bluuebunny/crossref_metadata_2025_split huggingface dataset:
Added value of zoomed-echo-planar imaging diffusion-weighted imaging for evaluation of periampullary carcinomas
Authors: Liu Jingjing , Huang Mengyue , Ren Yanan , Xu Man , Zhu Jinxia , Li Yinhua , Cheng Jingliang 
Published: July 2023

Abstract
Background
To assess the image quality feasibility and diagnostic value of zoomed diffusion-weighted imaging (z-EPI DWI) using echo-planar imaging (EPI) compared with conventional DWI (c-EPI DWI) in patients with periampullary disease.

Methods
Thirty-six patients with periampullary carcinomas and fifteen with benign periampullary disease were included in this study. All the subjects underwent MR cholangiopancreatography (MRCP), c-EPI DWI, and z-EPI DWI. Two radiologists independently assessed image quality of the two image sets, including overall image quality and lesion conspicuity. In addition, signal intensity and ADC measurements of DWIs in the periampullary lesions were conducted. Diagnostic accuracies of the combined image sets of MRCP and z-EPI DWI were compared with those of a combined set of MRCP and c-EPI DWI.

Results
z-EPI DWI showed significantly better image quality scores (anatomic structure visualization, 2.94 ± 0.24; overall image quality, 2.96 ± 0.17) compared to that with c-EPI DWI (anatomic structure visualization, 2.02 ± 0.22; overall image quality, 2.04 ± 0.24) (both P < 0.01). For all the periampullary malignant lesions and small lesions (≤ 20 mm), there was better delineation of lesion conspicuity and the lesion margin, as well as diagnostic confidence with z-EPI DWI (all P < 0.05). The rate of periampullary malignancy’s hyperintense signal on z-EPI DWI was increased to 91.7% (33/36) compared to c-EPI DWI (69.4% (25/36)) (P = 0.023). For all malignant lesions and small lesions, the diagnostic accuracy scores were increased using the MRCP and z-EPI DWI combined set, compared to the MRCP and c-EPI DWI combined set (P < 0.05). Diagnostic accuracy for detection and differentiation of malignant lesions from benign lesions significantly improved for the MRCP and z-EPI DWI combined set compared with MRCP and c-EPI DWI combined set (P < 0.05). There were no significant differences between c-EPI DWI and z-EPI DWI in the ADC values of periampullary malignant and benign lesions (P > 0.05).

Conclusions
z-EPI DWI has an advantage that could lead to remarkable image quality improvements and enhanced lesion visualization of periampullary carcinomas. z-EPI DWI was superior to c-EPI DWI for detecting, delineating, and diagnosing the lesions, particularly for small challenging lesions.

Graphical abstract
The current evidence on surgical management for synchronous bilateral renal tumors: results from a scoping review
Authors: Giulioni Carlo , Maggi Martina , Pirola Giacomo Maria , Martorana Eugenio , Cormio Angelo , Teoh Jeremy Yuen-Chun , Gauhar Vineet , Galosi Andrea Benedetto , Castellani Daniele 
Published: July 2023

Abstract
Purpose
Synchronous bilateral renal masses (SBRM) account for a low percentage of kidney tumors, and there is no current recommendation for their management. The objective was to review evidence regarding the best surgical approach for SBRM in terms of type and timing of surgery.

Methods
A broad literature search was performed on 28th January 2023 using Scopus, PubMed, and EMBASE. Only English papers dealing with adults were included. Meeting abstracts were excluded.

Results
Twenty-four papers were accepted and included. SBRM behave less aggressively than metachronous tumors, and partial nephrectomy (PN) is the preferred therapeutic option to preserve renal function. Open, laparoscopic, and robot-assisted approaches were found to be similar in oncological outcomes, though robot-assisted surgery resulted in lower comorbidities. Same-sitting PN was demonstrated to be a safe approach, particularly in the robotic-assisted one. Finally, the same-siting and staged NSS were similar in preserving renal function.

Conclusions
PN should be the desirable treatment for SBRM whenever feasible and if patients are fit, but surgeon expertise should also be taken into the account.
Convection-permitting climate simulations for South America with the Met Office Unified Model
Authors: Halladay Kate , Kahana Ron , Johnson Ben , Still Christopher , Fosser Giorgia , Alves Lincoln 
Published: July 2023

AbstractWe present the first convection-permitting regional climate model (CPRCM) simulations at 4.5 km horizontal resolution for South America at near-continental scale, including full details of the experimental setup and results from the reanalysis-driven hindcast and climate model-driven present-day simulations. We use a range of satellite and ground-based observations to evaluate the CPRCM simulations covering the period 1998–2007 comparing the CPRCM output with lower resolution regional and global climate model configurations for key regions of Brazil. We find that using the convection-permitting model at high resolution leads to large improvements in the representation of precipitation, specifically in simulating its diurnal cycle, frequency, and sub-daily intensity distribution (i.e. the proportion of heavy and light precipitation). We tentatively conclude that there are also improvements in the spatial structure of precipitation. We see higher precipitation intensity and extremes over Amazonia in the CPRCMs compared with observations, though more sub-daily observational data from meteorological stations are required to conclusively determine whether the CPRCMs add value in this regard. For annual mean precipitation and mean, maximum and minimum near surface temperatures, it is not clear that the CPRCMs add value compared with coarser-resolution models with parameterised convection. We also find large changes in the contribution to evapotranspiration from canopy evaporation compared to soil evaporation and transpiration compared with the RCM. This is likely to be related to the shift in precipitation intensity distribution of the CPRCMs compared to the RCM and its impact on the hydrological requires further investigation.
Reliability of whole mount radical prostatectomy histopathology as the ground truth for artificial intelligence assisted prostate imaging
Authors: Jager Auke , Postema Arnoud W. , van der Linden Hans , Nooijen Peet T.G.A. , Bekers Elise , Kweldam Charlotte F. , Daures Gautier , Zwart Wim , Mischi M. , Beerlage Harrie P. , Oddens Jorg R. 
Published: July 2023

AbstractThe development of artificial intelligence–based imaging techniques for prostate cancer (PCa) detection and diagnosis requires a reliable ground truth, which is generally based on histopathology from radical prostatectomy specimens. This study proposes a comprehensive protocol for the annotation of prostatectomy pathology slides. To evaluate the reliability of the protocol, interobserver variability was assessed between five pathologists, who annotated ten radical prostatectomy specimens consisting of 74 whole mount pathology slides. Interobserver variability was assessed for both the localization and grading of PCa. The results indicate excellent overall agreement on the localization of PCa (Gleason pattern ≥ 3) and clinically significant PCa (Gleason pattern ≥ 4), with Dice similarity coefficients (DSC) of 0.91 and 0.88, respectively. On a per-slide level, agreement for primary and secondary Gleason pattern was almost perfect and substantial, with Fleiss Kappa of .819 (95% CI .659–.980) and .726 (95% CI .573–.878), respectively. Agreement on International Society of Urological Pathology Grade Group was evaluated for the index lesions and showed agreement in 70% of cases, with a mean DSC of 0.92 for all index lesions. These findings show that a standardized protocol for prostatectomy pathology annotation provides reliable data on PCa localization and grading, with relatively high levels of interobserver agreement. More complicated tissue characterization, such as the presence of cribriform growth and intraductal carcinoma, remains a source of interobserver variability and should be treated with care when used in ground truth datasets.
Renal neuroendocrine tumors: clinical and molecular pathology with an emphasis on frequent association with ectopic Cushing syndrome
Authors: Kasajima Atsuko , Pfarr Nicole , von Werder Alexander , Schwamborn Kristina , Gschwend Jürgen , Din Nasir Ud , Esposito Irene , Weichert Wilko , Pavel Marianne , Agaimy Abbas , Klöppel Günter 
Published: July 2023

AbstractRenal neuroendocrine tumors (RenNETs) are rare malignancies with largely unknown biology, hormone expression, and genetic abnormalities. This study aims to improve our understanding of the RenNETs with emphasis of functional, hormonal, and genetic features. Surgically resected RenNETs (N = 13) were retrieved, and immunohistochemistry and next-generation sequencing (NGS) were performed in all cases. In addition, all published RenNETs were systematically reviewed. Our cohort (4 men and 9 women, mean age 42, mean tumor size 7.6 cm) included 2 patients with Cushing syndrome (CS). WHO grade (23% G1, 54% G2, and 23% G3) and tumor progression did not correlate. CS-associated RenNETs (CS-RenNETs) showed a solid and eosinophilic histology and stained for ACTH, while the remaining non-functioning tumors had a trabecular pattern and expressed variably hormones somatostatin (91%), pancreatic polypeptide (63%), glucagon (54%), and serotonin (18%). The transcription factors ISL1 and SATB2 were expressed in all non-functioning, but not in CS-RenNETs. NGS revealed no pathogenic alterations or gene fusions. In the literature review (N = 194), 15 (8%) of the patients had hormonal syndromes, in which CS being the most frequent (7/15). Large tumor size and presence of metastasis were associated with shorter patients’ survival (p < 0.01). RenNETs present as large tumors with metastases. CS-RenNETs differ through ACTH production and solid-eosinophilic histology from the non-functioning trabecular RenNETs that produce pancreas-related hormones and express ISL1 and SATB2. MEN1 or DAXX/ARTX abnormalities and fusion genes are not detected in RenNETs, indicating a distinct yet unknown molecular pathogenesis.
Does sequential examination under anaesthesia provide a reliable method to determine a management plan for unstable lateral compression pelvic ring injuries? a prospective study
Authors: Shawky Mostafa Ahmed , Abdelazeem Ahmed Hazem , Abdel-Kader Khaled Fawzy , Mohammad Molham Mahmood , Azzam Ahmad Hamdi 
Published: July 2023

Abstract
Purpose
To assess the reliability of sequential examination under anaesthesia (EUA) to determine pelvic instability and to evaluate radiological and functional outcomes in unstable lateral compression (LC) injuries.

Methods
A prospective case series study was conducted from 2020 to 2022 at a university hospital on 43 cases with LC injuries that met the inclusion criteria. Sequential EUA was carried out in three steps. Posterior-only fixation or anterior–posterior fixation was done according to the algorithm. Each patient was followed up for at least 12 months, both radiologically and functionally.

Results
Forty cases proved unstable and were fixed. None showed secondary displacement in the anterior–posterior fixation group. However, five cases (19.2%) of the posterior-only fixation group showed secondary displacement with a mean of 5.9 mm. Four cases of them had tetra-ramic injuries. There is a high tendency for secondary displacement at 14.5 mm or more preoperative displacement of the rami. Patients with secondary displacement showed comparable functional outcome scores to patients without secondary displacement. Posterior-only fixation showed shorter operative time, lesser radiological exposure, blood loss and iatrogenic nerve injury than anterior–posterior fixation.

Conclusion
EUA is a reliable method to determine pelvic instability and management plan for LC fractures with unilateral anterior ring injury. Anterior–posterior fixation is needed if there is a tetra-ramic fracture or initial anterior ring displacement of 14.5 mm or more, irrespective of EUA.
Perception-based high quality distributed virtual reality
Authors: Naylor William , Debattista Kurt , Chalmers Alan 
Published: July 2023

AbstractVirtual reality has great potential to enable remote collaborative work from anywhere in the world. Developing virtual reality into a platform suitable for natural interaction and immersive collaboration requires the experience to be reliably stable. For a networked collaborative environment, perceived smoothness of motion is limited by the tick rate, that is, the frequency at which information is distributed. As tick rate increases, motion will appear increasingly smooth; however, excessive tick rates may introduce additional load on a network without any perceptible benefit to a user. This paper details two visual psychophysics experiments ($$N_1 = 16$$

N
1

=
16

, $$N_2 = 11$$

N
2

=
11

) carried out to evaluate participant sensitivity to tick rate in virtual reality. The influence of three variables, velocity, complexity, and digital medium were investigated. Both velocity and digital medium displayed a significant effect, whilst complexity did not show significance. A model was then built and validated from the results of these experiments. The model predicts for average walking speed within the desktop condition, that 90% of the population will perceive motion to be smooth at 56 Hz, whilst this 90% threshold lies at 113 Hz for the VR condition. This model can predict participant perception of tick rate under given conditions, enabling networks to intelligently optimise participant experience without adding unnecessary further load on the network.
Burden of disease and real-world treatment patterns of patients with systemic lupus erythematosus in the Australian OPAL dataset
Authors: Ciciriello Sabina , Littlejohn Geoffrey , O’Sullivan Catherine , Smith Tegan , Deakin Claire T. 
Published: July 2023

Abstract
Objective
To describe the demographics, disease burden and real-world management of patients with systemic lupus erythematosus (SLE) in Australian community practice.

Methods
Patients with a physician diagnosis of SLE and at least 1 visit between 1 January 2009 and 31 March 2021 were identified in the OPAL dataset, an aggregated collection of data extracted from the electronic medical records of patients managed by 112 Australian rheumatologists. Demographics, basic clinical features and prescribed medications were described, with medication combinations used as a surrogate of disease severity.

Results
Of 5133 patients with a diagnosis of lupus, 4260 (83%) had SLE. Of these SLE patients, almost 90% of patients were female, with a median age of 49 years [IQR 37–61] at first-recorded visit. Of the 2285 SLE patients whose most recent visit was between 1 January 2019 and 31 March 2021, 52.5% had mild disease, 29.9% had moderate-severe disease and 7.4% had very severe disease. Visit frequency increased with disease severity. Most patients (85.8%) were treated with hydroxychloroquine, typically prescribed as first line-of-therapy.

Conclusion
In this large real-world Australian cohort of patients with SLE, a substantial burden of disease was identified, with a significant proportion (almost one-third of patients) considered to have moderate to severe disease based on medication use. This study provides a greater understanding of the path from symptom onset to treatment and the heterogeneous presentation of patients with SLE who are treated in community practice in Australia.

Key messages• Most published studies describing patients with SLE are derived from specialist lupus centres, typically in the hospital setting, therefore little is known about the characteristics of patients with SLE who are receiving routine care in community clinics.• The OPAL dataset is a large collection of clinical data from the electronic medical records of rheumatologists predominantly practising in private community clinics, which is where the majority (73–80%) of adult rheumatology services are conducted in Australia [1–3] . Since data from community care has not been widely available for SLE research, this study contributes important insight into this large and under-reported patient population.• To improve access to care and effective treatments, and reduce the burden of SLE in Australia, a greater understanding of the characteristics and unmet needs of patients with SLE managed in the community setting is required.
A systematic review of ambulance service-based randomised controlled trials in stroke
Authors: Dixon Mark , Appleton Jason P. , Siriwardena A. Niroshan , Williams Julia , Bath Philip M. 
Published: July 2023

Abstract
Background
Treatment for stroke is time-dependent, and ambulance services play a vital role in the early recognition, assessment and transportation of stroke patients. Innovations which begin in ambulance services to expedite delivery of treatments for stroke are developing. However, research delivery in ambulance services is novel, developing and not fully understood.

Aims
To synthesise literature encompassing ambulance service-based randomised controlled interventions for acute stroke with consideration to the characteristics of the type of intervention, consent modality, time intervals and issues unique to research delivery in ambulance services.

Summary of review
Online searches of MEDLINE, EMBASE, Web of Science, CENTRAL and WHO IRCTP databases and hand searches identified 15 eligible studies from 538. Articles were heterogeneous in nature and meta-analysis was partially available as 13 studies reported key time intervals, but terminology varied. Randomised interventions were evident across all points of contact with ambulance services: identification of stroke during the call for help, higher dispatch priority assigned to stroke, on-scene assessment and clinical interventions, direct referral to comprehensive stroke centres and definitive care delivery at scene. Consent methods ranged between informed patient, waiver and proxy modalities with country-specific variation. Challenges unique to the prehospital setting comprise the geographical distribution of ambulance resources, low recruitment rates, prolonged recruitment phases, management of investigational medicinal product and incomplete datasets.

Conclusion
Research opportunities exist across all points of contact between stroke patients and ambulance services, but randomisation and consent remain novel. Early collaboration and engagement between trialists and ambulance services will alleviate some of the complexities reported.

Registration number
PROSPERO 2018CRD42018075803
A systematic review of the use of bacteriophages for in vitro biofilm control
Authors: Meneses Luciana , Brandão Ana Catarina , Coenye Tom , Braga Ana Cristina , Pires Diana Priscila , Azeredo Joana 
Published: July 2023

AbstractBacteriophages (phages) are very promising biological agents for the prevention and control of bacterial biofilms. However, little is known about the parameters that can influence the efficacy of phages on biofilms. This systematic review provides a summary and analysis of the published data about the use of phages to control pre-formed biofilms in vitro, suggesting recommendations for future experiments in this area. A total of 68 articles, containing data on 605 experiments addressing the efficacy of phages to control biofilms in vitro were included, after a search conducted in Web of Science, Embase, and Medline (PubMed). The data collected from each experiment included information about biofilm growth conditions, phage characteristics, treatment conditions and biofilm reduction. In most cases, biofilms were formed in the surface of microtiter plates (82.5%); the median time for biofilm formation was 24 h, as is the median treatment duration. Quantification of biofilm biomass (52.6%), viable cells (25.5%) and metabolic activity (17.9%) were the most common biofilm assessment methods. Correlation analysis revealed that some phage parameters can influence the treatment outcome: higher phage concentrations were strongly associated with improved biofilm control, leading to higher levels of biofilm reduction, and phages with higher burst sizes and shorter latent periods seem to be the best candidates to control biofilms in vitro. However, the great variability of the methodologies used prompts the need for the development of standardized in vitro methodologies to characterize phage/biofilm interactions and to assess the efficacy of phages to control biofilms.
Post-infarct evolution of ventricular and myocardial function
Authors: Janssens K. L. P. M. , Kraamer M. , Barbarotta L. , Bovendeerd P. H. M. 
Published: July 2023

AbstractAdverse ventricular remodeling following acute myocardial infarction (MI) may induce ventricular dilation, fibrosis, and loss of global contractile function, possibly resulting in heart failure (HF). Understanding the relation between the time-dependent changes in material properties of the myocardium and the contractile function of the heart may further our understanding of the development of HF post-MI and guide the development of novel therapies. A finite element model of cardiac mechanics was used to model MI in a thick-walled truncated ellipsoidal geometry. Infarct core and border zone comprised 9.6 and 8.1% of the LV wall volume, respectively. Acute MI was modeled by inhibiting active stress generation. Chronic MI was modeled by the additional effect of infarct material stiffening, wall thinning and fiber reorientation. In acute MI, stroke work decreased by 25%. In the infarct core, fiber stress was reduced but fiber strain was increased, depending on the degree of infarct stiffening. Fiber work density was equal to zero. Healthy tissue adjacent to the infarct showed decreased work density depending on the degree of infarct stiffness and the orientation of the myofibers with respect to the infarct region. Thinning of the wall partially restored this loss in work density while the effects of fiber reorientation were minimal. We found that the relative loss in pump function in the infarcted heart exceeds the relative loss in healthy myocardial tissue due to impaired mechanical function in healthy tissue adjacent to the infarct. Infarct stiffening, wall thinning and fiber reorientation did not affect pump function but did affect the distribution of work density in tissue adjacent to the infarct.