bluuebunny/crossref_metadata_2025_split huggingface dataset:
Applying State-of-the-Art Artificial Intelligence to Simulation-based Education: A Study of Comparative Educational and Operational Benefits
Authors: Campbell Krystle K. , Holcomb Michael J. , Vedovato Sol , Young Lenora , Danuser Gaudenz , Dalton Thomas O. , Jamieson Andrew R. , Scott Daniel J. 
Published: July 2024

Abstract

Objective
Accreditation bodies are driving competency-based education in healthcare, prompting curriculum reform. Simulation-based education (SBE) addresses challenges curriculum reform has uncovered, like lack of standardization in bedside teaching. This study explores the impact of an AI-powered Automated System Protocol (ASP) for grading students' post-encounter notes in Clerkship OSCEs, comparing it to the legacy human grader system.
Methods
The ASP, utilizing GPT-4, mapped rubric items to prompts. Analyzing post-encounter notes from 684 medical students across four academic years, we compared ASP with legacy Standardized Patient Evaluator (SPE) grades. Time efficiency, cost savings, and ROI analyses assessed educational and financial implications.
Results
Significant cost savings and efficiency gains were observed utilizing GPT-4 in comparison to SPEs. The Cost of Investment for ASP totaled $69,112 over 1,150 hours. Comparing ASP to three SP graders yielded $13,112 in increased costs and initial time investment was required. However, beyond development time ASP execution-only, compared to legacy, showed an ROI of 589.44%, saving $47,877 with 87.5% time efficiency. ASP-execution versus three MD graders demonstrated an even stronger ROI of 797.09%.
Conclusion
Implementing ASP in medical education provides substantial time and cost savings, enhancing ROI compared to legacy grading models. These findings highlight significant cost savings and efficiency improvements achievable through ASP implementation, positioning automated assessment as an innovative force shaping the future of medical education. By liberating human resources from manual grading and enhancing the immediacy of feedback, this approach contributes to a more efficient, effective, and engaging learning experience.
Outcomes of Sclerokeratoplasty in Severe Ocular Surface Disease
Authors: Loya-Garcia Denise , Jimenez-Collado David , Jimenez-Corona Aida , Pedro-Aguilar Lucero , Morales Norma , Navas Alejandro , Valdez-Garcia Jorge E. , Graue-Hernández Enrique O 
Published: July 2024

Abstract

Sclerocorneal grafts are procedures considered in cases with extensive corneal and scleral tissue destruction. The study aims to describe sclerokeratoplasty outcomes in severely diseased eyes. We performed a retrospective review of clinical records. Demographic characteristics, medical history, surgical indications, aetiology of perforation, visual outcomes, complications associated with the surgical procedure, and ocular integrity at the end of the follow-up were obtained. Wilcoxon-signed rank tests and Mann-Whitney tests were used to compare complications between groups and outcomes at final follow-up. Survival analysis was performed to analyse vision preservation and global integrity and presented in Kaplan-Meier curves. 40 eyes from 40 patients with a mean age of 48.83 ± 18.85 years and a mean follow-up of 21.13 ± 33.92 months were included in the study. Median corrected visual acuity before and after the procedure remained at 2.8 logMAR. Twenty-seven eyes presented complications. The most common complications were a persistent epithelial defect in 11, hypertension in 10, and perforation in 8 eyes. More than half of the eyes (67.5%) presented with either one or more of all complications after corneoscleral graft. No significant differences were found regarding age, gender, or DM history. Concerning perforation, a significant difference was found between infectious and non-infectious only in the presentation of ocular hypertension (p = 0.048). Vision was preserved in 72.5% of the eyes, with a median survival probability of 4.12 years. Preservation of the ocular integrity was achieved in 85% of the eyes, with a median survival probability of 12 years. Sclerokeratoplasty despite being challenging and technically demanding followed by defiant complications, in some situations such as infectious keratitis and autoimmune diseases, is likely a procedure that salvages the eye and preserves vision.
Analysis of Microbial and Nematode Communities in the Apple Replant Disease Complex
Authors: Ali Shawkat , Fuller Keith , Yurgel Svetlana , forge tom , Levaesque Vicky , Mazzola Mark 
Published: July 2024

Abstract

Apple replant disease (ARD) is a complex issue caused by various fungal, oomycetes pathogens and parasites which can differ in their abundance between sites within a geographic region. Knowledge of the specific etiology of ARD at a particular site is required in order to develop commercially viable soil management strategies to combat specific/individual components of the disease. In this study we analyzed the soil from six ARD sites for the presence of fungal, bacterial and oomycetes communities and plant parasitic nematodes. Five fungal, and 17 bacterial classes were differentially represented in the microbiomes from different locations. Mortierellomycetes was the most abundant fungal taxa represented followed by Sordariomycetes.Mortierella exiguaa fungal endophyte was the most abundant fungal amplicon sequence variant (ASV) in the core microbiome. Proteobacteria was the most prevalent phylum identified in orchard soils. Several potential phytopathogenic fungi involved in ARD and endophytes includingFusarium oxysporum, F. solani,Nectria ramulariae, Ilyonectria robustaandNectriaceaewere identfied in the orchard soil.Pythium attrantheridium (Globisporangium attrantheridium),P. monospermumandP. ultimum(Globisporangium ultimum) were the most abundant oomycete taxa identified in these soil samples. Six different groups of plant-parasitic nematodes were found across the six orchards soil. Root-lesion nematodes,Pratylenchusspp., which are commonly associated with ARD, were identified in all orchards soil at population densities ranging from 12 to 33/100 cm3soil. This research contributes valuable understanding of the ARD complex as the apple industry needs alternative approaches to combat the disease.
Halpeh Extract-Derived Gold Nanoparticles: A Dual Force Against Microbes and for Phytochemical Enhancement
Authors: Dahaz Ehsan , Asadi Samer , Lashgari Somayeh 
Published: July 2024

Abstract

The increasing resistance of pathogenic microorganisms to conventional antibiotics has led to a growing interest in alternative antimicrobial agents. In this study, the antimicrobial activity (antibacterial and antifungal) of aqueous and methanolic extracts of Halpeh plant and gold nanoparticles synthesized using the extract of this plant was investigated. Additionally, the effect of different concentrations of synthesized gold nanoparticles on the phytochemical properties (antioxidant and reducing ability) of Halpeh plant extract was examined. The results of UV-Vis (Ultraviolet-Visible Spectroscopy), XRD (X-Ray Diffraction Analysis), TEM (Transmission Electron Microscopy), SEM (Scanning Electron Microscopy), and FTIR (Fourier Transform Infrared Spectroscopy) tests on gold nanoparticles confirmed their synthesis. SEM and TEM images showed that the gold nanoparticles were spherical in shape with an average size of 22.89 nm. According to the results, the methanolic extract exhibited significantly higher antibacterial and antifungal activity compared to the aqueous extract, with the maximum inhibition zone diameters observed for Escherichia coli (14 mm) and Aspergillus niger (15 mm). Moreover, the antimicrobial activity of gold nanoparticles showed that these nanoparticles have relatively good ability to inhibit gram-negative bacteria, with the largest inhibition zone diameters observed for Escherichia coli (18 mm) and Aspergillus niger (20 mm). The antioxidant and reducing power activity (phenolic flavonoids content) of Halpeh plant extract treated with different concentrations of synthesized gold nanoparticles increased with increasing nanoparticle concentrations up to 60 ppm (IC50 = 9.94 µg/ml and reducing power = 16.85 mMFe2+/mg sample), and decreased at higher concentrations.
An Oceanic Mechanism for Geyser Formation on Enceladus
Authors: Abdulah Daniel , Kang Wanying 
Published: July 2024

Abstract

The tiger stripes of Enceladus are a sequence of four parallel and evenly-spaced fissures 130~km long which erupt water from a global subsurface ocean out into space. We present the first theory of their formation which links the observed surface to yet unexplored features of the oceanic environment below. Given one initial fissure, topography on the underside of the ice shell rubs periodically against the ocean due to the satellite's libration. This motion excites internal gravity waves which propagate down and reflect at a bottom boundary, reimpacting the underside of the shell at a fixed distance away from primary fissure. This impact generates heat through wave breaking which melts the ice, forming the next fissures in a chain of parallel stripes. We solve for the internal wave field, energy dissipated, and ice melted using linear gravity wave analysis, extending previous literature on gravity wave conversion. The dissipation predicted by the analytical theory matches nonlinear simulations using the MITgcm, especially when the flow remains subcritical. Dissipative regimes where new fissures can form are identified. Maintaining that formation occurs at the observed 35 km spacing, we discuss implications for ocean depth and stratification.
Impact of Virtual Simulation vs. Video Refresher Training on NRP Simulation Performance: A Randomized Controlled Trial
Authors: Umoren Rachel , Gray Megan , Chitkara Ritu , Josephsen Justin , Lee Henry , Strand Marya , Sawyer Taylor , Ramachandran Shalini , Weiner Gary , Zaichkin Jeanette , Kan Peiyi , Pantone Gina , Ades Anne 
Published: July 2024

Abstract

Objective
To assess the impact of NRP virtual simulations (eSim™), video or no refresher training, on simulation performance, six months after a provider course; and to evaluate eSim™ acceptability.
Study Design:
In this multi-site randomized controlled trial, NRP providers from four U.S. institutions were randomized to receive refreshers every two months with NRP eSim™, NRP resuscitation video, or no refresher (control). Simulation performance was assessed immediately after an NRP course and six months later.
Result
248 participants completed the baseline simulation and 148 completed the six-month follow-up simulation. The majority (71%) of subjects had a decline in resuscitation skills at 6 months. There were no differences in performance between the study groups, but participants who reported using either the video or eSim™ had less decline in performance at the 6-month follow-up (p < 0.05).
Conclusion
NRP refreshers with either eSim™ or NRP video may mitigate the decline in resuscitation skills after training.
Combined phacoemulsification, goniosynechialysis and ab interno trabeculectomy in primary angle-closure glaucoma: three-year results
Authors: Yang Fengrui , Ma Yao , Liang Zhiqiao , Lv Kun , Yang Kangyi , Wu Huijuan 
Published: July 2024

Abstract

This research was designed to evaluate the efficacy and safety of ab-interno trabeculectomy (Trabectome and Kahook Dual Blade) combined with phacoemulsification, intraocular lens implantation, and goniosynechialysis in eyes with primary angle-closure glaucoma. A total of 51 patients were included in the study and all the patients received the combined surgery. Intraocular pressure, anti-glaucoma medications, best-corrected visual acuity, and the number of peripheral anterior synechiae quadrants were recorded at baseline and at various time points after surgery. Intraocular pressure decreased significantly from 21.19 ± 6.38 mmHg preoperatively to 16.00 ± 4.84 mmHg (P = 0.01) at 36 months. The number of glaucoma medications was significantly reduced from 2.33 ± 1.29 preoperatively to 1.42 ± 1.78 (P = 0.045) at 36 months. The success rate of the combined surgery was 87.5% at 36 months. The decrease of intraocular pressure exhibited a positive correlation with the baseline intraocular pressure (P < 0.01), while the reduction in the number of glaucoma medications was positively correlated with the baseline number of glaucoma medications (P < 0.001). Best-corrected visual acuity improved from 0.40 ± 0.29 to 0.50 ± 0.33 at 1 month (P = 0.001). There were no vision‑threatening complications intraoperatively or postoperatively. The combined surgery has been proven to be effective and safe for patients with primary angle-closure glaucoma in the long term, suggesting that combined surgery may be beneficial for patients with primary angle-closure glaucoma, especially those with long-term and extensive peripheral anterior synechiae.
Impact of inferior vena cava thrombosis on the incidence of pulmonary embolism in patients with lower extremity deep vein thrombosis
Authors: Zhang Yiman , Meng Yan , Li You , Kang Mengyang , Ma Qiang , Zhang Junbo , Yang Jian , Tian Hongyan , Yin Qian 
Published: July 2024

Abstract

Inferior vena cava thrombosis (IVCT) is a special form of venous thromboembolism. Lower extremity deep vein thrombosis (LEDVT) is associated with an increased incidence of pulmonary embolism (PE), but the association between concomitant IVCT and PE in patients with LEDVT has not been reported. We conducted a retrospective analysis of clinical data from patients confirmed with LEDVT at the First Affiliated Hospital of Xi’an Jiaotong University. Predictive variables of PE were selected using LASSO regression, and independent risk factors were identified through multivariable logistic regression. Of the 2929 patients, 40.9% had PE and 12.8% had IVCT. Multivariable logistic regression suggested that IVCT (OR 1.42, 95% CI 1.13–1.79) was an independent risk factor for PE. Subgroup analysis showed that IVCT was associated with increased odds of PE in patients with left LEDVT (OR 2.00, 95% CI 1.50–2.67), right LEDVT (OR 2.05, 95% CI 1.20–3.50), distal LEDVT (OR 5.15, 95% CI 1.31–20.22), and proximal LEDVT (OR 1.48, 95% CI 1.19–1.86). Concomitant IVCT significantly increased the incidence of PE in patients with LEDVT. There was no difference in PE severity or risk stratification between patients with and without IVCT. These finding could contribute to further improve the understanding of IVCT among clinicians, and optimize monitoring and management strategies of patients with LEDVT.
The Effects of Subtle Scent of 1,8-Cineole and (-)-Bornyl acetate on Mood, Cognition, And Behavior In The Elderly
Authors: Goto Seiko , Isa Akiko , Shimizu Kuniyoshi 
Published: July 2024

Abstract

This study explored the effects of subtle scents of 1,8-cineole and (-)-bornyl acetate on mood, cognition, and behavior in healthy individuals and elderly residents of nursing homes. Three experiments were conducted involving short- and long-term exposure to these scents to assess mood, memory, and task completion. Results from experiments with healthy individuals indicate that (-)-bornyl acetate improves mood, particularly for those who like the scent, whereas 1, 8-cineole improves mood, regardless of scent likability. Prolonged exposure to both scents, even at low concentrations, yielded different effects compared to no scent, such as sustained concentration of 1,8-cineole and drowsiness with (-)-bornyl acetate. In experiments with older adults, although the participants did not perceive scents, improvements in cognition, behavior, and sleep were observed. However, challenges have arisen, such as the caregiver's hypersensitivity reaction to 1,8-cineole, highlighting the need for careful consideration when implementing aromatherapy in nursing facilities. This study underscores the potential benefits of aromatherapy in improving the quality of life of the elderly. Furthermore, it emphasizes the importance of controlling scent distribution and considering individual sensitivities.
CSF Sphingolipids in Parkinson Disease and Dementia with Lewy Bodies with and without GBA1 variants
Authors: Brockmann Kathrin , Lerche Stefanie , Wurster Isabel , Valente Enza Maria , Avenali Micol , Samaniego Daniela , Martinez-Vicente Marta , Hernandez-Vara Jorge , Laguna Ariadna , Sturchio Andrea , Svenningsson Per , France Nicholas , Barlow Carrolee , Sankaranarayanan Sethu 
Published: July 2024

Abstract

Variants in GBA1 result in dysregulated sphingolipids. We investigated five CSF sphingolipid species in a multicenter cohort comprising people with Parkinson’s Disease and Dementia with Lewy bodies with and without GBA1 variants and healthy controls. We found no increase of sphingolipid species in heterozygous GBA1 variant carriers. Sphingolipid levels had no effect on development of cognitive impairment. Thereby, CSF Sphingolipids seem not useful as state marker in Parkinson’s Disease.
The impact of sequential bursting events of coherent flow structures on sediment entrainment at thereshold conditions in meandering channel- Time Fraction Approaches
Authors: Pour Mehrdad Kashkooli , Ghadampour Zahra , Ghalati Reza Mohammadpour 
Published: July 2024

Abstract

In this study, the effect of bed shear stress variation on quadrant time fractions and bed topography change in a meandering river was analyzed in an experimental model. Also this research tests the hypothesis that particle entrainment is associated with bursting quadrants and sequencing time fractions. Also, the variation of this parameter was examined with shear stress variation. Experimental tests were carried out in four different threshold conditions in an equilibrium state. The quadrant time fractions are probed with the Acoustic Doppler Velocimetry (ADV) at a near-bed in a Comprehensive point grid throughout the model in 120 points for each test. The results indicate that although the classical view about the dominant processes of sweep and ejection is accurate in straight channels and the central line, the maximum time fractions of these two phenomena have yet to occur in the eroded areas. After that, we describe the quadrant's time series using the sequences of quadrants. Examining three sequences of groups (GE), singles (SE), and the vortex-related sequences (VRS) and comparing their time fractions with eroded areas showed a good correlation between some sequences and erosion. The results point to the group sequences, especially sweep groups with a time fraction of more than 70% at the very lower threshold, and vortex-related sequences with a time fraction of 34% at the upper limit of the threshold were entirely under the eroded areas.
Unilateral versus bilateral lateral rectus recession for correction of small to moderate angle exotropia
Authors: Kassem Rehab Rashad , Radwan Rokaya Emad , El-Mofty Randa , Elhilali Hala Mostafa 
Published: July 2024

Abstract

Purpose: To compare the effect of unilateral versus bilateral lateral rectus (LR) recession for correction of small to moderate exotropia.
Methods: Records of all patients with exotropia (XT) 14 to 35 prism diopters (∆), operated upon by the authors, were included in a retrospective study to compare the effect of unilateral (Group 1) versus bilateral (Group 2) LR recession. The study end-point was the last follow-up visit scheduled at least 3 months postoperatively. A successful outcome was defined as 0 to 10∆ of horizontal tropia.
Results:The study included 154 patients (47 in Group 1 and 107 in Group 2). Patients were followed up for 3 to 120 months (26.7+/-24.88). A successful outcome was achieved in 83% in Group 1 and 82.2% in Group 2 (p=.976), with higher success in group 1 for surgical target angles up to 25∆. All failures in Group 1 were due to undercorrections., while the 17.8% failure rate in Group 2 comprised 15% undercorrections and 2.2% overcorrections (p=.419). Persistent lateral incomitance was seen in 29.5% in Group 1 versus 2.3% in Groups 2 (p <.001). Lateral incomitance was encountered in 71% of those undergoing 10mm unilateral recessions, versus 20% of those who had smaller recession doses. Limited ductions were mild, and exceeded -1 in 4 cases: 3 had had 10mm and 1 had had 9mm unilateral LR recession.
Conclusions: Unilateral and bilateral LR recessions offer essentially equal success rates. Unilateral recessions are advised for angles up to 25∆, without exceeding 10mm.
ENSO cycle modulation of grass pollen season in Auckland New Zealand with implications for allergy management
Authors: Newnham Rewi Munro , McDonald Laura , Holt Kat , Misra Stuti , Ngadi Natasha , Ngadi Calista , Chan Amy 
Published: July 2024

Abstract

In many regions, the ENSO cycle climate is a key factor in modulating climate processes that can influence seasonal variability in the production and dispersal of allergy-triggering pollen. However, the impacts on allergy health are not well known. We compare grass pollen seasons between the major modes of the ENSO cycle in Auckland, New Zealand. We find no clear difference in the timing of onset of the pollen seasons, but season length was longer, by > 30 days, during both El Niño phases than during the La Niña phase. Severity of the La Niña pollen season was also lower, although we have less confidence in this comparison due to differences in the sampling site locations. The difference in pollen season length is explained by the greater summer rainfall typically experienced in Auckland and elsewhere in northern New Zealand during La Niña phases, which tends to suppress grass pollen production and dispersal. As grass pollen is the principal source of allergenic pollen in New Zealand and in many other countries, these results have wider implications for allergy management. With ENSO forecasting often reliable with several months of lead time, there is potential for improving community preparedness and resilience to inter-annual dynamics of the grass pollen season. However, the strong geographical heterogeneity in ENSO cycle climate impacts necessitates a region-specific approach. This work further underscores the need for local-regional pollen monitoring in NZ and the risk of relying upon static, nationwide pollen calendars for informing allergy treatment.
DeepPlaq: Dental Plaque Indexing based on Deep Neural Networks
Authors: Chen Xu , Shen Yiran , Jeong Jin-Sun , Perinpanayagam Hiran , Kum Kee-Yeon , Gu Yu 
Published: July 2024

Abstract

Objectives
This study aimed to detect and segment target teeth and score on each individual teeth according to the Quigley-Hein plaque index (QHI) by using multi-view intraoral images and a deep learning approach.
Material and Methods
A dataset of intraoral images captured from both frontal and lateral views of permanent and deciduous dentitions was utilized. The dataset comprised of 210 photographs taken after applying a plaque disclosing agent. A three-stage method was employed, where the YOLOv8 model was first used to detect the target teeth, followed by the prompt-based SAM (Segment Anything Model) segmentation algorithm to segment teeth. A new single-tooth dataset consisting of 1400 photographs was obtained after applying a two-stage method. Finally, the multi-class classification model DeepPlaq we implemented was trained and evaluated on the accuracy of dental plaque indexing based on the QHI scoring system. Classification performance was measured using accuracy, recall, precision, and F1-score.
Results
The teeth detector exhibited an accuracy (mean average precision, mAP) of approximately 0.941 ± 0.005 in identifying teeth with plaque disclosing agents. The maximum accuracy attained in the plaque indexing through DeepPlaq was 0.84 (probability that DeepPlaq scored identical to an expert), and the average scoring error was less than 0.25 for a 0 to 5 scoring setting.
Conclusions
A three-stage approach demonstrated excellent performance in detecting and segmenting target teeth, and DeepPlaq model also showed strong performance in assessing dental plaque indices.
Clinical relevance
The evaluation of dental plaque indices using deep learning algorithms alleviated the burdensome and repetitive tasks of doctors, enabling quicker and more reliable decision-making.