with carina invasion (T4‐carina), T1, T2, T3, and T4, respectively. Multivariable Cox analysis indicated that T1‐bronchus patients had the best prognosis; T2‐main bronchus (≥2 cm) and T2‐main bronchus (<2 cm) patients had similar prognosis both in the entire cohort and in several subgroups. Survival curves showed that T1‐bronchus and T1 patients had similar survival rates; the survivals of T2‐main bronchus patients regardless of the distance from carina were comparable to those of T2 patients, and the survivals of T4‐carina patients were also similar to those of T4 patients.ConclusionsOur results validated and supported the current T category for the patients with bronchus involvements, which might provide certain reference value for the revisions of T category in the next version of the tumor‐node‐metastasis stage classification.
Pitfalls in soft tissue cytopathology
Authors: Rekhi Bharat , Qian Xiaohua , Domanski Henryk A. , Klijanienko Jerzy , Field Andrew 
Published: August 2023

AbstractFine needle aspiration biopsy (FNAB) is a diagnostic modality for the evaluation of suspicious soft tissue masses. Despite its reasonable sensitivity, specificity and positive predictive value in differentiating benign from malignant neoplasms, the exact subtyping of the primary soft tissue tumours can be challenging. Certain tumours constitute “pitfalls” and add to the diagnostic challenge. This review provides a detailed account of the diagnostic challenges in soft tissue cytopathology, including pitfalls and, more importantly, the ways to overcome these challenges by integrating clinical details, key cytomorphological features and judicious application of ancillary techniques.
Speciation and development
Authors: Cutter Asher D. 
Published: August 2023

AbstractUnderstanding general principles about the origin of species remains one of the foundational challenges in evolutionary biology. The genomic divergence between groups of individuals can spawn hybrid inviability and hybrid sterility, which presents a tantalizing developmental problem. Divergent developmental programs may yield either conserved or divergent phenotypes relative to ancestral traits, both of which can be responsible for reproductive isolation during the speciation process. The genetic mechanisms of developmental evolution involvecis‐ andtrans‐acting gene regulatory change, protein–protein interactions, genetic network structures, dosage, and epigenetic regulation, all of which also have roots in population genetic and molecular evolutionary processes. Toward the goal of demystifying Darwin's “mystery of mysteries,” this review integrates microevolutionary concepts of genetic change with principles of organismal development, establishing explicit links between population genetic process and developmental mechanisms in the production of macroevolutionary pattern. This integration aims to establish a more unified view of speciation that binds process and mechanism.
The reproductive tract of the black soldier fly (Hermetia illucens) is highly differentiated and suggests adaptations to sexual selection
Authors: Munsch‐Masset Paul , Labrousse Carole , Beaugeard Laureen , Bressac Christophe 
Published: August 2023

AbstractThe reproductive biology of the black soldier fly (BSF), Hermetia illucens (L.) (Diptera: Stratiomyidae), was investigated in males and females with a focus on how sperm is handled by males before – and by females after – copulation. As this insect has great economic importance for protein production from agri‐food wastes, its reproduction needs to be precisely known. A detailed description of male and female reproductive organs was made, and sperm were counted in male and female storage organs. Measures of testis and sperm counts were performed in males of various ages and their dynamics was compared to the ovaries of females. Both male and female tracts were long, and consisted of various successive parts. In males, testes fill the vas deferens with mature sperm, that are tangled as ‘windrows’, and sperm pass successively through a ‘studded pipe’ and three phallic ‘wands’ before being transferred to females. In virgin males, mean (± SEM) sperm number increased from approximately 9700 (± 1400, n = 5) to 39600 (± 3470, n = 13) in 20 days, and testes gradually decreased in size, indicating continuous spermatogenesis. Sperm cells are long, more than 3 mm. During copulation, sperm are deposited by phallic ‘wands’ at the base of each spermatheca in a smooth tube followed by a ‘fishnet canal’ at the top of which they accumulate before complete storage. They then pass through a ringed canal, an elbow, and a rigid rod strewn with glands, before reaching the spermathecal reservoir. Females store approximately 680 spermatozoa after one mating in each spermathecal reservoir. Such complex sperm storage organs of females may indicate strong female post‐mating selection, and reflect competition for long and numerous sperm in this species, in which female multiple matings are suspected. Besides its economical interest, BSF is an appealing model for further investigations on sexual selection.
CAR T cell therapy in multiple myeloma, where are we now and where are we heading for?
Authors: Fischer Luise , Grieb Nora , Platzbecker Uwe , Vucinic Vladan , Merz Maximilian 
Published: August 2023

AbstractThe introduction of chimeric antigen receptor (CAR) T cells revolutionized treatment of relapsed and refractory multiple myeloma (RRMM) in recent years. Currently, two CAR T cell products—idecabtagene vicleucel and ciltacabtagene autoleucel—are approved in the United States and the European Union to treat patients with three prior lines of therapy, including a proteasome inhibitor, an immunomodulatory drug, and an anti‐CD38 antibody. Moreover, seminal phase III trials of both agents in earlier lines of therapy have been published recently. Despite unprecedented rates of deep and lasting remissions in RRMM, there are still areas of uncertainty regarding the optimal use and distribution of CAR T cells in multiple myeloma. In the current review, we discuss the available data on approved CAR T cell products as well as unmet clinical needs and ongoing developments to optimize usage of this promising treatment modality in multiple myeloma.
Deep‐learning based classification of a tumor marker for prognosis on Hodgkin's disease
Authors: Motmaen Ila , Sereda Sergej , Brobeil Alexander , Shankar Ananth , Braeuninger Andreas , Hasenclever Dirk , Gattenlöhner Stefan 
Published: August 2023

AbstractPurposeHodgkin's disease is a common malignant disorder in adolescent patients. Although most patients are cured, approximately 10%–15% of patients experience a relapse or have resistant disease. Furthermore, there are no definitive molecular predictors for early identification of patients at high risk of treatment failure to first line therapy. The aim of this study was to evaluate the deep learning‐based classifier model of medical image classification to predict clinical outcome that may help in appropriate therapeutic decisions.MethodsEighty‐three FFPE biopsy specimens from patients with Hodgkin's disease were stratified according to the patient's qPET scores, stained with picrosirius red dye and digitalized by whole slide image scanning. The resulting whole slide images were cut into tiles and annotated by two classes based on the collagen fibers' degree of coloring with picrosirius red. The neural network (YOLOv4) was then trained with the annotated data. Training was performed with 30 cases. Prognostic power of the weakly stained picrosirius red fibers was evaluated with 53 cases. The same neural network was trained with MMP9 stained tissue slides from the same cases and the quantification results were compared with the variant from the picrosirius red cases.ResultsThere was a weak monotonically increasing relationship by parametric ANOVA between the qPET groups and the percentages of weakly stained fibers (p = .0185). The qPET‐positive cases showed an average of 18% of weakly stained fibers, and the qPET‐negative cases 10%–14%. Detection performance showed an AUC of 0.79.ConclusionsPicrosirius red shows distinct associations as a prognostic metric candidate of disease progression in Hodgkin's disease cases using whole slide images but not sufficiently as a prognostic device.
Text mining of electronic health records can validate a register‐based diagnosis of epilepsy and subgroup into focal and generalized epilepsy
Authors: Vulpius Siri A. , Werge Sebastian , Jørgensen Isabella Friis , Siggaard Troels , Hernansanz Biel Jorge , Knudsen Gitte M. , Brunak Søren , Pinborg Lars H. 
Published: August 2023

AbstractObjectiveCombining population‐based health registries and electronic health records offers the opportunity to create large, phenotypically detailed patient cohorts of high quality. In this study, we used text mining of clinical notes to confirm International Classification of Diseases, 10th Revision (ICD‐10)‐registered epilepsy diagnoses and classify patients according to focal and generalized epilepsy types.MethodsUsing the Danish National Patient Registry, we identified patients who between 2006 and 2016 received an ICD‐10 diagnosis of epilepsy. To validate the epilepsy diagnosis and stratify patients into focal and generalized epilepsy types, we constructed dictionaries for text mining‐based extraction of clinical notes. Two physicians manually reviewed the clinical notes for a total of 527 patients and assigned epilepsy diagnoses, which were compared with the text‐mined diagnoses.ResultsWe identified 23 632 patients with an ICD‐10 diagnosis of epilepsy, of whom 50% were registered with an unspecified epilepsy diagnosis. In total, 11 211 patients were considered likely to have epilepsy by text mining, with an F1 measure ranging from 82% to 90%. Manual review of the electronic health records for 310 patients revealed a false discovery rate of 29%. This rate was decreased to 4% by the text mining algorithm. The weighted average F1 measure for text mining‐assigned epilepsy types was 79% (82% for focal and 76% for generalized epilepsy). Text mining successfully assigned a focal or generalized epilepsy type to 92% of the text mining‐eligible patients registered with unspecified epilepsy.SignificanceText mining of electronic health records can be used to establish a patient cohort with much higher likelihood of having a diagnosis of epilepsy and a focal or generalized epilepsy type compared to the cohort created from ICD‐10 epilepsy codes alone. We believe the concept will be essential for future genome‐wide and phenome‐wide association studies and subsequently the development of precision medicine for epilepsy patients.