bluuebunny/crossref_metadata_2025_split huggingface dataset:
Urban sprawl analysis of Akhmim city (Egypt) and its risk to buried heritage sites: insights from geochemistry and geospatial analysis
Authors: Hagage Mohammed , Madani Ahmed A. , Aboelyamin Ahmed , Elbeih Salwa F. 
Published: August 2023

Abstract
The present study employs a multidisciplinary approach to highlight the risks of urban expansion on buried cultural heritage sites. The buried temple of Ramses II in Akhmim city was chosen as a case study to assess the impact of urban expansion on its preservation. Support Vector Machine (SVM) classification was utilized to analyze satellite images from multiple sensors and evaluate the extent of urban growth surrounding the temple. The study also incorporated petrographic and mineralogical analyses of statues discovered in the temple, along with calculations of saturation indices, to assess the potential interactions between groundwater and archaeological materials. The findings indicate that urban development is encroaching upon the temple, posing potential risks to its preservation. Saturation indices for minerals in groundwater indicate a high tendency to dissolve dolomite (a common mineral in limestone) and to precipitate halite (sodium chloride). This is a concern because the artifacts unearthed from the temple are primarily composed of limestone. Consequently, there is a risk to the artifacts due to erosion and disintegration caused by mineral crystallization and expansion, as evidenced by the analysis of the rock and mineral characteristics of the statues discovered in the temple. The study proposes protective measures for the temple, including defining its dimensions beneath the urban area and establishing a dedicated protection zone around it.
Co-creation of a complex, multicomponent rehabilitation intervention and feasibility trial protocol for the PostUraL tachycardia Syndrome Exercise (PULSE) study
Authors: Pearce Gemma , Holliday Nikki , Sandhu Harbinder , Eftekhari Helen , Bruce Julie , Timms Emma , Ablett Laura , Kavi Lesley , Simmonds Jane , Evans Rebecca , Magee Paul , Powell Richard , Keogh Shane , McGregor Gordon 
Published: August 2023

Abstract
Background
There is a dearth of research to support the treatment of people with postural tachycardia syndrome (PoTS). Despite expert consensus suggesting exercise is recommended for this patient group, there are no randomised control trials examining this rigorously. The aim was to co-create a feasibility trial protocol and a rehabilitation intervention for people living with PoTS.

Methods
The intervention and feasibility trial design were co-created as part of the PostUraL tachycardia Syndrome Exercise (PULSE) study. We used the ‘three co’s framework’ of co-define, co-design and co-refine. Recruitment included key national charities and National Health Service Trusts treating people living with PoTS in the UK. Eighteen patient and public involvement members attended the co-define session, and 16 co-creators with a mix of expertise attended the subsequent co-design and co-refine sessions. Seven intervention practitioners were trained in the rehabilitation intervention, providing feedback for further co-refinement.

Results
The final co-created intervention comprises online physical activity, and lifestyle and behaviour change support sessions. It is based on functional movement activities using a patient-centred approach tailored to individual needs. Physical activity intensity is guided by individuals’ perception of effort rather than by objective measures. Recumbent bikes are provided for home use. Patients deemed randomisation to be acceptable because research in this area was considered important.

Conclusions
An innovative approach was used to co-create the PULSE intervention and feasibility trial protocol to meet the evidence-based and logistical needs of people living with PoTS, clinicians, service deliverers, third-sector organisations, academics and funders. This can be used as a successful example and template for future research internationally. People living with PoTS were recognised as experts and involved in every aspect of conceptualisation, design and refinement. This complex rehabilitation intervention is currently being tested in a randomised feasibility trial comparing the PULSE intervention with best-practice usual care for people living with PoTS.

Trial registration
ISRCTN45323485 was registered on April 7, 2020.
Challenges and opportunities for spoken English learning and instruction brought by automated speech scoring in large-scale speaking tests: a mixed-method investigation into the washback of SpeechRater in TOEFL iBT
Authors: Gong Kaixuan 
Published: August 2023

AbstractThe extensive use of automated speech scoring in large-scale speaking assessment can be revolutionary not only to test design and rating, but also to the learning and instruction of speaking based on how students and teachers perceive and react to this technology. However, its washback remained underexplored. This mixed-method study aimed to investigate the washback of TOEFL iBT Speaking’s SpeechRater on Chinese EFL learners through questionnaire and interviews, and explore its associations with test performance and its multi-levelled influential factors. The participants received a mixture of positive and negative washback, such as their motivated individual learning through personal devices, decreasing real-life communicative practices, and increasing exam-driven behaviours. Test takers’ personal understandings of automated speech scoring were found directly influential to the washback of SpeechRater that they experienced. Furthermore, their test scores of TOEFL iBT Speaking were positively correlated with the implicit washback of SpeechRater on their learning but uncorrelated with its explicit washback on their test preparation. The findings have been drawn on to propose a washback model of automated speech scoring and make suggestions to test designers, teachers and learners on how to boost its positive washback and mitigate its negative washback. This research has concluded the importance of test takers’ awareness of the integrated dimensions to evaluate spoken English in real-life use. Accordingly, instructional implications are discussed on how teachers can guide the students to utilize automated speech scoring in learning and set up comprehensive learning goals for spoken English.
Short-term blood pressure variability as a potential therapeutic target for kidney disease
Authors: Ko Ye Eun , Jhee Jong Hyun 
Published: August 2023

AbstractShort-term blood pressure variability (BPV) measured with ambulatory blood pressure (BP) monitoring has been demonstrated to be significant in predicting various clinical outcomes. Short-term BPV is distinguished from long-term BPV based on the time interval in which BP fluctuations are measured. Increased short-term BPV has been linked to detrimental effects on the microvascular structure and contributes to subclinical organ damage in the heart, blood vessels, and kidneys, regardless of the average 24-h BP levels. Short-term BPV can be defined by various measures, including calculated metrics (standard deviation, coefficient of variation, average real variability, weighted standard deviation, variability independent of the mean) or dipping patterns. Nevertheless, the additional role of short-term BPV beyond the predictive value of average 24-h BPs or established risk factors for cardiovascular disease and kidney disease remains unclear. In particular, longitudinal studies that evaluate the association between short-term BPV and kidney function impairment are limited and no conclusive data exist regarding which short-term BPV indicators most accurately reflect the prognosis of kidney disease. The issue of how to treat BPV in clinical practice is another concern that is frequently raised. This paper presents a review of the evidence for the prognostic role of short-term BPV in kidney outcomes. Additionally, this review discusses the remaining concerns about short-term BPV that need to be further investigated as an independent risk modifier.
Community members’ experiences training as medical journal reviewers
Authors: Collins Cyleste C. , Hood Erika , Jewett-Tennant Jeri , Stange Kurt , Sehgal Ashwini R. 
Published: August 2023

Abstract
Purpose
Although medical research dissemination is intended to benefit members of society, few members of society actually participate in the process of publishing findings. This study shares findings from community members’ (including patients and the public) experiences being trained as medical journal reviewers.

Methods
We analyzed findings from two focus group interviews of community reviewers (N = 29) to identify themes in their experiences with the training program.

Results
Community members trained as journal reviewers appreciated learning the context under which manuscript development and review occur from authors and funders, the value of the community member perspectives to science, and strengthened their critical thinking skills. A range of training tools and strategies included glossaries of research terms, creating review guides, practicing reviews, being trained by a supportive team, and working with and learning collaboratively.

Conclusions
Training as a journal reviewer has a positive impact on participating community members. Programs training community members as journal reviewers should incorporate guest speakers well-versed in community engaged research, group activities, a variety of training tools and materials, and highly supportive training teams.
Post-pneumonectomy surgery in prone position: a case report
Authors: Swamy Vijay N. , Nair Pooja Surendran , Krishna Bhavya , Agrawal Nidhi 
Published: August 2023

Abstract
Background
Anesthesia in post-pneumonectomy patients is challenging as pneumonectomy is considered “a disease itself” with impaired oxygenation and ventilation. Literary data for prone ventilation in post-pneumonectomy patients is scarce.

Case presentation
A 45-year-old female patient with a history of right-sided pneumonectomy 10 years ago with restrictive pulmonary disease underwent uneventful lumbar spine surgery under general anesthesia in the prone position. The lung-protective ventilation using the pressure control mode of ventilation was done.

Conclusions
A good understanding of the physiology of the single lung and the concerns of prone ventilation, along with proper preoperative evaluation and optimization, are key to the successful management of such cases.
The use of fuzzy linear regression for the selection of the most appropriate fuzzy implication in a fly ash-based concrete model
Authors: Gkountakou Fani , Papadopoulos Basil 
Published: August 2023

AbstractIn this research, fuzzy linear regression (FLR) method combined with three well-known fuzzy implications was implemented for evaluating the relation among the amount of fly ash in concrete mixture and the compressive strength of concrete. More specifically, 267 experimental data 40 of which were used for testing the validation of the process were subjected to FLR method for calculating the truth values, which indicated the degree of how the experimental outputs belong to the predicted ones. Also, the degree of fuzziness was calculated for performing the sensitivity analysis of the model. The truth values that emerged were used for applying three basic fuzzy implications such as Lukasiewicz, Reinchenbach, and Kleene-Dienes implication. By evaluating and comparing the results of every fuzzy implication, it was concluded that Lukasiewicz was the most appropriate implication method as it yielded the smallest deviation of truth values (σ = 4.00) in contrast to the theoretical ones (σ = 4.83 in Reinchenbach and σ = 12.31 in Kleene-Dienes fuzzy implication). The accuracy of the FLR method was also validated for calculating the coefficient of the mean absolute percentage error level (MAPE = 5.56%) of the blind prediction process, and the results revealed that the application of fuzzy linear regression method is suitable for evaluating the truth values of experimental data in order to be used in fuzzy implications. Thus, it is a satisfactory procedure for making inferences between concrete parameters.
Intratumoral Hemorrhage in Vestibular Schwannomas After Stereotactic Radiosurgery: Multi-Institutional Study
Authors: Bin-Alamer Othman , Abou-Al-Shaar Hussam , Mallela Arka N. , Kallos Justiss A. , Deng Hansen , Nabeel Ahmed M. , Reda Wael A. , Tawadros Sameh R. , Abdelkarim Khaled , El-Shehaby Amr M. N. , Emad Reem M. , Peker Selcuk , Samanci Yavuz , Lee Cheng-chia , Yang Huai-che , Mathieu David , Tripathi Manjul , Mantziaris Georgios , Mullapudi Abhishek , Urgosik Dusan , Liscak Roman , Bowden Greg N. , Zaki Peter , Wegner Rodney E. , Shepard Matthew J. , Sheehan Jason P. , Niranjan Ajay , Hadjipanayis Constantinos G. , Lunsford L. Dade 
Published: August 2023

BACKGROUND AND OBJECTIVES:
Intratumoral hemorrhage (ITH) in vestibular schwannoma (VS) after stereotactic radiosurgery (SRS) is exceedingly rare. The aim of this study was to define its incidence and describe its management and outcomes in this subset of patients.

METHODS:
A retrospective multi-institutional study was conducted, screening 9565 patients with VS managed with SRS at 10 centers affiliated with the International Radiosurgery Research Foundation.

RESULTS:
A total of 25 patients developed ITH (cumulative incidence of 0.26%) after SRS management, with a median ITH size of 1.2 cm3. Most of the patients had Koos grade II-IV VS, and the median age was 62 years. After ITH development, 21 patients were observed, 2 had urgent surgical intervention, and 2 were initially observed and had late resection because of delayed hemorrhagic expansion and/or clinical deterioration. The histopathology of the resected tumors showed typical, benign VS histology without sclerosis, along with chronic inflammatory cells and multiple fragments of hemorrhage. At the last follow-up, 17 patients improved and 8 remained clinically stable.

CONCLUSION:
ITH after SRS for VS is extremely rare but has various clinical manifestations and severity. The management paradigm should be individualized based on patient-specific factors, rapidity of clinical and/or radiographic progression, ITH expansion, and overall patient condition.
Performance of ChatGPT and GPT-4 on Neurosurgery Written Board Examinations
Authors: Ali Rohaid , Tang Oliver Y. , Connolly Ian D. , Zadnik Sullivan Patricia L. , Shin John H. , Fridley Jared S. , Asaad Wael F. , Cielo Deus , Oyelese Adetokunbo A. , Doberstein Curtis E. , Gokaslan Ziya L. , Telfeian Albert E. 
Published: August 2023

BACKGROUND AND OBJECTIVES:
Interest surrounding generative large language models (LLMs) has rapidly grown. Although ChatGPT (GPT-3.5), a general LLM, has shown near-passing performance on medical student board examinations, the performance of ChatGPT or its successor GPT-4 on specialized examinations and the factors affecting accuracy remain unclear. This study aims to assess the performance of ChatGPT and GPT-4 on a 500-question mock neurosurgical written board examination.

METHODS:
The Self-Assessment Neurosurgery Examinations (SANS) American Board of Neurological Surgery Self-Assessment Examination 1 was used to evaluate ChatGPT and GPT-4. Questions were in single best answer, multiple-choice format. χ2, Fisher exact, and univariable logistic regression tests were used to assess performance differences in relation to question characteristics.

RESULTS:
ChatGPT (GPT-3.5) and GPT-4 achieved scores of 73.4% (95% CI: 69.3%-77.2%) and 83.4% (95% CI: 79.8%-86.5%), respectively, relative to the user average of 72.8% (95% CI: 68.6%-76.6%). Both LLMs exceeded last year's passing threshold of 69%. Although scores between ChatGPT and question bank users were equivalent (P = .963), GPT-4 outperformed both (both P < .001). GPT-4 answered every question answered correctly by ChatGPT and 37.6% (50/133) of remaining incorrect questions correctly. Among 12 question categories, GPT-4 significantly outperformed users in each but performed comparably with ChatGPT in 3 (functional, other general, and spine) and outperformed both users and ChatGPT for tumor questions. Increased word count (odds ratio = 0.89 of answering a question correctly per +10 words) and higher-order problem-solving (odds ratio = 0.40, P = .009) were associated with lower accuracy for ChatGPT, but not for GPT-4 (both P > .005). Multimodal input was not available at the time of this study; hence, on questions with image content, ChatGPT and GPT-4 answered 49.5% and 56.8% of questions correctly based on contextual context clues alone.

CONCLUSION:
LLMs achieved passing scores on a mock 500-question neurosurgical written board examination, with GPT-4 significantly outperforming ChatGPT.
Double-Interposition Bypass: Technical Case Report of a Novel Intraoperative Bypass Salvage Technique
Authors: Graffeo Christopher S. , Srinivasan Visish M. , Winkler Ethan A. , Lawton Michael T. 
Published: August 2023

BACKGROUND AND IMPORTANCE:
Complex cerebrovascular bypass operations may confer an increased risk of intraoperative complications, such as graft thrombosis. Novel techniques are needed to optimize the management of these challenging cases.

CLINICAL PRESENTATION:
A woman in her late 20s was incidentally diagnosed with a 1.5-cm basilar apex aneurysm, which grew to 3.5 cm over 2 years of active surveillance. Definitive treatment was then recommended with flow reversal and Hunterian ligation of the basilar trunk planned as a radial artery graft (RAG) bypass: M2 (S-Ec) RAG (E-Sc*) P2. Intraoperative graft thrombosis prompted multiple attempted salvage maneuvers; however, complete excision and repeat anastomosis were ultimately required. The procedure was completed using a novel double-interposition technique, with ligation of the index RAG approximately 1 cm proximal to the distal anastomosis (final bypass: M2 [S-Ec*] RAG [E-Ec*] RAG' [E-Sc] P2). These technical modifications yielded a less deep recipient site for the repeat bypass and an end-to-end anastomosis rather than an end-to-side anastomosis, collectively facilitating a more efficient and facile salvage. The patient recovered well from surgery, and flow reversal was successfully achieved within the aneurysm.

CONCLUSION:
Despite the increased risk of intraoperative thrombosis with complex cerebrovascular bypass operations, facility with salvage techniques can lead to technically and clinically excellent outcomes. We report the successful use of a novel fourth-generation double-interposition bypass that shortens the working distance and uses a more favorable anastomosis technique. This bypass may facilitate safe and efficient microsurgery in patients who require complete revision of an intracranial-intracranial construct.
The role of metabolism in cellular quiescence
Authors: Du Yipeng , Gupta Parul , Qin Shenlu , Sieber Matthew 
Published: August 2023

ABSTRACT
Cellular quiescence is a dormant, non-dividing cell state characterized by significant shifts in physiology and metabolism. Quiescence plays essential roles in a wide variety of biological processes, ranging from microbial sporulation to human reproduction and wound repair. Moreover, when the regulation of quiescence is disrupted, it can drive cancer growth and compromise tissue regeneration after injury. In this Review, we examine the dynamic changes in metabolism that drive and support dormant and transiently quiescent cells, including spores, oocytes and adult stem cells. We begin by defining quiescent cells and discussing their roles in key biological processes. We then examine metabolic factors that influence cellular quiescence in both healthy and disease contexts, and how these could be leveraged in the treatment of cancer.
Efficacy of an external cold and vibrating device in reducing discomfort during the administration of an inferior alveolar nerve block in children: A split-mouth randomised crossover study
Authors: H Ananthu , Rao Ashwin , Natarajan Srikant , Yarmunja Mahabala Karuna , Nayak Anupama 
Published: August 2023

Background: Local anaesthesia is the backbone of pain management. However, the administration of a local anaesthetic injection itself is considered a painful procedure and triggers fear and anxiety in the patient. Methods: A split-mouth randomised controlled crossover trial was designed to study the efficacy of an “external cold and vibrating” device in reducing discomfort during the administration of an inferior alveolar nerve block (IANB) in children. A total of 40 children who fulfilled the inclusion criteria were evaluated for pain response following administration of IANB with and without the “external cold and vibrating” device. Randomisation was performed to determine whether the subject received the control intervention first or the test intervention first. The intensity of the pain response and discomfort were recorded using the Wong-Baker FACES Pain Rating Scale and the Faces Legs Activity Cry and Consolability scale. Results: There was a statistically significant difference in the pain response between the test group and the control group (p<0.001). Females reported a higher pain response than males, with a statistically significant difference, when the FLACC scores were compared. Conclusions: The “external cold and vibrating” device reduced discomfort during the administration of an IANB in children selected for the study.
Intoxication-related teenagers' suicide attempts - an analysis of the issue
Authors: Sosnowska Weronika , Brzozowska Aleksandra , Tchórz Michał , Tomczyk Jakub , Więcław Kacper , Stańko Katarzyna 
Published: August 2023

Introduction and Aim: Adolescent suicide attempts are a significant clinical and social issue. Often, young people resort to medications, alcohol, or psychoactive substances in their suicide attempts. The aim of this study was to analyze the factors contributing to suicidal behaviors and the characteristics of substances used by adolescents for suicidal purposes.Materials and Methods: In this retrospective study, medical documentation analysis was used. The study included the medical records of 45 individuals up to 18 years of age who were admitted to the Clinical Toxicology-Cardiology Department due to poisoning for the purpose of suicide in the year 2022.Results: The study group consisted of 45 individuals aged 15 to 18 years. Suicide attempts accounted for 37.5% of toxicology hospitalizations in the under 18 age group. The dominant group consisted of females (82.2%) and urban residents (62.2%). Those hospitalized following a suicide attempt primarily used medications, often over-the-counter analgesics. The majority (71.1%) suffered from mental disorders, predominantly depressive disorders (81.2%).Conclusions: Among suicide attempts involving intoxication, those utilizing medications are dominant. A concerning phenomenon is the use of over-the-counter (OTC) medications, commonly considered safe. Girls are particularly vulnerable to emotional difficulties that can lead to suicide. Mental disorders pose a suicidal risk, and patients with such disorders have access to psychiatric medications that can become tools for self-harm.