bluuebunny/crossref_metadata_2025_split huggingface dataset:
Influence of beam pruning techniques on LET and RBE in proton arc therapy
Authors: Henjum Helge , Tjelta Johannes , Fjæra Lars Fredrik , Pilskog Sara , Stokkevåg Camilla H. , Lyngholm Erlend , Handeland Andreas H. , Ytre-Hauge Kristian S. 
Published: September 2023

IntroductionProton arc therapy (PAT) is an emerging treatment modality that holds promise to improve target volume coverage and reduce linear energy transfer (LET) in organs at risk. We aimed to investigate if pruning the highest energy layers in each beam direction could increase the LET in the target and reduce LET in tissue and organs at risk (OAR) surrounding the target volume, thus reducing the relative biological effectiveness (RBE)-weighted dose and sparing healthy tissue.MethodsPAT plans for a germinoma, an ependymoma and a rhabdomyosarcoma patient were created in the Eclipse treatment planning system with a prescribed dose of 54 Gy(RBE) using a constant RBE of 1.1 (RBE1.1). The PAT plans was pruned for high energy spots, creating several PAT plans with different amounts of pruning while maintaining tumor coverage, denoted PX-PAT plans, where X represents the amount of pruning. All plans were recalculated in the FLUKA Monte Carlo software, and the LET, physical dose, and variable RBE-weighted dose from the phenomenological Rørvik (ROR) model and an LET weighted dose (LWD) model were evaluated.Results and discussionFor the germinoma case, all plans but the P6-PAT reduced the mean RBE-weighted dose to the surrounding healthy tissue compared to the PAT plan. The LET was increasingly higher within the PTV for each pruning iteration, where the mean LET from the P6-PAT plan was 1.5 keV/μm higher than for the PAT plan, while the P4- and P5-PAT plans provided an increase of 0.4 and 0.7 keV/μm, respectively. The other plans increased the LET by a smaller margin compared to the PAT plan. Likewise, the LET values to the healthy tissue were reduced for each degree of pruning. Similar results were found for the ependymoma and the rhabdomyosarcoma case. We demonstrated a PAT pruning technique that can increase both LET and RBE in the target volume and at the same time decreased values in healthy tissue, without affecting the target volume dose coverage.
Delta radiomic patterns on serial bi-parametric MRI are associated with pathologic upgrading in prostate cancer patients on active surveillance: preliminary findings
Authors: Midya Abhishek , Hiremath Amogh , Huber Jacob , Sankar Viswanathan Vidya , Omil-Lima Danly , Mahran Amr , Bittencourt Leonardo K. , Harsha Tirumani Sree , Ponsky Lee , Shiradkar Rakesh , Madabhushi Anant 
Published: September 2023

ObjectiveThe aim of this study was to quantify radiomic changes in prostate cancer (PCa) progression on serial MRI among patients on active surveillance (AS) and evaluate their association with pathologic progression on biopsy.MethodsThis retrospective study comprised N = 121 biopsy-proven PCa patients on AS at a single institution, of whom N = 50 at baseline conformed to the inclusion criteria. ISUP Gleason Grade Groups (GGG) were obtained from 12-core TRUS-guided systematic biopsies at baseline and follow-up. A biopsy upgrade (AS+) was defined as an increase in GGG (or in number of positive cores) and no upgrade (AS−) was defined when GGG remained the same during a median period of 18 months. Of N = 50 patients at baseline, N = 30 had MRI scans available at follow-up (median interval = 18 months) and were included for delta radiomic analysis. A total of 252 radiomic features were extracted from the PCa region of interest identified by board-certified radiologists on 3T bi-parametric MRI [T2-weighted (T2W) and apparent diffusion coefficient (ADC)]. Delta radiomic features were computed as the difference of radiomic feature between baseline and follow-up scans. The association of AS+ with age, prostate-specific antigen (PSA), Prostate Imaging Reporting and Data System (PIRADS v2.1) score, and tumor size was evaluated at baseline and follow-up. Various prediction models were built using random forest (RF) classifier within a threefold cross-validation framework leveraging baseline radiomics (Cbr), baseline radiomics + baseline clinical (Cbrbcl), delta radiomics (CΔr), delta radiomics + baseline clinical (CΔrbcl), and delta radiomics + delta clinical (CΔrΔcl).ResultsAn AUC of 0.64 ± 0.09 was obtained for Cbr, which increased to 0.70 ± 0.18 with the integration of clinical variables (Cbrbcl). CΔr yielded an AUC of 0.74 ± 0.15. Integrating delta radiomics with baseline clinical variables yielded an AUC of 0.77 ± 0.23. CΔrΔclresulted in the best AUC of 0.84 ± 0.20 (p &lt; 0.05) among all combinations.ConclusionOur preliminary findings suggest that delta radiomics were more strongly associated with upgrade events compared to PIRADS and other clinical variables. Delta radiomics on serial MRI in combination with changes in clinical variables (PSA and tumor volume) between baseline and follow-up showed the strongest association with biopsy upgrade in PCa patients on AS. Further independent multi-site validation of these preliminary findings is warranted.
Parasitemia and antibody response to benznidazole treatment in a cohort of patients with chronic Chagas disease
Authors: Moreira Carlos Henrique Valente , Bierrenbach Ana Luiza , Taconeli Cesar Augusto , de Oliveira-da Silva Léa Campos , Buss Lewis F. , Keating Sheila M. , Manuli Erika Regina , Carvalho Noemia Barbosa , Guastini Cristina , Coco Sonia Bakkour , Lindoso José Ângelo Lauletta , Franco Lucas Augusto Moyses , Ghilardi Fabio , Sales Flavia Cristina da Silva , Contestable Paul , Di Germanio Clara , Busch Michael P. , Sabino Ester Cerdeira 
Published: September 2023

BackgroundEvaluating the effectiveness of Chagas disease treatment poses challenges due to the lack of biomarkers for disease progression and therapeutic response. In this study, we aimed to assess the clearance of Trypanosoma cruzi (T. cruzi) parasites in a group of benznidazole (BNZ)-treated chronic Chagas disease patients using high-sensitivity quantitative PCR (qPCR) and track T. cruzi antibody levels through a semiquantitative chemiluminescent assay.MethodsA total of 102 T. cruzi seropositive patients with previous PCR-positive results were enrolled in the study. We collected samples 30 days before treatment (T-30d), on the day before initiating BNZ treatment (T0d), and at follow-up visits 60 days (T60d), 6 months (T6M), 12 months (T12M), and 36 months (T36M) after treatment initiation. Treatment efficacy was assessed by testing of serial samples using a target-capture qPCR assay specific to satellite T. cruzi DNA and the ORTHO T. cruzi ELISA Test System for antibody quantitation.ResultsOf the enrolled individuals, 87 completed at least 50% of the treatment course, and 86 had PCR results at follow-up visits T6M, T12M, and T36M. PCR results exhibited fluctuations before and after treatment, but levels were significantly lower post-treatment. Only 15 cases consistently tested PCR-negative across all post-treatment visits. Notably, nearly all participants demonstrated a declining antibody trajectory, with patients who tested PCR-negative at T36M exhibiting an earlier and more pronounced decline compared to PCR-positive cases at the same visit.ConclusionOur study suggests that serial PCR results pose challenges in interpretation. In contrast, serial antibody levels may serve as an ancillary, or even a more reliable indicator of parasite decline following BNZ treatment. Monitoring antibody levels can provide valuable insights into the efficacy of treatment and the persistence of parasites in Chagas disease patients.
Empathy and bystander helping behavior in cyberbullying among adolescents: the mediating role of internet moral judgment and the moderating role of internet self-efficacy
Authors: Hu Yang , Zhang Tian , Shi Hui-fen , Fan Cui-ying 
Published: September 2023

IntroductionCyberbullying poses a significant challenge among adolescents. If bystanders stand up and help victims, their helping behavior may be able to reduce the frequency and negative impact of cyberbullying. This study investigates the association of empathy, internet moral judgment, and internet self-efficacy with bystander helping behavior among adolescents, building upon the empathy-altruism hypothesis, bystander intervention model, and dual-process model of morality.MethodsA sample of 919 Chinese adolescents from 3 schools in Hunan, Jiangxi and Guangdong provinces completed the Basic Empathy Scale, Internet Moral Judgment Questionnaire, Internet Self-Efficacy Questionnaire and Styles of Bystander Intervention Scale. And we constructed a moderated mediation model to examine the relationship between empathy and bystander helping behavior in cyberbullying and assessed the mediating role of internet moral judgment and the moderating role of internet self-efficacy.ResultsOur findings revealed a significant positive correlation between empathy and bystander helping behavior in cyberbullying. Internet moral judgment mediated the relationship between empathy and helping behavior, whereas internet self-efficacy moderated the latter half of the mediation pathway. Specifically, the association between internet moral judgment and helping behavior was stronger for bystanders with higher levels of internet self-efficacy compared with those that have lower levels.DiscussionThese results further deepen our understanding of the mechanisms involved in bystander helping behavior in cyberbullying, thus providing a basis for future interventions to encourage more helping actions from bystanders during cyberbullying incidents.
Quality of life in families under quarantine: a cross-sectional study in seven countries during the first outbreak of COVID-19
Authors: Moya-Salazar Jeel , Chiu-Higa Erika , Jaime-Quispe Alexis , Cañari Betsy , Moya-Espinoza Jeel G. , Contreras-Pulache Hans 
Published: September 2023

BackgroundThe COVID-19 pandemic has disrupted human well-being worldwide in unforeseen ways. In early 2020, the spread of the virus left its mark on every affected country, impacting mental health by limiting daily activities and causing fatalities amidst public health strategies to mitigate its impact. The influence of COVID-19 on the quality of life (QoL) may vary between countries, underscoring the need to examine its effects on individuals and families during the mandatory home quarantine. We aimed to assess the QoL of individuals and families during home isolation by COVID-19 lockdown.MethodsA cross-sectional study was conducted from February to May 2020. We included adult partners (≥18 years) of families from Brazil, Colombia, Spain, Japan, Peru, Russia, and Venezuela. Using the 26-item World Health Organization Quality of Life Brief (WHOQOL-BREF) questionnaire we assess the impact of COVID-19 on their partner/family member’s QoL.ResultsThe survey was completed by 466 participants (mean age = 38.59 ± 13.75 years; females = 298) and 76% worked mostly as health professionals from South America (69.2%), Europe (18.4%), and Asia (12.4%). The WHOQOL-BREF mean score from 38.38 ± 11.55 (range = 22.8–43.4). The average quality of life in South America (41.9 ± 1.2) was significantly higher than that of European countries (30.9 ± 11.5) (p = 0.002). The social relations dimension was the only one with values close to 100 (mean = 83.3) in 6/7 evaluated countries, where only Spain had a low score (41 ± 33.12). Women had a slightly lower quality of life than men, but it was not significant (40.2 ± 8.8 vs. 41.5 ± 9.9, p = 0.354), while we found differences in the overall QoL between young and older, and by employment type (p &lt; 0.05). According to family structure, we found differences on QoL between nuclear and siblings’ families (p = 0.024).ConclusionFamilies from seven countries of three continents reported poor QoL during the first outbreak of COVID-19. The pandemic scenario has dramatically weakened the QoL in 3/4 dimensions, where social relationships have remained high. It is important to fully address the impact of this reduced QoL on families after several waves of infection and to provide comprehensive support in the post-COVID future.
Neurocognitive outcomes of children exposed to and living with HIV aged 3–5 years in Kilifi, Kenya
Authors: Chongwo Esther Jebor , Wedderburn Catherine J. , Nyongesa Moses Kachama , Sigilai Antipa , Mwangi Paul , Thoya Janet , Odhiambo Rachel , Ngombo Katana , Kabunda Beatrice , Newton Charles R. , Abubakar Amina 
Published: September 2023

IntroductionGlobally, 1.7 million children are living with HIV, with the majority of them residing in sub-Saharan Africa. Due to reduced rates of vertical transmission of HIV, there is an increasing population of children born to HIV-infected mothers who remain uninfected. There is a growing concern around the development of these children in the antiretroviral therapy era. This study examined the neurocognitive outcomes of children who are HIV-exposed infected (CHEI), HIV-exposed uninfected (CHEU) and HIV-unexposed uninfected (CHUU) and explored the relationship between child neurocognitive outcomes and child's biomedical and caregivers’ psychosocial factors.MethodsCHEI, CHUU and CHEU aged 3–5 years and their caregivers were recruited into the study. Neurocognitive outcomes were assessed using a validated battery of assessments. One-way analysis of variance and covariance (ANOVA and ANCOVA) were used to evaluate differences among the three groups by neurocognitive outcomes. Linear regression models were used to investigate the association between child neurocognitive outcomes and biomedical factors (nutritional status, HIV disease staging) and caregivers’ psychosocial factors [symptoms of common mental disorders (CMDs) and parenting behaviour].ResultsThe study included 153 children and their caregivers: 43 (28.1%) CHEI, 52 (34.0%) CHEU and 58 (39.9%) CHUU. ANOVA and ANCOVA revealed a significant difference in cognitive ability mean scores across the child groups. Post hoc analysis indicated that CHEU children had higher cognitive ability mean scores than the CHUU group. Better nutritional status was significantly associated with higher cognitive ability scores (β = 0.68, 95% CI [0.18–1.18], p = 0.008). Higher scores of CMDs were negatively associated with inhibitory control (β = −0.28, 95% CI [−0.53 to 0.02], p = 0.036). While comparing HIV stages 2 and 3, large effect sizes were seen in working memory (0.96, CI [0.08–1.80]) and cognitive ability scores (0.83 CI [0.01–1.63]), indicating those in stage 3 had poor performance.ConclusionsNeurocognitive outcomes were similar across CHEI, CHEU and CHUU, although subtle differences were seen in cognitive ability scores where CHEU had significantly higher cognitive mean scores than the CHUU. Well-designed longitudinal studies are needed to ascertain these findings. Nonetheless, study findings underscore the need for strategies to promote better child nutrition, mental health, and early antiretroviral therapy initiation.
Is non-mentored initiation of laparoscopic colorectal surgery safe? Single surgeon initial experience with the first 40 cases
Authors: Bakula Branko 
Published: September 2023

IntroductionAlthough laparoscopic colorectal surgery is now accepted as a standard procedure in treating colorectal cancer, the proportion of laparoscopically operated patients with colorectal cancer is still generally quite low. The aim of this study is to assess feasibility, safety, and outcomes of a non-mentored initiation of laparoscopic colorectal resections by a young surgeon without previous experience in laparoscopic colorectal surgery.Materials and methodsWe analyzed the characteristics of the first 40 elective cases of laparoscopic colorectal resections performed by a single surgeon during the period between June 2019 and March 2022. All of the operations were performed without the attendance or supervision of an experienced surgeon in laparoscopic colorectal surgery. The patients were divided into three groups (the early, intermediate, and late group).ResultsThe conversion rate, complications rate, and postoperative recovery were similar among groups. The mean overall operative time was 219.5 min (range 130–420 min) and had reduced significantly during the learning curve (p = 0.047). The overall conversion rate was 12.5%. In two cases (5%), the oncological principles were violated (incomplete total mesorectal excision). In three patients (7.5%), intraoperative complications had occurred (small bowel injury, splenic injury, and significant bleeding from the minor peripancreatic artery). Three cases of major postoperative complications (Clavien–Dindo grade III) were recorded, two of which required reoperation (anastomotic bleeding and fascial dehiscence). There was no 90-day mortality reported. The overall mean number of lymph nodes retrieved was 12.45, which did not differ significantly among groups (p = 0.678). The average follow-up was 13.75 months (range 1–31 months). Cancer recurrence was recorded in four patients (10%). Port-site metastasis was not detected in any of the cases.ConclusionA safe and non-mentored initiation of laparoscopic colorectal surgery with an acceptable rate of complications and acceptable oncological results can be achieved. Still, when compared with a structured initiation in a controlled environment with the supervision of an experienced surgeon in laparoscopic colorectal surgery, the results of a non-mentored initiation are worse in most of the fields, including operative time, conversion rate, complications rate, and duration of hospital stay. Therefore, I strongly recommend engaging young surgeons in fellowship programs on structured laparoscopic colorectal surgery whenever possible before starting performing these procedures on their own.
Macromonas nakdongensis sp. nov., Isolated from Freshwater and Characterization of Bacteriophage BK-30P—The First Phage That Infects Genus Macromonas
Authors: Baek Kiwoon , Choi Ahyoung 
Published: September 2023

A Gram-stain-negative, non-motile, non-pigmented, rod-shaped bacterium was isolated from a freshwater sample of Nakdong River in South Korea and designated as strain BK-30T. An analysis of the 16S rRNA gene sequence of strain BK-30T revealed its closest phylogenetic neighbors were members of the genus Macromonas. Specifically, the strain formed a robust clade with Macromonas bipunctata DSM 12705T, sharing 98.4% similarity in their 16S rRNA gene sequences. The average nucleotide identity value between strain BK-30T and M. bipunctata DSM 12705T was 79.8%, and the genome-to-genome distance averaged 21.3%, indicating the representation of a novel genomic species. Strain BK-30T exhibited optimum growth at 30 °C and pH 7.0, in the absence of NaCl. The major respiratory isoprenoid quinone identified was ubiquinone-8 (Q-8). The principal fatty acids detected were C16:1 ω7c and/or C16:1 ω6c (49.6%), C16:0 (27.5%), and C18:1 ω7c and/or C18:1 ω6c (9.2%). The DNA G+C content of the strain was determined to be 67.3 mol%. Based on these data, we propose a novel species within the genus Macromonas, named Macromonas nakdongensis sp. nov., to accommodate the bacterial isolate. Strain BK-30T is designated as the type strain (=KCTC 52161T = JCM 31376T = FBCC-B1). Additionally, we present the isolation and complete genome sequence of a lytic phage infecting strain BK-30T, named BK-30P. This bacteriophage is the first reported to infect Macromonas, leading us to propose the name “Macromonasphage”.
Incidence and management of mallet finger in Dutch primary care: a cohort study
Authors: Krastman Patrick , de Schepper Evelien , Bindels Patrick , Bierma-Zeinstra Sita , Kraan Gerald , Runhaar Jos 
Published: September 2023

BackgroundA mallet finger (MF) is diagnosed clinically and can be managed in primary care. The actual incidence of MF and how it is managed in primary care is unknown.AimTo determine the incidence of MF in primary care and to obtain estimates for the proportions of osseous and tendon MF. An additional aim was to gain insight into the management of patients diagnosed with MF in primary care.Design & settingA cohort study using a healthcare registration database from general practice in the Netherlands.MethodPatients aged ≥18 years with a new diagnosis of MF from 1 January 2015–31 December 2019 were selected using a search algorithm based on International Classification of Primary Care (ICPC) coding.ResultsIn total, 161 cases of MF were identified. The mean incidence was 0.58 per 1000 person–years. A radiograph was taken in 58% (n= 93) of cases; 23% (n= 37) of cases had an osseous MF. The most applied strategies were referral to secondary care (45%) or conservative treatment in GP practice (43%). Overall, 7% were referred to a paramedical professional.ConclusionOn average, a Dutch GP assesses ≥1 patient with MF per year. Since only a minimal number of patients required surgical treatment and a limited number of GPs requested radiography, the recommendation in the guidelines to perform radiography in all patients with MF should potentially be reconsidered. The purpose of requesting radiographs should not be to distinguish between a tendinogenic or osseous MF, but to assess whether there is a possible indication for surgery.
Family Support and Motivation Relationship with Care for Children with Mental Disable
Authors: Saswati Nofrida , Harkomah Isti , Habibah Habibah 
Published: September 2023

Mentally retarded children have limited intelligence and limitations in self-careabilities. So it takes support and motivation from the family. It was knowing the relationship between family support, understanding the relationship between family support and motivation to care for children with mental disabled.
This research is a quantitative research with Cross Sectional design. This research was carried out on Agust 2021 at elementary school Sekolah Luar biasa. Total Sampling was used in this study, with a sample size of 54. We used family support questioner and motivation mother questioner. The association of the family support and motivation were confirmate by Chi-Square test test using SPSS 26.0.
The results of this study indicate that the majority of respondents have good family support, as many as 51.9% respondents, high motivation as many as 51.9% respondents, and mental disable child care well as many as 61.1% respondents. In addition, there is family support p-value = 0.045 (CI 95%) and motivation p-value = 0.047 (CI 95%) for mental disable child care.
The research results should be used as input for schools about the importance of family support for children with mental disable byproviding information and counseling about the care of children with mental disable both in the school environment and at home.