bluuebunny/crossref_metadata_2025_split huggingface dataset:
Virtual pretreatment patient‐specific quality assurance of volumetric modulated arc therapy using deep learning
Authors: Yoganathan SA , Ahmed Sharib , Paloor Satheesh , Torfeh Tarraf , Aouadi Souha , Al‐Hammadi Noora , Hammoud Rabih 
Published: June 2023

AbstractBackgroundAutomatic patient‐specific quality assurance (PSQA) is recently explored using artificial intelligence approaches, and several studies reported the development of machine learning models for predicting the gamma pass rate (GPR) index only.PurposeTo develop a novel deep learning approach using a generative adversarial network (GAN) to predict the synthetic measured fluence.Methods and materialsA novel training method called “dual training,” which involves the training of the encoder and decoder separately, was proposed and evaluated for cycle GAN (cycle‐GAN) and conditional GAN (c‐GAN). A total of 164 VMAT treatment plans, including 344 arcs (training data: 262, validation data: 30, and testing data: 52) from various treatment sites, were selected for prediction model development. For each patient, portal‐dose‐image‐prediction fluence from TPS was used as input, and measured fluence from EPID was used as output/response for model training. Predicted GPR was derived by comparing the TPS fluence with the synthetic measured fluence generated by the DL models using gamma evaluation of criteria 2%/2 mm. The performance of dual training was compared against the traditional single‐training approach. In addition, we also developed a separate classification model specifically designed to detect automatically three types of errors (rotational, translational, and MU‐scale) in the synthetic EPID‐measured fluence.ResultsOverall, the dual training improved the prediction accuracy of both cycle‐GAN and c‐GAN. Predicted GPR results of single training were within 3% for 71.2% and 78.8% of test cases for cycle‐GAN and c‐GAN, respectively. Moreover, similar results for dual training were 82.7% and 88.5% for cycle‐GAN and c‐GAN, respectively. The error detection model showed high classification accuracy (>98%) for detecting errors related to rotational and translational errors. However, it struggled to differentiate the fluences with “MU scale error” from “error‐free” fluences.ConclusionWe developed a method to automatically generate the synthetic measured fluence and identify errors within them. The proposed dual training improved the PSQA prediction accuracy of both the GAN models, with c‐GAN demonstrating superior performance over the cycle‐GAN. Our results indicate that the c‐GAN with dual training approach combined with error detection model, can accurately generate the synthetic measured fluence for VMAT PSQA and identify the errors. This approach has the potential to pave the way for virtual patient‐specific QA of VMAT treatments.
Pulmonary embolism detection on venous thrombosis ultrasound images with bi‐dimensional entropy measures: Preliminary results
Authors: Jamin Antoine , Hoffmann Clément , Mahe Guillaume , Bressollette Luc , Humeau‐Heurtier Anne 
Published: June 2023

AbstractBackgroundVenous thromboembolism (VTE) is a common health issue. A clinical expression of VTE is a deep vein thrombosis (DVT) that may lead to pulmonary embolism (PE), a critical illness. When DVT is suspected, an ultrasound exam is performed. However, the characteristics of the clot observed on ultrasound images cannot be linked with the presence of PE. Computed tomography angiography is the gold standard to diagnose PE. Nevertheless, the latter technique is expensive and requires the use of contrast agents.PurposeIn this article, we present an image processing method based on ultrasound images to determine whether PE is associated or not with lower limb DVT. In terms of medical equipment, this new approach (Doppler ultrasound image processing) is inexpensive and quite easy.MethodsWith the aim to help medical doctors in detecting PE, we herein propose to process ultrasound images of patients with DVT. After a first step based on histogram equalization, the analysis procedure is based on the use of bi‐dimensional entropy measures. Two different algorithms are tested: the bi‐dimensional dispersion entropy () mesure and the bi‐dimensional fuzzy entropy () mesure. Thirty‐two patients (12 women and 20 men, 67.63 ± 16.19 years old), split into two groups (16 with and 16 without PE), compose our database of around 1490 ultrasound images (split into seven different sizes from 32× 32 px to 128 × 128 px). p‐values, computed with the Mann‐Whitney test, are used to determine if entropy values of the two groups are statistically significantly different. Receiver operating characteristic (ROC) curves are plotted and analyzed for the most significant cases to define if entropy values are able to discriminate the two groups.Resultsp‐values show that there are statistical differences between of patients with PE and patients without PE for 112× 112 px and 128× 128 px images. Area under the ROC curve (AUC) is higher than 0.7 (threshold for a fair test) for 112× 112 and 128× 128 images. The best value of AUC (0.72) is obtained for 112× 112 px images.ConclusionsBi‐dimensional entropy measures applied to ultrasound images seem to offer encouraging perspectives for PE detection: our first experiment, on a small dataset, shows that on 112× 112 px images is able to detect PE. The next step of our work will consist in testing this approach on a larger dataset and in integrating in a machine learning algorithm. Furthermore, this study could also contribute to PE risk prediction for patients with VTE.
The constitutively active pSMAD2/3 relatively improves the proliferation of chicken primordial germ cells
Authors: Zare Masumeh , Mirhoseini Seyed Ziaeddin , Ghovvati Shahrokh , Yakhkeshi Saeed , Hesaraki Mahdi , Barati Mojgan , Sayyahpour Forough Azam , Baharvand Hossein , Hassani Seyedeh‐Nafiseh 
Published: June 2023

AbstractIn many multicellular organisms, mature gametes originate from primordial germ cells (PGCs). Improvements in the culture of PGCs are important not only for developmental biology research, but also for preserving endangered species, and for genome editing and transgenic animal technologies. SMAD2/3 appear to be powerful regulators of gene expression; however, their potential positive impact on the regulation of PGC proliferation has not been taken into consideration. Here, the effect of TGF‐β signaling as the upstream activator of SMAD2/3 transcription factors was evaluated on chicken PGCs' proliferation. For this, chicken PGCs at stages 26−28 Hamburger−Hamilton were obtained from the embryonic gonadal regions and cultured on different feeders or feeder‐free substrates. The results showed that TGF‐β signaling agonists (IDE1 and Activin‐A) improved PGC proliferation to some extent while treatment with SB431542, the antagonist of TGF‐β, disrupted PGCs' proliferation. However, the transfection of PGCs with constitutively active SMAD2/3 (SMAD2/3CA) resulted in improved PGC proliferation for more than 5 weeks. The results confirmed the interactions between overexpressed SMAD2/3CA and pluripotency‐associated genes NANOG, OCT4, and SOX2. According to the results, the application of SMAD2/3CA could represent a step toward achieving an efficient expansion of avian PGCs.
The effect of methylphenidate for giggle incontinence in children
Authors: Svendsen Ann-Kristine Mandoe , Kamperis Konstantinos , Hagstroem Soeren , Thorsteinsson Kristina Nauheimer , Arvad Mads , Borch Luise 
Published: June 2023

AbstractIntroductionGiggle incontinence (GI) is a rare form of urinary incontinence that occurs during or immediately after laughing due to involuntary and complete bladder emptying. Few studies in the literature report that methylphenidate can be effective in treatment of this condition.ObjectiveThe aim of this study is to characterize children with GI and evaluate their response to methylphenidate, as well as describe treatment duration, dosage of methylphenidate, relapse rates after discontinuation of medication, and side effects.MethodsMedical records and 48‐h frequency‐volume charts from children treated with methylphenidate for GI in the period January 2011–July 2021 were retrospectively analyzed.ResultsEighteen children were diagnosed with GI and fulfilled inclusion criteria. Fifteen patients were included in analysis, as 3 out of 18 children decided not to take the methylphenidate that was prescribed. In total, 14 out of the 15 GI patients treated with methylphenidate experienced clinical effect. All patients included in the study had methylphenidate prescribed in a dose range of 5–20 mg daily. Treatment duration ranged from 30 to 1001 days, with a median of 152 days (IQR 114, 243.5). Ten children experienced complete response and two of those reported symptom relapse after discontinuation of the methylphenidate. Only mild and short‐lasting side effects were reported by two patients.DiscussionOur study demonstrates that methylphenidate is an effective treatment in children diagnosed with GI. Side effects are mild and uncommon.
EML4::ALK fusions in complex lymphatic malformations
Authors: Apsel Winger Beth , Devine Walter Patrick , Hsiao Edward C. , Zapala Matthew , Van Ziffle Jessica , Gupta Nalin , Frieden Ilona J. , Shimano Kristin A. 
Published: June 2023

AbstractGorham–Stout disease (GSD) and generalized lymphatic anomaly (GLA) are subtypes of complex lymphatic malformations (CLMs) with osseous involvement that cause significant complications, including pain and pathologic fractures. As with other vascular anomalies, somatic mosaic mutations in oncogenes are often present, and the mTOR inhibitor sirolimus alleviates symptoms in some, but not all, patients. We describe two patients, one with GSD and one with GLA, found to have EML4::ALK fusions. This report of a targetable, oncogenic fusion in vascular malformations expands our understanding of the genetic basis for CLMs and suggests additional targeted therapies could be effective.
Impact of cytoreduction and remission status on hematopoietic cell transplantation outcomes in pediatric myelodysplastic syndrome and related disorders
Authors: Wachter Franziska , Hebert Kyle , Pikman Yana , Yang Jiemin , Shah Binita , Bledsoe Jacob , Shimamura Akiko , Neuberg Donna S. , Pollard Jessica A. , Lehmann Leslie E. 
Published: June 2023

AbstractBackgroundThe role of cytoreduction prior to hematopoietic cell transplant (HCT) for patients with pediatric myelodysplastic syndrome (MDS) and related disorders remains unclear.ProcedureWe performed a single‐center retrospective analysis of pre‐transplant disease management and subsequent HCT outcome for pediatric patients with MDS and related disorders who underwent HCT between 2010 and 2020.ResultsTotal 62 patients (median age 11 years) with idiopathic MDS (n = 16), MDS secondary to an underlying germline condition (n = 11), secondary acute myeloid leukemia (n = 9), myeloproliferative neoplasms (n = 8), and treatment‐related myeloid neoplasms (n = 18) received an allogeneic HCT. Cytoreduction prior to HCT was performed in 30/62 (48%) patients; this subset of patients had higher risk disease characteristics, including a higher blast count on presentation. In the overall cohort, use of cytoreduction before HCT was associated with higher rates of relapse (cumulative incidence of relapse 24 months post HCT: 48.1% [27.5%–66.1%]) for those who received cytoreduction versus 16.6% (5.9%–32.1%) for those who did not (p = .03). There was a trend toward decreased overall survival (OS) for those patients who received cytoreduction (24 months post HCT 57.1% vs. 75.3%, respectively; p = .06). OS for patients who received cytoreduction and attained measurable residual disease (MRD) negativity prior to HCT was superior compared to those with persistent disease (24 months post HCT 63.9% [36%–81.2%] vs. 33.3% [7.8%–62.3%], respectively; p = .04).ConclusionCytoreduction did not provide survival benefit in our overall cohort, but its increased use in children with higher risk disease impacted the analysis. Patients receiving cytoreduction and achieving MRD‐negative status before HCT demonstrated improved OS compared to those with persistent disease.
Marriage‐immigrant Filipinas' acculturation and learning experiences in South Korea
Authors: Kim Jihyun 
Published: June 2023

AbstractThis interview‐based qualitative study aimed to understand the acculturative experiences of marriage‐immigrant women in South Korea. Filipinas, who are married to Korean husbands, migrated to South Korea to live with their husbands, and could speak English, were recruited for the research. Interviews with 15 Filipinas were analyzed. As a result, the stories of each of the research participants were reconstructed based on their interviews, and three common themes and 11 subthemes emerged from the constant comparison method are presented. First, marriage‐immigrant Filipinas learned about the role and position of a daughter‐in‐law in South Korea. Second, as mothers with foreign backgrounds, marriage‐immigrant Filipinas' motherhood had to be negotiated. Finally, marriage‐immigrant Filipinas actively engaged in developing extrafamilial support in South Korea by expanding their horizons.
Concordance between needle electromyography and manual muscle test findings for muscles with motor grades 0 and 1
Authors: Lee Su Ji , Yoo Jeehyun , Park Seongeun , Shin Ji Cheol 
Published: June 2023

AbstractIntroductionWhen it is difficult to determine whether a muscle is grade 0 or 1, manual muscle test (MMT) accuracy can be further improved by using needle electromyography (EMG) as a supplementary and confirmatory examination tool.ObjectiveTo evaluate concordance between needle EMG and MMT findings for key muscles with motor grades 0 and 1 on the International Standards of Neurological Classification of Spinal Cord Injury (ISNCSCI) examination, and to potentially improve the prognosis for grade 0 muscles with proven muscle activity based on needle EMG findings.DesignA retrospective analysis.SettingInpatient tertiary rehabilitation facility.InterventionsNot applicable.PatientsOne hundred seven patients with spinal cord injury (SCI) admitted for rehabilitation (n = 1218 key muscles, grades 0 or 1).Main Outcome MeasuresInter‐rater reliability between MMTs and needle EMG was analyzed using Cohen's kappa coefficient (κ). A Mantel Haenszel linear‐by‐linear association chi‐square test was used to determine whether the presence of motor unit action potentials (MUAPs) in muscles graded 0 on the initial MMT at admission was associated with MMT grades at discharge and readmission.ResultsModerate‐to‐substantial agreement between needle EMG and MMT findings was observed (κ = 0.671, p < .01). Concerning key upper and lower extremity muscles, moderate and substantial agreement was identified, respectively. The lowest agreement was noted for C6 muscles. During follow up, 68.8% of muscles with proven MUAPs showed improved motor grades.ConclusionsAt initial assessment, distinguishing between motor grades 0 and 1 is imperative because motor grade 1 muscles are more likely to have a better prognosis for improvement. Moderate‐to‐substantial agreement was observed between MMT and needle EMG findings. The MMT is a reliable method of muscle grading, yet needle EMG may be of value in certain clinical situations to evaluate for the presence of MUAPs when evaluating motor function.
New mode of HPLC separation for multi‐charged polymers, peptides, and proteins
Authors: Zelechonok Yury , Widawer Bradley , Kolesnik Olga , Bezkhlebetskiy Yevgeniy , Sgibnev‐Gorodetskaya Tatiana 
Published: June 2023

AbstractThis article explores a new mode of chromatographic separation named BIST™ (Bridge Ion Separation Technique) that is designed specifically for the retention and separation of charged molecules. The proposed mechanism is supported by multiple examples. The separation technique is especially useful for analysis of low molecular weight charged polymers, the class of molecules where ion‐exchange, ion‐exclusion and size exclusion modes of separation do not work effectively. Among low molecular weight polymers, many compounds are of high importance for biological, medicinal, agricultural, and consumer applications. Some examples include heparin, poly amino acids, insulin, polyethyleneimine, as well as other peptides. The wide variety of applications of many charged polymers necessitates a high‐quality analytical technique for testing and research of these compounds.
State of the art on neonatal noninvasive respiratory support: How physiological and technological principles explain the clinical outcomes
Authors: Lavizzari Anna , Zannin Emanuela , Klotz Daniel , Dassios Theodore , Roehr Charles C. 
Published: June 2023

AbstractNoninvasive respiratory support has gained significant popularity in neonatal units because of its potential to reduce lung injury associated with invasive mechanical ventilation. To minimize lung injury, clinicians aim to apply for noninvasive respiratory support as early as possible. However, the physiological background and the technology behind such support modes are not always clear, and many open questions remain regarding the indications of use and clinical outcomes. This narrative review discusses the currently available evidence for various noninvasive respiratory support modes applied in Neonatal Medicine in terms of physiological effects and indications. Reviewed modes include nasal continuous positive airway pressure, nasal high‐flow therapy, noninvasive high‐frequency oscillatory ventilation, nasal intermittent positive pressure ventilation (NIPPV), synchronized NIPPV and noninvasive neurally adjusted ventilatory assist. To enhance clinicians’ awareness of each support mode's strengths and limitations, we summarize technical features related to the functioning mechanisms of devices and the physical properties of the interfaces commonly used for providing noninvasive respiratory support to neonates. We finally address areas of current controversy and suggest possible areas of research for implementing noninvasive respiratory support in neonatal intensive care units.
Polysomnography in hospitalized children: Characteristics and clinical practice at a single tertiary care center
Authors: Sunkonkit Kanokkarn , Alzaid Mohammed , Xiao Lena , Massicotte Colin , Al‐Saleh Suhail , Amin Reshma 
Published: June 2023

AbstractBackgroundPolysomnography (PSG) is the gold standard for the diagnosis of pediatric sleep‐disordered breathing (SDB). However, the literature characterizing the indications for inpatient PSGs and the impact on clinical decision‐making is limited.ObjectiveTo determine the indications, results, and outcomes for children undergoing inpatient PSGs at our institution.MethodsWe performed a retrospective review of children aged 0–18 years who underwent inpatient diagnostic PSGs between July 2018 and July 2021 at SickKids, Toronto, Canada. Baseline characteristics, indications, and management were reviewed and characterized by descriptive statistics.ResultsEighty‐eight inpatient PSGs were performed in 75 children (male 62.7%). Median (interquartile range) age and body mass index z‐score were 1.5 (0.2, 10.8) years and 0.27 (−1.58, 2.66), respectively. The most common indication for inpatient PSG was initiation and titration of ventilation (n = 34/75, 45.3%). Of the 75 children, 48 (64%) had multiple complex chronic conditions (CCCs). Sixty children (80%) underwent a baseline PSG for either the entire night or a portion of the night. Of these studies, 54 (90%) had clinically significant SDB of which isolated obstructive sleep apnea (OSA; 17/60, 28.3%) was the most common. The following management was undertaken for the 54 patients with SDB; respiratory technology (88.9%), surgical intervention (31.5%), positional therapy (1.9%), intranasal steroids (3.7%), and no further intervention (5.6%), respectively.ConclusionsOur study highlights that inpatient PSG was an important diagnostic tool resulting in directed medical and surgical management. Future multicenter studies are needed to compare indications for inpatient PSGs across institutions to develop evidence‐based clinical practice guidelines.
Update in postinfectious bronchiolitis obliterans
Authors: Teper Alejandro , Colom Alejandro J. , Schubert Ralf , Jerkic Pera‐Silvija 
Published: June 2023

AbstractPostinfectious bronchiolitis obliterans (PiBO) is a rare and severe form of chronic obstructive lung disease caused by an infectious injury to the lower respiratory tract. The most commonly recognized inciting stimuli leading to PiBO are airway pathogens, such as adenovirus and Mycoplasma. PiBO is characterized by persistent and nonreversible airway obstruction, with functional and radiological evidence of small airway involvement. The literature has limited information on the aetiology, clinical profile, treatment, and outcome of PiBO.
Effect of preterm chorioamnionitis on lung ultrasound score used to guide surfactant replacement
Authors: Vivalda Laura , Loi Barbara , Bisceglie Valeria , Ben‐Ammar Rafik , De Luca Daniele 
Published: June 2023

AbstractObjectiveLung ultrasound score (LUS) accurately guides surfactant replacement in preterm neonates with respiratory distress syndrome due to surfactant deficiency. However, surfactant deficiency is not the unique pathobiological feature, as there may be relevant lung inflammation, such as in certain cases of clinical chorioamnionitis (CC). We aim to investigate if CC influences LUS and ultrasound‐guided surfactant treatment.DesignRetrospective (2017–2022), large, cohort study targeted to recruit a homogeneous population treated with unchanged respiratory care policy and lung ultrasound protocol. Patients with (CC+: 207) and without (CC−: 205) chorioamnionitis were analyzed with propensity score matching and subsequent additional multivariate adjustments.ResultsLUS was identical at unmatched and matched comparisons. Consistently, at least one surfactant dose was given in 98 (47.3%) and 83 (40.5%) neonates in the CC+ and CC− matched cohorts, respectively (p = .210). Multiple doses were needed in 28 (13.5%) and 21 (10.2%) neonates in the CC+ and CC− cohorts, respectively (p = .373). Postnatal age at surfactant dosing was also similar. LUS was higher in patients who were diagnosed with neonatal acute respiratory distress syndrome (NARDS) (CC+ cohort: 10.3 (2.9), CC− cohort: 11.4 (2.6)), than in those without NARDS (CC+ cohort: 6.1 (3.7), CC− cohort: 6.2 (3.9); p < .001, for both). Surfactant use was more frequent in neonates with, than in those without NARDS (p < .001). Multivariate adjustments confirmed NARDS as the variable with greater effect size on LUS.ConclusionsCC does not influence LUS in preterm neonates, unless inflammation is enough severe to trigger NARDS. The occurrence of NARDS is key factor influencing the LUS.