bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of standard enhancement settings of endoscopy systems on performance of endoscopic artificial intelligence systems
Authors: Jong Martijn R. , Kusters Carolus H. J. , van Bokhorst Querijn N. E. , Jukema Jelmer B. , van Eijck van Heslinga Rixta A. H. , Fockens Kiki N. , Houwen Britt B. S. L. , Jaspers Tim J. M. , Boers Tim G. W. , van der Vlugt Manon , Dekker Evelien , van der Sommen Fons , de With Peter H. N. , de Groof Albert J. , Bergman Jacques J. G. H. M ,   on behalf of the BONS-AI Consortium
Published: January 2025

Background Artificial intelligence (AI) systems in endoscopy are predominantly developed and tested using high-quality imagery from expert centers. However, their performance may be different when applied in clinical practice, partly due to the diversity in post-processing enhancement settings used in endoscopy units. We evaluated the impact of post-processing enhancement settings on AI performance and tested specific data augmentation strategies to mitigate performance loss.
Methods We used a computer-aided detection (CADe) system for Barrett’s neoplasia (6223 images, 906 patients) and a computer-aided diagnosis (CADx) system for colorectal polyps (3288 images, 969 patients), both trained on datasets acquired with Olympus equipment and with limited variability in enhancement settings. The CAD systems were then tested across a wide range of test sets, which comprised the same images, but displayed with different enhancement settings. Both CAD systems were then retrained using image enhancement-based data augmentation. The performance of the adjusted CAD systems was evaluated on the same test sets.
Results Both systems displayed substantial performance variability over a range of enhancement settings (CADe: 83 %–92 % sensitivity, 84 %–91 % specificity; CADx: 78 %–85 % sensitivity, 45 %–63 % specificity). After retraining, variability in sensitivity and specificity was reduced to 2 % (P < 0.001) and 1 %, respectively (P = 0.003) for CADe, and 2 % (P = 0.03) and 8 %, respectively (P = 0.19) for CADx.
Conclusion The performance of endoscopic AI systems can vary substantially depending on post-processing enhancement settings of the endoscopy unit. Specific data augmentation can mitigate this performance loss.
Multidimensional Analysis of Preoperative Patient-Reported Outcomes Identifies Distinct Phenotypes in Total Knee Arthroplasty: Secondary Analysis of the SHARKS Registry in a Public Hospital Department
Authors: McGill Raquel , Scholes Corey , Torbey Stephen , Calabro Lorenzo 
Published: January 2025

AbstractTraditional research on total knee arthroplasty (TKA) relies on preoperative patient-reported outcome measures (PROMs) to predict postoperative satisfaction. We aim to identify distinct patient phenotypes among TKA candidates, and investigate their correlations with patient characteristics. Between 2017 and 2021, patients with primary knee cases at a metropolitan public hospital were enrolled in a clinical quality registry. Demographics, clinical data, and the Veterans Rand 12 and Oxford Knee Score were collected. Imputed data were utilized for the primary analysis, employing k-means clustering to identify four phenotypes. Analysis of variance assessed differences in scores between clusters, and nominal logistic regression determined relationships between phenotypes and patient age, sex, body mass index (BMI), and laterality. The sample comprised 389 patients with 450 primary knees. Phenotype 4 (mild symptoms with good mental health) exhibited superior physical function and overall health. In contrast, patients in phenotype 2 (severe symptoms with poor mental health) experienced the most knee pain and health issues. Phenotype 1 (moderate symptoms with good mental health) reported high mental health scores despite knee pain and physical impairment. Patient characteristics significantly correlated with phenotypes; those in the severe symptoms with poor mental health phenotype were more likely to be younger, female, have a higher BMI, and bilateral osteoarthritis (p < 0.05). This multidimensional analysis identified TKA patient phenotypes based on common PROMs, revealing associations with patient demographics. This approach has the potential to inform prognostic models, enhancing clinical decision-making and patient outcomes in joint replacement.
Academic freedom: Challenges to cultivating a revolutionary unconscious in a neoliberal world
Authors: O’Loughlin Michael 
Published: January 2025

Abstract
Seeking to frame the debate around academic freedom in terms of freedom of thought, this article begins with an exploration of the hazards of fascist ideology and the psychodynamics of persuadability. Attention is paid to the perverse lure of certainty and the apparent willingness of many people to accede to an instrumentalized unconscious. Through the writings of Butler and Athanasiou, an antithesis to the dispossession of an instrumentalized unconscious is explored in terms of radical performativity and critical relationality, modalities which have the potential to undo what Elizabeth Povinelli termed “the cunning of recognition.” The limitations of psychoanalysis due to its historical antecedents in colonialism and racialized capitalism are explored, and an argument for a genealogically and sociohistorically constituted psychoanalysis is entertained. Following Derrida’s imagining of the university as truth-seeker, aspects of the history of U.S. higher education are explored to illustrate the continuous struggle between sovereign power and capitalist logic and the possibility of education as the practice of freedom. The essay concludes with an exploration of the intersection between psychoanalysis and critical pedagogy, posing the question of whether analytic institutes and universities might become vehicles for an encounter with alterity that could potentially sow the seeds for a revolutionary unconscious.
Exploring L1/L2 and time impact on linguistic complexity of
Laozi translations
Authors: Cheung Joyce Oiwun 
Published: January 2025

Abstract
Research shows that language complexity is a crucial measure of
proficiency and that academic and scientific writing has evolved over time.
However, linguistic complexity may differ between first (L1) and second (L2)
language translations, and its development over time remains unexplored. This
study examines how the translator’s native language and the time of translation
affect the complexity of Laozi translations. Using a corpus of
79 translations, we analyzed syntactic and lexical complexity to compare L1 and
L2 English speakers’ translations across three distinct periods. Contrary to
expectations, our results reveal no significant complexity differences between
L1 and L2 translators, suggesting that native language proficiency does not
necessarily influence translation complexity. However, significant variations
were found across different historical periods, indicating changes in
translation styles over time. These findings show that time influences
translation complexity more than the translator’s native language.
Green materials in semiconductors: perspective from the IRDS beyond-CMOS roadmap
Authors: Ueda Akiko , Akinaga Hiroyuki , Agarwal Sapan , Hagmann Joseph A , Das Shamik , Marinella Matthew J , Chen An 
Published: January 2025

Abstract
Environmental, safety, health, and sustainability (ESHS) have become an indispensable issue in the semiconductor industry. The ‘Beyond CMOS’ chapter of the International Roadmap for Devices and Systems roadmap introduces the concept of ‘Green materials’, emphasizing their importance for maintaining sustainability in semiconductor manufacturing. We discuss the current trends of emerging architectures and devices in the perspective of ‘Green materials’. Additionally, we highlight the significance of benchmarking and standardization in advancing sustainable practices within the semiconductor industries.
Studying decoherence in hyperfine ground states of 133Cs atoms using two photon lineshape spectroscopy
Authors: Yadav Poonam , Ghosh Arnab , Yadav Hemant , Santra Bodhaditya 
Published: January 2025

Abstract
Hyperfine ground states in alkali atoms are among the most promising candidates for realizing high fidelity scalable quantum information processing architecture. Fast manipulation of ground states can be realized via two-photon transitions driven by lasers. The light-atom interaction can cause decoherence in the system. Here, we study the decoherence rate using accurate lineshape spectroscopy involving hyperfine ground states of D2 transition in

133

Cs

atoms in room-temperature-atomic-vapor. The measured decoherence rate varies very slowly as a function of the Rabi frequency of the probe field. Furthermore, we have investigated the slow light group velocity resulting from the narrow spectral width of the electromagnetically induced transparency lineshape. Our study paves the way to implement quantum information processing protocols using coherent photonic polarization qubits in an atomic medium across a large parameter range.
Climatology of waterspouts in Mexico and numerical modeling of a particular case
Authors: Monterde Daniela , Carbajal Noel , León-Cruz José Francisco , Pineda-Martínez Luis Felipe 
Published: January 2025

Abstract
Numerous waterspout events occur practically in all Mexican waters. The principal aim was to carry out a climatology of these events. A data compilation allowed the identification of 103 cases from 2010–2022. A Szilagyi waterspout nomogram was constructed to explain the formation mechanism using the ERA5 reanalysis data. The nomogram classified waterspout events according to their origin using thermodynamic parameters. The results revealed that the thermodynamics of some waterspouts in Mexico do not fit the current definition of the Szilagyi nomogram. Most waterspouts are thunderstorm-related and fit the nomogram. A minority that arises from land breezes and upper-low conditions also fit. A relevant case, which occurred in an area with a recurrent incidence of waterspouts, allowed observation of relevant dynamic properties, such as its strength, occurred on August 8, 2019, in Coatzacoalcos, Veracruz. The documented waterspout trajectory revealed that it moved through the sea and city. The Weather Research and Forecasting (WRF) model was used for modeling this event at a resolution of 250 m. The results showed the instability, a cyclonic disturbance (misocyclone) that caused the waterspout. The analysis showed the behavior of meteorological variables, such as temperature, humidity, wind, vorticity, and unstable atmospheric variables during the storm.
Transparency in United States healthcare sustainability: a scoping review
Authors: Locke Sara , Hadley Courtney , Sherman Jodi D , Hantel Andrew , Senay Emily 
Published: January 2025

Abstract
The United States (U.S.) healthcare sector—a significant contributor to climate change through emissions, pollution, and waste—is beginning to integrate sustainability into operations. Sustainability science and accounting have been widely adopted across other industries to measure and communicate mitigation progress. Transparency, defined as ensuring accurate reporting and open disclosure of sustainability data, is critical. Without it, organizations risk ‘greenwashing,’ where misleading claims can erode public trust and undermine sustainability efforts. This scoping review evaluates the extent to which U.S. healthcare literature addresses transparency as a critical component of sustainability initiatives. This review identified peer-reviewed and non-peer-reviewed literature on environmental sustainability within U.S. healthcare from 1994 to 2024, with a focus on transparency and related concepts. Articles were excluded if they were not in English, corporate reports, advertisements, or irrelevant to U.S. healthcare sustainability. The following databases were searched: Ovid MEDLINE, Nexis Uni, Business Source Complete, Scopus, and Health Care Administration. Two independent reviewers screened and extracted the data, with a third resolving disagreements. Qualitative and thematic analyses were employed to assess if and how transparency was defined and operationalized in the context of healthcare sustainability. Of the 835 articles screened, 33 met inclusion criteria. Only 10 of the 33 articles both defined and operationalized transparency. Key focus areas included environmental sustainability practices in healthcare (n = 18, 55%); ESG or CSR and public health impact (n = 18, 55%); the business of healthcare (n = 8, 24%); and policy-driven sustainability initiatives (n = 7, 21%). Barriers included absence of mandates, standardization, and leadership. Despite a growing body of research on healthcare sustainability, studies addressing transparency are sparse. Limitations included a narrow keyword focus and limited databases searched. Transparent reporting could be considered the sixth ‘R’ in the 5 Rs of sustainability–refuse, reduce, reuse, recycle, repurpose, and report.
2633 Reducing delays in Administration of First Dose Denosumab through introduction of ACP led consent process during inpatient stay
Authors: Atkinson A , Alićehajić-Bečić Đ , Adejumo S 
Published: January 2025

Abstract

Introduction
At Wrightington, Wigan and Leigh we admitted over 400 patients with hip fracture diagnosis in 2023. As part of orthogeriatric review, denosumab treatment would be utilised in a cohort of patients where this is appropriate, in line with NOGG guidelines. Traditional model of delivering first dose after outpatient appointment led to delays in treatment initiation and did not address the significant risk of ‘imminent fracture’ which was recognised in the latest NOGG guidelines. The aim of this project was to reduce delays in denosumab treatment initiation by introducing consenting process during hospital stay led by orthogeriatric Advanced Clinical Practitioner.

Method
Utilising hospital electronic records, a sample of patients was selected from patients admitted in 2022 (19 patients), 2023 (19 patients) and 2024 (6 patients). Time of decision to treat with denosumab to time of first dose administered was used as the outcome measure. Alongside this, analysis of time to outpatient appointment was completed which was where the pre-intervention consent was taken. Intervention of inpatient consent being taken was implemented in September 2023.

Results
The average length of time from clinical decision being made to first dose of denosumab being administered was 187 days in 2022 sample, 76 days in 2023 sample and 27 days in 2024 sample. The governance around consent process was established and adopted by the whole orthogeriatric team. Waiting times for outpatient bone health clinic were on average 240 days in 2022, 164 days in 2023 and unknown in 2024 cohort.

Conclusion(s)
Introduction of ward-based consent process for patients who are suitable for denosumab led to significant decrease in delays in time to first dose. This ensures that patients benefit from bone protection in a timely manner, as their risk of refracture is greatest in the first 6 months post index fracture.
2829 Improving door to needle times in stroke thrombolysis through simulation-based training in a district general hospital
Authors: Koushik S , Nagsayi S , Coombe L , Aguirre C , Elfeky M 
Published: January 2025

Abstract

Introduction/Background
Teamwork is very important in hospitals where the medical on-call team manage the stroke and thrombolysis alert calls. In addition to technical skills, human factors play a very significant role in meeting a target door-to-needle time.

Aim
To improve door-to-needle time by improving human factors (leadership, understanding and delegation of roles and confidence in participation) and technical factors (quick NIHSS and efficient documentation of vital information on radiology request forms for urgent CT head).

Method
We conducted 6 simulation-based training sessions and de-briefing sessions (role-playing and education around technical and non-technical skills) starting from November 2022. We measured the participants’ responses before and after the sessions, with the help of Kirkpatrick’s four level training evaluation model. We measured and compared the thrombolysis breakdown data (total of 38 consecutive patients from May 2022 to February 2023) throughout the process. We used statistical process control (SPC) charts to calculate and visually represent median values to demonstrate the changes.

Results
Thrombolysis breakdown data revealed substantial improvement post intervention (November 2022) compared to data from May–October 2022. SPC charts demonstrated significant reduction and step change in median door-to-needle time (83.7 to 52.2 minutes) and CT imaging to reporting time (36.2 min to 19.5 min).

Conclusion
A series of simulation-based training sessions and debriefing sessions for stroke thrombolysis was able to demonstrate statistically significant improvement in door-to-needle time. We will continue the simulation sessions and will assess sustainability of the interventions.
Declaration of Funding
None.

References
1. Ajmi SC, Advani R, Fjetland L. et al. Reducing door-to-needle times in stroke thrombolysis to 13 min through protocol revision and simulation training: a quality improvement project in a Norwegian stroke Centre. BMJ Quality & Safety. 2019;28:939–48.
2. Chalwin RP, Flabouris A. Non-technical skills training for MET. Intern Med J. 2013;43:962–9. https://doi.org/10.1111/imj.12172.
2893 Telemedicine Unreadiness in an older frail population attending the geriatric day hospital
Authors: Lynch A , Ensar D , Clancy C , Ryan D 
Published: January 2025

Abstract

Introduction
Telemedicine uses communications technology for remote healthcare. Unreadiness includes difficulties with hearing, speaking, cognitive issues, vision problems, lack of internet-enabled devices, or no recent use of digital communication. Telehealth can enhance access and convenience, especially for rural patients, but faces challenges such as technology issues and impacts on patient-provider relationships, examination quality, care quality, and patient satisfaction. The COVID-19 pandemic has accelerated telemedicine adoption to protect medical personnel and patients, with significant promotion of video visits for home-based care.

Objective
This study aims to evaluate telemedicine unreadiness in an older, frail population at a geriatric clinic. Patients were contacted from February 1st to March 14th, 2021, during Ireland’s COVID-19 ‘third wave,’ with up to three contact attempts made.

Method
Statistical analysis was conducted using STATA 14. 84 patients attended the Geriatric clinic, with 33 excluded for various reasons, leaving 51 participants (67%) who completed the survey. The mean age was 81.7 years, with 49% female. Most referrals were for cognitive issues (59%), followed by BPSD (13%), weight loss (9%), and falls (7%). The median Clinical Frailty Score was 4, indicating moderate to severe frailty. Regarding mobility, 77% were independent, 21% used an aid, and 2% were immobile. Cognitive assessments revealed 25% had normal cognition, 18% had mild impairment, and 57% had dementia.

Results
Only 10% of patients were ideal for teleconsultations, while 90% faced significant barriers, such as environmental impairments (26), sensory impairments (2), and both (18). Additionally, 25% lacked computer, and only 10% used the internet regularly. Despite 59% having family assistance, overall, 82% had some form of environmental impairment. Sensory impairments were common, with 29% using hearing aids but 37% still experiencing issues. Visual impairments were better managed, with 76% wearing glasses.

Conclusion
Telemedicine adoption has accelerated due to COVID-19, but significant barriers for geriatric patients highlight the need for better support.
2771 Improving collateral history taking in the geriatric population
Authors: Swain E , Ramsay K 
Published: January 2025

Abstract

Introduction
The geriatric population has a high incidence of dementia, delirium and frailty meaning often these patients cannot give comprehensive histories themselves. We are left with missing pieces of the puzzle; we might not know their ‘normal’ and frequently ask: ‘Are they always like this?’ A collateral history becomes a valuable tool, contributing to a Comprehensive Geriatric Assessment and assisting the whole MDT to make informed decisions for patient-centred care. The primary aim of this project was to improve the quality of collateral histories taken for patients admitted to the geriatric wards, with content measured against 8 domains. A secondary aim was to encourage timely collateral histories within 48 hours of admission to the ward.

Method
Using PDSA methodology, collateral histories were analysed before and after implementation of a poster and teaching session.

Results
At baseline each domain was covered a mean of 40.5% of the time (range 9%—81%). Following intervention this increased by 22% to 62.5% (range 18%—89%), demonstrating a significant improvement (paired t-test, P &lt; 0.05). It was already common practice to take collateral histories within 48 hours of admission to the ward (91%) which was sustained post-intervention (88%).

Conclusion
Use of a poster as a prompt, and delivering teaching, led to more thorough collateral histories. This suggests two barriers are knowing what to ask and perceived importance, elements which could be integrated into early postgraduate education. The impact on patient care has the potential to be significant and multidimensional but further work would be needed to understand this.
2838 Evaluation of the use of the National Early Warning Score (NEWS2) for delirium identification in welsh hospitals
Authors: Gravell E , Williams G , Smith B , Willimont C , Beynon-Howells C , Quinn P , Green T , Burberry DJ , Fernandez S , Davies EA 
Published: January 2025

Abstract

Introduction
The National Early Warning Score (NEWS) (2017) incorporated new confusion as a category for consciousness. NEWS2 is evidenced to have high specificity but low sensitivity in detecting delirium.

Methods
Morriston Hospital. 261 patients assessed. Consciousness, overall NEWS2 score and AMT4 recorded. 227 NEWS2 charts available. 208 patients recorded as alert. 44% (n = 87) scored less than 4 on AMT4, 55% (n = 48) didn’t have documented past medical history (PMH) of cognitive impairment. Data missing for 14 patients. Ysbyty Gwynedd. 178 patients assessed.161 recorded as alert. 58.4% patients scored less than 4 on AMT4, 77% had no PMH of cognitive impairment. Data missing for 15 patients. University Hospital Llandough. 40 patients; 38 patients were marked as Alert, 2 were excluded from observations.32.5% (n = 13) had a diagnosis of possible or definite delirium. An electronic survey coupled with training delivery of 103 Health Care Workers (HCW) and 112 Registered Nurses (RN) was undertaken at Morriston. 39 HCWs (37.8%) and 31 RNs (27.6%) weren’t confident in the use of NEWS2 in regards to acute confusion. Training was offered on a 1 to 1 basis for these 215 staff members.

Results
Post intervention, 221 patients were assessed at Morriston, 209 marked as alert. 2 patients had been identified as having a new confusion and 10 patients did not have their consciousness recorded. Of the 209 marked alert 42% (88 patients) scored less than 4 on AMT4; 53 had no PMH of cognitive impairment. Training yielded little benefit.

Conclusion
The accuracy of recording consciousness has wider implications on the use of the NEWS2. NEWS2 uses routine observations and delirium assessment is variably implemented meaning routine information is not always available. The NEWS2 should be used in conjuction with other tools developed for delirium e.g 4AT and SQiD.