bluuebunny/crossref_metadata_2025_split huggingface dataset:
The centrally restricted diffusion sign on MRI for assessment of radiation necrosis in metastases treated with stereotactic radiosurgery
Authors: Hainc Nicolin , Alsafwani Noor , Gao Andrew , O’Halloran Philip J. , Kongkham Paul , Zadeh Gelareh , Gutierrez Enrique , Shultz David , Krings Timo , Alcaide-Leon Paula 
Published: October 2021

Abstract
Purpose
Differentiation of radiation necrosis from tumor progression in brain metastases treated with stereotactic radiosurgery (SRS) is challenging. For this, we assessed the performance of the centrally restricted diffusion sign.

Methods
Patients with brain metastases treated with SRS who underwent a subsequent intervention (biopsy/resection) for a ring-enhancing lesion on preoperative MRI between 2000 and 2020 were included. Excluded were lesions containing increased susceptibility limiting assessment of DWI. Two neuroradiologists classified the location of the diffusion restriction with respect to the post-contrast T1 images as centrally within the ring-enhancement (the centrally restricted diffusion sign), peripherally correlating to the rim of contrast enhancement, both locations, or none. Measures of diagnostic accuracy and 95% CI were calculated for the centrally restricted diffusion sign. Cohen's kappa was calculated to identify the interobserver agreement.

Results
Fifty-nine patients (36 female; mean age 59, range 40 to 80) were included, 36 with tumor progression and 23 with radiation necrosis based on histopathology. Primary tumors included 34 lung, 12 breast, 5 melanoma, 3 colorectal, 2 esophagus, 1 head and neck, 1 endometrium, and 1 thyroid. The centrally restricted diffusion sign was seen in 19/23 radiation necrosis cases (sensitivity 83% (95% CI 63 to 93%), specificity 64% (95% CI 48 to 78%), PPV 59% (95% CI 42 to 74%), NPV 85% (95% CI 68 to 94%)) and 13/36 tumor progression cases (difference p < 0.001). Interobserver agreement was substantial, at 0.61 (95% CI 0.45 to 70.8).

Conclusion
We found a low probability of radiation necrosis in the absence of the centrally restricted diffusion sign.
Passing through resonance of the unbalanced rotor with self-balancing device
Authors: Drozdetskaya Olga , Fidlin Alexander 
Published: October 2021

AbstractThe slow dynamics of unbalanced rotors with a passive self-balancing system are investigated considering the interaction of the mechanical system with a limited power engine. The slow dynamics equations are obtained using the averaging technique for partially strongly damped systems. Stationary system configurations, different types of nonstationary solutions while passing through resonance, and areas of stability and attraction are investigated.
Predicting delays in service operations
Authors: von Schéele Fabian , Haftor Darek M. , Pashkevich Natallia 
Published: October 2021

AbstractDelays constitute a key challenge in the management of service operations, causing substantial quality and cost issues. Delays in one service event can cause delays in another service event and so on, which creates challenges in the management of complex services. Assuming a lower-triangular matrix formalism, we develop a novel approach to modelling such chains of delays in complex service operations such as health care and software development. This approach can enable service managers to identify, understand, predict and control delays. Our research provides a novel theoretical contribution to the literature on service delays.
Classification evaluation method for Chang 7 oil group of Yanchang formation in Ordos Basin
Authors: Jianming Fan , Jian Shi , Xiaolong Wan , Qichao Xie , Chong Wang 
Published: October 2021

AbstractThe Chang 7 oil group in the Ordos Basin has the characteristics of a tight lithology, a low formation pressure coefficient and strong reservoir heterogeneity. To better determine reasonable developmental technical countermeasures, oiliness, seepage capacity, and compressibility evaluations are combined. Using a combination of field practice and laboratory experiments, six types of sweetness classification evaluation parameters are screened: oil saturation, longitudinal oil layer structure coefficient, average pore throat radius, gas-oil ratio, brittleness index, and minimum horizontal principal stress. By combining the relationships among variables with the initial production from directional wells, the gray correlation method is used to quantify the weights of the contributions of evaluation parameters to production. On this basis, using the difference method for the curve slope, a sweetness evaluation and classification method for the Chang 7 oil group is constructed, and it solves the difficult problem of quality difference classification for the Chang 7 oil group and provides a reference basis for the optimal design of well patterns and fracturing reconstruction parameters.
Analytical performance of the point-of-care BIOSYNEX COVID-19 Ag BSS for the detection of SARS‐CoV‐2 nucleocapsid protein in nasopharyngeal swabs: a prospective field evaluation during the COVID-19 third wave in France
Authors: Fitoussi Frédéric , Tonen-Wolyec Serge , Awaida Natalio , Dupont Raphaël , Bélec Laurent 
Published: October 2021

Abstract
Background
The accuracy and reliability of rapid diagnostic tests are critical for monitoring and diagnosing SARS-CoV-2 infection in the general population. This study aimed to evaluate the analytical performance of the BIOSYNEX COVID-19 Ag BSS (Biosynex Swiss SA, Fribourg, Switzerland) antigen rapid diagnostic test (BIOSYNEX Ag-RDT), which targets the SARS-CoV-2 N-nucleocapsid protein for the diagnosis of COVID-19. The Ag-RDT was compared with a real-time RT-PCR (rtRT-PCR) as gold standard for performance measurement.

Methods
Two nasopharyngeal flocked swabs were prospectively collected simultaneously in March and April 2021 from 967 individuals aged ≥ 18 years tested for SARS-CoV-2 in two private laboratories, Paris, France.

Results
Overall, the Ag-RDT demonstrated high sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of 81.8%, 99.6%, 96.6%, and 97.5%, respectively. The agreement (97.0%), reliability assessed using Cohen’s κ-coefficient (0.87), and accuracy evaluated using Youden index (J) (81.6%) in detecting SARS-CoV-2 were high. The analytical performance of the Ag-RDT remained high when there was significant viral shedding (i.e., N gene Ct values ≤ 33 on reference RT-PCR). The sensitivity was only 55.2% in case of low or very low viral excretion (Ct > 33).

Conclusions
The BIOSYNEX Ag-RDT is a promising, potentially simple diagnostic tool, especially in symptomatic COVID-19 patients with substantial viral excretion in the nasopharynx.
Geometrically nonlinear dynamic analysis of functionally graded material plate excited by a moving load applying first-order shear deformation theory via generalized differential quadrature method
Authors: Nazari Hesam , Babaei Masoud , Kiarasi Faraz , Asemi Kamran 
Published: October 2021

Abstract
In this study, we present a numerical solution for geometrically nonlinear dynamic analysis of functionally graded material rectangular plates excited to a moving load based on first-order shear deformation theory (FSDT) for the first time. To derive the governing equations of motion, Hamilton’s principle, nonlinear Von Karman assumptions and FSDT are used. Finally, the governing equations of motion are solved by employing the generalized differential quadratic method as a numerical solution. Natural frequencies, dynamic bending behavior and stresses of the plate for linear and nonlinear type of geometrically strain–displacement relations and different factors, including the magnitude and velocity of moving load, length ratio, power law exponent and various edge conditions are obtained and compared.

Article highlights
Developing generalized differential quadrature method (GDQM) solution based on FSDT for dynamic analysis of FGM plate excited by a moving load for the first time.

Comparison of linear and nonlinear dynamic response of plate by considering Von-Karman assumption.

Observing considerable difference between linear and nonlinear results
Global cognitive dysfunction and β-amyloid neuropathology in late-life and treatment-resistant major depression
Authors: Li Cheng-Ta , Fuh Jong-Ling , Yang Bang-Hung , Hong Chen-Ji , Chang Chi-Wei , Tu Pei-Chi , Jeng Jia-Shyun , Chen Mu-Hong , Tsai Shih-Jen , Bai Ya-Mei , Su Tung-Ping , Lee Hsuan , Huang Wen-Sheng 
Published: October 2021

AbstractBackgroundCognitive impairment is common in late-life depression, which may increase Alzheimer disease (AD) risk. Therefore, we aimed to investigate whether late-life major depressive disorder (MDD) has worse cognition and increases the characteristic AD neuropathology. Furthermore, we carried out a comparison between treatment-resistant depression (TRD) and non-TRD. We hypothesized that patients with late-life depression and TRD may have increased β-amyloid (Aβ) deposits in brain regions responsible for global cognition.MethodsWe recruited 81 subjects, including 54 MDD patients (27 TRD and 27 non-TRD) and 27 matched healthy controls (HCs). Neurocognitive tasks were examined, including Mini-Mental State Examination and Montreal Cognitive Assessment to detect global cognitive functions. PET with Pittsburgh compound-B and fluorodeoxyglucose were used to capture brain Aβ pathology and glucose use, respectively, in some patients.ResultsMDD patients performed worse in Montreal Cognitive Assessment (p = 0.003) and had more Aβ deposits than HCs across the brain (family-wise error-corrected p < 0.001), with the most significant finding in the left middle frontal gyrus. Significant negative correlations between global cognition and prefrontal Aβ deposits existed in MDD patients, whereas positive correlations were noted in HCs. TRD patients had significantly more deposits in the left-sided brain regions (corrected p < 0.001). The findings were not explained by APOE genotypes. No between-group fluorodeoxyglucose difference was detected.ConclusionsLate-life depression, particularly TRD, had increased brain Aβ deposits and showed vulnerability to Aβ deposits. A detrimental role of Aβ deposits in global cognition in patients with late-onset or non-late-onset MDD supported the theory that late-life MDD could be a risk factor for AD.
Seasonal predictability of baroclinic wave activity
Authors: Zhang Gan , Murakami Hiroyuki , Cooke William F. , Wang Zhuo , Jia Liwei , Lu Feiyu , Yang Xiaosong , Delworth Thomas L. , Wittenberg Andrew T. , Harrison Matthew J. , Bushuk Mitchell , McHugh Colleen , Johnson Nathaniel C. , Kapnick Sarah B. , Tseng Kai-Chih , Zhang Liping 
Published: October 2021

AbstractMidlatitude baroclinic waves drive extratropical weather and climate variations, but their predictability beyond 2 weeks has been deemed low. Here we analyze a large ensemble of climate simulations forced by observed sea surface temperatures (SSTs) and demonstrate that seasonal variations of baroclinic wave activity (BWA) are potentially predictable. This potential seasonal predictability is denoted by robust BWA responses to SST forcings. To probe regional sources of the potential predictability, a regression analysis is applied to the SST-forced large ensemble simulations. By filtering out variability internal to the atmosphere and land, this analysis identifies both well-known and unfamiliar BWA responses to SST forcings across latitudes. Finally, we confirm the model-indicated predictability by showing that an operational seasonal prediction system can leverage some of the identified SST-BWA relationships to achieve skillful predictions of BWA. Our findings help to extend long-range predictions of the statistics of extratropical weather events and their impacts.
Development of deep learning-based detecting systems for pathologic myopia using retinal fundus images
Authors: Lu Li , Zhou Enliang , Yu Wangshu , Chen Bin , Ren Peifang , Lu Qianyi , Qin Dian , Lu Lixian , He Qin , Tang Xuyuan , Zhu Miaomiao , Wang Li , Han Wei 
Published: October 2021

AbstractGlobally, cases of myopia have reached epidemic levels. High myopia and pathological myopia (PM) are the leading cause of visual impairment and blindness in China, demanding a large volume of myopia screening tasks to control the rapid growing myopic prevalence. It is desirable to develop the automatically intelligent system to facilitate these time- and labor- consuming tasks. In this study, we designed a series of deep learning systems to detect PM and myopic macular lesions according to a recent international photographic classification system (META-PM) classification based on color fundus images. Notably, our systems recorded robust performance both in the test and external validation dataset. The performance was comparable to the general ophthalmologist and retinal specialist. With the extensive adoption of this technology, effective mass screening for myopic population will become feasible on a national scale.
Host methylation predicts SARS-CoV-2 infection and clinical outcome
Authors: Konigsberg Iain R. , Barnes Bret , Campbell Monica , Davidson Elizabeth , Zhen Yingfei , Pallisard Olivia , Boorgula Meher Preethi , Cox Corey , Nandy Debmalya , Seal Souvik , Crooks Kristy , Sticca Evan , Harrison Genelle F. , Hopkinson Andrew , Vest Alexis , Arnold Cosby G. , Kahn Michael G. , Kao David P. , Peterson Brett R. , Wicks Stephen J. , Ghosh Debashis , Horvath Steve , Zhou Wanding , Mathias Rasika A. , Norman Paul J. , Porecha Rishi , Yang Ivana V. , Gignoux Christopher R. , Monte Andrew A. , Taye Alem , Barnes Kathleen C. 
Published: October 2021

AbstractBackgroundSince the onset of the SARS-CoV-2 pandemic, most clinical testing has focused on RT-PCR1. Host epigenome manipulation post coronavirus infection2–4suggests that DNA methylation signatures may differentiate patients with SARS-CoV-2 infection from uninfected individuals, and help predict COVID-19 disease severity, even at initial presentation.MethodsWe customized Illumina’s Infinium MethylationEPIC array to enhance immune response detection and profiled peripheral blood samples from 164 COVID-19 patients with longitudinal measurements of disease severity and 296 patient controls.ResultsEpigenome-wide association analysis revealed 13,033 genome-wide significant methylation sites for case-vs-control status. Genes and pathways involved in interferon signaling and viral response were significantly enriched among differentially methylated sites. We observe highly significant associations at genes previously reported in genetic association studies (e.g.IRF7,OAS1). Using machine learning techniques, models built using sparse regression yielded highly predictive findings: cross-validated best fit AUC was 93.6% for case-vs-control status, and 79.1%, 80.8%, and 84.4% for hospitalization, ICU admission, and progression to death, respectively.ConclusionsIn summary, the strong COVID-19-specific epigenetic signature in peripheral blood driven by key immune-related pathways related to infection status, disease severity, and clinical deterioration provides insights useful for diagnosis and prognosis of patients with viral infections.
Left Frontal Lobe Tumor-Induced Intraoperative Premature Ventricular Beats
Authors: Bithal Parmod K. , Jan Ravees , Kumar Bharani , Rahman Insha ur 
Published: October 2021

AbstractIn the absence of cardiac pathology, premature ventricular contractions (PVCs) in neurosurgical patients frequently accompany subarachnoid hemorrhage, intracerebral hemorrhage, traumatic brain injury, or raised intracranial pressure. PVCs detected during preanesthesia assessment prompts detailed cardiac evaluation. Our 57-year-old patient, a case of left frontal meningioma, with controlled hypertension, diabetes and hypothyroidism, had normal preoperative ECG and potassium. However, immediately on anesthesia induction, she developed multiple refractory to treatment PVCs but with normal blood pressure. Anesthesia, which was maintained with sevoflurane and fentanyl, was deepened to exclude light anesthesia as the cause, without useful outcome. Two lignocaine boluses (100 mg each), followed by its infusion, also proved ineffective. Her blood gases and potassium, checked twice, were normal. Throughout, her hemodynamics remained stable. As soon as tumor was removed, the PVCs disappeared not to return. Her postoperative recovery was uneventful with normal ECG.
Effect of Beach-Chair Position on Cerebral Blood Flow in Patients Undergoing Shoulder Surgery—A Preliminary Observational Study
Authors: Antony Jesudoss , Singh Georgene , Yadav Bijesh , Abraham Melvin A. , George Sajan P. 
Published: October 2021

Abstract
Background Hypotension and cerebral hypoperfusion, commonly encountered in beach-chair position under general anesthesia, carry the risk of neurologic complications. There is a paucity of data on monitoring cerebral perfusion. Our objective was to compare the mean arterial pressure (MAP) and middle cerebral artery velocity (Vmca) in the supine and beach-chair position and estimate its correlation during hypotension.
Materials and Methods Twenty ASA class I and II patients undergoing elective shoulder surgery in beach-chair position were included in the study. MAP was measured invasively with the pressure transducer leveled to the phlebostatic axis. Vmca was measured with a 2 MHz transcranial Doppler (TCD) probe through the temporal window. Both MAP and Vmca were measured at baseline after anesthetic induction in the supine position (BL), on assuming the beach-chair position (AP), at steady-state hemodynamics in beach-chair position (P1), whenever there was a drop in MAP > 20% (P2), and on the restoration of MAP (P3).
Results A mean decrease in MAP and Vmca by 24.76% and 27.96%, respectively, from supine to beach-chair position with a significant linear correlation between MAP and Vmca along with a Pearsons' coefficient of 0.77 was seen. A change in MAP of 1 mm of Hg resulted in a change in Vmca by 0.53 cm/sec (p < 0.05).
Conclusion A significant decrease in MAP and Vmca was observed in the beach-chair position. TCD could be used as a point-of-care noninvasive technique to reliably assess cerebral perfusion.
Decoding the Onset of Intraoperative Normal Pressure Perfusion Breakthrough with Near-Infrared Spectroscopy and Jugular Venous Oxygen Saturation Catheter in a Case of Arteriovenous Malformation Surgery
Authors: Thakkar Keta , Thomas Jithumol T. , Hrishi Ajay P. , Sethuraman Manikandan 
Published: October 2021

AbstractMultimodal monitoring can be a useful tool to design an appropriate anesthesia technique in the intraoperative period during the surgical excision of an intracerebral arteriovenous malformation (AVM). Intraoperatively, hyperperfusion syndrome can be attributed to causes like insufficient blood pressure control, occlusion of venous drainage before complete resection of arterial feeders, or inadequate hemostatic control of distended capillaries receiving arterial flow. We would like to highlight the potential role of near-infrared spectroscopy and jugular venous oxygen saturation catheter in detection of intraoperative normal perfusion pressure breakthrough and take necessary measures to prevent further insult with the help of this case report.
Effect of Therapeutic Plasma Exchange on Plasma Constituents in Neurointensive Care Unit Patients: A Retrospective Study
Authors: Srinivas Deepti , Sriganesh Kamath , Chakrabarti Dhritiman , Venkateswaran Pavithra 
Published: October 2021

AbstractPurpose Plasma exchange is one of the recommended therapeutic procedures for autoimmune neurological conditions and involves removal of plasma over multiple sessions for exclusion of autoantibodies responsible for the disease process. This study aimed to evaluate the changes in the concentration of plasma constituents with five cycles of alternate day therapeutic plasma exchange (TPE), identify contributing factors for hypoproteinemia, and examine its impact on clinical outcomes.Methods This was a single-center, retrospective cohort study involving patients with autoimmune neurological diseases who underwent at least five cycles of TPE in the neurointensive care unit (NICU). Data regarding plasma protein concentrations, serum electrolytes, fluid input/output before and after every TPE cycle and clinical outcomes in terms of duration of ventilation, and NICU and hospital stay were collected from the medical records over a 1-year period.Results The levels of plasma proteins (total protein, albumin and globulin) (p < 0.001), sodium (p < 0.001), calcium (p < 0.001), and hemoglobin (p = 0.002) declined significantly after TPE. Difference in plasma protein levels before and after TPE did not correlate with durations of mechanical ventilation and hospital and NICU stay. Difference in total protein and globulin correlated negatively with fluid balance and positively with daily protein intake (p < 0.05 for both).Conclusion A significant decrease in plasma proteins and other plasma constituents is seen with TPE. Changes in plasma proteins are related to hemodilution and protein intake. Decrease in plasma proteins did not affect duration of hospital or NICU stay and duration of mechanical ventilation.
Rare Case of Left Ventricular Thrombus Postmyocardial Infarction for Emergency Decompressive Craniectomy
Authors: Arikrishnan Thirumurugan , Chakravarthy Deepak , Uthaman Duraiyarassu , Srinivasan Gnanasekaran 
Published: October 2021

AbstractLeft ventricular (LV) thrombus formation is a notorious complication encountered in postmyocardial infarction patients. Such cases, when coming for noncardiac surgery, put the patient at greater risk of embolic events. Anesthesiologists play a pivotal role in the management of such rare and difficult cases. There is sparse evidence on management of such cases for noncardiac surgery. Hence, we would like to share our experience of a young patient with LV thrombus posted for left decompressive craniectomy.
Anticoagulation after Spontaneous Intraparenchymal Hemorrhage in Patients with Mechanical Heart Valves and Concomitant Atrial Fibrillation
Authors: Kang Jennifer H. , James Michael L. , Gibson Allison , Inamullah Ovais , Sherrill Gary Clay , Lutz Michael W. , Swisher Christa B. 
Published: October 2021

Abstract
Aim Patients with mechanical heart valves and coexisting atrial fibrillation (AFib-MHV) who suffer an intraparenchymal hemorrhage (IPH, defined as bleeding solely within the brain parenchyma and/or ventricle) are at a high risk of thromboembolism without anticoagulation. Data are lacking regarding the safety of early re-initiation of anticoagulation in these patients.
Patients and Methods We performed a descriptive, single-institution retrospective analysis of patients with AFib-MHV who suffered a non-traumatic, supratentorial IPH between July 2013 and June 2017. We analyzed the patients and IPH characteristics, anticoagulation and antiplatelet use, the occurrence of thrombotic and hemorrhage complications, and discharge disposition. We described the timing of initiation of anticoagulation and outcomes after IPH while in-patient.
Results Six patients with AFib-MHV suffered a spontaneous IPH. Four were initiated on anticoagulation prior to discharge, of whom two were initiated within 3 days post-hemorrhage. These patients suffered no bleeding complications and were discharged home with a modified Rankin Scale of 1.
Conclusion Patients with AFib-MHV who suffer a spontaneous IPH are a rare population to study. Further studies to guide the management of restarting anticoagulation in this select population are warranted.