bluuebunny/crossref_metadata_2025_split huggingface dataset:
The new wave of Congo virus in Pakistan: emerging threat
Authors: Masood Isra , Tahir Muhammad Junaid , Naeem Ather , Shrateh Oadi N. , Ahmed Ali 
Published: November 2023

AbstractCongo virus, or Crimean–Congo hemorrhagic fever (CCHF), is a tick-borne disease caused by a single-stranded RNA virus (genus nairovirus, Bunyaviridae family). It spreads through infected ticks' bites or contact with viremic individuals or livestock. Factors supporting its spread include hot, humid climates, limited pesticide use, poor animal control, inadequate irrigation during monsoons, and vector control deficiencies. Nosocomial transmission in under-resourced hospitals poses a threat to healthcare workers. Decades of CCHF cases persist in Pakistan due to these factors, with six deaths reported by June 2023. To combat the epidemic, Pakistan should raise awareness, improve irrigation, establish surveillance systems, and implement livestock quarantine and vaccination.
Analysis of grounding system transient with consideration of soil ionization and mutual coupling effect
Authors: Sengar Kaushal Pratap , Chandrasekaran Kandasamy 
Published: November 2023

AbstractThe grounding system of an electrical substation provides safety to both operator and equipment. The lightning current waveform has a major influence on the dynamic performance of ground electrodes. If lightning current is large enough, soil will be ionized, which will have a great effect on the transient performance of the grounding system. Many numerical models have been developed to evaluate the transient performance of grounding system, still it is a challenging task to analyze the impulse behavior of grounding system efficiently. In this paper, the transient behavior of grounding systems with consideration of nonlinear and dynamic effects of soil ionization is presented. Grounding systems such as vertical rod, horizontal conductor and grounding grid buried in the homogeneous soil are considered as case study. Proposed model is the combination of circuit theory approach and method of moment with consideration of frequency-dependent impedance and mutual coupling effect between the conductor segments. Self and mutual component of inductance and resistance are considered in the analysis. Initially, transient performance of grounding system is analyzed for single vertical rod, horizontal and square grounding electrodes, further it is extended for vertical rod (more than one), horizontal conductor and grounding grids with different configurations. The analysis of grounding system with the consideration of mutual coupling effect is compared with devoid of mutual coupling, and differences between them are evaluated. For validating the developed method, simulated results are compared with the results reported in the literature, and good agreements are found. Analysis shows that the grounding impulse impedance decreased with increasing the magnitude of injected current. Developed method will help to improve the modeling of simple as well as complex grounding system buried in homogeneous soil.
Epigastric heteropagus twinning with dextrocardia: a case report
Authors: Siddiqua Ayesha , Noor-ul-Sabah  , Bhutta Muhammad Ramzan 
Published: November 2023

Abstract
Background
Heteropagus twinning is a rare birth defect in 1 in million live births. Epigastric heteropagus is the most frequent type, in which a smaller dependent (parasite twin) is attached to the body of the host (autosite twin) to the thorax and umbilicus. Several congenital anomalies have been previously described in the host twin. We describe the first case of epigastric heteropagus twinning with dextrocardia and situs inversus in which a successful surgical separation is performed.

Case presentation
A 48-h-old female sex twins were presented to Bahawal Victoria Hospital. A careful anatomic study using contrast X-ray, magnetic resonance imaging, and echocardiogram showed epigastric heteropagus twinning and situs inversus in autosite twin. A successful surgical separation was performed, and the parasite twin was removed from the body of the autosite twin.

Conclusions
Antepartum screening detects congenital malformations; however, several pregnancies are unsupervised in underdeveloped countries. In the case of heteropagus twinning, careful surgical separation in the absence of complications leads to the favorable survival of the autosite twin.
Effect of prematurely primary front teeth loss with anterior esthetic fixed appliance on fricative production in Arabic-speaking children
Authors: Sidhom Rania Makram , Melegy Reham Abd El-Waheed , Hosary Amina Mohamed El Nabawy El , Deen Shaima Mohamed Serag El 
Published: November 2023

Abstract
Background
Primary teeth affect the life quality regarding chewing, speech production, esthetics, and psychological well-being. Young children usually lose their primary maxillary incisors due to trauma or care and that leads to fault production of alveolar and dental fricatives. Fixed esthetic appliance replacing the lost primary front teeth were inserted and fricative sounds /s/,/s/,/∫ /,/z/and /z/ were tested before and after insertion of the fixed appliance through different time intervals.

Results
Improvement of fricative sound production occurred after fixed appliance insertion the /s/ sound, followed by /s/ sound showed immediate improvement while the /∫ / sound was the least to be improved even after 1 month duration. Both sounds /z/ and /z/ sound showed distortion immediately.

Conclusion
Premature loss of primary incisors in young children has a significant impact on speech production.
Endonasal endoscopic nasopharyngectomy for nasopharyngeal malignancies: a survival analysis
Authors: Iftikhar Haissan , Awan Muhammad Ozair , Ahmed Shahzada Khuram 
Published: November 2023

AbstractIntroductionNasopharyngeal cancer has a global incidence of less than 1.0 per 100,000 person-years. It originates from nasopharyngeal mucosa with the Fossa of Rosenmuller being the most common site. Radiation therapy with or without chemotherapy is an established first-line treatment modality given the sensitivity of the tumor.ObjectivesThe aim of our study was to report survival outcomes amongst patients undergoing endonasal endoscopic nasopharyngectomy at a tertiary care referral center.MethodsWe conducted a retrospective longitudinal cohort study. We collected data on age, gender, prior treatment, histology, extent of surgery, post-operative adjuvant therapy, and recurrence and reported the survival along mean survival time using Kaplan–Meier curves and log-rank test.ResultsA total of six patients, three males and three females with a mean age of 43.7 years were included in our study. Of the six, three patients underwent a salvage procedure whereas three patients received upfront definitive surgical resection. Three patients developed recurrence with a mean survival time of 19.3 months. The disease-free survival at 1 and 2 years of surgery was 88.3% and 66% respectively.ConclusionEndonasal endoscopic nasopharyngectomy is an effective surgical procedure that can be undertaken for both salvage and primary cases. Our survival results are comparable to the literature.
Prediction of Adjuvant Gemcitabine Sensitivity in Resectable Pancreatic Adenocarcinoma Using the GemPred RNA Signature: An Ancillary Study of the PRODIGE-24/CCTG PA6 Clinical Trial
Authors: Nicolle Rémy , Bachet Jean-Baptiste , Harlé Alexandre , Iovanna Juan , Hammel Pascal , Rebours Vinciane , Turpin Anthony , Ben Abdelghani Meher , Wei Alice , Mitry Emmanuel , Lopez Anthony , Biagi James , François Eric , Artru Pascal , Lambert Aurélien , Renouf Daniel J. , Monard Laure , Mauduit Marjorie , Dusetti Nelson , Conroy Thierry , Cros Jérome 
Published: November 2023

PURPOSE GemPred, a transcriptomic signature predictive of the efficacy of adjuvant gemcitabine (GEM), was developed from cell lines and organoids and validated retrospectively. The phase III PRODIGE-24/CCTG PA6 trial has demonstrated the superiority of modified folinic acid, fluorouracil, irinotecan, and oxaliplatin (mFOLFIRINOX) over GEM as adjuvant therapy in patients with resected pancreatic ductal adenocarcinoma at the expense of higher toxicity. We evaluated the potential predictive value of GemPred in this population. PATIENTS AND METHODS Routine formalin-fixed paraffin-embedded surgical specimens of 350 patients were retrieved for RNA sequencing and GemPred prediction (167 in the GEM arm and 183 in the mFOLFIRINOX [mFFX] arm). Survival analyses were stratified by resection margins, lymph node status, and cancer antigen 19-9 level. RESULTS Eighty-nine patients' tumors (25.5%) were GemPred+ and were thus predicted to be gemcitabine-sensitive. In the GEM arm, GemPred+ patients (n = 50, 30%) had a significantly longer disease-free survival (DFS) than GemPred– patients (n = 117, 70%; median 27.3 v 10.2 months, hazard ratio [HR], 0.43 [95% CI, 0.29 to 0.65]; P < .001) and cancer-specific survival (CSS; median 68.4 v 28.6 months, HR, 0.42 [95% CI, 0.27 to 0.66]; P < .001). GemPred had no prognostic value in the mFFX arm. DFS and CSS were similar in GemPred+ patients who received adjuvant GEM and mFFX (median 27.3 v 24.0 months, and 68.4 v 51.4 months, respectively). The statistical interaction between GEM and GemPred+ status was significant for DFS ( P = .008) and CSS ( P = .004). GemPred+ patients had significantly more adverse events of grade ≥3 in the mFFX arm (76%) compared with those in the GEM arm (40%; P = .001). CONCLUSION This ancillary study of a phase III randomized trial demonstrates that among the quarter of patients with a GemPred-positive transcriptomic signature, survival was comparable with that of mFOLFIRINOX, whereas those receiving adjuvant gemcitabine had fewer adverse events.
Perioperative Atezolizumab Plus Fluorouracil, Leucovorin, Oxaliplatin, and Docetaxel for Resectable Esophagogastric Cancer: Interim Results From the Randomized, Multicenter, Phase II/III DANTE/IKF-s633 Trial
Authors: Lorenzen Sylvie , Götze Thorsten Oliver , Thuss-Patience Peter , Biebl Matthias , Homann Nils , Schenk Michael , Lindig Udo , Heuer Vera , Kretzschmar Albrecht , Goekkurt Eray , Haag Georg Martin , Riera-Knorrenschild Jorge , Bolling Claus , Hofheinz Ralf-Dieter , Zhan Tianzuo , Angermeier Stefan , Ettrich Thomas Jens , Siebenhuener Alexander Reinhard , Elshafei Moustafa , Bechstein Wolf Otto , Gaiser Timo , Loose Maria , Sookthai Disorn , Kopp Christina , Pauligk Claudia , Al-Batran Salah-Eddin ,   for the AIO and SAKK Study Working Groups
Published: November 2023

PURPOSE This trial evaluates the addition of the PD-L1 antibody atezolizumab (ATZ) to standard-of-care fluorouracil, leucovorin, oxaliplatin, and docetaxel (FLOT) as a perioperative treatment for patients with resectable esophagogastric adenocarcinoma (EGA). METHODS DANTE started as multicenter, randomized phase II trial, which was subsequently converted to a phase III trial. Here, we present the results of the phase II proportion, focusing on surgical pathology and safety outcomes on an exploratory basis. Patients with resectable EGA (≥cT2 or cN+) were assigned to either four preoperative and postoperative cycles of FLOT combined with ATZ, followed by eight cycles of ATZ maintenance (arm A) or FLOT alone (arm B). RESULTS Two hundred ninety-five patients were randomly assigned (A, 146; B, 149) with balanced baseline characteristics between arms. Twenty-three patients (8%) had tumors with microsatellite instability (MSI), and 58% patients had tumors with a PD-L1 combined positive score (CPS) of ≥1. Surgical morbidity (A, 45%; B, 42%) and 60-day mortality (A, 3%; B, 2%) were comparable between arms. Downstaging favored arm A versus arm B (ypT0, 23% v 15% [one-sided P = .044]; ypT0-T2, 61% v 48% [one-sided P = .015]; ypN0, 68% v 54% [one-sided P = .012]). Histopathologic complete regression rates (pathologic complete response or TRG1a) were higher after FLOT plus ATZ (A, 24%; B, 15%; one-sided P = .032), and the difference was more pronounced in the PD-L1 CPS ≥10 (A, 33%; B, 12%) and MSI (A, 63%; B, 27%) subpopulations. Complete margin-free (R0) resection rates were relatively high in both arms (A, 96%; B, 95%). The incidence and severity of adverse events were similar in both groups. CONCLUSION Within the limitations of the exploratory nature of the data, the addition of ATZ to perioperative FLOT is safe and improved postoperative stage and histopathologic regression.
Drug Shortages in Oncology: ASCO Clinical Guidance for Alternative Treatments
Authors: Santos Edgardo S. , Oliver Thomas K. , Lacchetti Christina , Geisel Rachel , Wilfong Lalan S. , Fader Amanda N. , Eng Cathy 
Published: November 2023

PURPOSE To increase awareness, outline strategies, and offer clinical guidance on navigating the complexities of treatment planning amid antineoplastic drug shortages. METHODS A multidisciplinary panel of oncologists, ethicists, and patient advocates was assembled to provide rapid clinical guidance to help providers navigate appropriate patient care in cases where rationing or alternative therapies must be considered. The groups of content experts developed general principles for resource allocation during shortages and clinical guidance on alternative therapies for specific disease sites. The recommendations are supported by evidence when available. RESULTS A total of 44 volunteers with content expertise formed the Advisory Group that developed general guidance on the prioritization of antineoplastic agents in limited supply. Disease site–specific clinical guidance was then produced by subgroups on the basis of members' specialties and expertise. The majority of alternative treatment options were developed in consideration of cisplatin and carboplatin shortages. All guidance is posted on ASCO's website. RECOMMENDATIONS The prioritization of antineoplastic agents in limited supply should be based on specific goals of the therapy where evidence-based medicine has shown survival outcome and life-extending benefit in both early and advanced stages. Recommendations for specific disease sites are presented. While management options vary according to the disease site, alternatives are presented. For settings in which there are no alternatives with comparable efficacy and safety, it is recommended that patients are referred to an area where the necessary drug is available or can be obtained. Additional information is available at asco.org/drug-shortages .
Characterizing exceptional points using neural networks
Authors: Reja Afsar , Narayan Awadhesh 
Published: November 2023

Abstract
One of the key features of non-Hermitian systems is the occurrence of exceptional points (EPs), spectral degeneracies where the eigenvalues and eigenvectors merge. In this work, we propose applying neural networks to characterize EPs by introducing a new feature —summed phase rigidity (SPR). We consider different models with varying degrees of complexity to illustrate our approach, and show how to predict EPs for two-site and four-site gain and loss models. Further, we demonstrate an accurate EP prediction in the paradigmatic Hatano-Nelson model for a variable number of sites. Remarkably, we show how SPR enables a prediction of EPs of orders completely unseen by the training data. Our method can be useful to characterize EPs in an automated manner using machine learning approaches.
Building a “trap model” of glassy dynamics from a local structural predictor of rearrangements
Authors: Ridout S. A. , Tah I. , Liu A. J. 
Published: November 2023

Abstract
Here we introduce a variation of the trap model of supercooled liquids based on softness, a particle-based variable identified by machine learning that quantifies the local structural environment and energy barrier for the particle to rearrange. As in the trap model, we assume that each particle's softness, and hence energy barrier, evolves independently. We show that our model makes qualitatively reasonable predictions of behaviors such as the dependence of fragility on density in a model supercooled liquid. We also show failures of the model, indicating in some cases signs that softness may be missing important information, and in other cases features that may only be explained by correlations neglected in the trap model.
The Global Plastics Treaty: An Endocrinologist's Assessment
Authors: Fernandez Marina Olga , Trasande Leonardo 
Published: November 2023

Abstract
Plastics are everywhere. They are in many goods that we use every day. However, they are also a source of pollution. In 2022, at the resumed fifth session of the United Nations Environment Assembly, a historic resolution was adopted with the aim of convening an Intergovernmental Negotiating Committee to develop an international legally binding instrument on plastic pollution, including in the marine environment, with the intention to focus on the entire life cycle of plastics. Plastics, in essence, are composed of chemicals. According to a recent report from the secretariat of the Basel, Rotterdam, and Stockholm conventions, around 13 000 chemicals are associated with plastics and plastic pollution. Many of these chemicals are endocrine-disrupting chemicals and, according to reports by members of the Endocrine Society and others, exposure to some of these chemicals causes enormous costs due to the development of preventable diseases. The global plastics treaty brings the opportunity for harmonized, international regulation of chemicals with endocrine disrupting properties present in plastic products.
An Artificial Neural Network Model for Predicting Postoperative Facial Nerve Outcomes After Vestibular Schwannoma Surgery
Authors: Zohdy Youssef M. , Alawieh Ali M. , Bray David , Pradilla Gustavo , Garzon-Muvdi Tomas , Ashram Yasmine A. 
Published: November 2023

BACKGROUND AND OBJECTIVES:
The emergence of machine learning models has significantly improved the accuracy of surgical outcome predictions. This study aims to develop and validate an artificial neural network (ANN) model for predicting facial nerve (FN) outcomes after vestibular schwannoma (VS) surgery using the proximal-to-distal amplitude ratio (P/D) along with clinical variables.

METHODS:
This retrospective study included 71 patients who underwent VS resection between 2018 and 2022. At the end of surgery, the FN was stimulated at the brainstem (proximal) and internal acoustic meatus (distal) and the P/D was calculated. Postoperative FN function was assessed using the House-Brackmann grading system at discharge (short-term) and after 9–12 months (long-term). House-Brackmann grades I–II were considered good outcome, whereas grades III–VI were considered fair/poor. An ANN model was constructed, and the performance of the model was evaluated using the area under the ROC curve for internal validation and accuracy, sensitivity, specificity, and positive and negative predictive values for external validation.

RESULTS:
The short-term FN outcome was grades I–II in 57.7% and grades III–VI in 42.3% of patients. Initially, a model using P/D had an area under the curve of 0.906 (internal validation) and an accuracy of 89.1% (95% CI: 68.3%-98.8%) (external validation) for predicting good vs fair/poor short-term FN outcomes. The model was then refined to include only muscles with a P/D with a proximal latency between 6 and 8 ms. This improved the accuracy to 100% (95% CI: 79%-100%). Integrating clinical variables (patient's age, tumor size, and preoperative HB grade) in addition to P/D into the model did not significantly improve the predative value. A model was then created to predict the long-term FN outcome using P/D with latencies between 6 and 8 ms and had an accuracy of 90.9% (95% CI: 58.7%-99.8%).

CONCLUSION:
ANN models incorporating P/D can be a valuable tool for predicting FN outcomes after VS surgery. Refining the model to include P/D with latencies between 6 and 8 ms further improves the model's prediction. A user-friendly interface is provided to facilitate the implementation of this model.
Social Determinants of Health Impact Spinal Cord Injury Outcomes in Low- and Middle-Income Countries: A Meta-Epidemiological Study
Authors: Covell Michael M. , Naik Anant , Shaffer Annabelle , Cramer Samuel W. , Alan Nima , Shabani Hamisi K. , Rabiel Happiness , Rosseau Gail , Arnold Paul M. 
Published: November 2023

BACKGROUND AND OBJECTIVES:
Traumatic spinal cord injuries (SCI), which disproportionally occur in low- and middle-income countries (LMICs), pose a significant global health challenge. Despite the prevalence and severity of SCI in these settings, access to appropriate surgical care and barriers to treatment remain poorly understood on a global scale, with data from LMICs being particularly scarce and underreported. This study sought to examine the impact of social determinants of health (SDoH) on the pooled in-hospital and follow-up mortality, and neurological outcomes, after SCI in LMICs.

METHODS:
A systematic review was conducted in adherence to the Preferred Reporting in Systematic Review and Meta-Analysis-guidelines. Multivariable analysis was performed by multivariable linear regression, investigating the impact of the parameters of interest (patient demographics, country SDoH characteristics) on major patient outcomes (in-hospital/follow-up mortality, neurological dysfunction).

RESULTS:
Forty-five (N = 45) studies were included for analysis, representing 13 individual countries and 18 134 total patients. The aggregate pooled in-hospital mortality rate was 6.46% and 17.29% at follow-up. The in-hospital severe neurological dysfunction rate was 97.64% and 57.36% at follow-up. Patients with rural injury had a nearly 4 times greater rate of severe in-hospital neurological deficits than patients in urban areas. The Gini index, reflective of income inequality, was associated with a 23.8% increase in in-hospital mortality, a 20.1% decrease in neurological dysfunction at follow-up, and a 12.9% increase in mortality at follow-up.

CONCLUSION:
This study demonstrates the prevalence of injury and impact of SDoH on major patient outcomes after SCI in LMICs. Future initiatives may use these findings to design global solutions for more equitable care of patients with SCI.