bluuebunny/crossref_metadata_2025_split huggingface dataset:
Spatial multi-omics revealed the impact of tumor ecosystem heterogeneity on immunotherapy efficacy in patients with advanced non-small cell lung cancer treated with bispecific antibody
Authors: Song Xinyu , Xiong Anwen , Wu Fengying , Li Xuefei , Wang Jing , Jiang Tao , Chen Peixin , Zhang Xiaoshen , Zhao Zhikai , Liu Huifang , Cheng Lei , Zhao Chao , Wang Zhehai , Pan Chaohu , Cui Xiaoli , Xu Ting , Luo Haitao , Zhou Caicun 
Published: February 2023

BackgroundImmunotherapy for malignant tumors has made great progress, but many patients do not benefit from it. The complex intratumoral heterogeneity (ITH) hindered the in-depth exploration of immunotherapy. Conventional bulk sequencing has masked intratumor complexity, preventing a more detailed discovery of the impact of ITH on treatment efficacy. Hence, we initiated this study to explore ITH at the multi-omics spatial level and to seek prognostic biomarkers of immunotherapy efficacy considering the presence of ITH.MethodsUsing the segmentation strategy of digital spatial profiling (DSP), we obtained differential information on tumor and stromal regions at the proteomic and transcriptomic levels. Based on the consideration of ITH, signatures constructed by candidate proteins in different regions were used to predict the efficacy of immunotherapy.ResultsEighteen patients treated with a bispecific antibody (bsAb)-KN046 were enrolled in this study. The tumor and stromal areas of the same samples exhibited distinct features. Signatures consisting of 11 and 18 differentially expressed DSP markers from the tumor and stromal areas, respectively, were associated with treatment response. Furthermore, the spatially resolved signature identified from the stromal areas showed greater predictive power for bsAb immunotherapy response (area under the curve=0.838). Subsequently, our stromal signature was validated in an independent cohort of patients with non-small cell lung cancer undergoing immunotherapy.ConclusionWe deciphered ITH at the spatial level and demonstrated for the first time that genetic information in the stromal region can better predict the efficacy of bsAb treatment.Trial registration numberNCT03838848.
Using a validated case mix tool for use in the telephone-assisted triage of patients in a specialist palliative care community setting: a consecutive case series
Authors: Hough Emer , Lucey Michael , O'Reilly Martina , Featherstone Hannah , Twomey Feargal , Coffey Siobhan 
Published: February 2023

ObjectivesAllocating resources in palliative care is challenging due to the nature of life-limiting illness coupled with the propensity for significant physical symptoms and psychological distress. At present, there is no established system for triaging referrals and prioritising resource allocation.This study aimed to evaluate the feasibility of using a case mix assessment tool for telephone-assisted triaging of referrals to a specialist palliative care service. This assessed a patient’s phase of illness, Problem Severity Score (PSS) for complexity of symptom burden and psychological distress, and functional status.MethodsUsing a prospective consecutive case series approach, 450 referrals to community palliative care over a 6-month period were assessed. Scores for phase of illness, PSS and functional status were assessed at triage, as was the triage category of urgency of response.ResultsAnalysis demonstrated that phase of illness corresponds with triage category, with terminal or unstable phase patients significantly associated with urgent (category 1) referrals and highest priority for review. Decreased functional status and high PSS were useful predictors for increased urgency of referral.ConclusionsThese results demonstrate that this case mix tool could assist in the telephone assessment and triage of referrals to community palliative care.
Robustness of quantum reinforcement learning under hardware errors
Authors: Skolik Andrea , Mangini Stefano , Bäck Thomas , Macchiavello Chiara , Dunjko Vedran 
Published: February 2023

AbstractVariational quantum machine learning algorithms have become the focus of recent research on how to utilize near-term quantum devices for machine learning tasks. They are considered suitable for this as the circuits that are run can be tailored to the device, and a big part of the computation is delegated to the classical optimizer. It has also been hypothesized that they may be more robust to hardware noise than conventional algorithms due to their hybrid nature. However, the effect of training quantum machine learning models under the influence of hardware-induced noise has not yet been extensively studied. In this work, we address this question for a specific type of learning, namely variational reinforcement learning, by studying its performance in the presence of various noise sources: shot noise, coherent and incoherent errors. We analytically and empirically investigate how the presence of noise during training and evaluation of variational quantum reinforcement learning algorithms affect the performance of the agents and robustness of the learned policies. Furthermore, we provide a method to reduce the number of measurements required to train Q-learning agents, using the inherent structure of the algorithm.
Investigation of Caring Behavior and Caring Burden and Their Associated Factors among Nurses Who Cared for Patients with COVID-19 in East Guilan, the North of Iran
Authors: Darvishpour Azar , Mahdavi Fashtami Shiva 
Published: February 2023

Background. Nurses experience caring burdens, which can affect their caring behaviors. Caring for highly infectious patients, in particular COVID-19, is a new phenomenon and little is known about it. Considering that caring behaviors can be influenced by various factors and cultural differences of the society, it is necessary to conduct studies about caring behaviors and caring burdens. Thus, this study aimed to determine caring behavior and caring burden and their relationship with some associated factors among nurses who cared for patients with COVID-19. Materials and Methods. This cross-sectional, descriptive design study was conducted by census sampling on 134 nurses working in public health centers in East Guilan, the north of Iran, in 2021. The research instruments included the Caring Behavior Inventory (CBI-24) and the Caregiver Burden Inventory (CBI). Descriptive and inferential statistics were used to analyze the data using SPSS software version 20 with a significant level of 0.05. Results. The mean score of caring behavior and caring burden in nurses was 126.50 (SD = 13.63) and 43.65 (SD = 25.16), respectively. There was a significant relationship between caring behavior and some demographic characteristics (education, place of living, and history of COVID-19) and between caring burden and some demographic characteristics (housing status, job satisfaction, intention to change job, and history of COVID-19) (

p

< 0.05). Conclusions. Findings showed that despite the new emergence of COVID-19, the caring burden on nurses was moderate and they had good caring behavior. Despite these results, it is necessary for the relevant managers to pay special attention to protecting health workers during a national crisis such as COVID-19 so that they experience less caring burden and improve caring behavior.
Retrieval of Normalized Gamma Size Distribution Parameters Using Precipitation Imaging Package (PIP) Snowfall Observations during ICE-POP 2018
Authors: Tokay Ali , Liao Liang , Meneghini Robert , Helms Charles N. , Munchak S. Joseph , Wolff David B. , Gatlin Patrick N. 
Published: February 2023

Abstract
Parameters of the normalized gamma particle size distribution (PSD) have been retrieved from the Precipitation Image Package (PIP) snowfall observations collected during the International Collaborative Experiment–PyeongChang Olympic and Paralympic winter games (ICE-POP 2018). Two of the gamma PSD parameters, the mass-weighted particle diameter Dmass and the normalized intercept parameter NW, have median values of 1.15–1.31 mm and 2.84–3.04 log(mm−1 m−3), respectively. This range arises from the choice of the relationship between the maximum versus equivalent diameter, Dmx–Deq, and the relationship between the Reynolds and Best numbers, Re–X. Normalization of snow water equivalent rate (SWER) and ice water content W by NW reduces the range in NW, resulting in well-fitted power-law relationships between SWER/NW and Dmass and between W/NW and Dmass. The bulk descriptors of snowfall are calculated from PIP observations and from the gamma PSD with values of the shape parameter μ ranging from −2 to 10. NASA’s Global Precipitation Measurement (GPM) mission, which adopted the normalized gamma PSD, assumes μ = 2 and 3 in its two separate algorithms. The mean fractional bias (MFB) of the snowfall parameters changes with μ, where the functional dependence on μ depends on the specific snowfall parameter of interest. The MFB of the total concentration was underestimated by 0.23–0.34 when μ = 2 and by 0.29–0.40 when μ = 3, whereas the MFB of SWER had a much narrower range (from −0.03 to 0.04) for the same μ values.
Cholecystectomy After Percutaneous Cholecystostomy for Acute Cholecystitis: Experience and Outcomes in an Academic Practice
Authors: Giannopoulos Spyridon , Makhecha Keith , Madduri Sathvik , Garcia Felix , Baumgartner Timothy C. , Stefanidis Dimitrios 
Published: February 2023

Percutaneous cholecystostomy (PC) tube insertion has been shown to be an effective treatment of acute cholecystitis (AC) as a temporary step to subsequent laparoscopic cholecystectomy (LC). However, the optimal time gap between PC implantation and LC has not been identified. Adult patients who underwent PC followed by LC for the treatment of AC between 2016 and 2020 were retrospectively reviewed and analyzed. One hundred twelve patients, consisting of 59.8% males, were included and received LC after a median of 65 [48 - 96.5] days following the PC placement. No deaths or reoperations occurred within 30 days, but 16 (14.3%) patients were readmitted, and 16 (14.3%) required subsequent reintervention. Although a longer interval between PC and LC had no effect on perioperative outcomes, it was associated with considerably longer intensive care unit (ICU) stay. According to these findings, patients may benefit from early LC following PC for the treatment of AC.
Survey of Diagnostic and Management Practices in Small Bowel Obstruction: Individual and Generational Variation Despite Practice Guidelines
Authors: Fakhry Samir M. , Duane Therèse M. , Garland Jeneva M. , Dunne James R. , Kurek Stanley J. , Hunt Darrell L. , Plurad David S. , Shillinglaw William C. , Carrick Matthew M. , Lieser Mark J. , Wyse Ransom J. , Wilson Nina Y. , Watts Dorraine D. 
Published: February 2023

Background: Small bowel obstruction (SBO) is a common disorder managed by surgeons. Despite extensive publications and management guidelines, there is no universally accepted approach to its diagnosis and management. We conducted a survey of acute care surgeons to elucidate their SBO practice patterns. Methods: A self-report survey of SBO diagnosis and management practices was designed and distributed by email to AAST surgeons who cared for adult SBO patients. Responses were analyzed with descriptive statistics and Chi-square test of independence at α = .05. Results: There were 201 useable surveys: 53% ≥ 50 years, 77% male, 77% at level I trauma centers. Only 35.8% reported formal hospital SBO management guidelines. Computed tomography (CT) scan was the only diagnostic exam listed as “essential” by the majority of respondents (82.6%). Following NG decompression, 153 (76.1%) would “always/frequently” administer a water-soluble contrast challenge (GC). There were notable age differences in approach. Compared to those ≥50 years, younger surgeons were less likely to deem plain abdominal films as “essential” (16.0% vs 40.2%; P < .01) but more likely to require CT scan (88.3% vs 77.6%; P = .045) for diagnosis and to “always/frequently” administer GC (84.0% vs 69.2%; P < .01). Younger surgeons used laparoscopy “frequently” more often than older surgeons (34.0% vs 21.5%, P = .05). Discussion: There is significant variation in diagnosis and management of SBO among respondents in this convenience sample, despite existing PMGs. Novel age differences in responses were observed, which prompts further evaluation. Additional research is needed to determine whether variation in practice patterns is widespread and affects outcomes.
Optimal Trauma Activation Criteria for “Found Down” Patients
Authors: Johnson Emily , Lee Janet S. , Brockman Valerie , Finch Heather , Rodriquez Jennifer , Decker Cassie , Stillman Zach , Schroeppel Thomas J. 
Published: February 2023

Introduction Patients who are found down (FD) with unknown mechanism of injury pose a triage dilemma. At the study institution, this population with any “suspicion of trauma” criteria were previously triaged as a trauma team activation (TTA) but due to high rates of mis-triage was modified to “signs of trauma.” The purpose of this study is to compare injured and uninjured FD patients to identify patient characteristics and outcomes, and to evaluate triage accuracy of signs of trauma. Methods A single-center retrospective review was conducted on adult patients who were FD between 1/2019 and 4/2021. Based on injury severity score (ISS), FD patients were categorized as injured or uninjured and these groups were compared. Sensitivity and specificity were calculated for signs and suspicion of trauma as triage criteria, where suspicion of trauma included altered mental status, confusion, seizures, intoxication, or dementia. Signs of trauma were defined as abrasions, lacerations, ecchymosis, contusions, hematomas, deformity, pain, and crepitus. Results 415 FD patients were identified with 273 (65.8%) sustaining injury and 142 (34.2%) uninjured. There were no differences in age, gender, Glasgow Coma Scale (GCS) score, or vital signs. Signs of trauma had high sensitivity (96.0%) and moderate specificity (82.4%) for injury, whereas suspicion of trauma had low sensitivity (2.2%) and specificity (37.3%). Conclusion Injured and uninjured FD trauma patients had similar characteristics on arrival including GCS and vitals, emphasizing the challenge of identifying patients with injury requiring trauma evaluation. Signs of trauma represent a valuable indicator of injury in the FD population.
Effect of Timing of Readmission to the ICU on Mortality in Trauma Patients Requiring Critical Care
Authors: O’Quinn Payton C. , Whitaker Fiona J. , Suresh Sapna , King Sarah A. , Smith Lou M. 
Published: February 2023

ICU readmission is associated with increased mortality. The primary goal of our investigation was to determine the impact of early ICU readmission on mortality and to identify clinical factors which contribute to early ICU readmission in the trauma population. We retrospectively reviewed 175 patients admitted to ICU in a single, academic Level I Trauma Center from January 2019 to December 2021. Early readmission was defined as readmission within 72 hours of discharge and late readmission as after 72 hours. Early readmission mortality rate was 2.8 times higher than late readmission. Statistically significant variables in early readmission were more operations >2 hours, shorter initial length of stay in ICU, lower hematocrit and paCO2 on ICU discharge, and presence of a psychiatric diagnosis. Additional prospective research is needed to guide the development of practice guidelines that reduce frequency, morbidity, and mortality associated with ICU readmission in the trauma population.
Parainfectious autoimmune encephalitis related to SARS-CoV-2 infection, presenting with catatonia
Authors: Aktan Suzgun Merve , Kochan Kızılkılıc Esra , Ucar Bostan Busra , Tutuncu Melih , Kızıltan Gunes 
Published: February 2023

Objective SARS-CoV-2 infection commonly affects both the central and peripheral nervous systems, resulting in a variety of neurological and psychiatric symptoms. Whereas the effects of SARS-CoV-2 on neuronal structures in the short and long-term are still controversial, neurological involvement secondary to SARS-CoV- 2 is heterogeneous in terms of clinical presentation, treatment response, and prognosis. Method A case of autoimmune encephalitis developing after SARS-CoV-2 is described in this article. Results The patient was admitted to the clinic with classical signs of catatonia and encephalopathy. The emergence of neuropsychiatric problems after the relief of SARS-CoV-2 symptoms suggests that symptoms were primarily related to immune processes. This patient demonstrated a good clinical response to symptomatic catatonia treatment and immune-modulatory agents and recovered both physically and cognitively without sequelae. Conclusion SARS-CoV-2 infection may involve encephalitic involvement and psychological symptoms (including catatonia) after the infection by triggering autoimmune pathways.
Ethanol Extracts of Eriobotrya japonica (Loquat) Seeds, Leaves, and Fruits Have Anti-obesity and Hypolipidemic Effects in Rats
Authors: Abdelrahman Zainab R. , Bustanji Yasser K. , Abdalla Shtaywy S. 
Published: February 2023

Background: Obesity is a serious public health problem contributing to development of several diseases, including hyperlipidemia, hyperglycemia, and hypertension. The plant Eriobotrya japonica (loquat) has been used in traditional Chinese medicine to treat many ailments and traditional healers used it to reduce weight. Objectives: To examine the potential anti-obesity and hypolipidemic effects of ethanol extract of loquat in rats. Materials and Methods: Loquat leaves, fruits, or seeds were extracted with ethanol. About 96 Wistar male rats were fed either a normal rat diet (normal control group; group 1) or a high-fat diet (HFD) for 12 weeks (obese; groups 2−12). Obese rats were divided into11 groups as follows: (obese control: group 2) (obese positive control which received the hypolipidemic reference drug atorvastatin: group 3). Groups (4−6), (7−9), and (10−12) were given seed, leaf, or fruit extract, respectively, at 40,100, and 400 mg/kg. Body weight, serum glucose, lipid profile, creatinine, liver enzymes, albumin, and total protein were measured weekly. Results: HFD consumption significantly increased body weight and serum total cholesterol (TC), triglycerides (TGs), low-density lipoprotein (LDL), very-low density lipoprotein (VLDL), and glucose and decreased HDL compared to rats fed the normal diet. HFD also increased serum glutamic-oxaloacetic transaminase (GOT), gamma-glutamyl transferase (GGT), alkaline phosphatase (ALP) and creatinine but decreased serum albumin and total protein. Administration of E. japonica seed, leaf, or fruit extract significantly decreased body weight, TC, TGs, LDL, VLDL, glucose, liver, and renal enzymes but increased HDL, albumin, and total protein levels. Conclusion: E. japonica seed, leaf, and fruit ethanol extract regulates body weight gain, has hypolipidemic properties, and positively affects liver and kidney enzymes.
Eating disorders in young people
Authors: Phillipou Andrea , McGorry Patrick , Killackey Eóin , Maguire Sarah 
Published: February 2023

Objective Eating disorders (EDs) have their onset most frequently in adolescence and young adulthood. Treatment for EDs lack efficacy, and we have made little progress in improving outcomes for patients over the course of the last several decades. As with other mental health conditions, early intervention may greatly improve outcomes, yet, little research exists in this area. Conclusions More effective evidence-based treatments are sorely needed for EDs, particularly for early stages of the illness to minimise the potential harms of treatment and long-standing illness. Treatment service models would also benefit from taking an approach that ensures continuation of care from adolescence to young adulthood.
Conforming to the anatomy and not the standard: A technique of eccentric capsulorrhexis and intraocular lens haptic amputation for eyes with iris coloboma
Authors: Franco Jovany J. , Pineda Roberto 
Published: February 2023

Purpose To describe a novel technique for cataract surgery in patients with iris coloboma. Methods The technique involves 1) creation of an inferiorly displaced capsulorrhexis and 2) amputation of one intraocular lens (IOL) haptic, thus allowing for controlled IOL decentration in the direction of an inferior iris defect. Results We report favorable outcomes in two eyes (one patient) where eccentric capsulorrhexis and haptic amputation were employed during one-piece IOL repositioning in one eye and cataract surgery with three-piece IOL implantation in the contralateral eye. Conclusion In coloboma patients who are asymptomatic from their iris defect and do not have a cosmetic desire for repair, eccentric capsulorrhexis and IOL haptic amputation is a viable surgical option that allows for the preservation of a clear visual axis without the need for iris repair.
A new model for predicting the occurrence of polycystic ovary syndrome: Based on data of tongue and pulse
Authors: Wang Weiying , Zeng Weiwei , He Shunli , Shi Yulin , Chen Xinmin , Tu Liping , Yang Bingyi , Xu Jiatuo , Yin Xiuqi 
Published: February 2023

Background and objective Polycystic ovary syndrome is one of the most common types of endocrine and metabolic diseases in women of reproductive age that needs to be screened early and assessed non-invasively. The objective of the current study was to develop prediction models for polycystic ovary syndrome based on data of tongue and pulse using machine learning techniques. Methods A dataset of 285 polycystic ovary syndrome patients and 201 healthy women were investigated to identify the significant tongue and pulse parameters for predicting polycystic ovary syndrome. In this study, feature selection was performed using least absolute shrinkage and selection operator regression. Several machine learning algorithms (multilayer perceptron classifier, eXtreme gradient boosting classifier, and support vector machine) were used to construct the classification models to predict the presence of polycystic ovary syndrome. Results TB-L, TB-a, TB-b, TC-L, TC-a, h3, and h4/h1 in tongue and pulse parameters were statistically associated with polycystic ovary syndrome presence. Among the several machine learning techniques, the support vector machine model was optimal for the comprehensive evaluation of this dataset and deduced the area under the receiver operating characteristic curve, DeLong test, calibration curve, and decision curve analysis. Conclusion The machine learning model with tongue and pulse factors can predict the existence of polycystic ovary syndrome precisely.
Open Bankart Repair
Authors: Rasyid Hermawan Nagar , Prasetia Renaldi 
Published: February 2023

Shoulder instability is one of the most common complaints seen by orthopaedic surgeons taking care of an athletic patient. The management of shoulder instability has varied over the years and significant controversy and debate about the proper management of this pathology. The surgical treatment of anterior shoulder instability can present a dilemma. Historically, an open Bankart repair was the benchmark solution. Over the last decade as surgeons became more arthroscopically safe, the pendulum swung and a paradigm shift occurred. However, more recent studies have challenged this trend and, subsequently, revived interest in open repair. Thus, we feel it is critical to provide a more contemporary stepwise description of a procedure that has become essentially abandoned. The goal is to provide tips and pearls to achieve optimal exposure and, ultimately, a robust repair for a notoriously challenging operation. Patient selection, risk factors, and pathology are crucialin makig the correct treatment decision. The benefits of open Bankart repair including the indication of open Bankart repair will be discussed. Additionally, a reliable surgical technique will be presented