bluuebunny/crossref_metadata_2025_split huggingface dataset:
Asystole in a young child with tetrahydrocannabinol overdose: a case report and review of literature
Authors: Masilamani Mats Steffi Jennifer , Leff Rebecca , Kawai Yu 
Published: May 2024

IntroductionThe association between Δ8-tetrahydrocannabinol (THC) and cardiac dysrhythmia has not been well described in children. Asystole, while consistent with reports of severe bradycardia and apnea in children, is uncommonly described in the current literature. We present the first pediatric case of asystole and apnea following THC ingestion.CaseA 7-year-old male presented to the emergency department (ED) after his mother noticed he was lethargic 3–4 h after accidental ingestion of five 15 mg (total of 75 mg) Δ8-THC gummies. Upon arrival, he was vitally stable and well-appearing. He received maintenance intravenous fluids. Approximately 7 h after initial ingestion, he experienced a &gt;15-s episode of asystole and apnea on telemetry requiring sternal rub to awaken. This was followed by bradycardia (60 beats per minute range) which resolved with 0.1 mg glycopyrrolate. He was admitted to the PICU, drowsy but arousable with stable vitals. After an uneventful 24-h (post-ingestion) PICU observation, he was discharged home in stable condition.DiscussionTo our knowledge, this is the first reported pediatric case of THC-induced asystole. The etiology of asystole may be attributed to direct vagal stimulation of THC or respiratory depression. The typical recommended observation time after potential toxicity is 3–6 h after children have returned to their physiological and behavioral baseline. Our patient was clinically stable with no concern for respiratory depression or cardiac dysrhythmia yet experienced an asystolic pause with apnea 7 h after initial ingestion.ConclusionOur case demonstrates that asystole and apnea may occur in pediatric patients following large THC ingestions and those symptoms can appear late outside of the currently recommended observation period.
Modulation of the rat intestinal microbiota in the course of Anisakis pegreffii infection
Authors: Zeng Min-hao , Li Shan , Lv Qing-bo , Wang Xiao-xu , Qadeer Abdul , Mahmoud Mohamed H. 
Published: May 2024

BackgroundAnisakis are globally distributed, marine parasitic nematodes that can cause human health problems, including symptoms such as vomiting, acute diarrhea, and allergic reactions. As parasitic nematodes that primarily affect the patient’s digestive tract, intestinal helminths can interact directly with the host microbiota through physical contact, chemicals, or nutrient competition. It is widely accepted that the host microbiota plays a crucial role in the regulation of immunity.Materials and methodsNematodes collected from the abdominal cavity of marine fish were identified by molecular biology and live worms were artificially infected in rats. Infection was determined by indirect ELISA based on rat serum and worm extraction. Feces were collected for 16S rDNA-based analysis of microbiota diversity.ResultsMolecular biology identification based on ITS sequences identified the collected nematodes as A. pegreffii. The success of the artificial infection was determined by indirect ELISA based on serum and worm extraction from artificially infected rats. Microbiota diversity analysis showed that a total of 773 ASVs were generated, and PCoA showed that the infected group was differentiated from the control group. The control group contained five characterized genera (Prevotellaceae NK3B31 group, Turicibacter, Clostridium sensu stricto 1, Candidatus Stoquefichus, Lachnospira) and the infected group contained nine characterized genera (Rodentibacter, Christensenella, Dubosiella, Streptococcus, Anaeroplasma, Lactococcus, Papillibacter, Desulfovibrio, Roseburia). Based on the Wilcoxon test, four processes were found to be significant: bacterial secretion system, bacterial invasion of epithelial cells, bacterial chemotaxis, and ABC transporters.ConclusionThis study is the first to analyze the diversity of the intestinal microbiota of rats infected with A. pegreffii and to determine the damage and regulation of metabolism and immunity caused by the infection in the rat gut. The findings provide a basis for further research on host-helminth-microbe correlationships.
Breast cancer risk assessment for prescription of menopausal hormone therapy in women with a family history of breast cancer: an epidemiological modelling study
Authors: Huntley Catherine , Torr Bethany , Kavanaugh Grace , George Angela , Hanson Helen , Snape Katie , Broggio John , Glasgow Louise , Tischkowitz Marc , Evans D Gareth , Antoniou Antonis C , Turnbull Clare 
Published: May 2024

BackgroundMenopausal hormone therapy (MHT) can alleviate menopausal symptoms but has been associated with an increased risk of breast cancer. MHT prescription should be preceded by individualised risk/benefit evaluation; however, data outlining the impact of family history alongside different MHT therapeutic approaches are lacking.AimTo quantify the risks associated with MHT use in women with varying breast cancer family histories of developing and dying from breast cancer.Design and settingAn epidemiological modelling study for women in England using the BOADICEA breast cancer prediction model and data relating to MHT use and breast cancer risk taken from research by the Collaborative Group on Hormonal Factors in Breast Cancer.MethodThe risk of developing and dying from breast cancer between the ages of 50 and 80 years was modelled in women with four different breast cancer family history profiles: ‘average’, ‘modest’, ‘intermediate’, and ‘strong’ by using 1) background risks of breast cancer by age and family history, 2) relative risks for breast cancer associated with MHT use, and 3) 10-year breast cancer-specific net mortality rates. This study modelled use of combined oestrogen-progestogen MHT (cyclical or continuous) and oestrogen-only MHT.ResultsFor a woman of ‘average’ family history taking no MHT, the cumulative breast cancer risk (age 50–80 years) is 9.8%, and the risk of dying from the breast cancer is 1.7%. In this model, 5 years’ exposure to combined-cyclical MHT (age 50–55 years) was calculated to increase these risks to 11.0% and 1.8%, respectively. For a woman with a ‘strong’ family history taking no MHT, the cumulative breast cancer risk is 19.6% (age 50–80 years), and the risk of dying from the breast cancer is 3.2%. With 5 years’ exposure to MHT (age 50–55 years), this model showed that these risks increase to 22.4% and 3.5%, respectively.ConclusionIn this model, both family history and MHT are associated with increased risk of breast cancer. Estimates of the risks of breast cancer associated with MHT for women with different family histories can be used to support decision making around MHT prescription for women experiencing menopausal symptoms.
Predicting unplanned admissions to hospital in older adults using routinely recorded general practice data: development and validation of a prediction model
Authors: Klunder Jet H , Heymans Martijn W , van der Heide Iris , Verheij Robert A , Maarsingh Otto R , van Hout Hein PJ , Joling Karlijn J 
Published: May 2024

BackgroundUnplanned admissions to hospital represent a hazardous event for older people. Timely identification of high-risk individuals using a prediction tool may facilitate preventive interventions.AimTo develop and validate an easy-to-use prediction model for unplanned admissions to hospital in community-dwelling older adults using readily available data to allow rapid bedside assessment by GPs.Design and settingThis was a retrospective study using the general practice electronic health records of 243 324 community-dwelling adults aged ≥65 years linked with national administrative data to predict unplanned admissions to hospital within 6 months.MethodThe dataset was geographically split into a development (n= 142 791/243 324, 58.7%) and validation (n= 100 533/243 324, 41.3%) sample to predict unplanned admissions to hospital within 6 months. The performance of three different models was evaluated with increasingly smaller selections of candidate predictors (optimal, readily available, and easy-to-use models). Logistic regression was used with backward selection for model development. The models were validated internally and externally. Predictive performance was assessed by area under the curve (AUC) and calibration plots.ResultsIn both samples, 7.6% (development cohort:n= 10 839/142 791, validation cohort:n= 7675/100 533) had ≥1 unplanned hospital admission within 6 months. The discriminative ability of the three models was comparable and remained stable after geographic validation. The easy-to-use model included age, sex, prior admissions to hospital, pulmonary emphysema, heart failure, and polypharmacy. Its discriminative ability after validation was AUC 0.72 (95% confidence interval = 0.71 to 0.72). Calibration plots showed good calibration.ConclusionThe models showed satisfactory predictive ability. Reducing the number of predictors and geographic validation did not have an impact on predictive performance, demonstrating the robustness of the model. An easy-to-use tool has been developed in this study that may assist GPs in decision making and with targeted preventive interventions.
Методи машинного навчання для моніторингу навколишнього середовища
Authors: Мікава Поліна Віталіївна , Яйлимов Богдан Ялкапович 
Published: May 2024

У роботі запропоновано комплексний підхід до виявлення звалищ, який має дві основні складові. Перша базується на класифікації часових рядів мультиспектральних супутникових даних з використанням ансамблю нейронних мереж. Друга використовує модифіковану архітектуру U-Net для семантичної сегментації космічних знімків з метою безпосереднього виділення звалищ. Новизна представленого рішення полягає у використанні комбінованої функції втрат при навчанні моделі U-Net, що поєднує бінарну крос-ентропію та коефіцієнт Dice. Бінарна крос-ентропія забезпечує надійну попіксельну класифікацію, тоді як коефіцієнт Dice оптимізує сегментацію шляхом максимізації перетину між прогнозованими та істинними масками звалищ. Ця комбінація дозволяє досягти балансу між точністю класифікації та чутливістю до малих об’єктів, що важливо для виявлення звалищ за супутниковими даними. Запропоновано інтегрувати результати двох підходів на рівні прийняття рішень за допомогою ймовірнісного злиття з використанням ймовірностей кожної моделі. Такий гібридний метод дозволяє компенсувати недоліки кожного методу та підвищити загальну точність ідентифікації звалищ. Експериментальна перевірка на тестових даних продемонструвала ефективність розглянутого підходу. Загальна точність класифікації земного покриву склала 97,4 %, а точність визначення звалищ — 86,4 %. Розроблений метод застосовано для картографування звалищ на території Донецької області. Результати верифіковано експертами на місцевості. Отримані дані можуть бути використані місцевою владою для оперативного реагування та прийняття управлінських рішень.
Pemberdayaan Santri dalam Pengeloaan Akun Youtube sebagai Wakaf Produktif Pesantren Darul Hikmah Ponorogo
Authors: Muhammad Irkham Firdaus  , Alafianta Novan Fatchu , Utomo Bambang Setyo , Wahyudi Fajar Satriyawan 
Published: May 2024

Mitra dalam pengabdian masyarakat ini adalah pondok Pesantren Darul Hikmah Ponorogo. Yang mana Pesantren ini merupakan lembaga yang berbasis wakaf, sehingga seluruh aset pada Pesantren tersebut adalah aset wakaf. Salah satu aset wakaf yang berpotensi untuk dikembangkan adalah channel YouTube Darul Himah TVJadi kegitan pengabdian masyarakat ini adalah tindak lanjut dari kegiatan mitra, yang bertujuan meningkatkan pengetahuan dan manajemen pengelolan wakaf produktif yang berupa konten YouTube, dan sekaligus melatih pembuatan konten video yang lebih menarik, sehingga dapat mendukung tujuan utama PKM ini yaitu keberlangsungan Ekonomi Digital. Akan tetapi terdapat beberapa permasalahan yang dihadapi oleh pihak mitra, pertama permasalahan pengetahuan, dimana pihak mitra minim pemahaman dan kesadarannya dalam mengelola wakaf produktif berupa konten video YouTube, serta minimnya skill dan kreatifitas santri dalam membuat konten video. Kedua permasalahan manajemen, minimnya keaktifan santri dalam memberdayakan channel Darul Hikmah TV Maka solusi yang ditawarkan dalam mengatasi permasalahan-permasalahan tersebut adalah mengupayakan meningkatkan pemahaman santri terhadap pengelolaan wakaf produktif yang berupa konten video YouTube, serta meningkatkan keaktifan, skill, dan kreatifitas santri dalam pembuatan konten video. Motede yang digunakan adalah penyuluhan terhadap penggolaan wakaf produktif yang berupa konten video YouTube, pelatihan skill dan kreativitas pembuatan konten video, dan pendampingan dalam mengupayakan keaktivan santri.
Marconi Redux: Small-Footprint High-Frequency Antenna System Design
Authors: Durham Dr. Marcus O. , Durham Pruitt R. , Durham Dr. Robert A. 
Published: May 2024

The objective is to develop high-frequency (HF) antenna systems that are
small, unobtrusive, usable in limited space, indoor or portable, not
exposed to lightning, easily configurable for alternate patterns,
requiring only simple tools, minimum-skill install, without climbing,
and inexpensive. Construction, tests, and measurements clearly
illustrate an HF antenna system can be greatly reduced in size to a
couple of meters.
Ten circuit design implementations condense HF antennas to a miniscule
space, resulting in dramatically lessened environmental impact. A key
consideration is changing every antenna element to a tunable, loaded
inductor (TLI). Add inductor elements for wider bandwidth and
multi-band. SWR, impedance, and frequency evaluations illustrate the
performance.
Most contemporary antennas are variations of the balanced dipole used by
Hertz in 1888 or the unbalanced monopole advocated by Marconi in 1895.
Little has changed in high frequency antennas since those early two
designs. Below 30 MHz, antennas are still largely long-wires with
distributed electrical and magnetic properties. All antenna circuits
have two electrical connections: 1) the radiator and 2) the return,
comprised of the monopole counterpoise or the dipole non-radiating side.
More creativity is on the return side of the circuit than on the
radiator. This article summarizes the NM0D triad HF antenna system,
which fits all the objectives.
Endoscopic Fenestration of an Intra-ventricular Arachnoid Cyst in a Young Male – A Rare Entity
Authors: Muhammad Assad Javed  , Niaz Ahmad Khan  , Ain-us-Saba  
Published: May 2024

Introduction: Among intracranial space-occupying lesions, arachnoid cysts compromise 1% only. Abnormal collection of cerebrospinal fluid occurs in these types of cysts leading to pressure symptoms. Developmental abnormalities of cerebrospinal structures in early fetal life lead to the primary type of arachnoid cysts, while the second type of arachnoid cyst is formed after some neurological insult like head injury, tumor, meningitis, or brain surgery. In 60 – 90% of cases, the primary type predominates and presents with pressure symptoms before the age of 20 years. The adjudged incidence is 1.4% in adults, the least frequent being intraventricular location.
Clinical Case: A 23-year-old male presented with a long-standing left-sided cranial vault headache, right-sided focal seizures, and progressive right- hemiparesis. Neurological evaluation revealed upper motor neuron signs on the right side of the body. A computerized axial tomography raised the suspicion of an arachnoid cyst for which magnetic resonance imaging was done which revealed a large intraventricular cyst of lateral ventricles causing mass effect over the ipsilateral hemisphere and mild obstructive hydrocephalous. Surgical intervention was required as per symptomology (intractable headache, seizures, and hemiparesis) and large cyst size.
Conclusion: Cerebrospinal fluid accumulation in the brain's arachnoid layer causes non-cancerous arachnoid cysts. Larger cysts may push on brain tissue and cause neurological difficulties. MRI may diagnose arachnoid cysts, and treatment options include cystoperitoneal shunt, craniotomy, and neuro-endoscopic fenestration, the least invasive. Cyst size and location determine therapy. In this example, endoscopic treatment reduced symptoms and consequences.
The Swirl Sign and Its Relationship to Patient Outcomes in Extradural Hematomas: A Retrospective Investigation
Authors: Ul Haq Muhammad Ammad , Muhammad Jazib Ijaz  , Anam Ali  , Sania Bhatti  , Maheen Sabah  , Eesha Yaqoob  , Saad Javed  
Published: May 2024

Introduction:" Swirl sign" is a relatively uncommon sign, seen on non-contrast CT scans in patients with head trauma who develop extradural hematoma the prognostic significance of which is controversial. This research aims to evaluate the predictive significance of the swirl sign in patients with an extradural hemorrhage.
Material and Methods: It was a retrospective study and included 145 patients, with traumatic brain injury, who underwent surgical treatment at the Department of Neurosurgery Holy Family Hospital, Rawalpindi, Pakistan, between January 2022 and January 2023 and had traumatic EDH identified by computed tomography scan. Patients who did not undergo surgery or had combined or open craniocerebral injuries were eliminated. A Glasgow Outcome Scale score was used to evaluate outcomes after three months of traumatic brain injury. Mann-Whitney U test, the Chi-square test, and multivariate logistic regression were applied for descriptive and inferential analysis.
Results: A total of 145 cases were evaluated, 19 (13.1%) demonstrated the sign on a CT scan of the brain. Analysis displayed a notable association between the incidence of the swirl sign and pupillary size, preoperative Glasgow Coma Scale score, time between trauma and first CT scan, and volume of hematoma measured intraoperatively. Patients displaying the swirl sign showed an increased mortality rate (25%) compared to patients without the swirl sign (5%) and worse outcomes at 3 months.
Conclusion: The presence of the swirl sign on the CT scan had a significant association with worse outcomes. Early detection and prompt surgical evacuation are important for patients with this sign.
PET-CT Guided Gamma Knife Radiosurgery for Recurrent Glioblastoma Multiforme Recurrent Cases in Pakistan
Authors: Zaheen Shibli  , Aurangzeb Kalhoro  , Kashif Ahmed  , Abdul Sattar M. Hashim  
Published: May 2024

Objective: The treatment of recurrent Glioblastoma Multiforme (r-GBM) poses a significant confronts to neurosurgeons. This study was conducted to assess the effectiveness of PET-CT-guided Gamma Knife radiosurgery (GKRS) in treating r-GBM. The purpose of the study is to determine the outcome of this treatment approach.
Materials and Methods: Retrospective descriptive research was supervised at the Neurospinal and Cancer Care Institute, Karachi Pakistan between June 2017 to August 2022. The study comprised patients with biopsy-confirmed Grade IV Glioblastoma Multiforme who experienced recurrence during follow-up. PET-CT and MRI brain with contrast were performed to determine the target volume of the tumor, and GKRS was carried out based on the scan findings.
Results: A total of 24 patients, ranging in age from 47 to 77 years with a median age of 50 years, were included in the study. The tumor recurrence occurred within a median interval of 10 months after diagnosis, ranging from 1 to 16 months. The median time for progression-free survival from GKRS was 5 months, ranging from 2 to 6 months. The median overall survival from GKRS was 11 months, ranging from 5 to 12 months.
Conclusion: GKRS is a tool in the multimodal treatment of r-GBM. By co-registering PET-CT-MRI, it becomes possible to plan the treatment more effectively by targeting the active tumor while preserving healthy brain tissue. This approach has the potential to improve overall survival rates and patient outcomes.
Management and Outcome of Severe Traumatic Brain Injury
Authors: Arfa Qasim  , Lal Rehman  , Iram Bokhari  , Farrukh Javeed  , Haris Hamid  , Rubab Qadir  
Published: May 2024

Objective: To assess the management of patients with severe traumatic brain injury and their outcomes.
Materials and Methods: A prospective observational study was conducted at the Department of Neurosurgery of a tertiary care hospital. Our study included 279 patients in total. After meeting the requirements for inclusion, the patient's baseline information, such as age, gender, arrival GCS, and outcome, were noted. Three months of post-trauma observation were employed to assess the outcome. SPSS version 22.0 was used to evaluate the data obtained.
Results: According to our study out of the total, 118 (42.3%) patients with severe TBI showed good outcomes while 161 (57.7%) showed poor outcomes at 3 months. In our study, the arrival GCS and arrival pupillary reactivity were statistically significant outcome factors (p = 0.040 and 0.010 respectively). Overall mortality was 35.13% (98) at 3 months.
Conclusion: Patients presenting with severe TBI have high morbidity and mortality. Arrival GCS and pupillary reaction were important factors to significantly alter the outcome.
Keywords: Traumatic Brain Injury, Glasgow Coma Score, Head Trauma, Glasgow Outcome Score, Outcome.
Clinical Outcomes of Dexmedetomidine As An Anesthetic Adjuvant in Intracranial Surgery, An Experience from Irfan General Hospital Peshawar: A Prospective Case Series Study
Authors: Mabood Shahid , Khan Asad , Iqbal Javed , Mehmood Fahad , Sahibzada Abdul Haseeb 
Published: May 2024

Objective: Neuro anesthesia (most commonly general) is indicated in intracranial surgery, the goal of which is to maintain a stable hemodynamic environment. This study aimed at evaluating the effectiveness of Dexmedetomidine (DEX) when used as an adjuvant in intracranial surgery.
Materials And Methods: A prospective design was utilized and the data was collected at the Department of Neurosurgery Irfan General Hospital Peshawar in patients undergoing intracranial. All those patients having a score of 14 or 15 on the Glasgow Coma Scale, and I and II on the American Society of Anesthesiologists (ASA) undergoing intracranial surgery under general anesthesia were included in the study.
Results: The majority of patients were males 35 (66%) while 18 (34%) were females. 29(55%) patients were categorized as grade I while 24 (45%) as grade II according to the American Society of Anesthesiologists-Physical status. mean extubation time of our sample of patients undergoing craniotomy was 6.21 ± 2.16 minutes while the time for rescue analgesia was 41.23 ± 23.15 minutes. The heart rate values decreased significantly when noted at different intervals from the baseline.
Conclusion: Dexmedetomidine is an effective and safe anesthetic adjuvant when used in intracranial surgery and provides stable hemodynamics both intra and post-operatively. The neuro anesthetic drug also reduces the requirements of other opioids and rescue drugs.