bluuebunny/crossref_metadata_2025_split huggingface dataset:
Accuracy of ultrasound, magnetic resonance imaging and intraoperative frozen section in the diagnosis of ovarian tumours: data from a London tertiary centre
Authors: Mitchell Sian , Gleeson Joseph , Tiwari Mansi , Bailey Frances , Gaughran Jonathan , Mehra Gautam , Muallem Mustafa Zelal , Sayasneh Ahmad 
Published: July 2024

Abstract
Background
Ovarian cancer has the worst prognosis among all gynaecological cancers. The pre-operative and intraoperative diagnosis of ovarian tumours is imperative to ensure the right operation is performed and to improve patients’ outcomes.

Methodology
A retrospective review of cases with a confirmed histological diagnosis of ovarian cases was undertaken from January 2017 to December 2021. Comparison was undertaken between this final diagnosis and the pre-operative ultrasound, MRI and frozen section (FS) to assess diagnostic accuracy of each. In the ultrasound cases, the level of the examiner was collected. Statistical analysis was performed using Stata MP v17.0 software (USA, 2023).

Results
In total, 156 ovarian masses were examined by FS. In the histopathological examination, 123/156 of these tumours were epithelial tumours. Pre-operative US subjective impression was made in 63/156 cases and preoperative MRI subjective impression was made in 129/156 cases. For benign, borderline and malignant tumours, FS demonstrated a sensitivity of 90.8% (95%CI:81.9–96.2), 86.8% (95%CI:71.9–95.6) and 97.6% (95%CI:87.4–99.9) respectively. Ultrasound’s sensitivities were 95.2% (95%CI:76.2–99.9), 20% (95%:4.33–48.1), 57.1% (95%CI:28.9–82.3) and MRI’s sensitivities were 100% (95%CI:80.5–100), 31.5% (95%CI:19.5–45.6) and 63.2% (95%CI:46–78.2) respectively.

Conclusions
FS remains an accurate tool for diagnosing ovarian malignancy. However, across both imaging modalities and FS, the diagnosis of borderline ovarian tumours remains challenging.
An optimization scheme for vehicular edge computing based on Lyapunov function and deep reinforcement learning
Authors: Zhu Lin , Tan Long , Li Bingxian , Tian Huizi 
Published: July 2024

AbstractTraditional vehicular edge computing research usually ignores the mobility of vehicles, the dynamic variability of the vehicular edge environment, the large amount of real‐time data required for vehicular edge computing, the limited resources of edge servers, and collaboration issues. In response to these challenges, this article proposes a vehicular edge computing optimization scheme based on the Lyapunov function and Deep Reinforcement Learning. In this solution, this article uses Digital Twin technology (DT) to simulate the vehicular edge environment. The edge server DT is used to simulate the vehicular edge environment under the edge server, and the base station DT is used to simulate the entire vehicular edge system environment. Based on the real‐time data obtained from DT simulation, this paper defines the Lyapunov function to simplify the migration cost of vehicle tasks between servers into a multi‐objective dynamic optimization problem. It solves the problem by applying the Twin Delayed Deep Deterministic Policy Gradient (TD3) algorithm. Experimental results show that compared with other algorithms, this scheme can effectively optimize the allocation and collaboration of vehicular edge computing resources and reduce the delay and energy consumption caused by vehicle task processing.
Energy‐efficient adaptive dependent task scheduling in cooperative vehicle‐infrastructure system
Authors: Su Beipo , Dai Liang , Ju Yongfeng 
Published: July 2024

AbstractIn the cooperative vehicle‐infrastructure system (CVIS), due to its computation limitation, vehicles are difficult to handle computing‐intensive delay‐sensitive tasks, so offload tasks to roadside unit (RSU) become popular. Due to the complexity of vehicles’ tasks and tasks generated by different vehicles have different delay constraints, minimize energy consumption of RSUs under task dependence and delay constraints is challenging. This paper defines the task priority queuing criterion for the task priority division problem, proposes a task scheduling strategy for energy‐packet queue length tradeoff (TSET) in CVIS under RSUs distributed task scheduling problem and establishes the vehicle speed state model, task model, data queue model, task computing model and energy consumption model. After Lyapunov optimization theory transformed the optimization model, a knapsack problem was described. The simulation results verify that TSET reduces the average energy consumption of roadside units and ensures the stability of the data queue under task dependence and deadline conditions.
Transient frequency response test and measurement error prediction of DCTV based on adaptive inertial weight improved ACO
Authors: Yang Yutao , Zhai Shaolei , Tang Hansong , Duan Genyue , Deng Liwu 
Published: July 2024

AbstractA temporary frequency response test and measurement error prediction method of direct current voltage transformer (DCTV) based on artificial intelligence (AI) is proposed. Firstly, the frequency characteristic of direct current (DC) side voltage of DCTV is analyzed. On this basis, a DCTV transient Frequency Response testing method based on transient alternating current (AC) & DC superposition was developed. Then, the method of voltage sudden change and phase correction is used to achieve transient process DCTV response time testing. Finally, the ant colony optimization (ACO) algorithm was improved by combining an adaptive inertia weight improvement strategy, achieving accurate prediction of the Measurement Error of DCTV. The proposed AI based DCTV transient Frequency Response testing and Measurement Error prediction method were compared and analyzed with the other three methods through simulation experiments. Compared to the other three comparison methods, the maximum transformation error in the evaluation indicators of mean squared error (MSE), root mean squared error (RMSE), and mean absolute error (MAE) decreased by 0.006, 0.0119, and 0.0085, respectively, while the maximum phase error decreased by 0.2794, 0.3004, and 0.2823, respectively.
Separating source-intrinsic and Lorentz invariance violation induced delays in the very high-energy emission of blazar flares
Authors: Levy C. , Sol H. , Bolmont J. 
Published: July 2024

Aims.The aim of the present study is to explore how to disentangle energy-dependent time delays due to a possible Lorentz invariance violation (LIV) at Planck scale from intrinsic delays expected in standard blazar flares.Methods.We first characterised the intrinsic time delays in BL Lacs and flat-spectrum radio quasars in standard one-zone time-dependent synchrotron self-Compton or external Compton models, during flares produced by particle acceleration and cooling processes. We simulated families of flares with both intrinsic and external LIV-induced energy-dependent delays. Discrimination between intrinsic and LIV delays is then investigated in two different ways. A technique based on Euclidean distance calculation between delays obtained in the synchrotron and in the inverse-Compton spectral bumps is used to assess their degree of correlation. A complementary study is performed using spectral hardness versus intensity diagrams in both energy ranges.Results.We show that the presence of non-negligible LIV effects, which essentially act only at very high energy (VHE), can drastically reduce the strong correlation expected between the X-ray and the VHE gamma-ray emission in leptonic scenarios. The LIV phenomenon can then be hinted at measuring the Euclidean distancedEfrom simultaneous X-ray and gamma-ray flare monitoring. Large values of minimum distancedE, minwould directly indicate the influence of non-intrinsic time delays possibly due to LIV in SSC flares. LIV effects can also significantly modify the VHE hysteresis patterns in hardness-intensity diagrams and even change their direction of rotation compared to the X-ray behaviour. Both observables could be used to discriminate between LIV and intrinsic delays, provided high-quality flare observations are available.
Fast supermassive black hole growth in the SPT2349–56 protocluster at z = 4.3
Authors: Vito F. , Brandt W. N. , Comastri A. , Gilli R. , Ivison R. J. , Lanzuisi G. , Lehmer B. D. , Lopez I. E. , Tozzi P. , Vignali C. 
Published: July 2024

Context. Large-scale environment is one of the main physical drivers of galaxy evolution. The densest regions at high redshifts (i.e. z > 2 protoclusters) are gas-rich regions characterised by high star formation activity. The same physical properties that enhance star formation in protoclusters are also thought to boost the growth of supermassive black holes (SMBHs), most likely in heavily obscured conditions.
Aims. We aim to test this scenario by probing the active galactic nucleus (AGN) content of SPT2349–56: a massive, gas-rich, and highly star-forming protocluster core at z = 4.3 discovered as an overdensity of dusty star-forming galaxies (DSFGs). We compare our results with data on the field environment and other protoclusters.
Methods. We observed SPT2349–56 with Chandra (200 ks) and searched for X-ray emission from the known galaxy members. We also performed a spectral energy distribution fitting procedure to derive the physical properties of the discovered AGNs.
Results. In the X-ray band, we detected two protocluster members: C1 and C6, corresponding to an AGN fraction among DSFGs in the structure of ≈10%. This value is consistent with other protoclusters at z  =  2 − 4, but higher than the AGN incidence among DSFGs in the field environment. Both AGNs are heavily obscured sources, hosted in star-forming galaxies with ≈3 × 1010 M⊙ stellar masses. We estimate that the intergalactic medium in the host galaxies contributes to a significant fraction (or even entirely) to the nuclear obscuration. In particular, C1 is a highly luminous (LX = 2 × 1045 erg s−1) and Compton-thick (NH = 2 × 1024 cm−2) AGN, likely powered by a MBH > 6 × 108 M⊙ SMBH, assuming Eddington-limited accretion. Its high accretion rate suggests that it is in the phase of efficient growth that is generally required to explain the presence of extremely massive SMBHs in the centres of local galaxy clusters. Considering SPT2349–56 and DRC, a similar protocuster at z = 4, and under different assumptions on their volumes, we find that gas-rich protocluster cores at z ≈ 4 enhance the triggering of luminous (logLX/erg s−1 = 45 − 46) AGNs by three to five orders of magnitude with respect to the predictions from the AGN X-ray luminosity function at a similar redshift in the field environment. We note that this result is not solely driven by the overdensity of the galaxy population in the structures.
Conclusions. Our results indicate that gas-rich protoclusters at high redshift boost the growth of SMBHs, which will likely impact the subsequent evolution of the structures. Therefore, they stand as key science targets to obtain a complete understanding of the relation between the environment and galaxy evolution. Dedicated investigations of similar protoclusters are required to definitively confirm this conclusion with a higher statistical significance.
Akute Immunneuropathie und Optikusneuritis – Übersicht und
Fallbericht eines seltenen Überlappungssyndroms
Authors: Jüchtern Marvin , Nebelo Frederik Maximilian , Mull Michael , Dafotakis Manuel , Brunkhorst Robert , Matz Oliver 
Published: July 2024

ZusammenfassungDie vorliegende Arbeit gibt einen Überblick über nosologische,
pathomechanistische und therapeutische Aspekte von kranialen
Überlappungssyndromen akuter Immunneuropathien. Eine 18-jährige Patientin
entwickelte eine bilaterale faziale Parese, akrodistale Parästhesien und
Sehstörungen nach einem gastrointestinalen Infekt. Kraft, Koordination und
Muskeleigenreflexe der Extremitäten waren regelrecht. Bei Kontrastmittelaufnahme
mehrerer Hirnnerven sowie von Konus- und Kaudafasern, zytoalbuminärer
Dissoziation im Liquor und Demyelinisierungszeichen in der Elektroneurographie
diagnostizierten wir eine akut-inflammatorische demyelinisierende
Polyradikuloneuritis mit Neuritis nervi optici. Die Beschwerden der Patientin
sprachen gut auf eine Plasmapherese an. Auch bei Patienten mit Hirnnervenparesen
und Parästhesien ohne Hyporeflexie oder Extremitätenschwäche sollte an eine
akute Immunneuropathie gedacht werden. Kombinationen mit zentraler Affektion wie
der Optikusneuritis sind dabei möglich.
Elektrophysiologische Aspekte in der Diagnostik und Pathophysiologie
der Critical Illness Polyneuromyopathie (CIPNM)
Authors: Sekhniashvili Madona , Toyka Klaus Viktor , Baum Petra 
Published: July 2024

ZusammenfassungCritical Illness Neuromyopathie (CIPNM) ist eine Sepsis-Komplikation mit noch
immer ungeklärter Pathophysiologie. Die motorische und sensible
Elektroneurographie zeigen eine Minderung der Amplituden von Muskel- und
Nervensummenaktionspotentialen (MSAP/NSAP). Veränderungen im EMG finden sich in
der Frühphase der Erkrankung nicht. Mit einer aufwändigen elektrophysiologischen
Technik wurden Veränderungen der Nerven- und Muskelfaser-Erregbarkeit
beschrieben, die als Zeichen einer Fehlfunktion von Na-Kanälen interpretiert
wurden. Eine neue, auf jedem EMG-Gerät durchführbare 0,2–0,5 Hz Serienreizung
der motorischen Nerven oder direkt des Muskels führt bei CIPNM zu einer starken
Fazilitierung der MSAP und eignet sich als diagnostisches Kriterium. Die
hochgradige Variabilität der Fazilitierung spricht für eine fluktuierende,
dysfunktionelle Neuromyopathie. Sensible Nerven zeigten nur selten eine geringe
Fazilitierung. Als pathogene Faktoren wurden fokale Ischämie mit Hypoxie und
toxische Entzündungs-Botenstoffe vermutet, die ein Energiedefizit erzeugen und
neben anderem Na-Kanäle funktionell beeinträchtigen könnten.
Therapeutische Neurostimulation bei Epilepsien
Authors: Schulze-Bonhage Andreas 
Published: July 2024

ZusammenfassungDas Spektrum möglicher Neurostimulationsbehandlungen von Epilepsien hat sich in
den letzten Jahren deutlich erweitert. Nach Einführung der Vagusnervstimulation
1994 haben sich mit der Stimulation der anterioren Thalamuskerne, in den USA der
responsiven intrakranielle Fokusstimulation und zuletzt in Europa der
epicraniellen Fokalen Cortexstimulation neue klinische Behandlungsansätze
entwickelt. In dieser Übersichtsarbeit werden die den Stimulationsbehandlungen
zugrunde liegenden Prinzipien dargestellt, klinische Aspekte und Ergebnisse der
einzelnen Methoden dargestellt und abschließend eine Übersicht zu
Indikationsstellungen gegeben.
“Just Got Diagnosed; What Worked for You?”: A Mixed-Methods Analysis of Treatment Experiences in the Prolactinoma Subreddit
Authors: Dimitroyannis Rose , Fenton David , Thodupunoori Sharanya , Cho Stella , Nordgren Rachel , Polster Sean P. , Horowitz Peleg M. , Das Paramita , Roxbury Christopher R. 
Published: July 2024

Abstract
Introduction With improvement in complication and remission rates, recent studies have suggested the viability of transsphenoidal surgery as first-line management for prolactinomas. Reddit, an online forum, allows posters to interact with one another, and discuss symptoms, treatments, and disease courses through specialized forums known as “subreddits.” Given the lack of research comparing patient experience on pharmacotherapy versus surgery, we sought to assess the sentiment of treatment within the “r/Prolactinoma subreddit” community.
Methods A search was done by filtering the r/Prolactinoma subreddit. Posts were sorted by “top” of “all time,” meaning entries with the most engagement throughout the site's history. Welch's t-test was used to analyze treatment type, while sentiment regarding treatment was analyzed using grounded theory qualitative methods.
Results From 189 total entries, 82 were included; 33% (n = 27/82) were posts. Of posters disclosing their treatment, 11% underwent surgery (n = 9/79), while 76% received medication (n = 60/79). The proportion of positive:negative sentiment and level of engagement on posts regarding pharmacotherapy versus surgical treatments were not significantly different (p > 0.05). Qualitative analysis showed themes of changes after medical treatment, immediate changes postsurgery, and online community.
Conclusion Our mixed-methods study found statistically nonsignificant differences in sentiment when comparing Reddit posts from patients who underwent medical and surgical management. Qualitative analysis revealed several themes regarding patients' perceptions of medical and surgical management and the benefits of an online community. The qualitative themes brought to light by this study may serve to inform future studies examining the patient experience with prolactinoma care.
Are Neonatal Birth Weights Reduced in Low-Risk Patients Diagnosed with COVID-19 during Pregnancy?
Authors: Foster Hannah S. , Forkpa Markolline , Van Tienhoven Ximena A. , Schwartz Nadav , Srinivas Sindhu , Parry Samuel , Mccabe Meaghan G. 
Published: July 2024

Objective Studies have shown that the 2019 novel coronavirus disease (COVID-19) may be associated with an increased risk of adverse pregnancy outcomes including preeclampsia, preterm birth, and stillbirth. However, the relationship between COVID-19 and abnormal fetal growth (i.e., low neonatal birth weight) has not been elucidated. Because other viruses affect fetal growth, obstetrical providers began to recommend ultrasound studies during the third trimester to assess fetal growth in patients with COVID-19 during pregnancy. The aim of this study was to determine if neonatal birth weight was different between low-risk patients diagnosed with COVID-19 during pregnancy and low-risk patients without COVID-19 in pregnancy, to ascertain if third trimester growth ultrasound is warranted in this patient population.
Study Design We performed a retrospective cohort study of low-risk pregnant patients (who had no other indications for sonographic fetal surveillance during the third trimester) with and without COVID-19 during pregnancy. Patient demographics, gestational dating, neonatal birth weights, and corresponding Alexander growth curve birth weight percentiles were collected. The primary outcome was small-for-gestational age (SGA) neonates, defined as birth weight < 10th percentile for gestational age at delivery (SGA10).
Results Our cohort (N = 513) included 248 COVID-19-exposed patients and 265 patients who did not have COVID-19 during pregnancy. Gestational age at delivery and average neonatal birth weights were similar in COVID-19-exposed (38 weeks 5 days, 3,266 g) and unexposed patients (38 weeks 4 days, 3,224 g; p = 0.434, 0.358). Rates of SGA10 neonates were similar in the COVID-19-exposed (22/248, 8.9%) and -unexposed (23/265, 8.7%, p = 0.939) groups. Timing and severity of COVID-19 during pregnancy also were not associated with rates of SGA neonates.
Conclusion In a cohort of low-risk patients, rates of SGA neonates were similar in patients with and without COVID-19 during pregnancy. These findings suggest that ultrasound surveillance to detect fetal growth restriction in low-risk patients with COVID-19 during pregnancy is not warranted.
Key Points
Evaluation of Volumetric Changes between Pediatric Rotary Files and Manual Files during Canal Preparation of Primary Mandibular Canine: A Nano-CT Analysis
Authors: Suresh Balaji , Jeevanandan Ganesh , Ravindran Vignesh , Vishwanathaiah Satish , Panda Suman , Syed Ather Ahmed , Altowairqi Sultan , AlShehri Aram , Alaqla Ali , Khanagar Sanjeev , Maganur Prabhadevi 
Published: July 2024

Abstract
Objective Pediatric endodontics has become popular due to advancements in cleaning, shaping, and irrigation systems, resulting in faster and effective removal of infected pulp, saving time, and creating a pathogen-free environment. The patented rotary file system, Kedo S, designed for primary teeth, introduced a single file generation for efficient pulp therapy. However, there are currently no studies assessing canal preparation in primary mandibular canine using nano-computed tomography (nano-CT). This study aims to evaluate the efficacy of rotary file systems (Kedo S plus, Kedo SG blue) against traditional hand files in root canal preparation of primary mandibular canines using nano-CT.
Materials and Methods This in vitro study was performed in extracted primary mandibular canine based on certain inclusion and exclusion criteria. Samples were prepared and working length was determined before the preoperative scan using a high-resolution nano-CT device (SkyScan 2214, Bruker, Kontich, Belgium). A single well-experienced pediatric dentist prepared the canals using three file systems: Kedo S plus, Kedo SG blue, and hand K-files. A postoperative scan was performed similar to preoperative scan. Image reconstruction was performed with NRecon software for three-dimensional volumetric visualization and analysis of the root canals.
Results Kedo S plus displayed significant alterations in volumetric, surface area, and instrumented areas postpreparation compared with Kedo SG blue and hand files. Statistical analysis revealed significant differences in volumetric and surface changes between Kedo S plus and hand files.
Conclusion Rotary file systems, especially Kedo S plus, resulted in increased canal volume and surface area with minimal uninstrumented areas, showing promise for primary dentition root canal preparations. Further clinical assessments are warranted to validate these findings.
Pathways to Neuropalliative Care Practice
Authors: Harrigan Eileen , Kirsch Hannah L. , Adjepong Kwame , Crooms Rita Caroline 
Published: July 2024

AbstractAs neuropalliative care is better recognized and more widely utilized, there is as great a need for clinicians trained in the field as there is for disease-specific symptom management, advance care planning, and end-of-life care. In this manuscript, we describe potential career trajectories in neuropalliative care. For clinicians, this includes educational and training opportunities within primary neuropalliative care (integrating palliative care principles into usual neurology practice), specialty neuropalliative care (completing a hospice and palliative medicine fellowship), and hospice. We also describe considerations for establishing new clinical neuropalliative practices and highlight neuropalliative education and research as key areas for advancing the field.
The Young: Early-Onset Colon Cancer
Authors: Cohen David , Rogers Caitlin , Gabre Joel , Dionigi Beatrice 
Published: July 2024

AbstractEarly-onset colorectal cancer (EO-CRC), characterized by diagnosis before the age of 50 years, has emerged as a significant healthcare challenge with increasing global incidence. While traditional risk factors such as family history and inherited syndromes contribute to EO-CRC, a substantial proportion of cases remain sporadic, necessitating further investigation into additional etiological factors. Molecular studies reveal heterogeneity in EO-CRC, with distinct mutational profiles compared to late-onset CRC. Clinical management presents unique considerations, including challenges in early detection and treatment strategies tailored to younger patients. Addressing EO-CRC requires a multidisciplinary approach integrating epidemiological, molecular, and clinical insights to improve prevention, diagnosis, and therapeutic outcomes. Emerging research avenues explore novel biomarkers and therapeutic targets, offering promise for advancing understanding and management of this disease in contemporary oncology practice.