bluuebunny/crossref_metadata_2025_split huggingface dataset:
Optimizing Wait Times: Enhancing Server Accessibility with Two-Phase Imperative Services and Backup Server
Authors: Rathinasamy Poornima , Kirupa K. 
Published: January 2025

This article analyses a bulk arrival retrial queueing system with a single server and two-stage service coupled with a backup server. Client arrivals occur in batches following a compound Poisson process. If the server is idle, one of the clients from the batch receives the first-stage service immediately, and the rest join the orbit. Otherwise, the entire arriving batch joins the orbit. Once the first stage of service is completed, the client moves to the second stage of the service facility. Unsatisfied clients after receiving two stages of service may become feedback clients. After every two-stage service completion, the server may take a vacation of random length. The server has the option to extend its vacation. Breakdowns of the main server can occur at any point during the busy state, and the server has the option to choose its repair type with probabilities. During the vacation and repair period of the main server, clients receive service from a standby (backup) server. Performance measures are derived, stochastic decomposition laws are also verified and special cases are analysed. Numerical results are presented to validate the impact of parameters on the system. Cost analysis and optimization have been carried out for the proposed model. AMS Subject Classification: 60K25, 68M20, 90B22, 90B25
Nurturing subjective wellbeing through ethical climate: The mediating role of psychological empowerment
Authors: Barik Satyajit , Nayak Tanaya 
Published: January 2025

Background In the past couple of years, the concept of “ethical climate” has evolved into an increasingly popular keyword dominating news headlines, producing a worldwide interest. The existence of unethical work environments and ethically dubious business practices has sparked a surge in curiosity about the ethical climate. Objective The main purpose of this study is to examine the potential impact of ethical climate on employee subjective wellbeing, directly as well as indirectly, through a mediator psychological empowerment. Methods A theoretical framework is created by utilizing the situational strength theory. The postulated hypotheses were examined through the analysis of cross-sectional survey data obtained from 435 employees from the Indian IT industry via an online questionnaire. The model was evaluated using SmartPLS 4.0 software. Results The current study established a positive nexus between ethical climate and subjective wellbeing. Additionally, psychological empowerment partially mediates the nexus between ethical climate and subjective wellbeing. Conclusions The present study advanced the ethical climate literature by demonstrating that the ethical climate affects employees’ psychological empowerment and subjective wellbeing. Furthermore, the proposed theoretical model can be applied to different industries inside the country and other countries with similar features.
A Cross-sectional Study of the Length of Stay of Persons with Mental Illnesses and Revenue to a Government Tertiary Neuropsychiatric Hospital Under Ayushman Bharat
Authors: Deepa PS  , Angothu Hareesh , Thanapal Sivakumar , Krishna Prasad M  
Published: January 2025

Background: Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) is a health insurance scheme launched by the Government of India (GOI) in 2018 to cover the in-patient (IP) treatment expenditures, including mental illness treatment expenditures, for 500 million Indians. AB-PMJAY pays 100% of treatment expenditures for persons below the poverty line (BPL) and 30% for people above the poverty line (APL). Ayushman Bharat Arogya Karnataka (ABAK) trust implements this scheme in Karnataka, a southern Indian state. Methods: Data of persons with mental illness (PMI) admitted under AB-PMJAY at a tertiary care neuropsychiatric hospital between 2018 and 2021 was analyzed to understand the socio-demographic and clinical variables, the average length of stay (LOS), and the amount claimed by the hospital. Results: Median LOS for PMI with any clinical diagnoses was 18 days (range 2–145),14 for those with substance use or mood disorders, and 24 days for those with schizophrenia and other psychotic disorders. The hospital claimed an amount of Indian Rupees (INR) 15,291,349 for treating 868 PMI under AB-PMJAY. Conclusions: The minimum and maximum LOS varied 70-fold, and there was a significant difference between different PMIs based on their clinical diagnosis. ABAK paid ₹3,488–12,750 per PMI for their treatment. Further research is needed to determine the variables influencing the LOS and the cost to the implementing agency.
Physiological, Psychological, and Functional Health Determinants of Depressive Symptoms Among the Elderly in India: Evaluation of Classification Performance of XGBoost Models
Authors: Aswathy PV  , Verma Abhishek , Balasankar JM  , Roy Aratrika , Junaid KP 
Published: January 2025

Background: Depression among the elderly is a growing public health concern, especially in India. This study aimed to investigate the predictive validity of physiological, psychological, and functional health factors in classifying the level of depressive symptoms among the elderly using the extreme gradient boosting (XGBoost) technique. Additionally, we compared the performance of models trained on original and resampled data. Methods: This study is entirely based on secondary data analysis of the Longitudinal Aging Study in India wave 1 data. We classified the observations into “high depressive symptom” and “low/no depressive symptom” groups based on the predictors, including physiological, psychological, and functional health factors, along with socio-demographic factors. We developed three models (Models 1, 2, and 3) trained on original, over-sampled, and under-sampled data, respectively. Model performance was evaluated using the metrics of balanced accuracy, sensitivity, specificity, and area under the receiver operating characteristics curve (AUC). Results: The study included 26,065 individuals aged 60 and above. Model 3, trained on under-sampled data, demonstrated the best overall performance. It achieved a balanced accuracy of 64%, with a sensitivity of 62.8% and specificity of 65.2%. The AUC for Model 3 was 0.692. Feature importance analysis revealed that life satisfaction, instrumental activities of daily living, mobility, caste, and monthly per capita expenditure quintiles were among the most influential factors in predicting the level of depressive symptoms. Conclusion: The XGBoost models demonstrate promise in predicting depressive symptoms among the elderly. These findings suggest that machine learning models can be envisaged for early detection and management of depression, especially in primary care.
Machine learning web application for predicting varicose veins utilizing global prevalence data
Authors: Rusinovich Yury , Rusinovich Volha , Doss Markus 
Published: January 2025

Aim This study aimed to develop a web-based machine learning (ML) model to predict the lifetime likelihood of developing varicose veins using global disease prevalence data. Methods We utilized data from a systematic review, registered under PROSPERO (CRD42021279513), which included 81 studies on varicose vein prevalence across various geographic regions. The data used to build the ML model included disease prevalence as the outcome (%), along with the following predictors: mean age, gender distribution (%), mean body mass index (BMI) of the study cohort, and the mean gravity field of the study region (mGal), representing variations in Earth’s underground mass distribution that influence blood and fluid redistribution in the human body, affecting disease prevalence. After standardizing the outcome and predictors, the model was trained using neural network regression implemented with the TensorFlow.js library and deployed as a web-based ML application. Results After 406 epochs of training, and upon achieving a validation loss (mean squared error) of 0.9, training was stopped due to no further improvement. The achieved test loss was 0.49, and the mean absolute error (MAE) was 0.56, corresponding to an up to 6.7% difference between the predicted and true disease probabilities (calculated as MAE x σ, where σ is the standard deviation of the mean disease prevalence = 0.56 x 11.9 = 6.7). The likelihood of developing varicose veins, as predicted by the model, showed the strongest correlation with age (0.78), followed by gravity anomaly (0.30), BMI (0.27), and gender (0.15). Conclusion This study summarizes research on the prevalence of varicose veins by developing a web-based ML model to predict an individual’s likelihood of developing the disease. Using data reported in the literature, the ML algorithm provides a non-discriminatory predictive baseline, offering a valuable tool for future investigations into disease epidemiology.
Magnetic resonance imaging of focal organizing pneumonia: differential diagnosis with peripheral lung carcinoma
Authors: Duan Hai-feng , Dang Shan , Yu Nan , Chen Yuanyuan , Han Dong , Yu Yong , Duan Xiaoyi 
Published: January 2025

Background Computed tomography (CT) is the most common way to evaluate focal organizing pneumonia (FOP); however, sometimes it is difficult to differentiate FOP and peripheral lung carcinoma (PLC). Purpose To clarify the MRI manifestation of FOP and the value of MR in the differential diagnosis of FOP and PLC in comparison to CT. Material and Methods Chest MR (3D T1WI, T2WI TSE, DWI) and CT images of 72 patients (50 men: mean age=64.7 years; 22 women: mean age=64.9 years; 36 FOPs and 36 PLCs) were retrospectively analyzed. Two experienced radiologists reviewed all CT and MR images and graded CT and MR findings completely independently. The apparent diffusion coefficient (ADC) value was measured by the two radiologists independently. Paired sample t-test and Fisher’s exact test were used to compare the ADC values and MR features between the two groups. Finally, the ROC curve was used to evaluate the diagnostic efficiency of MR. Results The ADC value of FOP was larger than PLC ( P < 0.05). Necrosis, abscess cavity, broad contact with the pleura, and focal pleural effusion were more common in FOP ( P < 0.05). PLC patients showed more ( P < 0.05) irregular margins, pleural indentation, and lymphadenopathy. ADC value can be used to differentiate FOP and PLC, and the cutoff value is 1048 × 10−6mm2/s. The sensitivity, specificity, AUC and accuracy of diagnosis of CT, MR was (61.1%, 88.9%, 0.820, and 75%) vs (72.2%, 97.2%, 0.950, and 93.1%), respectively. Conclusion Compared with CT, MR can increase radiologists’ confidence in the differential diagnosis of FOP and PLC.
The role of four-dimensional flow MRI as an adjunct to endoscopy for predicting variceal bleeding in patients with cirrhosis
Authors: Moon Chung Man , Lee Yun Young , Park Sung Ho , Huh Hyungkyu , Kim Seul Kee , Heo Suk Hee , Shin Sang Soo 
Published: January 2025

Background Non-invasive approach other than conventional endoscopy could be effectively used for screening and monitoring esophageal variceal bleeding (EVB). Purpose To retrospectively investigate the role of four-dimensional (4D) flow magnetic resonance imaging (MRI) as an add-on tool to endoscopy for predicting EVB in cirrhotic patients with esophageal varices (EVs). Material and Methods A cohort of 109 cirrhotic patients with EVs was divided into four groups: A = negative red color [RC] sign, no EVB, n = 60; B = negative RC sign, EVB, n = 13; C = positive RC sign, no EVB, n = 10; and D = positive RC sign, EVB, n = 26. All patients underwent laboratory assessments and 4D flow MRI using a 3-T scanner to analyze hemodynamic parameters within the main portal vein (PV), splenic vein, and superior mesenteric vein. Comparative analysis of 4D flow parameters among the groups was performed using the Mann–Whitney U-test, and diagnostic accuracy was assessed through the area under the receiver operator characteristic curve (AUC). Results In the main PV, all 4D flow parameters were significantly lower in patients with a positive RC sign compared to those with a negative RC sign ( P < 0.05). Patients with EVB had lower parameters than those without EVB ( P < 0.05). The AUC values predicting actual variceal bleeding was 0.762 for endoscopy alone and 0.770−0.787 for 4D flow MRI. Integrating the endoscopic classification with the 4D flow MRI significantly improved the AUC value to 0.871 ( P < 0.05). Conclusion Four-dimensional flow MRI may be useful as an add-on tool to endoscopy for predicting actual bleeding in cirrhotic patients with EVs.
Osteochondral Fractures in Adolescents With First-time Patellar Dislocation: Three-dimensional Characterization and Association With Radiographic Features
Authors: Wang Annmarie , Torres-Izquierdo Beltran , Nepple Jeffrey J. 
Published: January 2025

Background: Consequences of osteochondral fractures associated with patellar dislocation can be severe for younger patients. Precise 3-dimensional characterization of fracture location, size, frequency, and radiographic associations remain undefined in this population. Purpose: (1) To define the topographic characteristics of osteochondral fractures in pediatric and adolescent patients with first-time patellar dislocations and (2) to determine the relationship between these characteristics and radiographic and patient factors. Study Design: Cross-sectional study; Level of evidence, 3. Methods: A retrospective observational study was conducted between 2015 and 2023 of consecutive patients aged <18 years undergoing surgical intervention for displaced osteochondral fractures in the setting of first-time patellar dislocation. Three-dimensional location and relative injury frequency were quantified with heat map analysis. Subgroup analysis of intraoperative osteochondral fracture size and location was conducted using chi-square testing and an independent t test at an alpha of .05. Results: The study cohort included 82 knees (80 patients) with first-time patellar dislocation and osteochondral fracture. A total of 97 osteochondral fractures were identified, with the lateral femur as the most common fracture site at 55% (n = 53), as compared with 43% (n = 42) for the patella and 2% (n = 2) for the lateral trochlea. Patellar osteochondral fractures were significantly larger than femoral lesions (mean ± SD, 258 ± 168 mm2 vs 126 ± 109 mm2; P < .001) and more amenable to fixation than femoral osteochondral fractures (fixation, 57.1% [n = 24] vs 15.1% [n = 8]; P < .001). Patellar and femoral osteochondral fractures were >100 mm2 in 78.6% (n = 33) and 32.1% (n = 17) of lesions, respectively. Patellar mean fracture size was significantly larger in the group with a tibial tubercle–trochlear groove distance <20 mm ( P = .018). The mean osteochondral fracture size of the lateral femoral condyle was significantly larger in the open physis group as compared with the closed physis group ( P = .027). Conclusion: We found that the most common site for osteochondral fracture was the femur, although patellar osteochondral fractures were significantly larger. Factors that affect anatomic structure and ligamentous laxity appear to contribute to patterns of osteochondral fractures.
Association Between Joint Line Convergence Angle and Patient-Reported Outcomes of Opening-Wedge High Tibial Osteotomy
Authors: Tsushima Takahiro , Sasaki Eiji , Sakamoto Yukiko , Kimura Yuka , Tsuda Eiichi , Ishibashi Yasuyuki 
Published: January 2025

Background: A larger joint line convergence angle (JLCA) increases the stress load on the medial compartment. Few reports, however, have discussed the effect of the JLCA on the cartilage status and clinical outcomes after opening-wedge high tibial osteotomy (OWHTO). Purpose/Hypothesis: To reveal the effect of the JLCA on clinical results after OWHTO. We hypothesized that a smaller JLCA improves cartilage status and clinical outcomes by reducing mechanical stress in the medial compartment. Study Design: Cohort study: Level of evidence, 3. Methods: This retrospective study included 106 knees that underwent OWHTO and second-look arthroscopy during implant removal 1 year after OWHTO. The mean follow-up period was 5.5 (SD, 2.9) years. The pre- and postoperative JLCAs were measured radiographically. The International Cartilage Repair Society (ICRS) grades of the medial femoral condyle (MFC) and the medial tibial plateau (MTP) were evaluated during the initial and second-look arthroscopy. The relationship between the JLCA and cartilage status, and the Knee injury and Osteoarthritis Outcome Score (KOOS) at the final follow-up were evaluated. Results: Preoperative JLCA was related to improvements in the ICRS grade of the MFC and the MTP, with cutoff values of 2.6° (sensitivity, 0.700; specificity, 0.561; P = .016) and 2.4° (sensitivity, 0.704; specificity, 0.595; P = .028), respectively. In addition, the preoperative JLCA was related to KOOS Pain ( P = .037), Symptoms ( P < .001), Activities of Daily Living ( P = .005), Sports Activities ( P = .005), and Quality of Life ( P = .006) subscales using multivariable linear regression analysis. The postoperative JLCA was not related to the improvement in the ICRS grade of the MFC but was related to the improvement in the ICRS grade of the MTP, with a cutoff value of 1.6° (sensitivity, 0.704; specificity, 0.603; P = .015). Furthermore, postoperative JLCA was related to the KOOS Pain ( P = .004), Symptoms ( P = .002), Activities of Daily Living ( P = .031), Sports Activities ( P < .001), and Quality of Life ( P = .015) subscales. Conclusion: A smaller pre- and postoperative JLCA was related to improvements in the ICRS grade and favorable clinical outcomes, with a mean 5.5-year follow-up after OWHTO.
Safer Stimulant Supply: Program Outcomes
Authors: Haines Marlene , O’Byrne Patrick 
Published: January 2025

Objectives With nearly 50,000 people having died since 2016 as a result of the unregulated toxic drug supply, novel approaches to care are needed. A small number of Safer Stimulant Supply programs have been piloted in Canada, which seek to provide a pharmaceutical-grade stimulant medication replacement for the toxic unregulated stimulant supply. In this paper, we describe the results of retrospective Safer Stimulant Supply program medical chart reviews. Methods We extracted data from program intake and check-in forms collected on an ongoing basis by the clinical teams. In total, 28 medical charts were included in this evaluation. Data collected was reported using descriptive statistics. Results Chart reviews showed that over the course of the program, program participants reported an overall decrease in their unregulated stimulant use. Specifically, at program intake and check-in appointments, cocaine use went from a median of 10 points/day to 0 points/day, and crystal methamphetamine use went from a median of 1.5 points/day to 0 points/day. Chart reviews also showed that program participants reported increased access to primary care and infectious disease programs and improvements in housing status. Conclusions Our research demonstrated that program participants found Safer Stimulant Supply programs to be impactful in addressing ongoing drug use. Safer Stimulant Supply programs remain an underutilized but important harm reduction tool to address the drug poisoning crisis.
Efficacy of a Community- and Family-Based Intervention on Cardiovascular Fitness and Cardiometabolic Disease Risk Factors Among Primarily Latino Families
Authors: Crespo Noe C. , Vega-López Sonia , Szeszulski Jacob , Todd Michael , Behar Alma I. , Ray Frank , Hartmann Leopoldo , Quintero Anabell Lorenzo , Hyde Eric T. 
Published: January 2025

Background Targeting cardiovascular fitness (CVF), rather than weight loss, may be a more acceptable and feasible outcome among Latinos. Purpose The purpose of this study was to test the short-term efficacy of Athletes for Life (AFL), a fitness- and lifestyle-focused behavioral intervention to improve CVF and performance among Latino families. Methods Latino parent-child dyads (n = 137) were randomized to either AFL program or a waitlist control condition. AFL consisted of 24 group family-based, nutrition and sport/fitness oriented 90-minute sessions (twice-weekly). Measures included 1-mile run/walk time, three-minute step test, accelerometer-measured physical activity, body mass index (BMI), waist circumference, DEXA-measured % body fat, cardiometabolic risk biomarkers, and sociodemographic characteristics. Group differences at post-intervention were tested using ANCOVA analyses adjusting for outcome values at baseline and demographic variables. Results Parents were primarily female (93%), aged 38.3 ± 6.9 years, and 96% Latino and children were 8.8 ± 1.7 years old and 58% female. Intervention participants showed significantly faster adjusted post-intervention 1-mile run/walk times compared to control group participants (difference of −76.6 seconds P < 0.01 and −44 seconds P = 0.04, respectively). Parents also showed a significantly higher adjusted relative VO2 max (ml/kg/min) compared to control group parents (43.91, SE = 0.41 vs 42.93, SE = 0.44, respectively, P < 0.01). There were no significant post-intervention group differences on physical activity, BMI, waist circumference, % body fat or cardiometabolic biomarkers P > 0.05. Conclusions The AFL program successfully improved aerobic performance among underserved Latino families with no observable changes in adiposity. These results support that fitness may be a more viable and acceptable outcome among Latino families than weight loss.