bluuebunny/crossref_metadata_2025_split huggingface dataset:
Novel ultrasonographic evaluation of microvascular blood flow for the non-operative management of uncomplicated acute appendicitis in children
Authors: Kosaka Seitaro , Toma Miki , Asai Nobuyoshi , Yanai Toshihiro 
Published: September 2023

Abstract
Background: Superb microvascular imaging (SMI), in contrast to power Doppler (PD), enables visualization of microvascular blood flow (BF). We compared PD and SMI to determine whether SMI is superior in detecting appendiceal BF in uncomplicated acute appendicitis patients.
Methods: We prospectively reviewed all pediatric patients with acute appendicitis initially treated non-operatively and clinically evaluated using PD and SMI to determine the case severity, monitor appendiceal BF, and assess the reversibility of appendicitis. Complicated acute cases were excluded. Severity was classified using B-mode, PD ultrasonography, and additional SMI: Grade I - smooth wall/normal BF, Grade IIa - irregular wall/increased BF, Grade IIb - irregular wall/decreased BF, and Grade III - absence of wall/loss of BF.
SMI results were compared with those of PD alone.
Results: 129 patients with acute appendicitis were reviewed; 29 were excluded. In 100 patients (Grade I: 10, IIa: 29, IIb: 55, III: 6), no differences were observed between PD and SMI in appendiceal BF for Grades I and IIa, which all fully recovered. In all 55 patients with Grade IIb and decreased appendiceal BF on PD, SMI effectively detected appendiceal BF, and 52 recovered. Neither PD nor SMI were able to detect BF in Grade III patients who developed abscesses and for whom non-operative management failed.
Conclusions: SMI can accurately detect BF, even when decreased BF is observed by PD. SMI showed a higher sensitivity in detecting appendiceal BF compared to PD and may serve as a tool for patient selection for non-operative management of acute appendicitis.
Numerical Simulation and Performance Prediction of Ejection Impact of Air Spring Based on Fluid–Structure Interaction
Authors: li yuru , Xiao Shoune , Xie Junke , zhu Tao 
Published: September 2023

Abstract
Air springs have found wide application in cushioning and shock absorption, but their use in ejection scenarios is still in its early stages. To address the challenges of applying air spring in high-speed ejections of rail vehicles, this study focuses on the ejection of the driver's cabin structure and investigates the elastic performance of air spring using a series-parallel combination. The study analyzes ejection characteristics for air spring in a series-parallel configuration by number simulation. A second-order response surface method is employed to establish a predictive model for the ejection performance of air spring in this configuration. The model's accuracy is verified through virtual collision analysis of the driver's cabin in a rail vehicle. The ejection velocity exhibits a relative error of only 9.1%. The test vehicle, driven by air spring, achieves a maximum kinetic energy of 415 kJ, meeting the initial target value of not less than 408 kJ. Additionally, the analysis of wheel-rail interaction reveals that the vertical lift and lateral displacement of the test vehicle are within acceptable limits, measuring 5.49 mm and 9.89 mm, respectively, without exceeding the wheel flange height and tread width. These results demonstrate that air spring with series-parallel combination can successfully propel the test vehicle to conduct driver's cabin collision tests, without any derailment or overturning. As a result, the study realizes ejection tests using air spring with series-parallel combination. The research on the ejection performance of air spring in this configuration offers a new driving and ejection method for applying air spring in rail vehicles, drones, and air-launched missiles, presenting promising prospects for future applications.
Dual Contrastive Learning based Image-to-Image Translation of Unstained Skin Tissue into Virtually Stained H&amp;E Images
Authors: Asaf Muhammad Zeeshan , Rao Babar , Akram Muhammad Usman , Khawaja Sajid Gul , Khan Samavia , Truong Thu Minh , Sekhon Palveen , Khan Irfan J. , Abbasi Muhammad Shahmir 
Published: September 2023

Abstract
Background: Staining is a crucial step in histopathology that prepares tissue sections for microscopic examination. Hematoxylin and eosin (H&E) staining, also known as basic or routine staining, is used in 80% of histopathology slides worldwide. To enhance the histopathology workflow, recent research has focused on integrating generative artificial intelligence and deep learning models. These models have the potential to improve staining accuracy, reduce staining time, and minimize the use of hazardous chemicals, making histopathology a safer and more efficient field.
Methods: In this study, we introduce a novel three-stage, dual contrastive learning-based, image-to-image generative (DCLGAN) model for virtually applying an "H&E stain" to unstained skin tissue images. The proposed model utilizes a unique learning setting comprising two pairs of generators and discriminators. By employing contrastive learning, our model maximizes the mutual information between traditional H&E-stained and virtually stained H&E patches. Our dataset consists of pairs of unstained and H&E-stained images, scanned with a brightfield microscope at 20x magnification, providing a comprehensive set of training and testing images for evaluating the efficacy of our proposed model.
Findings: Two metrics, Fréchet Inception Distance (FID) and Kernel Inception Distance (KID), were used to quantitatively evaluate virtual stained slides. Our analysis revealed that the average FID score between virtually stained and H&E-stained images (80.47) was considerably lower than that between unstained and virtually stained slides (342.01), and unstained and H&E stained (320.4) indicating a similarity virtual and H&E stains. Similarly, the mean KID score between H&E stained and virtually stained images (0.022) was significantly lower than the mean KID score between unstained and H&E stained (0.28) or unstained and virtually stained (0.31) images. In addition, a group of experienced dermatopathologists evaluated traditional and virtually stained images and demonstrated an average agreement of 78.8% and 90.2% for paired and single virtual stained image evaluations, respectively.
Interpretation: Our study demonstrates that the proposed three-stage dual contrastive learning-based image-to-image generative model is effective in generating virtual stained images, as indicated by quantified parameters and grader evaluations. In addition, our findings suggest that GAN models have the potential to replace traditional H&E staining, which can reduce both time and environmental impact. This study highlights the promise of virtual staining as a viable alternative to traditional staining techniques in histopathology.
Determinants of quality of life and emotional well-being in a prospective bariatric cohort of 1501 multi-ethnic Asian patients
Authors: Shabbir Asim , Chua Wei Yu , Chia Daryl , Chan Yiong Huak , Leong Eugene , Chen Ashley , Asif Sharen , Wong Yu An , Fung Javis , Johnson Rachel , Poojari Shefali , Gani Qamaruzaman , Lin Wen , Wai Shu Ning , Kayambu Geetha , Lim Serene , Neo Wen Joo , Wee Candice , Lomanto Davide , Kim Guowei , So Jimmy 
Published: September 2023

Abstract
Objective:The relationship between ethnicity, obesity and health-related quality of life (HR-QoL) outcomes in a multi-ethnic population remain poorly understood. We aim to investigate the relationship between ethnicity, body mass index (BMI), comorbidities, as well as determinants of quality of life (QoL) in Southeast Asian patients with obesity. We aim to develop and validate a simple objective score to identify bariatric patients at high risk for major depression.

Methods:Associations between ethnicity, comorbidities, BMI and determinants of QoL (PHQ-9 and SF-36) were analysed using multivariate logistic regression in a prospective cohort of 1501 bariatric patients. Multivariate regression and Receiver Operating Characteristics curves were used to develop and validate a novel scoring system to identify patients at risk of major depression.

Results:Patients of Chinese, Malay and Indian ethnicity had increased risk of hypertension (OR: 1.51 [95% CI: 1.19–1.92, p<0.001]), BMI Class 4 (OR: 17.89 [95% CI: 9.53-33.60, p<0.001]) and major depression (OR: 1.71 [95% CI: 1.23–2.39, p=0.002]) respectively. Females (OR: 1.46 [95% CI: 1.16 – 1.84, p=0.001] & OR: 1.43 [95% CI: 1.11 – 1.83, p=0.005]) and Indian ethnicity (OR: 1.47 [95% CI: 1.09 – 1.98, p=0.011] & OR: 1.42 [95% CI: 1.04 – 1.94, p=0.028]) are at increased risk for poor physical & mental quality of life. Factors associated with major depression (gender, ethnicity, age, OSA, PCS and MCS scores) were used to create and validate a novel scoring system with an AUC of 0.812 (95% CI: 0.787-0.837). A cut-off of 4 of 7 points was identified on ROC curves and Youden’s index with a sensitivity of 70%, specificity 81%, PPV 53% and NPV 90%.

Conclusion:The prevalence of metabolic complications from obesity significantly varies with ethnicity. We developed a novel and simple scoring tool combining objective demographic and patient-reported outcomes to screen and triage patients at risk of major depression.
Enhanced Recovery After Surgery in Pakistan: An Initial Assessment and Future Directions
Authors: Ahmad Hamza , Arnaert Antonia , Shedio Waqas , Tanoli Omaid , Deckelbaum Dan , Pasha Tayyab 
Published: September 2023

Abstract

Enhanced Recovery After Surgery, a novel and cost-effective perioperative surgical intervention, has been demonstrated to reduce patients’ hospital length of stay, provide a higher turnover of available resources and decrease the postoperative expenses for both patients and hospitals. Even though the potential benefits of implementing ERAS in LMICs could outweigh those in HICs, a successful long-term implementation of ERAS has yet to be completed across Pakistan. Thus, the purpose of this study was to gain insights and identify potential opportunities to ERAS implementation in the context of the local socio-environmental setting. A qualitative descriptive study design consisting of individual semi-structured interviews was utilized to explore the experiences of 11 surgical residents when implementing ERAS guidelines at one of the public tertiary care hospitals in Lahore, Pakistan. Acknowledging the benefits of ERAS, participants faced several challenges when implementing ERAS in their respective wards. Several key opportunities to successful implementation including enhanced team work and collaboration amongst medical teams, improved patient education and compliance towards ERAS, strengthening of peripheral healthcare services, and targeted resource allocation were identified by the participants. Even though several challenges identified by the participants were similar to those highlighted in HICs, unique barriers specific to the healthcare structure and culture of Pakistan also emerged. Further research exploring and highlighting these specific challenges is needed to overcome these core barriers and promote a shift towards a standardized healthcare system focused on improving patient outcomes.
Soldier crabs learn from the repetition of simple exploratory tasks
Authors: Kawai Takeshi , Gunji Yukio Pegio 
Published: September 2023

Abstract
Learning is a very important function for the survival of animals and is believed to occur in most species. Crustaceans are no exception, with several studies concluding that crabs and crayfish exhibit the ability to learn.
The soldier crab, a species that lives on a remote island in Okinawa, Japan, forms groups ranging from several hundred to several tens of thousands of individuals when foraging. However, few studies have examined the learning ability of crustaceans that form such large groups.
In this study, to examine the learning ability of individual soldier crabs, we conducted an experiment in which individuals in a laboratory environment were tested with a simple task: crabs were placed in a bisected arena, half with sand that allowed them to burrow underground and half with sand that did not. The significant results indicated that crabs may exhibit learning in response to the environment.
Effects of warming and elevated CO2 on stomatal conductance and chlorophyll fluorescence of C3 and C4 coastal wetland species
Authors: Sendall Kerrie , Muñoz Cyd M. Meléndez , Ritter Angela D. , Rich Roy L. , Noyce Genevieve L. , Megonigal J. Patrick 
Published: September 2023

Abstract
Coastal wetland communities provide valuable ecosystem services such as erosion prevention, soil accretion, and essential habitat for coastal wildlife, but are some of the most vulnerable to the threats of climate change. This work investigates the combined effects of two climate stressors, elevated temperature (ambient, +1.7°C, +3.4°C, and 5.1 °C) and elevated CO2 (eCO2), on leaf physiological traits of dominant salt marsh plant species. The research took place at the Salt Marsh Accretion Response to Temperature eXperiment (SMARTX) at the Smithsonian Environmental Research Center, which includes two plant communities: a C3 sedge community and a C4 grass community. Here we present data collected over five years on rates of stomatal conductance (gs), quantum efficiency of PSII photochemistry (Fv/Fm), and rates of electron transport (ETRmax). We found that both warming and eCO2 caused declines in all traits, but the warming effects were greater for the C3 sedge. This species showed a strong negative stomatal response to warming in 2017 and 2018 (28% and 17% reduction, respectively in +5.1°C). However, in later years the negative response to warming was dampened to <7%, indicating that S. americanus was able to partially acclimate to the warming over time. In 2022, we found that sedges growing in the combined +5.1°C eCO2 plots exhibited more significant declines in gs, Fv/Fm, and ETRmax than in either treatment individually. These results are important for predicting future trends in growth of wetland species, which serve as a large carbon sink that may help mitigate the effects of climate change.
Multiomics Analysis of COL12A1 as a Promising Prognostic Biomarker for Immune-Related Treatment of Gastric Cancer
Authors: Shi Jin , Ding Fan , Dai Dezhu , Song Xudong , Wu Xu , Yan Dongsheng , Han Xiao , Tao Guoquan , Dai Weijie 
Published: September 2023

Abstract
COL12A1 has an instrumental role in the extracellular matrix (ECM), but its effect on gastric cancer (GC) as well as the clinical significance remains unclear. The co-expression differential genes (co-DEGs) were acquired from Venn diagrams via The Cancer Genome Atlas (TCGA) as well as Gene Expression Omnibus (GEO) stomach RNAseq dataset. Intersection between co-DEGs and TCGA prognosis-related genes was used to to pinpoint genes differentially associated with prognosis. The COL12A1 gene was selected as the key factor for the present work. COL12A1 level within human GC was analyzed in relation to its clinicopathological characteristics, and the TCGA database was adopted for plotting overall survival (OS) together with disease-free survival (DFS) curves, and the prognostic column. The relative protein gene expression was assessed by Human Protein Atlas (HPA) database, four downloaded datasets, along with PCR experiments. Differentially expressed genes (DEGs related to COL12A1 were detected via LinkedOmics, and subject to GO as well as KEGG analysis based on related genes. The cBioPortal and Catalogue of Somatic Mutations in Cancer databases were first utilized for the expression and identification of COL12A1-correlated mutation analysis. Multiple databases were analyzed for the relationship between COL12A1 and methylation. COL12A1 was examined using the Tumor Immune Estimation Resource (TIMER) database for identifying association of COL12A1 gene level with stomach adenocarcinoma-infiltrating immune cells. Finally, this work examined correlation of COL12A1 with drug sensitivity with RNAactDrug database. COL12A1 over-expression within gastric cancer was detected, which was closely related to clinicopathological features. GO/KEGG functional enrichment analysis revealed that COL12A1 was associated with pathways like extracellular structure organization, extracellular matrix organization and collagen-containing extracellular matrix. The analysis of several databases revealed that COL12A1 was associated with gene mutation and methylation. Additionally, as revealed by CIBERSORT profiling and TIMER database, COL12A1 expression related to immune cell infiltration. Correlation analysis through the RNAactDrug website revealed that COL12A1 is associated with drug sensitivity. COL12A1 can be a diagnostic and therapeutic biomarker for GC, which may be associated with tumor immune infiltration and drug sensitivity.
Tailoring Remote Patient Management in Cardiovascular Risk Management for Healthcare Professionals using Panel Management: a Qualitative Study
Authors: Rakers Margot , Hattem Nicoline van , Simic Iris , Chavannes Niels , Peet Petra van , Bonten Tobias , Vos Rimke , Os Hine van 
Published: September 2023

Abstract

Background
While remote patient management (RPM) holds potential to reach cardiovascular risk factor treatment targets in primary care, its effectiveness can vary across different patient subgroups. Panel management - proactive care to specific patient risk groups - could be a promising approach to tailor RPM. This study aimed (i) to assess the perception of healthcare professionals and other stakeholders of the adoption of a panel management approach to tailor an RPM intervention to specific patient risk groups and (ii) to identify the barriers and facilitators for successful implementation of a panel management approach for RPM for cardiovascular risk factor control in primary care.
Methods
In total, 24 participants (GPs, nurses, health insurers, project managers, and IT consultants) participated in nineteen semi-structured interviews and two focus group discussions for this qualitative study conducted in the Netherlands. Three authors reviewed the audited transcripts. The Consolidated Framework for Implementation Strategies (CFIR) domains were used for the thematic analysis.
Results
Overall, panel management was considered valuable. Implementation barriers encompassed concerns about missing necessary risk factors for patient stratification, additional clinical and technical tasks for nurses, and reimbursement agreements. Facilitators included tailoring consultation frequency and early detection of at-risk patients, an implementation manager accountable for supervising project procedures, and establishing agreements on assessing implementation metrics and ambassador roles.
Conclusion
Panel management could enhance proactive care and accurately identify which patients could benefit most from RPM to mitigate CVD risk. However, for successful implementation, it is recommended to have clear agreements on technical support, financial infrastructure and the criteria for measuring evaluation outcomes.
WHICH WAVELENGTH OF LASER YIELD THE MOST SUCCESSFUL RESULTS IN MRONJ TREATMENT? AN EXPERIMENTAL STUDY
Authors: AYHAN Mustafa , KALELIOGLU Ekrem Emir , KUNDAKCIOGLU Abdulsamet , GEDIK Betul , ADEMOGLU Evin , YALTIRIK Mehmet , KOCAELLI Humeyra , ALATLI Fatma Canan , KUCUKGERGIN Canan , CANKAYA Abdulkadir Burak 
Published: September 2023

Abstract
Background: This study aims to investigate the effectiveness of lasers at various wavelengths in treating medication-related osteonecrosis of the jaw (MRONJ) using biochemical, clinical scoring, micro CT analysis, and histopathological methods.
Methods: In our study, there were 6 groups, including one SHAM group, one CONTROL group, and four experimental groups, with 8 rats in each individual group. Each rat received antiresorptive drug intraperitoneally for 4 weeks and then extracted the left second molar in the mandible. All animals were sacrificed at the end of the 12th week. In the experimental groups, lasers at wavelengths of 405nm, 445nm, 660nm, and 808nm were applied to the animals. In all groups, parameters such as serum vitamin D levels, bone density and bone volume at the extraction site, new bone formation, dead bone count, inflammatory cell count, and epithelial regeneration were examined. Additionally, clinical scoring was conducted after sacrifice. Statistical analyses were performed with the NCSS (Number Cruncher Statistical System) 2007 Statistical Software (Utah, USA) package program. The results were evaluated at the p<0.05 significance level.
Results: According to the results obtained from our study, new bone formation in all experimental groups was significantly higher than in the SHAM and CONTROL groups. Furthermore, the 660nm and 808nm wavelengths increased considerably serum vitamin D levels. The most successful outcomes were observed in clinical scoring, dead bone count, epithelial cell regeneration, and bone density in the 660nm and 808nm wavelength groups.
Conclusions: The combined use of lasers at 660nm and 808nm wavelengths may yield successful results in treating MRONJ.
Impact of COVID-19 on Gynecological Cancer Incidence: A Large Cohort Study in Japan
Authors: Komatsu Hiroaki , Ikeda Yuji , Kawana Kei , Nagase Satoru , Yoshino Kiyoshi , Yamagami Wataru , Tokunaga Hideki , Kato Kiyoko , Kimura Tadashi , Aoki Daisuke 
Published: September 2023

Abstract
Background: The influence of the coronavirus disease (COVID-19) pandemic on the number of newly diagnosed gynecological cancers has not been extensively investigated in Japan. This study aimed to determine the impact of COVID-19 on the incidence of gynecological cancer.
Methods: Using the registry database of the Japanese Society of Obstetricians and Gynecologic Oncology, the distribution of the number of patients by clinical staging or tumor-node-metastasis (TNM) classifications before and during the COVID-19 pandemic was analyzed to compare the trends. The clinical staging classification of cervical cancer in Japan was based on the International Federation of Gynecology and Obstetrics (FIGO)-2008 from 2018 to 2020 and on the FIGO-2018 from 2021. Since FIGO-2018 classified N1 cases as stage IIIC, we focused on T classification without reference to the clinical staging (FIGO staging) of patients with cervical cancer in 2021.
Results: The number of patients with endometrial cancer and malignant ovarian tumor of all clinical stages increased uniformly year-by-year while the number of patients with stage III cervical cancer increased sharply in 2021 owing to the adoption of the revised classification. On comparing cases with cervical cancer in 2020 and 2021, we found that T1 cases decreased and T2 and T3 cases increased in 2021 compared to those in 2020 (p=0.006). CIN3/AIS decreased in 2020 compared to in 2019 but increased again in 2021. The number of patients with cervical cancer decreased in most prefectures in 2020.
Conclusion: The incidence of locally advanced cervical cancer increased during the COVID-19 pandemic.