bluuebunny/crossref_metadata_2025_split huggingface dataset:
Whole-volume apparent diffusion coefficient histogram analysis for prediction of regional lymph node metastasis in periampullary carcinomas
Authors: Bi Lei , Chen Wei , Zhou Shijuan , Xu Hongzhi , Lin Yushuai , Zhang Juntao , Duan Shaofeng , Dai Shouping , Li Xiaodong , Wang Ximing 
Published: March 2023

Abstract
Background: Accurate preoperative evaluation of lymph node (LN) status is crucial for selecting optimal individualized treatment strategy and predicting patients’ prognosis. This study aimed to evaluate whether whole-volume apparent diffusion coefficient (ADC) histogram parameters of the primary tumor were useful to predict regional lymph node metastasis (LNM) in periampullary carcinomas.
Methods: Thirty-eight patients with periampullary carcinoma who underwent pancreaticoduodenectomy between January 2016 to April 2019 were retrospectively enrolled. Whole-volume ADC histogram analysis of the primary tumor was performed by two radiologists independently. Clinical factors, pathological results and histogram parameters were evaluated. Interclass correlation coefficient (ICC) was used to assess agreement between observers. Receiver operating characteristic (ROC) analysis was performed to evaluate the performance of parameters in differentiating LNM-positive group and LNM-negative group.
Results: Interobserver agreements were good to excellent for histogram analysis between two radiologists, with ICCs ranging from 0.766 to 0.967. Tumor size, MR-reported LN status and most ADC histogram parameters (including mean, minimum ADC value, 10th, 25th, 50th, 75th, and 90th percentile, and kurtosis) were significantly different between LNM-positive group and LNM-negative group (p < 0.050), and revealed significant correlations with LNM (p < 0.050). At ROC analysis, tumor size and minimum ADC value generated highest area under the curve (AUC) (AUC = 0.764, 95% confidence interval [CI]: 0.599, 0.886). When diagnostic predictive values were calculated with the combined model incorporating tumor size, MR-reported LN status and 75th percentile, the best diagnosis performance was obtained, with AUC of 0.879 (95% CI: 0.771, 0.986), sensitivity of 100.0%, and specificity of 75.0%.
Conclusions: Whole-volume ADC histogram parameters of the primary tumor held great potential in differentiating regional LNM in periampullary carcinomas.
Ethnic disparity in chemotherapy–induced febrile neutropenia incidence in Asian breast cancer patients: A retrospective cohort study
Authors: Lim Zi Lin , Ho Peh Joo , Hartman Mikael , Tan Ern Yu , Riza Nur Khaliesah Binte Mohamed , Lim Elaine Hsuen , Nitar Phyu , Wong Fuh Yong , Li Jingmei 
Published: March 2023

Abstract
Background
Majority of published findings on chemotherapy–induced febrile neutropenia (FN) are restricted to three ethnic groups: Asians, Caucasians, and African Americans. In this two–part study, we examined FN incidence and risk factors in Chinese, Malay and Indian chemotherapy–treated breast cancer (BC) patients in Southeast Asia.
Methods
Hospital records or ICD codes (fever:ICD9/10:2880/D70 and neutropenia:ICD9/10:7806/R509) were used to identify patients with FN, during or within 30 days from the last chemotherapy session. In both Singapore Breast Cancer Cohort (SGBCC) and Joint Breast Cancer Registry (JBCR), time to first FN from start of chemotherapy was estimated using Cox regression. Multinomial regression was used to evaluate differences in patient, tumour, and treatment characteristics across ethnicities.
Results
FN was observed in 170 of 1,014 patients (16.7%) in SGBCC. Cox model showed that non–Chinese were at higher risk of developing FN (HRMalay[95% CI]:2.04[1.44–2.88], p < 0.001; HRIndian:1.88[1.11–3.18], p = 0.018). In JBCR, FN was observed in 965 of 7449 patients (13.0%). Indian patients, lower baseline absolute neutrophil count, non– luminal A proxy subtypes, and anthracycline–containing regimens were identified as risk factors for FN in the univariable Cox models. Disparities across ethnicities risk (HRMalay: 1.29 [1.07–1.54], p = 0.006; HRIndian: 1.50 [1.19–1.88], p < 0.001) remained significant even after further adjustments. Finally, age–adjusted multinomial model showed that as compared to Chinese patients, non–Chinese (ORMalay vs Chinese(ref):3.65[1.45–9.16],p = 0.006;ORIndian vs Chinese(ref):4.43[1.45–13.60],p = 0.009) were significantly more likely to develop multiple episodes of FN during treatment.
Conclusion
Ethnic differences in chemotherapy–induced FN among BC patients exist. Further studies can focus on investigating pharmacogenetic differences across ethnicities.
First Report of Anthracnose-twister disease of Welsh onion caused by Colletotrichum siamense in Taiwan
Authors: Yuan Chin-Ya , Huang Chiao-Wen , Lin Chu-Ping , Huang Jin-Hsing 
Published: March 2023

Abstract
A new disease of Welsh onion (Allium fistulosum L.) occurred seriously in Taiwan. The symptoms included brown necrotic spots of leaves, yellowing and blight of outer leaves, twisting and curling of new leaf, stem rot, and plant death. Three isolates (col-377, col-387 and col-413) were collected and identified as Colletotrichium siamense based on the morphology and molecular characteristics. The fungus caused the same leaf spot and twisting of Welsh onion after inoculation and was re-isolated from the diseased tissue. This is the first report of C. siamense causing anthracnose-twister disease on Welsh onion in Taiwan.
Exosome-derived circ_0001785 delays atherogenesis through the ceRNA network mechanism of miR-513a- 5p/TGFBR3
Authors: Tong Xiao , Dang Xuan , Liu Dongmei , Wang Ning , Li Miao , Han Jianbin , Zhao Jinjin , Wang Yueqing , Huang Meijiao , Yang Yanliang , Yang Yuhang , Wang Weili , Kou Yan , Kou Junjie 
Published: March 2023

Abstract
Purpose
Endothelial cell dysfunction is a major cause of early atherosclerosis. Although the role of extracellular vesicles in stabilizing atherosclerotic plaques is well established, the effect of circulating exosomes on plaque formation is still unknown. Here, we explored the effect of exosomes on atherosclerosis based on the function that exosomes can act on intercellular communication.
Patients and methods:
We extracted serum exosomes from the blood of CHD patients (CHD-Exo) and healthy individuals (Con-Exo). The obtained exosomes were co-cultured with human umbilical vein endothelial cells (HUVECs) in vitro. In addition, we determined that circ_0001785 functions as a competing endogenous RNA (ceRNAs) in coronary artery disease by dual luciferase reporter gene analysis. The protective effect of circ_0001785 against endothelial cell injury was also verified using over-expression lentiviral transfection functional assays. In vivo experiments, we injected over-expressed circ_0001785 lentivirus into the tail vein of mice to observe its therapeutic effect on a mouse model of atherosclerosis.
Results
The vitro co-cultured results showed that the amount of plasma-derived exosomes have an increase in patients with coronary artery disease, and the inflammation and apoptosis of endothelial cells were exacerbated. Over-expression of circ_0001785 reduced endothelial cell injury through the ceRNA network pathway of miR-513a-5p/TGFBR3. Quantitative reverse transcription-polymerase chain reaction identified that the expressed amount of circ_0001785 was reduced in the circulating peripheral blood of CHD patients and increased within human and mouse atherosclerotic plaque tissue. The results of in vivo experiments showed that circ_0001785 reduced aortic endothelial cell injury and the formation of intraplaque neo-vascularization, and enhanced left ventricular diastolic function, thereby delaying the development of atherosclerosis in mice.
Conclusion
Our results demonstrated a new biomarker, exosome-derived circ_0001785, for atherogenesis, which can reduce endothelial cell injury and thus delay atherogenesis through the miR-513a-5p/TGFBR3 ceRNA network mechanism, providing an exosome-based intervention strategy for atherosclerosis.
Optimized Unilateral Magnetic Resonance Sensor with Constant Gradient and Its Applications on Composite Insulators
Authors: Guo Pan , Yang Chenjie , Wu Jiamin , Xu Zheng 
Published: March 2023

Abstract
In this study, an optimized unilateral magnetic resonance sensor with a three-magnet array is presented for assessing the aging of composite insulators in power grids. The sensor's optimization involved enhancing the static magnetic field strength and the homogeneity of the RF field while maintaining a constant gradient in the direction of the vertical sensor surface and maximizing homogeneity in the horizontal direction. The center layer of the target area is positioned 4 mm from the coil's upper surface, resulting in a magnetic field strength of 139.74 mT at the center point of the area, with a gradient of 2.318 T/m and a corresponding hydrogen atomic nuclear magnetic resonance frequency of 5.95 MHz. The magnetic field uniformity over a 10 mm × 10 mm range on the plane is 0.75%. The sensor measures 120 mm × 130.5 mm × 76 mm and weighs 7.5 kg. Employing the optimized sensor, magnetic resonance assessment experiments were conducted on composite insulator samples utilizing the CPMG (Carr-Purcell-Meiboom-Gill) pulse sequence. The T2 distribution provides visualizations of the T2 decay in insulator samples with different degrees of aging.
Elucidating the Characteristics and Functional Significance of Disulfidptosis-related Genes in Head and Neck Squamous Cell Carcinoma
Authors: Zhang Zhenxing , Zhao Chifeng , Zhu Haoran , Zhang Wei , Xu Xuhui , Ying Yukang , Luo Jun , Yang Suqing 
Published: March 2023

Abstract
Disulfidptosis is a newfound programmed cell death (PCD) mode characterized by disulfide stress. Several computer-aided bioinformatic analyses were performed to elucidate the characteristics and functional significance of disulfidptosis-related genes in head and neck squamous cell carcinoma (HNSCC). The relative compositions of cells in the tumor microenvironment (TME), mutant landscape, lasso regression analysis, and predicted clinical outcome were performed by analyzing bulk RNA-sequence data. The prognostic model was verified by qRT-PCR. Besides, single-cell sequence data (scRNA) was analyzed by Seurat, CopyKAT, and monocle2 to reveal the expression characteristics of disulfidptosis-related genes. Moreover, the spatial distribution characteristics of each cell subgroup in the section and the functional significance of cancer-associated fibroblasts (CAFs) were clarified by STUtility, SpaCET, and SPATA2. Here, two clusters with different expression characteristics of disulfidptosis-related genes were identified. Cluster 1 (C1) patients had a worse prognosis and a higher proportion of stromal cells but lower effector T cell infiltration than cluster 2 (C2). A novel prognostic model was established and verified in our patient cohort. Additionally, diploid and inflammatory CAFs showed higher disulfidptosis-related gene expression levels. Furthermore, disulfidptosis-related genes exhibited extensive and differential spatial expression on tissue sections. Collectively, our study may contribute to revealing the function of disulfidptosis, and improve the expansion of knowledge of crosstalk between cancer cells and CAFs.
A Retrospective Study of GTV Additive Accelerated Hyperfractionation Radiotherapy Combined with Concurrent Chemotherapy in Stage II-IIIa Non-Small Cell Lung Cancer
Authors: Huang Shulin , Pan Weihong , Xu Jingxuan , Tang Mutao , Sun Cheng , Zhu Wenjuan , Zhang Jianguang , Tan Yongli 
Published: March 2023

Abstract
Background
Among patients with inoperable or declined surgery for stage I-IIIa NSCLC, radiation therapy is the dominant treatment method. When SBRT is used, the outcome is comparable to surgery for stage I NSCLC. Increasing the cure rate and reducing radiation damage by modifying the dose-fraction-time pattern of radiation therapy for stage II-IIIa NSCLC is currently a top priority. In this study, we evaluated gross tumor volume (GTV) plus accelerated hyperfractionation radiotherapy and concurrent chemotherapy for stage II-IIIa NSCLC patients in a retrospective manner.
Methods Retrospective analysis of 168 cases with pathologically or cytologically confirmed stage II-IIIa (T1-4N0-2M0) who received accelerated hyperfractionated radiotherapy with wild-center field GTV plus (two different target areas, two different doses) (planned target volume (PTV): PTV 45Gy/25f, GTV 25Gy/25f after 6 hours, 5 days/week, 2 times/day, end of 5-6 weeks) and synchronized chemotherapy (platinum-containing double agent combination chemotherapy or oral etoposide capsules and vincristine capsules) in patients with NSCLC at our hospital from 2002.12-2017.12. Four to six weeks after treatment, the efficacy was evaluated according to Response Evaluation Criteria In Solid Tumours (RECIST), and toxic reactions during the treatment were observed. Survival analysis was performed using the Kaplan-Meier method to calculate patients' local control rates (LC), overall survival rates (OS), and progression-free survival rates (PFS) at 1, 3, and 5 years. Multi-factor prognostic analysis was performed by the Logrank test, and univariate prognostic analysis and Cox model.
Results: The complete response rates (CR)were30.4%, partial response rates (PR) were 58.9% and stable disease rates (SD) were 7.7%. The LC rates at 1, 3 and 5 years were 95.8%, 85.1% and 79.8%, respectively; the OS rates were 91.1%, 66.1% and 50.0%, and the PFS rates were 70.2%, 54.2% and 45.2%. All indicators were better than those of the standard conventional fractionated 60Gy/30F concurrent chemotherapy regimen. Since the second daily radiotherapy only irradiated GTV, the doses received by organs at risk (OAR) such as the lung, esophagus and heart could be controlled within the standard range, except for the high incidence of bone marrow suppression due to radiotherapy, the incidence of grade 2-3 lung radiation injury and esophageal radiation injury was ≤7%. Multivariate analysis revealed that clinical stage, platinum-containing chemotherapy regimens and type of pathology were independent risk factors for prognosis (P<0.05).
Conclusion GTV additive accelerated hyperfractionation radiotherapy and concurrent chemotherapy in patients with stage II-IIIa NSCLC has an encouraging efficacy profile with tolerable toxicity.
Evaluation of Landfill Site Suitability Using GIS, Remote Sensing, and the Multi-Criteria Decision-Making (AHP) Approach, Ethiopia
Authors: Desta Mulumebet Demeke , Tesseme Tamiru , Yigezu Tesfaye Tefera , Nigussie Asmare Belay 
Published: March 2023

Abstract
Determining a suitable location of landfill sites is a challenging and complicated process because it must consider social, environmental, and technical factors. This investigation used an integrated Geographic Information System (GIS), Remote Sensing, and Analytical Hierarchy Process (AHP) to find a suitable landfill site. Twelve factors, namely proximity to the river, road, residential area, groundwater depth, proximity to the borehole, slope, industrial area, soil, geology, land use/land cover (LULC), reservoir, and religious sites, were used in the present study as suitable site selection criteria. Each criterion was evaluated by experts with the aid of AHP and their suitability was classified by GIS. The final suitability map was produced by merging the weights of the criteria and the suitability of the factor maps. Four suitability classes (high, moderate, low, and unsuitable areas) were identified as a consequence of the AHP with GIS analysis, which represented 33.5 km2 (23%), 75.6 km2 (51.75%), 0.36km2 (0.25%), and 36.54 km2 (25%) of the total study area, respectively. Accordingly, three candidate landfill sites are suggested. The finding of this study indicated that the integration of GIS with AHP approaches is a promising option to obtain suitable landfill sites.
A Scoping Review of the Ethical Impacts of International Medical Electives on Local Students and Patient Care
Authors: Chmura Magdalena , Nagraj Shobhana 
Published: March 2023

Abstract
Background: International electives are often considered a valuable learning opportunity for medical students. Yet, as travelling to lower and middle income countries (LMICs) becomes more common following the global pandemic in 2020, ethical considerations of such practices re-emerge. We conducted a scoping review to assess the extent to which five ethical themes were addressed in existing literature about electives, with the aim of investigating the ethical impacts of medical student electives on local resources, patients and clinicians in LMICs.
Methods: We systematically searched PubMed, Global Health and Embase databases using the search terms “(ethics) AND (medical electives)”. Thematic content analysis was undertaken using a combination of deductive and inductive themes. The deductive themes included: exceeding clinical competence, use of limited local resources, respect for patients and local culture, collaboration with local community/colleagues, and one-sided benefits in partnership. In addition, we also allowed for emerging themes within the data, and conducted a narrative synthesis of the results.
Results: A total of 37 papers discussed ethical issues relating to medical student international electives to LMICs. Most publications were written from the medical student perspective (n=14), rather than by the host-institution (n=5), with several written from third-party perspectives (n=18). Negative impacts on local host students and impact upon patient care, were identified as additional ethical considerations.
Conclusions: Our review demonstrated that there is limited awareness in the existing literature of the potential negative impacts of medical electives to local LMIC students’ access to medical education, and patient care. We recommend that these ethical themes should be further explored in pre-departure elective teaching courses, and post-elective debriefs to increase medical students’ awareness of the impact of their presence on host communities.
Conspicuous, green flowers are an honest signal of nectar rewards in a bird-pollinated tree (Fuchsia excorticata, Onagraceae)
Authors: Lim Ganges , Burns K. C. 
Published: March 2023

Abstract
Bird pollinated flowers typically appear ‘red’. Fuchsia excorticata (Onagraceae), a gynodioecious tree species endemic to New Zealand, is a notable exception. It produces ‘green’, cauliflorous flowers at early stages in flower ontogeny, when pistils are receptive. Flowers later turn ‘red’ as they lose their receptivity. We conducted field observations and spectrographic analyses to test whether: (1) receptive, green-phase flowers are actually more conspicuous to avian pollinators against their natural backgrounds than red-phase flowers, (2) green-phase flowers produce more nectar, and (3) relationships between flower conspicuousness and nectar production are similar in females and hermaphrodites. Results showed that the reflectance properties of green-phase flowers sharply contrast ‘orange’ tree bark, their natural visual background, rendering them more conspicuous to the avian eye than red-phase flowers. Green-phase flowers also produced more nectar than red-phase flowers as an honest signal of rewards. Similar results were observed in both female and hermaphrodite plants. Overall results provide an example of reversed flower-background colour contrasts, with ‘reddish’ hues being incorporated into the visual backgrounds of floral displays rather than being associated with the flowers themselves. They also illustrate that flower conspicuousness can serve as an honest signal of nectar rewards to pollinators.
Factors influencing career development and job satisfaction among anesthesia graduates: a cross-sectional study in China
Authors: Yang Fengyan , Jiang An , Xu Bing , Wei Kai , Jiang Zhengyu , Yu Jian , Xu Tianying , Zou Zui , Sun Yuming , Li Mi 
Published: March 2023

Abstract
Background In addition to providing painless and comfortable treatments to patients, anesthesiologists also ensure the safety of their lives and provide emergency services during public health emergencies, natural disasters, and trauma cases. Globally, the ratio of anesthesiologists to surgeons is 1:2.9, but only 1:7.5 in China, according to a WHO survey. In addition to an urgent need to train more anesthesia professionals, China should also pay attention to their career development and job satisfaction. To identify the relevant factors affecting job satisfaction, we conducted a survey among the graduates majored in anesthesiology at the Naval Medical University.
Methods A questionnaire survey was conducted among 595 college graduates majored in anesthesiology who graduated from 1995 to 2021. It contained demographic information, career development status, a job satisfaction scale, work pressure, and turnover intention of the graduates. A multivariate logistic model was used to analyze the influencing factors of satisfaction.
Results We received 318 valid questionnaires. According to the survey, 72.96% of respondents were satisfied with their current job, and the overall job satisfaction score was 3.54. According to the results of the logistic regression, age (p = 0.037), level of the medical institution (p < 0.001), and work pressure (p = 0.002) were independent variables associated with graduates' job satisfaction.
Conclusion Results indicate that job satisfaction of the graduates is comparable to levels in developed countries, however, the influencing factors are different, leading to different solutions for the improvement. Age, level of the medical institution, and work pressure all play an essential role in predicting job satisfaction. More targeted approaches are needed, for instance, providing more employment guidance for newly graduated trainees, offering more training opportunities for working groups in different positions, and providing clinicians with a better evaluation method. In addition to increasing job satisfaction, these measures may also be helpful to stabilize the anesthesia workforce and improve the attractiveness of the profession.