bluuebunny/crossref_metadata_2025_split huggingface dataset:
Laryngeal mask airway versus endotracheal tube during percutaneous dilatational tracheostomy in critically ill adult patients
Authors: Elnafad Sobhy Ali , Fahmy Tamer Salah Eldin , Aqabawy Hazem Abdel Hamid El , Elansary Mohamed Gamal 
Published: August 2024

Abstract
Background
One of the most often used bedside surgical techniques in critical care units (ICUs) for critically ill individuals who need prolonged mechanical ventilation is percutaneous dilatational tracheostomy (PDT). Numerous difficulties may arise from puncturing the esophagus or making a false passage during surgery.

Objectives
To compare the use of laryngeal mask airway (LMA) and endotracheal tube (ETT) during PDT guided by ultrasonography (US) or bronchoscopy.

Methods
Our study was a prospective cohort of 120 patients admitted to the Critical Care Department at Kasr Alainy Hospital and Damanhur Medical National Institute between March 2020 and November 2021. Hemodynamics, arterial blood gasses, complications, and outcomes of the patients were recorded.

Results
The studied patients were divided into the ETT and LMA groups (60 patients in each group). Then, each group was subdivided into two subgroups (ETT-US, ETT-Bronch, LMA-US, and LMA-Bronch; 30 patients in each subgroup) according to the guiding procedure used for puncturing the trachea: US-guided or bronchoscopy-guided. Regarding HR, there was no statistically significant difference between the two groups or four subgroups before, during, and after the procedure. In addition, there was no statistically significant difference between the two studied groups regarding MAP before the procedure. However, during and after the procedure, MAP was significantly higher in the ETT group. There was no discernible change in oxygen saturation or PaO2 before, during, or after the procedure. However, there was no discernible difference in PaCO2 levels before and after the procedure; it was much greater in the ETT group and ETT-Bronch subgroup during the process. Furthermore, there was no statistically significant variation in the number of punctures between the two groups or the four subgroups. The length of the process varied significantly across the two major groups and the four evaluated subgroups. The LMA group had the shortest procedure duration (5.05 ± 1.28 min), the LMA-Bronch subgroup (4.79 ± 1.42 min), and the LMA-US subgroup (5.31 ± 1.10 min), while the ETT had the longest procedure duration group (5.86 ± 1.11 min), the ETT-Bronch subgroup (6.09 ± 1.23 min), and ETT-US (5.63 ± 0.94 min). Regarding complications, there was no considerable difference between the two groups or four subgroups except aerophagia. Aerophagia was considerably more common in the LMA group (7 candidates) and was not observed in the ETT group.

Conclusions
Our study concluded that the laryngeal mask airway improves ventilation during percutaneous dilatation tracheostomy, especially when used with ultrasound, and thus can be used for candidates with traumatic brain injury and brain edema.
What EU Conditionality Says about the Rule of Law
Authors: Fromont Louise 
Published: August 2024

Abstract
The Covid-19 crisis provided an opportunity for the European Union to offer an alternative regulatory response to the crisis of values by systemically linking European funding to respect for the rule of law. A rule of law conditionality mechanism for spending was introduced in the Recovery and Resilience Facility and in Regulation 2020/2092. It is both positive – in that it encourages Member States to implement reforms and investments aimed at improving the rule of law – and negative – in that it takes the form of financial sanctions. However, the development of the rule of law conditionality is leading to an economisation of the concept of the rule of law, insofar as it mainly concerns those dimensions of the rule of law that are conducive to growth – such as justice systems and the fight against corruption. As a result, it could paradoxically exacerbate the very crisis it is designed to resolve.
The Development Risks Defence in the Digital Age
Authors: Izquierdo Grau Guillem 
Published: August 2024

Abstract
One of the pillars on which product liability law is based is the defence for development risks. According to this defence, the producer is not liable for the damage caused to the injured party if, at the time the product was put into circulation, the state of scientific and technical knowledge did not allow the existence of the defect to be discovered. The Proposal for a Directive drafted by the European Commission and published on 28 September 2022 continues to provide, in Article 10.1.e), the defence for development risks. The Proposal for a Directive refers to this particular issue in Recital 39, which introduces some requirements for the assessment of such defence.
However, despite this recognition, does this defence fit into the digital paradigm, and how can it be applied to damage caused by defects in products with digital elements that incorporate artificial intelligence?
Exploring the electrophysiology of Parkinson’s disease with magnetoencephalography and deep brain recordings
Authors: Rassoulou Fayed , Steina Alexandra , Hartmann Christian J. , Vesper Jan , Butz Markus , Schnitzler Alfons , Hirschmann Jan 
Published: August 2024

AbstractAberrant information processing in the basal ganglia and connected cortical areas are key to many neurological movement disorders such as Parkinson’s disease. Investigating the electrophysiology of this system is difficult in humans because non-invasive methods, such as electroencephalography or magnetoencephalography, have limited sensitivity to deep brain areas. Recordings from electrodes implanted for therapeutic deep brain stimulation, in contrast, provide clear deep brain signals but are not suited for studying cortical activity. Therefore, we combine magnetoencephalography and local field potential recordings from deep brain stimulation electrodes in individuals with Parkinson’s disease. Here, we make these data available, inviting a broader scientific community to explore the dynamics of neural activity in the subthalamic nucleus and its functional connectivity to cortex. The dataset encompasses resting-state recordings, plus two motor tasks: static forearm extension and self-paced repetitive fist clenching. Most patients were recorded both in the medicated and the unmedicated state. Along with the raw data, we provide metadata on channels, events and scripts for pre-processing to help interested researchers get started.
Distance and similarity measures on belief and plausibility under q-rung orthopair fuzzy sets with applications
Authors: Hussain Rashid , Hussain Zahid , Sarhan Nadia M. , Juraev Nizomiddin , Ur Rahman Shams 
Published: August 2024

AbstractBelief and plausibility functions based on evidence theory (ET) have been widely used in managing uncertainty. Various generalizations of ET to fuzzy sets (FSs) have been reported in the literature, but no generalization of ET to q-rung orthopair fuzzy sets (q-ROFSs) has been made yet. Therefore, this paper proposes a novel, simple, and intuitive approach to distance and similarity measures for q-ROFSs based on belief and plausibility functions within the framework of ET. This research addresses a significant research gap by introducing a comprehensive framework for handling uncertainty in q-ROFSs using ET. Furthermore, it acknowledges the limitations inherent in the current state of research, notably the absence of generalizations of ET to q-ROFSs and the challenges in extending belief and plausibility measures to certain aggregation operators and other generalizations including Hesitant fuzzy sets, Bipolar fuzzy sets, Fuzzy soft sets etc. Our contribution lies in the proposal of a novel approach to distance and similarity measures for q-ROFSs under ET, utilizing Orthopairian belief and plausibility intervals (OBPIs). We establish new similarity measures within the generalized ET framework and demonstrate the reasonability of our method through useful numerical examples. Additionally, we construct Orthopairian belief and plausibility GRA (OBP-GRA) for managing daily life complex issues, particularly in multicriteria decision-making scenarios. Numerical simulations and results confirm the usability and practical applicability of our proposed method in the framework of ET.
Interstitial cells of the sip syncytium regulate basal membrane potential in murine gastric corpus
Authors: Hwang Sung Jin , Kim MinKyung , Jones Amanda , Basma Naseer , Baker Salah A. , Sanders Kenton M. , Ward Sean M. 
Published: August 2024

AbstractSmooth muscle cells (SMCs), Interstitial cells of Cajal (ICC) and Platelet‐derived growth factor receptor α positive (PDGFRα+) cells form an integrated, electrical syncytium within the gastrointestinal (GI) muscular tissues known as the SIP syncytium. Immunohistochemical analysis of gastric corpus muscles showed that c‐KIT+/ANO1+ ICC‐IM and PDGFRα+ cells were closely apposed to one another in the same anatomical niches. We used intracellular microelectrode recording from corpus muscle bundles to characterize the roles of intramuscular ICC and PDGFRα+ cells in conditioning membrane potentials of gastric muscles. In muscle bundles, that have a relatively higher input impedance than larger muscle strips or sheets, we recorded an ongoing discharge of stochastic fluctuations in membrane potential, previously called unitary potentials or spontaneous transient depolarizations (STDs) and spontaneous transient hyperpolarizations (STHs). We reasoned that STDs should be blocked by antagonists of ANO1, the signature conductance of ICC. Activation of ANO1 has been shown to generate spontaneous transient inward currents (STICs), which are the basis for STDs. Ani9 reduced membrane noise and caused hyperpolarization, but this agent did not block the fluctuations in membrane potential quantitatively. Apamin, an antagonist of small conductance Ca2+‐activated K+ channels (SK3), the signature conductance in PDGFRα+ cells, further reduced membrane noise and caused depolarization. Reversing the order of channel antagonists reversed the sequence of depolarization and hyperpolarization. These experiments show that the ongoing discharge of STDs and STHs by ICC and PDGFRα+ cells, respectively, exerts conditioning effects on membrane potentials in the SIP syncytium that would effectively regulate the excitability of SMCs.
Lymphovenous Bypass as an Alternative Strategy for Managing Phleboedema and Venous Leg Ulcers: Preliminary Results
Authors: Chao Sungchuan , Kuan Chenhisang , Lin Yingsheng , Tai Haochih , Cheng Naichen 
Published: August 2024

Background:
Chronic venous leg ulcers (VLUs) are a common manifestation of chronic venous insufficiency, accounting for up to 70% of all chronic leg ulcers. Patients sustained refractory ulcers and persistent phleboedema even with a combination of different treatment methods. Lymphovenous bypass (LVB) has shown promising results in patients with lymphedema. We hypothesize that LVB could potentially alleviate VLUs and phleboedema, given their symptom similarities with lymphedema.

Methods:
From May 2021 to June 2023, we prospectively deployed LVB in patients with nonhealing stasis ulcers after 4-week traditional care, or in those with persistent phleboedema despite prior surgery for vein etiologies. Demographics, healing course and recurrence, lymphoscintigraphy, and VLU quality of life (QoL) questionnaires were collected.

Results:
Thirty-one patients were treated with LVB and additional skin grafting as necessary. Their mean age was 62.6 ± 14.7 years, with male predominance (20, 64.5%), and most patients sustained clinical, etiologic, anatomic, pathophysiologic classification C6 (25, 80.6%). Postoperatively, wound healing and phleboedema decongestion were observed mostly within 2 months. The VLU QoL questionnaire (39.3% response rate) showed improvement in QoL in activities, and psychological and symptom distress aspects.

Conclusions:
Using LVB for chronic venous insufficiency showed an increase in the success rate of ulcer healing and decompression of the swollen limbs with durable results. Patient-reported outcome measures disclosed the potential benefits of LVB. Large-scale randomized controlled trials and pathophysiological studies are warranted to elucidate its efficacy.
Social Environment and Neurobehavioral Outcomes 1 Year After Severe Pediatric TBI in the Intensive Care Unit
Authors: Miley Aimee E. , Patronick Jamie , Zhang Nanhua , Bode Rachel L. , Fabio Anthony , Treble-Barna Amery , Chima Ranjit S. , Adlam Anna-Lynne R. , Bell Michael J. , Wisniewski Stephen R. , Beers Sue R. , Wade Shari L. , Kurowski Brad G. 
Published: August 2024

Objective:
To examine the association of home and neighborhood environment with neurobehavioral outcomes after severe pediatric traumatic brain injury (TBI).

Setting:
Domestic and international children’s medical centers.

Participants:
Participants enrolled in the study were 18 years or younger at the time of their severe TBI (Glasgow Coma Scale [GCS] ≤ 8), admitted to the intensive care unit, and underwent placement of an intracranial pressure (ICP) monitor. Exclusionary criteria included less severe injury (GCS > 8), pregnancy, and/or ICP monitor placement occurred at a non-participating hospital.

Design:
A multicenter, observational cohort study.

Main Measures:
Outcomes assessed at 12 months post-injury included measures of global functioning, intellectual ability, caregiver-report measures of family functioning, executive functioning behaviors, behavior problems, and health-related quality of life. We examined mortality risk (assessed acutely after injury), family functioning (assessed at 12 months post-injury) and parenting practices, social environment, and neighborhood stressors (all assessed > 12 months post-injury), as correlates and moderators of the 12-month post-injury outcomes.

Results:
Home and neighborhood factors were associated with neurobehavioral outcomes (ie, intellectual ability, executive functioning, behavioral adjustment, and health-related quality of life) but not with global functioning outcomes. A negative association between a more vulnerable home and neighborhood environment and neurobehavioral outcomes was more consistent in older children compared with younger children, based on age of injury. The influence of mortality risk on neurobehavioral outcomes was variable.

Conclusion:
Parenting practices and quality of social and neighborhood environment are associated with neurobehavioral outcomes 12 months after severe pediatric TBI. More research is needed to better understand the relationship between home/neighborhood stressors and TBI recovery to develop and implement strategies for patients and families to optimize outcomes. Future intervention development should focus on addressing parenting practices and social environment in a developmentally sensitive way for children who have sustained a severe TBI.
Evaluation of a Slim Modiolar Electrode Array: A Temporal Bone Study
Authors: Asfour Leena , Risi Frank , Treaba Claudiu , Kirk Jonathon , Roland Thomas J. 
Published: August 2024

Hypothesis
Evaluation of the Slim Modiolar (SM) electrode in temporal bones (TB) will elucidate the electrode's insertion outcomes.

Background
The SM electrode was designed for atraumatic insertion into the scala tympani, for ideal perimodiolar positioning and with a smaller caliber to minimize interference with cochlear biological processes.

Methods
The SM electrode was inserted into TBs via a cochleostomy. First, the axial force of insertion was measured. Next, TBs were inserted under fluoroscopy to study insertion dynamics, followed by histologic evaluation of electrode placement and cochlear trauma. A subset of TBs were inserted with the Contour Advance (CA) electrode for comparison.

Results
Sixteen of 22 insertions performed to measure the axial force of insertion had flat or near zero insertion force profiles. Six insertions had increased insertion forces, which were attributed to improper sheath depth before electrode insertion. Under real-time fluoroscopy, 23 of 25 TBs had uneventful insertion and good perimodiolar placement. There was 1 scala vestibuli insertion due to suboptimal cochleostomy position and 1 tip roll over related to premature electrode deployment. When compared with the CA electrode, 14 of 15 insertions with the SM electrode resulted in a more perimodiolar electrode position. No evidence of trauma was found in histologic evaluation of the 24 TBs with scala tympani insertions.

Conclusion
TB evaluation revealed that the SM electrode exerts minimal insertion forces on cochlear structures, produces no histologic evidence of trauma, and reliably assumes the perimodiolar position. Nonstandard cochleostomy location, improper sheath insertion depth, or premature deployment of the electrode may lead to suboptimal outcomes.
Utility of MRI in the Outpatient Evaluation of Patients With Chronic Continuous or Recurrent Dizziness
Authors: Gupta Ankur , Thai Anthony , Steenerson Kristen K. , Alyono Jennifer 
Published: August 2024

Objective
This study aimed to assess the utility of magnetic resonance imaging (MRI) in outpatient evaluation of patients with chronic continuous or recurrent dizziness (CCRD) and determine whether certain patient characteristics, symptoms, or examination findings are associated with diagnostic MRI findings.

Study Design
Retrospective cohort study.

Setting
Ambulatory center.

Patients
304 patients who received an MRI for CCRD.

Intervention
Diagnostic utility of MRI in patients with CCRD.

Main Outcome Measure
MRI diagnostic findings in patients with CCRD and associated patient characteristics, symptoms, or examination findings.

Materials and Methods
In this retrospective analysis, 304 patients who visited an outpatient clinic between 1998 and 2023 and underwent MRI for CCRD, without previously diagnosed neurological abnormalities, were examined. The study investigated the relationship between demographic characteristics, comorbidities, clinical symptoms, and examination findings with diagnostic MRI findings. Univariate analysis was used to identify factors predictive of diagnostic MRI findings.

Results
Out of 304 patients, 11 (3.6%; 95% confidence interval [CI], 1.5–5.72%) had diagnostic MRI findings. The most common diagnostic finding (36.4%) was brain metastasis, seen only in patients with previously diagnosed metastatic cancer. Univariate analysis revealed that hypertension (p = 0.004, likelihood ratio [LR] = 2.51), hyperlipidemia (p = 0.004, LR = 2.91), and cancer (p = 0.021, LR = 2.96) were significantly associated with diagnostic MRI findings. Incidental findings were observed in 73 patients (24%; 95% CI, 19.2–28.8%). Outside of cancer patients, six (2.3%; 95% CI, 1.1–5.0%) had diagnostic MRI findings.

Conclusion
In our study, MRI rarely displayed diagnostic findings in patients with CCRD and normal neurologic examination. However, individuals with hypertension, hyperlipidemia, or cancer were significantly more likely to display positive MRI findings. It is essential to carefully consider the need for MRI when assessing patients with CCRD.
Determining the Impact of Preoperative Psychiatric Comorbidities on Readmission After Resection of Vestibular Schwannoma
Authors: Patel Aneesh A. , Kennedy Dean , Dupuis Genevieve , Levi Jessica R. , Weber Peter C. 
Published: August 2024

Objective
To determine the impact of comorbid depression on readmission after vestibular schwannoma resection.

Study design
Retrospective database analysis.

Setting
National database of readmitted patients.

Patients
The Nationwide Readmission Database (NRD) was retrospectively reviewed for patients with history of vestibular schwannoma, identified by International Classification of Disease, Ninth Revision (ICD-9) code 225.1 and ICD-10 code D33.3, who underwent surgical resection (ICD-9 04.01, ICD-10-PCS 00BN0ZZ) in 2020.

Interventions
Therapeutic.

Main outcome measures
Need for rehabilitation, need for procedures, length of stay, cost of readmission, and insurance status.

Results
A total of 1997 patients were readmitted after resection of vestibular schwannoma in 2020. Of these patients, 290 had history of a comorbid depressive disorder.
A significantly higher proportion of patients with history of comorbid depression were transferred to a rehabilitation facility after readmission (11.30% versus 4.30%, p < 0.001). Length of stay (p = 0.227) and total readmission cost (p = 0.723) did not differ significantly, but a significantly lower proportion had private insurance (55.40% versus 64.40%, p = 0.027).

Conclusion
Depression is associated with higher utilization of postoperative rehabilitation services and higher rates of medical comorbidities, and should be considered during preoperative evaluation.
Improving Linkages Between Sexual and Reproductive Health and Substance Use Providers: The Partnership to Advance Integrated Referrals
Authors: Dublin Sonya , Bermudez Dayana , Ortiz Christina , Tobier Natalie , Levy Joslyn , Hargarten Leah 
Published: August 2024

Background and Objectives:
Women of reproductive age with substance use (SU) disorders have lower rates of contraceptive use and higher rates of unintended pregnancy than women without SU disorders and are less likely to access treatment than men. Integration of SU and sexual and reproductive health (SRH) services, using a model known as Screening, Brief Intervention, and Referral to Treatment (SBIRT), has been proven effective in reducing SU and improving health care equity. The SBIRT model includes screening, brief intervention (a short client-centered conversation providing an opportunity to identify/discuss concerns), and referral to treatment. The purpose of this study was to test whether an established quality improvement (QI) learning collaborative model could be used to support SU and SRH sites in implementing an SBIRT/SBIRT-like model to improve health outcomes for women. Five SRH sites and 4 SU sites across New York State participated in the Partnership to Advance Integrated Referrals (PAIR), an 18-month QI learning collaborative designed and implemented by Public Health Solutions.

Methods:
Six standardized mixed-methods data collection tools were used over 18 months to gather process and outcome data from over 130 QI team members and site staff and over 5000 clients.

Results:
By the end of PAIR, QI team members and site staff showed a reduction in bias, increased knowledge and comfort, increased rating of organizational practices related to client-centered care, and increased access to peer learning, information about best practices, and training and technical assistance. SU sites increased SRH screening from 47.9% in the first quarter of data collection to 67.4% in the final quarter and increased brief interventions from 92.5% in the first quarter to 100.0% in the final quarter. Similarly, SRH sites increased SU screening from 51.6% to 75.6% and increased brief interventions from 81.3% to 85.1%. The processes and outcomes were very different for the SU and SRH sites, and their varying successes and challenges are discussed. Making and verifying referrals remained challenging.

Conclusions:
The results of PAIR demonstrated the feasibility of SU and SRH sites implementing an SBIRT/SBIRT-like model when supported by a QI learning collaborative. Larger community and organizational challenges (COVID-19, staff turnover) still present barriers to improved reproductive health and SU outcomes for women.