bluuebunny/crossref_metadata_2025_split huggingface dataset:
A few-shot learning framework for the diagnosis of osteopenia and osteoporosis using knee X-ray images
Authors: Xie Hua , Gu Chenqi , Zhang Wenchao , Zhu Jiacheng , He Jin , Huang Zhou , Zhu Jinzhou , Xu Zhonghua 
Published: September 2024

Objective We developed a few-shot learning (FSL) framework for the diagnosis of osteopenia and osteoporosis in knee X-ray images. Methods Computer vision models containing deep convolutional neural networks were fine-tuned to enable generalization from natural images (ImageNet) to chest X-ray images (normal vs. pneumonia, base images). Then, a series of automated machine learning classifiers based on the Euclidean distances of base images were developed to make predictions for novel images (normal vs. osteopenia vs. osteoporosis). The performance of the FSL framework was compared with that of junior and senior radiologists. In addition, the gradient-weighted class activation mapping algorithm was used for visual interpretation. Results In Cohort #1, the mean accuracy (0.728) and sensitivity (0.774) of the FSL models were higher than those of the radiologists (0.512 and 0.448). A diagnostic pipeline of FSL model (first)–radiologists (second) achieved better performance (0.653 accuracy, 0.582 sensitivity, and 0.816 specificity) than radiologists alone. In Cohort #2, the diagnostic pipeline also showed improved performance. Conclusions The FSL framework yielded practical performance with respect to the diagnosis of osteopenia and osteoporosis in comparison with radiologists. This retrospective study supports the use of promising FSL methods in computer-aided diagnosis tasks involving limited samples.
Debate as a Pedagogical Tool for Pluralist Economics Education
Authors: He Zengping 
Published: September 2024

Pluralist economics education aims to liberate students from the worship of mainstream economics and develop their ability to think critically from the perspective of pluralist economic theories. This study introduces class debate as a pedagogical tool for pluralist economics education in a course on the history of economic thought. The results show that the debates made students more supportive of economic pluralism. According to students’ self-assessments, the debates improved their understanding of pluralist economic theories and real-world issues, motivated their active thinking, and encouraged them to compare different economic theories. Class debates are a worthwhile pedagogical method for promoting economic pluralism. JEL Classification: A2, B0, B5
Treatment of Neuropsychiatric Symptoms in Parkinson’s Disease With Botulinum Toxin A: A 12 week Randomized, Double-Blind, Placebo-Controlled Trial
Authors: Zhu Xiaofeng , Wei Ming , Wang Lijun , Tong Qiang , Yang Xiu , Han Qiu 
Published: September 2024

Objective The study aimed to evaluate the impact of Botulinum toxin A (BoNT/A) on neuropsychiatric symptoms in Parkinson’s disease (PD) patients. Methods A total of 125 PD patients and an equal number of age- and gender-matched healthy controls were involved. Mental health status was assessed using the Cornell Medical Index (CMI) self-assessment questionnaire. Sixty-four PD patients exhibiting neuropsychiatric symptoms were selected for the controlled study and randomly grouped into treatment and control groups. The treatment group received BoNT/A injections, while the control group received a placebo. The primary outcome measures included depression scores from the CMI and the proportion of patients displaying improvement in neuropsychiatric symptoms at 8 weeks post-treatment. The secondary outcome was other CMI scores at 4, 8, and 12 weeks post-treatment. Results The outcomes revealed that PD patients had significantly higher scores in various neuropsychiatric factors compared to healthy controls. At 4 weeks post-treatment, the treatment group displayed improvements in depression and tension. At 8 weeks post-treatment, they exhibited significant reductions in depression, anxiety, sensitivity, and tension compared to the control group. Moreover, a notably higher percentage of patients in the treatment group showed improvement in neuropsychiatric symptoms compared to the control group. At 12 weeks post-treatment, the treatment group exhibited significant improvements in somatization, depression, sensitivity, and tension. Conclusion PD patients commonly experience multiple neuropsychiatric symptoms, and BoNT/A has demonstrated efficacy in alleviating these symptoms. Specifically, BoNT/A was found to effectively alleviate somatization, tension, anxiety, depression, and sensitivity in PD patients.
The Relationship Between Vitamin B-12 Levels and Attention in Children and Adolescents
Authors: Alkan Hatice Kocak , Kocak Elif Nur , Coskun Orhan , Çıvak Serpil Çars¸anbalı , Güleç Seda Geylani 
Published: September 2024

Background and Aim: Vitamin B-12 plays a role in normal growth and development in childhood and adolescence. In this study, the effect of vitamin B-12 on attention was investigated. Method: A total of 138 participants who were admitted to the pediatric clinic during a three-month period between June 15, 2021, and September 15, 2021, between the ages of 9 and 16 years, who had their vitamin B-12 levels measured and met the inclusion criteria of the study were included in our study. D2 Attention Test data were obtained from the participants. Results: While 24.5% of the group with low vitamin B-12 levels had pathology according to the D2 Attention Test, 5.9% of the control group had pathology according to the D2 Attention Test. The percentage of pathology in those with low vitamin B-12 levels was statistically significantly higher than in the group with normal B-12 levels. Conclusion: It was observed that the attention level of the group with vitamin B-12 deficiency was lower. In the follow-up of healthy children, it is recommended to pay attention to the research on vitamin B-12 values.
Reflection on the RANZCP position on the adverse effects of psychotherapy
Authors: Allison Stephen , Looi Jeffrey CL , Kisely Steve , Bastiampillai Tarun 
Published: September 2024

Objective In this perspective, we investigate how the Royal Australian and New Zealand College of Psychiatrists’ (RANZCP) position statement on psychotherapy takes the potential for adverse effects into account. Conclusions Psychotherapy has two critical outcomes – efficacy and adverse effects. Evidence-based psychotherapy is significantly more effective than care-as-usual for about one in 10 psychotherapy patients. However, a similar proportion also reports adverse effects. Despite this, the RANZCP position statement on psychotherapy focuses on efficacy with minimal discussion of the adverse effects. This is an oversight because psychiatrists have legal and ethical obligations to consider the adverse effects as well as the benefits of any treatment. We therefore reflect on the RANZCP’s six recommendations in light of the adverse effects of psychotherapy.
Effects of Prolonged Proton-Pump Inhibitor Use on Renal Dysfunction and Bone Fragility: A Retrospective Study
Authors: Protopapadakis Yianni , Shuster Hayden , Bambach Austin B. , Fitzgerald Sean , Brayman Christian , Ewing Joseph A. , Blumer Mary 
Published: September 2024

Background: Proton-pump inhibitor (PPI) use for management of gastroesophageal reflux disease (GERD) consists of a short-duration trial, according to guidelines. Long-term usage is appropriate under certain indications. Literature has increasingly documented an adverse effect profile of PPIs, including kidney disease and bone fragility. Objective: To investigate the rate of occurrence of osteopenia, osteoporosis, and chronic kidney disease (CKD) in patients using PPI therapy for longer than the recommended trial period of 8 weeks. Methods: Retrospective cohort analysis of a single-site primary care clinic. Patients aged 18 to 65 years with PPI prescriptions longer than 8 weeks were included. Information regarding PPI prescriptions, demographics, and medical diagnoses was collected. Results: The search discovered 293 PPI-users and 1908 never-PPI-users. Demographics varied, with a P-value <0.05 in age, body mass index (BMI), and black population (higher in PPI group). The PPI cohort featured higher rates of osteoporosis/osteopenia and CKD ( P < 0.001). The odds ratios (ORs) of diagnosis with PPI use was 2.91 (95% CI = [1.692, 4.979]) in osteoporosis/osteopenia. The OR was 1.14 (95% CI = [1.141, 2.229]) in CKD and PPI use but higher with diabetes, elevated BMI, black race, and male gender. Conclusions and Relevance: We observed increased occurrence rates of osteoporosis, or osteopenia, and CKD in patients with prolonged PPI use. Demographics varied in age, BMI, and black race proportion. A logistic regression revealed increased likelihood of kidney disease and osteoporosis/osteopenia in association with PPI use. These results add to the evidence regarding long-term PPI use and the development of these conditions, but additional studies are needed.
Optimal design of dynamic vibration absorber for elastic vibration control of vehicle carbody in time-varying service environment
Authors: Li Fansong , Du Xiang , Liu Letian , Wang Hao , Liu Chaotao , Wu Hao 
Published: September 2024

Due to frequent acceleration and deceleration and large passenger capacity, metro vehicles generally experience eccentric wear on the wheels. Moreover, the highest running speed is between 80 km/h and 100 km/h, and the corresponding wheel rotation frequency is mainly between 7 Hz and 11 Hz, which is close to the first-order vertical bending modal frequency of the carbody. Therefore, the dynamic performance of the carbody would be deteriorated in the later stage of wheel wear. In order to suppress the vibration caused by eccentric wear, this study intends to design the underframe equipment as a dynamic vibration absorber. Unlike the traditional fixed-point theory method, this paper takes the external time-varying running speed as the input, a suspension frequency optimal design method based on probability distribution of wheel rotation frequency is proposed. And the design principle is experimentally verified based on the full-scale railway vehicle vibration test rig. Compared with the design method based on fixed-point theory, the results show that the acceleration rms value of carbody by optimal design method is reduced by 8% ∼ 20%. It is suggested that the design of underframe equipment for metro vehicles should be combined with the characteristics of time-varying service environment.
Performance of steel beams with endplate connections exposed to fire
Authors: Rezaeian Abbas , Salehi Mohammad Sajjad , Kodur Venkatesh 
Published: September 2024

This paper presents results from an experimental study on the fire behavior of endplate joints and the connected steel beams in a moment resisting frame (MRF). Utilizing the subframe assemblage, full-scale steel beams with various endplate connections were tested according to the ISO834 standard fire exposure. The thermal and structural responses of the beam and its endplate joints to the column, together with failure modes were monitored throughout the fire test. The effect of key factors such as endplate dimensions, bolt size and grade, and the presence of stiffeners were investigated. The results of the fire tests show that the specimen experiences flexural failure in 746–773°C temperature range, through mid-span deflection exceeding the deflection limit as per British standard 476. When the beam experienced a deflection greater than span/20, the endplate joints got fractured at about 40 min in to fire at temperatures higher than 815°C. The results also indicated that the endplate bending and the tensile fracture of the bolts control the failure of the endplate joint under fire exposure. The endplate connection details have a notable influence on the beam’s behavior under fire conditions, and the use of grade 10.9 bolts and wider endplates in the connection can improve the fire resistance of MRFs.
Wait, Where Was I? Minimizing the Chaotic Moment Through Timeline Drawing Elicitation in Phone Interviews
Authors: Park Jiyea 
Published: September 2024

This research arose from a moment when one of the author’s interviewees said, “Wait, where was I?” Through 60–90 minutes, in-depth phone interviews, shared highly detailed accounts of their personal stories of entering underemployment in South Korea. However, the first six interviewees talked about many different topics during their interviews, and confused the chronological sequences of multiple episodes. The interviewer recognized these instances as emergent chaotic moments, so she decided to incorporate various methods into her interviews. Among the many elicitation strategies that can be employed in qualitative interviewing, the author applied timeline elicitation to more accurately document their life events. Timeline elicitation is useful for extracting narratives of individual journeys and delineating the meaning of specific events. This technique proved the most effective strategy for minimizing confusions and successfully completing the interviews. This study used comparative analysis to assess the transcripts of two different groups (with/without applying timeline drawing elicitation), and presents findings showing their different reactions to dealing with the transition of time. This study demonstrated the potential of visual timeline approaches to reflect and illustrate the complexity of women participants’ experiences of underemployment. Moreover, the efficacy of this timeline drawing elicitation method will be critically discussed, along with its limitations within the context of innovative qualitative methodologies.
Functional Significance and Implications of Phyto-Oxylipins as Potential Anti-Cancer Agents
Authors: Dofuor Aboagye Kwarteng 
Published: September 2024

Objective Phyto-oxylipins are lipid molecules produced in plants by the oxidative transformation of unsaturated fatty acids via diverse metabolic pathways. Recently, the chemical diversity and functional significance of oxylipins is gaining significant attention. However, the functional significance of these compounds as anti-cancer agents remains largely uncharacterized. The objective of this review is to provide a comprehensive synthesis and analysis of the functional significance of plant oxylipins as anti-cancer agents to facilitate their exploitation in drug discovery and development. Methods This review was based on a thorough compilation and analysis of research work carried out on biological significance and implications of plant-derived anti-cancer oxylipins. Curation of data was based on several databases and resources such as Scopus, PubMed, DrugBank and PubChem. Within the context of the scope and subject matter as guided by the objective, no exclusion and inclusion criteria were necessarily employed in the screening of articles. Results The present review explores the origins, anti-cancer properties and functional mechanisms of phyto-oxylipins. The potential functional significance of new and poorly characterized plant oxylipins have also been highlighted. The prospects of plant oxylipins in research, medicine and biotechnology that could optimize their potential are also explored. Insights into the promising avenues that may originate from innovative therapeutic approaches are also discussed. Conclusion Despite the rich source of oxylipins in plants, much of their potential as therapeutic agents for cancer treatment remains to be fully established. Clinical investigations are also needed to determine safe doses and effective delivery methods. Research into phyto-oxylipins require significant attention due to the promise it may hold in addressing key challenges in biotechnology, health, and environmental sustainability.
The Impact of Socioeconomic Status on Pediatric Facial Trauma
Authors: Wright Avery , Hinson Madison , Davidson Amelia , Curtis Caitrin , Runyan Christopher 
Published: September 2024

Study Design Retrospective chart review. Objective Socioeconomic status (SES) greatly impacts one’s health status and the type of trauma that a patient experiences due to increased risk of exposure and varying availability of resources to treat emergent conditions. There is a need for large-scale databases of pediatric facial trauma to identify discrepancies in occurrence and identify risk factors. Methods This retrospective examination uses a multi-center database to evaluate pediatric facial trauma patients (n = 644) visiting Atrium Heath Wake Forest Baptist (AHWFB) hospital from 2020 to 2022. Data collected included demographic information, past medical and surgical history, trauma history, interventions, and long-term outcomes such as scarring, deformities, and sensory or motor deficits. The number of incidents for each zip code surrounding AHWFB was compared with SES data including unemployment rate, mean household income, and poverty level. Results Thirty-five percent of patients sustained a high-energy injury, and 65% sustained a low-energy injury. Within the surrounding counties of AHWFB, there were more incidents of pediatric facial trauma in areas with greater rates of poverty ( P = 0.006). Additionally, there were more incidents due to high-energy injuries in areas with lower income ( P = 0.044) and more poverty ( P = 0.002). Specifically, motor vehicle accidents were more common in areas with lower income ( P = 0.017) and more poverty ( P = 0.001). Conclusions These findings in the central Piedmont region of North Carolina are consistent with previous research of SES’s effect on health inequalities and serve as evidence of the need to take steps to prevent pediatric facial trauma in areas of low SES.
In- Versus Out-Fracture: A Novel Concept in Naso-Orbito-Ethmoid Injury
Authors: Menville Jesse , Soliman Luke , Shinde Nidhi , Spake Carole , Francalancia Stephanie , Marquez-Garcia Josue , Sobti Nikhil , Rao Vinay , Woo Albert S. 
Published: September 2024

Study Design A retrospective study. Objective The Markowitz-Manson classification system categorizes nasoorbitoethmoid (NOE) fractures by severity of injury and remaining integrity of the medial canthal tendon. However, this system does not account for direction of bony displacement (in-fracture vs out-fracture), which can greatly affect symptomatology and management. We hypothesize that NOE fractures will present differently based upon their severity: Type I injuries are likely to present with medial nasal bone displacement (in-fracture), whereas Type III fractures will be more prone to lateral displacement (out-fracture). Methods A retrospective review was performed for all patients with NOE fractures who were evaluated by the plastic surgery department at a level 1 trauma center over a 6-year period. Computed tomography data were evaluated to assess for directionality of fracture segment displacement. Frequencies of medial, lateral, and non-displacement across NOE types were compared by Chi-Squared Goodness of Fit and Fisher’s Exact Tests. Results 111 patients met inclusion criteria. The patient population was 73.9% male and averaged 51.2 years old. When bilateral fractures were counted independently, there were 141 cases in total: 115 Type I, 20 Type II, and 6 Type III. Type I fractures were most commonly in-fractured (48.7%), while Type III injuries were consistently out-fractured (100%) ( p < .001). Conclusions While Type II and III NOE fractures have dominated clinical focus, this study highlights the prevalence of impaction within Type I fractures. These findings advocate for a more comprehensive approach to the evaluation of Type I NOE fractures and their potential risks, including traumatic hypotelorism and nasal airway obstruction.
Predictors of Mothers Living with HIV Uptake of HIV Early Infant Diagnosis Services in Iringa District, Tanzania
Authors: Kyando Happy Alfayo , Tesha Novatus , Metta Emmy 
Published: September 2024

Background Uptake of HIV early infant diagnosis (HEID) among HIV-exposed infants is the key to timely initiation of Antiretroviral Treatment (ART). However, despite the availability of HEID services in Tanzania, its uptake is low. We aimed to determine predictors of mothers living with HIV’ with HIV-exposed infants’ uptake of HEID services in Iringa District, Tanzania. Methods A health facility-based cross-sectional study was conducted in Iringa District from May to June 2023. Mothers with HIV-exposed infants were recruited in the study through a multistage sampling technique and interviewed using pre-tested structured questions. Logistic regression analysis was employed to determine potential predictors of HEID uptake. Results A total of 309 mothers with HIV-exposed infants participated in the study. About 78.3% of the HIV-exposed infants had initial DNA PCR for HEID within 6 weeks of age and 86.1% within 8 weeks. Most mothers had high perceived benefits on uptake of HEID with a mean score of 4.3, high perceived self-efficacy with a mean score of 3.8 and 2.7 perceived risk of HIV infection on their HIV-exposed infants on the 5 scale Likert scale with 5 showing the highest perceived benefit, self-efficacy and risk. High perceived self-efficacy and being a businesswoman were the predictors of uptake of HEID. The odds of self-efficacy on the uptake of HEID by 2.4 times (aOR 2.4 95% CI 1.6–3.2) within 6 weeks of age and 1.9 (aOR 1.9 95% CI 1.3-2.7) within 8 weeks. The odds of being a businesswoman were 0.4 for 6 weeks and 0.3 for 8 weeks (aOR 0.4 95% CI 0.2-0.8) and (aOR 0.3 95% CI 0.1-0.8) respectively. Conclusion Over three-quarters of the HIV-exposed infants had initial DNA PCR for HEID testing as recommended. Perceived self-efficacy was the main factor influencing HEID uptake. These findings highlight the need for strengthening HIV-positive mother's self-efficacy for improved uptake of HEID services.
Long-term Outcomes of Partial Meniscectomy for Degenerative Medial Meniscus Posterior Root Tears
Authors: Lamba Abhinav , Regan Christina , Levy Bruce A. , Stuart Michael J. , Krych Aaron J. , Hevesi Mario 
Published: September 2024

Background: Previous studies have demonstrated that medial meniscus posterior root tear (MMPRT) repair is superior to debridement in terms of patient-reported outcomes, rates of conversion to total knee arthroplasty (TKA), and long-term costs. Despite the known poor midterm outcomes, there is a paucity of long-term results of partial meniscectomy for degenerative MMPRTs. Purpose: To 1) evaluate long-term patient-reported and radiographic outcomes of patients who underwent partial medial meniscectomy (PMM) for MMPRTs, and 2) determine the rate of and risk factors for conversion to total knee TKA. Study Design: Case series; Level of evidence, 4. Methods: A previously identified cohort of 26 patients treated with partial meniscectomy for isolated MMPRTs between 2005 and 2013 was prospectively followed for long-term outcomes at a minimum 10-year follow-up. Patients were evaluated for International Knee Documentation Committee (IKDC) outcome score, reoperation, and conversion to TKA. Failure was defined as conversion to arthroplasty or a severely abnormal IKDC subjective score <75.4. Results: This study included 26 patients (10 men, 16 women; mean age, 54 ± 8.7 years [range, 38-71 years] at diagnosis; body mass index, 32.9 ± 5.5) who were followed for a mean of 14.0 ± 3.6 years (range, 10.1-19.6 years). At the final follow-up, 1 patient was deceased and 18 (72%) of the remaining 25 patients had progressed to TKA, with 1 (4%) patient undergoing repeat meniscectomy. The 6 (24%) patients who had not progressed to TKA or revision surgery reported a mean IKDC score of 57 ± 23. Nineteen patients underwent subsequent surgery and 5 demonstrated severely abnormal IKDC scores resulting in a clinical failure rate of 96% (24 of the 25 living patients) at a mean 14-year follow-up. Conclusion: PMM for medial meniscus posterior horn root tears demonstrated 72% progression to TKA and 96% failure according to subjective clinical outcomes at a minimum 10-year follow-up.