bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical experience with the Bendit steerable microcatheter: a new paradigm for endovascular treatment
Authors: Killer-Oberpfalzer Monika , Chapot René , Orion David , Barr John D , Cabiri Oz , Berenstein Alejandro 
Published: July 2022

BackgroundVessel tortuosity poses a challenge during endovascular treatment of neurovascular lesions. Bendit Technologies (Petah Tikva, Israel) has developed flexible, steerable microcatheters designed with unique bending and torquing capabilities.ObjectiveTo describe our first-in-human trial of Bendit21.MethodsBendit21 was used in our exploratory, prospective, multicenter, open-label, single-arm clinical study, and in two compassionate use cases. Procedures were conducted at four centers in Austria, Germany, Israel, and the United States between May 2021 and March 2022, in patients with neurovascular conditions. The primary endpoints were device-related safety events, successful navigation through the neurovasculature, and, when intended, successful delivery of contrast or therapy.ResultsTwo patients with giant aneurysms were treated successfully under compassionate use approval. The clinical study included 25 patients (mean age: 63.4±11.8 years; 32.0% female). Fourteen patients (56.0%) had aneurysms, two had arteriovenous malformations/fistulas (8.0%), one had a stroke (4.0%), four (16.0%) had intracranial stenosis, and four (16.0%) had other conditions. Bendit21 was used without a guidewire in 12/25 (48.0%) procedures. Bendit21 was successfully navigated through the vasculature without delays or spasms in all cases (100%). Contrast was delivered as intended in 7/7 (100%) cases. Therapeutic devices were delivered successfully with Bendit as intended in 14/18 (77.8%) cases; four deficiencies occurred in three patients with aneurysms, in whom delivery of coils, an intrasaccular device, or a flow diverter was attempted. There were no device-related safety events or mortalities.ConclusionsOur initial clinical experience with the Bendit21 microcatheter demonstrates its usefulness in achieving technical success in patients with challenging neurovascular conditions.
Accuracy of augmented reality-guided drainage versus stereotactic and conventional puncture in an intracerebral hemorrhage phantom model
Authors: Demerath Theo , Stanicki Amin , Roelz Roland , Farina Nunez Mateo Tomas , Bissolo Marco , Steiert Christine , Fistouris Panagiotis , Coenen Volker Arnd , Urbach Horst , Fung Christian , Beck Jürgen , Reinacher Peter Christoph 
Published: July 2022

BackgroundMinimally invasive intracranial drain placement is a common neurosurgical emergency procedure in patients with intracerebral hemorrhage (ICH). We aimed to retrospectively investigate the accuracy of conventional freehand (bedside) hemorrhage drain placement and to prospectively compare the accuracy of augmented/mixed reality-guided (AR) versus frame-based stereotaxy-guided (STX) and freehand drain placement in a phantom model.MethodsA retrospective, single-center analysis evaluated the accuracy of drain placement in 73 consecutive ICH with a visual rating of postinterventional CT data. In a head phantom with a simulated deep ICH, five neurosurgeons performed four punctures for each technique: STX, AR, and the freehand technique. The Euclidean distance to the target point and the lateral deviation of the achieved trajectory from the planned trajectory at target point level were compared between the three methods.ResultsAnalysis of the clinical cases revealed an optimal drainage position in only 46/73 (63%). Correction of the drain was necessary in 23/73 cases (32%). In the phantom study, accuracy of AR was significantly higher than the freehand method (P<0.001 for both Euclidean and lateral distances). The Euclidean distance using AR (median 3 mm) was close to that using STX (median 1.95 mm; P=0.023).ConclusionsWe demonstrated that the accuracy of the freehand technique was low and that subsequent position correction was common. In a phantom model, AR drainage placement was significantly more precise than the freehand method. AR has great potential to increase precision of emergency intracranial punctures in a bedside setting.
Improving resident well-being: a narrative review of wellness curricula
Authors: Ahart Erin R , Gilmer Lisa , Tenpenny Kelsey , Krase Kelli 
Published: July 2022

Abstract

Background
To improve wellness among residents, many graduate medical education programs have implemented formal wellness curricula. Curricular development has recently shifted focus from drivers of burnout to promotion of wellness. The specific components of successful wellness curricula, however, are not yet well defined.

Objective
To review the published literature assessing core components of wellness curricula in graduate medical education programs.

Methods
Searches were conducted through June 2020 in PubMed, Education Resources Information Center, Google Scholar and Web of Science using the search terms wellness curricula, wellness programs, well-being and graduate medical education. Additional articles were identified from reference lists. Curricula from primarily undergraduate medical education, singular interventions, non-peer-reviewed studies and non-English language studies were excluded.

Results
Eighteen articles were selected and reviewed by three authors. Critical drivers of success included support from program leadership and opportunities for resident involvement in the curriculum implementation. Most curricula included interventions related to both physical and mental health. Curricula including challenging components of professionalisation, such as critical conversations, medical errors and boundary setting, seemed to foster increased resident buy-in. The most frequently used curricular assessment tools were the Maslach Burnout Inventory and resident satisfaction surveys.

Conclusions
Different specialties have different wellness needs. A resource or ‘toolbox’ that includes a variety of general as well as specialty-specific wellness components might allow institutions and programs to select interventions that best suit their individual needs. Assessment of wellness curricula is still in its infancy and is largely limited to single institution experiences.
BiqBin: A Parallel Branch-and-bound Solver for Binary Quadratic Problems with Linear Constraints
Authors: Gusmeroli Nicolò , Hrga Timotej , Lužar Borut , Povh Janez , Siebenhofer Melanie , Wiegele Angelika 
Published: July 2022

We present BiqBin, an exact solver for linearly constrained binary quadratic problems. Our approach is based on an exact penalty method to first efficiently transform the original problem into an instance of Max-Cut, and then to solve the Max-Cut problem by a branch-and-bound algorithm. All the main ingredients are carefully developed using new semidefinite programming relaxations obtained by strengthening the existing relaxations with a set of hypermetric inequalities, applying the bundle method as the bounding routine and using new strategies for exploring the branch-and-bound tree.Furthermore, an efficient C implementation of a sequential and a parallel branch-and-bound algorithm is presented. The latter is based on a load coordinator-worker scheme using MPI for multi-node parallelization and is evaluated on a high-performance computer.The new solver is benchmarked against BiqCrunch, GUROBI, and SCIP on four families of (linearly constrained) binary quadratic problems. Numerical results demonstrate that BiqBin is a highly competitive solver. The serial version outperforms the other three solvers on the majority of the benchmark instances. We also evaluate the parallel solver and show that it has good scaling properties. The general audience can use it as an on-line service available athttp://www.biqbin.eu.
On the Explainability of Natural Language Processing Deep Models
Authors: Zini Julia El , Awad Mariette 
Published: July 2022

Despite their success, deep networks are used as black-box models with outputs that are not easily explainable during the learning and the prediction phases. This lack of interpretability is significantly limiting the adoption of such models in domains where decisions are critical such as the medical and legal fields. Recently, researchers have been interested in developing methods that help explain individual decisions and decipher the hidden representations of machine learning models in general and deep networks specifically. While there has been a recent explosion of work on Explainable Artificial Intelligence (ExAI) on deep models that operate on imagery and tabular data, textual datasets present new challenges to the ExAI community. Such challenges can be attributed to the lack of input structure in textual data, the use of word embeddings that add to the opacity of the models and the difficulty of the visualization of the inner workings of deep models when they are trained on textual data.
Lately, methods have been developed to address the aforementioned challenges and present satisfactory explanations on Natural Language Processing (NLP) models. However, such methods are yet to be studied in a comprehensive framework where common challenges are properly stated and rigorous evaluation practices and metrics are proposed.

Motivated to democratize ExAI methods in the NLP field, we present in this work a survey that studies
model-agnostic
as well as
model-specific
explainability methods on NLP models. Such methods can either develop
inherently
interpretable NLP models or operate on pre-trained models in a
post hoc
manner. We make this distinction and we further decompose the methods into three categories according to what they explain: (1) word embeddings (input level), (2) inner workings of NLP models (processing level), and (3) models’ decisions (output level). We also detail the different evaluation approaches interpretability methods in the NLP field. Finally, we present a case-study on the well-known neural machine translation in an appendix, and we propose promising future research directions for ExAI in the NLP field.
Exploiting Multi-modal Contextual Sensing for City-bus’s Stay Location Characterization: Towards Sub-60 Seconds Accurate Arrival Time Prediction
Authors: Mandal Ratna , Karmakar Prasenjit , Chatterjee Soumyajit , Das Spandan Debaleen , Pradhan Shouvit , Saha Sujoy , Chakraborty Sandip , Nandi Subrata 
Published: July 2022

Intelligent city transportation systems are one of the core infrastructures of a smart city. The true ingenuity of such an infrastructure lies in providing the commuters with real-time information about citywide transport like public buses, allowing them to pre-plan their travel. However, providing prior information for transportation systems like public buses in real-time is inherently challenging because of the diverse nature of different stay-locations where a public bus stops. Although straightforward factors like stay duration extracted from unimodal sources like GPS at these locations look erratic, a thorough analysis of public bus GPS trails for 1,335.365 km at the city of Durgapur, a semi-urban city in India, reveals that several other fine-grained contextual features can characterize these locations accurately. Accordingly, we develop
BuStop
, a system for extracting and characterizing the stay-locations from multi-modal sensing using commuters’ smartphones. Using this multi-modal information
BuStop
extracts a set of granular contextual features that allows the system to differentiate among the different stay-location types. A thorough analysis of
BuStop
using the collected in-house dataset indicates that the system works with high accuracy in identifying different stay-locations such as regular bus stops, random ad hoc stops, stops due to traffic congestion, stops at traffic signals, and stops at sharp turns. Additionally, we develop a proof-of-concept setup on top of
BuStop
to analyze the potential of the framework in predicting expected arrival time, a critical piece of information required to pre-plan travel at any given bus stop. Subsequent analysis of the PoC framework, through simulation over the test dataset, shows that characterizing the stay-locations indeed helps make more accurate arrival time predictions with deviations less than 60 seconds from the ground-truth arrival time.
Upfront Biology-Guided Therapy in Diffuse Intrinsic Pontine Glioma: Therapeutic, Molecular, and Biomarker Outcomes from PNOC003
Authors: Kline Cassie , Jain Payal , Kilburn Lindsay , Bonner Erin R. , Gupta Nalin , Crawford John R. , Banerjee Anu , Packer Roger J. , Villanueva-Meyer Javier , Luks Tracy , Zhang Yalan , Kambhampati Madhuri , Zhang Jie , Yadavilli Sridevi , Zhang Bo , Gaonkar Krutika S. , Rokita Jo Lynne , Kraya Adam , Kuhn John , Liang Winnie , Byron Sara , Berens Michael , Molinaro Annette , Prados Michael , Resnick Adam , Waszak Sebastian M. , Nazarian Javad , Mueller Sabine 
Published: July 2022

AbstractPurpose:PNOC003 is a multicenter precision medicine trial for children and young adults with newly diagnosed diffuse intrinsic pontine glioma (DIPG).Patients and Methods:Patients (3–25 years) were enrolled on the basis of imaging consistent with DIPG. Biopsy tissue was collected for whole-exome and mRNA sequencing. After radiotherapy (RT), patients were assigned up to four FDA-approved drugs based on molecular tumor board recommendations. H3K27M-mutant circulating tumor DNA (ctDNA) was longitudinally measured. Tumor tissue and matched primary cell lines were characterized using whole-genome sequencing and DNA methylation profiling. When applicable, results were verified in an independent cohort from the Children's Brain Tumor Network (CBTN).Results:Of 38 patients enrolled, 28 patients (median 6 years, 10 females) were reviewed by the molecular tumor board. Of those, 19 followed treatment recommendations. Median overall survival (OS) was 13.1 months [95% confidence interval (CI), 11.2–18.4] with no difference between patients who followed recommendations and those who did not. H3K27M-mutant ctDNA was detected at baseline in 60% of cases tested and associated with response to RT and survival. Eleven cell lines were established, showing 100% fidelity of key somatic driver gene alterations in the primary tumor. In H3K27-altered DIPGs, TP53 mutations were associated with worse OS (TP53mut 11.1 mo; 95% CI, 8.7–14; TP53wt 13.3 mo; 95% CI, 11.8–NA; P = 3.4e−2), genome instability (P = 3.1e−3), and RT resistance (P = 6.4e−4). The CBTN cohort confirmed an association between TP53 mutation status, genome instability, and clinical outcome.Conclusions:Upfront treatment-naïve biopsy provides insight into clinically relevant molecular alterations and prognostic biomarkers for H3K27-altered DIPGs.
PD-1T TILs as a Predictive Biomarker for Clinical Benefit to PD-1 Blockade in Patients with Advanced NSCLC
Authors: Hummelink Karlijn , van der Noort Vincent , Muller Mirte , Schouten Robert D. , Lalezari Ferry , Peters Dennis , Theelen Willemijn S.M.E. , Koelzer Viktor H. , Mertz Kirsten D. , Zippelius Alfred , van den Heuvel Michel M. , Broeks Annegien , Haanen John B.A.G. , Schumacher Ton N. , Meijer Gerrit A. , Smit Egbert F. , Monkhorst Kim , Thommen Daniela S. 
Published: July 2022

Abstract

Purpose:
Durable clinical benefit to PD-1 blockade in non–small cell lung cancer (NSCLC) is currently limited to a small fraction of patients, underlining the need for predictive biomarkers. We recently identified a tumor-reactive tumor-infiltrating T lymphocyte (TIL) pool, termed PD-1T TILs, with predictive potential in NSCLC. Here, we examined PD-1T TILs as biomarker in NSCLC.

Experimental Design:
PD-1T TILs were digitally quantified in 120 baseline samples from advanced NSCLC patients treated with PD-1 blockade. Primary outcome was disease control (DC) at 6 months. Secondary outcomes were DC at 12 months and survival. Exploratory analyses addressed the impact of lesion-specific responses, tissue sample properties, and combination with other biomarkers on the predictive value of PD-1T TILs.

Results:
PD-1T TILs as a biomarker reached 77% sensitivity and 67% specificity at 6 months, and 93% and 65% at 12 months, respectively. Particularly, a patient group without clinical benefit was reliably identified, indicated by a high negative predictive value (NPV) (88% at 6 months, 98% at 12 months). High PD-1T TILs related to significantly longer progression-free (HR 0.39, 95% CI, 0.24–0.63, P &lt; 0.0001) and overall survival (HR 0.46, 95% CI, 0.28–0.76, P &lt; 0.01). Predictive performance was increased when lesion-specific responses and samples obtained immediately before treatment were assessed. Notably, the predictive performance of PD-1T TILs was superior to PD-L1 and tertiary lymphoid structures in the same cohort.

Conclusions:
This study established PD-1T TILs as predictive biomarker for clinical benefit to PD-1 blockade in patients with advanced NSCLC. Most importantly, the high NPV demonstrates an accurate identification of a patient group without benefit.
See related commentary by Anagnostou and Luke, p. 4835
Pan-Cancer Analysis Reveals Recurrent BCAR4 Gene Fusions across Solid Tumors
Authors: Nickless Andrew , Zhang Jin , Othoum Ghofran , Webster Jace , Inkman Matthew J. , Coonrod Emily , Fontes Sherron , Rozycki Emily B. , Maher Christopher A. , White Nicole M. 
Published: July 2022

Abstract

Chromosomal rearrangements often result in active regulatory regions juxtaposed upstream of an oncogene to generate an expressed gene fusion. Repeated activation of a common downstream partner–with differing upstream regions across a patient cohort–suggests a conserved oncogenic role. Analysis of 9,638 patients across 32 solid tumor types revealed an annotated long noncoding RNA (lncRNA), Breast Cancer Anti-Estrogen Resistance 4 (BCAR4), was the most prevalent, uncharacterized, downstream gene fusion partner occurring in 11 cancers. Its oncogenic role was confirmed using multiple cell lines with endogenous BCAR4 gene fusions. Furthermore, overexpressing clinically prevalent BCAR4 gene fusions in untransformed cell lines was sufficient to induce an oncogenic phenotype. We show that the minimum common region to all gene fusions harbors an open reading frame that is necessary to drive proliferation.

Implications:
BCAR4 gene fusions represent an underappreciated class of gene fusions that may have biological and clinical implications across solid tumors.
Coaptation Reserve Predicts Optimal Reduction in Mitral Regurgitation and Long-Term Survival With Transcatheter Edge-to-Edge Repair
Authors: Sato Hirotomo , Cavalcante João L. , Bae Richard , Bapat Vinayak N. , Garcia Santiago , Gössl Mario , Hashimoto Go , Fukui Miho , Enriquez-Sarano Maurice , Sorajja Paul 
Published: July 2022

Background:
Although transcatheter edge-to-edge repair (TEER) is effective and safe, there is a need for better prediction of optimal outcomes. We aimed to determine predictors of optimal reduction in mitral regurgitation (MR) and survival with TEER.

Methods:
We examined mitral anatomy and its change with TEER on outcomes in 183 patients (age, 82 [77–87] years; 53% women). Coaptation reserve was measured as the distance of continuous apposition of the A2 and P2 leaflet segments in 2-dimensional apical long-axis imaging at the site of the predominant jet of MR. Augmentation in coaptation was measured as the total amount of leaflet insertion. Addressable coaptation area was calculated using the physical boundaries of the TEER device.

Results:

Coaptation reserve, its augmentation, and addressable coaptation area were strong predictors of MR reduction (all
P
<0.001), as well as heart failure hospitalization and death. For patients with either mild or no residual MR, median values for coaptation reserve, its augmentation, and addressable coaptation area were 3.7 (2.8–4.5) mm, 7.3 (5.2–9.5) mm, and 59.0 (48.0–71.8) mm
2
, respectively. Receiver operating characteristic analyses determined the best values for optimal MR reduction as a coaptation reserve of >3.0 mm (
P
<0.001), addressable coaptation area of ≥52 mm
2
(
P
<0.001), and coaptation augmentation of ≥4.7 mm (
P
<0.001). These values were associated with greater 2-year survival free of all-cause mortality and persisting even in analyses restricted to those with mild or no residual MR after TEER.

Conclusions:
Coaptation reserve and its augmentation are simple, independent parameters that predict optimal MR reduction and better survival in patients undergoing TEER. These findings may have implications for patient selection and expanded use of the therapy.
Transcatheter Thoracic Duct Decompression for Multicompartment Lymphatic Failure After Fontan Palliation
Authors: Smith Christopher L. , Dori Yoav , O’Byrne Michael L. , Glatz Andrew C. , Gillespie Matthew J. , Rome Jonathan J. 
Published: July 2022

Background:
Lymphatic embolization therapy has proven effective for Fontan failure from plastic bronchitis or protein-losing enteropathy but not when multiple lymphatic compartments are involved; furthermore, embolization does not alter the underlying pathophysiology of lymphatic dysfunction. A technique for transcatheter thoracic duct decompression (TDD), rerouting the thoracic duct to the pulmonary venous atrium to treat multicompartment lymphatic failure is described and early outcomes presented.

Methods:
Initially covered stents were used to channel the innominate vein flow inside of the cavopulmonary pathway into the pulmonary venous atrium. A modified approach was developed where covered stents redirected innominate vein directly to the left atrium via an extravascular course. Baseline and follow-up data on all patients undergoing TDD were reviewed.

Results:
Twelve patients underwent TDD between March 2018 and February 2021 at a median age of 12 (range: 2–22) years. Lymphatic failure occurred in median of 3 compartments per patient (protein-losing enteropathy, ascites, pleural effusions, plastic bronchitis); 10 patients had lymphatic embolizations before TDD. TDD method was intra-Fontan tunnel in 4, direct approach in 7, and other in 1. There were no major procedural complications; 6 patients underwent subsequent procedures, most commonly to treat endoleaks. Lymphatic failure resolved in 6 patients, improved in 2, and was unchanged in 4 at 6 (range: 1–20) months follow-up. One patient died after TDD from Fontan failure.

Conclusions:
TDD is a promising new treatment for the failing Fontan physiology from multicompartment lymphatic failure. Additional work is needed to refine the technique and define optimal candidates.