bluuebunny/crossref_metadata_2025_split huggingface dataset:
Israeli Female Physicians' Motives for Choosing Orthopedics as Their Specialty Choice
Authors: Yonai Yaniv , Masarwa Rawan , Steinfeld Yaniv , Ben Natan Merav , Berkovich Yaron 
Published: March 2023

AbstractBackgroundOrthopedics is not a popular field of specialization among female medical students. Therefore, the purpose of the study was to examine factors related to women's choice of orthopedics as their field of specialty, compared to those who chose other fields.MethodsIn this cross‐sectional survey, 149 female medical residents from Israel—33 specializing in orthopedics and 116 in other fields—completed a questionnaire. A comparison was held between the two groups.ResultsOrthopedic residents were more likely to have received clinical training in this field during their medical studies and were more likely to have expressed a desire to specialize in orthopedics before and at the completion of their studies. In addition, orthopedic residents ascribed greater importance to job security when choosing a field of specialty and, in contrast, ascribed no importance at all to lifestyle. No difference was found between the two groups in their level of dissatisfaction as a result of their residency. However, orthopedic residents were more inclined to perceive gender discrimination in the field of orthopedics but, despite this, had a greater intention to recommend a residency in orthopedics. A negative association was found between the level of dissatisfaction as a result of the residency and intention to recommend a residency in orthopedics.ConclusionsDifferences between the two groups point to potential factors that might have been related to women's choice of orthopedics as their field of specialty. The findings may help form strategies for attracting women to specialize in orthopedics.
In‐Hospital Obstetric Delays in Rural Uganda: A Cross‐Sectional Analysis of a Hospital Cohort
Authors: Poppens McKayla , Oke Rasheedat , Carvalho Melissa , Ledesma Yeranui , Okullu Silas , Ariokot Mary Goretty , Agwang Esther , Ekuchu Peter , Wange Hyginus , Boeck Marissa , Juillard Catherine , Ajiko Mary Margaret , Dicker Rochelle 
Published: March 2023

AbstractBackgroundDeaths related to pregnancy and childbirth are extremely high in low‐resource countries such as Uganda. Maternal mortality in low‐ and middle‐income countries is related to delays in seeking, reaching, and receiving adequate health care. This study aimed to investigate the in‐hospital delays to surgical care for women in labor arriving to Soroti Regional Referral Hospital (SRRH).MethodsFrom January 2017 to August 2020, we collected data on obstetric surgical patients in labor using a locally developed, context‐specific obstetrics surgical registry. Data regarding patient demographics, clinical and operative characteristics, as well as delays in care and outcomes were documented. Descriptive and multivariate statistical analyses were conducted.ResultsA total of 3189 patients were treated during our study period. Median age was 23 years, most gestations were at term (97%) at the time of operation, and nearly all patients underwent Cesarean Section (98.8%). Notably, 61.7% of patients experienced at least one delay in their surgical care at SRRH. Lack of surgical space was the greatest contributor to delay (59.9%), followed by lack of supplies or personnel. The significant independent predictors of delayed care were having a prenatal acquired infection (AOR 1.73, 95% CI 1.43–2.09) and length of symptoms less than 12 h (AOR 0.32, 95% CI 0.26–0.39) or greater than 24 h (AOR 2.61, 95% CI 2.18–3.12).ConclusionIn rural Uganda, there is a significant need for financial investment and commitment of resources to expand surgical infrastructure and improve care for mothers and neonates.
G6PD deficiency—does it alter the course of COVID-19 infections?
Authors: Au Tsz Yuen , Wiśniewski Oskar Wojciech , Benjamin Shamiram , Kubicki Tadeusz , Dytfeld Dominik , Gil Lidia 
Published: March 2023

AbstractDespite the existence of well-founded data around the relationship between reactive oxygen species (ROS) and glucose-6-phosphate dehydrogenase (G6PD), current research around G6PD-deficient patients with viral infections, and limitations as a result of their condition, are inadequate. Here, we analyze existing data around immunological risks, complications, and consequences of this disease, particularly in relation to COVID-19 infections and treatment. The relationship between G6PD deficiency and elevated ROS leading to increased viral load suggests that these patients may confer heightened infectivity. Additionally, worsened prognoses and more severe complications of infection may be realized in class I G6PD-deficient individuals. Though more research is demanded on the topic, preliminary studies suggest that antioxidative therapy which reduces ROS levels in these patients could prove beneficial in the treatment of viral infections in G6PD-deficient individuals.
Klassifikation aggressiver B-Zell-Lymphome
Authors: Rosenwald Andreas , Menter Thomas , Dirnhofer Stefan 
Published: March 2023

ZusammenfassungDie 5. Edition der WHO-Klassifikation maligner Lymphome (WHO-HAEM5) und die Internationale Konsensus-Klassifikation (ICC) zeigen, was die Einteilung aggressiver B‑Zell-Lymphome angeht, erfreulicherweise nur wenige Unterschiede, die unseren diagnostischen Alltag wenig beeinflussen dürften. Auch die Neuerungen gegenüber der revidierten WHO-Klassifikation aus dem Jahr 2017 (WHO-HAEM4R) sind moderat. Sie betreffen meist geringfügige Namensänderungen einzelner Entitäten, Anpassung diagnostischer Kriterien oder eine Aufwertung „provisorischer“ zu „distinkten“ Entitäten. Die Definition des häufigsten aggressiven B‑Zell-Lymphoms, des diffus großzellige B‑Zell-Lymphom, nicht anderweitig klassifiziert (DLBCL, NOS), bleibt unverändert, eine Unterteilung in den Keimzentrumstyp bzw. Nicht-Keimzentrumstyp sehen beide Klassifikationen als wichtig an. Das DLBCL, NOS, muss im Rahmen der Routinediagnostik von anderen großzelligen B‑Zell-Lymphomen abgegrenzt werden. Dazu zählen das großzellige B‑Zell-Lymphom mit IRF4-Rearrangement, das in der ICC und WHO-HAEM5 zu einer definitiven Entität hochgestuft wurde, und das großzellige bzw. high-grade B‑Zell-Lymphom mit 11q-Aberration. Aggressive B‑Zell-Lymphome mit MYC- und BCL2-Rearrangement stellen biologisch eine homogene Gruppe dar und werden in beiden Klassifikationen als definitive Entitäten gelistet. Dies gilt nicht für die sehr heterogene Gruppe aggressiver Lymphome mit MYC- und BCL6-Rearrangements, welche von der ICC als provisorische Entität anerkannt werden, während die WHO-HAEM5 diese entweder unter den DLBCL, NOS oder den hochmalignen B‑Zell-Lymphomen, nicht anderweitig spezifiziert (HGBL, NOS), listet.
Quantification of airway wall contrast enhancement on virtual monoenergetic images from spectral computed tomography
Authors: Bodenberger Arndt Lukas , Konietzke Philip , Weinheimer Oliver , Wagner Willi Linus , Stiller Wolfram , Weber Tim Frederik , Heussel Claus Peter , Kauczor Hans-Ulrich , Wielpütz Mark Oliver 
Published: March 2023

Abstract
Objectives
Quantitative computed tomography (CT) plays an increasingly important role in phenotyping airway diseases. Lung parenchyma and airway inflammation could be quantified by contrast enhancement at CT, but its investigation by multiphasic examinations is limited. We aimed to quantify lung parenchyma and airway wall attenuation in a single contrast-enhanced spectral detector CT acquisition.

Methods
For this cross-sectional retrospective study, 234 lung-healthy patients who underwent spectral CT in four different contrast phases (non-enhanced, pulmonary arterial, systemic arterial, and venous phase) were recruited. Virtual monoenergetic images were reconstructed from 40–160 keV, on which attenuations of segmented lung parenchyma and airway walls combined for 5th–10th subsegmental generations were assessed in Hounsfield Units (HU) by an in-house software. The spectral attenuation curve slope between 40 and 100 keV (λHU) was calculated.

Results
Mean lung density was higher at 40 keV compared to that at 100 keV in all groups (p < 0.001). λHU of lung attenuation was significantly higher in the systemic (1.7 HU/keV) and pulmonary arterial phase (1.3 HU/keV) compared to that in the venous phase (0.5 HU/keV) and non-enhanced (0.2 HU/keV) spectral CT (p < 0.001). Wall thickness and wall attenuation were higher at 40 keV compared to those at 100 keV for the pulmonary and systemic arterial phase (p ≤ 0.001). λHU for wall attenuation was significantly higher in the pulmonary arterial (1.8 HU/keV) and systemic arterial (2.0 HU/keV) compared to that in the venous (0.7 HU/keV) and non-enhanced (0.3 HU/keV) phase (p ≤ 0.002).

Conclusions
Spectral CT may quantify lung parenchyma and airway wall enhancement with a single contrast phase acquisition, and may separate arterial and venous enhancement. Further studies are warranted to analyze spectral CT for inflammatory airway diseases.

Key Points
• Spectral CT may quantify lung parenchyma and airway wall enhancement with a single contrast phase acquisition.
• Spectral CT may separate arterial and venous enhancement of lung parenchyma and airway wall.
• The contrast enhancement can be quantified by calculating the spectral attenuation curve slope from virtual monoenergetic images.
Virtual monochromatic images for coronary artery imaging with a spectral photon-counting CT in comparison to dual-layer CT systems: a phantom and a preliminary human study
Authors: Greffier Joel , Si-Mohamed Salim A. , Lacombe Hugo , Labour Joey , Djabli Djamel , Boccalini Sara , Varasteh Mohammad , Villien Marjorie , Yagil Yoad , Erhard Klaus , Boussel Loic , Beregi Jean-Paul , Douek Philippe C. 
Published: March 2023

Abstract
Objectives

To evaluate the quality of virtual monochromatic images (VMIs) from spectral photon-counting CT (SPCCT) and two energy-integrating detector dual-energy CT (EID-DECT) scanners from the same manufacturer, for the coronary lumen.

Methods
A 21-cm section of the Mercury v4.0 phantom was scanned using a cardiac CT protocol. VMIs from 40 to 90 keV were reconstructed using high-resolution (HR) parameters for EID-DECT and SPCCT (CB and HRB kernels at 0.67 mm slice thickness, respectively). Ultra-high-resolution (UHR) parameters were used in addition to SPCCT (detailed-2 kernel, 0.43 mm slice thickness). Noise-power-spectrum (NPS), task-based transfer function (TTF), and detectability index (d′) were computed for 2-mm-diameter lumen detection. In consensus, two radiologists analyzed the quality of the images from 8 patients who underwent coronary CTA on both CT systems.

Results
For all keV images, fpeak, f50, and d′ were higher with SPCCT. The fpeak and f50 were higher with UHR-SPCCT with greater noise and lower d′ compared to those of the HR-SPCCT images. Noise magnitude was constant for all energy levels (keV) with both systems, and lower with HR images, and d′ decreased as keV decreased. Subjective analysis showed greater lumen sharpness and overall quality for HR and UHR-SPCCT images using all keV, with a greater difference at low keV compared to HR-EID-DECT images.

Conclusion
HR and UHR-SPCCT images gave greater detectability of the coronary lumen for 40 to 90 keV VMIs compared to two EID-DECT systems, with benefits of higher lumen sharpness and overall quality.

Key Points
• Compared with 2 dual-energy CT systems, spectral photon-counting CT (SPCCT) improved spatial resolution, noise texture, noise magnitude, and detectability of the coronary lumen.
• Use of ultra-high-resolution parameters with SPCCT improved spatial resolution and noise texture and provided high detectability of the coronary lumen, despite an increase in noise magnitude.
• In eight patients, radiologists found greater overall image quality with SPCCT for all virtual monochromatic images with a greater difference at low keV, compared with dual-energy CT systems.
Infliximab response associates with radiologic findings in bio-naïve Crohn’s disease
Authors: Yueying Chen , Jing Feng , Qi Feng , Jun Shen 
Published: March 2023

AbstractObjectivesSince a reliable model for predicting infliximab (IFX) benefits in bio-naïve Crohn’s disease (CD) is still lacking, we constructed a magnetic resonance enterography (MRE)-based model to predict the risk of loss of response to IFX in bio-naïve patients with CD.MethodsThis retrospective multicenter study enrolled 188 bio-naïve patients with CD who underwent MRE before IFX therapy. Therapeutic outcomes were determined based on clinical symptoms and endoscopic findings within 52 weeks. The areas of bowel wall segmentation were decided by two experienced radiologists in consensus. Texture features were extracted using the least absolute shrinkage and selection operator, and a radiomic model was built using multivariate logistic regression. The model performance was validated by receiver operating characteristic, calibration curve, and decision curve analysis.ResultsThe area under the curve of radiomic model was 0.88 (95% confidence interval: 0.82–0.95), and the model provided clinical net benefit in identifying the loss of response to IFX and exhibited remarkable robustness among centers, scanners, and disease characteristics. The high-risk patients defined by the radiomic model were more likely to develop IFX nonresponse than low-risk patients (allp < 0.05).ConclusionsThis novel pretreatment MRE-based model could act as an effective tool for the early estimation of loss of response to IFX in bio-naïve patients with CD.Key Points• Magnetic resonance enterography model guides infliximab therapy in Crohn’s disease.• The model presented significant discrimination and provided net clinical benefit.• Model divided patients into low- and high-risk groups for infliximab failure.
Single-center, prospective phase 2 trial of high-intensity focused ultrasound (HIFU) in patients with unilateral localized prostate cancer: good functional results but oncologically not as safe as expected
Authors: Duwe Gregor , Boehm Katharina , Haack Maximilian , Sparwasser Peter , Brandt Maximilian Peter , Mager Rene , Tsaur Igor , Haferkamp Axel , Höfner Thomas 
Published: March 2023

Abstract
Purpose
Focal therapy (FT) for localized prostate cancer (PCa) is only recommended within the context of clinical trials by international guidelines. We aimed to investigate oncological follow-up and safety data of focal high-intensity focused ultrasound (HIFU) treatment.

Methods
We conducted a single-center prospective study of 29 patients with PCa treated with (focal) HIFU between 2016 and 2021. Inclusion criteria were unilateral PCa detected by mpMRI-US-fusion prostate biopsy and maximum prostate specific antigen (PSA) of 15 ng/ml. Follow-up included mpMRI-US fusion-re-biopsies 12 and 24 months after HIFU. No re-treatment of HIFU was allowed. The primary endpoint was failure-free survival (FFS), defined as freedom from intervention due to cancer progression.

Results
Median follow-up of all patients was 23 months, median age was 67 years and median preoperative PSA was 6.8 ng/ml. One year after HIFU treatment PCa was still detected in 13/ 29 patients histologically (44.8%). Two years after HIFU another 7/29 patients (24.1%) were diagnosed with PCa. Until now, PCa recurrence was detected in 11/29 patients (37.93%) which represents an FFS rate of 62%.One patient developed local metastatic disease 2 years after focal HIFU. Adverse events (AE) were low with 70% of patients remaining with sufficient erectile function for intercourse and 97% reporting full maintenance of urinary continence.

Conclusion
HIFU treatment in carefully selected patients is feasible. However, HIFU was oncologically not as safe as expected because of progression rates of 37.93% and risk of progression towards metastatic disease. Thus, we stopped usage of HIFU in our department.
Design of experiments and machine learning with application to industrial experiments
Authors: Fontana Roberto , Molena Alberto , Pegoraro Luca , Salmaso Luigi 
Published: March 2023

AbstractIn the context of product innovation, there is an emerging trend to use Machine Learning (ML) models with the support of Design Of Experiments (DOE). The paper aims firstly to review the most suitable designs and ML models to use jointly in an Active Learning (AL) approach; it then reviews ALPERC, a novel AL approach, and proves the validity of this method through a case study on amorphous metallic alloys, where this algorithm is used in combination with a Random Forest model.
Query semantic reconstruction for background in few-shot segmentation
Authors: Guan Haoyan , Spratling Michael 
Published: March 2023

AbstractFew-shot segmentation (FSS) aims to segment unseen classes using a few annotated samples. Typically, a prototype representing the foreground class is extracted from annotated support image(s) and is matched to features representing each pixel in the query image. However, models learnt in this way are insufficiently discriminatory, and often produce false positives: misclassifying background pixels as foreground. Some FSS methods try to address this issue by using the background in the support image(s) to help identify the background in the query image. However, the backgrounds of these images are often quite distinct, and hence, the support image background information is uninformative. This article proposes a method, QSR, that extracts the background from the query image itself, and as a result is better able to discriminate between foreground and background features in the query image. This is achieved by modifying the training process to associate prototypes with class labels including known classes from the training data and latent classes representing unknown background objects. This class information is then used to extract a background prototype from the query image. To successfully associate prototypes with class labels and extract a background prototype that is capable of predicting a mask for the background regions of the image, the machinery for extracting and using foreground prototypes is induced to become more discriminative between different classes. Experiments achieves state-of-the-art results for both 1-shot and 5-shot FSS on the PASCAL-$$5^{i}$$

5
i

and COCO-$$20^{i}$$

20
i

dataset. As QSR operates only during training, results are produced with no extra computational complexity during testing.
Added value of a regional coupled model: the case study for marine heatwaves in the Caribbean
Authors: Pontoppidan Marie , De Falco Chiara , Mooney Priscilla A. , Nummelin Aleksi , Tjiputra Jerry 
Published: March 2023

AbstractThere is an urgent need to improve capacity to predict marine heatwaves given their substantial negative impacts on marine ecosystems. Here we present the added value of a regional climate simulation, performed with the regional Coupled-Ocean–Atmosphere-Wave-Sediment Transport model COAWST, centered over the Caribbean – one of the first of its kind on a climatological scale. We show its added value with regards to temporal distribution of marine heatwaves, compared with state-of-the-art global models. In this region, global models tend to simulate too few heatwaves that last too long compared to the observation-based dataset of CoralTemp. The regional climate model agrees more favourably with the CoralTemp dataset, particularly in winter. While examining potential mechanisms behind the differences we find that the more realistic representation of marine heatwaves in the regional model arises from the sea surface temperatures ability to increase/decrease more quickly in the regional model than in the global model. The reason for this is two fold. Firstly, the regional model has a shallower mixed layer than the global model which results in a lower heat capacity that allows its sea surface temperatures to warm and cool more quickly. The second reason is found during days when marine heatwaves are increasing in intensity. During these days, reduced wind speeds leads to less latent heat release and a faster warming surface, more so in the regional model than in the global models.
A pilot study of multi-modal pain management for same-day discharge after minimally invasive repair of pectus excavatum (Nuss procedure) in children
Authors: Akinboro Sophia , John Rebecca , Reyna Troy , Davis Rachel , Ayoub Christine , Sangster Rebecca , Kim Joseph , Nguyen Hai , Moreno Claudia , Guner Yigit , Goodman Laura , Yu Peter T. , Morphew Tricia , Kabeer Mustafa 
Published: March 2023

Abstract
Background
Despite advancements in minimally invasive repair of pectus excavatum (MIRPE), Nuss procedure, postoperative pain control remains challenging. This report covers a multimodal regimen using bilateral single-shot paravertebral block (PVB) and bilateral thoracoscopic intercostal nerve (T3–T7) cryoablation, leading to significant reduction in length of stay (LOS) and high rate of same-day discharge.

Methods
This is a comparative study of pain management protocols for patients undergoing the Nuss procedure at a single center from 2016 through 2020. All patients underwent the the same surgical technique for the treatment of pectus excavatum at a single center. Patients received bilateral PVB with continuous infusion (Group 1, n = 12), bilateral PVB with infusion and right-side cryoablation (Group 2, n = 9), or bilateral single-shot PVB and bilateral cryoablation (Group 3, n = 17). The primary outcome was LOS with focus on same-day discharge, and the secondary outcome was decreased opioid usage.

Results
Eleven of 17 patients in Group 3 (65%) (bilateral single-shot PVB and bilateral cryoablation) were discharged the same day as surgery. The remaining Group 3 patients were discharged the following day with no complications or interventions. Compared to Group 1 (no cryoablation), Group 3 had shorter LOS (median 4.4 days vs. 0.7 days, respectively, p < 0.001) and significantly decreased median opioid use on the day of surgery (0.92 mg/kg vs. 0.47 mg/kg, p = 0.006).

Conclusion
Findings demonstrate the feasibility of multimodal pain management for same-day discharge after the Nuss procedure. Future multisite studies are needed to investigate the superiority of this approach to established methods.

Level of Evidence
III.
Inferior vena cava diameter is associated with prognosis in patients with chronic heart failure independent of tricuspid regurgitation velocity
Authors: Iaconelli Antonio , Cuthbert Joe , Kazmi Syed , Maffia Pasquale , Clark Andrew L. , Cleland John G. F. , Pellicori Pierpaolo 
Published: March 2023

Abstract
Aims
A high, Doppler-derived, tricuspid regurgitation velocity (TRV) indicates pulmonary hypertension, which may contribute to right ventricular dysfunction and worsening tricuspid regurgitation leading to systemic venous congestion, reflected by an increase in inferior vena cava (IVC) diameter. We hypothesized that venous congestion rather than pulmonary hypertension would be more strongly associated with prognosis.

Methods and results
895 patients with chronic heart failure (CHF) (median (25th and 75th centile) age 75 (67–81) years, 69% men, LVEF 44 (34–55)% and NT-proBNP 1133 (423–2465) pg/ml) were enrolled. Compared to patients with normal IVC (< 21 mm) and TRV (≤ 2.8 m/s; n = 504, 56%), those with high TRV but normal IVC (n = 85, 9%) were older, more likely to be women and to have LVEF ≥ 50%, whilst those with dilated IVC but normal TRV (n = 142, 16%) had more signs of congestion and higher NT-proBNP. Patients (n = 164, 19%) with both dilated IVC and high TRV had the most signs of congestion and the highest NT-proBNP.
During follow-up of 860 (435–1121) days, 239 patients died. Compared to those with both normal IVC and TRV (reference), patients with high TRV but normal IVC did not have a significantly increased mortality (HR: 1.41; CI: 0.87–2.29; P = 0.16). Risk was higher for patients with a dilated IVC but normal TRV (HR: 2.51; CI: 1.80–3.51; P < 0.001) or both a dilated IVC and elevated TRV (HR: 3.27; CI: 2.40–4.46; P < 0.001).

Conclusion
Amongst ambulatory patients with CHF, a dilated IVC is more closely associated with an adverse prognosis than an elevated TRV.

Graphical Abstract