bluuebunny/crossref_metadata_2025_split huggingface dataset:
Sweet spots of standard and directional leads in patients with refractory essential tremor: white matter pathways associated with maximal tremor improvement
Authors: Avecillas-Chasin Josue M. , Honey Christopher R. , Heran Manraj K. S. , Krüger Marie T. 
Published: May 2022

OBJECTIVE
In patients with essential tremor (ET) treated with standard deep brain stimulation (sDBS) whose ET had progressed and who no longer received optimal benefit from sDBS, directional deep brain stimulation (dDBS) may provide better tremor control. Current steering may provide better coverage of subcortical structures related to tremor control in patients with ET and significant progression without optimal response to sDBS.

METHODS
This study included 6 patients with ET initially treated with sDBS whose tremor later progressed and who then underwent reimplantation with dDBS to optimize their tremor control. To investigate the differences in the local effects of sDBS and dDBS, the authors generated the volume of tissue activation (VTA) to calculate the sweet spots associated with the best possible tremor control with no side effects. Then, to investigate the anatomical structures associated with maximal tremor control, the white matter pathways of the posterior subthalamic areas (PSAs) were generated and their involvement with the sDBS and dDBS sweet spots was calculated.

RESULTS
Tremor improvement was significantly better with dDBS (68.4%) than with sDBS (48.7%) (p = 0.017). The sDBS sweet spot was located within the ventral intermediate nucleus, whereas the sweet spot of the dDBS was mainly located within the PSA. The sweet spots of both sDBS and dDBS involved a similar portion of the cerebellothalamic pathway. However, the dDBS had greater involvement of the pallidofugal pathways than the sDBS.

CONCLUSIONS
In patients with ET treated with sDBS who later had ET progression, dDBS provided better tremor control, which was related to directionality and a more ventral position. The involvement of both the cerebellothalamic and pallidofugal pathways obtained with dDBS is associated with additional improvement over the sDBS.
Incidencia de litiasis vesicular asintomática en pacientes con complicaciones biliares
Authors: Salom Andrés , Miranda Andrés , Pais Cecilia , Murias Federico , Giliberti Bruno , Abiuso Luciano , Mastrogiovanni Nicolás , Valiñas Roberto 
Published: May 2022

Introducción: Las complicaciones de la litiasis biliar (LB) son una causa importante de morbilidad en nuestro país y en el mundo entero y generan elevados costos en salud. Objetivo: El objetivo de este trabajo fue determinar, que pacientes con una complicación de su patología litiásica de la vía biliar (colecistitis, colangitis aguda, pancreatitis aguda), fueron previamente asintomáticos, resultando dicha complicación el debut de la enfermedad.
Lugar: Sanatorio Asociación Española de Socorros Mutuos, Montevideo Uruguay.
Diseño: Estudio observacional descriptivo, retrospectivo, análisis de historias clínicas.
Materiales y Métodos: Se analizaron 234 casos clínicos. Se constató en este grupo de pacientes, características epidemiológicas, metodología diagnóstica, tratamientos recibidos y complicaciones.
Resultados: Del total de pacientes (n=234), 109 (46.6%) tenían una litiasis vesicular asintomática (LVA) y la complicación biliar, fue el debut de su enfermedad. La colecistitis aguda fue la complicación más frecuente (68%), en segundo lugar, la colangitis aguda (22%) y en tercer lugar la pancreatitis aguda (10%). La edad promedio de presentación de la enfermedad fue los 59 años.
Conclusiones: Casi la mitad de los pacientes (46.6%) que presentaron una complicación de su litiasis biliar eran asintomáticos. Este sería un argumento importante para indicar la colecistectomía laparoscópica con un criterio profiláctico en pacientes con una LVA.
A scalable algorithm for network reachability analysis with cyclic attack graphs
Authors: Zenitani Kengo 
Published: May 2022

Today, it is indispensable for us to know our IT infrastructure’s security level to make rational decisions to protect it from malicious attacks. However, the ever-growing scale and complexity of our infrastructures make it difficult. One available approach is attack-graph analysis, a model-based algorithm that generates a directed graph called an attack graph composed of possible attack actions and their AND/OR combinations. An attack graph allows us to identify the logical possibility of cyber-attacks. Unfortunately, attack graphs lack quantitative information, such as the likelihood of a successful attack – the reachability. Meanwhile, some advanced approaches, such as the Bayesian attack-graph, compute reachabilities with an attack graph. Still, those methods have problems in the scalability and the handling of cycles contained in attack graphs. This study proposes and examines another approach named reachability-graph analysis. A reachability graph is a directed graph obtained from an attack graph by which we can compute the reachabilities. It is extremely fast to generate, thus applicable to large-scale network analysis. Furthermore, this method allows cycles in attack graphs. Such a scalable algorithm has been awaited for over a decade; it generates probabilistic security metrics and is guaranteed applicable to any cyclic AND/OR graphs. We compare our approach’s computational efficiency with the Bayesian attack-graph. Also, we apply our approach to large-scale, cyclic attack graphs. Several theoretical properties with proofs and the computational complexity of our approach are examined too.
Combined effects of cerebellar tDCS and task-oriented circuit training in people with multiple sclerosis: A pilot randomized control trial
Authors: Baroni Andrea , Magro Giacomo , Martinuzzi Carlotta , Brondi Laura , Masiero Stefano , Milani Giada , Zani Giulia , Bergonzoni Antonella , Basaglia Nino , Straudi Sofia 
Published: May 2022

Background: Balance and mobility impairments are frequent in people with multiple sclerosis, partly due to cerebellar dysfunctions. Task-oriented behavioural approaches were previously shown to promote physical function. The possibility exists that cerebellar transcranial direct current stimulation (ctDCS) applied during training, known to increase the excitability of the brain, can boost rehabilitation effects through modulation of cerebellum-brain inhibition. Objective: To test the efficacy of cerebellar ctDCS stimulation combined with motor training on mobility and balance in people with multiple sclerosis. Methods: 16 subjects were randomly assigned to receive real- or sham-ctDCS and task-oriented training daily over two weeks in a double-blind, randomised clinical pilot trial. Functional mobility, balance, walking performance and quality of life were tested before and after treatment and at two-week follow-up. Effects of cerebellar stimulation on psychological and executive functions were also recorded. Results: Walking performance, balance and quality of life improved for both groups at post-treatment assessment which was maintained at 2-weeks follow up. A two-way ANOVA revealed a significant time effect for balance and walking performance. A significant interaction effect of time–treatment ( F = 3.12, df = 2,26; p = 0.03) was found for motor aspects of quality of life assessment in patients who received real-ctDCS. Conclusions: Task-oriented training improves balance and mobility in people with multiple sclerosis, but ctDCS does not boost motor training effects.
Automatic detection of breast cancer in ultrasound images using Mayfly algorithm optimized handcrafted features
Authors: Vijayakumar K. , Rajinikanth V. , Kirubakaran M.K. 
Published: May 2022

BACKGROUND: The incidence rates of breast cancer in women community is progressively raising and the premature diagnosis is necessary to detect and cure the disease. OBJECTIVE: To develop a novel automated disuse detection framework to examine the Breast-Ultrasound-Images (BUI). METHODS: This scheme includes the following stages; (i) Image acquisition and resizing, (ii) Gaussian filter-based pre-processing, (iii) Handcrafted features extraction, (iv) Optimal feature selection with Mayfly Algorithm (MA), (v) Binary classification and validation. The dataset includes BUI extracted from 133 normal, 445 benign and 210 malignant cases. Each BUI is resized to 256×256×1 pixels and the resized BUIs are used to develop and test the new scheme. Handcrafted feature-based cancer detection is employed and the parameters, such as Entropies, Local-Binary-Pattern (LBP) and Hu moments are considered. To avoid the over-fitting problem, a feature reduction procedure is also implemented with MA and the reduced feature sub-set is used to train and validate the classifiers developed in this research. RESULTS: The experiments were performed to classify BUIs between (i) normal and benign, (ii) normal and malignant, and (iii) benign and malignant cases. The results show that classification accuracy of > 94%, precision of > 92%, sensitivity of > 92% and specificity of > 90% are achieved applying the developed new schemes or framework. CONCLUSION: In this work, a machine-learning scheme is employed to detect/classify the disease using BUI and achieves promising results. In future, we will test the feasibility of implementing deep-learning method to this framework to further improve detection accuracy.
Development of an automatic multiplanar reconstruction processing method for head computed tomography
Authors: Sato Mitsuru , Kondo Yohan , Takahashi Noriyuki , Ohmura Tomomi , Takahashi Naoya 
Published: May 2022

BACKGROUND: Head computed tomography (CT) is a commonly used imaging modality in radiology facilities. Since multiplanar reconstruction (MPR) processing can produce different results depending on the medical staff in charge, there is a possibility that the antemortem and postmortem images of the same person could be assessed and identified differently. OBJECTIVE: To propose and test a new automatic MPR method in order to address and overcome this limitation. METHODS: Head CT images of 108 cases are used. We employ the standardized transformation of statistical parametric mapping 8. The affine transformation parameters are obtained by standardizing the captured CT images. Automatic MPR processing is performed by using this parameter. The sphenoidal sinus of the orbitomeatal cross section of the automatic MPR processing of this study and the conventional manual MPR processing are cropped with a matrix size of 128×128, and the value of zero mean normalized correlation coefficient is calculated. RESULTS: The computed zero mean normalized cross-correlation coefficient (Rzncc) of≥0.9, 0.8≤Rzncc < 0.9 and 0.7≤Rzncc < 0.8 are achieved in 105 cases (97.2%), 2 cases (1.9%), and 1 case (0.9%), respectively. The average Rzncc was 0.96±0.03. CONCLUSION: Using the proposed new method in this study, MPR processing with guaranteed accuracy is efficiently achieved.
Exploring value of CT coronary imaging combined with machine-learning methods to predict myocardial ischemia
Authors: Yang You-Chang , Wei Xiao-Yu , Tang Xiao-Qiang , Yin Ruo-Han , Zhang Ming , Duan Shao-Feng , Pan Chang-Jie 
Published: May 2022

PURPOSE: To establish a machine-learning (ML) model based on coronary computed tomography angiography (CTA) images for evaluating myocardial ischemia in patients diagnosed with coronary atherosclerosis. METHODS: This retrospective analysis includes CTA images acquired from 110 patients. Among them, 58 have myocardial ischemia and 52 have normal myocardial blood supply. The patients are divided into training and test datasets with a ratio 7 : 3. Deep learning model-based CQK software is used to automatically segment myocardium on CTA images and extract texture features. Then, seven ML models are constructed to classify between myocardial ischemia and normal myocardial blood supply cases. Predictive performance and stability of the classifiers are determined by receiver operating characteristic curve with cross validation. The optimal ML model is then validated using an independent test dataset. RESULTS: Accuracy and areas under ROC curves (AUC) obtained from the support vector machine with extreme gradient boosting linear method are 0.821 and 0.777, respectively, while accuracy and AUC achieved by the neural network (NN) method are 0.818 and 0.757, respectively. The naive Bayes model yields the highest sensitivity (0.942), and the random forest model yields the highest specificity (0.85). The k-nearest neighbors model yields the lowest accuracy (0.74). Additionally, NN model demonstrates the lowest relative standard deviations (0.16 for accuracy and 0.08 for AUC) indicating the high stability of this model, and its AUC applying to the independent test dataset is 0.72. CONCLUSION: The NN model demonstrates the best performance in predicting myocardial ischemia using radiomics features computed from CTA images, which suggests that this ML model has promising potential in guiding clinical decision-making.
Desarrollo de una aplicación para espacios vectoriales en álgebra lineal
Authors: Chávez Molina Claudia Cecilia , Caldera Franco Marisela Ivette , Valenzuela González Verónica 
Published: May 2022

Las tecnologías de la información y la comunicación (TIC) en la educación han tenido un amplio desarrollo, ya que logran en el estudiante la adquisición de competencias tecnológicas que lo llevarán a mejorar sus desempeños laborales. En la actualidad, en el área académica, es requerida la incorporación de TIC, y aun cuando existe gran cantidad de software comercial, no siempre son los más adecuados, ya sea por sus altos costos, requerimientos de conexión a internet, instalación en una computadora o porque no se cubren los temas requeridos en la asignatura. Este desarrollo tecnológico consiste en realizar una aplicación móvil, que ayude en la enseñanza del álgebra lineal, en específico, espacios vectoriales, para las carreras de ingeniería. Dicha aplicación resuelve problemas de independencia lineal, combinación lineal y conjunto generador en vectores en R2 y R3, para su uso en dispositivos móviles con sistema operativo Android; es gratuita, no requiere estar conectado a internet y estará a disposición en PlayStore. Las herramientas de programación utilizadas fueron Java y Android Studio.
High-Sensitive CRP Correlates With the Severity of Liver Steatosis and Fibrosis in Obese Patients With Metabolic Dysfunction Associated Fatty Liver Disease
Authors: Zhu Cuiling , Huang Dongdong , Ma Huihui , Qian Chunhua , You Hui , Bu Le , Qu Shen 
Published: May 2022

BackgroundMetabolic dysfunction associated fatty liver disease (MAFLD) is the most common hepatopathy worldwide due to the obesity epidemic and is associated with chronic low-grade inflammation. High-sensitive C-reactive protein (hsCRP) as an inflammatory marker has been used in diagnosing MAFLD. However, the association between hsCRP and the severity of liver steatosis and fibrosis among obese patients with MAFLD remains to be elucidated.ObjectiveTo explore the correlation of hsCRP with the severity of liver steatosis and fibrosis among Chinese obese patients with MAFLD.MethodsA total of 393 obese patients with mean BMI 34.8 ± 6.6 kg/m2 were selected and categorized as MAFLD and non-MAFLD groups. Anthropometric data, biochemical indices, and hsCRP were measured. The severity of hepatic steatosis and fibrosis was assessed using FibroScan. Multivariate logistic regression analysis was performed to determine the relationship between hsCRP and the risk of MAFLD and its disease severity.ResultsPatients with MAFLD showed significantly elevated hsCRP levels and were more likely to have severe steatosis and fibrosis compared to those without MAFLD. The proportions of MAFLD, severe steatosis, and severe fibrosis were significantly increased across the hsCRP quartiles (P-trend = 0.004, 0.021, and 0.006, respectively). After multivariable adjustments, the adjusted ORs (AORs) and 95%CI for MAFLD were 1.00 (reference), 1.298 (0.587-2.872), 2.407 (1.002-5.781), and 2.637(1.073-6.482) (Q1-Q4, P-trend = 0.014). Likewise, the AORs (95%CI) for severe steatosis and severe fibrosis were remarkably increased with the increment of serum hsCRP quartiles (P-trend &lt; 0.001, P-trend = 0.021, respectively).ConclusionsElevated serum hsCRP levels were associated with increased risk of MAFLD among Chinese obese patients and correlated positively with the severity of liver steatosis and fibrosis, suggesting that hsCRP can be used as a potential biomarker to monitor and predict disease severity among Chinese obese population with MAFLD.
Mind the Gap: Understanding Differences Between Sexual and Reproductive Health-Related Legal Frameworks on Paper and in Practice
Authors: Ferguson Laura , Jardell William , Lambert-Peck Miles , Guo Lillie , Lopez Sophia , Canaves Violeta , Filmer-Wilson Emilie 
Published: May 2022

IntroductionUNFPA recently developed a composite indicator to assess sexual and reproductive health (SRH)-related laws as part of the Sustainable Development Goals monitoring framework (Indicator 5.6.2). However, there is still little understanding of how best to ensure a supportive SRH-related legal framework can improve SRH outcomes. This research draws on country case studies (Colombia, Malawi, Uruguay, Zambia) to provide more generalizable lessons on the processes by which these laws are translated into practice and their impact on lived realities.MethodsPeer-reviewed and gray literature on laws and policies related to maternity care, contraception, sexuality education, HIV and HPV was reviewed. Key informant interviews were carried out with 8–16 people in each country, including representatives of government, civil society and academia to understand factors affecting implementation of relevant laws and policies. Findings were thematically analyzed by country and contextualized within each country's score on Indicator 5.6.2 and relevant SRH outcome data.FindingsAcross these countries, some common organizational steps help move from laws on paper to impacting people's lives including budget allocation, development of technical guidance, health worker training, population awareness creation and demand generation. It is also important to address sociocultural challenges such as entrenched inequalities, conservative cultural and religious beliefs and the potential existence of customary law. Challenges can be encountered across all these steps and can vary based on the area of SRH: implementation of laws to reduce maternal mortality is generally less controversial than laws around abortion, often making the latter harder to implement. Local specificities in structures, systems and cultures bring opportunities and challenges, highlighting the need for tailored actions.DiscussionA legal framework supportive to SRH is critical, particularly in the face of backlash against sexual and reproductive rights, but alone it is insufficient. Understanding that a generic pathway exists for moving laws into practice is a critical starting point for exploring the specificities of each national context as a way of identifying entry points for action. These findings can be used to inform advocacy and monitoring to help ensure that the potential benefits of supportive SRH-related laws can be realized in these four countries and around the world.
An Immune-Related Gene Signature for Predicting Neoadjuvant Chemoradiotherapy Efficacy in Rectal Carcinoma
Authors: Qian Liwen , Lai Xiaojing , Gu Benxing , Sun Xiaonan 
Published: May 2022

BackgroundLocally advanced rectal cancers (LARC) show a highly variable response to neoadjuvant chemoradiotherapy (nCRT), and the impact of the tumor immune response in this process is poorly understood. This study aimed to characterize the immune-related gene expression profiles (GEP), pathways, and cell types associated with response or resistance to neoadjuvant chemoradiotherapy.MethodsThe transcriptomic and clinical data of Rectal carcinoma from the Gene Expression Omnibus database and Immune-related genes (IRGs) from ImmPort were downloaded to identify the differentially expressed immune-related genes (DEIRGs) between responder and non-responder to neoadjuvant chemoradiotherapy. Gene set enrichment analyses were performed to uncover significantly enriched GO terms and KEGG pathways. Immune cell infiltration was estimated from RNA-sequencing data using ImmuCellAI. Afterward, we constructed an immune-related gene-based predictive model (IRGPM) by Support Vector Machine and validated it in an external cohort.ResultA 15-gene signature (HLA-DPB1, HLA-DQA1, CXCL9, CXCL10, TAP2, INHBB, BMP2, CD74, IL33, CCL11, CXCL11, DEFB1, HLA-DPA1, CCN3, STAT1) was identified as DEIRGs and found to be significantly associated with nCRT outcomes. Gene set enrichment analyses indicated that the 15 genes play active roles in inflammation-related biological processes. In addition, ImmuCellAI revealed that CD4 naive T cells, Tex, Th1 were significantly up-regulated (p=0.035, p=0.02, p=0.0086, respectively), while Tfh were significantly down-regulated (p=0.015) in responder subgroup. Finally, a novel predictive model was developed by SVM based on DEIRGs with an AUC of 80% (internal validation) and 73.5% (external validation).ConclusionOur team conducted a genomic study of the relationship between gene expression profile and response to nCRT in LARC. Our data suggested that the DEIRGs signature could help predict the efficacy of nCRT. And a DEIRGs‐based SVM model was developed to monitor the outcomes of nCRT in LARC.
Preliminary Study on the Imbalance Between Th17 and Regulatory T Cells in Antiphospholipid Syndrome
Authors: Yan Huanhuan , Li Baochen , Su Rui , Gao Chong , Li Xiaofeng , Wang Caihong 
Published: May 2022

ObjectivePatients with antiphospholipid syndrome (APS) have immune cell abnormalities that remain poorly understood. This study compared primary APS (PAPS) and secondary APS (SAPS) patients with healthy controls with respect to peripheral blood lymphocytes, CD4+T cell subsets, and cytokine levels. The correlation between antiphospholipid antibody titres and T helper 17 (Th17) and T regulatory (Treg) cell subsets was also analyzed, together with the correlations between cytokine profiles and the clinical characteristics of APS patients.MethodsThe retrospective study population consisted of 67 APS patients (12 with PAPS, 55 with SAPS) and 40 healthy controls. Absolute numbers of peripheral blood lymphocyte subsets and CD4+ T cell subsets were detected by flow cytometry, and serum cytokine levels by flow cytometry bead array.ResultsPatients with SAPS had lower absolute values of T, B and CD4+T cells than the healthy control group, while only natural killer (NK) cell levels were decreased in patients with PAPS. Absolute numbers of T, B, NK, and CD4+T cells were significantly higher in the PAPS than SAPS group. The trends in CD4+T cell subsets were the same in PAPS and SAPS patients as in healthy controls, with increased Th1, decreased Th2, and decreased Treg levels, and thus an increased Th17/Treg ratio. Th2, Th17, and Treg cell counts were higher in the PAPS than SAPS group. Cytokine analysis showed that only IL-10 levels differed between the two APS groups. However, the levels of all of the studied cytokines were higher in APS patients than healthy controls, and correlated with the clinical characteristics of the patients. In the PAPS group, the titres of two autoantibodies correlated positively with the Th17/Treg ratio and negatively with the levels of D-dimer and Treg subsets.ConclusionsOur study clearly showed that APS patients have immune disturbances, the most prominent of which is an increase in the Th17/Treg ratio, due to a decrease in the number of Treg cells. These abnormalities may be involved in the occurrence and progression of APS. An additional finding was a higher level of peripheral blood lymphocytes in PAPS than SAPS patients, which may be related to the immunosuppressive treatment of SAPS patients.