bluuebunny/crossref_metadata_2025_split huggingface dataset:
Quantitative Measurement of Poststroke Spasticity and Response to Treatment With Botulinum Toxin: A 2-Patient Case Report
Authors: Cousins Elizabeth , Ward Anthony B. , Roffe Christine , Rimington Lesley D. , Pandyan Anand D. 
Published: May 2009

Background and Purpose
Spasticity (hypertonicity) is a frequent problem that can develop after stroke and can lead to a number of secondary complications, such as contractures and pain. Consequently, many rehabilitation resources are used in treating the condition and its secondary complications. At present, the clinical assessment of spasticity incorporates descriptive scales of resistance to passive movement, but the use of a neurophysiological measure of muscle activity levels has been advocated. This case report focuses on the diagnosis of spasticity through the use of a neurophysiological measure.

Case Descriptions
Two individuals who required botulinum toxin treatment for poststroke spasticity were assessed over a course of 20 weeks with both clinical (Modified Ashworth Scale) and neurophysiological (surface electromyography recording of levels of muscle activity) measures of spasticity. Additionally, arm function, arm movement, and pain were measured. The individuals’ responses to treatment with botulinum toxin and overall recovery after stroke are described.

Outcomes
There were discrepancies between the clinical and the neurophysiological measures of spasticity. The clinical measure of spasticity was not effective in consistently identifying the presence of spasticity and, therefore, also was ineffective in documenting the individuals’ responses to treatment. The neurophysiological measure was able to identify when muscle activity levels had been reduced, but a reduction in muscle activity levels did not always correspond with a reduction in Modified Ashworth Scale scores.

Discussion
The accurate identification of spasticity is important not only for assessment but also for the selection of appropriate treatments after stroke.
Endoscopic endonasal transsphenoidal approach for pituitary adenomas invading the cavernous sinus
Authors: Ceylan Savas , Koc Kenan , Anik Ihsan 
Published: May 2009

Object
In this report, the authors describe their experience with surgical access to the cavernous sinus via a fully transnasal endoscopic approach in 20 cases. Clinical and endocrinological follow-up are discussed.

Methods
The authors used an endoscopic transsphenoidal approach in 192 patients with pituitary adenomas between September 1997 and January 2008, adding a cavernous sinus approach in 20 patients with invasive tumors during the last 5 years of this period. Parasellar extension of the tumor was measured according to the Knosp Scale. Radical tumor removal was achieved in 13 (65%) of 20 patients, and subtotal removal in 7 (35%). The authors used recently defined cavernous sinus approaches in the first 14 cases, including the paraseptal approach in 6, middle turbinectomy in 7, and contralateral middle turbinectomy in 1 case. Combined approaches rather than defined standard cavernous sinus approaches were used in 4 cases and an extended approach in 2.

Results
The tumors included nonsecretory adenomas in 5 cases (25%), growth hormone–secreting adenomas in 7 (35%), prolactin-secreting adenomas in 4 (20%), and adrenocorticotropic hormone–secreting adenomas in 4 cases (20%). Normal growth hormone and insulin-like growth factor 1 levels were achieved in 4 patients (57%) with growth hormone adenomas, and remission criteria were obtained in 3 patients with prolactinomas and 3 patients with adrenocorticotropic hormone–secreting adenomas.

Conclusions
Compared with transcranial and microscopic transsphenoidal surgery, endoscopic transsphenoidal surgery offers a wide exposure for cavernous sinus medial wall adenomas that enables removal of the adenoma from the medial cavernous sinus wall. Because of the necessity for multidisciplinary treatment to achieve satisfactory results, Gamma Knife surgery and medical therapy should be supplementary treatment options after endoscopic transsphenoidal surgery.
Stress and Cardiovascular Disorders: A Review and Suggested Impairment Rating Methodology
Authors: Demeter Stephen L. 
Published: April 2024

Abstract
Stress can be divided into two types: physical and mental. This review focuses only on mental and/or psychological stress and two types of cardiovascular problems—coronary artery disease and hypertension—because they are the two most commonly encountered cardiovascular diseases requiring an impairment evaluation. This information can serve as a paradigm for other cardiovascular disorders.
Comprehensive Medical History Interview: Practical Guidance
Authors: Brigham Christopher R. , Feinberg Steven , Buttar Waqas A. 
Published: April 2024

Abstract
Independent medical evaluations (IMEs), impairment assessments, and providing clinical care mandate obtaining an appropriate history. The medical interview is a crucial component for obtaining an accurate and complete medical history for IMEs, which requires interpersonal and analytical skills. The interview is a purposeful conversation aimed at understanding the patient's experiences, with a focus on verbal and nonverbal cues, to help build a comprehensive understanding of the patient's injury and current problems within the context of their overall health. The extent of history that is documented depends on the purpose of the evaluation and the nature of the injury. The process involves documenting chief complaints, injury details, pre-existing conditions, clinical course, current symptoms, and functional and past medical history.
Should Injuries—What's Normal? Part 1
Authors: Talmage James B. , Snyder Robert B. , Oglesby J. Willis 
Published: April 2024

Abstract
Shoulder injuries can present a puzzling picture for physicians. It is important to understand how biases affect physicians when they are making decisions regarding shoulder surgery. This article discusses what can be considered “normal” for shoulder function, how to determine when surgery is and is not indicated, and what might delay return to work in workers' compensation cases.
Silicosis Among Immigrant Engineered Stone (Quartz) Countertop Fabrication Workers in California
Authors: Fazio Jane C. , Gandhi Sheiphali A. , Flattery Jennifer , Heinzerling Amy , Kamangar Nader , Afif Nawal , Cummings Kristin J. , Harrison Robert J. 
Published: April 2024

Key Points
Question
What are the characteristics of patients in California with silicosis from occupational exposure to dust from engineered stone (quartz), a popular material that is high in silica content and that is used to fabricate countertops?

Findings
In this case series of 52 patients, the median age was 45 years at diagnosis, and nearly all were Latino immigrant men. Diagnosis was delayed in 58%, with 38% presenting with advanced disease (progressive massive fibrosis), and 19% died.

Meaning
In California, silicosis associated with occupational exposure to dust from engineered stone primarily occurred among young Latino immigrant men; many patients presented with severe disease, and some cases were fatal.
A Primer for Workers' Compensation
Authors: Bible Jesse E. , Spengler Dan M. , Mir Hassan R. 
Published: April 2024

Abstract
Background Context:
A physician's role within a workers' compensation injury extends far beyond just evaluation and treatment with several socioeconomic and psychological factors at play when compared to similar injuries occurring outside of the workplace. Although workers' compensation statutes vary among states, all have several basic features with the overall goal of returning the injured worker to maximal function in the shortest time period, with the least residual disability and shortest time away from work.

Purpose:
To help physicians unfamiliar with the workers' compensation process accomplish these goals.

Study Design:
Review.

Methods:
Educational review.

Results:
The streamlined review addresses the topics of 1) Why is Workers' Compensation Necessary? 2) What does Workers' Compensation Cover? 3) Progression following Work Injury 4) Impairment and Maximum Medical Improvement (MMI), including how to use the 6th edition of American Medical Association's (AMA) Guides, 5) Completion of Work Injury Claim after Impairment Rating, 6) Independent Medical Evaluation, and 7) Causation.

Conclusions:
In the ‘no-fault’ workers' compensation system, physicians play a key role is progressing the claim along and, more importantly, getting the injured worker back to work as soon as safely possible. Physicians should remain familiar with the workers' compensation process, along with how to properly utilize the AMA Guides.
Neighborhood-Level Disadvantage and Delayed Adjuvant Therapy in Head and Neck Cancer
Authors: Graboyes Evan M. , Cagle Joshua Lee , Ramadan Salma , Prasad Kavita , Yan Flora , Pearce John , Mazul Angela L. , Anoma Jean-Sebastien , Hill Elizabeth G. , Chera Bhisham S. , Puram Sidharth V. , Jackson Ryan , Sandulache Vlad C. , Tam Samantha , Topf Michael C. , Kahmke Russel , Osazuwa-Peters Nosayaba , Nussenbaum Brian , Alberg Anthony J. , Sterba Katherine R. , Halbert Chanita Hughes 
Published: April 2024

ImportanceFor patients with head and neck squamous cell carcinoma (HNSCC), initiation of postoperative radiation therapy (PORT) within 6 weeks of surgery is recommended by the National Comprehensive Cancer Network Guidelines and the Commission on Cancer. Although individual-level measures of socioeconomic status are associated with receipt of timely, guideline-adherent PORT, the role of neighborhood-level disadvantage has not been examined.ObjectiveTo characterize the association of neighborhood-level disadvantage with delays in receiving PORT.Design, Setting, and ParticipantsThis retrospective cohort study included 681 adult patients with HNSCC undergoing curative-intent surgery and PORT from 2018 to 2020 at 4 US academic medical centers. The data were analyzed between June 21, 2023, and March 5, 2024.Main Outcome Measures and MeasuresThe primary outcome was delay in initiating guideline-adherent PORT (ie, &amp;gt;6 weeks after surgery). Time-to-PORT (TTP) was a secondary outcome. Census block-level Area Deprivation Index (ADI) scores were calculated and reported as national percentiles (0-100); higher scores indicate greater deprivation. The association of ADI scores with PORT delay was assessed using multivariable logistic regression adjusted for demographic, clinical, and institutional characteristics. PORT initiation across ADI score population quartiles was evaluated with cumulative incidence plots and Cox models.ResultsAmong 681 patients with HNSCC undergoing surgery and PORT (mean [SD] age, 61.5 [11.2] years; 487 [71.5%] men, 194 [29.5%] women) the PORT delay rate was 60.8% (414/681) and median (IQR) TTP was 46 (40-56) days. The median (IQR) ADI score was 62.0 (44.0-83.0). Each 25-point increase in ADI score was associated with a corresponding 32% increase in the adjusted odds ratio (aOR) of PORT delay (aOR, 1.32; 95% CI, 1.07-1.63) on multivariable regression adjusted for institution, age, race and ethnicity, insurance, comorbidity, cancer subsite, stage, postoperative complications, care fragmentation, travel distance, and rurality. Increasing ADI score population quartiles were associated with increasing TTP (hazard ratio of PORT initiation, 0.71; 95% CI, 0.53-0.96; 0.59; 95% CI, 0.44-0.77; and 0.54; 95% CI, 0.41-0.72; for ADI quartiles 2, 3, and 4 vs ADI quartile 1, respectively).Conclusions and RelevanceIncreasing neighborhood-level disadvantage was independently associated with a greater likelihood of PORT delay and longer TTP in a dose-dependent manner. These findings indicate a critical need for the development of multilevel strategies to improve the equitable delivery of timely, guideline-adherent PORT.
Comprehensive genomic profiling of pulmonary spindle cell carcinoma using tissue and plasma samples: insights from a real‐world cohort analysis
Authors: Sun Yi , Qin Shilei , Wang Song , Pang Jiaohui , Ou Qiuxiang , Liang Weiquan , Zhong Hai 
Published: April 2024

AbstractPulmonary spindle cell carcinoma (PSCC) is a rare and aggressive non‐small cell lung cancer (NSCLC) subtype with a dismal prognosis. The molecular characteristics of PSCC are largely unknown due to its rarity, which limits the diagnosis and treatment of this historically poorly characterized malignancy. We present comprehensive genomic profiling results of baseline tumor samples from 22 patients histologically diagnosed with PSCC, representing the largest cohort to date. Somatic genetic variant detection was compared between paired plasma samples and primary tumors from 13 patients within our cohort. The associations among genomic features, treatment, and prognosis were also analyzed in representative patient cases. TP53 (54.5%), TERT (36.4%), CDKN2A (27.3%), and MET (22.7%) were most frequently mutated. Notably, 81.8% of patients had actionable targets in their baseline tumors, including MET (22.7%), ERBB2 (13.6%), EGFR (9.1%), KRAS (9.1%), ALK (9.1%), and ROS1 (4.5%). The median tumor mutation burden (TMB) for PSCC tumors was 5.5 mutations per megabase (muts/Mb). TMB‐high tumors (>10 muts/Mb) exhibited a significantly higher mutation frequency in genes such as KRAS, ARID2, FOXL2, and LRP1B, as well as within the DNA mismatch repair pathway. The detection rates for single nucleotide variants and structural variants were comparable between matched tumor and plasma samples, with 48.6% of genetic variants being mutually identified in both sample types. Additionally, a patient with a high mutation load and positive PD‐L1 expression demonstrated a 7‐month survival benefit from chemoimmunotherapy. Furthermore, a patient with an ALK‐rearranged tumor achieved a remarkable 3‐year progression‐free survival following crizotinib treatment. Overall, our findings deepen the understanding of the complex genomic landscape of PSCC, revealing actionable targets amenable to tailored treatment of this poorly characterized malignancy.
Electron streaming dose measurements and calculations on a 1.5 T MR‐Linac
Authors: Patterson Elizabeth , Powers Marcus , Metcalfe Peter E. , Cutajar Dean , Oborn Bradley M. , Baines John A. 
Published: April 2024

AbstractPurposeTo evaluate the accuracy of different dosimeters and the treatment planning system (TPS) for assessing the skin dose due to the electron streaming effect (ESE) on a 1.5 T magnetic resonance (MR)‐linac.MethodSkin dose due to the ESE on an MR‐linac (Unity, Elekta) was investigated using a solid water phantom rotated 45° in the x‐y plane (IEC61217) and centered at the isocenter. The phantom was irradiated with 1 × 1, 3 × 3, 5 × 5, 10 × 10, and 22 × 22 cm2 fields, gantry at 90°. Out‐of‐field doses (OFDs) deposited by electron streams generated at the entry and exit surface of the angled phantom were measured on the surface of solid water slabs placed ±20.0 cm from the isocenter along the x‐direction. A high‐resolution MOSkin™ detector served as a benchmark due to its shallower depth of measurement that matches the International Commission on Radiological Protection (ICRP) recommended depth for skin dose assessment (0.07 mm). MOSkin™ doses were compared to EBT3 film, OSLDs, a diamond detector, and the TPS where the experimental setup was modeled using two separate calculation parameters settings: a 0.1 cm dose grid with 0.2% statistical uncertainty (0.1 cm, 0.2%) and a 0.2 cm dose grid with 3.0% statistical uncertainty (0.2 cm, 3.0%).ResultsOSLD, film, the 0.1 cm, 0.2%, and 0.2 cm, 3.0% TPS ESE doses, underestimated skin doses measured by the MOSkin™ by as much as –75.3%, –7.0%, –24.7%, and –41.9%, respectively. Film results were most similar to MOSkin™ skin dose measurements.ConclusionsThese results show that electron streams can deposit significant doses outside the primary field and that dosimeter choice and TPS calculation settings greatly influence the reported readings. Due to the steep dose gradient of the ESE, EBT3 film remains the choice for accurate skin dose assessment in this challenging environment.
Global adaptive practical tracking control for high‐order uncertain nonstrict feedback nonlinear systems with unknown control coefficients
Authors: He Zhongjie , Fan Weiyi , Yu Miao , Wang Yuesheng 
Published: April 2024

SummaryIn this article, the problem of global adaptive practical tracking for high‐order uncertain nonstrict feedback nonlinear systems with unknown control coefficients is studied. To avoid the algebraic loop problem associated with the nonstrict feedback condition and guarantee the controllability of the tracking error, a novel dual dynamic gain scaling method is introduced to compensate nonlinearities and the tracking error simultaneously. Besides, by incorporating the sign functions into the design of adding a power integrator, a general approach for the handing of unknown control coefficients and the direction design of the controller is developed. The presented control scheme can ensure that all system states are globally bounded without constraints on state variables while the reference signal is tracked with expected precision. Three simulation examples, including a practical application, are provided to illustrate the validity of the control scheme.
An On‐Skin‐Formed Silk Protein Bioelectrode for Conformable and Robust Electrophysiological Interface
Authors: Yang Zhonghua , Zhang Zishuo , Zhou Tao , Yu Nuo , Yu Rouhui , Du Xiangheng , Bai Xiaowen , Miao Zhenyu , Wu Liang , Pan Shaowu , Zhu Meifang 
Published: April 2024

AbstractThe electrophysiological interface is essential for understanding electrical activities within biological organisms and human‐machine interaction. However, traditional preformed bioelectrodes show insufficient interface contact with hairy and irregular skin, causing signal attenuation and distortion. Here, an on‐skin‐formed silk protein bioelectrode is reported with a conformable and robust interface, achieving a high signal‐to‐noise ratio for electromyographic signals, showing up to a 38.9% increase compared to traditional ones. The fluid‐gel transition of silk protein is induced by a gelling agent composed of ethanol and sodium alginate, leading to a conformable and seamless interface with hairy and irregular human skin, thus resulting in a high signal‐to‐noise ratio. The developed bioelectrode can record electrophysiological signals stably, even underwater. Additionally, human‐machine interaction using electromyographic signals is designed to precisely control the model car's motion trajectory. This work presents an effective method for developing a seamless and conformable electrophysiological interface in bioelectronics.
Synergetic Nitrogen‐Rich Nanocarbon Decoration and Metal Intercalation Enabled Low‐Crystalline V3O7 Hybrids for Boosting Capacitive Sodium Capture
Authors: Yang Yu , Sun Zeyu , Zhang Lu , Ye Meidan , Wen Xiaoru 
Published: April 2024

AbstractFaradaic capacitive deionization (FCDI) with attractive ion‐capture capacity, outstanding durability, and potential compatibility in high‐salinity water has been recognized as the robust alternative to address the alarming freshwater scarcity. The further innovation of boosting electrode materials is the indispensable requisite for highly efficient FCDI application. Herein, a low‐crystalline nitrogen‐doped carbon quantum dots modified Mg2+‐pillar preintercalated V3O7 (i.e., NCQDs/Mg‐V3O7) heterostructure is assembled via an ingenious one‐spot hydrothermal avenue, and is investigated as the advanced FCDI electrode for desalination application. Taking advantages of the synergic effect of unique microstructure, improved electronic conductivity, and exceptional structural durability, the NCQDs/Mg‐V3O7 electrode delivers an admirable gravimetric adsorption capacity of 54.32 mg g−1 in a NaCl solution of 1500 mg L−1 and attractive cyclic durability. Further, density functional theory calculations verify the intense interface electron coupling interaction between tri‐components, enabling the significantly promoting Na+ capture capability. The synergy removal mechanism is clarified by ex‐situ X‐ray photoelectron spectroscopy and in‐situ Raman tests. Additionally, the average removal efficiency of hybrid electrode attains 93.75% in the simulated wastewater comprising the NaCl of 50 mg L−1 and diverse metal nitrates from 10 to 100 mg L−1 for each, certifying the great prospects for practical wastewater treatment.
Integrated GaN Prism Array Self‐Powered Photodetector on Si for Ultraviolet Imaging and Communication
Authors: Xu Tong , Fan Xuefeng , Zhu Gangyi , Qin Feifei , Wan Peng , Tang Kai , Kan Caixia , Shi Daning , Fang Xiaosheng , Jiang Mingming 
Published: April 2024

AbstractTo realize the advantageous combination of microelectronic integrated circuit technology and photonic technology, the development of high‐speed, low‐power, and chip‐integrated photodetection devices is extremely critical. Here, a large‐scale on‐chip integration photodetector array on a Si wafer consisting of 21×21 GaN p‐n homojunction pixels is prepared. The GaN homojunction subunit has significant photovoltaic performance at a bias voltage of 0 V, including high responsivity of 229.5 mA W−1, outstanding specific detectivity of 2.46×1013 Jones (360 nm, 45.7 µW cm−2), and fast response speed of 240/290 µs. Especially, external quantum efficiency can reach 94% in the faint UV illumination at 0 V bias. The excellent photoresponse is confirmed by finite element analysis, which is resulted from an oversized built‐in potential at the p‐n homojunction interface. For exploring potential practical applicability of the device, the full range of active pixels is statistically analyzed. It is confirmed that the small relative deviation of the GaN array is extremely favorable for obtaining high‐resolution imaging capability. Moreover, the prepared device can be used as an optical data receiver for UV optical communication. With compatibility and integrability to Si‐based optoelectronics platforms, the devices are appealing for sensing, imaging and communications.
Iron Active Center Coordination Reconstruction in Iron Carbide Modified on Porous Carbon for Superior Overall Water Splitting
Authors: Guo Wenxin , Li Jinlong , Chai Dong‐Feng , Guo Dongxuan , Sui Guozhe , Li Yue , Luo Dan , Tan Lichao 
Published: April 2024

AbstractIn this work, a novel liquid nitrogen quenching strategy is engineered to fulfill iron active center coordination reconstruction within iron carbide (Fe3C) modified on biomass‐derived nitrogen‐doped porous carbon (NC) for initiating rapid hydrogen and oxygen evolution, where the chrysanthemum tea (elm seeds, corn leaves, and shaddock peel, etc.) is treated as biomass carbon source within Fe3C and NC. Moreover, the original thermodynamic stability is changed through the corresponding force generated by liquid nitrogen quenching and the phase transformation is induced with rich carbon vacancies with the increasing instantaneous temperature drop amplitude. Noteworthy, the optimizing intermediate absorption/desorption is achieved by new phases, Fe coordination, and carbon vacancies. The Fe3C/NC‐550 (550 refers to quenching temperature) demonstrates outstanding overpotential for hydrogen evolution reaction (26.3 mV at −10 mA cm−2) and oxygen evolution reaction (281.4 mV at 10 mA cm−2), favorable overall water splitting activity (1.57 V at 10 mA cm−2). Density functional theory (DFT) calculations further confirm that liquid nitrogen quenching treatment can enhance the intrinsic electrocatalytic activity efficiently by optimizing the adsorption free energy of reaction intermediates. Overall, the above results authenticate that liquid nitrogen quenching strategy open up new possibilities for obtaining highly active electrocatalysts for the new generation of green energy conversion systems.