bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical presentation of bone tumours in children and young people: a systematic review and meta-analysis
Authors: Liu Jo-Fen , Shanmugavadivel Dhurgshaarna , Ball-Gamble Ashley , Walker David 
Published: February 2025

BackgroundChildren and young people (CYP) with bone tumours often experience lengthy intervals prior to diagnosis that can lead to increased morbidity and mortality. Early diagnosis is key to optimising treatment options and long-term outcomes. This review aims to describe symptomatology at diagnosis, in order to develop interventions to accelerate diagnosis.MethodsA literature search of MEDLINE and EMBASE was conducted for studies published between January 2008 and May 2023, reporting signs and symptoms in CYP with bone tumours. Pooled proportions of symptoms and signs were calculated.Results16 studies (1452 patients; 492 osteosarcoma and 932 Ewing’s sarcoma) were included in the analysis. The most prevalent symptoms were pain (64%, 95% CI 52% to 75%) and swelling (22%, 95% CI 6% to 42%). Other symptoms included fever, pain and swelling, history of trauma, pathological fracture, palpable mass, functional limitation, increased volume and limp. Subanalysis identified differences in symptom clusters: osteosarcoma more frequently presented with a history of trauma, pathological fracture, pain on weight-bearing, pain worse at night, pain at rest and weight loss. Ewing’s sarcoma was associated with fever, functional limitation and a palpable mass.ConclusionsThese data highlight the differences in presentations between osteosarcoma and Ewing sarcoma, which may account for differences in survival and outcome. This will be used to inform professional and public health interventions through the Child Cancer Smart campaign to accelerate diagnosis for all. This review also highlights the need for a renewed research focus to identify patients earlier in the disease development as a strategy to improve the current static outcomes.
UK medical students’ mental health and their intention to drop out: a longitudinal study
Authors: Medisauskaite Asta , Silkens Milou , Lagisetty Neha , Rich Antonia 
Published: February 2025

ObjectiveThe attrition of medical students is an incredibly important problem feeding into healthcare workforce issues. This study seeks to explore the relationships between various mental health issues and dropout.DesignThis is a longitudinal study where medical students completed an online questionnaire between November 2020 and February 2021 and those who took part were invited (February–May 2021) to complete the questionnaire again 3 months later.SettingsStudents from nine geographically spread medical schools in the UK took part in this study.Participants792 (71.16%) participants filled in the baseline questionnaire and 407 (51.39%) of these students completed the follow-up survey (385 participants were lost to follow-up).Outcome measuresDropout intentions.ExposuresVarious mental ill-health symptoms using validated scales: emotional exhaustion, insomnia, somatisation, hazardous drinking, anxiety/depression, anorexia tendencies, obsessive-compulsive disorder (OCD), paranoia and bipolar.ResultsA large number of students met the criteria for mental health disorders (eg, 54.1% insomnia, 37.9% anxiety/depression, 19.4% paranoia) and 19.4% (79) said that they considered dropping out from medical school. Those students who were more emotionally exhausted (Badjusted=0.94, p<0.0001) and expressed higher anxiety/depression symptoms (Badjusted=1.12, p<0.0001), insomnia symptoms (Badjusted=0.69, p<0.0001), somatisation symptoms (Badjusted=0.77, p<0.0001), anorexia tendencies (Badjusted=−0.84, p<0.0001), OCD symptoms (Badjusted=0.61, p<0.0001) and paranoia symptoms (Badjusted=0.52, p<0.0001) expressed significantly stronger intentions to leave their medical education. Hazardous drinking and bipolar symptoms did not predict students’ intention to drop out (p>0.05).ConclusionsA substantial number of UK medical students experienced mental ill-health symptoms, about one in five medical students considers leaving medical school, and mental ill-health symptoms contributed to students’ intentions to leave their medical education. Medical schools should improve the learning environment for students and encourage them to seek help to reduce the stigma of mental ill-health symptoms (eg, through education, signposting). It may be useful for medical schools to help applicants/medical students understand whether medical school is the right decision for them and provide them with resources should they wish to leave.
Understanding cardiac arrest dispatch of physician-paramedic critical care prehospital teams: a survey-based evaluation
Authors: Morton Sarah , Eagle Chris , Wallman Scott , Wareham Gaynor , Major Rob , Edmunds Christopher , McLachlan Sarah 
Published: February 2025

BackgroundAppropriate dispatch of critical care teams to out-of-hospital cardiac arrest (OHCA) has been identified as a research priority emergency care in the UK. The study aimed to understand the criteria informing the decision to dispatch a critical care physician-paramedic prehospital team to OHCA in one UK region.MethodsAn invitation to participate in an anonymised online survey was sent by email to clinicians and non-clinicians working on the critical care (physician-paramedic) dispatch desk for the East of England Ambulance Service NHS Trust between June and July 2023. Demographic data relating to the experience of the dispatchers were collected alongside evaluating the effect of 15 predetermined criteria on OHCA dispatch (based on a pilot survey) on their decision to dispatch a physician-paramedic team. Responses to closed-end questions were calculated as percentages. A compulsory free text question on dispatching the physician-paramedic team was included. Free text data were interpreted by one author and the interpretation reviewed by all authors.Results20 respondents (19 critical care paramedics and one non-clinical dispatcher) participated, yielding a 79% response rate for clinical and 17% for non-clinical dispatchers. ‘Witnessed cardiac arrest’ and return of spontaneous circulation achieved on scene were criteria used by 100% of respondents in informing dispatch of a physician-paramedic team to OHCA. 10 of the 15 preidentified criteria were considered important in their decision-making by at least 75% of respondents. ‘Age’ was considered as more than just a number, instead incorporating both the nuances of a paediatric cardiac arrest and the importance of physiological reserve and frailty.ConclusionThe only 100% agreement in dispatch criteria was ‘witnessed arrest’. Otherwise, variation existed and additional information, like identification of frailty, was gathered to support nuanced decision-making. Wider research across the UK would help identify factors and commonalities in OHCA physician-paramedic dispatch to target improved survival rates.
Insufficient sleep, impaired sleep and medically treated injury in Canadian adolescents: a national cross-sectional study
Authors: Pagnotta Valerie Frances , Liu Jian , Vine Michelle , Pickett William 
Published: February 2025

BackgroundInsufficient and impaired sleep are common in adolescents and can adversely impact health and well-being. One likely consequence of poor sleep is a risk of unintentional injuries, yet the evidence base is limited for such relationships. We, therefore, documented contemporary sleeping behaviours of young people in Canada and examined relationships between these behaviours and risks for injury.MethodsA cross-sectional study was employed using records from the 2017/2018 Canadian Health Behaviour in School-aged Children study (n=21 745). Indicators of poor sleep (insufficient sleep on school and non-school days, impaired sleep, daytime sleepiness) and annual reports of medically treated injuries (any, serious) were obtained. Descriptive and hierarchical modified Poisson regression analyses were performed to explore these relationships, while controlling for potential confounders.ResultsInsufficient sleep, impaired sleep and daytime sleepiness were reported by 11.3–35.3% of adolescents; variations in these estimates were observed by gender. Sleep indicators were modestly but consistently associated with risks for the occurrence of ‘any injury’, whereas impaired sleep and daytime sleepiness were the only meaningful and significant risk factors for ‘serious injuries’ in adjusted models (prevalence ratio range: 1.18–1.30). The analysis of interactions revealed boys with insufficient sleep on non-school days as well as impaired sleep to have higher injury risks compared with girls.Discussion and conclusionsImpaired sleep and its effects have emerged as a quiet epidemic, affecting up to one-third of Canadian adolescents and being associated with risks for injury. Sleep hygiene may therefore act as a plausible focus for clinical and public health initiatives to mitigate injury risks.
New physics in spin entanglement
Authors: Duch Mateusz , Strumia Alessandro , Titov Arsenii 
Published: February 2025

Abstract
We propose a theory that preserves spin-summed scattering and decay rates at tree level while affecting particle spins. This is achieved by breaking the Lorentz group in a non-local way that tries avoiding stringent constraints, for example leaving unbroken the maximal sub-group SIM(2). As a phenomenological application, this new physics can alter the spins of top-antitop pairs (and consequently their entanglement) produced in pp collisions without impacting their rates. Some observables affected by loops involving top quarks with modified entanglement receive corrections.
Research on Flashover Characteristics and Charge Evolution Mechanism of Silicone Rubber Under Different Temperature and Pressure
Authors: Xu Fengyuan , Zhang Liankang , Feng Hao , Li Guochang , Zhu Yuanwei , Wei Yanhui 
Published: February 2025

The interface between gas and insulation dielectric is one of the weakest links in the insulation of electrical equipment. This paper focuses on the influence of temperature and pressure on the surface flashover of silicone rubber under the action of AC electric field was studied by combining simulation and experiment, and the influence mechanism of temperature and pressure on the surface flashover was revealed. The experimental results show that the flashover voltage decreases from 12.24 kV to 9.43 kV when the temperature increases from −40 °C to 60 °C. Meanwhile, the pressure decreases from 1 atm to 0.5 atm, and the flashover voltage decreases from 10.24 kV to 6.43 kV. At the same time, the lower temperature weakens the ionization process, resulting in less electron accumulation. The simulation results show that the electron density of the material surface decreases from 1.41 × 1019 m−3 to 8.46 × 1018 m−3. As the pressure decreases, the impact-ionization process is enhanced, resulting in increased electron accumulation. The electron density of the material surface increases from 2.25 × 1019 m−3 to 6.59 × 1019 m−3. This work has important guiding significance for studying the influence mechanism of different environments on flashover.
Experiences of Empathy‐Based Stress Among Care Staff Supporting Children and Adolescents With Intellectual Disabilities and/or Autism in Residential and Respite Services: A Qualitative Exploration
Authors: Madden Riona , Coffey Laura 
Published: February 2025

Background: Care staff in the disability sector experience high levels of work‐related stress and burnout, which contribute to high staff turnover and limited residential service capacity and affect both staff well‐being and the quality of care provided. Little is currently known about the impact that exposure to secondary trauma has on care staff, which could put them at risk of experiencing empathy‐based stress. This qualitative study aimed to explore how empathy‐based stress is experienced by care staff supporting children and adolescents with intellectual disabilities and/or autism in residential and respite services, and the factors they perceive as contributing towards or protecting them from experiencing empathy‐based stress.Methods: Twelve care staff from four different community‐based organisations in Ireland (two residential care and two overnight respite) took part in online semistructured interviews, which were recorded and transcribed verbatim. Reflexive thematic analysis was used to analyse the data.Results: Four themes were identified, which had two to three subthemes each: (i) Challenging Periods (exposure to distress and trauma, empathy and feeling powerless), (ii) Organisational Factors (lack of support from management, training and staff cohesion), (iii) Personal Resilience (awareness, focussing on the positives) and (iv) Impact of Empathy‐Based Stress (negative work affect, adverse impact on health and well‐being).Conclusion: Staff were exposed to service user distress or trauma, which at times initiated an empathy‐based stress process. A build‐up of factors, both individual and contextual, led to adverse physical and psychological outcomes and negative work affect. These findings have implications for policy and practice within disability care settings and suggest that interventions at a personal and organisational level and the adoption of a trauma‐informed approach may help to reduce empathy‐based stress in care staff and improve quality of care for service users.
Bābur and Muḥammad Šaybānī: Fighting for Literary Pre-eminence in Early 16th-Century Central Asia
Authors: Péri Benedek 
Published: February 2025

Abstract
Rival rulers of the Persianate Turkic cosmopolis often clashed not only on the battlefield in the late 15th–early 16th centuries, but also competed with each other in the virtual space of literary accomplishments. Two outstanding Central Asian characters of the period, namely Ẓahīr ad-Dīn Muḥammad Bābur (d. 1530) and his nemesis, Muḥammad Šaybānī Ḫān (d. 1510) also fought each other both in bloody battles and on the literary sphere. As is well known, their political rivalry ended with Bābur’s defeat on the battlefield. It is less known, however, how these two individuals fared against each other on the literary scene. The present article seeks to offer a comparative analysis of the two statesmen’s poetic accomplishments with the hope of showing how close attention to these two figure’s imitation ghazals can contribute to a better understanding of their respective literary personalities.
Serum magnesium levels and the risk of acute kidney injury in ICU patients with acute pancreatitis: A MIMIC-IV cohort study
Authors: Zhou Xuehong , Jin Shoubing , Wu Dong , Su Wantong 
Published: February 2025

Objective This cohort study investigated the relationship between serum magnesium levels and the incidence of acute kidney injury (AKI) in patients with acute pancreatitis (AP). Methods We analyzed data from the Medical Information Mart for Intensive Care IV (MIMIC-IV) database, focusing on adult AP patients (≥18 years old) with ICU stays longer than 24 h. Univariable logistic regression was used to identify key covariates. Both univariate and multivariable logistic regression models were used to evaluate the link between serum magnesium levels and AKI occurrence. A restricted cubic spline (RCS) was used to visualize the associations, and odds ratios (ORs) with 95% confidence intervals (CIs) were calculated. Results During hospitalization, 455 (69.1%) participants experienced AKI. After adjusting for relevant factors, higher serum magnesium concentrations were significantly associated with AKI (OR: 2.247, 95% CI: 1.234–4.091; p = 0.008). Magnesium levels between 1.6–2.6 mg/dL (OR: 1.872, 95% CI: 1.105–1.174, p = 0.020) and ≥2.6 mg/dL (OR: 3.851, 95% CI: 1.08–13.736, p = 0.038) were linked to increased AKI occurrence. The RCS curve indicated a nonlinear relationship, suggesting a potential threshold effect between serum magnesium and AKI risk. Conclusions Higher serum magnesium levels were found to be associated with AKI in ICU patients with acute pancreatitis. Further studies are needed to explore this relationship.
Comparison of pulmonary function between sleeve lobectomy and standard lobectomy
Authors: Kuroda Sanae , Nishikubo Megumi , Haga Nanase , Nishioka Yuki , Shimizu Nahoko , Nishio Wataru 
Published: February 2025

Background The extent of anastomotic stenosis after sleeve lobectomy (SL) remains unclear, and there are limited reports on postoperative pulmonary function. This study aimed to compare postoperative pulmonary function between SL and standard lobectomy (STL) and to evaluate anastomotic stenosis in SL. Methods This study included 44 SL patients and 825 STL patients from 2012 to 2023. Post- or preoperative forced expiratory volume in 1 s (FEV1.0) values (FEV1.0 preservation rate) were analyzed and compared between the SL and STL groups. The lobe expanded rate values, calculated using volumes of the lung lobe(s) distal to the bronchial anastomosis in the SL group and the corresponding lobe(s) in the STL group, measured using three-dimensional computed tomography (3D-CT), were analyzed and compared. In the SL group, the surface area of the lumen at the site corresponding to the bronchial anastomosis was measured on 3D-CT, and the postoperative/preoperative value (bronchus stenosis rate) was calculated. Results The SL and STL groups significantly differed in terms of the FEV1.0 preservation rate (84.6% vs. 87.7%, p = 0.180); however, the lobe expanded rate was significantly lower in the SL group (119.1% vs. 134.6% p = 0.009). The average bronchus stenosis rate was 64.3%, with no significant difference between wedge and circumferential bronchial resection groups (63.4% vs. 66.4%, p = 0.730). Conclusion The volume of the lung lobe(s) distal to the bronchial anastomosis after SL was lower than that after STL. However, this did not affect postoperative pulmonary function. The type of bronchoplasty did not influence the development of anastomotic stenosis.
Combined Correction of Coronal and Rotational Deformities of the Femur With Distal Femoral Osteotomy Using Patient-Specific Instrumentation
Authors: Neopoulos Georgios , Jud Lukas , Vlachopoulos Lazaros , Fucentese Sandro F. 
Published: February 2025

Background: Distal femoral osteotomy (DFO) can be used to simultaneously correct coronal and rotational deformities. Patient-specific instruments (PSIs) are known to be helpful in such complex osteotomies, but data on surgical accuracy for the combined correction of coronal and rotational deformities of the femur are missing. Purpose: To investigate the radiological results of DFO for simultaneous correction of coronal and rotational deformities using PSIs. Study Design: Case series; Level of evidence, 3. Methods: All included patients underwent DFO (34 patients, 36 knees) using PSIs for combined correction of coronal and rotational deformities. The hip-knee-ankle angle (HKA) was measured in weightbearing long-leg radiographs, and the femoral torsion was assessed using computed tomography scans, both pre- and postoperatively. The achieved corrections of HKA and femoral torsion were determined for each knee, and surgical accuracy was calculated. Results: HKA and femoral torsion changed significantly from preoperatively to postoperatively (from 2.4° ± 3.6° vs 0.1° ± 1.8° [ P < .001] and 31.2° ± 17.2° vs 18.7° ± 7.4° [ P < .001]). The difference from planned to achieved correction was statistically greater for HKA (–2.9° ± 3.8° vs –2.3° ± 3.5°; P = .018) than for femoral torsion (–12.4° ± 11.8° vs –12.3° ± 12.2°; P = .771), which did not reach significance. The accuracies of HKA and femoral torsion correction were 1.1° ± 1° and 2.4° ± 1.9°, respectively. Conclusion: Coronal and rotational deformities of the femur can accurately be corrected simultaneously by a DFO, utilizing PSIs. High accuracy was achieved for the correction of both coronal and rotational deformities, with absolute mean differences from planned to achieved correction of 1.1° and 2.4°, respectively.
Artificial intelligence based BCI using SSVEP signals with single channel EEG
Authors: Kanagaluru Venkatesh , M Sasikala 
Published: February 2025

Background Brain–Computer Interfaces (BCIs) enable direct communication between the brain and external devices. Steady-state visual-evoked potentials (SSVEPs) are particularly useful in BCIs because of their rapid communication capabilities and minimal calibration requirements. Although SSVEP-based BCIs are highly effective, traditional classification methods face challenges in maintaining high accuracy with minimal EEG channels, especially in real-world applications. There is a growing need for improved classification techniques to enhance performance and efficiency. Objective The aim of this research is to improve the classification of SSVEP signals using machine-learning algorithms. This involves extracting dominant frequency features from SSVEP data and applying classifiers such as Decision Tree (DT), Linear Discriminant Analysis (LDA), and Support Vector Machine (SVM) to achieve high accuracy while reducing the number of EEG channels required, making the method practical for BCI applications. Methods SSVEP data were collected from the Benchmark Dataset at Tsinghua BCI Lab using 64 EEG channels per subject. The Oz channel was selected as the dominant channel for analysis. Wavelet decomposition (db4) was used to extract frequency features in the range 7.8 Hz to 15.6 Hz. The frequency of the maximum amplitude within a 5-s window was extracted as the key feature, and machine learning models (DT, LDA, and SVM) were applied to classify these features. Results The proposed method achieved a high classification accuracy, with 95.8% for DT and 96.7% for both LDA and SVM. These results show significant improvement over existing methods, indicating the potential of this approach for BCI applications. Conclusion This study demonstrates that SSVEP classification using machine-learning models improves accuracy and efficiency. The use of wavelet decomposition for feature extraction and machine learning for classification offers a robust method for SSVEP-based BCIs. This method is promising for assistive technologies and other BCI applications.
Systematic literature review of intravenous immunoglobulin use in non-renal and non-hematologic systemic lupus erytehmatosus
Authors: Primo-Gabriel Cristina , García-Gómez Carmen , Calvo-Alén Jaime 
Published: February 2025

Objective: Intravenous immunoglobulins (IVIG) are an established treatment in several immune-mediated diseases such as dermatomyositis or Kawasaki disease and they have been used in distinct clinical scenarios in systemic lupus erythematosus (SLE). However, in this latter disease no clear evidence besides hematological or renal involvement supports its use. The aim of the present study is to establish evidence for the treatment of non-renal non-hematological lupus with IVIG. Methods: We have carried out a systematic literature review following PRYSMA principles on the use of this treatment in SLE patients with no renal no hematologic manifestations. Results: We found 35 articles which were split into two subtypes, those with individualized data (29) and those with grouped data. Overall, 198 lupus patients treated with IVIGs [178 (90%) women and 20 (10%) men] were included. In 167 (84.3%) a clinical response was obtained [62 (31.3%) complete and 105 (53%) a partial one]. Adverse events were reported in 40 patients (20.2%), most of them mild with only 2 (1%) severe. According to individualized data, all cases with respiratory problems (5), 82.4% of those with cardiac involvement (18) and 53.8% of those with neuropsychiatric manifestations (18) achieved a complete response as more outstanding results. Conclusions: After reviewing the experience of the use of IVIGs in extra-renal and extra-hematologic SLE patients, this treatment is demonstrated to be useful in refractory cases, especially in pulmonary, cardiac or neuropsychiatric complications with a good safety profile.