bluuebunny/crossref_metadata_2025_split huggingface dataset:
Vertebral giant cell tumour of bone in a domestic shorthair cat
Authors: Caldero Carrete Jordina , Tabanez Joana , Civello Alexander , Rusbridge Clare 
Published: April 2023

Case summary A 10-year-old male neutered domestic shorthair cat was presented with a 5-month history of progressive non-ambulatory paraparesis. Initial vertebral column radiographs revealed an L2–L3 expansile osteolytic lesion. Spinal MRI showed a well-demarcated, compressive expansile extradural mass lesion affecting the caudal lamina, caudal articular processes and right pedicle of the second lumbar vertebra. The mass was hypointense/isointense on T2-weighted images, isointense on T1-weighted images and had mild homogeneous contrast enhancement after gadolinium administration. MRI of the remaining neuroaxis and CT of the neck, thorax and abdomen with ioversol contrast revealed no additional neoplastic foci. The lesion was removed by en bloc resection via a dorsal L2–L3 laminectomy, including the articular process joints and pedicles. Vertebral stabilisation was performed with titanium screws placed within L1, L2, L3 and L4 pedicles with polymethylmethacrylate cement embedding. Histopathology revealed an osteoproductive neoplasm composed of spindle and multinucleated giant cells without detectable cellular atypia or mitotic activity. On immunohistochemical evaluation, osterix, ionised calcium-binding adaptor molecule 1 and vimentin labelling were observed. Based on the clinical and histological features, a giant cell tumour of bone was considered most likely. Follow-up at 3 and 24 weeks postoperatively demonstrated significant neurological improvement. Postoperative full-body CT at 6 months showed instability of the stabilisation construct but absence of local recurrence or metastasis. Relevance and novel information This is the first reported case of a giant cell tumour of bone in the vertebra of a cat. We present the imaging findings, surgical treatment, histopathology, immunohistochemistry and outcome of this rare neoplasm.
Hidden Pitches in Major League Baseball: What Are the Injury Implications of These Often Overlooked Pitches?
Authors: Erickson Brandon J. , Buchheit Paul , Rauch Joseph , Segedin Rob , Ciccotti Michael G. , Cohen Steven B. 
Published: April 2023

Background: Pitch counts are tightly monitored in Major League Baseball (MLB). Hidden pitches—including warm-up pitches before and between innings and pitches before the starting/relieving pitcher’s appearance in a game—are not as closely monitored. Purpose/Hypothesis: To report the number of hidden pitches thrown per game and over the course of a season for a single organization. We hypothesized that players who threw more hidden pitches would be at an increased risk of injury compared with those who threw fewer hidden pitches. Study Design: Case-control study; Level of evidence, 3. Methods: All pitchers who played for a single MLB organization in the 2021 season were included. Hidden pitches, in-game pitches, and total pitches thrown during all games in the season were recorded. Injuries to these pitchers were also recorded. Players were defined as having an injury if they spent any time on the injured list. Results: Overall, 137 pitchers were included, 66 (48%) of whom sustained an injury and were placed on the IL during the 2021 season (mean time on IL, 53.6 ± 45.6 days). Of the 66 players who sustained an injury, 18 (27.3%) sustained an elbow injury, while 12 (18.2%) sustained a shoulder injury. Only 1 player sustained an ulnar collateral ligament tear. When comparing hidden pitches, in-game pitches, and total pitches between pitchers who sustained an injury and those who did not, there were no significant differences between groups ( P = .150; P = .830; and P = .377, respectively). On average, hidden pitches made up 45.4% of the total number of pitches thrown during the course of the season. When evaluating the number of hidden pitches as a percentage of the total number of pitches thrown in a season, there was no significant difference between pitchers who sustained an injury and those who did not ( P = .654). Conclusion: MLB pitchers who sustained an injury did not throw more hidden pitches than those who did not sustain an injury. Larger scale studies are needed to confirm the results of this single-team study.
Bionate® nucleus disc replacement: bench testing comparing two different designs
Authors: Vanaclocha Amparo , Vanaclocha Vicente , Atienza Carlos M. , Clavel Pablo , Jordá-Gómez Pablo , Barrios Carlos , Vanaclocha Leyre 
Published: April 2023

Abstract
Background
Intervertebral disc nucleus degeneration initiates a degenerative cascade and can induce chronic low back pain. Nucleus replacement aims to replace the nucleus while the annulus is still intact. Over time, several designs have been introduced, but the definitive solution continues to be elusive. Therefore, we aimed to create a new nucleus replacement that replicates intact intervertebral disc biomechanics, and thus has the potential for clinical applications.

Materials and methods
Two implants with an outer ring and one (D2) with an additional midline strut were compared. Static and fatigue tests were performed with an INSTRON 8874 following the American Society for Testing and Materials F2267-04, F2346-05, 2077-03, D2990-01, and WK4863. Implant stiffness was analyzed at 0–300 N, 500–2000 N, and 2000–6000 N and implant compression at 300 N, 1000 N, 2000 N, and 6000 N. Wear tests were performed following ISO 18192-1:2008 and 18192-2:2010. GNU Octave software was used to calculate movement angles and parameters. The statistical analysis package R was used with the Deducer user interface. Statistically significant differences between the two designs were analyzed with ANOVA, followed by a post hoc analysis.

Results
D1 had better behavior in unconfined compression tests, while D2 showed a “jump.” D2 deformed 1 mm more than D1. Sterilized implants were more rigid and deformed less. Both designs showed similar behavior under confined compression and when adding shear. A silicone annulus minimized differences between the designs. Wear under compression fatigue was negligible for D1 but permanent for D2. D1 suffered permanent height deformation but kept its width. D2 suffered less height loss than D1 but underwent a permanent width deformation. Both designs showed excellent responses to compression fatigue with no breaks, cracks, or delamination. At 10 million cycles, D2 showed 3-times higher wear than D1. D1 had better and more homogeneous behavior, and its wear was relatively low. It showed good mechanical endurance under dynamic loading conditions, with excellent response to axial compression fatigue loading without functional failure after long-term testing.

Conclusion
D1 performed better than D2. Further studies in cadaveric specimens, and eventually in a clinical setting, are recommended.
Level of evidence 2c.
A voting-based machine learning approach for classifying biological and clinical datasets
Authors: Daneshvar Negar Hossein-Nezhad , Masoudi-Sobhanzadeh Yosef , Omidi Yadollah 
Published: April 2023

AbstractBackgroundDifferent machine learning techniques have been proposed to classify a wide range of biological/clinical data. Given the practicability of these approaches accordingly, various software packages have been also designed and developed. However, the existing methods suffer from several limitations such as overfitting on a specific dataset, ignoring the feature selection concept in the preprocessing step, and losing their performance on large-size datasets. To tackle the mentioned restrictions, in this study, we introduced a machine learning framework consisting of two main steps. First, our previously suggested optimization algorithm (Trader) was extended to select a near-optimal subset of features/genes. Second, a voting-based framework was proposed to classify the biological/clinical data with high accuracy. To evaluate the efficiency of the proposed method, it was applied to 13 biological/clinical datasets, and the outcomes were comprehensively compared with the prior methods.ResultsThe results demonstrated that theTraderalgorithm could select a near-optimal subset of features with a significant level of p-value < 0.01 relative to the compared algorithms. Additionally, on the large-sie datasets, the proposed machine learning framework improved prior studies by ~ 10% in terms of the mean values associated with fivefold cross-validation of accuracy, precision, recall, specificity, and F-measure.ConclusionBased on the obtained results, it can be concluded that a proper configuration of efficient algorithms and methods can increase the prediction power of machine learning approaches and help researchers in designing practical diagnosis health care systems and offering effective treatment plans.
Adaptive evolution characteristics of mitochondrial genomes in genus Aparapotamon (Brachyura, Potamidae) of freshwater crabs
Authors: Ji Yu-Tong , Zhou Xiao-Juan , Yang Qian , Lu Yuan-Biao , Wang Jun , Zou Jie-Xin 
Published: April 2023

Abstract
Background
Aparapotamon, a freshwater crab genus endemic to China, includes 13 species. The distribution of Aparapotamon spans the first and second tiers of China's terrain ladder, showing great altitudinal differences. To study the molecular mechanisms of adaptive evolution in Aparapotamon, we performed evolutionary analyses, including morphological, geographical, and phylogenetic analyses and divergence time estimation. We sequenced the mitogenomes of Aparapotamon binchuanense and Aparapotamon huizeense for the first time and resequenced three other mitogenomes of Aparapotamon grahami and Aparapotamon gracilipedum. These sequences were combined with NCBI sequences to perform comparative mitogenome analysis of all 13 Aparapotamon species, revealing mitogenome arrangement and the characteristics of protein-coding and tRNA genes.

Results
A new species classification scheme of the genus Aparapotamon has been detected and verified by different aspects, including geographical, morphological, phylogenetics and comparative mitogenome analyses. Imprints from adaptive evolution were discovered in the mitochondrial genomes of group A, including the same codon loss at position 416 of the ND6 gene and the unique arrangement pattern of the tRNA-Ile gene. Multiple tRNA genes conserved or involved in adaptive evolution were detected. Two genes associated with altitudinal adaptation, ATP8 and ND6, which experienced positive selection, were identified for the first time in freshwater crabs.

Conclusions
Geological movements of the Qinghai-Tibet Plateau and Hengduan Mountains likely strongly impacted the speciation and differentiation of the four Aparapotamon groups. After some group A species dispersed from the Hengduan Mountain Range, new evolutionary characteristics emerged in their mitochondrial genomes, facilitating adaptation to the low-altitude environment of China's second terrain tier. Ultimately, group A species spread to high latitudes along the upper reaches of the Yangtze River, showing faster evolutionary rates, higher species diversity and the widest distribution.
High frequency of NDM-1 and OXA-48 carbapenemase genes among Klebsiella pneumoniae isolates in central Iran
Authors: Abbasi Elnaz , Ghaznavi-Rad Ehsanollah 
Published: April 2023

Abstract
Background
The emergence and distribution of multidrug-resistant (MDR) and carbapenem-resistant Klebsiella pneumoniae (CRKP) has become a global health threat. Therefore, this study aimed to investigate the frequency and antibiotic resistance patterns of MDR, extensively drug-resistant (XDR), and CRKP, as well as the antibiotic resistance genes of Klebsiella pneumoniae (K. pneumoniae) isolates from patients’ infectious samples from central Iran.

Methods
This study examined 546 clinical samples of patients to identify K. pneumoniae. The isolates were investigated for their antibiotic resistance profile, extended-spectrum β-lactamase (ESBL), AMPC β-lactamase, carbapenemase resistance, sulfonamide, tetracycline, plasmid-mediated quinolone resistance (PMQR) along with their resistance genes, integrase, and quaternary ammonium compounds (qac) by polymerase chain reaction (PCR).

Results
Out of 546 clinical samples, 121 (22.1%) cases of K. pneumoniae were identified using culture and PCR methods. The highest antibiotic resistance rates were found for ampicillin (119/121; 98.3%), cotrimoxazole (78/121; 64.4%), and cefixime, cefotaxime, ceftriaxone, and ceftazidime as a group (77/121; 63.6%). Tigecycline, colistin, and fosfomycin were the most effective antimicrobial agents with 98.4%, 96.7%, and 95.9% susceptibility, respectively. The amount of CRKP was 51 (42.1%). All CRKP isolates were MDR. The most abundant genes were blaTEM (77/77; 100%), blaCTX−M1 (76/77; 98.7%), blaSHV (76/77; 98.7%), blaCTX−M15 (73/77; 94.8%) for ESBL; blaCIT 28 (48.3%) and blaCMY−2 26 (44.8%) for AMPC β-lactamase; and blaOXA−48 46 (90.1%) and blaNDM 36 (70.5%) for carbapenemase. Among the PMQR determinants, qnrB (25/52; 48%), qnrS (19/52; 36.5%), and qnrA (11/52; 21.1%) were positive from the isolates. TetA and tetB were recognized in 25 (44.6%) and 17 (30.3%) isolates, respectively. Class 1 and 2 integrons were recognized in 97 (80.1%) and 53 (43.8%) isolates, respectively.

Conclusions
Due to the high prevalence of MDR and CRKP in central Iran, tracking and immediate intervention are necessary for control and inhibition of K. pneumoniae resistant isolates. Tigecycline, colistin, and fosfomycin are the best treatment options for treatment of patients with CRKP in this geographical area.
Zinc supplementation and light intensity affect 2-acetyl-1-pyrroline (2AP) formation in fragrant rice
Authors: Shuochen Jiang , Lihe Zhang , Fenqin Hu , Xiangru Tang , Bin Du 
Published: April 2023

Abstract
Background
Improving the yield and aroma content of fragrant rice is the focus of fragrant rice research. Light and Zinc (Zn) management generally cause regulations in the 2-acetyl-1-pyrroline (2AP) accumulation in fragrant rice. In addition, Zn promotes rice growth and improves rice yield, which has the potential to compensate for the negative impact of low light on fragrant rice yield. However, the potential of Zn to improve fragrant rice yield and 2AP content under shading conditions has not been verified.

Methods
Field experiments were conducted in the rice season (May–September) in 2019 to 2021. Two light i.e., normal light (NL) and low light (LL) and four Zn levels i.e., 0 kg Zn ha− 1 (N0), 1 kg Zn ha− 1 (Zn1), 2 kg Zn ha− 1(Zn2), and 3 kg Zn ha− 1 (Zn3), which applied at booting stage was set up. The grain yield, 2AP contents, Zn content in polished rice, photosynthesis related indicators, MDA content, antioxidant enzyme activity and the biochemical parameters related to 2AP formation were investigated.

Results
Shading reduced yield by 8.74% and increased 2AP content by 24.37%. In addition, shading reduced net photosynthetic rate (Pn), superoxide dismutase (SOD), peroxidase (POD) and catalase (CAT), and increased proline, γ-aminobutyric acid (GABA), and pyrroline-5-carboxylic acid (P5C), proline dehydrogenase (PDH), △1-pyrroline-5-carboxylic acid synthetase (P5CS), malondialdehyde (MDA). With increasing Zn application levels, yield, 2AP, Zn content in polished rice, Pn, proline, P5C, GABA, PDH, P5CS, SOD, CAT and POD increased, and MDA decreased. Significant Light and Zn interaction effect on 2AP content was detected, and both shading and increasing Zn application increased the 2AP content.

Conclusion
Shading can increase the 2AP content but reduce the yield of fragrant rice. Increasing Zn application under shading conditions can further promote the biosynthesis of 2AP, but the effect of improving yield is limited.
A rare case report of the successful withdrawal of a stent balloon that failed to deflate
Authors: Yang Yong , Yang Shijun , Cheng Xiang , Liu Kun 
Published: April 2023

Abstract
Background
In current percutaneous coronary intervention (PCI) practice, the balloon used in the procedure should be deflated a short time after balloon dilation to avoid having prolonged balloon dilation in the coronary artery, which would block the coronary artery and cause myocardial ischemia. It is very rare for a dilated stent balloon to fail to deflate.

Case summary
A 44-year-old male was admitted to the hospital due to chest pain after exercise. Coronary angiography showed severe proximal stenosis of the right coronary artery (RCA) consistent with a diagnosis of coronary artery disease, and coronary stent implantation was required. After the last stent balloon was dilated, the stent balloon could not be deflated and continued to expand, resulting in blockage of the RCA blood flow. The patient then suffered decreased blood pressure and heart rate. Finally, the stent balloon in its expanded state was forcefully and directly withdrawn from the RCA and successfully removed from the body.

Conclusion
Deflation failure of a stent balloon is an extremely rare complication of PCI. Various treatment strategies can be considered based on hemodynamic status. In the case described herein, the balloon was pulled out of the RCA directly to restore blood flow, which kept the patient safe.
Comparing primary caregivers’ reported injury data with routinely recorded injury data to assess predictors of childhood injury
Authors: Ghebreab Luam , Kool Bridget , Lee Arier , Morton Susan 
Published: April 2023

Abstract
Background
Linking self-reported data collected from longitudinal studies with administrative health records is timely and cost-effective, provides the opportunity to augment information contained in each and can offset some of the limitations of both data sources. The aim of this study was to compare maternal-reported child injury data with administrative injury records and assess the level of agreement.

Methods
A deterministic linkage was undertaken to link injury-related data from the Growing up in New Zealand (GUiNZ) study to routinely collected injury records from New Zealand’s Accident Compensation Corporation (ACC) for preschool children. The analyses compared: (i) the characteristics of mothers with linked data vs. those without, (ii) injury incidences from maternal recall with those recorded in ACC injury claims, and (iii) the demographic characteristics of concordant and discordant injury reports, including the validity and reliability of injury records from both data sources.

Results
Of all mothers who responded to the injury questions in the GUiNZ study (n = 5836), more than 95% (n = 5637) agreed to have their child’s record linked to routine administrative health records. The overall discordance in injury reports showed an increasing trend as children grew older (9% at 9 M to 29% at 54 M). The mothers of children with discordance between maternal injury reports and ACC records were more likely to be younger, of Pacific ethnicity, with lower educational attainment, and live in areas of high deprivation (p < 0.001). The level of agreement between maternal injury recall and ACC injury record decreased (κ = 0.83 to κ = 0.42) as the cohort moved through their preschool years.

Conclusions
In general, the findings of this study identified that there was underreporting and discordance of the maternal injury recall, which varied by the demographic characteristics of mothers and their child’s age. Therefore, linking the routinely gathered injury data with maternal self-report child injury data has the potential to augment longitudinal birth cohort study data to investigate risk or protective factors associated with childhood injury.
Sample size calculations for indirect standardization
Authors: Wang Yifei , Chu Philip 
Published: April 2023

AbstractIndirect standardization, and its associated parameter the standardized incidence ratio, is a commonly-used tool in hospital profiling for comparing the incidence of negative outcomes between an index hospital and a larger population of reference hospitals, while adjusting for confounding covariates. In statistical inference of the standardized incidence ratio, traditional methods often assume the covariate distribution of the index hospital to be known. This assumption severely compromises one’s ability to compute required sample sizes for high-powered indirect standardization, as in contexts where sample size calculation is desired, there are usually no means of knowing this distribution. This paper presents novel statistical methodology to perform sample size calculation for the standardized incidence ratio without knowing the covariate distribution of the index hospital and without collecting information from the index hospital to estimate this covariate distribution. We apply our methods to simulation studies and to real hospitals, to assess both its capabilities in a vacuum and in comparison to traditional assumptions of indirect standardization.
Simulating complex patient populations with hierarchical learning effects to support methods development for post-market surveillance
Authors: Davis Sharon E. , Ssemaganda Henry , Koola Jejo D. , Mao Jialin , Westerman Dax , Speroff Theodore , Govindarajulu Usha S. , Ramsay Craig R. , Sedrakyan Art , Ohno-Machado Lucila , Resnic Frederic S. , Matheny Michael E. 
Published: April 2023

Abstract
Background
Validating new algorithms, such as methods to disentangle intrinsic treatment risk from risk associated with experiential learning of novel treatments, often requires knowing the ground truth for data characteristics under investigation. Since the ground truth is inaccessible in real world data, simulation studies using synthetic datasets that mimic complex clinical environments are essential. We describe and evaluate a generalizable framework for injecting hierarchical learning effects within a robust data generation process that incorporates the magnitude of intrinsic risk and accounts for known critical elements in clinical data relationships.

Methods
We present a multi-step data generating process with customizable options and flexible modules to support a variety of simulation requirements. Synthetic patients with nonlinear and correlated features are assigned to provider and institution case series. The probability of treatment and outcome assignment are associated with patient features based on user definitions. Risk due to experiential learning by providers and/or institutions when novel treatments are introduced is injected at various speeds and magnitudes. To further reflect real-world complexity, users can request missing values and omitted variables. We illustrate an implementation of our method in a case study using MIMIC-III data for reference patient feature distributions.

Results
Realized data characteristics in the simulated data reflected specified values. Apparent deviations in treatment effects and feature distributions, though not statistically significant, were most common in small datasets (n < 3000) and attributable to random noise and variability in estimating realized values in small samples. When learning effects were specified, synthetic datasets exhibited changes in the probability of an adverse outcomes as cases accrued for the treatment group impacted by learning and stable probabilities as cases accrued for the treatment group not affected by learning.

Conclusions
Our framework extends clinical data simulation techniques beyond generation of patient features to incorporate hierarchical learning effects. This enables the complex simulation studies required to develop and rigorously test algorithms developed to disentangle treatment safety signals from the effects of experiential learning. By supporting such efforts, this work can help identify training opportunities, avoid unwarranted restriction of access to medical advances, and hasten treatment improvements.