bluuebunny/crossref_metadata_2025_split huggingface dataset:
Lightfield hyperspectral imaging in neuro-oncology surgery: an IDEAL 0 and 1 study
Authors: MacCormac Oscar , Noonan Philip , Janatka Mirek , Horgan Conor C. , Bahl Anisha , Qiu Jianrong , Elliot Matthew , Trotouin Théo , Jacobs Jaco , Patel Sabina , Bergholt Mads S. , Ashkan Keyoumars , Ourselin Sebastien , Ebner Michael , Vercauteren Tom , Shapey Jonathan 
Published: September 2023

IntroductionHyperspectral imaging (HSI) has shown promise in the field of intra-operative imaging and tissue differentiation as it carries the capability to provide real-time information invisible to the naked eye whilst remaining label free. Previous iterations of intra-operative HSI systems have shown limitations, either due to carrying a large footprint limiting ease of use within the confines of a neurosurgical theater environment, having a slow image acquisition time, or by compromising spatial/spectral resolution in favor of improvements to the surgical workflow. Lightfield hyperspectral imaging is a novel technique that has the potential to facilitate video rate image acquisition whilst maintaining a high spectral resolution. Our pre-clinical and first-in-human studies (IDEAL 0 and 1, respectively) demonstrate the necessary steps leading to the first in-vivo use of a real-time lightfield hyperspectral system in neuro-oncology surgery.MethodsA lightfield hyperspectral camera (Cubert Ultris ×50) was integrated in a bespoke imaging system setup so that it could be safely adopted into the open neurosurgical workflow whilst maintaining sterility. Our system allowed the surgeon to capture in-vivo hyperspectral data (155 bands, 350–1,000 nm) at 1.5 Hz. Following successful implementation in a pre-clinical setup (IDEAL 0), our system was evaluated during brain tumor surgery in a single patient to remove a posterior fossa meningioma (IDEAL 1). Feedback from the theater team was analyzed and incorporated in a follow-up design aimed at implementing an IDEAL 2a study.ResultsFocusing on our IDEAL 1 study results, hyperspectral information was acquired from the cerebellum and associated meningioma with minimal disruption to the neurosurgical workflow. To the best of our knowledge, this is the first demonstration of HSI acquisition with 100+ spectral bands at a frame rate over 1Hz in surgery.DiscussionThis work demonstrated that a lightfield hyperspectral imaging system not only meets the design criteria and specifications outlined in an IDEAL-0 (pre-clinical) study, but also that it can translate into clinical practice as illustrated by a successful first in human study (IDEAL 1). This opens doors for further development and optimisation, given the increasing evidence that hyperspectral imaging can provide live, wide-field, and label-free intra-operative imaging and tissue differentiation.
Opposite trends in incidence of breast cancer in young and old female cohorts in Hungary and the impact of the Covid-19 pandemic: a nationwide study between 2011–2020
Authors: Kiss Zoltán , Kocsis Judit , Nikolényi Alíz , Horváth Zsolt , Knollmajer Kata , Benedek Angéla , Várnai Máté , Polányi Zoltán , Kovács Krisztina Andrea , Berta Andrea , Köveskuti István , Karamousouli Eugenia , Szabó Tamás Géza , Rokszin György , Fábián Ibolya , Bartókné Tamás Renáta , Surján Orsolya , Fürtős Diána , Surján György , Kenessey István , Weber András , Barcza Zsófia , Berki Tamás , Vokó Zoltán , Dózsa Csaba , Dank Magdolna , Boér Katalin 
Published: September 2023

BackgroundThis nationwide study examined breast cancer (BC) incidence and mortality rates in Hungary between 2011–2019, and the impact of the Covid-19 pandemic on the incidence and mortality rates in 2020 using the databases of the National Health Insurance Fund (NHIF) and Central Statistical Office (CSO) of Hungary.MethodsOur nationwide, retrospective study included patients who were newly diagnosed with breast cancer (International Codes of Diseases ICD)-10 C50) between Jan 1, 2011 and Dec 31, 2020. Age-standardized incidence and mortality rates (ASRs) were calculated using European Standard Populations (ESP).Results7,729 to 8,233 new breast cancer cases were recorded in the NHIF database annually, and 3,550 to 4,909 all-cause deaths occurred within BC population per year during 2011-2019 period, while 2,096 to 2,223 breast cancer cause-specific death was recorded (CSO). Age-standardized incidence rates varied between 116.73 and 106.16/100,000 PYs, showing a mean annual change of -0.7% (95% CI: -1.21%–0.16%) and a total change of -5.41% (95% CI: -9.24 to -1.32). Age-standardized mortality rates varied between 26.65–24.97/100,000 PYs (mean annual change: -0.58%; 95% CI: -1.31–0.27%; p=0.101; total change: -5.98%; 95% CI: -13.36–2.66). Age-specific incidence rates significantly decreased between 2011 and 2019 in women aged 50–59, 60–69, 80–89, and ≥90 years (-8.22%, -14.28%, -9.14%, and -36.22%, respectively), while it increased in young females by 30.02% (95%CI 17,01%- 51,97%) during the same period. From 2019 to 2020 (in first COVID-19 pandemic year), breast cancer incidence nominally decreased by 12% (incidence rate ratio [RR]: 0.88; 95% CI: 0.69–1.13; 2020 vs. 2019), all-cause mortality nominally increased by 6% (RR: 1.06; 95% CI: 0.79–1.43) among breast cancer patients, and cause-specific mortality did not change (RR: 1.00; 95%CI: 0.86–1.15).ConclusionThe incidence of breast cancer significantly decreased in older age groups (≥50 years), oppositely increased among young females between 2011 and 2019, while cause-specific mortality in breast cancer patients showed a non-significant decrease. In 2020, the Covid-19 pandemic resulted in a nominal, but not statistically significant, 12% decrease in breast cancer incidence, with no significant increase in cause-specific breast cancer mortality observed during 2020.
Prediabetes and the risk of breast cancer: a meta-analysis
Authors: Lin Jing , Tu Rongzu , Lu Zhai’e 
Published: September 2023

BackgroundDiabetes has been related to a higher risk of breast cancer (BC) in women. However, it remains unknown whether the incidence of BC is increased in women with prediabetes. A systematic review and meta-analysis was therefore performed to evaluate the relationship between prediabetes and risk of BC.MethodsObservational studies with longitudinal follow-up relevant to the objective were found via searching Medline, Embase, Cochrane Library, and Web of Science. A fixed- or random-effects model was used to pool the results depending on heterogeneity.ResultsEight prospective cohort studies and two nest case-control studies were included. A total of 1069079 community women were involved, and 72136 (6.7%) of them had prediabetes at baseline. During a mean duration follow-up of 9.6 years, 9960 (0.93%) patients were diagnosed as BC. Pooled results with a fixed-effects model showed that women with prediabetes were not associated with a higher incidence of BC as compared to those with normoglycemia (risk ratio: 0.99, 95% confidence interval: 0.93 to 1.05, p = 0.72) with mild heterogeneity (p for Cochrane Q test = 0.42, I2 = 3%). Subgroup analyses showed that study characteristics such as study design, menopausal status of the women, follow-up duration, diagnostic criteria for prediabetes, methods for validation of BC cases, and study quality scores did not significantly affect the results (p for subgroup analyses all &gt; 0.05).ConclusionWomen with prediabetes may not be associated with an increased risk of BC as compared to women with normoglycemia.
Case report: Successful treatment of recurrent E. coli infection with bacteriophage therapy for patient suffering from chronic bacterial prostatitis
Authors: Johri Apurva Virmani , Johri Pranav , Hoyle Naomi , Nadareishvili Lia , Pipia Levan , Nizharadze Dea 
Published: September 2023

Background: Chronic Bacterial Prostatitis (CBP) is inflammation of the prostate caused by bacterial infection. An estimated 8.2% of men have prostatitis, most commonly under the age of 50. Antibiotics often fail to treat CBP due to presence of bacterial biofilms and rising antibiotic resistance of pathogenic bacterial strains. The multidrug resistant (MDR) bacterial strains often implicated in cases of CBP include Extended Spectrum Beta Lactam resistant Escherichia coli, Vancomycin resistant Enterococci, Gram-positive bacterial strains like Staphylococci and Streptococci, Enterobacteriaceae like Klebsiella and Proteus, and Pseudomonas aeruginosa. CBP patients experience significant deterioration in quality of life, with impact on mental health comparable with patients of diabetes mellitus and chronic heart failure, leading patients to explore alternatives like phage therapy.Case presentation: We present the case of a patient diagnosed with and exhibiting typical symptoms of CBP. Tests of the prostatic and seminal fluids identified E. coli as the causative pathogen. The patient did not experience favourable long-term treatment outcomes despite repeated antibiotic courses administered over 5 years. This led him to seek phage therapy for treatment of his condition.Methods and outcome: The cultured strain of E. coli was tested against bacteriophage preparations developed by the Eliava Institute, Georgia. Preparations showing lytic activity against the strain were used for the patient’s treatment at the Eliava Phage Therapy Center (EPTC). The patient underwent two courses of treatment with the EPTC. The first treatment course resulted in significant symptomatic improvement, followed by complete resolution of symptoms post the second course of phage therapy. Samples tested during treatment showed declining bacterial growth, corresponding with symptomatic improvement. Post-treatment cultures had no growth of pathogenic bacteria.Discussion: This case illustrates the efficacy of bacteriophages in treating CBP, a condition that is often resistant to antibiotic therapies. Antibiotics such as ofloxacin, Fosfomycin, trimethoprim, nitrofurantoin and ceftriaxone were administered in multiple courses over 5 years, but the infection recurred after each course. After two courses of phage therapy, the patient experienced long-term symptom resolution and substantial reduction in bacterial load. Increasing numbers of such cases globally warrant further research into the potential for bacteriophages for treating MDR and chronic infections.
Locally advanced head and neck squamous cell carcinoma treatment efficacy and safety: a systematic review and network meta-analysis
Authors: Wang Huanhuan , Zheng Zhuangzhuang , Zhang Yangyu , Bian Chenbin , Bao Jindian , Xin Ying , Jiang Xin 
Published: September 2023

Head and neck squamous cell carcinoma (HNSCC) accounts for approximately 3% of new cancer cases and 3% of all deaths worldwide. Most HNSCC patients are locally advanced (LA) at diagnosis. The combination of radiotherapy (RT), chemotherapy, targeted therapy, and immunotherapy are the primary LA-HNSCC treatment options. Nevertheless, the choice of optimal LA-HNSCC treatment remains controversial. We systematically searched public databases for LA-HNSCC-related studies and assess treatment effectiveness and safety by assessing the objective response rate (ORR), ≥3 adverse events (AEs), overall survival (OS), progression-free survival (PFS), disease-free survival (DFS), local-region control (LRC), and disease-specific survival (DSS). 126 randomized controlled clinical trials (RCTs) were included in this study. We show that concurrent RT with nimotuzumab or conventional concurrent chemo-radiotherapy (CCRT) had significantly better efficacy and long-term survival without increasing AEs than RT alone. Accelerated fractionated radiotherapy (AFRT) showed better efficiency than conventional fractionated RT, although it had higher AEs. In addition, concurrent cetuximab combined with RT failed to show a significant advantage over RT alone.Trial registration: PROSPERO CRD42022352127.
A novel approach for quantitative imaging of the seated anatomy of the buttocks using ultrasound and MRI
Authors: Mogale Nkhensani , Scott Justin D. , Schanz Daniel , Ilyasov Viktor , Bush Tamara Reid , van Schoor Albert-Neels , Slade Jill M. 
Published: September 2023

Background:Pressure injuries are commonly noted in individuals who use wheelchairs for mobility and sit for prolonged periods. Understanding soft tissue composition is an essential part of treating and preventing pressure injuries. This study proposes novel approaches for imaging the soft tissue of the buttocks in unloaded and loaded conditions using ultrasound (US) and magnetic resonance imaging (MRI).Methods:The soft tissue of the buttocks was measured in able-bodied participants (n= 26, 50% female) and one male with a spinal cord injury using an innovative chair that allowed seated US acquisition of the buttocks and a newly developed MRI compatible loader. The US test–retest reliability (reproducibility) of buttocks soft tissue was assessed, and US was validated with MRI. Soft tissue was measured between the peak of the ischial tuberosity (IT) and proximal femur and the skin. MRI was used to quantify the fat fraction of the gluteus maximus muscle, with the goal of determining the influence of intramuscular fat on loaded soft tissue responses and was used to assess tissue thickness during buttocks loading.Results:US reproducibility was excellent, ICC = 0.934–0.981, with no statistical differences between scan days. Coefficients of variation (CVs) between visits ranged from 2.5% to 7.4% for loaded and unloaded tissue. US and MRI measures of tissue thickness were significantly correlated (r = 0.68–0.91,p≤ 0.001). US underestimated the unloaded tissue thicknesses, with a mean bias of 0.39–0.56 cm. When the buttocks were loaded, US- and MRI-measured total tissue thickness was reduced by up to 64.2% ± 9.1% (p&lt; 0.001). The US- and MRI-unloaded total soft tissue of the IT was correlated with loaded tissue thickness (r = 0.54–0.67,p≤ 0.027). Intramuscular fat of the gluteus maximus was not correlated to changes in muscle thickness with loading (r = 0.05,p&gt; 0.05).Conclusion:We have developed and validated a novel US methodology using MRI as a comparison measure to investigate soft tissue anatomy and deformation during sitting and loading. The ability to obtain such data in the loaded condition is unique and fills an unmet need in understanding loading and pressure injury formation.
Metabolomics and transcriptomics analyses for characterizing the alkaloid metabolism of Chinese jujube and sour jujube fruits
Authors: Xue Xiaofang , Zhao Ailing , Wang Yongkang , Ren Haiyan , Su Wanlong , Li Yi , Shi Meijuan , Liu Li , Li Dengke 
Published: September 2023

IntroductionJujube is an important economic forest tree whose fruit is rich in alkaloids. Chinese jujube (Ziziphus jujuba Mill.) and sour jujube (Ziziphus spinosa Hu.) are the two most important species of the jujube genus. However, the mechanisms underlying the synthesis and metabolism of alkaloids in jujube fruits remain poorly understood.MethodsIn this study, the fruits of Ziziphus jujuba ‘Hupingzao’ and Ziziphus spinosa ‘Taigusuanzao’ in different harvest stages were used as test materials, we first integrated widely targeted metabolomics and transcriptomics analyses to elucidate the metabolism of alkaloids of jujube fruits.ResultsIn the metabolomics analysis, 44 alkaloid metabolites were identified in 4 samples, 3 of which were unique to sour jujube fruit. The differential alkaloid metabolites (DAMs) were more accumulated in sour jujube than in Chinese jujube; further, they were more accumulated in the white ripening stage than in the red stage. DAMs were annotated to 12 metabolic pathways. Additionally, transcriptomics data revealed 259 differentially expressed genes (DEGs) involved in alkaloid synthesis and metabolism. By mapping the regulatory networks of DAMs and DEGs, we screened out important metabolites and 11 candidate genes.DiscussionThis study preliminarily elucidated the molecular mechanism of jujube alkaloid synthesis. The candidate genes regulated the synthesis of key alkaloid metabolites, but the specific regulation mechanism is unclear. Taken together, our results provide insights into the metabolic networks of alkaloid synthesis in Chinese jujube and sour jujube fruits at different harvest stages, thereby providing a theoretical reference for further research on the regulatory mechanism of jujube alkaloids and their development and utilization.
Latitudinal and zoo specific zeitgebers influence circadian and circannual rhythmicity of behavior in captive giant pandas (Ailuropoda melanoleuca)
Authors: Gandia Kristine M. , Kessler Sharon E. , Buchanan-Smith Hannah M. 
Published: September 2023

IntroductionThe circadian clock influences many aspects of animal welfare including metabolism, breeding, and behavior. In most species, circadian clocks are internal clocks regulated by external environmental cues called zeitgebers. The most common zeitgebers are light/dark cycles, food, and temperature. However, within captive environments, animals can be housed at latitudes with different light/dark cycles than their natural habitat and most other zeitgebers are controlled by humans. The effects that modified zeitgebers have on captive animals’ circadian and circannual rhythmicity is largely unknown. To explore this and potential welfare implications, we measured and analyzed observational behavioral data of zoo-housed giant pandas for one year utilizing live camera footage from six zoos across the world. The worldwide distribution of the zoos gives us the unique opportunity to investigate how housing giant pandas within and outside of their natural latitudinal range can affect circadian rhythmicity and behavior.MethodsFocal sampling was completed for 11 giant pandas each month for 12 consecutive months to gain an estimate of one circannual cycle. Within each month, we estimated one daylight or 24 h cycle of activity/behavior by conducting 10-min observation sessions systemically each hour the pandas were visible.ResultsZero-inflated negative binomial mixture models found that latitude is associated with activity levels, with pandas housed outside of their natural latitudinal range displaying less activity than those within their latitudinal range. Amount of daylight, temperature minimum, and temperature range were also associated with activity cycles, potentially acting as zeitgebers. An association between sexual-related and stereotypic behavioral cycles was found, with the circannual cycles fluctuating in synchrony throughout several points in a year.DiscussionThese results indicate that changes to common zeitgebers and environmental conditions can influence circadian and circannual cycles. The widespread evolution of circadian rhythms suggests an adaptive advantage to possessing one in an environment with cyclical changes, allowing species to anticipate changes in their environment and respond accordingly. Therefore, although animals are highly adaptive, creating a captive environment that mimics the environmental conditions for which the animal has evolved can encourage naturalistic cycles that ultimately aid in promoting positive welfare states and increasing chances of successful breeding and conservation.
Job burnout on subjective wellbeing among clinicians in China: the mediating role of mental health
Authors: Fu Yingjie , Huang Derong , Zhang Shuo , Wang Jian 
Published: September 2023

BackgroundAlthough job burnout and mental health difficulties are prevalent negative influences on clinicians’ subjective wellbeing (SWB), there are few investigations into their relationships. This research investigates the mediating role of mental illness in the association between clinicians’ SWB and job burnout in China.MethodsThis study used the data collected from a cross-sectional survey conducted in China. Using convenience sampling, we conducted a face-to-face questionnaire survey among clinicians in a tertiary hospital in Shandong Province from August to September 2019. The 22-item Maslach Burnout Inventory-Human Service Survey (Chinese version) and the Personal Wellbeing Index-Adult assessed job burnout and SWB. The Chinese short version of Depression, Anxiety and Stress Scale (DASS-C21) assessed mental health. We also collected data on participants’ sociodemographic characteristics and job-related factors. Structural equation modeling (SEM) was applied to examine the associations between variables.ResultsAmong the 422 participants, 80.8% of the participants reported at least one symptom of job burnout, whereas 5.7% reported all three symptoms of burnout. The prevalence rates of depression, anxiety, and stress were 40.3, 41.7, and 24.9%, respectively. Only 12.8% of the participants had high level of SWB. In mediation analysis, job burnout is positively associated with mental illness (β = 0.809, P &lt; 0.001), mental illness had a significant negative association with SWB (β = −0.236, P = 0.013), and a negative association between job burnout and SWB was significant (β = −0.377, P = 0.002). Mental illness played a partially mediated role in the association between job burnout and SWB (indirect effect = −0.191, 95% CI: −0.361∼−0.017), and the mediating effect of mental illness can explain the 33.6% of the total effect of job burnout on SWB.ConclusionThis study provides evidence that the effect of job burnout on SWB is partially mediated by mental illness among clinicians in China. Medical administration departments and hospital administrators should pay close attention to the job burnout and mental health of clinicians, so as to effectively improve the SWB of clinicians.