bluuebunny/crossref_metadata_2025_split huggingface dataset:
Predictors of Mortality Using Machine Learning Decision Tree Algorithm in Critically Ill Adult Patients with COVID-19 Admitted to the ICU.
Authors: Elhazmi Alyaa , Alomari Awad , sallam Hend , Mufti Hani N , Rabie Ahmed A. , Alshahrani Mohammed S , Mady Ahmed , Alghamdi Adnan , Altalaq Ali , Azzam Mohamed H , Sindi Anees , Kharaba Ayman , Al-Aseri Zohair A , Almekhlafi Ghaleb A , Tashkandi Wail , Alajmi Saud A , Faqihi Fahad , Alharthy Abdulrahman , Al-Tawfiq Jaffar A , Melibari Rami Ghazi , Al-Hazzani Waleed , Arabi Yaseen 
Published: October 2021

Abstract
Background:The Coronavirus Disease-19 (COVID-19) caused by the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) is a major cause of intensive care unit (ICU) admissions globally. Robust data of epidemiology, characteristics, and disease outcomes from different regions and populations showed considerable variations. However, limited number of reports addressed predictors of mortality utilizing machine learning methods. Herein, we aimed to describe the association and relationship of a predefined set of variables found to be predictive of 28–day ICU outcome among adults COVID-19 patients admitted to the ICU using a machine learning decision tree (DT) algorithm.Methods:This was a prospective/retrospective, multicenter cohort study from 14 hospitals in Saudi Arabia. We included critically ill COVID-19 patients admitted to the ICU between March 1, 2020, and October 31, 2020. The primary outcome was 28-day ICU mortality. Secondary outcomes were 90-day mortality and ICU length of stay. The predictors of mortality were identified using two predictive models, the conventional logistic regression and DT analysis.Results:A total of 1468 critically ill COVID-19 patients were included. The mean age was 55.9 (SD±15.1) years, with 74% of the patients were males. The 28-day ICU mortality was 540 (36.8%), while 90-day mortality was 600 (40.9%). The multivariable logistic regression model demonstrated that the PaO2/FiO2 ratio on ICU admission and the need for intubation or vasopressors could strongly predict 28-day ICU mortality. The DT algorithm identified five variables [need for intubation, need for vasopressors, age, gender, and PaO2/FiO2 ratio] provided in an algorithmic fashion to predict 28-day ICU outcome. Conclusion:Five clinical predictors of 28-day ICU outcome were identified using DT algorithmic analysis of COVID-19 patients admitted to ICU. The findings of this DT analysis may be used in ICU for early identification of critically ill COVID-19 patients who are at high risk of 28-day mortality.
One-way flow over uniformly heated U-shaped bodies driven by thermal edge effects
Authors: Taguchi Satoshi , Tsuji Tetsuro 
Published: October 2021

Abstract
The thermal edge flow is a gas flow typically induced near a sharp edge (or a tip) of a uniformly heated flat plate. This flow has potential applicability as a nonmechanical flow controller in microelectromechanical systems (MEMS). However, it has a shortcoming: the thermal edge flows from each edge cancel out, resulting in no net flow. In this study, to circumvent this difficulty, the use of a U-shaped body is proposed and is examined numerically. More specifically, a rarefied gas flow over an array of U-shaped bodies, periodically arranged in a straight channel, is investigated using the direct simulation Monte-Carlo (DSMC) method. The U-shaped bodies are kept at a uniform temperature different from that of the channel. Two types of U-shaped bodies are considered, namely, a square-U shape and a round-U shape. It is demonstrated that a steady one-way flow is induced in the channel for both types. The mass flow rate is obtained for a wide range of the Knudsen numbers, i.e., the ratio of the molecular mean free path to the characteristic size of the U-shape body. For the square-U type, the direction of the overall mass flow is in the same direction for the entire range of the Knudsen numbers investigated. For the round-U type, the direction of the total mass flux is reversed when the Knudsen number is moderate or larger. This reversal of the mass flow rate is attributed to a kind of thermal edge flow induced over the curved part of the round-U-shaped body, which overwhelms the thermal edge flow induced near the tip. The force acting on each of the bodies is also investigated.
Association of Trauma Severity with Antibody Seroconversion in Heparin-Induced Thrombocytopenia: A Multicenter, Prospective Observational Study
Authors: Fujita Motoo , Maeda Takuma , Miyata Shigeki , Mizugaki Asumi , Hayakawa Mineji , Miyagawa Noriko , Ushio Noritaka , Shiraishi Atsushi , Ogura Takayuki , Irino Shiho , Sekine Kazuhiko , Fujinami Yoshihisa , Kiridume Kazutaka , Hifumi Toru , Kushimoto Shigeki 
Published: October 2021

Abstract
BACKground: Heparin administration can induce the production of anti-platelet factor 4 (PF4)/heparin antibodies with platelet-activating properties, causing heparin-induced thrombocytopenia (HIT). Previous studies have suggested that trauma severity influences HIT immune responses, but their relationship has not been fully explained. This study aimed to clarify this association by multicenter prospective observational study.methods: Trauma patients who met the criteria of age ≥18 years and Injury Severity Scores (ISS) ≥ 9 from March 2018 to February 2019 were included. Patients who did not receive any heparin and those who received it as flushes or for treatment were also included. A total of 184 patients were divided into three groups based on trauma severity (mild (9 ≤ ISS ≤ 15), moderate (16 ≤ ISS ≤ 24), severe (25 ≤ ISS)), and were compared by the seroconversion time and rate, as well as the disappearance rate of antibodies on day 30. RESULTS: Overall, the seroconversion rates of anti-PF4/heparin IgG and HIT antibodies by washed platelet activation assay were 26.6% and 16.3%, respectively. There was a significant difference in the seroconversion rates of anti-PF4/heparin IgG (p = 0.016) and HIT antibodies (p = 0.046) among the groups. Seroconversion rates in both assays increased with increasing trauma severity. The time required to achieve seroconversion was similar (between 5 and 10 days of trauma onset) regardless of heparin administration. Anti-PF4/heparin IgG and HIT antibodies were no longer detected on day 30 in 28.6% and 60.9% of seroconverted patients, respectively.Conclusions: Development of HIT antibodies was observed commonly in severely injured trauma patients. HIT antibody development may related to trauma severity, with high disappearance rate on day 30. HIT should be considered as a differential diagnosis in patients with thrombocytopenia or thromboembolism between 5 and 10 days after trauma.
Comparison of Short-Term Surgery Outcomes Between Older and Younger Patients With Middle Third Parasagittal and Falx Meningioma
Authors: Lin Tao , Chen Zhijie , Liu Da , Zeng Yongqin , Zhang Xubiao , Lu Ming 
Published: October 2021

Abstract
Background and Purpose
Middle third parasagittal and falx meningiomas can cause severe neurological deficits. The incidence of meningioma rises with age and comorbidities. Elderly patients may suffer from operative complications and recover more slowly than younger patients. The aim of this study was to assess the clinical characteristics and surgery outcomes between younger and elderly patients with meningiomas.
Methods
The patients of middle third parasagittal and falcine meningiomas operated from January 2011 and December 2019 were reviewed in this retrospective study. All lesions arose from the middle third of the falx or superior sagittal sinus (SSS). The complications, such as peritumoral edema, operative blood loss, and neurological deficit, and postoperative hospital stay, were compared between groups.
Results
Forty-three elderly patients and 63 younger patients were included in the current study. The elderly had larger and more aggressive lesions than younger individuals (P=0.013). Moreover, the aging group had severe peritumoral edema (P=0.019) and longer postoperative hospital stay (P=0.009) than younger patients, while the younger suffered from higher blood loss (P=0.022) and reoperation (3 vs. 1) at perioperative period. Furthermore, no significant difference was detected in the neurological deficit between the two groups (p=0.97).
Conclusions
Although severe peritumoral edema gave rise to larger lesions, elderly patients with the middle third of parasagittal and falcine meningiomas shared similar surgery outcomes as younger individuals. However, after considering all the factors, elderly patients were more likely to develop minor postoperative complications compared to younger ones.
The Framework of Mechanics for Dynamic Behaviors of Fractional-Order Stochastic Dynamic Systems
Authors: Ren Ruibin , Yuan George 
Published: October 2021

Abstract
The main goal of this paper is to establish a general framework for dynamic behaviors of coupled fractional-order stochastic dynamic systems of particles by using star-coupled models. In particular, the general mechanics on the dynamic behaviors related to the stochastic resonance (SR) phenomenon of a starcoupled harmonic oscillator subject to multiplicative fluctuation and periodic force in viscous media are established by considering couplings, memory effects, the occurring of synchronization linked to the occurring of SR induced. Here the noise is modeled with the fractional power kernel function and analytical expressions for the first moment of the stability between system responses and parameters in the long-time (of asymptotic stability) are also given. The theoretic and simulation results show the non-monotonic dependence between the response output gain and the input signal frequency, noise parameters provided by fractional-order stochastic dynamics are significant different by comparing those exhibited under the traditional integer-order stochastic dynamics, which indicates that the bona fide resonance and the generalized SR phenomena would appear. Furthermore, the fluctuation noise, the number of the particles for the systems, and the fractional order work together, producing more complex dynamic phenomena compared with the traditional integral-order systems. The theoretical analyses are supported by the corresponding numerical simulations, and thus it seems that the results established in this paper would provide a possible fundamental mathematical framework for the study of Schumpeter’s theory on the economic development under the “innovation and capital paradigm” and related disciplines. In particular, the framework established by this paper allows us at the first time logically concluding that “in principle. the ratio of SMEs growing up successfully is less than one third”, this is consistent with what the market has been observed commonly, but similar conclusion not available from the existing literature today. Finally, we like to point out that the framework established in this paper actually shows that under the basic model established in Section 2, through numerical simulation results given in sections 3 and 4, the fractional derivative in the interval (0; 1) as a basic tool, which can provide a new world with a more refined description of the market financial scene, such as in identifying risk factors or describing mechanics for enterprises’ growths more precisely with extra features compared with the traditional integer derivative one.
Atmospheric Trends Over the Arctic Ocean in Simulations from the Coordinated Regional Downscaling Experiment (CORDEX) and Their Driving GCMs
Authors: Reader Cathy , Steiner Nadja 
Published: October 2021

Abstract
The Arctic Coordinated Regional Downscaling Experiment (Arctic-CORDEX) uses regional climate models (RCMs) to downscale selected Fifth Coupled Model Intercomparison Project (CMIP5) simulations, allowing trend validation and projection on subregional scales. For 1986-2015, the CORDEX seasonal-average near-surface temperature (tas), wind speed (sfcWind), precipitation (pr) and snowfall (prsn) trends are consistent with the ERA5 analysis for the Arctic Ocean regions considered. The projected Representative Concentration Pathway 8.5 (RCP8.5) 2016-2100 subregional annual tas trends range from 0.03 to 0.18 K/year. Projected annual pr and prsn trends have a large inter-model spread centered around approximately 5.0x10−8 mm/s/year and -5.0x10−8 mm/s/year, respectively, while projected sfcWind summer and winter trends range between 0.0 and 0.4 m/s/year. For all variables except prsn, and sometimes total precipitation, the driving general circulation model (GCM) dominates the trends, however there is a tendency for the GCMs to underestimate the sfcWind trends compared to the downscaled simulations. Subtracting the Arctic-Ocean mean from subregional trends reveals a consistent, qualitative anomaly pattern in several variables and seasons characterized by greater-than or average trends in the central and Siberian Arctic Ocean and lesser or average trends in the Atlantic Sector and the Bering Sea, related to summer sea-ice trends. In particular, a strong proportional relationship exists between the summer sea-ice concentration and fall tas and sfcWind trend anomalies. The RCP4.5 annual, multi-model mean trends are 35-55% of the corresponding RCP8.5 trends for most variables and subregions.
Predictors of Spontaneous Echocardiographic Contrast Within the Left Atrial Appendage in Cardiac Computed Tomography of Patients with Atrial Fibrillation
Authors: Ouchi Kotaro , Sakuma Toru , Higuchi Takahiro , Yoshida Jun , Narui Ryosuke , Nojiri Ayumi , Yamane Teiichi , Ojiri Hiroya 
Published: October 2021

Abstract
PurposeCardiac computed tomography (CT) depiction of the relationship between spontaneous echocardiographic contrast (SEC) and findings of the left atrial appendage (LAA) has not been reported. We evaluated predictors of SEC within the LAA using findings of cardiac CT in patients with atrial fibrillation (AF).MethodsWe retrospectively analyzed cardiac CT findings of the LAA, including morphology, volume, and filling defects, of 641 patients who underwent Transesophageal echocardiography (TEE) prior to pulmonary vein isolation (PVI) from January 6, 2013 through December 16, 2019 at our institution. We investigated potential associated factors that might be predictors of SEC and computed a receiver operator characteristic,choosing a threshold value at which the likelihood of SEC could be predicted based on the LAA volume indexed for body size.ResultsSEC correlated significantly with history of persistent AF (P<0.001; odds ratio [OR], 3.74; 95% confidence interval [CI], 1.91–7.29), LAA early filling defects (P =0.003; OR, 2.83; 95% CI, 1.43–5.62), LAAFV (P<0.001; OR, 0.97; 95% CI, 0.96–0.99), and indexed LAA volume (P = 0.001; OR, 1.18; 95% CI, 1.07–1.30) of 8.04 cm3/m2 or greater (sensitivity, 75.0%; specificity, 48.7%).The addition of LAAFV to indexed LAA volume increased the area under the receiver operator characteristic curve from 0.642 to 0.724 (P< 0.001).ConclusionFindings of LAA in cardiac CT might allow the noninvasive estimation of SEC and additional information for risk stratification and management of thromboembolic events in patients with AF.
Combined Endoscopic and Exoscopic Resection of Intracranial Epidermoid Cysts
Authors: Chuzhong Li , Zhenye Li , Songbai Gui , Peng Zhao , Jiwei Bai , Lei Cao , Sen Cheng , Chunhui Liu , Haibo Zhu , Zhang Yazhuo 
Published: October 2021

Abstract
Objective

In the past ten years, a fully endoscopic technique has also been widely used. Exoscope has also been developed for microneurosurgery which offers quality image and convenient manipulation. This article aims at introducing an endoscopic-exoscopic technique for the resection of epidermoid cysts.
Methods

We retrospectively analyzed the patients with intracranial epidermoid cysts who received whole course combined endoscopic and exoscopic resection between 2017 and 2020 at our institution, to explore the benefit of combined endoscopic and exoscopic resection of intracranial epidermoid cysts and evaluated the clinical utility of endoscopic-exoscopic technique.
Results

A total of 17 patients were enrolled in the study. Of all patients, 6 patients (6/17, 35.3%) underwent total resection, 10 patients (10/17, 58.8%) underwent subtotal resection (residual capsule and/or) and 1 patients (1/17, 5.9%) underwent partial resection. Postoperative surgical complications were seen in 3 patients (3/17, 17.6%), including intracranial infection in 2 patients (2/17, 11.8%), and a delayed postoperative hematoma observed in the seventh day after operation for 1 patient (1/17, 5.9%), who was treated in a conservative manner and recovered smoothly from the hemorrhage. The median follow-up time was 33.3 months (range 14.5-54.5 months). During the follow-up period, there was no recurrence of the tumors that received total resection. 2 patients developed residual tumor regrowth but did not show any symptom therefore no further surgery was required.
Conclusions

Endoscopic-exoscopic technique is safe and efficient in the resection of intracranial epidermoid cysts with panoramic views and superior maneuverability. With further development and accumulation of practical experiences, the endoscopic-exoscopic technique can also be applied in the resection of other intracranial tumors.
Interhemispheric Asymmetry of the Brain in Patients with Type 1 Diabetes Mellitus and Cognitive Impairment
Authors: Tonkikh Oksana Sergeevna , Samoylova Yulia Gennadevna , Matveeva Mariia Vladimirovna , Gerget Olga Mihaylovna , Kudlay Dimitry Anatolievich , Kanev Alexander Fedorovich , Kilina Oksana Yurievna , Aremu Stephen Olaide 
Published: October 2021

Abstract
With an ageing of population and a splurging epidemic of diabetes mellitus (DM), the prevalence of complications associated with pathology of the central nervous system are expected to increase, which in the future may have serious consequences for public health. It is known that one of the main manifestations of brain damage in type 1 diabetes is cognitive impairment, which is possibly associated with the peculiarities of vascularization and interhemispheric asymmetry, which requires in-depth analysis using modern neuroimaging methods. The aim of the study is to assess the symmetry of structural, metabolic and neurovascularization changes in the brain in patients with type 1 diabetes and cognitive impairment. The study included 120 patients with type 1 diabetes aged 18 to 45 years suffering from cognitive impairment, and 30 people without cognitive decline which constituted the control group. Neuropsychological testing included the Montreal Cognitive Dysfunction Assessment Scale (MoCA test). For neuroimaging methods, standard magnetic resonance imaging (MRI), magnetic resonance spectroscopy (MRS), contrast and non-contrast-enhanced perfusion were used. Statistical processing was carried out using the SPSS Statistic 2020 software. In patients with type 1 diabetes with cognitive impairment, as manifested by impaired memory and/or attention, perfusion imaging revealed the presence of brain asymmetry zones. Standard MRI allowed to demonstrate changes in the white, gray matter and hippocampus in the right hemisphere. The results obtained were refined taking into account the topical localization, so during the perfusion study, regions with asymmetric blood flow were identified - namely, the white matter of the frontal lobe and the gray matter in the occipital lobe. Spectroscopy of the brain revealed that it was in these areas of the brain that the most significant metabolic disorders were noted – in the form of significantly altered ratio of N-acetylaspartate (NAA) / choline (Cho) on the left, along with the asymmetry in phosphocreatine level (Cr 2) on the right. In conclusion, early preclinical predictive diagnostics with the use of modern neuroimaging methods allows for timely detection of impaired vascularization and brain metabolism in this group of patients.
Preventive Strategies for Feeding Intolerance in Patients with Severe Traumatic Brain Injury in China: An Online Cross-Sectional Survey
Authors: Fang Yuli , Ma Yuanyuan , He Haiyan , Chen Ting , Zhu Jingci 
Published: October 2021

Abstract
Background

The application of preventive strategies for feeding intolerance in severe traumatic brain injury (STBI) patients is discrepant among different hospitals. We aim to investigate the application status of preventive measures of feeding intolerance in China.
Method

A cross-sectional study was carried out among 996 clinicians and nurses working in intensive care units of 89 hospitals in China (response rate of 89.81%). Data were collected by means of an online survey. Descriptive statistics were used to analyze respondents’ characteristics and questionnaire responses.
Results

Clinicians and nurses usually applied several methods simultaneously to assess gastrointestinal functions and risk of feeding intolerance among STBI patients, including assessment scales, gastrointestinal symptoms, etc. Furthermore, initiating enteral nutrition (EN) within 24-48 hours (61.45%), < 500 ml initial volume of EN solution (50.00%), using non-nutritional preparations as initial EN formula (65.56%), nasogastric tube EN (91.16%), continuous feeding by pump (72.89%), 30°-45° of head-of-bed elevation during EN (89.46%), monitoring gastric residual volume by syringe (93.67%), assessing gastric residual volume every 4 hours (51.51%), EN solution temperature of 38℃-40℃ (65.46%), prokinetic agents (73.29%), enema (73.59%), probiotics (79.01%), and antacid agents (84.13%), were mostly applied strategies in clinical practice for preventing feeding intolerance among STBI patients.
Conclusions

The data from the survey showed that medical staffs in China are closely concerned with the gastrointestinal functions of STBI patients and EN delivery protocol, and have a positive attitude towards preventive strategies for feeding intolerance. Meanwhile, there are still many points need to be paid attention to and solved, and researchers, clinicians, nurses and dietitians should strengthen the cooperation to explore more valuable preventive strategies for feeding intolerance in STBI patients.