bluuebunny/crossref_metadata_2025_split huggingface dataset:
Competency‐based assessment of procedural skills in resident training
Authors: Meliagros Pete , Garber Adam , Sadr Nargiza , Forrest Rebecca , Qayyum Rehan 
Published: July 2023

AbstractBackgroundNo standardized summative tools exist to assess competency in bedside procedures or provide residents and programs with summative feedback.ObjectiveTo provide competency‐based procedure training and feedback to residents, we created a procedure competency committee (PCC). Here, we describe the PCC process, its impact on procedure training, and examine residents' attainment of competency in bedside procedures.Design, Setting, and ParticipantsThe PCC consisted of hospitalists and met twice annually to review resident procedure portfolios for three academic years 2019–2022 at a university‐based internal medicine residency program. Residents were designated to one of the five competency levels; being able to participate, perform under supervision with assistance, perform under direct supervision (DS) without assistance, perform independently with indirect supervision (IS), and perform independently with IS and supervise others. We analyzed the probability of advancing competency levels with each additional procedure using multinomial logistic regression models.ResultsOf the 97 residents, 48 (49.5%) were women and 60 (62%) subsequently matched in procedure‐oriented fields. More residents achieved IS level for paracentesis than for lumbar puncture (LP) or central venous catheterization (CVC) (62 vs. 25 and 37, respectively; p < .001). Each incremental procedure performed was associated with a higher chance of being advanced to IS group from the DS group; 1.31 times for paracentesis (95% confidence interval [CI] = 1.07, 1.60; p < .008), 1.83 times for LP (95% CI = 1.35, 2.47; p = .0001), and two times for CVC (95% CI = 1.32, 3.05; p = .001).ConclusionThe PCC provided competency‐based assessment of a resident's procedural skills and may be used to assess the impact of curriculum changes.
Soft tissues influence nasal airflow in diapsids: Implications for dinosaurs
Authors: Bourke Jason M. , Witmer Lawrence M. 
Published: July 2023

AbstractThe nasal passage performs multiple functions in amniotes, including olfaction and thermoregulation. These functions would have been present in extinct animals as well. However, fossils preserve only low‐resolution versions of the nasal passage due to loss of soft‐tissue structures after death. To test the effects of these lower resolution models on interpretations of nasal physiology, we performed a broadly comparative analysis of the nasal passages in extant diapsid representatives, e.g., alligator, turkey, ostrich, iguana, and a monitor lizard. Using computational fluid dynamics, we simulated airflow through 3D reconstructed models of the different nasal passages and compared these soft‐tissue‐bounded results to similar analyses of the same airways under the lower‐resolution limits imposed by fossilization. Airflow patterns in these bony‐bounded airways were more homogeneous and slower flowing than those of their soft‐tissue counterparts. These data indicate that bony‐bounded airway reconstructions of extinct animal nasal passages are far too conservative and place overly restrictive physiological limitations on extinct species. In spite of the diverse array of nasal passage shapes, distinct similarities in airflow were observed, including consistent areas of nasal passage constriction such as the junction of the olfactory region and main airway. These nasal constrictions can reasonably be inferred to have been present in extinct taxa such as dinosaurs.
Defining RSV epidemic season in southwest China and assessing the relationship between birth month and RSV infection: A 10‐year retrospective study from June 2009 to May 2019
Authors: Li Taoyu , Fang Heping , Liu Xiangyu , Deng Yu , Zang Na , Xie Jun , Xie Xiaohong , Luo Zhengxiu , Luo Jian , Liu Yulin , Fu Zhou , Ren Luo , Liu Enmei 
Published: July 2023

AbstractRespiratory syncytial virus (RSV) is one of the most common causes of lower respiratory tract infections (LRTI). However, only limited information is available regarding its seasonality and its relationship with birth month. A retrospective hospital‐based study was carried out from June 2009 to May 2019 in Chongqing, southwest of China. LRTI cases under 5 years were enrolled in this study and PCR was used to detect 8 respiratory viruses. RSV seasonality was determined using “average annual percentage” (AAP) and “percent positivity” method. A total of 6991 cases were enrolled in this study, with an RSV positivity of 34.5%. From June 2009 to May 2019, we analyzed RSV epidemic season during 10 RSV epidemic years in Chongqing using two methods. The result of AAP method was similar to that of percent positivity method with a 30% threshold, which showed an epidemic season of roughly October to March in the subsequent year, with a small peak in June. On average, the RSV epidemic season in RSV‐A dominant years typically started earlier (week 42 for RSV‐A vs. week 46 for RSV‐B), ended earlier (week 12 for RSV‐A vs. week 14 for RSV‐B), lasted longer (24 weeks for RSV‐A vs. 22 weeks for RSV‐B), and reached its peak earlier (week 2 for RSV‐A vs. week 3 for RSV‐B) than in RSV‐B dominant years. The proportion of severe LRTI was higher in cases of single infection with RSV‐A compared to those of single infection with RSV‐B (26.3% vs. 22.3%, p = 0.024). Among infants under 1 year, those born in May and August through December were more likely to be infected with RSV. Infants born 1–2 months before the epidemic season were relatively more susceptible to RSV infection. In Chongqing, the RSV epidemic was seasonal and usually lasted from October to March of next year with a small peak in summer. Infants born 1–2 months before the epidemic season were relatively more susceptible to RSV infection and this population should be targeted while developing RSV immunization strategies.
Parallel EM optimization using improved pole‐residue‐based neuro‐TF surrogate and isomorphic orthogonal DOE sampling for microwave components design
Authors: Na Wei‐Cong , Liu Wen‐Xu , Liu Ke , Feng Feng , Zhang Jia‐Nan , Zhang Wan‐Rong , Xie Hong‐Yun , Jin Dong‐Yue 
Published: July 2023

AbstractDirect electromagnetic (EM) optimization for microwave components design is usually a time‐consuming process. To improve the optimization efficiency, this paper proposes a novel parallel EM optimization technique exploiting improved pole‐residue‐based neuro‐transfer function (neuro‐TF) surrogate and isomorphic orthogonal design of experiment (DOE) sampling strategy. We propose a new sampling method combining isomorphic orthogonal DOE and parallel EM simulations to generate training data for developing the neuro‐TF surrogate. This proposed sampling method can ensure the scattered distribution of data samples in the overall optimization process, thus effectively improving the surrogate accuracy and increasing the optimization speed. We also propose a new pole‐residue tracking technique for order‐changing to solve the discontinuity problem of pole/residues during the neuro‐TF surrogate development. Different from the fixed split ratio in existing pole‐residue tracking technique, the split ratio of poles and residues in the proposed technique is adaptive and determined according to the information of neighboring samples. Therefore, the continuity and smoothness of pole/residues after the splitting are improved, so as the neuro‐TF surrogate accuracy. In addition, the trust region algorithm is exploited during EM optimization to improve the convergence speed. In this way, the proposed EM optimization technique obtains the optimal solution in a shorter time with fewer iterations than the existing techniques. Two examples of EM optimizations of microwave components are used to illustrate the proposed technique.
Vulnerability diffusions in software product networks
Authors: Kang Martin , Templeton Gary , Um SungYong 
Published: July 2023

AbstractDuring software product development, the combination of digital resources (such as application programming interfaces and software development kits) establishes loose and tight edges between nodes, which form a software product network (SPN). These edges serve as observable conduits that may help practitioners and researchers better understand how vulnerabilities diffuse through SPNs. We apply network theory to analyze data from over 12 years of records extracted from the National Vulnerability Database. We contribute novel measures established using machine learning to gauge the properties influencing vulnerability diffusion within an SPN. We observed an SPN having a discernable shape that changed over time via network updates. We propose hypotheses and find empirical evidence that vulnerability diffusion is influenced by edge dynamics, developer responses, and their interaction. Implications for practice are that increased developer responses reduce software vulnerability diffusion attributed to edge dynamics.
Dynamics of recurrence after curative resection of nonsmall cell lung cancer
Authors: Muraoka Yuji , Yotsukura Masaya , Yoshida Yukihiro , Nakagawa Kazuo , Shiraishi Kouya , Kohno Takashi , Yatabe Yasushi , Watanabe Shun‐ichi 
Published: July 2023

AbstractBackground and ObjectivesThis study examined the trend of hazards for postoperative recurrence of lung cancer according to pathologic stages.MethodsWe reviewed the records of 1987 patients who underwent resection for lung cancer between 2007 and 2012. Postoperative recurrence and development of second primary lung cancer were analyzed to evaluate the trend of hazard rate.ResultsRecurrence‐free survival (RFS) probabilities at 5 postoperative years in patients with stage I/II/III disease were 87.8%/54.7%,/33.4%, respectively. The hazard rate of RFS was consistently low (<0.005) for stage I patients for 5 years after surgery. The hazard rate of RFS for stage II patients showed a peak of 0.016 at 12.4 months after surgery, and that for stage III patients had a higher peak of 0.029 at 13.7 months after surgery, after which they showed a gradual decrease. The hazard rate for the development of second primary lung cancer exceeded that of recurrence of first primary lung cancer after 72 months postoperatively.ConclusionsShort‐interval postoperative surveillance might be unnecessary for stage I patients but should be considered in stage II/III patients. Screening of second primary lung cancer rather than surveillance of recurrence might be beneficial after more than 6 years postoperatively.
Close distal margin is associated with locoregional rectal cancer recurrence: A multicenter study
Authors: Varlamos Christopher J. , Sinco Brandy , Van Weiren Inga , Regenbogen Scott , Gamboa Adriana C. , Silviera Matthew , Abdel‐Misih Sherif R. Z. , Hawkins Alexander T. , Balch Glen , Hendren Samantha 
Published: July 2023

AbstractBackground and ObjectivesThe importance of the radial margin for rectal cancer resection is well understood. However, surgeons have deemphasized the distal margin, accepting very close distal margins to perform sphincter‐preserving surgery. We hypothesized that distal margins < 1 cm would be an independent risk factor for locoregional recurrence. The objective was to determine whether close distal margins are associated with increased locoregional recurrence risk.MethodsThis was a multi‐institutional retrospective cohort study conducted at six academic medical centers including patients who received low anterior resection surgery for primary rectal cancer between 2007 and 2018.ResultsOf 556 low anterior resection patients, the rate of close distal margin was 12.8% (n = 71), and the locoregional recurrence rate was 5.0% (n = 28). The locoregional recurrence rate for close distal margin cases was 9.9% (n = 7) compared to 4.3% (n = 21) for distal margins ≥1.0 cm. In multivariable analysis, the only factor significantly associated with locoregional recurrence was close distal margin (adjusted odds ratio: 2.80, confidence interval: 1.08–7.25, p = 0.035).ConclusionsRectal cancer patients with close distal margins (<1 cm) following low anterior resection had a significantly higher risk for locoregional recurrence. Therefore, the decision to perform low anterior resection with margins < 1 cm should be taken with caution.
MRI characteristics due to gene mutations in a Chinese pedigree with Lafora disease
Authors: Sun Yueqian , Zhou Ziqi , Wang Qun , Yan Jing , Zhang Zaiqiang , Cui Tao 
Published: July 2023

AbstractBackground and PurposeLafora disease (LD) is a very rare autosomal recessive disorder manifesting primarily as fatal, congenital, and neurodegenerative epilepsies. We aimed to describe the MRI characteristics due to gene mutations in a Chinese pedigree with LD.MethodsWhole‐exome sequencing, muscle biopsy, pedigree analysis, and MRI analysis were conducted. Five family members (two of whom were affected by LD) were whole‐genome sequenced. Longitudinal changes in brain MRI volumes were analyzed by Freesurfer.ResultsWe identified a new intron heterozygous mutation in the EMP2A gene c.71 (exon 1) G>A in a Chinese LD pedigree that was characterized by refractory seizures, progressive vision impairment, and declines in motor and cognitive functions. The patient suffered generalized tonic–clonic seizures since the age of 15 years and had severe forms of progressive myoclonic seizure. She eventually died after being admitted to the intensive care unit due to status epilepticus at the age of 24 years. Period acid Schiff staining showed positive polyglucosan particles in muscle biopsy specimens. Regions of atrophy in the whole brain, and especially in the hippocampus, were detected.ConclusionsWe identified a new heterozygous mutation (c.71+1G>A) in a Chinese LD pedigree, which broadens the mutation spectrum of LD genes. We found that the patient exhibited brain volumetric atrophy along with rapidly worsening symptoms. These results contribute to our understanding of LD.
Real‐time 3D reconstruction of guidewires and stents using two update X‐ray projections in a rotating imaging setup
Authors: Vöth Tim , Koenig Thomas , Eulig Elias , Knaup Michael , Wiesmann Veit , Hörndler Klaus , Kachelrieß Marc 
Published: July 2023

AbstractBackgroundVascular diseases are often treated minimally invasively. The interventional material (stents, guidewires, etc.) used during such percutaneous interventions are visualized by some form of image guidance. Today, this image guidance is usually provided by 2D X‐ray fluoroscopy, that is, a live 2D image. 3D X‐ray fluoroscopy, that is, a live 3D image, could accelerate existing and enable new interventions. However, existing algorithms for the 3D reconstruction of interventional material require either too many X‐ray projections and therefore dose, or are only capable of reconstructing single, curvilinear structures.PurposeUsing only two new X‐ray projections per 3D reconstruction, we aim to reconstruct more complex arrangements of interventional material than was previously possible.MethodsThis is achieved by improving a previously presented deep learning‐based reconstruction pipeline, which assumes that the X‐ray images are acquired by a continuously rotating biplane system, in two ways: (a) separation of the reconstruction of different object types, (b) motion compensation using spatial transformer networks.ResultsOur pipeline achieves submillimeter accuracy on measured data of a stent and two guidewires inside an anthropomorphic phantom with respiratory motion. In an ablation study, we find that the aforementioned algorithmic changes improve our two figures of merit by 75 % (1.76 mm → 0.44 mm) and 59 % (1.15 mm → 0.47 mm) respectively. A comparison of our measured dose area product (DAP) rate to DAP rates of 2D fluoroscopy indicates a roughly similar dose burden.ConclusionsThis dose efficiency combined with the ability to reconstruct complex arrangements of interventional material makes the presented algorithm a promising candidate to enable 3D fluoroscopy.
Multimodal fusion workflow for target delineation in cardiac radioablation of ventricular tachycardia
Authors: Rigal Louis , Benali Karim , Barré Valentin , Bougault Mathilde , Bellec Julien , Crevoisier Renaud De , Martins Raphaël , Simon Antoine 
Published: July 2023

AbstractBackgroundCardiac radioablation (CR) is an innovative treatment to ablate cardiac arrythmia sources by radiation therapy. CR target delineation is a challenging task requiring the exploitation of highly different imaging modalities, including cardiac electro‐anatomical mapping (EAM).PurposeIn this work, a data integration process is proposed to alleviate the tediousness of CR target delineation by generating a fused representation of the heart, including all the information of interest resulting from the analysis and registration of electro‐anatomical data, PET scan and planning computed tomography (CT) scan. The proposed process was evaluated by cardiologists during delineation trials.MethodsThe data processing pipeline was composed of the following steps. The cardiac structures of interest were segmented from cardiac CT scans using a deep learning method. The EAM data was registered to the cardiac CT scan using a point cloud based registration method. The PET scan was registered using rigid image registration. The EAM and PET information, as well as the myocardium thickness, were projected on the surface of the 3D mesh of the left ventricle. The target was identified by delineating a path on this surface that was further projected to the thickness of the myocardium to create the target volume. This process was evaluated by comparison with a standard slice‐by‐slice delineation with mental EAM registration. Four cardiologists delineated targets for three patients using both methods. The variability of target volumes, and the ease of use of the proposed method, were evaluated.ResultsAll cardiologists reported being more confident and efficient using the proposed method. The inter‐clinician variability in delineated target volume was systematically lower with the proposed method (average dice score of 0.62 vs. 0.32 with a classical method). Delineation times were also improved.ConclusionsA data integration process was proposed and evaluated to fuse images of interest for CR target delineation. It effectively reduces the tediousness of CR target delineation, while improving inter‐clinician agreement on target volumes. This study is still to be confirmed by including more clinicians and patient data to the experiments.
METTL3‐dependent m6A modification mediates bladder remodeling after partial bladder outlet obstruction through CCN2 activation
Authors: Yang Yafei , Long Jun , Yang Jin , Zheng Hanxiong , Lai Yongchang , Chen Chiheng , Tang Fucai , Gao Yibo , Chen Lin , He Zhaohui 
Published: July 2023

AbstractAimsN6‐methyladenosine (m6A) modification is a critical posttranscriptional event in gene regulation. Thus, identifying methyltransferase, demethylase, or m6A binding protein‐mediated m6A modifications in cancer or noncancer transcriptomes has become a promising novel strategy for disease therapy development. However, novel insights into m6A modification in partial bladder outlet obstruction (pBOO) and detailed information about the drivers of bladder remodeling remain to be elucidated. Here, we first characterized the m6A modification landscape in pBOO and investigated potential actionable pharmaceutical targets for future therapies.MethodsWe generated an improved animal model of pBOO in SD rats with urethral meatus stricture induced by suturing. Urodynamic investigations and cystometry were carried out to evaluate the physiologic changes elicited by pBOO. Whole‐transcriptome sequencing (RNA‐seq) and m6A‐modified RNA immunoprecipitation sequencing (MeRIP‐seq) were subsequently performed to analyze the expression pattern associated with bladder remodeling in pBOO.ResultsThe cystometric evaluation of bladder function demonstrated obvious increases in pressure‐related parameters in the pBOO group. Hematoxylin and eosin staining and Masson's trichrome staining validated the occurrence of bladder remodeling. A global elevation in m6A RNA methylation levels was observed in parallel to a increased expression of METTL3 in the pBOO group. High‐throughput sequencing revealed the differences in expression patterns between the pBOO and sham‐operated groups. Furthermore, potential m6A‐modified genes, including CCN2, may serve as new pharmaceutical targets to reverse bladder remodeling.ConclusionsExploring the roles of m6A‐modified genes identified as associated with bladder remodeling by integrating RNA‐seq and MeRIP‐seq data can offer new insights for developing promising treatments for pBOO patients.
Stochastic spectral cell method for structural dynamics and wave propagations
Authors: Zakian Pooya 
Published: July 2023

AbstractThe spectral element method when enriched with the concept of fictitious domain constitutes the spectral cell method which is appropriately able to model geometrically complicated problems by simplifying the mesh generation. In this paper, we propose a new computational framework called stochastic spectral cell method (SSCM) as a stochastic development of the spectral cell method for uncertainty quantification applied to structural dynamics and wave propagations. The stochastic form of spectral cell method has not been developed yet. Hence, the SSCM is a novel stochastic method comprising the advantages of spectral cell method for computational mechanics considering the geometrical complexity resulting from computer‐aided design. The SSCM is established by incorporating the polynomial chaos and Karhunen‐Loève expansions for the uncertainty quantification, and the interpolation functions of spectral elements for the spatial discretization. In the SSCM, the numerical solution of the Fredholm integral equation of the second kind required in Karhunen‐Loève expansion is obtained using the spectral cell method. The use of Cartesian mesh, diagonal mass matrix, and higher order interpolation functions of spectral elements for stochastic dynamic analysis lead to desirable computational efficiency and accuracy of the SSCM. The capability, effectiveness, and accuracy of the proposed SSCM are demonstrated with several numerical examples of wave propagation as well as dynamic analysis of structures.
Influence of BN doped 2‐hydroxyethyl methacrylate phosphate coated expandable graphite on flame retardancy and thermal conductivity of styrene‐butadiene rubber composites
Authors: Xu Wenzong , Cheng Pengfei , Ding Ding , Zhang Zhihui , Bian Ziwei 
Published: July 2023

AbstractAs one of the three general rubbers, styrene‐butadiene rubber (SBR) is widely used in the manufacturing of tires and cables. However, due to its unsatisfactory performance of flame retardancy and thermal conductivity, its rang of application is limited. In order to improve SBR's flame retardancy and thermal conductivity, flame retardant and thermal conductive additive EG microcapsules (BN‐PPEG) were prepared by doping boron nitride (BN) with 2‐hydroxyethyl methacrylate phosphate (HEMAP) as shell. The results of Fourier transform infrared spectroscopy, x‐ray diffraction, scanning electron microscope energy and TG showed that BN‐PPEG was successfully prepared. The thermal conductivity of the SBR composite added with 15 phr BN‐PPEG was 58.0% higher than that of pure SBR, and its limiting oxygen index (LOI) value reached 26.6%, which was 38.5% higher than that of pure SBR. The peak heat release rate (pHRR) of the composites was 53.9% lower than that of pure SBR. The main reasons were that the physical barrier of BN and EG, the phosphorous free radicals captured active free radicals generated by the decomposition of HEMAP when heated, and the carbonization of SBR was promoted by generated phosphoric acid, metaphosphoric acid and other substances.