bluuebunny/crossref_metadata_2025_split huggingface dataset:
Automated Prediction of Proximal Middle Cerebral Artery Occlusions in Noncontrast Brain Computed Tomography
Authors: Kim Pyeong Eun , Yang Hyojung , Kim Dongmin , Sunwoo Leonard , Kim Chi Kyung , Kim Beom Joon , Kim Joon-Tae , Ryu Wi-Sun , Kim Ho Sung 
Published: May 2024

BACKGROUND:
Early identification of large vessel occlusion (LVO) in patients with ischemic stroke is crucial for timely interventions. We propose a machine learning–based algorithm (JLK-CTL) that uses handcrafted features from noncontrast computed tomography to predict LVO.

METHODS:
We included patients with ischemic stroke who underwent concurrent noncontrast computed tomography and computed tomography angiography in seven hospitals. Patients from 5 of these hospitals, admitted between May 2011 and March 2015, were randomly divided into training and internal validation (9:1 ratio). Those from the remaining 2 hospitals, admitted between March 2021 and September 2021, were designated for external validation. From each noncontrast computed tomography scan, we extracted differences in volume, tissue density, and Hounsfield unit distribution between bihemispheric regions (striatocapsular, insula, M1–M3, and M4–M6, modified from the Alberta Stroke Program Early Computed Tomography Score). A deep learning algorithm was used to incorporate clot signs as an additional feature. Machine learning models, including ExtraTrees, random forest, extreme gradient boosting, support vector machine, and multilayer perceptron, as well as a deep learning model, were trained and evaluated. Additionally, we assessed the models’ performance after incorporating the National Institutes of Health Stroke Scale scores as an additional feature.

RESULTS:
Among 2919 patients, 83 were excluded. Across the training (n=2463), internal validation (n=275), and external validation (n=95) datasets, the mean ages were 68.5±12.4, 67.6±13.8, and 67.9±13.6 years, respectively. The proportions of men were 57%, 53%, and 59%, with LVO prevalences of 17.0%, 16.4%, and 26.3%, respectively. In the external validation, the ExtraTrees model achieved a robust area under the curve of 0.888 (95% CI, 0.850–0.925), with a sensitivity of 80.1% (95% CI, 72.0–88.1) and a specificity of 88.6% (95% CI, 84.7–92.5). Adding the National Institutes of Health Stroke Scale score to the ExtraTrees model increased sensitivity (from 80.1% to 92.1%) while maintaining specificity.

CONCLUSIONS:
Our algorithm provides reliable predictions of LVO using noncontrast computed tomography. By enabling early LVO identification, our algorithm has the potential to expedite the stroke workflow.
Surviving Turbulent Times: A Close Reading of Manila Shinbun’s Portrayal of Chinese Filipino Communities during the Pacific War
Authors: GUO JingXuan 
Published: May 2024

Abstract
This paper aims to explore the experiences of the Chinese in the Philippines during the Japanese occupation (1942–1945) by analyzing the only Chinese newspaper, Manila Shinbun Chinese Edition. Although the Manila Shinbun certainly reflected the military administration’s will and possessed characteristics of news propaganda, being the only Chinese-language newspaper permitted to publish at the time, it nonetheless offers invaluable insights into the experiences of the Chinese community. With limited research, gaps persist in understanding the Chinese community’s story during this period. This study seeks a more comprehensive understanding of their history by meticulously analyzing news coverage and delving into underlying narratives. Ultimately, it reveals the failure of Japanese attempts to control and unify the Chinese community through military means, leading to the collapse of the Manila Shinbun and the Japanese-controlled Chinese Association prior to the arrival of the U.S. Army.
Flow capabilities of arterial and drainage cannulae during venoarterial extracorporeal membrane oxygenation: A simulation model
Authors: Wickramarachchi Avishka , Burrell Aidan J. C. , Joyce Patrick R. , Bellomo Rinaldo , Raman Jaishankar , Gregory Shaun D. , Stephens Andrew F. 
Published: May 2024

Background Large cannulae can increase cannula-related complications during venoarterial extracorporeal membrane oxygenation (VA ECMO). Conversely, the ability for small cannulae to provide adequate support is poorly understood. Therefore, we aimed to evaluate a range of cannula sizes and VA ECMO flow rates in a simulated patient under various disease states. Methods Arterial cannulae sizes between 13 and 21 Fr and drainage cannula sizes between 21 and 25 Fr were tested in a VA ECMO circuit connected to a mock circulation loop simulating a patient with severe left ventricular failure. Systemic and pulmonary hypertension, physiologically normal, and hypotension were simulated by varying systemic and pulmonary vascular resistances (SVR and PVR, respectively). All cannula combinations were evaluated against all combinations of SVR, PVR, and VA ECMO flow rates. Results A 15 Fr arterial cannula combined with a 21 Fr drainage cannula could provide >4 L/min of total flow and a mean arterial pressure of 81.1 mmHg. Changes in SVR produced marked changes to all measured parameters, while changes to PVR had minimal effect. Larger drainage cannulae only increased maximum circuit flow rates when combined with larger arterial cannulae. Conclusion Smaller cannulae and lower flow rates could sufficiently support the simulated patient under various disease states. We found arterial cannula size and SVR to be key factors in determining the flow-delivering capabilities for any given VA ECMO circuit. Overall, our results challenge the notion that larger cannulae and high flows must be used to achieve adequate ECMO support.
The Relationships Among Chronic Pain Subtypes, Motor Function, and Physical Activity in Community-Dwelling Japanese Older Adults: A Cross-Sectional Study
Authors: Chen Cen , Saito Takafumi , Wang Lefei , Yokote Tsubasa , Yatsugi Harukaze , Liu Xin , Kishimoto Hiro 
Published: May 2024

Purpose We investigated the relationships among motor function, physical activity, and the characteristics of chronic pain (the number of pain sites, pain intensity, and pain-type). Design Cross-sectional study. Setting An ongoing community-based prospective study conducted in Itoshima, Japan. Subjects Community-dwelling Japanese aged 65-75 years (n = 805; 401 men, 404 women). Measures Chronic pain subtypes were examined in terms of the number of pain sites, pain intensity, and pain type. Motor function was evaluated by handgrip strength, walking speed, and the 5 Times Stand-up and Sit Test (FTSST). Locomotive activity, non-locomotive activity, and sedentary time were evaluated by a tri-axial accelerometer as physical-activity parameters. Analysis Multiple regression model adjusting for age, sex, education level, employment status, subjective economic status, body mass index, cognitive function, comorbidity, current tobacco use, current alcohol consumption, and regular exercise. Results In a multivariate analysis, the subjects’ walking speed was negatively associated with multisite, moderate-to-severe, and neuropathic-like pain. The FTSST was positively associated with single-site, moderate-to-severe, and neuropathic-like pain. There was no significant association between handgrip strength and any chronic pain subtypes. Locomotive activity was negatively related to multisite, moderate-to-severe, and neuropathic-like pain, but there was no clear association between the amount of non-locomotive activity, sedentary time, and chronic pain subtypes. Conclusion Severe chronic pain was associated with decreased locomotion-related motor function and physical activity.
Hearing Impairment in Babies Born to Mothers with Gestational Diabetes Mellitus
Authors: Paul Janeta Kurian , Bhat T. Mahesh , James Jijo 
Published: May 2024

Introduction: The earlier the hearing loss in a child, the more difficult will it be for the child to achieve optimal development and lead a normal life. This study is directed toward early identification of deafness in neonates born to gestational diabetic mothers that help in the early rehabilitation of the child. Materials and Methods: Around 50 infants born to mothers with gestational diabetes were taken and screened after obtaining consent from parents and clearance from the ethics committee. Neonates born to gestational diabetic mothers in Father Muller Medical College were included. Critically ill neonates, neonates with hyperbilirubinemia, family history of deafness, use of ototoxic drugs, and low APGAR score babies (<6) were excluded. Detailed family history and information of the patients were obtained. The occupation of both parents, family income, and consanguinity was noted. It was also observed if the antenatal mother has attended ANC clinic regularly. Results: A longitudinal descriptive study was conducted on 50 infants born to gestational diabetic mothers. Hearing loss was assessed using distortion product otoacoustic emission. The majority of gestational diabetic mothers were homemakers followed by salesgirls. The other occupations also included Anganwadi workers, beedi workers, manual laborers, tailors, and farmers. The list also included cooks, hotel receptionist, office assistant, and floor manager. Most of the fathers were drivers ( n = 10) followed by farmers. The list also included fishermen, manual laborers, painters, salesmen, security personnel, waiters, tailors, teachers, office assistants as well as storekeepers. Conclusion: Our study assessed if there was a correlation between hearing loss in infants and gestational diabetes. Hence, in our study, we found that there may not be any relationship between hearing loss and diabetes in pregnancy.
Maternal and Perinatal Factors Associated With Childhood Brain Tumors: A Case-Control Study in Vietnam
Authors: Pham Huy Ngoc , Goldberg Robert J. , Pham Loc Quang , Nguyen Hoa L. , Pham Dao Anh , Mai Linh Thi Thuy , Phung Toi Lam , Hung Doan Quoc , Dong He Van , Duong Ha Dai 
Published: May 2024

Introduction Brain cancer is the leading cause of cancer-related deaths in children and the majority of childhood brain tumors are diagnosed without determination of their underlying etiology. Little is known about risk factors for childhood brain tumors in Vietnam. The objective of this case-control study was to identify maternal and perinatal factors associated with brain tumors occurring in young Vietnamese children and adolescents. Methods We conducted a hospital-based case-control study at Viet Duc University Hospital in Hanoi, Vietnam. Cases consisted of children with brain tumors aged 0-14 years old admitted to the hospital from January 2020 to July 2022 while the controls were age and sex-matched hospitalized children diagnosed with head trauma. Perinatal characteristics were abstracted from hospital medical records and maternal medical, behavioral, and sociodemographic factors were collected through in-person interviews. Conditional logistic regression models were used to examine maternal and perinatal factors associated with childhood brain tumors. Results The study sample included 220 children (110 cases and 110 controls) whose average age was 8.9 years and 41.8% were girls. Children born to mothers aged greater than 30 years at the time of the child’s birth had a higher risk of childhood brain tumors compared to those born to mothers aged from 18 to 30 years old (OR = 2.55; 95% CI: 1.13-5.75). Additionally low maternal body mass index prior to the current pregnancy of <18.5 kg/m2 significantly increased the odds of having a child with a brain tumor in relation to normal maternal body mass index from 18.5-22.9 kg/m2 (OR = 3.19; 95% CI: 1.36 - 7.50). Conclusion Advanced maternal age and being markedly underweight were associated with an increased odds of having a child with a brain tumor. A population-based study with larger sample size is needed to confirm and extend the present findings.
Trismus caused by migration of orthodontic archwire into the infratemporal fossa: a case report
Authors: Chan Boon Hui , Goh Aik Wei , Lai Su-Hsyen Cheryl 
Published: May 2024

Introduction: Soft tissue injuries are known complications of orthodontic treatment. Most of the injuries are mild, but severe complications can arise from deeper penetration or dislodgement of brackets and other foreign bodies into the surrounding tissues of the oropharynx and infratemporal fossa. Patient concerns: The patient, accompanied by his parents, presented to the Children’s Emergency Department with the concern of gradual limitation of mouth opening and eventual trismus, which occurred over a span of 2 weeks. Clinical findings: The patient presented with trismus and slight discomfort at the left cheek region. He reported a history of gradual limitation to his mouth opening 2 weeks prior. He was wearing upper and lower fixed orthodontic appliances and the left distal end of the maxillary archwire was found to have migrated into the left infratemporal fossa. Primary diagnoses: Left medial pterygoid muscle inflammation, or bleeding and haematoma formation, or infection within the infratemporal region. Interventions: The maxillary archwire was removed in the Children’s Emergency Department and a computed tomography (CT) scan performed subsequently confirmed the diagnosis of left medial pterygoid muscle inflammation. The patient was started on an intravenous (IV) antibiotic and a 2-day course of IV dexamethasone to reduce the muscle inflammation. Outcome: By the second day, the patient was able to achieve a mouth opening of 6 mm, and by the second week, the mouth opening had returned to normal. Conclusion: The potential risk of soft tissue injury and complications from orthodontic treatment is generally mild and limited. Soft tissue injuries can be avoided with careful management by the operator with the proper precautions taken. Clinicians should be familiar with the surrounding soft tissue anatomy and be aware of the potential for more severe complications and provide management or referral to the appropriate specialty accordingly.
Understanding the lived experience of idiopathic pulmonary fibrosis and how this shapes views on home-based pulmonary rehabilitation in Delhi, India
Authors: Hanif Humaira , Ahmed Obaidullah , Manifield James , Ishrat Rubia , Pina Ilaria , Ahmed Zahira , Shibli Mohd , Malcolm Dominic , Talwar Deepak , Singh Sally J. , Orme Mark W 
Published: May 2024

Objectives Pulmonary Rehabilitation (PR) is a high-impact intervention for individuals with idiopathic pulmonary fibrosis (IPF) but access is limited in India. PR barriers include distance to travel, lack of service provision and lack of healthcare professionals to deliver PR, thus it is disproportionate to the immense burden of IPF in India. We explored the lived experiences of people living with IPF, family caregivers (CGs) and healthcare workers (HCWs) as well as their views towards home-based PR (HBPR) in Delhi, India. Methods A qualitative study using semi-structured interviews with individuals with IPF (n = 20), CGs (n = 10) and HCWs (n = 10) was conducted. Data were analysed using codebook thematic analysis. Results Three major themes were generated: (i) Health impact, which included pathophysiological changes, range of symptoms experienced, disease consequences and impact of comorbidities; (ii) Disease management, which described strategies to control the progression and overall management of IPF, such as medications and exercises; (iii) Mode of Pulmonary Rehabilitation, which described perceptions regarding HBPR, comparisons with centre-based programmes, and how HBPR may fit as part of a menu of PR delivery options. Conclusion People living with IPF, family caregivers and healthcare workers were positive about the potential implementation of HBPR and suggested the development of a paper-based manual to facilitate HBPR over digital/online approaches. The content of HBPR should be sensitive to the additional impact of non-IPF health issues and challenges of reduced interactions with healthcare professionals.
A single institution experience of the Manta closure device in endovascular aortic repair
Authors: Moonan Ali , Hameed Aisha , Nachiappan Subramanian , Das Neelan , Pantos Athanasios , Valencia Dexter , Kaikini Robert , Prashar Akash 
Published: May 2024

Background Majority of EVAR procedures are performed with percutaneous arterial access, unless there is severe steno-occlusive disease in the common femoral arteries (CFA). We present our experience of using MANTA closure device with a retrospective evaluation of its safety and efficacy, in the elective setting, and in the emergent setting for ruptured aortic aneurysm. Design and methods Between Feb 2021 and May 2023 a total of 75 EVAR procedures were closed with a Manta device. Data was collected prospectively and analysed retrospectively. In 75 patients, 128 CFAs were closed with a Manta closure device including 4 emergent ruptured aneurysms. Results 67 male and 8 female patients with a median age of 77 years had percutaneous EVAR using Manta as a closure device. 128 CFAs were closed with Manta closure device. 3% (4/128) had deployment failures, with three requiring surgical cut down and closure. In one patient, a second Manta device deployment achieved satisfactory haemostasis. Three deployments were complicated by pseudoaneurysms of the CFA, all requiring no further interventions/treatment. No death related to severe haemorrhage from device failure. The pre- and post-procedure CFA puncture site AP diameter was recorded in a total of 106 cases with appropriate follow-up. 66% of these (70/106) had no reduction in CFA diameter post Manta closure. 34% (36/106) had some reduction of vessel AP size CFA post EVAR. No adverse features or further treatment was required due to reduction of vessel diameter in these cases (ongoing yearly surveillance). Conclusions Manta closure device is safe and easy to deploy with an overall success rate of 97%. There is a short learning curve. Ultrasound assessment and precise puncture at the healthy section of femoral artery are the key to achieve successful haemostasis with Manta closure device. Our findings suggest there is an association of non-clinically significant mild reduction in CFA vessel AP diameter post Manta closure device, which does not require further intervention.
Telemedicine and virtual healthcare for survivors of sexual assault and intimate partner violence: A qualitative study
Authors: Mercier Olivia , Parpia Rabea , Presseau Justin , Muldoon Katherine A , Sampsel Kari 
Published: May 2024

Background: Survivors of sexual assault and intimate partner violence often face many challenges in seeking/receiving healthcare and are often lost to follow up. Objectives: Our study objectives are to evaluate the feasibility, acceptability, and satisfaction of using telemedicine technology among sexual assault and intimate partner violence patients who present to a Canadian Emergency Department. Design: Qualitative research was conducted using a thematic approach. Methods: Patients were identified from a case registry of all sexual assault and intimate partner violence cases seen between 1 April 2020 and 31 March 2022 from an emergency department of a large Canadian hospital. Qualitative trauma-informed interviews were conducted with consenting participants. Thematic qualitative analyses were performed to investigate barriers and drivers of telemedicine for follow-up care. Results: Of the 1007 sexual assault and intimate partner violence patients seen during the study timeframe, 180 (8%) consented to be contacted for future research, and 10 completed an interview regarding telemedicine for follow-up care. All participants were cisgendered women, 5 (50%) experienced sexual assault, 6 (60%) physical assault, and 3 (30%) verbal assault. All knew their assailant, and 6 (60%) were assaulted by a current or former intimate partner. Three themes emerged as drivers of telemedicine use: increased comfort, increased convenience, and less time required for the appointment. Three thematic barriers to telemedicine use included lack of privacy from others, lack of safety from their assailant, and pressure to balance competing tasks during the appointment. Conclusion: This study illustrated that telemedicine for sexual assault and intimate partner violence follow-up care is feasible, acceptable, and can improve patient satisfaction with follow-up care. Ensuring safety and privacy are key considerations when offering telemedicine as an appropriate option for survivors.
Assessment of novel prognostic biomarkers to predict pathological complete response in patients with non-metastatic triple-negative breast cancer using a window of opportunity design
Authors: Akshatha Chitradurga Rajashekhar , Halanaik Dhanapathi , Nachiappa Ganesh Rajesh , Kishore Nanda , Ganesan Prasanth , Kayal Smita , Kumar Harichandra , Dubashi Biswajit 
Published: May 2024

Background: Triple-negative breast cancer (TNBC) includes approximately 20% of all breast cancer and is characterized by its aggressive nature, high recurrence rates, and visceral metastasis. Pathological complete response (pCR) is an established surrogate endpoint for survival. The window of opportunity studies provide valuable information on the disease biology prior to definitive treatment. Objectives: To study the association of dynamic change in pathological, imagining, and genomic biomarkers that can prognosticate pCR. The study aims to develop a composite prognostic score. Design: Clinical, interventional, and prognostic biomarker study using the novel window of opportunity design. Methods: The study aims to enroll 80 treatment-naïve, pathologically confirmed TNBC patients, administering a single dose of paclitaxel and carboplatin during the window period before neoadjuvant chemotherapy (NACT). Tumor tissue will be obtained through a tru-cut biopsy, and positron emission tomography and computed tomography scans will be performed for each patient at two time points aiming to evaluate biomarker alterations. This will be followed by the administration of standard dose-dense NACT containing anthracyclines and taxanes, with the study culminating in surgery to assess pCR. Results: The study would develop a composite prognostic risk score derived from the dynamic change in the Ki-67, tumor-infiltrating lymphocytes, Standardized Uptake Value (SUV max), Standardized Uptake Value for lean body mass (SUL max), and gene expression level pre- and post-intervention during the window period prior to the start of definitive treatment. This outcome will aid in categorizing the disease biology into risk categories. Trial registration: The current study is approved by the Institutional Ethics Committee [Ethics: Protocol. no. JIP/IEC/2020/019]. This study was registered with ClinicalTrials.gov [CTRI Registration: CTRI/2022/06/043109]. Conclusion: The validated biomarker score will help to personalize NACT protocols in patients in TNBC planned for definitive treatment.