bluuebunny/crossref_metadata_2025_split huggingface dataset:
Radiomic and clinical data integration using machine learning predict the efficacy of anti-PD-1 antibodies-based combinational treatment in advanced breast cancer: a multicentered study
Authors: Zhao Jianli , Sun Zhixian , Yu Yunfang , Yuan Zhongyu , Lin Ying , Tan Yujie , Duan Xiaohui , Yao Herui , Wang Ying , Liu Jieqiong 
Published: May 2023

BackgroundImmune checkpoint inhibitors (ICIs)-based therapy, is regarded as one of the major breakthroughs in cancer treatment. However, it is challenging to accurately identify patients who may benefit from ICIs. Current biomarkers for predicting the efficacy of ICIs require pathological slides, and their accuracy is limited. Here we aim to develop a radiomics model that could accurately predict response of ICIs for patients with advanced breast cancer (ABC).MethodsPretreatment contrast-enhanced CT (CECT) image and clinicopathological features of 240 patients with ABC who underwent ICIs-based treatment in three academic hospitals from February 2018 to January 2022 were assigned into a training cohort and an independent validation cohort. For radiomic features extraction, CECT images of patients 1 month prior to ICIs-based therapies were first delineated with regions of interest. Data dimension reduction, feature selection and radiomics model construction were carried out with multilayer perceptron. Combined the radiomics signatures with independent clinicopathological characteristics, the model was integrated by multivariable logistic regression analysis.ResultsAmong the 240 patients, 171 from Sun Yat-sen Memorial Hospital and Sun Yat-sen University Cancer Center were evaluated as a training cohort, while other 69 from Sun Yat-sen University Cancer Center and the First Affiliated Hospital of Sun Yat-sen University were the validation cohort. The area under the curve (AUC) of radiomics model was 0.994 (95% CI: 0.988 to 1.000) in the training and 0.920 (95% CI: 0.824 to 1.000) in the validation set, respectively, which were significantly better than the performance of clinical model (0.672 for training and 0.634 for validation set). The integrated clinical-radiomics model showed increased but not statistical different predictive ability in both the training (AUC=0.997, 95% CI: 0.993 to 1.000) and validation set (AUC=0.961, 95% CI: 0.885 to 1.000) compared with the radiomics model. Furthermore, the radiomics model could divide patients under ICIs-therapies into high-risk and low-risk group with significantly different progression-free survival both in training (HR=2.705, 95% CI: 1.888 to 3.876, p<0.001) and validation set (HR=2.625, 95% CI: 1.506 to 4.574, p=0.001), respectively. Subgroup analyses showed that the radiomics model was not influenced by programmed death-ligand 1 status, tumor metastatic burden or molecular subtype.ConclusionsThis radiomics model provided an innovative and accurate way that could stratify patients with ABC who may benefit more from ICIs-based therapies.
7 Principles of delivery of surgical care from a military facility to a local population; lessons learnt from deployed surgical care in Gao
Authors:   Maj Grosset Antoine
Published: May 2023

Medical aid to the population stems from a long French tradition of caring for native populations. It has evolved through the various deployments in modern conflicts and is now based on well-defined principles. It is diplomatically important, as it allows the acceptance of the Force by the population. It is governed by military and strategic, legal but also ethical rules.The experience of the surgical assistance offered at the operational base in Gao has highlighted the limits that each surgeon has had to impose on himself to ensure the sustainability of this care.It was necessary to consider the local environment, to learn and adapt to socio-cultural norms, and to assess the needs of the population. Very costly in terms of human and material resources, it was necessary to define the care that could be offered.Confronted by a very large request for care, and the virtual absence of local health structures, not everything can be done, nor should it be done.Throughout his mandate, the military surgeon must consider the operational mission which takes precedence, and the humanitarian side. The principle of beneficence is at the heart of the medical reflection.The transmission of knowledge is essential for sustainability. The basic principles are taught to junior surgeons during specific theoretical courses, and practical training alongside an experienced surgeon.The main idea is that this surgical aid should be beneficial to the greatest number and be sustainable, without compromising the operational mission or giving false hope to the local population.
Five-dimensional Einstein–Gauss–Bonnet gravity compactified and applied to a colour-flavour-locked equation of state
Authors: Bogadi Robert S. , Govender Megandhren , Moyo Sibusiso 
Published: May 2023

AbstractEinstein–Gauss–Bonnet gravity in five dimensions is applied to compact stellar objects, in particular to quark stars obeying a colour-flavour-locked equation of state. Matter under such extreme conditions welcomes the use of higher-order gravity theories or the inclusion of extra dimensions in support of higher-curvature effects. In so doing, we focus on the representation of quantities in higher dimensions in standard four-dimensional spacetime via compactification. Invoking extra compact dimensions from a basic string-theoretic perspective provides for the rationalisation of physical quantities computed in higher dimensions.
T cell–Mediated Development of Stromal Fibroblasts with an Immune-Enhancing Chemokine Profile
Authors: Yan Ran , Moresco Philip , Gegenhuber Bruno , Fearon Douglas T. 
Published: May 2023

Abstract
Stromal fibroblasts reside in inflammatory tissues that are characterized by either immune suppression or activation. Whether and how fibroblasts adapt to these contrasting microenvironments remains unknown. Cancer-associated fibroblasts (CAF) mediate immune quiescence by producing the chemokine CXCL12, which coats cancer cells to suppress T-cell infiltration. We examined whether CAFs can also adopt an immune-promoting chemokine profile. Single-cell RNA sequencing of CAFs from mouse pancreatic adenocarcinomas identified a subpopulation of CAFs with decreased expression of Cxcl12 and increased expression of the T cell–attracting chemokine Cxcl9 in association with T-cell infiltration. TNFα and IFNγ containing conditioned media from activated CD8+ T cells converted stromal fibroblasts from a CXCL12+/CXCL9− immune-suppressive phenotype into a CXCL12−/CXCL9+ immune-activating phenotype. Recombinant IFNγ and TNFα acted together to augment CXCL9 expression, whereas TNFα alone suppressed CXCL12 expression. This coordinated chemokine switch led to increased T-cell infiltration in an in vitro chemotaxis assay. Our study demonstrates that CAFs have a phenotypic plasticity that allows their adaptation to contrasting immune tissue microenvironments.
Long-Term Outcomes of Early Coronary Artery Disease Testing After New-Onset Heart Failure
Authors: Zheng Jimmy , Heidenreich Paul A. , Kohsaka Shun , Fearon William F. , Sandhu Alexander T. 
Published: May 2023

BACKGROUND:
Coronary artery disease (CAD) testing remains underutilized in patients with newly diagnosed heart failure (HF). The longitudinal clinical impact of early CAD testing has not been well-characterized. We investigated changes in clinical management and long-term outcomes after early CAD evaluation in patients with incident HF.

METHODS:
We identified Medicare patients with incident HF from 2006 to 2018. The exposure variable was early CAD testing within 1 month of initial HF diagnosis. Covariate-adjusted rates of cardiovascular interventions after testing, including CAD-related management, were modeled using mixed-effects regression with clinician as a random intercept. We assessed mortality and hospitalization outcomes using landmark analyses with inverse probability-weighted Cox proportional hazards models. Falsification end points and mediation analysis were employed for bias assessment.

RESULTS:
Among 309 559 patients with new-onset HF without prior CAD, 15.7% underwent early CAD testing. Patients who underwent prompt CAD evaluation had higher adjusted rates of subsequent antiplatelet/statin prescriptions and revascularization, guideline-directed therapy for HF, and stroke prophylaxis for atrial fibrillation/flutter than controls. In weighted Cox models, 1-month CAD testing was associated with significantly reduced all-cause mortality (hazard ratio, 0.93 [95% CI, 0.91–0.96]). Mediation analyses indicated that ≈70% of this association was explained by CAD management, largely from new statin prescriptions. Falsification end points (outpatient diagnoses of urinary tract infection and hospitalizations for hip/vertebral fracture) were nonsignificant.

CONCLUSIONS:
Early CAD testing after incident HF was associated with a modest mortality benefit, driven mostly by subsequent statin therapy. Further investigation on clinician barriers to testing and treating high-risk patients may improve adherence to guideline-recommended cardiovascular interventions.
Timing of Antihypertensive Drug Therapy: A Systematic Review and Meta-Analysis of Randomized Clinical Trials
Authors: Maqsood Muhammad Haisum , Messerli Franz H. , Skolnick Adam H. , Newman Jonathan D. , Berger Jeffrey S. , Bangalore Sripal 
Published: May 2023

Background:
The timing of antihypertensive drugs administration is controversial. The aim was to compare the efficacy of dosing of antihypertensive drugs in the morning versus evening.

Methods:

A PubMed, EMBASE, and
clinicaltrials.gov
databases search for randomized clinical trials of antihypertensive therapies where patients were randomized to morning versus evening dosing. The outcomes were ambulatory blood pressure (BP) parameters (day-time, night-time, and 24/48-hour systolic blood pressure [SBP] and diastolic blood pressure [DBP]) and cardiovascular outcomes.

Results:

Of 72 randomized controlled trials included, evening dosing significantly reduced ambulatory BP parameters: 24/48-hour SBP (mean difference [MD]=1.41 mm Hg; [95% CI, 0.48–2.34]), DBP (MD=0.60 mm Hg [95% CI, 0.12–1.08]), night-time SBP (MD=4.09 mm Hg [95% CI, 3.01–5.16]), DBP (MD, 2.57 mm Hg [95% CI, 1.92–3.22]), with a smaller reduction in day-time SBP (MD=0.94 mm Hg [95% CI, 0.01–1.87]), and DBP (MD=0.87 mm Hg [95% CI, 0.10–1.63]), and numerically lower cardiovascular events compared with morning dosing. However, when controversial data by Hermida (23 trials, 25  734 patients) were omitted (
P
heterogeneity
<0.05 for most outcomes), the above effect of evening dosing attenuated with no significant effect on 24/48-hour ambulatory blood pressure, day-time BP, and major adverse cardiac event and smaller reduction in night-time ambulatory SBP and DBP.

Conclusions:
Evening dosing of antihypertensive drugs significantly reduced ambulatory BP parameters and lowered cardiovascular events but the effect was mainly driven by trials by Hermida group. Unless the intention is to specifically lower night-time BP, antihypertensive drugs should be taken at a time of day that is convenient, optimizes adherence, and minimizes undesirable effects.
Location-Specific Hematoma Volume Cutoff and Clinical Outcomes in Intracerebral Hemorrhage
Authors: Teo Kay-Cheong , Fong Sze-Man , Leung William C.Y. , Leung Ian Y.H. , Wong Yuen-Kwun , Choi Olivia M.Y. , Yam Ka-Keung , Lo Rachel C.N. , Cheung Raymond T.F. , Ho Shu-Leong , Tsang Anderson C.O. , Leung Gilberto K.K. , Chan Koon-Ho , Lau Kui-Kai 
Published: May 2023

Background:
Major intracerebral hemorrhage (ICH) trials have largely been unable to demonstrate therapeutic benefit in improving functional outcomes. This may be partly due to the heterogeneity of ICH outcomes based on their location, where a small strategic ICH could be debilitating, thus confounding therapeutic effects. We aimed to determine the ideal hematoma volume cutoff for different ICH locations in predicting ICH outcomes.

Methods:
We retrospectively analyzed consecutive ICH patients enrolled in the University of Hong Kong prospective stroke registry from January 2011 to December 2018. Patients with premorbid modified Rankin Scale score >2 or who underwent neurosurgical intervention were excluded. ICH volume cutoff, sensitivity, and specificity in predicting respective 6-month neurological outcomes (good [modified Rankin Scale score 0–2], poor [modified Rankin Scale score 4–6], and mortality) for specific ICH locations were determined using receiver operating characteristic curves. Separate multivariate logistic regression models were also conducted for each location-specific volume cutoff to determine whether these cutoffs were independently associated with respective outcomes.

Results:

Among 533 ICHs, the volume cutoff for good outcome according to ICH location was 40.5 mL for lobar, 32.5 mL for putamen/external capsule, 5.5 mL for internal capsule/globus pallidus, 6.5 mL for thalamus, 17 mL for cerebellum, and 3 mL for brainstem. ICH smaller than the cutoff for all supratentorial sites had higher odds of good outcomes (all
P
<0.05). Volumes exceeding 48 mL for lobar, 41 mL for putamen/external capsule, 6 mL for internal capsule/globus pallidus, 9.5 mL for thalamus, 22 mL for cerebellum, and 7.5 mL for brainstem were at greater risk of poor outcomes (all
P
<0.05). Mortality risks were significantly higher for volumes that exceeded 89.5 mL for lobar, 42 mL for putamen/external capsule, and 21 mL for internal capsule/globus pallidus (all
P
<0.001). All receiver operating characteristic models for location-specific cutoffs had good discriminant values (area under the curve >0.8), except in predicting good outcome for cerebellum.

Conclusions:
ICH outcomes differed with location-specific hematoma size. Location-specific volume cutoff should be considered in patient selection for ICH trials.
Roundtable on John Clark's The Asian Modern
Authors: Juneja Monica , Minglu Gao , Sambrani Chaitanya , Taylor Nora Annesley , Tiampo Ming 
Published: May 2023

Abstract
The book, The Asian Modern, by John Clark (with an Introduction by the Manila-based critic and curator, Patrick Flores) seeks to construct a “cross-Asian” account through a detailed historical and empirical focus on 30 artists spanning Southeast, East, and South Asia, as well as Australia. At the core of the book is the premise that the given place, “Asia,” is the locus for a critique of the normative account of modernism tethered to another locale, identified by Clark as “Euramerica.” These focused geographic arenas provide the basis for novel itineraries, dynamic dispersals, and alternative sightlines that reject the conventional frame of the nation. Given the ambitious scale and scope of Clark's project, the ARTMargins editors invited five historians of modern and contemporary art in Asia—Monica Juneja, Ming Tiampo, Nora Taylor, Gao Minglu, and Chaitanya Sambrani—to critically reflect upon the methodological and scholarly implications of his undertaking for the narratives of art history in Asia and beyond. Their responses point up both the limits and merits of The Asian Modern, and address important themes and debates in approaches to global art history, more broadly.
Chronological Dyslexia: Remembering/Representing/Performing Aids
Authors: Jones Amelia 
Published: May 2023

Abstract
Exploring two major books on the visual and performance histories of the ongoing and historical AIDS crisis in the US and beyond—Brian Getnick's edited volume Final Transmission and Avram Finkelstein's firsthand account, After Silence—this review asks how we have come to contemplate and understand the intensities, losses, and absences of the AIDS catastrophe. Drawing on theories on death, dying, and the cultural expressions around them, the review puts pressure on the particular offerings of these two very different books, ultimately pulling out passionate moments of vulnerability and self-reflexivity in each book as the most effective and powerful ruminations on global crises such as the AIDS pandemic.
Controversies and progress on standardization of large-scale brain network nomenclature
Authors: Uddin Lucina Q. , Betzel Richard F. , Cohen Jessica R. , Damoiseaux Jessica S. , De Brigard Felipe , Eickhoff Simon B. , Fornito Alex , Gratton Caterina , Gordon Evan M. , Laird Angela R. , Larson-Prior Linda , McIntosh A. Randal , Nickerson Lisa D. , Pessoa Luiz , Pinho Ana Luísa , Poldrack Russell A. , Razi Adeel , Sadaghiani Sepideh , Shine James M. , Yendiki Anastasia , Yeo B. T. Thomas , Spreng R. Nathan 
Published: May 2023

Abstract
Progress in scientific disciplines is accompanied by standardization of terminology. Network neuroscience, at the level of macroscale organization of the brain, is beginning to confront the challenges associated with developing a taxonomy of its fundamental explanatory constructs. The Workgroup for HArmonized Taxonomy of NETworks (WHATNET) was formed in 2020 as an Organization for Human Brain Mapping (OHBM)–endorsed best practices committee to provide recommendations on points of consensus, identify open questions, and highlight areas of ongoing debate in the service of moving the field toward standardized reporting of network neuroscience results. The committee conducted a survey to catalog current practices in large-scale brain network nomenclature. A few well-known network names (e.g., default mode network) dominated responses to the survey, and a number of illuminating points of disagreement emerged. We summarize survey results and provide initial considerations and recommendations from the workgroup. This perspective piece includes a selective review of challenges to this enterprise, including (1) network scale, resolution, and hierarchies; (2) interindividual variability of networks; (3) dynamics and nonstationarity of networks; (4) consideration of network affiliations of subcortical structures; and (5) consideration of multimodal information. We close with minimal reporting guidelines for the cognitive and network neuroscience communities to adopt.
Low Molecular Weight Heparin Is Superior for Venous Thromboembolism Prophylaxis in High-Risk Geriatric Patients
Authors: Deusenberry Christina M. , Bardsley Casey , Sharon Mindy , Hobbs Gerald R. , Wilson Alison M. , Bardes James M. 
Published: May 2023

Introduction Venous thromboembolism (VTE) is a source of preventable morbidity and mortality in critically ill trauma patients. Age is one independent risk factor. Geriatric patients embody a population at high thromboembolic and hemorrhagic risk. Currently, there is little guidance between low molecular weight heparin (LMWH) and unfractionated heparin (UFH) for anticoagulant prophylaxis in the geriatric trauma patient. Methods A retrospective review was conducted at an ACS verified, Level I Trauma center from 2014 to 2018. All patients 65 years or older, with high-risk injuries and admitted to the trauma service were included. Choice of agent was at provider discretion. Patients in renal failure, or those that received no chemoprophylaxis, were excluded. The primary outcomes were the diagnosis of deep vein thrombosis or pulmonary embolism and bleeding associated complications (gastrointestinal bleed, TBI expansion, hematoma development). Results This study evaluated 375 subjects, 245 (65%) received enoxaparin and 130 (35%) received heparin. DVT developed in 6.9% of UFH patients, compared to 3.3% with LMWH ( P = .1). PE was present in 3.8% of UFH group, but only .4% in the LMWH group ( P = .01). Combined rate of DVT/PE was significantly lower ( P = .006) with LMWH (3.7%) compared to UFH (10.8%). 10 patients had documented bleeding events, and there was no significant association between bleeding and the use of LMWH or UFH. Conclusions VTE events are more common in geriatric patients treated with UFH compared to LMWH. There was no associated increase in bleeding complications when LMWH was utilized. LMWH should be considered the chemoprophylatic agent of choice in high risk geriatric trauma patients.
Evaluating the Effect of Timing on Point-of-Care Testing of INR
Authors: Son Joanne , Kim Elise M. 
Published: May 2023

Objectives: To evaluate if there is a difference in International Normalized Ratio (INR) readings taken within the 15 second time frame after lancing the finger vs 30-60 seconds of obtaining a blood drop utilizing a CoaguChek® XS Plus point-of-care (POC) INR machine in patients on warfarin therapy. Methods: All adult patients on anticoagulation therapy with warfarin who were managed in a pharmacist-run anticoagulation clinic were considered for inclusion in the study. The mean difference of INR readings taken less than 15 seconds vs between 30-60 seconds after the blood drop was obtained from the finger was assessed. Results: A total of 62 pairs of INR results were included in the study. There was a mean difference in INR of .076 (95% CI 0.011-.140; P = .0217) when comparing INR readings taken less than 15 seconds and between 30-60 seconds after the blood drop was obtained from the finger. Conclusions: There was a significant difference in INR readings taken less than 15 seconds vs 30-60 seconds after obtaining the blood drop when utilizing a POC INR machine. INR readings taken 30-60 seconds after obtaining a blood drop with the CoaguChek® XS Plus POC INR machine is not acceptable for use to monitor patients on warfarin.
Field epidemiology, clinical findings and outcome of Scrub typhus patients admitted at Gedu District Hospital, Chhukha, Bhutan
Authors: Nepal Tej Nath , Chhetri Geeta 
Published: May 2023

Objectives: This study aimed to understand the field epidemiology, clinical findings, diagnostic reports and outcome of Scrub typhus patients admitted at Gedu District Hospital, Bhutan. Methods: The researcher extracted data from the records of patients admitted at the hospital from 1 January 2017 to 31 December 2020, with diagnosis of Scrub typhus. A total of 185 records were used to study the demographic distribution, results of rapid diagnostic test for Scrub typhus, presence of eschar, treatment outcome and duration of admission in the hospital. Results: The months of May to October had increased admissions of 137 (74%) patients with a peak in September. Three gewogs (sub-districts) had 173 (93.5%) patients; age range was 6 months to 84 years and a greater proportion of patients were females. Conclusion: Scrub typhus is endemic in the district. The absence of recorded fever or a negative rapid diagnostic test report may not exclude the diagnosis of Scrub typhus.