bluuebunny/crossref_metadata_2025_split huggingface dataset:
Revisiting the WFNS Score: Native Computed Tomography Imaging Improves Identification of Patients With “False Poor Grade” Aneurysmal Subarachnoid Hemorrhage
Authors: Hofmann Björn B. , Fischer Igor , Neyazi Milad , Karadag Cihat , Donaldson Daniel M. , Abusabha Yousef , Muhammad Sajjad , Beseoglu Kerim , Cornelius Jan F. , Hänggi Daniel 
Published: October 2023

BACKGROUND AND OBJECTIVES:
In patients suffering from aneurysmal subarachnoid hemorrhage (aSAH), the optimal time to determine the World Federation of Neurosurgical Societies (WFNS) score remains controversial because of possible confounding factors. Goals of this study were (1) to analyze the most sensitive timepoint to determine the WFNS score in patients with aSAH and (2) to evaluate the impact of initial native computed tomography (CT) imaging on reducing the mismatch of “false poor grade” patients.

METHODS:
We retrospectively analyzed daily WFNS scores from admission until day 7 in 535 aSAH patients and evaluated their predictive value for the modified Rankin Scale at discharge and 6 months postbleeding. Patients with an initial WFNS score of IV–V who showed improvement to a WFNS score of I–II within the first 7 days (even short-term) were defined as “false poor grade” patients. We tried to identify the “false poor grade” patients using parameters of the initial native CT imaging.

RESULTS:
Later determination of the WFNS score (day 1 vs 7; pseudo-R2 = 0.13 vs 0.21) increasingly improved its predictive value for neurological outcome at discharge (P < .001). We identified 39 “false poor grade” patients who had significantly better outcomes than “real poor grade” patients (N = 220) (modified Rankin Scale-discharge: 0-2, 56% vs 1%, P < .001; 3-5: 41% vs 56%, P = .12; 6: 3% vs 43%, P < .001). “False poor grade” patients differed significantly in initial CT parameters. A predictive model called “initial CT WFNS” (ICTWFNS) was developed, incorporating SEBES, Hijdra score, and LeRoux score (sensitivity = 0.95, specificity = 0.84, accuracy = 0.859, F1 = 0.673). ICTWFNS scores of ≤4.6 classified patients as “false poor grade.”

CONCLUSION:
The initial WFNS score may misclassify a subgroup of patients with aSAH as poor grade, which can be avoided by later determination of the WFNS score, at days 3–4 losing its usefulness. Alternatively, the initial WFNS score can be improved in its predictive value, especially in poor-grade patients, using criteria from the initial native CT imaging, such as the Hijdra, LeRoux, and Subarachnoid Hemorrhage Early Brain Edema score, combined in the ICTWFNS score with even higher predictive power.
Biologically Effective Dose and Prediction of Obliteration of Arteriovenous Malformations in Pediatric Patients Treated by Gamma Knife Radiosurgery
Authors: Grogan Dayton , Dumot Chloe , Tewari Anant , Mantziaris Georgios , Dayawansa Sam , Schlesinger David , Sheehan Jason 
Published: October 2023

BACKGROUND AND OBJECTIVES:
Stereotactic radiosurgery (SRS) represents an effective treatment for pediatric arteriovenous malformations (AVMs). Biological effective dose (BED) has shown promising results in 2 previous studies as a predictive variable for outcomes in adults, but its role has never been studied in pediatric outcomes.

METHODS:
Retrospective data for patients 18 years or younger treated with a single-session SRS for AVMs were collected from 1989 to 2019. BED calculations were performed using an α/β ratio of 2.47. Kaplan-Meier analysis was used to evaluate obliteration, new hemorrhage, and radiation-induced changes (RIC). Cox-regression analysis was used for obliteration prediction using 2 models (margin dose vs BED).

RESULTS:
One hundred ninety-seven patients (median age = 13.1 years, IQR = 5.2) were included; 72.6% (143/197) of them presented initially with spontaneous hemorrhage. A median margin dose of 22 Gy (IQR = 4.0) with a median BED of 183.2 Gy (IQR = 70.54) was used to treat AVM with a median volume of 2.8 cm3 (IQR = 2.9). After SRS, obliteration was confirmed in 115/197 patients (58.4%) using magnetic resonance imaging and angiography at a median follow-up of 2.85 years (IQR = 2.26). The cumulative obliteration probability was 43.6% (95% CI = 36.1-50.3), 60.5% (95% CI+ = 2.2-67.4), and 66.0% (95% CI = 56.0-73.7) at 3, 5, and 10 years, respectively. In Cox multivariate analysis, a BED >180 Gy (hazard ratio [HR] = 2.11, 95% CI = 1.30-3.40, P = .002) in model 1 and a margin dose >20 Gy (HR = 1.90, 95% CI = 1.15-3.13, P = .019) in model 2 were associated with obliteration. An AVM nidus volume >4 cm3 was associated with lower obliteration rates in both models. The probability of symptomatic RIC at 10 years was 8.6% (95% CI = 3.5-13.4). Neither BED nor margin dose was associated with RIC occurrence, with the only predictive factor being deep AVM location (HR = 3, 95% CI = 1-9.1, P = .048).

CONCLUSION:
This study confirms BED as a predictor for pediatric AVM obliteration. Optimization of BED in pediatric AVM SRS planning may improve cumulative obliteration rates.
Effectiveness of balance training on pain and functional outcomes in knee osteoarthritis: A systematic review and meta-analysis
Authors: Prabhakar Ashish John , R Shruthi , Thomas Dias Tina , Nayak Pradeepa , Joshua Abraham M. , Prabhu Srikanth , Kamat Yogeesh Dattakumar 
Published: October 2023

Background: Knee osteoarthritis (OA) is a musculoskeletal disorder that causes pain and increasing loss of function, resulting in reduced proprioceptive accuracy and balance. Therefore, the goal of this systematic review and meta-analysis is to evaluate the effectiveness of balance training on pain and functional outcomes in knee OA. Methods: “PubMed”, “Scopus”, “Web of Science”, “Cochrane”, and “Physiotherapy Evidence Database” were searched for studies conducted between January 2000 and December 2021. Randomized controlled trials (RCTs) that investigated the effectiveness of balance training in knee OA, as well as its effects on pain and functional outcome measures, were included. Conference abstracts, case reports, observational studies, and clinical commentaries were not included. Meta-analysis was conducted for the common outcomes, i.e., Visual Analog Scale (VAS), The Timed Up and Go (TUG), Western Ontario and McMaster Universities Arthritis Index (WOMAC). The PEDro scale was used to determine the quality of the included studies. Results: This review includes 22 RCTs of which 17 articles were included for meta-analysis. The included articles had 1456 participants. The meta-analysis showed improvement in the VAS scores in the experimental group compared to the control group [I 2= 92%; mean difference= -0.79; 95% CI= -1.59 to 0.01; p<0.05] and for the WOMAC scores the heterogeneity (I 2) was 81% with a mean difference of -0.02 [95% CI= -0.44 to 0.40; p<0.0001]. The TUG score was analyzed, the I 2 was 95% with a mean difference of -1.71 [95% CI= -3.09 to -0.33; p<0.0001] for the intervention against the control group. Conclusions: Balance training significantly reduced knee pain and improved functional outcomes measured with TUG. However, there was no difference observed in WOMAC. Although due to the heterogeneity of the included articles the treatment impact may be overestimated. Registration: The current systematic review was registered in PROSPERO on 7th October 2021 (registration number CRD42021276674).
Case Report: Concomitant spontaneous dissection of the coronary artery and internal carotid artery in a young man
Authors: Laajimi Sondes , Mbarek Rabeb , Dhaoui Randa , Bradai Haifa , Loghmari Dorra , Nouira Semir 
Published: October 2023

Introduction: Spontaneous coronary artery dissection (SCAD) is a relatively rare cause of acute coronary syndrome (ACS), generally affecting young or middle-aged women and people with few conventional atherosclerosis risk factors. Its association with dissection of the internal carotid artery is exceptional. Through our observation of a concomitant spontaneous coronary and carotid dissection, we discuss its clinical presentation, therapeutic management, pathogenesis and factors favouring its occurrence. Case: We report the case of a 34-year-old man admitted to emergency with a segment elevation myocardial infarction (STEMI). The patient developed right hemiplegia and aphasia. Cerebral CT revealed a left ischaemic stroke in the anterior junctional territory, and CT angiography of the supra-aortic arteries revealed a dissection of the left internal carotid artery. However, CT angiography of the aorta revealed no abnormalities. Coronary angiography performed after 48 hours showed a dissection of the anterior inter-ventricular artery. Conclusions: Concurrent dissection of the coronary and internal carotid arteries with an uninjured aorta is a rare entity. This association suggests a congenital pathology of the vessels such as Marfan's disease or Ehlers-Danlos syndrome.
Impact of slice thickness on reproducibility of CT radiomic features of lung tumors
Authors: Gupta Sanat , Nayak Kaushik , Pendem Saikiran 
Published: October 2023

Background: Radiomics, a field of research, relies on the theory that quantified characteristics from radiographic images would reflect underlying pathophysiology. Lung cancer continues to stand as one of the prevalent and well-known forms of cancer, causing mortality. The slice thickness (ST) of computed tomography (CT) images would be key concern regarding generalizability of radiomic features (RF) results in oncology. There is scarcity of research that has delved into how ST affects variability of RF in lung tumors. Hence, aim of the study is to evaluate influence of ST on reproducibility of CT-RF for lung tumors. Methods: This is a prospective study, 32 patients with confirmed histopathological diagnosis of lung tumors were included. Contrast Enhanced CT (CECT) thorax was performed using a 128- Incisive CT (Philips Health Care). The image acquisition was performed with 5-mm and 2 mm ST, and was reconstructed retrospectively. RF were extracted from the CECT thorax images of 5-mm and 2-mm ST. We conducted a paired t-test to evaluate the disparity in RF between the two thicknesses. Lin’s Concordance Correlation Coefficient (CCC) was performed to identify the reproducibility of RF between the two thicknesses. Results: Out of 107 RF extracted, 66 (61.6%) exhibited a statistically significant distinction (p<0.05) when comparing two slice thicknesses and while 41 (38.3%) RF did not show significant distinction (p>0.05) between the two ST measurements. 29 features (CCC ≥ 0.90) showed excellent to moderate reproducibility, and 78 features (CCC ≤ 0.90) showed poor reproducibility. Among the 7 RF categories, the shape-based features (57.1%) showed the maximum reproducibility whereas NGTDM-based features showed negligible reproducibility. Conclusions: The slice thickness had a notable impact on the majority of CT-RF of lung tumors. Shape based features (57.1%). First order (44.4%) features showed highest reproducibility compared to other RF categories.
Case Report: An infant with agenesis of the corpus callosum (AgCC) with normal developmental milestones
Authors: Lamture Varsha , Lamture Prajwal , Lamture Yeshwant 
Published: October 2023

Background: Agenesis of the corpus callosum (AgCC) is a unique and rare brain malformation that can have long-term effects on the cognitive and neurological development of those affected. Individuals with AgCC must undergo regular neuropsychological screening to secure conceivable problems and diagnose and tackle them at the appropriate times. Case report: This case is of a male-term infant born through vaginal delivery to a primigravida mother. Antenatal history was insignificant. Fetal Ultrasonography (USG) done at 24 weeks of gestation showed AgCC. The risk factor was explained to the parents, but they wanted to continue the pregnancy. The infant was delivered at term gestation and weighed 2500 gm. The baby was discharged from the hospital and was advised for follow-up. On follow-up, milestones were normal. Magnetic resonance imaging (MRI) of his brain at 24 months during follow-up showed total AgCC. Surprisingly, milestones were not delayed for his age, so he was advised to screen for neurocognitive in the subsequent follow-up. Discussion: AgCC is typically diagnosed through antenatal MRI or genetic testing, but it may be isolated in cases where no additional anomalies are present. It is also associated with various hereditary syndromes, and prenatal diagnosis through Ultrasonography (USG) can be performed between 18 and 22 weeks of gestation to identify features suggestive of AgCC so that early intervention can be done. Though we do not have exact treatment, supporting treatment is equally important to combat further complications. Conclusions: Despite diagnostic tools for AgCC, many physicians are not familiar with the neurological and cognitive features of AgCC, which can lead to delayed management and treatment. Therefore, medical professionals must receive education and training on this condition to manage individuals with AgCC and receive the most supportive care they need.
Unraveling market mysteries: a comprehensive review of financial anomalies and puzzles
Authors: Osterrieder Joerg , Seigne Michael 
Published: October 2023

This comprehensive literature review consolidates various market anomalies and puzzles, providing an aggregated perspective to understand these complex dynamics that challenge the traditional Efficient Market Hypothesis. We examined numerous academic works to reveal insights into long-term return irregularities, earnings management influence on equity offerings, and information uncertainty’s impact on stock returns. The review delves into unique phenomena like persistent mutual fund performance, the day-of-the-week returns, the January effect, weather-induced mood shifts on the market, and the dynamics of multiple anomalies. International asset pricing and weekend anomalies were also discussed, with a particular focus on cryptocurrency efficiency. Incorporating behavioral finance perspectives, we explored social transmission bias, emotional finance, biased beliefs, investor optimism, sentiment, and global market inefficiencies. The influence of unique events and seasonal factors, such as the Super Bowl, daylight saving time, and the Halloween effect, were also analyzed. The review concludes by highlighting the evolving landscape of market anomalies, discussing ma- chine learning approaches to anomaly research, investor behavior challenges, and the disappearing anomalies in country and industry returns. It sets the groundwork for holistic comprehension of market anomalies, suggesting future research directions such as exploring new data sources, comprehensive theoretical modeling, and the role of technology, market regulations, and environmental changes on market anomalies.
Safety and immunogenicity of varied doses of R21/Matrix-M™ vaccine at three years follow-up: A phase 1b age de-escalation, dose-escalation trial in adults, children, and infants in Kilifi-Kenya
Authors: Sang Samuel , Datoo Mehreen S. , Otieno Edward , Muiruri Charles , Bellamy Duncan , Gathuri Emmaloise , Ngoto Omar , Musembi Janet , Provstgaard-Morys Sam , Stockdale Lisa , Aboagye Jeremy , Woods Daniel , Lawrie Alison , Roberts Racheal , Keter Kelvias , Kimani Domtila , Ndungu Francis , Kapulu Melissa , Njau Irene , Orindi Benedict , Ewer Katie J. , Hill Adrian V.S. , Bejon Philip , Hamaluba Mainga 
Published: October 2023

Background: Falciparum malaria remains a global health problem. Two vaccines, based on the circumsporozoite antigen, are available. RTS, S/AS01 was recommended for use in 2021 following the advice of the World Health Organisation (WHO) Strategic Advisory Group of Experts (SAGE) on Immunization and WHO Malaria Policy Advisory Group (MPAG). It has since been pre-qualified in 2022 by the WHO. R21 is similar to RTS, S/AS01, and recently licensed in Nigeria, Ghana and Burkina Faso following Phase 3 trial results. Methods: We conducted a Phase 1b age de-escalation, dose escalation bridging study after a change in the manufacturing process for R21. We recruited healthy adults and children and used a three dose primary vaccination series with a booster dose at 1–2 years. Variable doses of R21 and adjuvant (Matrix-M ™) were administered at 10µgR21/50 µg Matrix-M™, 5µgR21/25µg Matrix-M™ and 5µgR21/50µg Matrix-M™ to 20 adults, 20 children, and 51 infants. Results: Self-limiting adverse events were reported relating to the injection site and mild systemic symptoms. Two serious adverse events were reported, neither linked to vaccination. High levels of IgG antibodies to the circumsporozoite antigen were induced, and geometric mean titres in infants, the target group, were 1.1 (0.9 to 1.3) EU/mL at day 0, 10175 (7724 to 13404) EU/mL at day 84 and (following a booster dose at day 421) 6792 (5310 to 8687) EU/mL at day 456. Conclusions: R21/Matrix-M™ is safe, and immunogenic when given at varied doses with the peak immune response seen in infants 28 days after a three dose primary vaccination series given four weeks apart. Antibody responses were restored 28 days after a 4th dose given one year post a three dose primary series in the young children and infants. Registration: Clinicaltrials.gov (NCT03580824; 9th of July 2018; Pan African Clinical Trials Registry (PACTR202105682956280; 17th May 2021).
Specifying how intervention content is communicated: Development of a Style of Delivery Ontology
Authors: Wright Alison J. , Zhang Lisa , Howes Ella , Veall Clement , Corker Elizabeth , Johnston Marie , Hastings Janna , West Robert , Michie Susan 
Published: October 2023

Background: Investigating and enhancing the effectiveness of behaviour change interventions requires detailed and consistent specification of all aspects of interventions. We need to understand not only their content, that is the specific techniques, but also the source, mode, schedule, and style in which this content is delivered. Delivery style refers to the manner by which content is communicated to intervention participants. This paper reports the development of an ontology for specifying the style of delivery of interventions that depend on communication. This forms part of the Behaviour Change Intervention Ontology, which aims to cover all aspects of behaviour change intervention scenarios. Methods: The Style of Delivery Ontology was developed following methods for ontology development used in the Human Behaviour-Change Project, with seven key steps: 1) defining the scope of the ontology, 2) identifying key entities and developing their preliminary definitions by reviewing 100 behaviour change intervention evaluation reports and existing classification systems, 3) refining the ontology by piloting the ontology through annotations of 100 reports, 4) stakeholder review by eight behavioural science and public health experts, 5) inter-rater reliability testing through annotating 100 reports using the ontology, 6) specifying ontological relationships between entities, and 7) disseminating and maintaining the ontology. Results: The resulting ontology is a five-level hierarchical structure comprising 145 unique entities relevant to style of delivery. Key areas include communication processes, communication styles, and attributes of objects used in communication processes. Inter-rater reliability for annotating intervention evaluation reports was α=0.77 (good) for those familiar with the ontology and α=0.62 (acceptable) for those unfamiliar with it. Conclusions: The Style of Delivery Ontology can be used for both annotating and describing behaviour change interventions in a consistent and coherent manner, thereby improving evidence comparison, synthesis, replication, and implementation of effective interventions.
Using machine learning to extract information and predict outcomes from reports of randomised trials of smoking cessation interventions in the Human Behaviour-Change Project
Authors: West Robert , Bonin Francesca , Thomas James , Wright Alison J. , Mac Aonghusa Pol , Gleize Martin , Hou Yufang , O'Mara-Eves Alison , Hastings Janna , Johnston Marie , Michie Susan 
Published: October 2023

Background Using reports of randomised trials of smoking cessation interventions as a test case, this study aimed to develop and evaluate machine learning (ML) algorithms for extracting information from study reports and predicting outcomes as part of the Human Behaviour-Change Project. It is the first of two linked papers, with the second paper reporting on further development of a prediction system. Methods Researchers manually annotated 70 items of information (‘entities’) in 512 reports of randomised trials of smoking cessation interventions covering intervention content and delivery, population, setting, outcome and study methodology using the Behaviour Change Intervention Ontology. These entities were used to train ML algorithms to extract the information automatically. The information extraction ML algorithm involved a named-entity recognition system using the ‘FLAIR’ framework. The manually annotated intervention, population, setting and study entities were used to develop a deep-learning algorithm using multiple layers of long-short-term-memory (LSTM) components to predict smoking cessation outcomes. Results The F1 evaluation score, derived from the false positive and false negative rates (range 0-1), for the information extraction algorithm averaged 0.42 across different types of entity (SD=0.22, range 0.05-0.88) compared with an average human annotator’s score of 0.75 (SD=0.15, range 0.38-1.00). The algorithm for assigning entities to study arms (e.g., intervention or control) was not successful. This initial ML outcome prediction algorithm did not outperform prediction based just on the mean outcome value or a linear regression model. Conclusions While some success was achieved in using ML to extract information from reports of randomised trials of smoking cessation interventions, we identified major challenges that could be addressed by greater standardisation in the way that studies are reported. Outcome prediction from smoking cessation studies may benefit from development of novel algorithms, e.g., using ontological information to inform ML (as reported in the linked paper (1)).
Thermal intermodulation backaction in a high-cooperativity optomechanical system
Authors: Pluchar Christian M. , Agrawal Aman R. , Wilson Dalziel J. 
Published: October 2023

The pursuit of room temperature quantum optomechanics with tethered
nanomechanical resonators faces stringent challenges owing to
extraneous mechanical degrees of freedom. An important example is
thermal intermodulation noise (TIN), a form of excess optical noise
produced by mixing of thermal noise peaks. While TIN can be decoupled
from the phase of the optical field, it remains indirectly coupled via
radiation pressure, implying a hidden source of backaction that might
overwhelm shot noise. Here we report observation of TIN backaction in
a high-cooperativity, room temperature cavity optomechanical system
consisting of an acoustic-frequency Si3N4 trampoline coupled to a Fabry–Perot
cavity. The backaction we observe exceeds thermal noise by
20 dB and radiation pressure shot noise by 40 dB,
despite the thermal motion being 10 times smaller than the cavity
linewidth. Our results suggest that mitigating TIN may be critical to
reaching the quantum regime from room temperature in a variety of
contemporary optomechanical systems.