bluuebunny/crossref_metadata_2025_split huggingface dataset:
Characterisation of a hollow-cathode lamp to measure accurate branching fractions of rare-earth elements.
Authors: Sen Sarma Pratyush Ranjan , Belmonte Maria Teresa , Mar Santiago 
Published: June 2024

Abstract
This work describes the tests performed with a newly built hollow-cathode lamp to ensure its capability to measure atomic parameters such as transition probabilities accurately. We discuss the design of the lamp and the experimental setup that will be used to measure transition probabilities. We show the discharge characteristics of the lamp and also the stability of spectral emission of the lamp over a period of two hours. Finally, it is concluded that the experimental setup, the lamp, and a camera with high resolving power are well suited for the measurement of the transition probabilities of doubly ionised rare-earths like Nd III.

Graphical abstract
Graphical abstract illustrating the use of a hollow-cathode lamp setup for accurately measuring branching fractions of rare-earth elements. The setup includes a diffraction grating spectrometer and a CMOS camera to detect radiation across a spectral range of 200 nm to 800 nm with a resolving power of 150,000 at 450 nm
Systematic Review and Meta‐Analysis of Prehospital Machine Learning Scores as Screening Tools for Early Detection of Large Vessel Occlusion in Patients With Suspected Stroke
Authors: Alobaida Muath , Joddrell Martha , Zheng Yalin , Lip Gregory Y. H. , Rowe Fiona J. , El‐Bouri Wahbi K. , Hill Andrew , Lane Deirdre A. , Harrison Stephanie L. 
Published: June 2024

Background
Enhanced detection of large vessel occlusion (LVO) through machine learning (ML) for acute ischemic stroke appears promising. This systematic review explored the capabilities of ML models compared with prehospital stroke scales for LVO prediction.

Methods and Results
Six bibliographic databases were searched from inception until October 10, 2023. Meta‐analyses pooled the model performance using area under the curve (AUC), sensitivity, specificity, and summary receiver operating characteristic curve. Of 1544 studies screened, 8 retrospective studies were eligible, including 32 prehospital stroke scales and 21 ML models. Of the 9 prehospital scales meta‐analyzed, the Rapid Arterial Occlusion Evaluation had the highest pooled AUC (0.82 [95% CI, 0.79–0.84]). Support Vector Machine achieved the highest AUC of 9 ML models included (pooled AUC, 0.89 [95% CI, 0.88–0.89]). Six prehospital stroke scales and 10 ML models were eligible for summary receiver operating characteristic analysis. Pooled sensitivity and specificity for any prehospital stroke scale were 0.72 (95% CI, 0.68–0.75) and 0.77 (95% CI, 0.72–0.81), respectively; summary receiver operating characteristic curve AUC was 0.80 (95% CI, 0.76–0.83). Pooled sensitivity for any ML model for LVO was 0.73 (95% CI, 0.64–0.79), specificity was 0.85 (95% CI, 0.80–0.89), and summary receiver operating characteristic curve AUC was 0.87 (95% CI, 0.83–0.89).

Conclusions
Both prehospital stroke scales and ML models demonstrated varying accuracies in predicting LVO. Despite ML potential for improved LVO detection in the prehospital setting, application remains limited by the absence of prospective external validation, limited sample sizes, and lack of real‐world performance data in a prehospital setting.
Statin Overuse in Cerebral Ischemia Without Indications: Systematic Review and Annual US Burden of Adverse Events
Authors: Sung Eleanor Mina , Saver Jeffrey L. 
Published: June 2024

BACKGROUND:
Statin agents play a major role in secondary prevention after acute cerebral ischemia (ACI) events but are not indicated in all patients with ischemic stroke and transient ischemic attack. National guidelines recommend statins for patients with ACI of large or small vessel atherosclerotic origin and without these stroke mechanisms but coexisting coronary artery disease or primary prevention indications. The potential adverse effect burden of statin overuse in the remaining ACI patients have not been well delineated.

METHODS:
Per Preferred Reporting Items of Systematic Reviews and Meta-Analyses guidelines, we performed systematic meta-analyses of: (1) statin randomized clinical trials to determine absolute risk increases for 6 major adverse events; (2) large clinical series to determine the proportion of ACI events due to large or small vessel atherosclerotic disease; and (3) the proportion of remaining patients with coronary artery disease/primary prevention statin indications.

RESULTS:
For adverse effects, data were available from 63 randomized clinical trials enrolling 155 107 patients. Statin therapy was associated with an increased risk of the occurrence of 6 conditions: diabetes, myalgia or muscle weakness, myopathy, liver disease, renal insufficiency, and eye disease. Across 55 large series enrolling 53 501 patients, the rate of ACI due to large and small artery atherosclerosis was 45.0% (large artery atherosclerosis 21.6%, small vessel disease 23.4%), the rate of remaining patients with coronary artery disease/primary prevention statin indications was 31.8%, and the rate of patients without statin indications was 23.2%. Data synthesis indicated that, in the United States, were all patients with ACI without statin indications treated with statins, a total of 5601 patients would develop needless adverse events each year, most commonly diabetes, myopathy, and eye disease.

CONCLUSIONS:
More than one-fifth of patients with ACI do not have an indication for statins, and statin overuse in these patients could annually lead to over 5600 adverse events each year in the United States, including diabetes, myopathy, and eye disease. These findings emphasize the importance of adhering to guideline indications for the start of statin therapy in ACI.
The Causes of Intraseasonal Alternating Warm and Cold Variations over China in Winter 2021/22
Authors: Yang Hongqing , Fan Ke 
Published: June 2024

Abstract
The subseasonal variability of winter air temperature in China during 2021/22 underwent significant changes, showing warm, warm, and cold anomalies during 2–23 December 2021 (P1), 1–27 January 2022 (P2), and 28 January–24 February 2022 (P3). The strong (weak) zonal circulation over East Asia led to positive (negative) surface air temperature anomalies (SATAs) during P1 and P2 (P3). The position of the Siberian high affected the distribution of the warmest center of SATA over northeastern and northwestern China in P1 and P2, respectively. Further investigations indicated that intraseasonal components (10–90 days) primarily drove the warm-to-cold transition in China during P2 and P3, contributing to 79.5% of the variance in SATA in winter 2021/22. Strong (weak) East Asian intraseasonal zonal circulations and positive (negative) meridional wind anomalies over China–Lake Baikal led to warm (cold) anomalies over China during P2 (P3). East Asian circulation alternations from P2 to P3 were associated with a shift in intraseasonal geopotential height anomalies over the North Atlantic region from positive to negative in the mid- to high troposphere through the propagation of north and south branch wave trains. The reversal of the North Atlantic geopotential height anomalies between P2 and P3 was modulated by intraseasonal higher-latitude SST anomalies over the North Atlantic and the location of intraseasonal stratospheric polar vortex. Furthermore, the intensified south branch wave train from the Indian Peninsula to China in the mid- to high troposphere was associated with active convection over the tropical western Indian Ocean during P3. These processes could be verified by using the linear baroclinic model.
The value of synthetic MRI for quantitative analysis in the diagnosis of cervical lymph node metastasis in thyroid cancer
Authors: Wei Mei , Yang Haitao , Li Zhihua , Hu Wei , Qin Yong , Wan Liangbin 
Published: June 2024

Background Preoperative effective assessment of cervical lymph node metastasis in thyroid cancer plays an important role in formulating the surgical plan. Purpose To investigate the significance of synthetic magnetic resonance imaging (MRI) for quantitatively analyzing cervical lymph node metastasis in thyroid cancer. Material and Methods A retrospective analysis was conducted on 30 patients with thyroid cancer, consisting of 19 thyroid cancer nodules, 45 metastatic lymph nodes, and 47 non-metastatic lymph nodes. Regions of interest (ROIs) for each type of nodule were manually delineated using a workstation. Quantitative parameters, such as T1, T2, and proton density (PD) values, were automatically extracted from synthetic MRI scans. Statistical tests and regression analysis were performed to assess differences and correlations among the quantitative parameters. Results There were no significant differences in the quantitative parameter values between the primary tumor and metastatic lymph node tissues ( P > 0.05). However, significant differences were observed in the quantitative parameters between the primary tumor and non-metastatic lymph node tissues and between the metastatic and non-metastatic lymph node tissues ( P < 0.05). The diagnostic accuracy for cervical lymph node metastasis in thyroid cancer was 94.4% for the T1 and T2 combined index, 91.9% for T2, 86.8% for T1, and 71.7% for PD values. Conclusion The application of quantitative parameters from synthetic MRI can assist clinicians in accurately planning surgical interventions for thyroid cancer patients before surgery.
Onabotulinumtoxina (craniotomy scar combined with cranial suture line injections) for persistent post craniotomy headache: Case series with long-term follow-up
Authors: Leon Janet , Rozen Todd D. , Bhatt Alok A. 
Published: June 2024

Background There is no defined preventive treatment protocol for persistent post-craniotomy headache. In several small case series and individual case reports onabotulinumtoxinA injected into the craniotomy scar has shown possible efficacy. What is lacking is long term follow-up and if focusing on the cranial suture lines along with the craniotomy scar can enhance improvement and provide more sustained benefit. Methods Retrospective chart review with case series. Results Four patients (three women, one man) with ICHD-3 defined persistent post craniotomy headache were treated using a novel onabotulinumtoxinA injection protocol. All the patients presented with continuous head pain of moderate to severe intensity. All had severe allodynia on the side of their craniotomy. All had significant reduction in quality of life. Our application of onabotulinumtoxinA involved injection into both the surgical scar and the transected/irritated cranial suture lines noted on neuroimaging and physical examination. With treatment all patients demonstrated significant benefit including a reduction in daily pain intensity (75%-100%), developing periods of pain freedom (2–7 days per week) and having a dramatic improvement in quality of life (close to 100% in all). The benefit was sustained for at least five years of follow-up. Conclusion From our case series it appears that injection not only along the painful craniotomy scar but into the involved cranial suture lines provides positive efficacy and sustained improvement in patients with persistent post craniotomy headache.
Necrotizing Soft Tissue Infection Following a Closed Distal Radius Fracture: A Case Report and Literature Review
Authors: Law Jenaleen , Duraku Liron S. , Sivakumar Brahman , Hile Mark 
Published: June 2024

Necrotizing soft tissue infections (NSTIs), characterized by extensive soft tissue destruction, are rare but life-threatening. We present a case of a NSTI in a healthy 65-year-old woman following a closed distal radius fracture. The patient presented with severe pain, fever, and lethargy 4 days after her index injury, with physical examination of the right upper limb revealing erythema and swelling to the mid-humeral level and blisters of the fingers and hand. Multiple surgical debridements were required to control the infection, which was caused by Streptococcus pyogenes. This case highlights the rapid progression and devastating consequences of NSTI, which can occur even in the setting of closed injuries in patients without comorbidities. Prompt diagnosis, early surgical intervention, and appropriate antimicrobial therapy are crucial in managing this pathology. Level of Evidence: Level 5.
Enhancing Healthcare Professionals’ Culinary Skills, Food Management, Counseling Confidence, and Mediterranean Diet Adherence Through a Culinary Medicine Boot Camp: A Pilot Implementation Program (PIP)
Authors: Fernando Joan , Alonso Lucia , Gastaldo Isabella , Coll Alba , Lozano Josep , Martini Vinicius , Roura Elena , Williamson Lina , Escarrabill Joan , Moize Violeta 
Published: June 2024

Awareness of nutrition’s role in chronic diseases is rising, demanding guidance on the diet-disease relationship. Nutritional practices become crucial for prevention, prompting healthcare professionals (HCP) to respond. The present study assessed a Culinary Medicine (CM) program’s impact on HCP’s Mediterranean diet adherence, food and diet therapy knowledge, food management skills, culinary proficiency, and counseling confidence. A mixed-methods pilot implementation program (PIP) engaged 20 HCP from Hospital Clinic Barcelona at the Alícia Foundation kitchen-lab. Four 8-hour CM sessions, held weekly, covered culinary knowledge emphasizing disease prevention and care. All twenty participants; 86% women, 14% men, 86% aged above 40, 14% between 31 and 39 years, 71% nurses, 7% medical doctors and 21% other occupation, completed the course and fourteen fulfilled pre-and post-program questionnaires. Notably, 86% had prior nutrition training, while only 14% had culinary training. After the program, there was significant improvement in Mediterranean diet adherence ( P < .05). Perceptions on dietary advice usefulness, patient-transferable knowledge acquisition, cooking techniques, and personal cooking skills confidence showed post-course improvements. This study underscores the potential of hands-on CM training in HCP nutrition education, influencing their culinary knowledge. Future studies with larger samples is needed to elucidate CM training’s impact on HCP and potential public health benefits.
Stigma and the use of umbrellas, hiking poles and walking sticks to aid walking in Hong Kong
Authors: Maximo Tulio , Fong Kenneth NK , Lau Newman ML 
Published: June 2024

Background The use of walking aids is widely acknowledged as one of the most relied-on forms of assistive technology. Using stick-shaped devices, such as a cane, is often the entrance for many people to the world of assistive technologies, often accompanied by the negative stigma associated with ageing and disability. Objectives This study investigated the perception of disability and needs of the Hong Kong population using walking aids, aiming to inform device design and service provision. Methods We observed 391 individuals using cane-like devices in their natural environment and conducted semi-structured interviews with 28 participants to understand stigma, barriers to acquisition, training, and design requirements. Results Half of the interviewees (50%, n = 14) did not feel disabled when using a walking stick, while 39% felt slightly disabled. 56% of the observed sample used non-medical-looking aids like hiking poles or umbrellas. Most interviewees (79%) purchased off-the-shelf devices, but less than half received seller support in choosing appropriate aids. Conclusion The feelings associated with using walking sticks and similar devices are mostly positive. There is a preference in Hong Kong for using devices without a medical appearance to aid walking, such as umbrellas and hiking poles. There is a need to raise awareness of the risks of using umbrellas to aid walking and empower the user to make informed decisions when purchasing walking aid devices. In addition, there is a need to support the supply chain of walking aids, including umbrellas and hiking poles, to provide more information on device use, misuse, training, and maintenance.
PaiNEd app. Assessing central sensitization in survivors of breast cancer: A reliability study
Authors: Fernández-Gualda Miguel Ángel , Ariza-Vega Patrocinio , Galiano-Castillo Noelia , Tovar-Martín Isabel , Ortiz-Comino Lucía , Lozano-Lozano Mario , Fernández-Lao Carolina 
Published: June 2024

Introduction Pain is a common adverse event in survivors of breast cancer (sBCs). As there is no gold standard to assess pain experience predominantly related to central sensitization (CS) symptoms, we designed the PaiNEd app, which includes an algorithm to report whether patients are under predominant CS pain mechanisms. Objective We aimed to assess the reliability of the PaiNEd app to estimate whether sBC pain experience is predominantly related to CS symptoms. Methods An observational, descriptive reliability design was employed to assess the inter- and intrarater reliability of the PaiNEd app. This app includes an algorithm that considers the number of painful body parts and some questionnaires related to pain, such as the Numeric Pain-Rating Scale, the Brief Pain Inventory, the Tampa Scale for Kinesiophobia, the Pain Catastrophizing Scale, and the Central Sensitization Inventory (CSI). Results A total of 21 sBCs with persistent pain were recruited. We observe a general trend of close agreement between the paper-based and app-based formats (ICCs ranged between 0.802 and 0.972; Cronbach's alpha ranged between 0.797 and 0.971). Test–retest reliabilities were moderate to excellent (ICCs ranged between 0.510 and 0.941; Cronbach's alpha ranged between 0.499 and 0.938). The agreement between the categorization of the CS algorithm and the CSI (cut-off point ≥ 40 for CS symptoms) was 95.24%. Conclusion The PaiNEd app emerges as a robust tool for evaluating pain experience predominantly related to CS and pain-related symptoms in sBCs. Its demonstrated reliability not only bolsters its utility but also signifies its potential as a valuable asset for healthcare professionals engaged in pain education programs.
Can Survival Scoring Systems for Spinal Metastases be Used to Predict Postoperative Neurologic Recovery? A Retrospective Study on 204 Patients With Thoracolumbar Metastases Treated at a Tertiary Center
Authors: Kontakis Michael G. , Tsagkozis Panagiotis 
Published: June 2024

Study Design Retrospective Cohort Study. Objective Scoring systems for metastatic disease of the spine are used to select patients for surgical treatment based on survival estimation, but it is unknown whether they can be used to predict the outcome of surgery. This study aims to investigate the association between two widely used prognostic scores and the neurologic function after surgery. Methods Retrospective analysis of 204 patients with thoracolumbar metastases treated with decompressive surgery at Karolinska University Hospital (2001-2020). Modified Bauer and Tokuhashi scores were categorized based on surgical indication, and post-operative neurological function was assessed using the Frankel scale at two different post-surgery intervals. Results Modified Bauer scores ≥2 yielded higher late follow-up Frankel scores (3.9 ± 1.1) than scores <2 (3.5 ± 1.1), P = .03. Modified Tokuhashi scores ≥9 correlated with higher Frankel scores (4.5 ± .9) than scores <9 (3.5 ± 1.1), P < .0001. Both scoring systems positively predicted neurological outcomes at late follow-up, with odds ratios of 1.6 ( P = .03) for Bauer and 9.2 ( P < .0001) for Tokuhashi. However, only Tokuhashi predicted ambulatory function at late follow-up ( P < .0001), demonstrating its utility in prognosticating post-surgical mobility. Conclusion Higher modified Bauer and Tokuhashi scores were associated with better neurologic function at last follow-up, as well as greater likelihood of being able to walk again. The Tokuhashi score was found to be more accurate than the modified Bauer score in predicting the neurological outcome after surgery.
By Medical Students, for Medical Students: A Narrative Medicine Antiracism Program
Authors: Iwai Yoshiko , Holdren Sarah , Browne Alyssa R. , Lenze Nicholas R. , Lopez Felix Gabriel , Randolph Antonia M. , Weil Amy B. 
Published: June 2024

Objectives Medical schools have sought to incorporate concepts of race and racism in their curricula to facilitate students’ abilities to grapple with healthcare disparities in the United States; however, these efforts frequently fail to address implicit bias or equip students with cultural humility, reflective capacity, and interpersonal skills required to navigate racialized systems in healthcare. The purpose of this study was to develop and evaluate an antiracism narrative medicine (NM) program designed by and for preclinical medical students. Method Preclinical medical students at a single center were eligible to participate from June-July 2021. Program evaluation included a postprogram qualitative interview and electronic survey. The semistructured interview included questions about program experience, lessons learned, and perspectives on antiracism curricula in medical education. Interviews were qualitatively analyzed using open and axial coding. Survey data were analyzed with descriptive statistics. Results A total of 30 students registered. All (100%) respondents reported “somewhat true” or “very true” in the postprogram survey when asked about their ability to reflect on their own racial identity, racial identity of others, and influence of their racial identity on their future role as a healthcare worker through the program. Qualitative analysis revealed 3 themes: (1) curricular engagement; (2) racism and antiracism in medicine; and (3) group experience. Subthemes included: meaningful theoretical content; multimodal works and unique perspectives; race, identity, and intersectionality; deeper diversity, equity, and inclusion engagement; reconstructive visions; future oriented work; close reading and writing build confidence in discomfort; community and support system; and authentic space among peer learners. Conclusion This virtual, peer-facilitated antiracism NM program provided an engaging and challenging experience for participants. Postprogram interviews revealed the program deepened students’ understanding of racism, promoted self-reflection and community building, and propagated reconstructive visions for continuing antiracism work.