bluuebunny/crossref_metadata_2025_split huggingface dataset:
Vertebral Artery Dissection in the Setting of Unstable Os Odontoideum
Authors: Finkel Ryan A. , Narendran Nakul , Nilssen Paal K. , Skaggs David L. , Illingworth Kenneth D. 
Published: December 2023

Update
This article was updated on February 23, 2024 because of a previous error. One author was left off of the author list. The updated author list is Ryan A. Finkel, MD, Nakul Narendran, BA, Paal K. Nilssen, BA, David L. Skaggs, MD, MMM, and Kenneth D. Illingworth, MD.
An erratum (JBJS Case Connect. 2024;14[1]:e23.00466ER) has been published for this article.

Case:
A healthy 5-year-old boy presented with a gradual onset of headaches and acute global right-sided weakness over 10 days. The work-up revealed unstable os odontoideum leading to multiple posterior circulation infarcts with vertebral artery dissection. He underwent antiplatelet therapy, cervical collar immobilization, and delayed occiput to C2 posterior spinal fusion and instrumentation with iliac crest autograft. At 2-year follow-up, the patient had a solid fusion mass, appropriate cervical alignment, and was without neurologic sequelae.

Conclusion:
This case adds to a sparse body of literature in the management of vertebral artery dissection with vertebrobasilar insufficiency secondary to unstable os odontoideum.
Empirical Vulnerability Analysis of Automated Smart Contracts Security Testing on Agricultural Blockchains
Authors: Ganguly Ankit , Dash Dipti , Mohapatra Priyabrata 
Published: December 2023

Abstract
This study endeavors to uncover and rectify potential vulnerabilities within smart contracts, specifically within the framework of an agricultural block-chain setting. The overarching goal is to bolster the security and credibility of agricultural smart contracts, thereby establishing a foundation of trust and dependability in block-chain-driven agricultural ecosystems. The study’s primary focus lies in the synthesis of two innovative techniques: the ABC-GOA optimization and ensemble learning model. ABC-GOA optimization methodically windows down optimal feature selections from the set of features, which are extracted by AST from smart contract dataset, ensuring that only the most pertinent attributes are considered. This step augments the precision and efficacy of subsequent processes. Complementing this, the ensemble learning model ingeniously amalgamates diverse individual models, culminating in a collective classification approach that is more robust, insightful, and proficient. The results offer a resilient shield against potential threats and vulnerabilities inherent to smart contracts in agriculture, thereby fortifying the reliability and safety of block-chain-powered agricultural systems. This research contributes significantly to advancing secure and efficient smart contract deployment in the dynamic realm of agricultural block-chain applications.
The role of machine learning methods in assessing the risk of neonatal Sepsis: A study of biochemical markers and genetic variants
Authors: Zhao Xiaofen , Yang Mifeng , Feng Xingxing , Zhao Pengna , Zhu Shuangyan , Liu Kai 
Published: December 2023

Abstract
Neonatal Sepsis is a life-threatening infection that affects neonates, and its morbidity and mortality rates remain high. There is currently no effective method for timely diagnosis and prevention of neonatal Sepsis. Using machine learning techniques, we aimed to analyze the risk factors of neonatal Sepsis, including biochemical indicators and genetic variants. We collected data from 107 neonates, 56 of whom were in the sepsis cohort and 51 were not. We classified the data using support vector machine (SVM) and random forest (RF) models and evaluated model performance and feature significance. PCT (calcitoninogen level), WBC (white blood cell count), and IL-6 (interleukin-6 level) were the characteristics most strongly associated with sepsis risk. We analyzed the association between genetic variants in CRP (C-reactive protein) and IL-10 and biochemical markers using the Kruskal-Wallis H test and linear regression. CRP gene variants were significantly associated with CRP levels, whereas IL-10 gene variants were substantially distinct from Hb (hemoglobin) levels. These findings shed light on potential biomarkers and genetic correlates of neonatal Sepsis, which will inform future clinical diagnosis and treatment.
Sequential structural evolution triggered by O-O dimerization in oxygen-redox reactions
Authors: Yamada Atsuo , Shi Xiang-Mei , Okubo Masashi 
Published: December 2023

Abstract
The participation of oxygen in electrochemical reactions increases the capacity of lithium-ion battery positive electrodes beyond conventional cationic-redox limits. However, structural degradation due to oxidized oxide ions significantly reduces the discharge voltage compared with that in the first charge, mostly with a capacity loss. In this study, we showed that O-O dimerization triggers transition-metal migration in an oxygen-redox positive electrode upon charging. First-principles calculations were performed to reveal the thermodynamic and kinetic energy landscapes of the full structural evolution of a typical lithium-rich oxide, i.e., Li1.2Ni0.13Co0.13Mn0.54O2. The oxygen oxidation process can be divided into three sequential steps: (i) generation of persistent oxidized oxide ion O−; (ii) peroxide formation; and (iii) transition-metal migration. The elusive use of O2−/O− while blocking O-O dimerization is the key to avoiding structural degradation due to transition-metal migration and realizing energy-efficient oxygen-redox reactions.
Using the GEPR model to predict outcomes of geriatric emergency general surgery
Authors: Xu Dequan , Zhou Haoxin , Rong Jie , Xie Xin , Hou Limin 
Published: December 2023

Abstract
Purpose
The present study aimed to develop artificial intelligence (AI)-based model and GEPR, derived from geriatric data, to predict the outcomes of geriatric EGS.
Methods
A retrospectively database of geriatric EGS patients who underwent emergency surgery was used for the development of the AI model and GEPR. The study employed a specialized algorithm, comprising of four sequential steps: scale prototype selection, clinical data collection and collation, AI model development, and GEPR development.
Results
In total, 1500 patients were enrolled with mean age of 69.8 years in the study.RandomForestClassifier algorithm outperformed the other AI models. Based on the feature importance, GEPR was derived with a total score range of 0–26. The GEPR has a c-statistic of 0.872 for mortality in hospital (95%CI 0.840–0.905). The observed probability of mortality in hospital gradually increased from 0% at a score of 0 to 63.3% at a score of 12 and 100% at a score of 15 .
Conclusion
Using patient-related and technical parameters, an GEPR derived from AI algorithms for prediction of surgical complications in geriatric EGS was developed. GEPR reliably predicts postoperative the mortality in hospital in geriatric EGS patients. Further prospective multicenter trials are needed to externally validate the model developed.
Triumph Over Adversity: A Case Report on Early Diagnosis and Effective Treatment of Progressive Acute Transverse Myelitis in the COVID-19 Era
Authors: Xiong Xudong , Chen Liyun , Xie Fang , Li Shufang 
Published: December 2023

Abstract
Introduction: Acute Transverse Myelitis (ATM) is a rare acute inflammatory disease. Currently, there are no data on the incidence rates in China or other Asian countries. ATM can occur due to various causes, including infections, autoimmune diseases, and demyelinating diseases. The incidence of ATM related to COVID-19 is even rarer, with few reports available. The aim of the current study is to report a rare case of transverse myelitis during COVID-19 infection.
Case presentation: A 65-year-old male patient developed fever, cough, and fatigue on December 25, 2022, and tested positive for COVID-19. After self-medicating, his fever subsided, but he soon experienced chest tightness and abdominal discomfort. Admitted to the emergency department on January 2, 2023, he quickly developed muscle weakness in his lower limbs, progressing to severe weakness (1/5 strength) and urinary retention. This weakness extended to his upper limbs, reducing his strength to 3-/5 and impairing his ability to use a mobile phone. Numbness also spread to his navel area. A positive Babinski sign was noted five days later. He showed significant improvement following timely diagnosis and pulse glucocorticoid therapy.
Discussion: Research increasingly recognizes ATM as a neurological complication of COVID-19, though the exact mechanism of SARS-CoV-2 causing ATM is unclear. The virus may affect the spinal cord through direct invasion, cytokine storms, or autoimmune responses. ATM rapidly progresses and can cause multi-organ failure if untreated.
Conclusion: No specific treatment or standard protocol exists for ATM, but corticosteroid pulse therapy, especially with methylprednisolone, has been effective in treating ATM by promoting nerve conduction and restoring neurological function.
Curcumin Loaded Poly(Lactic Acid) – Poly(Propylene Glycol) with Boc-Glycine End group Copolymer in Drug Delivery Applications.
Authors: G Kalaimagal , Devarajan S , Soundararajan S , Gajalakshmi D 
Published: December 2023

Abstract
Poly (lactic acid) , Poly (propylene glycol) with Boc-Glycine linked polymer was synthesized from lactic acid, Poly (Propylene glycol) with Boc-Glycine. The synthesized polymers were characterized by using Infrared (IR) , Thermo gravimetric analysis (TGA), Nuclear Magnetic Resonance spectroscopic Techniques (1H NMR) and also characterized by Stability, Anti-inflammatory and Drug delivery studies were conducted in Vitro environments. PLA-PPG with Boc-Glycine copolymer polymer may be used in potential Drug delivery Applications in Pharmaceutical fields.
Work-related stress among Nurses: a comparative cross- sectional study of two Government Hospitals in Ghana
Authors: Gmayinaam Vincent Uwumboriyhie , Nortey Abraham Norman , Sedode Saviour , Apedo Samuel Kwasi , Ananga Mark Kwame , Kyedodu Gideon , Kwabla Pearl , Osei Eric 
Published: December 2023

Abstract

Background
Occupational stress is increasing globally and affecting all workplaces and countries' health professionals. There is, however, a paucity of literature on the issue in Ghana. Besides, policymakers have not given it the needed much attention. We, therefore, examined the prevalence and causes of occupational stress among nurses working in a secondary care and tertiary hospitals in Ghana.
Methods
We conducted health facility-based cross-sectional study among 248 nurses from two hospitals (Volta Regional Hospital [VRH] and Ho Teaching Hospital [HTH]). The Perceived stress scale (PSS) and Weiman Occupational Stress Scale (WOSS) were used to measure the stress level and occupational stressors among the nurses. Descriptive analyses and t-test were performed, and statistical significance as measured at the 0.05 level.
Results
Majority of nurses 77.8% of experienced a moderate level of stress. The total individual mean score of the nurses from the two hospitals (VRH = 3.02 and HTH = 3.09) were 25% higher than the established WOSS. Nursing difficult patients (t=-1.1196, p = 0.037), Unfriendly relationship with superiors, colleagues, and subordinates (t=-2.3333, p = 0.020), working with incompetent staff (t=-1.3129, p = 0.037) were the statistically significant stressors among nurses in the HTH. However, long work hours (t = 2.0841, p = 0.038) and needle-stick injuries (t = 2.6669, p = 0.008) were the statistically significant stressors among nurses from the VRH. Headache (VRH = 73.8% and HTH = 97.9%), Fatigue (VRH = 68.9% and HTH = 83.5%), Frustration VRH = 50.5% and HTH = 68.3%) and Lack of Concentration (VRH = 81.6% and HTH = 80.0%) were the effects of occupational stress reported.
Conclusion
The study demonstrated increasing levels of occupational stress among nurses. To accelerate progress towards achieving the sustainable development goal (SDG) 3.4 of promoting mental health and wellbeing by 2030, the 2012 Mental Health Act of Ghana and the Occupation Health and safety regulations, should fully and effectively be implemented by health facilities across the country.
Massive penetrating brain injury combined with open skull fracture- response strategies for complex head injuries
Authors: Zheng Yun-Cong 
Published: December 2023

Abstract
Purpose: Penetrating traumatic brain injury (PTBI) is an extremely serious and fatal trauma. Proper primary evaluation and prompt surgical management will improve patient survival rates. However, this condition is rare in Taiwan, and there are no updated standards and guidelines to deal with this condition.Materials and Methods: A 67-year-old male, worker, fell from a height of 3 meters. His head was inserted into the metal structure at the site. The emergency medical technician cut off a piece of metal to deliver the patient to my emergency room under the protection of a neck collar. Brain CT in E1V1M5 status shows a metallic foreign body penetrating through the left high fronto-parietal lobe into Lt parietal lobe with associated open skull fracture, pneumocephalus, and adjacent intracerebral hemorrhage (ICH). Depressed skull pieces with traumatic subarachnoid hemorrhage complicated the neurological conditions. We provide experience with possible steps in setting up PTBI.Results: After initial resuscitation, emergency personnel prescribed ceftriaxone and metronidazole to control central nervous system infection. A loading dose of depakine is also given to prevent seizures. We arranged an emergency craniectomy to remove the foreign body, ICH, and bone fragments inserted into the brain parenchyma with a microscope. After bleeding control and debridement, a subdural drain was inserted as an intracranial pressure monitor. Following antibiotics control and anticonvulsant agent continued at neurosurgery intensive care unit. Cranioplasty was performed 2 weeks later. He was transferred to the rehabilitation department under E4V2M5 status with right hemiplegia. Now, the patient's coma scale has recovered to E4V3M6, and the muscle power of the right lower limb has recovered to 2 in the bottom of this September.Conclusions: In the era of the ongoing war between Ukraine and Russia, the possibility of PTBI occurring may continue to increase. As a neurosurgeon, you must be prepared for danger in times of crisis and know how to deal with PTBI efficiently. When faced with many injuries or a war situation, our cases can provide valuable experience.
Efficacy of MP-3 Microperimeter Biofeedback Fixation Training in Children with Eccentric Fixation Amblyopia
Authors: Wang Shaoyi , Wang Jiawei , Xi Ruijie , Chai Song 
Published: December 2023

Abstract
Background：To evaluate the efficacy of MP-3 microperimeter biofeedback fixation training (MBFT) in children with eccentric fixation amblyopia, including assessment of retinal sensitivity, fixation characteristics, and fixation stability.
Methods: This prospective study evaluated 11 amblyopic eyes of 11 children under 12 years old. All the patients presented to the Second Hospital of Hebei Medical University, China, from December 2020 to December 2022. All children were trained for three 20 minutes MBFT sessions per week for 8 weeks using the MP-3 microperimeter (NIDEK, Japan). Best corrected visual acuity (BCVA) was recorded pre- and post-training. The microperimeter automatically measured the mean retinal sensitivity, fixation stability [(including the percentage of fixation points located within 2° and 4° diameter circles, and calculated the area containing 68.2%, 95.4%, 99.6% of fixation points to construct the bivariate contour ellipse area (BCEA)] and fixation characteristics (percentage of fixation points within a 2° foveal diameter) pre- and post-training. The differences between mean retinal sensitivity, fixation stability, and fixation characteristics were compared pre- and post-training with P<0.05 indicating statistical significance.
Results：BCVA and mean retinal sensitivity improved significantly after training (P=0.0078, P=0.0071, respectively). The fixation stability at both 2° and 4° was significantly better after training (P=0.0020, P=0.0106, respectively). BCEAs encompassing 68.2%, 95.4%, 99.6% of fixation points decreased significantly after training (P=0.0377, P=0.0378, P=0.0377, respectively). The percentage of fixation points within the 2° foveal diameter increased significantly after training (P=0.0245).
Conclusions: MBFT with the MP-3 can effectively improve visual acuity, fixation characteristics, fixation stability and mean retinal sensitivity in children with eccentric fixation amblyopia, offering a new treatment for intractable cases.
Report of an intergeneric hybrid between the jandaya parakeet (Aratinga jandaya) and the beach parakeet (Eupsittula aurea) and a possible pairing between hybrid and parent
Authors: Leandro-Silva Victor , Queiroz Marney , Pereira Glauco Alves 
Published: December 2023

Abstract
Hybridization is relatively common and is underestimated due to the low level of knowledge about the reproductive biology of many bird species, especially neotropical ones. Here, we present a case of intergeneric hybridization in the Psittacidae family between the Jandaya Parakeet (Aratinga jandaya) and the Peach-fronted Parakeet (Eupsittula aurea). As well as reporting the hybrid, we also show a possible pairing between the hybrid and its parents. The plumage pattern of the recorded hybrid is similar to that of the Peach-fronted Parakeet, but with features that differ in the belly and head regions of the individual. Similarities in behavior and an almost complete overlap in the distribution of the species may have facilitated hybridization. Also, because they are illegally bred species (trafficking), we can't rule out the possibility that this individual came from captivity.
Evaluation of Post-Thrombolytic Events to Determine Appropriate ICU Monitoring Duration for Ischemic Stroke Patients
Authors: Reimer James , Wang Fajun , Ramiro Joanna , Welch Emily , Christopher Kara , Braun James 
Published: December 2023

Abstract

Background:
Alteplase, a tissue plasminogen activator, is the only FDA-approved medication for acute ischemic stroke (AIS). Current guidelines recommend monitoring patients in an intensive care unit (ICU) for 24 hours after thrombolytic therapy. However, recent studies have questioned the need for prolonged ICU monitoring. This retrospective cohort aims to identify potential candidates for early transition to a lower level of care by assessing risk factors for neurological deterioration, symptomatic intracranial hemorrhage (sICH), or need for ICU intervention within 24-hours post-thrombolysis.
Methods:
This retrospective cohort study included adult AIS patients 18 years and older who received thrombolysis in a tertiary care center. Patients were excluded if they were transferred to another facility, transitioned to comfort care or hospice care within 24 hours, or lacked imaging and National Institutes of Health Stroke Scale (NIHSS) score data. The primary endpoint was incidence of sICH between 0-12-hours and 12-24-hours. Secondary endpoints include the need for ICU intervention and rates of neurological deterioration.
Results:
The analysis included 204 patients who received the full dose of alteplase. Among them, 10 patients (4.9%) developed sICH, with the majority (n=7) occurring within 12 hours post-thrombolysis (p=0.350). Sixty-two patients required ICU interventions within 12 hours compared to 4 patients after 12 hours (p=0.022). Twenty-four patients had neurological deterioration within 12 hours and 7 patients after (p=0.415). Multivariable analysis identified mechanical thrombectomy and increased blood pressure at presentation as predictors of ICU need beyond 12 hours post-thrombolysis.
Conclusions:
Our study demonstrates that sICH, neurological deterioration, and need for ICU intervention rarely occurs beyond 12 hours after thrombolytic administration. These findings suggest that patients receiving thrombolysis for AIS, particularly those undergoing mechanical thrombectomy, may require 24 hours of ICU monitoring. Our results support the potential for early transition out from the ICU, leading to reduced hospital costs and optimized resource utilization.
Identifying obesogenic environment through spatial clustering of body mass index among adults
Authors: Wong Kimberly Yuin Yng , Moy Foong Ming , Shafie Aziz , Rampal Sanjay 
Published: December 2023

Abstract
Background
The environment plays a pivotal role in the increasing prevalence of obesity especially in developing countries due to globalization and nutrition transition. The tendency of body mass index (BMI) to cluster spatially indicates the presence of an obesogenic environment. However, spatial clustering analysis often requires lower regional data which are a challenge in developing countries. Therefore, this study aimed to determine the spatial clustering of BMI among adults in Malaysia through available point locations of national health survey respondents.
Method
This study utilized information of respondents aged 18 to59 years old from the National Health and Morbidity Survey (NHMS) 2014 and 2015 at Peninsular Malaysia and East Malaysia. Fast food restaurant proximity, district population density, and district median household income were determined from other sources. The analysis was conducted for total respondents and stratified by sex.
Results
Multilevel regression was used to produce the BMI estimates on a set of variables, adjusted for data clustering at enumeration blocks. Global Moran’s I and Local Indicator of Spatial Association statistics were applied to assess the general clustering and location of spatial clusters of BMI, respectively. Point locations of respondents and spatial weights of 8 km Euclidean radius or 5 nearest neighbours were applied. Spatial clustering of BMI independent of individual sociodemographic was significant (p < 0.001) in Peninsular and East Malaysia with Global Moran’s index of 0.12 and 0.15, respectively. High-BMI clusters (hotspots) were in suburban areas, whilst the main cities were low-BMI clusters (cold spots). Spatial clustering was greater among males with hotspots located closer to urban areas, whereas hotspots for females were in less urbanized areas.
Conclusion
Obesogenic environment was identified in suburban areas, where spatial clusters differ between males and females in some areas. Future studies and interventions on creating a healthier environment should be geographically targeted and consider gender differences.
A Universal Validation Method for Mitigating Machine Learning Extrapolation Risk
Authors: Yan Fangyou , Yu Mengxian , Zhou Yin-Ning , Wang Qiang 
Published: December 2023

Abstract
Machine Learning (ML) can provide decision-making advice for major challenges in science and engineering, and its rapid development has led to advances in fields like chemistry & medicine, earth & life, and communications & transportation. Grasping the trustworthiness of the decision-making advice given by ML models remains challenging, especially when applying them to samples outside the domain-of-application. Here, an untrustworthy application situation (i.e., complete extrapolation-failure) that would occur in models developed by ML methods involving tree algorithms is confirmed, and the root cause is revealed. Further, a universal extrapolation risk evaluation scheme, termed the extrapolation validation (EV) method, is proposed, which is not restricted to specific ML methods and model architecture in its applicability. The EV method quantitatively evaluates the extrapolation ability of 11 popularly applied ML methods and digitalizes the extrapolation risk arising from variations of the independent variables in each method. Meanwhile, the EV method provides insights and solutions for evaluating the reliability of out-of-distribution sample prediction and selecting trustworthy ML methods.