bluuebunny/crossref_metadata_2025_split huggingface dataset:
A fusion‐attention swin transformer for cardiac MRI image segmentation
Authors: Yang Ruiping , Liu Kun , Liang Yongquan 
Published: September 2023

AbstractFor semantic segmentation of cardiac magnetic resonance image (MRI) with low recognition and high background noise, a fusion‐attention Swin Transformer is proposed based on cognitive science and deep learning methods. It has a U‐shaped symmetric encoding–decoding structure with an attention‐based skip connection. The encoder realizes self‐attention for deep feature representation and the decoder up‐samples global features to the corresponding input resolution for pixel‐level segmentation. By introducing a skip connection between the encoder and decoder based on fusion attention, the remote interaction of global information is realized, and the attention to local features and specific channels is enhanced. A public ACDC cardiac MRI image dataset is used for experiments. The segmentation of the left ventricle, right ventricle, and myocardial layer is realized. The method performs well on a small sample dataset, for example, the pixel accuracy obtained by the proposed model is 93.68%, the Dice coefficient is 92.28%, and HD coefficient is 11.18. Compared with the state‐of‐the‐art models, the segmentation precision has been significantly improved, especially for the low recognition and heavily occluded targets.
DES J024008.08-551047.5: A new member of the polar ring galaxy family
Authors: Akhil Krishna R. , Kartha Sreeja S. , Mathew Blesson , Ujjwal Krishnan , Ezhikode Savithri H. , Robin Thomas 
Published: September 2023

Aims. This study presents the discovery of a new polar ring galaxy (PRG) candidate and highlights its unique features and characteristics. We provide evidence from photometric analysis that supports the inclusion of galaxy DES J024008.08-551047.5 (DJ0240) in the PRG catalogue.
Methods. During the visual observations of optical imaging data obtained from the Dark Energy Camera Legacy Survey, a serendipitous discovery was made of a ringed galaxy, DJ0240. We conducted a one-dimensional isophotal analysis to determine the position angle of the ring component and its relative orientation to the host galaxy. A two-dimensional GALFIT analysis was performed to confirm the orthogonal nature of the ring galaxy and identify distinct components within the host galaxy. We compared the photometric properties of the host and ring components of DJ0240 with PRGs and other ring-type galaxies (RTGs), finding that DJ0240 shares similar properties with both of these galaxy types.
Results. We have discovered the galaxy DJ0240, a PRG candidate with a ring component positioned almost perpendicular to the host galaxy. The position angles of the ring and host components are ∼80° and ∼10°, respectively, indicating that they are nearly orthogonal to each other. The extension of the ring component is three times greater than that of the host galaxy and shows a distinct colour separation, being bluer than the host. The estimated g − r colour values of the host and ring components are 0.86 ± 0.02 and 0.59 ± 0.10 mag, respectively. The colour value of the ring component is similar to those of typical spiral galaxies. The host galaxy’s colour and the presence of a bulge and disc components indicate that the host galaxy may be lenticular. Our findings reveal a subtle yet noticeable colour difference between the host and ring components of PRGs and RTGs. We observe that both the host and ring components of DJ0240 align more closely with PRGs than with RTGs. Furthermore, we compared the Sersic index values of the ring component (nring) of galaxy DJ0240 with a selected sample of PRGs and Hoag-type galaxies. The results show that DJ0240 has a remarkably low nring value of 0.13, supporting the galaxy’s classification as a PRG. Hence, we suggest that the ring galaxy DJ0240 is a highly promising candidate for inclusion in the family of PRGs.
Use of Steroids in Diagnostic Confusion between Intestinal Tuberculosis and Crohn's Disease: A Brief Experience
Authors: Panigrahi Manas Kumar , Kumar Chandan 
Published: September 2023

Background Differentiating intestinal tuberculosis (TB) from Crohn's disease (CD) is challenging. Even after complete workup, the underlying diagnosis can often remain unclear. Traditionally, trial of antitubercular therapy (ATT) is resorted to in such situations, but the use of ATT could increase stricturing complications in CD.
Methods We report findings from our cohort of patients with ileocecal ulcers. Among patients with a diagnostic confusion between intestinal TB and CD, steroids were started in an in-hospital setting under close observation. We report a brief series of patients with a close overlap in terms of disease presentation, behavior, laboratory, and histopathological findings. All the cases had skip lesions in the colon with inconclusive final diagnosis. We attempted to differentiate between the two by a short trial of steroids for 2 weeks.
Results Of the 30 patients with ileocecal ulceration, the diagnosis remained uncertain between intestinal TB and CD in three patients. All three patients received steroids for 2 weeks. Eventually, all were diagnosed to have TB. Administration of steroids helped increase microbiological yield with all three having a positive microbiological diagnosis at 2 weeks. However, one patient developed dissemination (pulmonary lesions).
Conclusion With a definitive risk of flare of TB with steroid, we encountered a positive diagnosis with repeat colonoscopy biopsy, positive result in bronchoalveolar lavage, and in third case positive report of cartridge-based nucleotide acid amplification test on repeat colonoscopy biopsy. In cases where differentiation of ileocecal TB from CD is not possible confidently, using a steroid-first approach increases the microbiological yield with a potential risk of dissemination.
Tuberculosis is a Common Cause of Post-Liver Transplant Ascites: An Observational Study
Authors: R. Sowmya T. , Kulkarni Anand V. , Sharma Mithun , Reddy Raghuram , Menon Balachandran P. , Reddy Nageshwar , Rao Padaki Nagaraja 
Published: September 2023

Background Ascites is expected to resolve within 2 to 4 weeks following orthotopic liver transplantation. New-onset ascites after transplant is associated increased morbidity and affects quality of life. The risk of opportunistic infections is high in transplant recipients due to immunosuppressive drugs.
Objective The objective was to assess the incidence of new-onset ascites in the transplant recipients and describe the cause and course of the same.
Methods We retrospectively collected data of all the patients who underwent liver transplantation at our center from April 1, 2020 to April 1, 2021. The details of patients developing ascites post-liver transplantation were retrieved. The patients were followed up for 1 year after transplant.
Results A total of 95 patients underwent living donor liver transplantation at our center. The incidence of new-onset ascites was 8.42% (8/95). Six out eight patients were diagnosed with tubercular ascites of whom one had disseminated tuberculosis. None of the patients had concomitant pulmonary tuberculosis. Ascites secondary to hypoalbuminemia was reported in two patients. Immunoglobulin A nephropathy and tacrolimus therapy were the underlying causes of proteinuria.
Conclusion Tuberculosis was the leading cause of ascites in post-transplant period in our study. Tuberculosis should be considered as a differential diagnosis while evaluating these patients especially in the Asia-Pacific region. Being a potentially curable cause, timely diagnosis and treatment significantly improves graft survival.
Sofosbuvir-Velpatasvir Full Dose in Chronic Hepatitis C in End-Stage Renal Disease: An Observational Study from a Himalayan Region
Authors: Ashraf Aadil , Shah Altaf , Wani Muzafar , Khan Mushtaq , Gulzar G.M. , Parveen Shaheena , Singh Jaswinder , Dar Hilal , Ahmad Nadeem 
Published: September 2023

Background Treatment of chronic hepatitis C (CHC) in the setting of chronic kidney disease and end-stage renal disease (ESRD) is challenging.
Objectives We planned to evaluate the efficacy and safety of full dose of combination of sofosbuvir-velpatasvir in the treatment of CHC in patients with ESRD or those on maintenance hemodialysis.
Methods The prospective observational study was conducted in a tertiary care center in North India where all patients with chronic kidney disease (CKD) were assessed. Those with hepatitis C virus (HCV) antibody positivity underwent testing for HCV ribonucleic acid and were treated if eligible. Full dose of sofosbuvir-velpatasvir was administered daily for 12 weeks (or 24 weeks for decompensated liver disease).
Results Of the 162 patients (mean age: 43.08 ± 12.08 years, 114 males), 125 were on regular hemodialysis. Twenty-four (15%) had evidence of liver cirrhosis, out of which four patients had evidence of decompensation. One hundred forty-two patients (87.6%) had an early virological response. Most patients, 160 (98.7%), obtained end of therapy viral clearance and sustained virological response at 12 weeks after therapy. Two patients died, and rest of the patients completed therapy. The adverse effects noticed were nausea (20%), vomiting (18%), headache (10%), and weakness (7%).
Conclusion A combination of sofosbuvir and velpatasvir is effective and safe in treating CHC in the setting of CKD.
Review: Modern Management of Liver Abscess
Authors: Wadhera Sarthak , Arora Navneet , Dhibar Deba Prasad 
Published: September 2023

AbstractAn encapsulated collection of suppurated material within the liver is termed a liver abscess, which may be caused due to bacterial, parasitic, or fungal infection. Liver abscesses can be divided into infectious, iatrogenic, and malignant. Infection spreading through the biliary tract is the most common cause now. Escherichia coli, the most common organism causing liver abscess two decades ago, is replaced by Klebsiella pneumonia, accounting for 50 to 70% of cases in the Asian subcontinent; however, liver abscesses due to Entameba histolytica are also found quiet often in day to day clinical practice. Risk factors associated with the development of liver abscess are increasing age, male sex, presence of underlying diabetes mellitus, liver cirrhosis, continuous use of proton pump inhibitors, and immunocompromised state. Fever and abdominal pain are the typical clinical symptoms of a liver abscess. Other common symptoms include nausea, vomiting, malaise, and chills. Tachycardia, right upper quadrant tenderness, and hepatomegaly are common examination findings. USG of the abdomen is performed in all suspected cases of liver abscess and has a sensitivity of 85%. Small abscesses, less than 3 to 4 cm, can be managed with antibiotics. Percutaneous drainage can be done either by single-time needle aspiration or catheter drainage.
Computational Fluid Dynamics Analysis of Trigeminal Neuralgia Associated with the Vertebral Artery: A Report of Two Cases
Authors: Patil Kapil , Komatsu Fuminari , Tanaka Riki , Sasaki Kento , Yamada Yasuhiro , Okubo Mai , Katayama Tomoka , Miyatani Kyosuke , Chemate Sachin , Satoh Toru , Kato Yoko 
Published: September 2023

AbstractTrigeminal neuralgia is a nerve disorder that causes unilateral severe facial pain. The clinical features of trigeminal neuralgia are agonizing, paroxysmal, anticipated in one or more divisions of the trigeminal nerve, with repetitive bursts of a few seconds, exacerbated by cutaneous stimuli. Microvascular decompression is proven effective, resulting in a positive outcome. Here, we report two cases of trigeminal neuralgia associated with the vertebral artery, who underwent endoscopic microvascular decompression. This case report aims to show the benefit of computational fluid dynamics evaluation of the neurovascular contact and its effect on change in wall shear stress magnitude of the offending vertebral artery after surgical management with microvascular decompression.
Systemic Review: Neurological Deficits following Ventriculoperitoneal Shunt (VPS) Insertion
Authors: Moshref Rana , Algethmi Rafaa Ahmed 
Published: September 2023

AbstractA reduction in fluid absorption or an obstruction of normal outflow is a common cause of hydrocephalus. It typically requires medical attention, which frequently entails the placement of a ventriculoperitoneal shunt (VPS) to lower intracranial pressure. We intend to list the few, documented examples of neurological impairments resulting from the installation of a VPS in this systematic study. Two search engines (PubMed and Cochrane) were used to conduct a systematic review from 1975 to December 12, 2021. The following search terms were employed: neurological deficits or neurological injury or palsies or thalamus or tract or longitudinal fasciculus or somatotropy or fasciculus or hearing loss or hemisensory or cortico AND ventriculoperitoneal shunt or VPS AND hydrocephalus. The inclusion criteria included VPS, neurological deficits, and human participants. The exclusion criteria included ventriculoarterial shunt, lumboperitoneal shunt, nonhuman subjects, and infection. Twenty trials in total, including a total of 25 patients, were included. There were 17 case report studies. A total of 35/785 patients (4.46%) experienced neurological impairments. In 9/25 (36%) of shunt cases had one of the three recognized causes: trapped fourth ventricle, dandy walker, or syringomyelia. Most of the patients developed VI, VII nerve palsies 11/25 (44%) followed by weakness, cerebellar symptoms, and VI nerve palsy. The brainstem was seen to be the most often injured structure (15/25; 60%), followed by deep brain structures (thalamus, basal ganglia, and white matter tracts; 20%). Even though ventriculoperitoneal shunting is a routine and straightforward treatment, issues can still arise. Although rare, there have been reports of cranial nerve impairments, therefore care should be taken.
Treatment of Idiopathic Normal Pressure Hydrocephalus with a Novel Programmable Valve: Prospective Evaluation of Costs, Efficacy, and Safety
Authors: Reis Rodolfo Casimiro , Yamashita Renata Harumi Gobbato , Solla Davi Jorge Fontoura , Ramin Laís Fajardo , Teixeira Manoel Jacobsen , Pinto Fernando Campos Gomes 
Published: September 2023

Abstract
Objective Programmable valves provide an equal or superior neurological outcome when compared with fixed pressure ones, with fewer complications, in treating idiopathic normal pressure hydrocephalus (iNPH) patients. Long-term costs of these treatments have not been properly compared in literature. We sought to compare costs, efficacy, and safety of 1-year treatment of iNPH patients with programmable valve Sphera Pro and a fixed pressure valve.
Materials and Methods A prospective cohort of iNPH patients treated with programmable valve was compared with a historical cohort of iNPH patients treated with fixed pressure valve. Our primary outcome was mean direct cost of treating iNPH up to 1 year. Efficacy in treating iNPH and safety were assessed as secondary outcomes.
Statistical Analysis Proportions were compared using chi-square or Fisher's exact tests. Normally distributed variables were compared using the Student's t-test or the Mann–Whitney's U test. Differences in the evolution of the variables over time were assessed using generalized estimating equations. All tests were two-sided, with an α of 0.05.
Results A total of 19 patients were analyzed in each group (mean age 75 years, the majority male). Comorbidities and clinical presentation were similar between groups. Both fixed pressure and programmable valve patients had neurological improvement over time (p < 0.001), but no difference was seen between groups (p = 0.104). The fixed pressure valve group had more complications than the programmable valve group (52.6% vs. 10.5%, respectively, p = 0.013). Annual treatment cost per patient was US$ 3,820 ± 2,231 in the fixed pressure valve group and US$ 3,108 ± 553 in the programmable valve group. Mean difference was US$712 (95% confidence interval, 393–1,805) in favor of the programmable valve group.
Conclusion The Sphera Pro valve with gravitational unit had 1 year treatment cost not higher than that of fixed pressure valve, and resulted in similar efficacy and fewer complications.
Evaluation of cyclooxygenase-2, P53, vascular endothelial growth factor, and nitric oxide synthase-2 in angiogenesis and growth of tobacco-related malignancies
Authors: Gautam Shruti , Sangma Manisha , Rana Safia , Khetrapal Shaan , Kapur Sujala , Jairajpuri Zeeba S. 
Published: September 2023

Objectives:
In India, tobacco consumption is responsible for half of all the cancers in men and a quarter in women. The present study focuses on the expression of cyclooxygenase-2 (COX-2), P53, vascular endothelial growth factor (VEGF), and nitric oxide synthase (NOS) and their relationship with the growth and angiogenesis of tobacco-related malignancies of the oral cavity, esophagus, lungs, and stomach. It further evaluates the carcinogenic action of nicotine and examines whether COX-2 and NOS-2 overexpression is responsible for tumor growth and associated angiogenic VEGF expression via its receptor.

Materials and Methods:
A cross-sectional study on 140 biopsies, resected specimens of cancer of oral cavity, esophagus, stomach, and lungs, was done. Immunohistochemical evaluation for p53, COX-2, VEGF, and inducible NOS was done. Relevant statistical analysis was applied for the significance of the findings.

Statistical Analysis:
Relevant statistical analysis was done using SPSS, chi-square and Fisher's exact tests were applied for the significance of the findings. A p-value of < 0.05 was considered as significant value.

Results:
Immunohistochemical evaluation of pattern of expression of COX-2, NOS-2, VEGF, and p53 was done in both tobacco- and nontobacco-associated cases. The results of the present study revealed an upregulation of COX-2, NOS-2, VEGF, and p53 in all the malignancies.

Conclusion:
The present results indicated that p53 protein accumulation and increased expression of COX-2, NOS-2, and VEGF might be responsible for carcinogenesis and tumor aggressiveness by enhancing angiogenesis. A possible significant effect of nicotine on COX-2 and P53 expression in tumorigenesis is revealed. These data might have important implications for the therapeutic use of COX-2, NOS-2, and VEGF inhibitors as well as of p53 gene therapy in future anticancer therapeutic strategies in tobacco-related malignancies.
A Case Report and Review of Literature: Epithelioid Hemangioendothelioma—An Uncommon Challenging Case
Authors: Soni Sweta , Devnani Bharti , Elhence Poonam , Soni Kapil , Vedant Deepak , Gupta Palak , Pareek Puneet , Vyas Rakesh Kumar 
Published: September 2023

Abstract
Introduction Epithelioid hemangioendothelioma (EHE) is a rare vascular tumor of soft tissue and bone that may uncommonly occur in the liver, lung, and head and neck region. EHEs have a higher predilection for recurrence at the local site as well as distant metastasis. Surgical excision is important and is the treatment in localized diseases. A decision to give adjuvant radiotherapy should be subjective and may differ on case-to-case basis. Limited studies are available exploring the role of targeted or systemic therapy.
Case Presentation A 56-year-old lady represented with right-sided submandibular region EHE with bilateral lung metastasis. The patient underwent surgery and radiotherapy followed by targeted therapy tab pazopanib for systemic control. At 2 years of follow-up, positron emission tomography-computed tomography showed local regional control and stable systemic diseases.
Conclusion The uncertainty in choosing the most suitable treatment of EHE patients is high and may result in dissatisfactory outcomes among several patients. The present case study identified a treatment dilemma making management more challenging for rare EHE with mandibular involvement.
Design of an ultra-wideband solar absorber based on tungsten
Authors: Wang Yunji , Liu Fei , Ni Bo , Chen Lin , Ji Ke 
Published: September 2023

A solar absorber based on tungsten with an ultra-wide wavelength band is investigated numerically using the finite-difference time–domain method. The designed structure consists of a cross-shaped resonator on top of the absorber and a metal thin film on the bottom that are separated by an intermediate dielectric layer. The absorber demonstrates continuous high absorptivity (&gt;90%) over the 514–1945 nm wavelength range, and the average absorptivity ranges up to 92.36% within the 200–2000 nm range. The excitation of propagating surface plasmon resonance (SPR) and localized SPR in combination with Fabry–Pérot resonance leads to the observed wideband absorption. We also demonstrate that the proposed absorber is insensitive to both transverse electric and transverse magnetic polarizations and study its absorptive performance at larger angles of incidence. The effects of the structural parameters and of different dielectric layer materials on the absorption performance have also been investigated. Furthermore, we explain the absorption mechanism using a power flow plot and impedance matching. The proposed absorber has promising prospects for applications, including solar cells, solar energy harvesting, and thermal emitters.
The COVID-19 pandemic and changing meanings of flatten the curve
Authors: Kang Ji-in , Kwon Iksoo 
Published: September 2023

Abstract
This paper conducts a comparative analysis of the meanings of the phrase flatten the curve before and after the outbreak of the COVID-19 pandemic. Using data from two corpora, the iWeb Corpus and the Coronavirus Corpus, it focuses on semantic frames (Fillmore, 1985) and frame metonymy (Dancygier & Sweetser, 2014). The investigation reveals that the construal of the phrase after the outbreak of COVID-19 requires the invocation of both bell curve and pandemic frames; that is, without the pandemic frame, the phrase would remain in the domain of statistics and refer to a change in a graph. The data are sorted into four semantic categories based on the context in which they appear (epidemiological/non-epidemiological) and on the effect they pursue regarding the flattening-the-curve scenario (rigorous/non-rigorous). The phrase’s polysemy is explained by the part of the process for effect of the process metonymy. The flatter curve, as a salient part of a scenario, serves to refer to one of the scenario’s effects. The analysis also observes a correlation between the real-world experience of the pandemic and the actual frequency of flatten the curve in that the ratio of each semantic category reflects the contemporaneous real-world significance of reducing the rate of increase of new infections.