bluuebunny/crossref_metadata_2025_split huggingface dataset:
Implementing Formal Mitral Heart Team Improves Multidisciplinary Evaluation Rate and Survival of Patients With Severe Primary Mitral Regurgitation
Authors: Waldron Christina , Mori Makoto , Krane Markus , Reinhardt Samuel W. , Ahmad Yousif , Kaple Ryan , Forrest John K. , Geirsson Arnar 
Published: February 2024

Background
Multidisciplinary heart team (HT) evaluation is recommended for patients with severe primary mitral regurgitation to optimize treatment decisions. However, its impact on patient outcomes remains unknown. We evaluated the impact of implementing mitral HT on patient survival.

Methods and Results

We conducted a retrospective cohort study of patients with new diagnoses of severe primary mitral regurgitation in a large healthcare network echocardiogram database between 2016 and 2020. We compared the incidence of multidisciplinary evaluation by structural cardiology and cardiac surgery services and 2‐year survival before and after mitral HT implementation. The 1:1 propensity‐score matching between pre‐ and post‐mitral HT used Society of Thoracic Surgeons Predicted Risk of Mortality for mitral repair, age, sex, race, heart failure symptoms, inpatient setting, history of MI, and dementia as covariates. Logistic regression identified variables associated with the likelihood of undergoing multidisciplinary evaluation. Among 70 510 echocardiograms performed, 391 patients had severe primary mitral regurgitation (median age, 77 years; 46% women). Multidisciplinary evaluation increased from 29% to 89% (
P
<0.001), and intervention increased from 24% to 75% following mitral HT implementation (
P
<0.001). Among 180 propensity‐score matched patients, mortality was lower post‐mitral HT at 2 years (19% versus 32%,
P
=0.04). The multivariable model showed that mitral HT implementation and heart failure symptoms were associated with higher odds of undergoing multidisciplinary evaluation (OR [odds ratio], 18.7 and 2.72, respectively), whereas female sex and older age were associated with lower odds (OR, 0.39 and 0.93, respectively).

Conclusions
Implementation of mitral HT was associated with drastic improvement in multidisciplinary evaluation for patients with severe primary mitral regurgitation. This coincided with higher proportions of patients undergoing mechanical correction of MR and improved overall patient survival.
Impaired brain-heart axis in focal epilepsy: Alterations in information flow and implications for seizure dynamics
Authors: Frassineti Lorenzo , Catrambone Vincenzo , Lanatà Antonio , Valenza Gaetano 
Published: February 2024

Abstract
This study delves into functional brain-heart interplay (BHI) dynamics during interictal periods before and after seizure events in focal epilepsy. Our analysis focuses on elucidating the causal interaction between cortical and autonomic nervous system (ANS) oscillations, employing electroencephalography and heart rate variability series. The dataset for this investigation comprises 47 seizure events from 14 independent subjects, obtained from the publicly available Siena Dataset. Our findings reveal an impaired brain-heart axis especially in the heart-to-brain functional direction. This is particularly evident in bottom-up oscillations originating from sympathovagal activity during the transition between preictal and postictal periods. These results indicate a pivotal role of the ANS in epilepsy dynamics. Notably, the brain-to-heart information flow targeting cardiac oscillations in the low-frequency band does not display significant changes. However, there are noteworthy changes in cortical oscillations, primarily originating in central regions, influencing heartbeat oscillations in the high-frequency band. Our study conceptualizes seizures as a state of hyperexcitability and a network disease affecting both cortical and peripheral neural dynamics. Our results pave the way for a deeper understanding of BHI in epilepsy, which holds promise for the development of advanced diagnostic and therapeutic approaches also based on bodily neural activity for individuals living with epilepsy.
A Review of Saudi E-Commerce Regulation Under the Scope of the GDPR
Authors: Bouderhem Rabaï 
Published: February 2024

Abstract
The purpose of this article is to analyse and make an initial assessment of the Saudi legislative framework regarding E-commerce and data protection throughout a set of rules imposed on Internet service providers (ISPs) to ensure confidentiality, integrity of data and the safety of online transactions. Some efforts have been made in the Middle East and beyond and making an initial assessment may help us strengthen the existing legal instruments. The basic postulate is that we deal with cybercrimes and potential transnational offences. States should cooperate on a bilateral and multilateral basis in order to increase data protection and both security and predictability of E-commerce. The analysis of European law which opted very early for increased protection of personal data and strict regulation of cyberspace could allow us to put into perspective the evolution of Saudi law and possibly try to bridge or improve its approach to the matter.
From Athens to Alexandria: What Damascius Learned from Ammonius
Authors: Golitsis Pantelis 
Published: February 2024

Abstract
Damascius of Damascus, last ‘Platonic successor’ in Athens, is rarely compared to one of his masters, namely Ammonius, the philosopher of Alexandria. When scholars do compare the two Neoplatonist philosophers, they usually focus on the negative picture of Ammonius, which is drawn by Damascius in his Philosophical History. In this paper, I argue that Damascius admired Ammonius’ intellectual endeavours and espoused a basic feature of the philosophical exegesis of his master, namely his concordism regarding the philosophies of Plato and Aristotle, as is evident in Damascius’ surviving work on Plato and his (fragmentarily preserved) treatise On Time. Damascius’ downgrading of Ammonius came about rather as a disappointment, which is however by no means fully justified.
Wood of Qualea from the Piedra Chamana in-situ fossil forest (late Middle Eocene, Peru) and the comparative wood anatomy of Vochysiaceae and Myrtaceae
Authors: Woodcock Deborah W. 
Published: February 2024

Summary
A wood from a late Middle Eocene in-situ fossil forest in northern Peru shows affinity with Qualea (Vochysiaceae), a genus of South American lowland tropical trees, based on features including vestured pits, aliform-confluent to banded paratracheal parenchyma, and homocellular rays. Additional features suggest adaptation to dry conditions. The fossil is named as a new species within Qualeoxylon (Q. lafila). Vochysiaceae and sister-group Myrtaceae share features unique to Myrtales (vestured pits, intraxylary phloem) or common in the order (vessels generally solitary and in >1 diameter class, heterocellular rays) but in other ways are clearly differentiated. Vochysiaceae has narrow to very wide vessels with elaborated axial parenchyma and lacks most characters considered less specialized such as scalariform perforations. Myrtaceae generally has vessels with vasicentric tracheids, usually exclusively solitary, very narrow to wide, and often diagonally arranged, and includes taxa with less to more specialized features. Woods with elaborated paratracheal parenchyma and vessels wide to very wide occur in wet tropical forest environments in both families Erisma, Vochysia and Qualea/Ruizterania (Vochysiaceae) in the Neotropics and Syzygium (Myrtaceae) in the Asian tropics. The Eucalyptus spp. dominating open forests in Australia have typical myrtaceous features (including vasicentric tracheids) plus homocellular rays, whereas the eucalypt clade Angophora + Corymbia, occurring mainly in the northern, monsoonal regions of Australia, has both vasicentric tracheids and aliform to banded axial parenchyma. The fossil is an early record for Vochysiaceae and adds to indications that Vochysiaceae and sister-group Myrtaceae showed significant diversification by the late Paleogene.
A Machine Learning Approach to Improve the Usability of Severe Thunderstorm Wind Reports
Authors: Tirone Elizabeth , Pal Subrata , Gallus William A. , Dutta Somak , Maitra Ranjan , Newman Jennifer , Weber Eric , Jirak Israel 
Published: February 2024

Abstract
Many concerns are known to exist with thunderstorm wind reports in the National Center for Environmental Information Storm Events Database, including the overestimation of wind speed, changes in report frequency due to population density, and differences in reporting due to damage tracers. These concerns are especially pronounced with reports that are not associated with a wind speed measurement, but are estimated, which make up almost 90% of the database. We have used machine learning to predict the probability that a severe wind report was caused by severe intensity wind, or wind ≥ 50 kt (∼25 m s−1). A total of six machine learning models were trained on 11 years of measured thunderstorm wind reports, along with meteorological parameters, population density, and elevation. Objective skill metrics such as the area under the ROC curve (AUC), Brier score, and reliability curves suggest that the best performing model is the stacked generalized linear model, which has an AUC around 0.9 and a Brier score around 0.1. The outputs from these models have many potential uses such as forecast verification and quality control for implementation in forecast tools. Our tool was evaluated favorably at the Hazardous Weather Testbed Spring Forecasting Experiments in 2020, 2021, and 2022.
The psychopathology among the offspring of schizophrenia and bipolar I disorder patients in an Egyptian sample: A comparative study
Authors: Gabrielle Fiby Fayez , Refaat Ghada , Mahmoud Dalia Abdel Moneim , Ezzat Lina , Hassan Kasem Rania Elsayed 
Published: February 2024

Background: A variety of psychiatric illnesses can develop in children of parents who suffer from bipolar affective disorder. Aims: The purpose of the research was to investigate, among the offsprings of patients diagnosed with schizophrenia and bipolar disorder type I, the prevalence of a variety of psychiatric diseases as well as a range of behavioral abnormalities. Method: This was a cross-sectional observational comparative study. The outpatient psychiatric clinics at Shebin Elkom Mental Health Hospital, Menofia Governorate, Egypt 500 offspring (there were 250 offspring of parents both diagnosed with schizophrenia and 250 offsprings born to parents with bipolar affective disorder). Results: Statistically significant association of male gender with somatic complaints, social problems, and attention problems in the bipolar offspring group. In addition, there was a statistically significant association between female gender and anxiety or depression in the bipolar offspring group. Moreover, there was a statistically significant association between male gender and thought problems and aggressive behavior in the schizophrenia group. Assessment of psychiatric symptoms using K-SADS in relation to gender revealed a statistically significant association of male gender with affective disorder, behavioral disorder, and substance use disorder in the bipolar offspring group. Moreover, there was a statistically significant association between female gender and psychotic disorder in the schizophrenia group. Conclusion: We concluded that offspring with bipolar illness had a significant association with somatic symptoms, anxiety/depressive disorder, social issues, attention problems, and aggressive behavior. Schizophrenia offspring were strongly related to thought issues.
Dysphoric Milk Ejection Reflex in Human Lactation: An Integrative Literature Review
Authors: Lynn Herr Stephanie , Devido Jessica , Zoucha Richard , Demirci Jill R. 
Published: February 2024

Background: Dysphoric Milk Ejection Reflex is an understudied condition of lactation involving emotional dysregulation during letdown or milk ejection. Affected individuals may experience transient feelings of helplessness, melancholy, and general unhappiness. Research Aim: To evaluate the scope of published literature on Dysphoric Milk Ejection Reflex. Method: Whittemore and Knafl’s methodology guided this integrative review. Five databases were searched for primary research, summaries, and editorials on Dysphoric Milk Ejection Reflex in lactating individuals. Literature searched also included websites, pamphlets, and conference proceedings via Google and Google Scholar. A total of 11 articles, from five different countries, met inclusion criteria for review. Results: Studies on Dysphoric Milk Ejection Reflex and negative emotional sensations during lactation were synthesized under five conceptual umbrellas: (1) Experiences, Sensations, and Symptom Management; (2) Biological Underpinnings; (3) Influence on Maternal Role and Breastfeeding Self-Efficacy; (4) Support, Understanding, and Awareness; and (5) Reduction and Cessation of Breastfeeding. Conclusion: Dysphoric Milk Ejection Reflex is a neurobiological condition characterized by low mood and negative feelings during milk ejection throughout lactation. Dysphoric Milk Ejection Reflex is linked to maternal psychological distress and breastfeeding discontinuation. Priority areas for future research include biological origins and interventions aimed at prevention, symptom control, and greater awareness of the condition on a more international scope.
Overjet in Infants: A Cross-Sectional Study
Authors: El-Rabbany Mohamed , Shargo Ryan , Ricalde Pat 
Published: February 2024

Objective The purpose of this study was to determine the normal ranges for overjet in healthy infants under 12 months of age. Design A cross sectional study of consecutive patients below 12 months of age. Setting The study was conducted at a private practice in Tampa, FL that specializes in pediatric craniomaxillofacial disorders. Patients All patients under the age 12 months were considered for entry into the study. Patients were excluded if they had temporomandibular joint pathology, sleep disordered breathing, facial trauma, or were diagnosed with a craniofacial anomaly. Interventions Measures of overjet, defined as the distance between the anterior surfaces of the alveolar ridges when in centric relation, were obtained. Main Outcome Measure The primary study outcome was the overjet of the enrolled patients. Results A total of 152 infants were included in this study. Of these, 51 were female, and 40 were born prematurely (ranging from 32–37 weeks of gestation). In neonates below 1 month of age, the mean overjet was 2.25 mm (95% CI 1.31–3.19). Multivariate linear regression analysis showed overjet to significantly decrease with age, at a mean rate of approximately 0.1 mm per month (coefficient of −0.09, 95% CI −1.61 to −0.02, p = 0.01). When controlling for potential confounders, average overjet was not shown to vary significantly between the sexes, with prematurity, with race, or with primary diagnosis at presentation. Conclusion This paper establishes normative values for overjet in infants below 12 months of age.
Factors Associated with Parametrial Involvement in Endometrial Carcinoma in Patients Treated with Radical Hysterectomy
Authors: Barquet-Muñoz Salim , Bandala-Jaques Antonio , Perez-Montiel Ma Delia , Prada Diddier , Martínez-Flores Marithe , Salcedo-Hernández Rosa A. , Pérez-Plasencia Carlos , Gonzalez-Enciso Aaron , Leon David Cantu-de 
Published: February 2024

Introduction Describe factors associated with parametrial involvement, and how these factors modify the prognosis of patients with endometrial carcinoma treated with radical hysterectomy. Methods Observational study in which categorized patients according to those with and without parametrial involvement. A descriptive analysis and comparative analysis were performed for associations between parametrial spread and clinical, surgical, and pathology variables. Results We analyzed 85 patients, which 18 (21%) had parametrial involvement. Pathology factors associated with parametrial involvement were the endometrioid subtype, grade 3, and variants of poor prognosis (odds ratio (OR) 3.41, 95% CI 1.09-10.64; P = 0.035), myometrial invasion of over 50% (OR 7.76, 95% CI 1.65-36.44; P = 0.009), serosal involvement (OR 17.07, 95% CI 3.87-75.35; P < 0.001), ovarian metastasis (OR 5.15, 95% CI 1.36-19.46; P = 0.016), positive peritoneal cytology (OR 3.9, 95% CI 1.04-14.77; P = 0.044), and lymph node metastasis (OR 3.4; 95% CI 1.16-9.97; P = 0.026). Five-year disease-free survival was 74% (95% CI 57.4-85.4) for the group without parametrial spread and 50.8% (95% CI 22.7-73.4) for the group with parametrial spread ( P = 0.001). Similarly, 5-year overall survival was 85.2% (95% CI 67.9-93.6) for the group without parametrial spread and 47.5% (95% CI 8.1-80.2) for the group with parametrial spread ( P = 0.002). Conclusion Factors associated with parametrial involvement were histologies of poor prognosis, tumors affecting uterine serosa, cervix, or spread beyond the uterus. Additionally, parametrial involvement directly affects prognosis by reducing overall survival, disease-free survival and increasing odds for recurrence.
Optimal insertion site for ultrasound-guided radial artery catheterization utilizing the dynamic needle tip positioning technique: A prospective randomized controlled study
Authors: Sun Jiahui , Lu Bo , Shan Jianbo , Pan Zhihao , Sun Jianliang 
Published: February 2024

Background: The dynamic needle tip positioning technique represents an advanced version of the short-axis out-of-plane ultrasound-guided approach employed for radial artery catheterization. The study aimed to explore the most effective insertion site capable of expeditiously and accurately executing the procedure in a clinical setting. Methods: A prospective randomized controlled study encompassed 246 elective surgery patients necessitating invasive arterial monitoring. Participants were randomly assigned to three distinct groups: Site 1 (targeting the radial styloid process), Site 2 (midway between Sites 1 and 3), and Site 3 (distal one-third of the forearm). The dynamic needle tip positioning technique was implemented across all groups. Crucial parameters, such as first-attempt success rate, time to success, overall success rate, total catheterization time, number of attempts, and complications, were meticulously documented and compared. Results: The Site 2 cohort presented a significantly heightened first-attempt success rate compared to Site 1 (97.5% vs 80%, p = 0.003) and Site 3 (97.5% vs 81.25%, p = 0.006). Moreover, Site 2 displayed a reduced time to success in contrast to Site 1 (31.5 vs 38, p = 0.003) and Site 3 (31.5 vs 40, p = 0.006). Total catheterization time was significantly shorter in Site 2 compared to Site 1 (32 vs 42.5, p < 0.001) and Site 3 (32 vs 43.5, p < 0.001). Site 2 necessitated fewer attempts than Site 1 ( p = 0.02) and Site 3 ( p = 0.03). Male gender and puncture at Site 2 were associated with expedited time to success. Adverse events manifested more frequently in the Site 3 group compared to the Site 1 group (15% vs 3.75%, p = 0.03) and the Site 2 group (15% vs 2.5%, p = 0.01). Conclusions: The optimal insertion site for ultrasound-guided radial artery catheterization utilizing the dynamic needle tip positioning technique in adult patients is situated midway between the radial styloid process and the distal one-third of the forearm.
Problems with “problem behavior”: A secondary systematic review of intervention research on transition-age autistic youth
Authors: Bottema-Beutel Kristen , McKinnon Rachael , Mohiuddin Sarah , LaPoint Shannon Crowley , Kim So Yoon 
Published: February 2024

In this secondary systematic review of single-case and controlled group design intervention studies conducted with transition-age autistic youth, we examined features of 48 studies with 273 participants that measured at least one “problem behavior” outcome (Prospero registration number: 231764). We searched 11 databases for relevant studies, and the final search date was November 2022. Our primary aims were to determine how problem behaviors were defined and selected for reduction, how functions were determined, and the interventions used to address them. Studies were coded and codes were tabulated and converted to percentages to answer each research question. Thirty-eight percent of studies defined problem behavior, and 88% of studies implemented behavioral strategies to reduce problem behaviors. Behaviors with low potential for harm constituted the majority of the 67 outcome variables (61%), while behaviors with high potential for harm were a minority (39%). The most common intervention target was stereotypic behavior. Fewer than half of studies: reported procedures for selecting behaviors, reported procedures to determine behavior function, or ascribed functions to behaviors. We were unable to report on some demographic features of participants (e.g. race/ethnicity) because they were rarely reported in primary studies. We conclude that problem behavior is poorly conceptualized in this research. Lay abstract In a previous study, we looked at research done on strategies to support autistic people who were between 14 and 22 years old. For this study, we looked at all of the studies in our previous study that tried to decrease or stop autistic people from doing certain things—many researchers call these things “problem behavior.” There were 48 studies that tried to reduce problem behavior, and most of them used strategies like prompting and reinforcement to try get autistic people to change their behavior. We found many things wrong with these studies. Most of them did not define the group of behaviors they were trying to stop autistic people from doing. None of the studies looked at whether any side effects happened when they tried the strategy they were studying. Also, most of the studies tried to stop autistic people from doing behaviors that probably were not harmful, like stereotypic behavior. Most of the studies did not say how they decided that the behaviors they tried to stop were a problem for the autistic people in the study, and most studies did not try to figure out why the autistic people in the study did the behaviors the researchers were trying to stop them from doing.