bluuebunny/crossref_metadata_2025_split huggingface dataset:
Response evaluation of hepatocellular carcinoma treated with stereotactic body radiation therapy: magnetic resonance imaging findings
Authors: Mai Zhijun , Yang Qiuxia , Xu Jiahui , Xie Hui , Ban Xiaohua , Xu Guixiao , Zhang Rong 
Published: March 2023

Abstract
Purpose
To summarize the magnetic resonance imaging manifestations of hepatocellular carcinoma (HCC) with and without progression after stereotactic body radiation therapy (SBRT) and evaluate the treatment effect using the modified Liver Reporting and Data System (LI-RADS).

Methods
Between January 2015 and December 2020, 102 patients with SBRT-treated HCC were included. Tumor size, signal intensity, and enhancement patterns at each follow-up period were analyzed. Three different patterns of enhancement: APHE and wash-out, non-enhancement, and delayed enhancement. For modified LI-RADS, delayed enhancement with no size increase were considered to be a “treatment-specific expected enhancement pattern” for LR-TR non-viable.

Results
Patients were divided into two groups: without (n = 96) and with local progression (n = 6). Among patients without local progression, APHE and wash-out pattern demonstrated conversion to the delayed enhancement (71.9%) and non-enhancement (20.8%) patterns, with decreased signal intensity on T1WI(92.9%) and DWI(99%), increased signal intensity on T1WI (99%), and decreased size. The signal intensity and enhancement patterns stabilized after 6–9 months. Six cases with progression exhibited tumor growth, APHE and wash-out, and increased signal intensity on T2WI/DWI. Based on the modified LI-RADS criteria, 74% and 95% showed LR-TR-nonviable in 3 and 12 months post-SBRT, respectively.

Conclusions
After SBRT, the signal intensity and enhancement patterns of HCCs showed a temporal evolution. Tumor growth, APHE and wash-out, and increased signal intensity on T2WI/DWI indicates tumor progression. Modified LI-RADS criteria showed good performance in evaluating nonviable lesions after SBRT.
Treatment Strategy of Pancreas‐Sparing Distal Duodenectomy for Distal Duodenal Malignancies with Adjustable Dissection Levels According to Disease Progression (with Video)
Authors: Kato Tomotaka , Ono Yoshihiro , Oba Atsushi , Sato Takafumi , Ito Hiromichi , Inoue Yosuke , Saiura Akio , Takahashi Yu 
Published: March 2023

AbstractBackgroundPancreas‐sparing distal duodenectomy (PSDD) is a favorable option for distal duodenal neoplasms, and its procedure, including the extent of lymphadenectomy, should be modified according to the malignancy of the tumor. However, there are no coherent reports on the details of this procedure or long‐term outcomes after each resection.MethodsThis study included 24 patients who underwent PSDD at our institution between January 2009 and October 2020. Patients were divided into two groups according to the tumor progression: nine with (Lv‐II) and fifteen without (Lv‐I) mesopancreas dissection. Postoperative outcomes were compared between the two groups.ResultsTwo groups had similar operation times, blood loss, hospital stay, and the rate of delayed gastric emptying (DGE): 40% versus 44%. There were no Clavien–Dindo classification ≥ III complications in the Lv‐II group. The Lv‐II group had a larger number of examined lymph nodes (median: 29), and three (33%) patients had lymph node metastasis. No local recurrence was observed, although two patients in the Lv‐II group had liver metastasis. The 5‐year overall survival rates of the Lv‐I and Lv‐II groups were 100% and 78%, respectively. None of the patients had an impaired nutrition status after one year of surgery, and no rehospitalization was observed in either group.ConclusionAlthough PSDD with or without mesopancreas dissection entailed a high risk of DGE, this procedure showed favorable long‐term outcomes and may be an alternative to pancreatoduodenectomy in patients with distal duodenal neoplasms.
Selecting regional climate models based on their skill could give more credible precipitation projections over the complex Southeast Asia region
Authors: Nguyen Phuong-Loan , Bador Margot , Alexander Lisa V. , Lane Todd P. 
Published: March 2023

AbstractThis study focuses on future seasonal changes in daily precipitation using Regional Climate Models (RCMs) from the Coordinated Regional Climate Downscaling Experiments-Southeast Asia ensemble (CORDEX-SEA). Projections using this RCM ensemble generally show a larger inter-model spread in winter than in summer, with higher significance and model agreement in summer over most land areas. We evaluate how well the RCMs simulate climatological precipitation using two skill metrics. To extract reliable projections, two sub-ensembles of ‘better’ and ‘worse’ performing models are selected and their respective projections compared. We find projected intensification of summer precipitation over northern SEA, which is robust across RCMs. On the contrary, in the southern part of SEA, the ‘worse’ ensemble projects a significant and widespread decrease in summer rainfall intensity whereas a slight intensification is projected by the ‘better’ ensemble. Further exploration of inter-model differences in future changes reveals that these are mainly explained by changes in moisture supply from large-scale sources (i.e., moisture convergence) with enhanced effects from local sources (i.e., evapotranspiration). The ‘worse’ models project greater changes in atmospheric circulation compared with the ‘better’ models, which can explain part of the uncertainty in projections for daily precipitation over the CORDEX-SEA domain. Hence, our findings might help assess more reliable projections over the SEA region by selecting models based on a two-step model evaluation: the ability of models to simulate historical daily precipitation and their performance in reproducing key physical processes of the regional climate.
CT measured pulmonary artery to ascending aorta ratio stratified by echocardiographically obtained systolic pulmonary artery pressure values for noninvasive detection of pulmonary hypertension in patients with severe aortic valve stenosis
Authors: Boxhammer Elke , Kletzer Joseph , Kellermair Jörg , Scharinger Bernhard , Kaufmann Reinhard , Hammerer Matthias , Blessberger Hermann , Steinwender Clemens , Lichtenauer Michael , Hergan Klaus , Hoppe Uta C. , Hecht Stefan 
Published: March 2023

Abstract
Background
Transthoracic echocardiography (TTE) offers a measurement method for the determination of pulmonary hypertension (PH) in patients with severe aortic valve stenosis (AS) with determination of maximal tricuspid regurgitation velocity (TRVmax) and systolic pulmonary artery pressure (sPAP). Radiological parameters for noninvasive detection of PH, most importantly computed tomography (CT) based PA/AA-ratio = ratio of pulmonary artery diameter (PA) and ascending aorta diameter (AA), are also included in the latest ESC guidelines. The aim of the present study was to define cut-off values for PA/AA-ratio taking also into account cardiovascular biomarkers to determine criteria for noninvasive diagnosis of PH.

Methods
194 patients with severe AS undergoing transcatheter aortic valve replacement (TAVR) underwent pre-procedural TTE and CT with measurement of PA/AA-ratio. Additionally, common cardiovascular biomarkers were determined.

Results
TAVR patients with an sPAP ≥ 40 mmHg or a TRVmax ≥ 2.9 m/s had a PA/AA-ratio ≥ 0.80 in an AUROC analysis. The cut-off value of ≥ 0.80 resulted in a significantly higher mortality rate (log-rank test: p = 0.034) in these patients in a Kaplan–Meier analysis regarding 1-year survival after TAVR. Significant differences in biomarker expression between patients with a PA/AA-ratio ≥ 0.80 or < 0.80 occurred for BNP (p = 0.001), cTnI (p = 0.032), GDF-15 (p = 0.002) and H-FABP (p = 0.015).

Conclusion
PA/AA-ratio ≥ 0.80 is a promising radiological parameter that can provide information about mortality in patients with severe AS undergoing TAVR; combined with biomarkers it may contribute to noninvasive detection of PH in patients with severe AS.

Graphical abstract
Exacerbated central fatigue and reduced exercise capacity in early-stage breast cancer patients treated with chemotherapy
Authors: Hucteau Elyse , Mallard Joris , Pivot Xavier , Schott Roland , Pflumio Carole , Trensz Philippe , Favret Fabrice , Pagano Allan F. , Hureau Thomas J. 
Published: March 2023

Abstract
Purpose
The present study aimed to characterize the etiology of exercise-induced neuromuscular fatigue and its consequences on the force-duration relationship to provide mechanistic insights into the reduced exercise capacity characterizing early-stage breast cancer patients.

Methods
Fifteen early-stage breast cancer patients and fifteen healthy women performed 60 maximal voluntary isometric quadriceps contractions (MVCs, 3 s of contraction, 2 s of relaxation). The critical force was determined as the mean force of the last six contractions, while W’ was calculated as the force impulse generated above the critical force. Quadriceps muscle activation during exercise was estimated from vastus lateralis, vastus medialis and rectus femoris EMG. Central and peripheral fatigue were quantified via changes in pre- to postexercise quadriceps voluntary activation (ΔVA) and quadriceps twitch force (ΔQTw) evoked by supramaximal electrical stimulation, respectively.

Results
Early-stage breast cancer patients demonstrated lower MVC than controls preexercise (− 15%, P = 0.022), and this reduction persisted throughout the 60-MVC exercise (− 21%, P = 0.002). The absolute critical force was lower in patients than in controls (144 ± 29N vs. 201 ± 47N, respectively, P < 0.001), while W’ was similar (P = 0.546), resulting in lower total work done (− 23%, P = 0.001). This was associated with lower muscle activation in the vastus lateralis (P < 0.001), vastus medialis (P = 0.003) and rectus femoris (P = 0.003) in patients. Immediately following exercise, ΔVA showed a greater reduction in patients compared to controls (− 21.6 ± 13.3% vs. − 12.6 ± 7.7%, P = 0.040), while ΔQTw was similar (− 60.2 ± 13.2% vs. − 52.8 ± 19.4%, P = 0.196).

Conclusion
These findings support central fatigue as a primary cause of the reduction in exercise capacity characterizing early-stage breast cancer patients treated with chemotherapy.

Clinical trials registration
No. NCT04639609—November 20, 2020.
Concurrent/sequential versus sequential immune checkpoint inhibition in inoperable large stage III non-small cell lung cancer patients treated with chemoradiotherapy: a prospective observational study
Authors: Käsmann Lukas , Eze Chukwuka , Taugner Julian , Nieto Alexander , Hofstetter Kerstin , Kröninger Sophie , Guggenberger Julian , Kenndoff Saskia , Flörsch Benedikt , Tufman Amanda , Reinmuth Niels , Duell Thomas , Belka Claus , Manapov Farkhad 
Published: March 2023

Abstract
Purpose/aim
The international standard for patients with large inoperable stage III NSCLC is durvalumab consolidation after concurrent chemoradiotherapy (CRT). In this single centre observational study based on individual data, we prospectively evaluated the role of concurrent/sequential versus sequential immune checkpoint inhibition (ICI).

Methods and patients
In total, 39 stage III NSCLC patients were prospectively enrolled, 11 (28%) patients were treated with simultaneous and consolidation therapy with PD-1 inhibition (nivolumab) (SIM-cohort) and 28 (72%) patients received PD-L1 inhibition (durvalumab) as consolidation treatment up to 12 months after the end of CRT (SEQ-cohort).

Results
For the entire cohort, median progression-free survival (PFS) was 26.3 months and median survival (OS), locoregional recurrence-free survival and distant metastasis-free survival were not reached. For the SIM-cohort, median OS was not reached and PFS was 22.8 months, respectively. In the SEQ-cohort, neither median PFS nor OS were reached. After propensity score matching, PFS at 12/24 months were 82/44% in the SIM-cohort and 57/57% in the SEQ-cohort (p = 0.714), respectively. In the SIM-cohort, 36.4/18.2% of patients showed grade II/III pneumonitis; in the SEQ-cohort 18.2/13.6% after PSM (p = 0.258, p = 0.55).

Conclusion
Both concurrent/sequential and sequential ICI show a favorable side effect profile and promising survival in treated patients with inoperable large stage III NSCLC. Concurrent ICI showed a numerical non-significant improvement regarding 6- and 12-months PFS and distant control compared to sequential approach in this small study. However, concurrent ICI to CRT was associated with a non-significant moderate increase in grade II/III pneumonitis.
Speech emotion recognition and text sentiment analysis for financial distress prediction
Authors: Hajek Petr , Munk Michal 
Published: March 2023

AbstractIn recent years, there has been an increasing interest in text sentiment analysis and speech emotion recognition in finance due to their potential to capture the intentions and opinions of corporate stakeholders, such as managers and investors. A considerable performance improvement in forecasting company financial performance was achieved by taking textual sentiment into account. However, far too little attention has been paid to managerial emotional states and their potential contribution to financial distress prediction. This study seeks to address this problem by proposing a deep learning architecture that uniquely combines managerial emotional states extracted using speech emotion recognition with FinBERT-based sentiment analysis of earnings conference call transcripts. Thus, the obtained information is fused with traditional financial indicators to achieve a more accurate prediction of financial distress. The proposed model is validated using 1278 earnings conference calls of the 40 largest US companies. The findings of this study provide evidence on the essential role of managerial emotions in predicting financial distress, even when compared with sentiment indicators obtained from text. The experimental results also demonstrate the high accuracy of the proposed model compared with state-of-the-art prediction models.
A planar Schrödinger–Newton system with Trudinger–Moser critical growth
Authors: Liu Zhisu , Rădulescu Vicenţiu D. , Zhang Jianjun 
Published: March 2023

AbstractIn this paper, we focus on the existence of positive solutions to the following planar Schrödinger–Newton system with general critical exponential growth $$\begin{aligned} \left\{ \begin{array}{ll} -\Delta {u}+u+\phi u =f(u)&{} \text{ in }\,\,\mathbb {R}^2, \\ \Delta {\phi }=u^2 &{} \text{ in }\,\, \mathbb {R}^2, \end{array} \right. \end{aligned}$$

-
Δ
u
+
u
+
ϕ
u
=
f
(
u
)

in

R

2

,

Δ
ϕ
=

u
2

in

R

2

,

where $$f\in C^1(\mathbb {R},\mathbb {R})$$

f
∈

C
1

(
R
,
R
)

. We apply a variational approach developed in [36] to study the above problem in the Sobolev space $$H^1(\mathbb {R}^2)$$

H
1

(

R

2

)

. The analysis developed in this paper also allows to investigate the relation between a Riesz-type of Schrödinger–Newton systems and a logarithmic-type of Schrödinger–Poisson systems. Furthermore, this approach can overcome some difficulties resulting from either the nonlocal term with sign-changing and unbounded logarithmic integral kernel, or the critical nonlinearity, or the lack of monotonicity of $$\frac{f(t)}{t^3}$$

f
(
t
)

t
3

. We emphasize that it seems much difficult to use the variational framework developed in the existed literature to study the above problem.
Krankenhaus 2030 – Was sich ändern muss
Authors: Minz Rainer , Grüttner Damian , von Heusinger-Lender Marlis 
Published: March 2023

Zusammenfassung
Hintergrund
In den vergangen 30 Jahren hat sich in Deutschland die Anzahl der Krankenhäuser um 21 % und die Anzahl der Krankenhausbetten um 27 % reduziert. Im selben Zeitraum halbierte sich die durchschnittliche Verweildauer der Krankenhausfälle. Dennoch ist die Systemeffizienz zu gering.

Fragestellung
Ursachen für die Systemineffizienz im Krankenhaussektor und Ansätze für eine Krankenhausreform.

Material und Methode
Auswertung der amtlichen Statistiken, Zusammenfassung von Grundlagenarbeiten, Studien und Expertenempfehlungen sowie Übersichtsaufsätze.

Ergebnisse
Das ordnungspolitische Nebeneinander von Krankenhausplanung und Krankenhausfinanzierung führt zu einer strukturellen Unterfinanzierung von Krankenhäusern und zu einer suboptimalen Versorgung mit Krankenhausleistungen. Das rein stationär bezogene Vergütungssystem konserviert stationäre Behandlungsformen. Deutschland weist im internationalen Vergleich eine sehr hohe Krankenhausdichte auf. Dies verschärft den Fachkräftemangel in den Gesundheitsfachberufen. Außerdem haben deutsche Krankenhäuser einen zu niedrigen Digitalisierungsgrad.

Schlussfolgerung
Eine Reduzierung der Anzahl an Krankenhäusern mit gleichzeitig zunehmender Spezialisierung kann sowohl die Versorgungsqualität für die Patienten als auch die Effektivität des Einsatzes knapper Fachkräfte erhöhen. Es bedarf eines nach Versorgungsstufen differenzierten Finanzierungskonzepts. Eine Steigerung der Attraktivität von Gesundheitsfachberufen, insbesondere durch eine Verbesserung der Ausbildung, kann dem Fachkräftemangel begegnen. Das Krankenhauswesen muss mit der Digitalisierung aufschließen, um zeitgemäß ausgestattete Arbeitsplätze und modern organisierte Arbeitsprozesse anbieten zu können, auch, um die Wirtschaftlichkeit zu verbessern.
Genomic epidemiology and transmission dynamics of recurrent Clostridioides difficile infection in Western Australia
Authors: Knight Daniel R. , Imwattana Korakrit , Collins Deirdre A. , Lim Su-Chen , Hong Stacey , Putsathit Papanin , Riley Thomas V. 
Published: March 2023

AbstractRecurrent cases of Clostridioides difficile infection (rCDI) remain one of the most common and serious challenges faced in the management of CDI. The accurate distinction between a relapse (caused by infection with the same strain) and reinfection (caused by a new strain) has implications for infection control and prevention, and patient therapy. Here, we used whole-genome sequencing to investigate the epidemiology of 94 C. difficile isolates from 38 patients with rCDI in Western Australia. The C. difficile strain population comprised 13 sequence types (STs) led by ST2 (PCR ribotype (RT) 014, 36.2%), ST8 (RT002, 19.1%) and ST34 (RT056, 11.7%). Among 38 patients, core genome SNP (cgSNP) typing found 27 strains (71%) from initial and recurring cases differed by ≤ 2 cgSNPs, suggesting a likely relapse of infection with the initial strain, while eight strains differed by ≥ 3 cgSNPs, suggesting reinfection. Almost half of patients with CDI relapse confirmed by WGS suffered episodes that occurred outside the widely used 8-week cut-off for defining rCDI. Several putative strain transmission events between epidemiologically unrelated patients were identified. Isolates of STs 2 and 34 from rCDI cases and environmental sources shared a recent evolutionary history, suggesting a possible common community reservoir. For some rCDI episodes caused by STs 2 and 231, within-host strain diversity was observed, characterised by loss/gain of moxifloxacin resistance. Genomics improves discrimination of relapse from reinfection and identifies putative strain transmission events among patients with rCDI. Current definitions of relapse and reinfection based on the timing of recurrence need to be reconsidered.
A personal retrospective on language workbenches
Authors: van den Brand Mark 
Published: March 2023

AbstractModel-driven software engineering and specifically domain-specific languages have contributed to improve the quality of software and the efficiency in the development of software. However, the design and implementation of domain-specific languages requires still an enormous investment. Language workbenches are the most important tools in the field of software language engineering. The introduction of language workbenches has alleviated partly the development effort, but there are still a few major challenges that need to be tackled. This paper presents a personal perspective on the development of tools for language engineering and language workbenches in particular and future challenges to be tackled.
The two faces of risk
Authors: Autzen Bengt 
Published: March 2023

AbstractThe relationship between decision theory and the theory of natural selection in evolutionary biology offers a fertile ground for philosophical inquiry. A topic that has recently been addressed in the philosophical literature is the connection between decision-theoretic and biological discussions of risk. The paper adds to this literature by drawing attention to a distinction between two different notions of risk originating in the economic literature and by exploring their relationship in a biological context. More specifically, the paper shows that the two notions of risk can part ways in models of risk-sensitive foraging theory. The paper also draws attention to an important difference in contemporary explanations of the apparent lack of empirical success of rational choice theory and risk-sensitive foraging theory.
HIsarna Process Simulation Model: Using FactSage with Macro Facility
Authors: Yan Zhiming , Htet Theint Theint , Hage Johannes , Meijer Koen , Li Zushu 
Published: March 2023

AbstractThe HIsarna process is one of the emerging technologies for reducing the carbon footprint of the ironmaking process, which is currently in the pilot plant stage. A kinetic HIsarna process simulation model based on the effective equilibrium reaction zone concept has been developed using the FactSage macro programming facility to advance understanding of the whole process. In the model, the HIsarna process is conceptually divided into various equilibrium zones involving combustion, coal pyrolysis and gasification, gas/slag/carbon reactions, and slag/metal reaction. The model has been validated through the pilot plant data, and the results are in good agreement with the quantity and composition of hot metal, slag, and gas. The HIsarna off-gas stream with high CO2 content can potentially allow capture and storage directly for carbon mitigation. The utilization of titanium magnetite ore in the HIsarna process has also been investigated via the developed model. The injection of titanium magnetite ore which has high FeO content decreases coal consumption. Still, it increases the slag volume as higher gangue content when keeping the same productivity as the pilot plant trial. The HIsarna process shows promising potential in using low-quality high titania iron ore as feed materials, but the slag system needs to be further optimized. From the heat distribution, the off-gas sensible heat accounts for a large part of the input heat due to its high temperature but can be recovered with good efficiency. The present model is an efficient tool for understanding the HIsarna process and providing theoretical guidance for future pilot research.