bluuebunny/crossref_metadata_2025_split huggingface dataset:
A dynamically stable self-healable wire based on mechanical–electrical coupling
Authors: Wang Shuo , Ouyang Zhaofeng , Geng Shitao , Wang Yan , Zhao Xiaoju , Yuan Bin , Zhang Xiao , Xu Qiuchen , Tang Chengqiang , Tang Shanshan , Miao Han , Peng Huisheng , Sun Hao 
Published: January 2024

ABSTRACT
The rise in wearable electronics has witnessed the advancement of self-healable wires, which are capable of recovering mechanical and electrical properties upon structural damage. However, their highly fluctuating electrical resistances in the range of hundreds to thousands of ohms under dynamic conditions such as bending, pressing, stretching and tremoring may seriously degrade the precision and continuity of the resulting electronic devices, thus severely hindering their wearable applications. Here, we report a new family of self-healable wires with high strengths and stable electrical conductivities under dynamic conditions, inspired by mechanical–electrical coupling of the myelinated axon in nature. Our self-healable wire based on mechanical–electrical coupling between the structural and conductive components has significantly improved the electrical stability under dynamic scenarios, enabling precise monitoring of human health status and daily activities, even in the case of limb tremors from simulated Parkinson's disease. Our mechanical–electrical coupling strategy opens a new avenue for the development of dynamically stable electrodes and devices toward real-world wearable applications.
Derivation and Internal Validation of a Mortality Prognostication Machine Learning Model in Ebola Virus Disease Based on Iterative Point-of-Care Biomarkers
Authors: Bearnot Courtney J , Mbong Eta N , Muhayangabo Rigo F , Laghari Razia , Butler Kelsey , Gainey Monique , Perera Shiromi M , Michelow Ian C , Tang Oliver Y , Levine Adam C , Colubri Andrés , Aluisio Adam R 
Published: January 2024

Abstract

Background
Although multiple prognostic models exist for Ebola virus disease mortality, few incorporate biomarkers, and none has used longitudinal point-of-care serum testing throughout Ebola treatment center care.

Methods
This retrospective study evaluated adult patients with Ebola virus disease during the 10th outbreak in the Democratic Republic of Congo. Ebola virus cycle threshold (Ct; based on reverse transcriptase polymerase chain reaction) and point-of-care serum biomarker values were collected throughout Ebola treatment center care. Four iterative machine learning models were created for prognosis of mortality. The base model used age and admission Ct as predictors. Ct and biomarkers from treatment days 1 and 2, days 3 and 4, and days 5 and 6 associated with mortality were iteratively added to the model to yield mortality risk estimates. Receiver operating characteristic curves for each iteration provided period-specific areas under curve with 95% CIs.

Results
Of 310 cases positive for Ebola virus disease, mortality occurred in 46.5%. Biomarkers predictive of mortality were elevated creatinine kinase, aspartate aminotransferase, blood urea nitrogen (BUN), alanine aminotransferase, and potassium; low albumin during days 1 and 2; elevated C-reactive protein, BUN, and potassium during days 3 and 4; and elevated C-reactive protein and BUN during days 5 and 6. The area under curve substantially improved with each iteration: base model, 0.74 (95% CI, .69–.80); days 1 and 2, 0.84 (95% CI, .73–.94); days 3 and 4, 0.94 (95% CI, .88–1.0); and days 5 and 6, 0.96 (95% CI, .90–1.0).

Conclusions
This is the first study to utilize iterative point-of-care biomarkers to derive dynamic prognostic mortality models. This novel approach demonstrates that utilizing biomarkers drastically improved prognostication up to 6 days into patient care.
Peasant Productivity and Welfare in The Middle Ages and Beyond
Authors: Hatcher John 
Published: January 2024

Abstract
Driven by the quality of sources rather than their representativeness, the history of English agriculture has been written primarily from the perspective of well-documented large farms to the neglect of smallholders and cottagers who for centuries cultivated the greater part of the nation’s farmland but left scant records. The superb series recording the mediocre and low crop yields of the expansive demesnes of great lords has long been adopted for the productivity of all medieval England’s arable and is deeply embedded in economic and social histories and calculations of economic growth and the welfare of the population. Yet no convincing justification for this supposition has ever been made, and an increasing flow of research and analysis indicates that the productivity of land varied markedly in accordance with the size and function of farms, with the output per acre of large farms constrained by the need to control costs in order to sell surpluses at a profit, while smallholders, at the cost of low and frequently abysmal labour productivity, produced higher yields by striving to maximize output using abundant family labour to secure subsistence from meagre acreages. An appraisal of farming across the centuries and the continents from the Middle Ages to modern times clearly shows that an inverse relationship generally prevailed between farm size and land productivity.
Not Just Small Adults: Operative Versus Nonoperative Treatment in Adolescent Tibial Shaft Fractures
Authors: Kiani Sara N. , Badrinath Raghav , Baldwin Keith D. 
Published: January 2024

Background:
The standard of care for tibial shaft fractures in young children is nonoperative management, while in adults, operative treatment is considered the mainstay. There are no clear guidelines on preferred treatment for adolescents.

Purpose:
This paper aims to 1) identify clinical and radiographic characteristics predictive of malalignment and 2) determine if treatment type affects malalignment risk.

Methods:
This retrospective cohort study identified patients aged 12 to 16 years old with a tibial shaft fracture at a Level 1 pediatric trauma center. The primary outcome of interest was malalignment, classified as meeting one or more of the following: >5° coronal angulation, >5° sagittal angulation, translation (cortical width or 100% displaced), and/or rotational deformity. Comparative analyses were done to identify risk factors for malalignment.

Results:
A total of 162 patients were included—initial treatment was “planned nonoperative” for 102 patients and “planned operative” for 60 patients. The malalignment rate was 34% in the planned nonoperative group versus 32% in the planned operative group. In a multivariate regression, older patients [odds ratio (OR)=−0.07, 95% CI: −0.13 to −0.01; P=0.024] and those with 100% initial displacement (OR=−0.35, 95% CI: −0.64 to −0.05; P=0.021) had decreased odds of malalignment, and having increased sagittal angulation (OR=0.02, 95% CI: 0.01-0.04; P=0.002) and a fibula fracture (OR=0.22, 95% CI: 0.03-0.41; P=0.023) increased the odds of malalignment. There was no difference in the rate of malalignment by initial treatment (P=0.289). Having a planned nonoperative treatment (OR=22.7, 95% CI: 14.0-31.5; P<0.001) and having a fibula fracture (OR=8.52, 95% CI: 0.59-16.45; P=0.035) increased the time immobilized.

Conclusions:
This study provides insight into factors affecting tibial shaft fracture alignment among patients aged 12 to 16 years. This study suggests that the risk of malalignment is higher among patients with increased initial sagittal angulation and concomitant fibula fractures, but the risk of malalignment is comparable in patients initially treated nonoperatively and operatively. Although healing parameters on average were similar, nonoperative treatment results in longer immobilization time and time for unrestricted weight bearing.

Level of Evidence:
Level III—retrospective comparative study.
Effect of Solitary Osteochondroma on Alignment and Length in the Lower Extremities
Authors: Park Hoon , Kim Hyun Woo , Park Kun-Bo , Kim Jae Hong , Chang Won June , Park Byoung Kyu 
Published: January 2024

Background:
There is a lack of information about the effects of untreated solitary osteochondroma (SO) on longitudinal growth of the lower extremities in children and adolescents. This study aimed to assess the coronal alignment and length of the lower extremity in patients with SO around the knee and to identify the factors related to the development of deformities.

Methods:
We retrospectively reviewed 111 patients diagnosed with SO around the knee. The patients were classified into 2 groups depending on the location of the SO: 51 in the distal femur and 60 in the proximal tibia. Characteristics of the lesions, such as type, location, size, and distance from the joint line, were determined. Radiographic analysis of the lower limbs included mechanical lateral distal femoral angle, mechanical medial proximal tibial angle, whole-leg length, femoral length, and tibial length.

Results:
The mean age at the time of diagnosis was 12.3±3.4 years. No statistically significant differences were found between the affected and contralateral sides for mechanical lateral distal femoral angle and mechanical medial proximal tibial angle in either the distal femur or the proximal tibia groups. In patients with femoral lesions, the femoral and whole-leg lengths were significantly shorter on the affected side than on the unaffected side (P<0.001 and 0.002, respectively), and the mean differences were 2.1±3.6 and 2.1±4.4 mm, respectively. Univariate logistic regression analysis did not reveal any factors associated with limb length discrepancy (LLD). In patients with tibial lesions, no statistically significant differences were found in LLD.

Conclusions:
SOs around the knee did not cause clinically significant deformity of the lower extremity. However, in contrast to proximal tibia lesions, SO in the distal femur was associated with the shortening of the affected limb. Consideration should be given to the development of LLD in skeletally immature children with SO in the distal femur.

Level of Evidence:
Level III—retrospective comparative study.
Does Preoperative Back Pain Impact Patient-reported Outcomes in Patients Undergoing Minimally Invasive Transforaminal Lumbar Interbody Fusion for Isthmic Spondylolisthesis?
Authors: Nie James W. , Hartman Timothy J. , Zheng Eileen , Oyetayo Omolabake O. , MacGregor Keith R. , Federico Vincent P. , Massel Dustin H. , Sayari Arash J. , Singh Kern 
Published: January 2024

Study Design:
Retrospective review.

Objective:
To determine postoperative clinical outcomes in patients undergoing minimally invasive (MIS) transforaminal lumbar interbody fusion (TLIF) for isthmic spondylolisthesis (IS).

Background:
Few studies have examined the postoperative clinical trajectory in patients undergoing MIS-TLIF specifically for IS.

Methods:
Patients were separated into two cohorts based on the previously defined Visual Analog Scale (VAS) back pain (BP) for severe pain: VAS-BP <7 and VAS-BP ≥7. Patient-reported outcome measures (PROMs) of Patient-Reported Outcomes Measurement Information System–physical function (PF), 12-item Short Form (SF-12) Physical/Mental Component Score, Patient Health Questionnaire-9, VAS-BP, VAS leg pain, and Oswestry Disability Index were collected preoperatively and up to 2-year postoperatively. Minimum clinically important difference (MCID) was calculated through previously defined thresholds.

Results:
A total of 160 patients were recorded, with 58 patients in the VAS-BP <7 cohort. The VAS-BP <7 cohort demonstrated significant improvement in all PROMs at one or more postoperative time points. The VAS-BP ≥7 demonstrated significant improvement at 3 or more postoperative time points in all PROMs except for SF-12 Mental Component Score. The VAS-BP <7 cohort reported significantly superior preoperative and postoperative PROMs in all domains, except for SF-12 Physical Component Score. The VAS-BP ≥7 cohort had higher MCID achievement rates at one or more time points in multiple PROMs.

Conclusion:
Patients undergoing MIS-TLIF for IS demonstrated significant postoperative improvement in PF, mental function, pain, and disability outcomes independent of preoperative severity of BP. Patients with lower preoperative BP demonstrated superior outcomes in PF, mental function, pain, and disability. However, patients with greater preoperative BP achieved higher rates of MCID in mental function, BP, and disability outcomes. Patients with greater severity of preoperative BP undergoing MIS-TLIF for IS may experience greater rates of clinically relevant improvement in mental function, BP, and disability outcomes.
The Effects of Preoperative Epidural Steroid Injection on Pseudarthrosis Following Lumbar Fusion
Authors: Coskun Ergin , Wellington Ian J. , Desai Shivam , Singh Hardeep , Mallozzi Scott S. , Moss Isaac L. 
Published: January 2024

Study Design:
Retrospective cohort study.

Objective:
The goal of this study is to evaluate the effects of preoperative lumbar epidural steroid injection on the rate of pseudarthrosis following lumbar spine fusion surgery.

Summary of Background Data:
Epidural corticosteroids help to reduce nerve root edema and suppress proinflammatory cytokines in patients with radiculopathy. Corticosteroids may inhibit bone formation and reduce bone matrix synthesis rates. Thus, there is concern that corticosteroids may reduce lumbar fusion capability, potentially resulting in increased rates of symptomatic pseudarthrosis.

Materials and Methods:
We identified all patients who underwent 1-level or 2-level lumbar fusion surgery between 2018 and 2022. Patients were categorized into one of 3 groups: no preoperative epidural steroid injection (ESI) history (group 0), preoperative ESI within 90 days of surgery (group 1), or most recent ESI >90 days before surgery (group 2). The primary outcome of this study was pseudarthrosis. Binominal regression analyses were performed to determine the relationships between potential risk factors (sex, age, body mass index, smoking history, diabetes status, history of systemic steroid use, preoperative ESI, perioperative intravenous steroid administration, type of surgery, and postoperative ESI within 6 mo) and the development of postoperative pseudarthrosis.

Results:
A total of 446 patients were included in this study. Of those, 106 patients (23.7%) did not have a preoperative ESI (group 0), 132 patients (29.5%) had an ESI within 90 days of surgery (group 1), and 208 patients (46.6%) had their most recent ESI >90 days before surgery (group 2). The overall incidence of pseudarthrosis following lumbar fusion was 8.7% (39 of 446). Although the incidence of pseudarthrosis following ESI at any time point was higher than in our control cohort (group 0), this difference was not statistically significant.

Conclusions:
This study found no increased risk of postoperative pseudarthrosis in patients who underwent 1-level or 2-level lumbar fusions after preoperative ESI.

Level of Evidence:
Level III.
Cerebral Oximetry During Pediatric In-Hospital Cardiac Arrest: A Multicenter Study of Survival and Neurologic Outcome
Authors: Raymond Tia T. , Esangbedo Ivie D. , Rajapreyar Prakadeshwari , Je Sangmo , Zhang Xuemei , Griffis Heather M. , Wakeham Martin K. , Petersen Tara L. , Kirschen Matthew P. , Topjian Alexis A. , Lasa Javier J. , Francoeur Conall I. , Nadkarni Vinay M. ,   for the pediatric Resuscitation Quality (pediRES-Q) Collaborative Investigators
Published: January 2024

Objectives:
To determine if near-infrared spectroscopy measuring cerebral regional oxygen saturation (crSo
2) during cardiopulmonary resuscitation is associated with return of spontaneous circulation (ROSC) and survival to hospital discharge (SHD) in children.

Design:
Multicenter, observational study.

Setting:
Three hospitals in the pediatric Resuscitation Quality (pediRES-Q) collaborative from 2015 to 2022.

Patients:
Children younger than 18 years, gestational age 37 weeks old or older with in-hospital cardiac arrest (IHCA) receiving cardiopulmonary resuscitation greater than or equal to 1 minute and intra-arrest crSo
2 monitoring.

Interventions:
None.

Measurements and Main Results:
Primary outcome was ROSC greater than or equal to 20 minutes without extracorporeal membrane oxygenation. Secondary outcomes included SHD and favorable neurologic outcome (FNO) (Pediatric Cerebral Performance Category 1–2 or no change from prearrest). Among 3212 IHCA events (index and nonindex), 123 met inclusion criteria in 93 patients. Median age was 0.3 years (0.1–1.4 yr) and 31% (38/123) of the cardiopulmonary resuscitation events occurred in patients with cyanotic heart disease. Median cardiopulmonary resuscitation duration was 8 minutes (3–28 min) and ROSC was achieved in 65% (80/123). For index events, SHD was achieved in 59% (54/91) and FNO in 41% (37/91). We determined the association of median intra-arrest crSo
2 and percent of crSo
2 values above a priori thresholds during the: 1) entire cardiopulmonary resuscitation event, 2) first 5 minutes, and 3) last 5 minutes with ROSC, SHD, and FNO. Higher crSo
2 for the entire cardiopulmonary resuscitation event, first 5 minutes, and last 5 minutes were associated with higher likelihood of ROSC, SHD, and FNO. In multivariable analysis of the infant group (age < 1 yr), higher crSo
2 was associated with ROSC (odds ratio [OR], 1.06; 95% CI, 1.03–1.10), SHD (OR, 1.04; 95% CI, 1.01–1.07), and FNO (OR, 1.05; 95% CI, 1.02–1.08) after adjusting for presence of cyanotic heart disease.

Conclusions:
Higher crSo
2 during pediatric IHCA was associated with increased rate of ROSC, SHD, and FNO. Intra-arrest crSo
2 may have a role as a real-time, noninvasive predictor of ROSC.
Multimodal Imaging Characterization of Butterfly Hair–Induced Keratitis
Authors: Yuan Yue , Wang Shanshan , Guo Dadong , Zhao Zengchao , Zheng Fangqiang , Xu YongYu , Jin Ziqun , Bi Hongsheng , Wen Ying 
Published: January 2024

Purpose:
Multimodal imaging was performed to characterize butterfly hair–induced keratitis based on anterior segment optical coherence tomography and in vivo confocal microscopy.

Methods:
This study was a case report.

Results:
A 6-year-old girl presented with acute keratitis induced by multiple butterfly hairs. Severe itching and pain developed immediately after rubbing her left eye, leading to significant pain and moderate vision loss, even after undergoing twice removal of the corneal epithelium. The hair-like foreign bodies were distributed at various depths inside the corneal stroma, even extending into the anterior chamber. The symptoms and corneal infiltration gradually decreased within 6 months with the use of topical steroids and immunosuppressors. The hairs located in the superficial and middle stromal layers of the cornea disappeared at the 6-month follow-up, but the hairs in the deep stromal layer tended to move deeper. The diagnosis was confirmed by in vivo confocal microscopy and microphotography. The migration tendency of the hairs into the intraocular space was observed using anterior segment optical coherence tomography (AS-OCT).

Conclusions:
Butterfly hair–induced keratitis can be controlled by the treatment with topical steroids and immunosuppressors, but the hairs tend to move into the eyes. To the best of our knowledge, this is the first case of corneal in vivo confocal imaging of butterfly hairs.
Development and external validation of a novel model for predicting new clinically important atrial fibrillation after thoracoscopic anatomical lung cancer surgery: a multicenter retrospective cohort study
Authors: Tong Chaoyang , Niu Zhenyi , Zhu Hongwei , Li Tingting , Xu Yuanyuan , Yan Yan , Miao Qing , Jin Runsen , Zheng Jijian , Li Hecheng , Wu Jingxiang 
Published: January 2024

Background:
New clinically important postoperative atrial fibrillation (POAF) is the most common arrhythmia after thoracoscopic anatomical lung cancer surgery and is associated with increased morbidity and mortality. The full spectrum of predictors remains unclear, and effective assessment tools are lacking. This study aimed to develop and externally validate a novel model for predicting new clinically important POAF.

Methods:
This retrospective study included 14 074 consecutive patients who received thoracoscopic anatomical lung cancer surgery from January 2016 to December 2018 in Shanghai Chest Hospital. Based on the split date of 1 January 2018, we selected 8717 participants for the training cohort and 5357 participants for the testing cohort. For external validation, we pooled 2941 consecutive patients who received this surgical treatment from July 2016 to July 2021 in Shanghai Ruijin Hospital. Independent predictors were used to develop a model and internally validated using a bootstrap-resampling approach. The area under the receiver operating characteristic curves (AUROCs) and Brier score were performed to assess the model discrimination and calibration. The decision curve analysis (DCA) was used to evaluate clinical validity and net benefit. New clinically important POAF was defined as a new-onset of POAF that causes symptoms or requires treatment.

Results:
Multivariate analysis suggested that age, hypertension, preoperative treatment, clinical tumor stage, intraoperative arrhythmia and transfusion, and operative time were independent predictors of new clinically important POAF. These seven candidate predictors were used to develop a nomogram, which showed a concordance statistic (C-statistic) value of 0.740 and good calibration (Brier score; 0.025). Internal validation revealed similarly good discrimination (C-statistic, 0.736; 95% CI: 0.705–0.768) and calibration. The decision curve analysis showed positive net benefits with the threshold risk range of 0–100%. C-statistic value and Brier score were 0.717 and 0.028 in the testing cohort, and 0.768 and 0.012 in the external validation cohort, respectively.

Conclusions:
This study identified seven predictors of new clinically important POAF, among which preoperative treatment, intraoperative arrhythmia, and operative time were rarely reported. The established and externally validated model has good performance and clinical usefulness, which may promote the application of prevention and treatment in high-risk patients, and reduce the development and related adverse outcomes of this event.