bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Neglected Healers: Urgent Need for Physicians Self-care in Healthcare
Authors: Raza Syed Ali 
Published: May 2024

In the heart of healthcare, where doctors tirelessly tend to their patients, a crisis quietly brews – the disregard for their own well-being. The phenomenon of physician burnout is rampant, fuelled by relentless work demands, unyielding stress, and a culture that prizes patient care above self-care. In Pakistan, where the health system is still developing, clinicians have to go beyond their capacity for the provision of standard care to the patients.
Physician burnout, a shadow that looms over the medical profession, is reaching alarming proportions. Studies reveal shocking rates of emotional exhaustion, detachment, and a sense of diminished accomplishment among doctors.1 This epidemic not only threatens the mental health of physicians but also compromises patient care and safety.2
Yet, burnout is just the tip of the iceberg. Mental health struggles, like anxiety and depression, affect doctors at disproportionately high rates.3 Stress-induced ailments, from hypertension to musculoskeletal disorders, plague the healers who sacrifice their own well-being in the name of their patients.
The solution lies in a radical shift – a culture of wellness and self-care within the medical community. Institutions must step up to provide the support systems necessary for doctors to thrive. Mental health resources, wellness initiatives, and flexible work arrangements are not luxuries but necessities in combating burnout and promoting resilience.4
Doctors must carve out time amidst their demanding schedules for rest, rejuvenation, and reflection. Regular exercise, mindfulness practices, and hobbies are essential tools for preserving physical and emotional well-being.5
Education on stress management and self-care should be woven into the fabric of medical training, right from the medical college, empowering future generations of physicians to prioritize their own health. Peer support networks and mentorship programs offer a great support in the face of adversity.2
As there are regular campaigns and awareness sessions for the patients and general public, there is an immense need to talk about well-being of the health professionals. In conclusion, the plight of physicians neglecting their own health demands urgent attention. By championing self-care and wellness, we can create a more resilient medical workforce, better equipped to navigate the challenges of patient care with compassion and efficacy.
Letter to the Chief Editor
Authors: Choudry Zafar Ali 
Published: May 2024

Dear Chief Editor,
It is with great privilege that I pen these words to you, addressing the esteemed journal of our institution, the Annals of PMC. In this communication, I wish to highlight a significant and pressing concern within the realm of scientific journals today — the matter of "Paper Mills."
Paper mills refer to organizations that engage in unethical practices related to scientific publishing, such as selling fake scientific manuscripts or offering authorship positions for a fee. These organizations have been identified in various scientific disciplines, and their activities include plagiarism, data fabrication, redundant publications, and copyright breaches. The prevalence of paper mills has led to the retraction of numerous publications, with over 1000 papers identified as originating from paper mills since January 2020. These papers are often associated with fraudulent practices and are typically retracted or labeled with expressions of concern. The International Association of Scientific, Technical, and Medical Publishers has launched a tool to detect papers generated by paper mills, aiming to tackle research fraud. The increasing frequency of retracted papers originating from paper mills poses a challenge for the research community, highlighting the need for new mechanisms to identify and prevent this type of misconduct.
Professionals may opt for paper mills for various reasons. One reason is the pressure to publish to achieve academic success, which has led to unethical practices in academia, including the use of paper mills to buy authorship positions or obtain fake scientific manuscripts. Another reason could be the convenience and cost-effectiveness of using paper mills to have work published in reputable journals without going through the rigorous peer review process. Additionally, some professionals may turn to paper mills due to the desire for mass production of papers with a consistent intaglio pattern or to meet specific industry standards. It is important for editors of academic journals to be aware of the potential targeting by paper mills and implement editorial procedures to counteract these fraudulent practices.
In my view, paper mills are hazardous for research, unethical, and should be discouraged, as they may promote fake data and may cause defamation of the journal as well as publishing authority and professionals. Therefore, I wish to caution you to be vigilant against such misconduct, as it could jeopardize the reputation of both the journal and the institution.
I wish you and the whole editorial team best of luck for this and upcoming issues of the journal.

PROF. DR. ZAFAR ALI CHOUDRY (T.I),
Vice Chancellor
Faisalabad Medical University
Faisalabad Pakistan
Foreword Message from the Chief Editor
Authors: Husain Aamir 
Published: May 2024

Dear Esteemed Colleagues and Readers of Annals of PMC,
Assalam-o-Alikum,
I hope this message finds you well and filled with the same enthusiasm for scientific discovery that drives us here at Faisalabad Medical University. I Welcome your all to the latest edition of the University journal. It is with great pleasure and pride that I present to you this collection of articles, research highlights, and stories from the diverse world of science at our esteemed institution.
In these pages, you will discover the vibrancy and depth of our scientific community, where curiosity knows no bounds and innovation thrives. From the laboratories where groundbreaking discoveries are made to the classrooms where knowledge is shared, our university is a hub of intellectual exploration and collaboration.
In the upcoming issue of Scientific Collage Magazine, you can look forward to insightful articles highlighting some of our most recent achievements. These stories not only demonstrate our dedication to scientific excellence but also underscore the tangible contributions we are making to address some of the most pressing challenges of our time.
This magazine serves as a window into the incredible work being done by the faculties of researchers, and students from various national and international institutions. Each article reflects the dedication, passion, and ingenuity that define an institution's approach to scientific inquiry.
As we navigate a world of ever-evolving challenges and opportunities, the importance of scientific research and discovery has never been more apparent. It is our collective responsibility to push the boundaries of knowledge, to seek solutions to pressing global issues, and to inspire the next generation of scientists and innovators.
I encourage you to delve into the pages of this issue, where you will find a reflection of the collective passion for discovery and a glimpse into the future of scientific innovation.
I extend my heartfelt thanks to all who have contributed to this publication, as well as to our readers for your ongoing support and interest. Together, we continue to shape the future of science and make meaningful contributions to society.
Warm regards,
PROF. DR. AAMIR HUSSAIN
Editor in Chief, Annals of Punjab Medical College (APMC)
Faisalabad Medical University, Faisalabad Pakistan
Regresi Binomial Negatif untuk Memodelkan Kematian Bayi di Kalimantan Timur
Authors: Fathurahman M 
Published: May 2024

Negative Binomial Regression (NBR) is an alternative regression model to model the relationship between the dependent variable in overdispersion count data and one or more independent variables. Overdispersion is a problem in Poisson regression modeling. Namely, the variance of the dependent variable is more than the mean. If there is overdispersion, then the parameter estimator of the Poisson regression model has a standard error value that is not under-estimated. The NBR model was applied to modeling infant mortality in East Kalimantan in 2019. Data on infant mortality in East Kalimantan in 2019 indicated overdispersion. Infant mortality is an indicator that can measure the progress of development outcomes in the health sector in a region. In the last three years, from 2017 to 2019, infant mortality data in East Kalimantan has increased. Therefore, it is necessary to do modeling to get the factors that cause it. The modeling results with NBR show that the percentage of the complete neonatal visit of KN3, the percentage of infant health services, and the percentage of visits by pregnant women K4 significantly affect infant mortality in East Kalimantan in 2019.
Penyelesaian Masalah Pemrograman Kuadratik Menggunakan Metode Beale
Authors: Erlina Erlina , Syaripuddin Syaripuddin , Amijaya Fidia Deny Tisna 
Published: May 2024

Quadratic programming is a special form of nonlinear programming which has the general form of the objective function in the form of a quadratic functions and the constraints in the form of linear functions. One of the methods used to solve the quadratic programming model is Beale’s method. This method is a modification of the simplex method for linear programming problems. This study aims to determine the optmal results of paddy production data in Balikpapan city using Beale’s method. The quadratic programming model was formed using the least squares method with the objective functions by selecting two types of plants,namely lowland paddy and upland paddy. Furthermore, the quadratic programming model formed that is formed is solved using Beale’s method. The data used is data on the paddy production of balikpapan city in 2005-2019. Based on the calculatios, the objective function is with the constraint functions and . After calculating using Beale’s method, the optimal result for the maximum yield of lowland paddy and upland paddy is quintals with a harvested area of hectares of lowland paddy and a harvested paddy of hectares of upland paddy.
ANALISA PENERAPAN PUTUSAN ULTRA PETITA OLEH MAHKAMAH KONSTITUSI DALAM PUTUSAN PERSELISIHAN HASIL PEMILIHAN UMUM
Authors: Putri Ratu Syifa Junaedi , Farhan Alif , Wasistha Ariani Nurhanifah Putri 
Published: May 2024

The Constitutional Court is a particular judicial state institutions that has a position as a judicial institution besides the Supreme Court. Their responsibilities and power are controlled in Article 24C paragraph (1) of the 1945 Constitution of the Republic of Indonesia, where one of them is determining disputes over the outcome of the presidential elections. Requests for these types of issues may only be submitted by election participants considering the rules and regulations provided in Law no. 24 of 2003. In giving a decision, the judge has the right to find his own law, including giving a decision that exceeds the application submitted by the applicant which is called a decisionultra small. This is intended to provide substantive justice to the applicants. The objective of doing this research is to analyze whether the decisionultra smallcan be applied in the issue of disputes over election results. For this reason, , a normative research was conducted using a qualitative methodology so that the results provided are a comprehensive discussion. The outcomes from this research prove that the verdictultra smallcan be given to cases of disputed election results. Example of applicationultra small against the action of the Constitutional Court is the Constitutional Court Decision Number 41/PHPU.D-VI/2008 and the Constitutional Court Decision Number 57/PHPU.D-VI/2008.Keywords:ultra petita, verdict, election dispute
Microscope-integrated optical coherence tomography for in vivo human brain tumor detection with artificial intelligence
Authors: Kuppler Patrick , Strenge Paul , Lange Birgit , Spahr-Hess Sonja , Draxinger Wolfgang , Hagel Christian , Theisen-Kunde Dirk , Brinkmann Ralf , Huber Robert , Tronnier Volker , Bonsanto Matteo Mario 
Published: May 2024

OBJECTIVE
It has been shown that optical coherence tomography (OCT) can identify brain tumor tissue and potentially be used for intraoperative margin diagnostics. However, there is limited evidence on its use in human in vivo settings, particularly in terms of its applicability and accuracy of residual brain tumor detection (RTD). For this reason, a microscope-integrated OCT system was examined to determine in vivo feasibility of RTD after resection with automated scan analysis.

METHODS
Healthy and diseased brain was 3D scanned at the resection edge in 18 brain tumor patients and investigated for its informative value in regard to intraoperative tissue classification. Biopsies were taken at these locations and labeled by a neuropathologist for further analysis as ground truth. Optical OCT properties were obtained, compared, and used for separation with machine learning. In addition, two artificial intelligence–assisted methods were utilized for scan classification, and all approaches were examined for RTD accuracy and compared to standard techniques.

RESULTS
In vivo OCT tissue scanning was feasible and easily integrable into the surgical workflow. Measured backscattered light signal intensity, signal attenuation, and signal homogeneity were significantly distinctive in the comparison of scanned white matter to increasing levels of scanned tumor infiltration (p < 0.001) and achieved high values of accuracy (85%) for the detection of diseased brain in the tumor margin with support vector machine separation. A neuronal network approach achieved 82% accuracy and an autoencoder approach 85% accuracy in the detection of diseased brain in the tumor margin. Differentiating cortical gray matter from tumor tissue was not technically feasible in vivo.

CONCLUSIONS
In vivo OCT scanning of the human brain has been shown to contain significant value for intraoperative RTD, supporting what has previously been discussed for ex vivo OCT brain tumor scanning, with the perspective of complementing current intraoperative methods for this purpose, especially when deciding to withdraw from further resection toward the end of the surgery.
A watch, wait, and rescan approach for incidental benign-appearing notochordal lesions of the skull base
Authors: Usher Inga E. , Drosos Evangelos , Morsy Abdalla , Wadeson Andrea , Laitt Roger , Abdulla Sarah , Madhavan Aparna , Halliday Jane , Rutherford Scott , King Andrew T. , Pathmanaban Omar N. 
Published: May 2024

OBJECTIVE
The aim of this study was to describe the natural history of incidental benign-appearing notochordal lesions of the skull base with specific attention to features that can make differentiation from low-grade chordoma more difficult, namely contrast uptake and bone erosion.

METHODS
In this retrospective case series, the authors describe the clinical outcomes of 58 patients with incidental benign-appearing notochordal lesions of the clivus, including those with minor radiological features of bone erosion or contrast uptake.

RESULTS
All lesions remained stable during a median follow-up of almost 3 years. Thirty-seven (64%) patients underwent contrast-enhanced MRI; lesions in 14 (38%) of these patients exhibited minimal contrast enhancement. Twenty-seven (47%) patients underwent CT; lesions in 6 (22%) of these patients exhibited minimal bone erosion.

CONCLUSIONS
These data make the case for monitoring selected cases of benign-appearing notochordal lesions of the clivus in the first instance even when there is minor contrast uptake or minimal bone erosion.
Proton versus photon adjuvant radiotherapy: a multicenter comparative evaluation of recurrence following spinal chordoma resection
Authors: Ghaith Abdul Karim , Nguyen Ryan , El-Hajj Victor Gabriel , Montaser Alaa , De Biase Gaetano , Ravindran Krishnan , Perez-Vega Carlos , Lee Seung Jin , Dominari Asmina , Battistin Umberto , Suárez-Meade Paola , Moussalem Charbel , Patel Naresh P. , Kalani Maziyar A. , Clarke Michelle J. , Rose Peter S. , Bydon Mohamad , Abode-Iyamah Kingsley , Akinduro Oluwaseun O. 
Published: May 2024

OBJECTIVE
Chordomas are rare tumors of the skull base and spine believed to arise from the vestiges of the embryonic notochord. These tumors are locally aggressive and frequently recur following resection and adjuvant radiotherapy. Proton therapy has been introduced as a tissue-sparing option because of the higher level of precision that proton-beam techniques offer compared with traditional photon radiotherapy. This study aimed to compare recurrence in patients with chordomas receiving proton versus photon radiotherapy following resection by applying tree-based machine learning models.

METHODS
The clinical records of all patients treated with resection followed by adjuvant proton or photon radiotherapy for chordoma at Mayo Clinic were reviewed. Patient demographics, type of surgery and radiotherapy, tumor recurrence, and other variables were extracted. Decision tree classifiers were trained and tested to predict long-term recurrence based on unseen data using an 80/20 split.

RESULTS
Fifty-three patients with a mean ± SD age of 55.2 ± 13.4 years receiving surgery and adjuvant proton or photon therapy to treat chordoma were identified; most patients were male. Gross-total resection was achieved in 54.7% of cases. Proton therapy was the most common adjuvant radiotherapy (84.9%), followed by conventional or external-beam radiation therapy (9.4%) and stereotactic radiosurgery (5.7%). Patients receiving proton therapy exhibited a 40% likelihood of having recurrence, significantly lower than the 88% likelihood observed in those treated with nonproton therapy. This was confirmed on logistic regression analysis adjusted for extent of tumor resection and tumor location, which revealed that proton adjuvant radiotherapy was associated with a decreased risk of recurrence (OR 0.1, 95% CI 0.01–0.71; p = 0.047) compared with photon therapy. The decision tree algorithm predicted recurrence with an accuracy of 90% (95% CI 55.5%–99.8%), with the lowest risk of recurrence observed in patients receiving gross-total resection with adjuvant proton therapy (23%).

CONCLUSIONS
Following resection, adjuvant proton therapy was associated with a lower risk of chordoma recurrence compared with photon therapy. The described machine learning models were able to predict tumor progression based on the extent of tumor resection and adjuvant radiotherapy modality used.
Quality of life in chordoma survivors: results from the Chordoma Foundation Survivorship Survey
Authors: Jimenez Adrian E. , Cicalese Kyle V. , Jimenez Miguel A. , Chakravarti Sachiv , Kuo Cathleen C. , Lozinsky Shannon , Schwab Joseph H. , Knowlton Sasha E. , Rowan Nicholas R. , Mukherjee Debraj 
Published: May 2024

OBJECTIVE
Chordomas are rare malignant bone tumors whose location in the skull base or spine, invasive surgical treatment, and accompanying adjuvant radiotherapy may all lead patients to experience poor quality of life (QOL). Limited research has been conducted on specific demographic and clinical factors associated with decreased QOL in chordoma survivors. Thus, the aim of the present study was to investigate several potential variables and their impact on specific QOL domains in these patients as well the frequencies of specific QOL challenges within these domains.

METHODS
The Chordoma Foundation (CF) Survivorship Survey was electronically distributed to chordoma survivors subscribed to the CF Chordoma Connections forum. Survey questions assessed QOL in three domains: physical, emotional/cognitive, and social. The degree of impairment was assessed by grouping the participants into high- and low-challenge groups designated by having ≥ 5 or < 5 symptoms or challenges within a given QOL domain. Bivariate analysis of demographic and clinical characteristics between these groups was conducted using Fisher’s exact test and the Mann-Whitney U-test.

RESULTS
A total of 665 chordoma survivors at least partially completed the survey. On bivariate analysis, female sex was significantly associated with increased odds of significant emotional (p = 0.001) and social (p = 0.019) QOL burden. Younger survivors (age < 65 years) were significantly more likely to experience significant physical (p < 0.0001), emotional (p < 0.0001), and social (p < 0.0001) QOL burden. Skull base chordoma survivors had significantly higher emotional/cognitive QOL burden than spinal chordoma survivors (p = 0.022), while the converse was true for social QOL challenges (p = 0.0048). Survivors currently in treatment were significantly more likely to experience significant physical QOL challenges compared with survivors who completed their treatment > 10 years ago (p = 0.0074). Fear of cancer recurrence (FCR) was the most commonly reported emotional/cognitive QOL challenge (49.6%). Only 41% of the participants reported having their needs met for their physical QOL challenges as well as 25% for emotional/cognitive and 18% for social.

CONCLUSIONS
The authors’ findings suggest that younger survivors, female survivors, and survivors currently undergoing treatment for chordoma are at high risk for adverse QOL outcomes. Additionally, although nearly half of the participants reported a FCR, very few reported having adequate emotional/cognitive care. These findings may be useful in identifying specific groups of chordoma survivors vulnerable to QOL challenges and bring to light the need to expand care to meet the QOL needs for these patients.
The utility of inflammatory biomarkers in predicting overall survival and recurrence in skull base chordoma
Authors: Hoppe Meagan , Gersey Zachary C. , Muthiah Nallammai , Abdallah Hussein M. , Plute Tritan , Abou-Al-Shaar Hussam , Wang Eric W. , Snyderman Carl H. , Zenonos Georgios A. , Gardner Paul A. 
Published: May 2024

OBJECTIVE
Numerous studies have investigated the impact of inflammatory factors in cancer, yet few attempts have been made to investigate these markers in skull base chordoma (SBC). Inflammatory values including neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), lymphocyte-monocyte ratio (LMR), systemic immune inflammation index (SII), and systemic inflammation response index (SIRI) can serve as prognostic markers in various cancers. This study aimed to determine whether these inflammatory factors influence overall survival (OS) or progression-free survival (PFS) in patients with primary SBC.

METHODS
The electronic medical records of patients with primary SBC who underwent resection from 2001 to 2020 were retrospectively reviewed for the associations of sex, age at diagnosis, preoperative steroid use, tumor volume, extent of resection, adjuvant radiation after surgery, tumor metastasis, Ki-67 index, percent homozygous deletion of 9p23 and percent 1p36 loss, and potential prognostic inflammatory markers of NLR, PLR, LMR, SII, and SIRI with the primary outcome measures of OS and PFS. Maximum log-rank statistical tests were used to determine inflammatory marker thresholds for grouping prior to Kaplan-Meier and Cox proportional hazards analysis for OS and PFS of the elucidated groups.

RESULTS
The cohort included 115 primary SBC patients. The mean ± SD tumor volume was 23.0 ± 28.0 cm3, 73% of patients received gross-total resection, 40% received postoperative radiation, 25% had local recurrence, and 6% had subsequent metastatic disease (mean follow-up 47.2 months). Univariable Cox analysis revealed that NLR (p < 0.01), PLR (p = 0.04), LMR (p = 0.04), SII (p < 0.01), and SIRI (p < 0.01) were independently associated with PFS. Additionally, NLR (p = 0.05) and SII (p = 0.03) were significant in multivariable Cox analysis of PFS. However, both univariable and multivariable Cox analysis revealed no correlations with OS.

CONCLUSIONS
The routine assessment of inflammatory biomarkers such as NLR and SIRI could have prognostic value in postresection SBC patients.