bluuebunny/crossref_metadata_2025_split huggingface dataset:
Fluorodeoxyglucose positron emission tomography (18F-FDG PET)-computed tomography (CT) in the initial staging of bladder cancer: a single institution experience
Authors: Shahait Mohammed , Abu-Hijlih Ramiz , Farkouh Ala’a , Obeidat Shahed , Salah Samer , Abdlkadir Ahmed Saad , Al-Ibraheem Akram 
Published: July 2023

Abstract
Background
The purpose of this study was to assess the usefulness of fluorodeoxyglucose positron emission tomography (18F-FDG PET)-computed tomography (CT) scan for staging urinary bladder cancer. The study also sought to determine the effect of 18F-FDG PET/CT on management decisions and its implications for patient care.

Methods
A total of 133 patients with bladder cancer who had both conventional imaging and 18F-FDG PET/CT for initial staging were identified. All 18F-FDG-PET/CT findings were classified as true positive, true negative, false positive, or false negative based on their potential to impact the intent of treatment. The sensitivity, specificity, positive predictive value, and negative predictive value were calculated using the standard definition. Furthermore, the rate of change in therapy intent was determined for the entire sample and for subgroups with non-muscle-invasive bladder cancer (NMIBC) and muscle-invasive bladder cancer (MIBC) patients.

Results
The overall concordance rate between PET/CT and conventional imaging was around 54%. On conventional images, 18% of patients had localized disease, which was upstaged in 6.8% of cases using 18F-FDG PET/CT. Pelvic lymph node involvement was detected in 18.8% of cases using conventional imaging, which was downstaged to localized disease in 4.5% of cases using 18F-FDG PET/CT. While 63.2% of patients had systemic disease on a CT scan, 24.7% of cases were downstaged using PET/CT. Overall, the rate of change in therapy intent was 26.3% for the entire sample, 24.5% for NMIBC subgroup, and 27.3% for MIBC patients.

Conclusions
The study found that 18F-FDG PET/CT is an effective and accurate tool for staging bladder cancer in newly diagnosed patients. Approximately one quarter of patients had a change in management intent based on 18F-FDG PET/CT results. The study suggests that PET/CT should be used as a standard for newly diagnosed patients, but more research is needed to confirm this.
Bevacizumab in Combination With Oxaliplatin-Based Chemotherapy As First-Line Therapy in Metastatic Colorectal Cancer: A Randomized Phase III Study
Authors: Saltz Leonard B. , Clarke Stephen , Díaz-Rubio Eduardo , Scheithauer Werner , Figer Arie , Wong Ralph , Koski Sheryl , Lichinitser Mikhail , Yang Tsai-Shen , Rivera Fernando , Couture Felix , Sirzén Florin , Cassidy Jim 
Published: July 2023

Purpose To evaluate the efficacy and safety of bevacizumab when added to first-line oxaliplatin-based chemotherapy (either capecitabine plus oxaliplatin [XELOX] or fluorouracil/folinic acid plus oxaliplatin [FOLFOX-4]) in patients with metastatic colorectal cancer (MCRC). Patients and Methods Patients with MCRC were randomly assigned, in a 2 × 2 factorial design, to XELOX versus FOLFOX-4, and then to bevacizumab versus placebo. The primary end point was progression-free survival (PFS). Results A total of 1,401 patients were randomly assigned in this 2 × 2 analysis. Median progression-free survival (PFS) was 9.4 months in the bevacizumab group and 8.0 months in the placebo group (hazard ratio [HR], 0.83; 97.5% CI, 0.72 to 0.95; P = .0023). Median overall survival was 21.3 months in the bevacizumab group and 19.9 months in the placebo group (HR, 0.89; 97.5% CI, 0.76 to 1.03; P = .077). Response rates were similar in both arms. Analysis of treatment withdrawals showed that, despite protocol allowance of treatment continuation until disease progression, only 29% and 47% of bevacizumab and placebo recipients, respectively, were treated until progression. The toxicity profile of bevacizumab was consistent with that documented in previous trials. Conclusion The addition of bevacizumab to oxaliplatin-based chemotherapy significantly improved PFS in this first-line trial in patients with MCRC. Overall survival differences did not reach statistical significance, and response rate was not improved by the addition of bevacizumab. Treatment continuation until disease progression may be necessary in order to optimize the contribution of bevacizumab to therapy.
Modified gauge-unfixing formalism and gauge symmetries in the noncommutative chiral bosons theory
Authors: Costa Cleber N. , Ambrósio Gabriella V. , Alves Paulo R. F. , Ananias Neto Jorge , Thibes Ronaldo 
Published: July 2023

Abstract
We use the gauge-unfixing (GU) formalism framework in a two-dimensional noncommutative chiral bosons (NCCB) model to disclose new hidden symmetries. That amounts to converting a second-class system to a first-class one without adding any extra degrees of freedom in phase space. The NCCB model has two second-class constraints —one of them turns out as a gauge symmetry generator while the other one, considered as a gauge-fixing condition, is disregarded in the converted gauge-invariant system. We show that it is possible to apply a conversion technique based on the GU formalism direct to the second-class variables present in the NCCB model, constructing deformed gauge-invariant GU variables, a procedure which we name here as modified GU formalism. For the canonical analysis in noncommutative phase space, we compute the deformed Dirac brackets between all original phase space variables. We obtain two different gauge-invariant versions for the NCCB system and, in each case, a GU Hamiltonian is derived satisfying a corresponding first-class algebra. Finally, the phase space partition function is presented for each case allowing for a consistent functional quantization for the obtained gauge-invariant NCCB.
Targeted volume correlative light and electron microscopy of an environmental marine microorganism
Authors: Mocaer Karel , Mizzon Giulia , Gunkel Manuel , Halavatyi Aliaksandr , Steyer Anna , Oorschot Viola , Schorb Martin , Le Kieffre Charlotte , Yee Daniel P. , Chevalier Fabien , Gallet Benoit , Decelle Johan , Schwab Yannick , Ronchi Paolo 
Published: July 2023

ABSTRACT
Photosynthetic microalgae are responsible for an important fraction of CO2 fixation and O2 production on Earth. Three-dimensional (3D) ultrastructural characterization of these organisms in their natural environment can contribute to a deeper understanding of their cell biology. However, the low throughput of volume electron microscopy (vEM) methods along with the complexity and heterogeneity of environmental samples pose great technical challenges. In the present study, we used a workflow based on a specific electron microscopy sample preparation method compatible with both light and vEM imaging in order to target one cell among a complex natural community. This method revealed the 3D subcellular landscape of a photosynthetic dinoflagellate, which we identified as Ensiculifera tyrrhenica, with quantitative characterization of multiple organelles. We show that this cell contains a single convoluted chloroplast and show the arrangement of the flagellar apparatus with its associated photosensitive elements. Moreover, we observed partial chromatin unfolding, potentially associated with transcription activity in these organisms, in which chromosomes are permanently condensed. Together with providing insights in dinoflagellate biology, this proof-of-principle study illustrates an efficient tool for the targeted ultrastructural analysis of environmental microorganisms in heterogeneous mixes.
PRINCIPAIS INDICADORES DE DESEMPENHO LOGÍSTICO DAS TRANSPORTADORAS NA QUALIDADE DA DISTRIBUIÇÃO DE MEDICAMENTOS NO BRASIL
Authors: Miquilim Marcello 
Published: July 2023

O mercado de distribuição de medicamentos cresce a cada ano no Brasil, e a logística torna-se cada vez mais a estratégia da empresa não apenas em custos, mas em serviços e qualidade. O objetivo deste estudo é verificar quais são os principais indicadores de desempenho logístico das transportadoras na qualidade da distribuição de medicamentos no Brasil. Na cadeia de abastecimento de medicamentos, os distribuidores contratam transportadoras para que realizem as entregas para as farmácias, e mais da metade dos medicamentos que chegam às farmácias são nessas vias. Neste estudo, foi utilizado o método qualitativo, onde foram entrevistados 36 colaboradores de 9 empresas transportadoras e 9 farmácias recebedoras de medicamentos, vinculados aos maiores distribuidores de medicamentos no Brasil com representatividade de mais de 50% do mercado de distribuição de medicamentos no país. Na revisão de literatura, ficou confirmado que os indicadores de desempenho logístico com mais representatividade na qualidade da distribuição de medicamentos foram os prazos de entregas e a acuracidade dos pedidos, seguidos pelas regularizações da Anvisa para o transporte de medicamentos. Esses indicadores também foram os mais representativos no resultado das entrevistas, tanto da parte das transportadoras como por parte das farmácias.

Palavras-chave: Cadeia de Abastecimento. Transportes. Distribuição. Logística. Desempenho logístico. Qualidade na distribuição; Medicamentos.
Curative to palliative care transition challenges in the intensive care unit. A narrative review.
Authors: Koutsouki Sotiria , Kosmidis Dimitrios 
Published: July 2023

Abstract
Introduction: The need for high quality palliative care services for critically ill patients and their families remains of high importance.
Purpose: This review aims to present the benefits and barriers to implementing palliative care in Intensive Care Units and suggest ways to facilitate the shift from therapeutic to palliative care.
Methods: PubMed, Scopus, and Google Scholar databases were searched online. Studies included were eligible for the provision of palliative care in the intensive care unit, published in English from 2012 through 2022.
Review: Evidence shows that integrating palliative care impacts the quality of life in intensive care unit and increases rates of use of palliative care facilities. On the other hand decrease length of stay and impacts the cost and the opportunity cost of the intensive care unit. The data suggest that a large subset of intensive care units patients would benefit from palliative care, but palliative care remains underutilized in the ICU setting. Lack of training in palliative care, organizational factors, decisions about end of life, lack of defined criteria for inclusion, and life-saving culture of the intensive care unit are barriers to providing palliative care. Efforts should focus on education, support for effective communication and decision-making, early integration of a palliative approach, redesign of clinical protocols, and reallocation of resources to provide an environment conducive to quality at the end of life.
Conclusion: Involving palliative care in critically ill patients has reduced intensive care unit resource use. Nurses need to define their essential management roles within the multidisciplinary critical care team and help develop systems by which these roles can be implemented.
Estimation of the prevalence of risk factors of type 2 diabetes in the population from age group 30-50 years in Wardha District
Authors: Kshirsagar Kalyani , Mude Gaurav 
Published: July 2023

Background: One of the most prevalent long-lasting illnesses globally is type 2 diabetes mellitus (T2DM), and the population of diabetic people is increasing. A sizable population also has impaired glucose tolerance (IGT); of which many will eventually acquire type 2 diabetes. Population expansion, aging, urbanization, a rise in physical inactivity and obesity are all contributing factors to the rising incidence of diabetes worldwide. In April 2021, World Health Organization unveiled the Global Diabetes Compact, a worldwide initiative with an emphasis on supporting low-and middle-income countries. Its objective is to make notable advancements in diagnosing and avoiding diabetes. Through the compact, all parties are coming together to work toward the collective objective of lowering the risk of developing diabetes and ensuring that everyone who develops the disease has access to affordable, comprehensive, high-quality, and equitable care. Methods: This study focuses on assessing the frequency of risk factors for type 2 diabetes in Wardha district. It is an observational study by using risk factor checklist we will assess the prevalence of risk factors related to diabetes. Conclusions: The study’s strength lies in the use of a systematic risk factor checklist which will ensure consistency in data collection and minimize bias. The use of large sample size will also improve the precision of the study and increase the generalizability of the result.
Exploring system drivers of gender inequity in development assistance for health and opportunities for action
Authors: Bartel Doris , Coile Amanda , Zou Annette , Martinez Valle Adolfo , Nyasulu Hester Mkwinda , Brenzel Logan , Orobaton Nosa , Saxena Sweta , Addy Paulina , Strother Sita , Ogundimu Modupe , Banerjee Banny , Kasungami Dyness 
Published: July 2023

Background: Deep-rooted and widespread gender-based bias and discrimination threaten achievement of the Sustainable Development Goals. Despite evidence that addressing gender inequities contributes to better health and development outcomes, the resources for, and effectiveness of, such efforts in development assistance for health (DAH) have been insufficient. This paper explores systemic challenges in DAH that perpetuate or contribute to gender inequities, with a particular focus on the role of external donors and funders. Methods: We applied a co-creation system design process to map and analyze interactions between donors and recipient countries, and articulate drivers of gender inequities within the landscape of DAH. We conducted qualitative primary data collection and analysis in 2021 via virtual facilitated discussions and visual mapping exercises among a diverse set of 41 stakeholders, including representatives from donor institutions, country governments, academia, and civil society. Results: Six systemic challenges emerged as perpetuating or contributing to gender inequities in DAH: 1) insufficient input and leadership from groups affected by gender bias and discrimination; 2) decision-maker blind spots inhibit capacity to address gender inequities; 3) imbalanced power dynamics contribute to insufficient resources and attention to gender priorities; 4) donor funding structures limit efforts to effectively address gender inequities; 5) fragmented programming impedes coordinated attention to the root causes of gender inequities; and 6) data bias contributes to insufficient understanding of and attention to gender inequities. Conclusions: Many of the drivers impeding progress on gender equity in DAH are embedded in power dynamics that distance and disempower people affected by gender inequities. Overcoming these dynamics will require more than technical solutions. Groups affected by gender inequities must be centered in leadership and decision-making at micro and macro levels, with practices and structures that enable co-creation and mutual accountability in the design, implementation, and evaluation of health programs.
An observational analysis of risk factors associated with symptomatic third molar teeth
Authors: Bruce Douglas , Dudding Tom , Gormley Mark , Richmond Rebecca C , Haworth Simon 
Published: July 2023

Background: Third molar teeth (wisdom teeth) are a common cause of pain and infection in young adults. The study aimed to describe the prevalence of symptomatic third molar teeth and identify factors which predispose to third molar symptoms in a birth cohort. Methods: An observational study was undertaken nested in the Avon Longitudinal Study of Parents and Children (ALSPAC), a birth cohort based in south west England. The main outcomes were self-reported third molar pain, swelling and treatment for third molar problems, taken from questionnaires completed at age 23 years. The exposures including sex, dental history, socioeconomic status, diet, and genetic factors were obtained from earlier ALSPAC data. Results: In total 4,222 ALSPAC participants responded to one or more questions about third molar teeth. The final sample included more female participants than male participants. The majority of participants (56.6%) reported at least one episode of pain associated with their third molars. Females had greater odds than males of reporting swelling (adjusted odds ratio (OR) 1.97; 95%confidence interval (CI) 1.56, 2.51), pain (adjusted OR=1.96; 95%CI 1.56, 2.51) and receiving both non-surgical and surgical treatment (adjusted OR=2.30; 95%CI 1.62, 3.35, adjusted OR=1.54; 95%CI 1.17, 2.06 respectively). Participants with previously filled teeth had greater odds of third molar extraction. There were no strong associations between index of multiple deprivation (IMD) score or sugar intake and the third molar outcomes. There was weak evidence for a genetic contribution to third molar pain. Conclusions: Symptomatic third molars are common in this age group, with over half of the participants reporting pain or other symptoms. Female participants had greater odds for third molar pain, swelling and treatment.
Factors associated with the uncorrectable congenital heart disease in children with pulmonary arterial hypertension
Authors: Handoyo  , Gunawijaya Eka , Yantie Ni Putu Veny Kartika 
Published: July 2023

BACKGROUND Pulmonary arterial hypertension associated with congenital heart disease (PAH-CHD) is a common complication of uncorrected left-to-right shunt defects in acyanotic CHD and a frequent type of pulmonary hypertension in youth. The standards for operability in left-to-right shunts with increased pulmonary vascular resistance are not universally agreed upon. This study aimed to identify variables associated with uncorrectable lesion in children with PAH-CHD.
METHODS This retrospective study used a database of all children who underwent cardiac catheterization at Sanglah Hospital, Bali, from May 2009 to April 2021. Pulmonary hypertension was defined as pulmonary artery pressure of >25 mmHg, while correctability was a fall of >20% in the pulmonary arterial resistance index (PARI) with final value of <6 WU/m2 when doing an acute vasoreactivity test using 100% oxygen. The analyses were carried out using SPSS software version 22.0 (IBM Corp., USA).
RESULTS A total of 104 children were included. Cardiac catheterization showed that the uncorrectable group had a higher PARI (14.4 [8.88] WU/m2 versus 8.43 [3.85] WU/m2) and lower flow ratio (1.27 [0.83] versus 1.47 [0.77]) at baseline. In terms of correctability, pre-tricuspid lesions (OR = 0.05; 95% CI = 0.01–0.47; p = 0.01) and younger age group (OR = 0.32; 95% CI = 0.12–0.85; p = 0.01) were protective variables, whilst high baseline PARI (OR = 4.54; 95% CI = 1.64–12.57; p = 0.01) was unfavorable.
CONCLUSIONS High baseline PARI was the most significant variable in predicting uncorrectable left-to-right shunt defects in PAH-CHD.
Secondary lens with hybrid structure of freeform surface and microstructure for ultra-thin backlight unit
Authors: Feng Qibin , Sun Qiyu , Li Kejing , Wang Zi , Lv Guoqiang 
Published: July 2023

Ultra-thin has become the development trend of the direct-lit backlight
unit (BLU). Double freeform surface lenses are commonly used in
direct-lit BLUs to reduce thickness. However, for an ultra-thin BLU
with quite small optical distance (OD) and a large LED pitch distance,
the curvature of the designed lens would be quite large, which would
make the final optical performance heavily affected by fabrication
errors. This paper proposes a lens with freeform surfaces and
microstructures. The rays from LEDs are first collimated by the
freeform surfaces and the collimated rays are then reflected by the
microstructures to the bottom of the BLU, which can effectively
enlarge the spot size and reduce the OD. The simulation results show
that the uniformity can be improved from 41.3% of the conventional
double freeform surface lens to 83% when OD is 3 mm. Such
hybrid lenses can avoid the fabrication of freeform surfaces with
large curvature and the advantages of easy design and easy
fabrication.
Shape recovery from fusion of polarization binocular vision and shading
Authors: Tan Zhiying , Kong Weifeng , Ji Yan , Tao Xu , Zhao Jinying , Wang Meiling , Xu Xiaobin 
Published: July 2023

The shape from polarization can recover the fine texture of the target
surface. However, the gradient field for shape recovery by
polarization is ambiguous, which is caused by the multi-value of the
azimuth angle. In response to the problem, a method of correcting the
ambiguity by the fusion of polarization binocular vision and shading
information is proposed in this paper. An iterative optimization
algorithm is designed to estimate the direction of the light source,
which provides the basis for the shading method to calculate the depth
map. Additionally. the low-frequency depth map generated by binocular
matching is used to correct the polarization gradient field. The
polarization gradient field of the holes and small zenith angle
regions in the binocular are corrected by the improved shading method.
In the experiment, four different material target objects were used
for shape recovery and compared with other methods. The results of the
fusion method proposed are better in terms of fine texture. At the
camera working distance of 700 mm, the resolving power
performs well and demonstrates that changes in the depth of at least
0.1 mm can be distinguished from that recovery result.
Intracavity filtering effect in a dual-output linear-cavity all-PM fiber laser mode-locked by NPE
Authors: Peng Siwei , Liu Xuanyi , Fu H. Y. , Li Qian 
Published: July 2023

We have demonstrated a stable and low-noise all-polarization-maintaining (PM) ultrafast erbium-doped fiber laser mode-locked via nonlinear polarization evolution (NPE) in a linear cavity with dual outputs. A detailed design strategy is presented. The all-PM configuration enhances the capability of resistance to environmental fluctuations. Self-starting mode-locking is realized by using a non-reciprocal phase shifter. The dual-output structure offers the intracavity filtering effect, where the reflective port serves as a bandpass spectral filter, significantly improving the transmissive-port optical properties. The laser directly generates ultrashort pulses with a pulse duration of 129 fs operating at a fundamental repetition rate of 105.8 MHz. The integrated root-mean-square (RMS) relative intensity noise from 10 Hz to 10 MHz is ∼0.008%, and the integrated RMS timing jitter from 5 kHz to 10 MHz is ∼36fs. Long-term stability is confirmed in 25 h with a RMS power fluctuation of ∼0.10%. Our high-performance fiber laser is a prospective candidate for low-noise applications.
Nested micro-ring refractive index sensor based on a subwavelength grating waveguide and the Vernier effect
Authors: Shi Xinyu , Chen Ming , Li Renjie , Wang Xiangyang , Han Wenhao , Zhao Wanli , Liu Jinbiao , Teng Chuanxin , Deng Shijie , Cheng Yu , Yuan Libo 
Published: July 2023

In this paper, a nested micro-ring refractive index sensor based on a
subwavelength grating waveguide and the Vernier effect is proposed. In
this scheme, the nested micro-ring structure is combined with a
subwavelength grating structure to enhance the contact area between
the optical field and the analyte, and the wavelength offset is
doubled through the Vernier effect. The proposed sensor can
effectively increase sensing sensitivity, taking into account the
improvement of the free spectral range. This structure enables the
device to reach a sensitivity of 8030 nm/RIU near
1550 nm wavelength in a deionized water environment, with a
detection limit of 5.659×10−5 RIU and free spectral range of
41.956 nm. The device suggested in this study has a greater
reduced footprint than the conventional micro-ring resonant sensor,
measuring just 35µm×25µm. Due to its high integration, high
sensitivity, and large free spectral range compared to conventional
micro-ring resonant sensors, such structures are of great value in
biosensing and environmental monitoring.