bluuebunny/crossref_metadata_2025_split huggingface dataset:
Optimal Planning Target Volume Margins to Account for Intra‐Fractional Prostate Motion Relative to Treatment Duration: A Study Using Real‐Time Transperineal Ultrasound Guidance
Authors: Bannai Masaki , Brown Amy , Rumley Christopher , Squire Timothy , Tan Alex 
Published: January 2025

ABSTRACTIntroductionProstate motion during external beam radiotherapy (EBRT) is common and typically managed using fiducial markers and cone beam CT (CBCT) scans for inter‐fractional motion correction. However, real‐time intra‐fractional motion management is less commonly implemented. This study evaluated the extent of intra‐fractional prostate motion using transperineal ultrasound (TPUS) and examined the impact of treatment time on prostate motion.MethodsPatients undergoing prostate EBRT with TPUS at a single institution from August 2016 to August 2021 were analysed. Pre‐treatment daily CBCT corrected inter‐fractional prostate shift. Continuous intra‐fractional prostate motion was recorded at two frames per second in three dimensions, with three‐dimensional (3D) displacement calculated as a vector. Motion data were modelled to determine the probability of the prostate remaining within pre‐specified PTV margins relative to treatment delivery time.ResultsThe study analysed 3364 fractions delivered to 122 patients. The mean treatment delivery time was 3.8 min. The prostate remained within a 5 mm margin with high frequencies in the superior–inferior (SI) and left–right (LR) directions, 97.8% and 98.4% of fractions respectively while 5.5% of fractions had deviations greater than 5 mm in the anterior–posterior (AP) direction. By contrast, the 3D vector exceeded a 5 mm margin in 14.5% of fractions. Drift motion modelling indicated a 99% probability of the vector staying within a 3 mm margin for 2 min, while for a 5 mm margin, the duration extended to 3.4 min.ConclusionsIntra‐fractional prostate motion monitoring is increasingly important as SABR with reduced PTV margins are utilised in prostate radiotherapy. Smaller PTV margins and longer treatment time require real‐time monitoring to avoid geographical miss.
Quantification of racial and ethnic disparities in alcohol‐related problems in light of different methodological approaches
Authors: Ye Yu , Lui Camillia K. , Martinez Priscilla , Greenfield Thomas K. , Kerr William C. 
Published: January 2025

AbstractAimWe applied the Institute of Medicine (IOM) definition of racial and ethnic disparities in healthcare to estimate disparities in alcohol‐related problems. This estimation involved adjusting for drinking patterns, gender and age, with observed disparities further explained by socioeconomic status (SES). We compared results of five statistical approaches which use different methods for adjusting covariates.Design and settingWe conducted analysis of the repeated cross‐sectional data from the US National Alcohol Surveys (NAS) from 2000 to 2020, comparing traditional regression, rank‐and‐replacement, propensity score weighting, G‐computation and the double‐robust methods.Participants39 239 respondents aged 18 + across five NAS surveys oversampling Black and Hispanic/Latino/a populations.MeasurementsOur primary analysis examined the dichotomous outcomes of the three alcohol problem measures: occurrence of negative consequences, alcohol dependence (using DSM‐IV criteria) and alcohol use disorder (AUD, using DSM‐5 criteria). The drinking pattern variables encompassed past year total alcohol volume and measures of heavy drinking, including the number of days consuming 12+, 8–11 and 5–7 drinks.FindingsAfter adjusting for age, alcohol volume and heavy drinking days, statistically significantly higher prevalence of DSM‐IV dependence and DSM‐5 AUD were observed for Black and Hispanic men who drank in the past year compared with White men who drank. For instance, the Black–White difference in AUD prevalence ranged from 3.7% (95% confidence interval = 1.1%, 6.2%) to 4.9% (2.1%, 7.8%)–, while the HispanicWhite difference ranged from 2.3% (0.1%, 4.4%) to 3.4% (1.1%, 5.6%), using different adjustment methods. Further adjusting for SES factors only moderately explained the observed disparities. We found consistent results in the estimation of disparities across all five methods.ConclusionsThere appear to be racial and ethnic disparities in alcohol‐related problems between Black and Hispanic men in the United States relative to White men after alcohol drinking patterns and age are adjusted. The findings also exhibit overall consistency across the five different methods or measurement applied.
Outpatient surgical management of head and neck keratinocyte cancers in a regional centre: an updated analysis of costs and outcomes
Authors: Sapsford Timothy , Wilson Zachary , Chen Fang Joe , Nightingale James , Grigg Roger , Anderson Daniel , Fitzgerald Garret 
Published: January 2025

AbstractBackgroundAustralia has the highest global incidence of keratinocyte cancer. Surgically managing keratinocyte cancers in regional Australia presents geographic and economic challenges, which necessitate cost‐effective resource allocation. Previous work has outlined the cost benefit for outpatient day surgical excision of head and neck skin lesions that can be closed primarily. We expand on this analysis with the inclusion of graft and local flap reconstructions.MethodsA retrospective analysis was completed in a single regional centre across 24 months from July 2022 to June 2024. Patient demographics, lesion characteristics, margin status, cost comparison, and complication rates were recorded.ResultsThere were 256 excisions for proven or suspected keratinocyte cancers. Basal cell carcinomas comprised 73.1% of lesions, squamous cell carcinoma for 21.9% of lesions, and intra‐epidermal carcinoma for 5.1%. Lesion defects were closed primarily in 63.8% while 23.0% underwent full thickness graft reconstruction and 13.2% required local flaps. Involved margins were reported in 8.1% of excisions. Follow‐up wound review was undertaken in primary care for 26.1% of all lesion excisions. Average indicative costs were three‐to‐four times higher for procedures performed in theatre compared to the outpatient setting, and these savings were greatest for graft and local flap reconstructions. There were 20 recorded complications including 16 partial or complete graft failures and one partial flap failure.ConclusionThis study demonstrates further cost effectiveness for graft and local flap reconstruction of head and neck skin excisions under local anaesthetic in the regional outpatient setting, while maintaining low complication and incomplete excision rates.
Advancement of the Dragon Heart 7‐Series for Pediatric Patients With Heart Failure
Authors: Matlis Giselle C. , Palazzolo Thomas C. , Lawley Jonathan E. M. , Day Steven W. , Woodland Emily , Tchantchaleishvili Vakhtang , Stevens Randy M. , Throckmorton Amy L. 
Published: January 2025

ABSTRACTBackgroundSafe and effective pediatric blood pumps continue to lag far behind those developed for adults. To address this growing unmet clinical need, we are developing a hybrid, continuous‐flow, magnetically levitated, pediatric total artificial heart (TAH). Our hybrid TAH design, the Dragon Heart (DH), integrates both an axial flow and centrifugal flow blood pump within a single, compact housing. The axial pump is embedded in the central hub region of the centrifugal pump, and both pumps rotate around a common central axis, while maintaining separate fluid domains.MethodsIn this work, we concentrated our design and development effort on the centrifugal blood pump by performing computational modeling. An iterative process was employed to improve the DH design. The pressure generation, scalar stress levels, and fluid forces exerted on the magnetically levitated impellers were computationally estimated. A shaft driven centrifugal prototype was also manufactured and tested using a hydraulic flow loop circulating a water–glycerol blood analog. Pressure and flow performance of the pump prototype was measured for a given rotational speed for comparison to computational predictions.ResultsOur design achieved the target pump pressures of 60–140 mm Hg for flow rates of 1–5 L/min, and strong agreement in pressure rise was demonstrated between the experimental data and simulation results (less than 10% deviation on average). Fluid stress levels were, however, found to exceed thresholds in the outflow region of the pump, and fluid residence times were less than 600 ms.ConclusionThe findings of this work demonstrate that the more compact, next‐gen DH's centrifugal pump design is able to achieve pressure–capacity requirements. Next steps will require a focused strategy to reduce hemolytic potential and to integrate magnetic suspension components for full rotor levitation.
The Pivotal Role of an Early Post‐Acute Cardiac Rehabilitation as an Evidence‐Based Management of Left Ventricular Assist Device Patients
Authors: Pistono Massimo , Giordano Andrea , Gnemmi Marco , Gambarin Fabiana Isabella , Granata Mario , Imparato Alessandro , Temporelli Pier Luigi , Mannucci Letizia , Prolo Silvia , Corrà Ugo 
Published: January 2025

ABSTRACTBackgroundLeft Ventricular Assist Device (LVAD) implantation is an important treatment option for patients with advanced CHF. Referral to an early, intensive cardiac rehabilitation (CR) program in these patients seems still underused. This observational descriptive study aimed to evaluate the feasibility and efficacy of an early intensive CR program in LVAD recipients, also comparing results with a matched group of advanced HFrEF patients.MethodsThe study involved patients with LVAD implantation due to HFrEF who were admitted to our intensive post‐acute CR program from several surgery wards from 2009 to 2023. They underwent a twice‐a‐day individualized exercise program and physiotherapeutic treatment, according to clinical stability and functional assessment. The study exclusively focused on the in‐hospital rehabilitation period and documented cardiac and non‐cardiac complications, including the Hemocompatibility‐Related Adverse Events (HRAEs). The Barthel index (BI) was used to assess functional recovery from admission to discharge. Results in a subgroup of 210 LVAD patients matched on a 1:1 basis with an HFrEF population were also analyzed.ResultsOne patient died during the inward rehabilitation period (respiratory failure). The majority (70.0%) of patients improved their disability (BI 67 ± 24 to 84 ± 23, p < 0.001). HRAEs occurred in 25 patients (9.1%). Compared to the HFrEF group, LVAD patients showed similar improvement in disability (p = 0.54).ConclusionsThe study suggests that an early intensive post‐acute CR program can significantly improve functional capacity and disability in LVAD patients, similar to HFrEF patients admitted to the same program. Our data support scientific recommendations suggesting participation of LVAD to a CR.
First insight into gemstones on historical ecclesiastical artefacts in Sicily (17th‐19th centuries): A non‐invasive survey
Authors: Fugazzotto Maura , Caggiani Maria Cristina , Spironello Marilisa Yolanda , Barone Germana , Mazzoleni Paolo 
Published: January 2025

AbstractA wide production of ecclesiastical artefacts is traceable in Sicily between the 17th and 19th centuries, admirable in many diocesan museums. Nevertheless, these artefacts were never studied from an archaeometric point of view: Beyond their historical value, it is time to understand whether the information concerning the decorating gemstones is reliable. In situ investigations through portable instrumentations (Raman spectroscopy and portable X‐ray fluorescence) were performed on the gems decorating monstrances, a reliquary, and an archbishop's insignia, kept in two museums at Caltagirone (Sicily). The analyses in some cases confirmed the identification, whereas in others they contradicted the pre‐existing information.
Motivating tones to enhance education: The effects of vocal awareness on teachers' voices
Authors: Paulmann Silke , Weinstein Netta 
Published: January 2025

AbstractBackgroundEffective classroom communication is key to shaping the learning environment and inspiring student engagement. And, it's not just what is said, but how it's said, that influences students. Yet, few (current or future) teachers receive education on vocal pedagogy.AimsThis study examined the impact of raising vocal awareness in teachers on their voice production through delivering a voice training program.MethodSpecifically, we explored how primary school teacher trainees produced motivational (either soft, warm, and encouraging, or harsh, pressuring, and controlling) and neutral communications before and after the delivery of a voice education program that concentrated on raising voice awareness, vocal anatomy, exercise techniques (e.g. breath control, voice modulation), and voice care. Hypotheses: We hypothesised that trainees' voice production would change over the course of the program and lead to more ‘prototypical’ displays of motivational prosody (e.g. softly spoken encouraging intentions vs. harshly spoken controlling intentions).ResultsResults indicated a noticeable difference when communicating motivational intentions between pre‐ and post‐training voice samples: post training, trainees spoke more slowly and with reduced vocal effort irrespective of motivational intention, suggesting that raising vocal awareness can alter classroom communications.ConclusionThe results underscore the importance of vocal awareness training to create a supportive and autonomy‐enhancing learning environment.
New evidence finds young people in Mainland China are now bicultural
Authors: Wang Yi‐meng , Wang Feng‐yan , Talhelm Thomas , Chen Yi‐qun 
Published: January 2025

AbstractThis study reports new evidence that young people in Mainland China are now bicultural. We followed the established method of testing biculturalism by priming participants with images from two different cultures and measuring whether those images activate different thought styles. First, we replicated findings from 25 years ago that college students in Hong Kong are bicultural (Study 1). Next, we found that priming Mainland Chinese college students with Chinese culture increased external attributions (which are more common in China), whereas priming American culture increased internal attributions (which are more common in the US; Study 2). Next, we tested a “negative control” group that we expected should not respond to bicultural primes. Older adults who were born before China's Reform and Opening policy in 1978 showed no evidence of biculturalism (Study 3). This new evidence extends biculturalism to Mainland China, and it provides a crucial negative control test for biculturalism research.
A Hybrid Lagrangian–Eulerian Formulation of Thin‐Shell Fracture
Authors: Fan L. , Chitalu F. M. , Komura T. 
Published: January 2025

AbstractThe hybrid Lagrangian/Eulerian formulation of continuum shells is highly effective for producing challenging simulations of thin materials like cloth with bending resistance and frictional contact. However, existing formulations are restricted to materials that do not undergo tearing nor fracture due to the difficulties associated with incorporating strong discontinuities of field quantities like velocity via basis enrichment while maintaining continuity or regularity. We propose an extension of this formulation to simulate dynamic tearing and fracturing of thin shells using Kirchhoff–Love continuum theory. Damage, which manifests as cracks or tears, is propagated by tracking the evolution of a time‐dependent phase‐field in the co‐dimensional manifold, where a moving least‐squares (MLS) approximation then captures the strong discontinuities of interpolated field quantities near the crack. Our approach is capable of simulating challenging scenarios of this tearing and fracture, all‐the‐while harnessing the existing benefits of the hybrid Lagrangian/Eulerian formulation to expand the domain of possible effects. The method is also amenable to user‐guided control, which serves to influence the propagation of cracks or tears such that they follow prescribed paths during simulation.
Head and Neck Squamous Cell Carcinoma of Unknown Primary—Who Can Be Offered Surgery as the Sole Treatment Modality? A Systematic Review
Authors: Takhar Arunjit , Wilkie Mark D. , Srinivasan Devraj , King Emma 
Published: January 2025

ABSTRACTObjectiveEvaluate the role of surgery as the sole treatment modality for patients with cervical head and neck squamous cell carcinoma of unknown primary (HNSCCUP).DesignSystematic review of observational cohort studies with qualitative synthesis.SettingPubMed, Ovid EMBASE, and Cochrane Controlled register of Trials (CENTRAL) were screened from January 2000 up to October 2021.ParticipantsPatients with HNSCCUP after completing diagnostic workup subsequently treated with single‐modality surgery.Main Outcome MeasuresThe primary outcome was 3‐year overall survival (OS). Secondary outcomes included disease‐free survival (DFS), primary emergence, regional recurrence, and distant metastasis.ResultsFourteen eligible studies were identified, including 1780 patients, of whom 294 received surgery as their sole treatment (seven studies) with 3‐year OS ranging from 43.9% to 100%. 3‐year DFS was reported in four studies (n = 62) ranging from 42.8% to 67.0%. 5‐year OS and DFS were available in three studies (n = 31), ranging from 36.6% to 75.0%, and 43.6% to 67.0%, respectively. The rate of primary emergence ranged from 11.1% to 33.3% (seven studies, n = 157), regional relapse from 0.0% to 50.0% (five studies, n = 60) and distant metastasis from 0.0% to 3.3% (three studies, n = 45). Patients undergoing surgery as a sole treatment had predominantly p16/HPV positive N1 (TNM7) disease without ECS.ConclusionOutcomes for HNSCCUP patients undergoing surgery alone range widely in the literature but may be reasonable in a subset of patients with early‐stage p16/HPV positive disease. Data is lacking for p16/HPV negative disease where the potential primary site is more varied and primary emergence appears more common.
Generic Competencies in Dentistry: Students' and Teachers' Perceptions of Their Professional Relevance and Their Development in Undergraduate Studies at Universidad Diego Portales of Chile
Authors: Soto‐Araya Milena , Baños Josep E. , Pérez Jorge , Moyano Elisabeth 
Published: January 2025

ABSTRACTIntroductionGeneric competencies are transferable skills, knowledge and attitudes essential for personal and professional development and not restricted to any particular field. Evidence shows the relevance of incorporating them into the dentistry curriculum. However, defining which competencies to prioritise is complex and requires input from the academic community. This research aimed to understand the perception of dentistry students and teachers at Universidad Diego Portales regarding the importance of generic competencies in the profession and their development during undergraduate studies.Materials and Methods74 teachers and 256 students participated, representing 55% of the study population. The Tuning Latin America project's generic competencies questionnaire was used, assessing 27 competencies in terms of relevance, ranking, and development.ResultsA positive perception regarding the importance of generic competencies was observed, with over 90% of participants considering them quite or highly relevant. When ranking, five skills stood out: three from the learning process, one from social values, and one from interpersonal skills. Regarding the development of such skills, both teachers and students expressed that many competencies were not well implemented; over 50% of participants considered 14 of the presented skills as poorly developed or not developed at all.DiscussionEach programme must select generic competencies for their students' training, as this definition varies according to the consulted group and country.ConclusionsBoth teachers and students recognised the professional relevance of generic competencies in dentistry. Both groups perceived that many were not adequately developed in the curriculum.
Incidence of childhood and youth epilepsy: A population‐based prospective cohort study utilizing current International League Against Epilepsy classifications for seizures, syndromes, and etiologies
Authors: Vikin Truls , Lossius Morten I. , Brandlistuen Ragnhild E. , Chin Richard F. , Aaberg Kari M. 
Published: January 2025

AbstractObjectiveThis study was undertaken to describe incidence and distribution of seizures, etiologies, and epilepsy syndromes in the general child and youth population, using the current International League Against Epilepsy (ILAE) classifications.MethodsThe study platform is the Norwegian Mother, Father, and Child Cohort Study (MoBa). Epilepsy cases were identified through registry linkages facilitated by Norway's universal health care system and mandatory reporting to the Norwegian Patient Registry. A standardized protocol guided medical record review, leading to validation of diagnoses and classification of seizures, epilepsy types, syndromes, and etiologies based on the latest ILAE criteria.ResultsMoBa included 111 365 participants aged 12–21 years by the end of follow‐up on December 31, 2020. We identified 1053 children and youth with epilepsy (CYE). A defined epilepsy syndrome and/or identified etiology was found in 76% of CYE in this population‐based study. Seizure types exhibited variation by age at onset. Focal epilepsies were predominant, occurring in 61% of CYE, whereas generalized epilepsies were identified in 24% of CYE. Standard clinical assessment identified etiology in 30% of CYE and in 55% with onset age < 2 years. Structural and identified genetic etiologies constituted 21% and 10%, respectively. Including presumed genetic and rare etiologies, 53% exhibited known etiology. A defined ILAE epilepsy syndrome was found in 53% of CYE. The cumulative incidence per 1000 children of the following ILAE epilepsy syndrome groups were as follows: self‐limited epilepsies, 2.25; idiopathic generalized epilepsies, 1.75; and developmental and/or epileptic encephalopathies, 2.62.SignificanceUsing the new ILAE classifications, this population‐based childhood study provides incidences of seizures, epilepsies, and epilepsy syndromes. Half of epilepsy cases are classified as an ILAE epilepsy syndrome with its prognostic and therapeutic implications, but a substantial proportion of cases still have unknown etiology.