bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Retrospective Cohort Comparing Left and Right Middle Cerebral Artery Ischemic Stroke Functional Outcomes in Acute Inpatient Rehabilitation
Authors: Rovito Craig , Park Albert , Goldstein Richard , Zafonte Ross , Black‐Schaffer Randie , Schneider Jeffrey C. 
Published: August 2020

BackgroundTo date, no large population studies compare left and right middle cerebral artery (MCA) strokes and corresponding patient performance in acute rehabilitation as measured by the Functional Independence Measure (FIM).ObjectiveTo compare granular performance data using the six FIM subcategories between left and right MCA territory strokes. This may foster development of individualized rehabilitation programs and affect rehabilitation policy based on phenotypic variations.DesignRetrospective cohort study.SettingInpatient rehabilitation facilities, using Uniform Data System for Medical Rehabilitation data from 2015 to 2017.PatientsIndividuals with MCA strokes admitted to inpatient rehabilitation facilities (n = 38 812).Main Outcome MeasuresMean FIM efficiency and FIM gain within the six FIM subcategories (self‐care, sphincter control, transfers, locomotion, communication, and social cognition) were compared between left and right MCA strokes. All were stratified by admission FIM severity categories (<40, 40–80, >80). The study also examined length of stay and percentage discharged to home.ResultsMean FIM efficiency was significantly higher for left MCA strokes compared to right MCA strokes. Left MCA strokes with admission FIM <40 and 40‐80 had significantly higher FIM efficiencies within the majority of FIM subcategories. However, left and right MCA strokes with admission FIM > 80 did not display any significant differences. Overall, patients with left MCA strokes were discharged to home at a significantly higher percentage. Patients with left MCA strokes with admission FIM 40–80 had on average a 2‐day shorter length of stay than those with right MCA strokes.ConclusionsOverall, patients with left MCA ischemic strokes had shorter length of stays, higher FIM efficiencies, and larger FIM gains than those with right MCA strokes. These results allow clinicians to counsel patients regarding functional gains based on diagnosis and to tailor rehabilitation programs to impairments encountered in left and right MCA territories. Including laterality of stroke and admission functional status would also improve algorithms for determining reimbursement.
Spontaneous Recovery of Executive Function, Attention, and Processing Speed in Stroke Patients in Colombia
Authors: Pugh Mickeal , Olabarrieta‐Landa Laiene , Chagualá Amilkar Calderón , Perrin Paul B. , Arango‐Lasprilla Juan Carlos 
Published: August 2020

BackgroundPrevious literature has shown disparities between developing and developed regions in executive functioning, attention, and processing speed performance following stroke. Research on post‐stroke longitudinal outcomes in Latin America specifically is almost nonexistent.ObjectivesTo assess spontaneous recovery among individuals with stroke in the absence of cognitive rehabilitation services in Colombia, South America during the first year post‐stroke by comparing their functioning to that of healthy controls across executive functioning, attention, and processing speed at 3, 6, and 12 months.DesignCohort.SettingStroke rehabilitation center at the regional hospital.ParticipantsA sample of 50 individuals with stroke and 50 matched healthy controls from Colombia were included in this study. Consistent with the healthcare resources in this region, participants did not receive any inpatient or outpatient cognitive rehabilitation.InterventionsNot applicable.Main Outcome MeasuresExecutive functioning, attention, and processing speed.ResultsHierarchical linear models suggested improvements over time for both individuals with stroke and controls, but trajectories of neuropsychological performance were significantly lower for individuals with stroke. Only on one of nine outcomes was there a significant time*group interaction, suggesting greater gains for the stroke group than controls.ConclusionsThese data suggest extremely minor spontaneous recovery among individuals with stroke in Colombia relative to practice effects in controls, and that apparent improvements in executive functioning after stroke were likely just due to practice effects. These findings underscore the bleak outcomes in cognitive functioning after stroke that occur in regions without cognitive rehabilitation.
Differences in Self‐Reported Physical and Behavioral Health in Musculoskeletal Patients Based on Physician Gender
Authors: Cheng Abby L. , Fogarty Alexandra E. , Calfee Ryan P. , Salter Amber , Colditz Graham A. , Prather Heidi 
Published: August 2020

BackgroundDifferences in patient–physician interactions based on physician gender have been demonstrated. However, the association between patients' self‐perceived health and their decision to see a female versus male physician is still unclear.ObjectiveTo determine if self‐reported physical or behavioral health is different in musculoskeletal patients who present to female vs male physicians. We hypothesized that patients who present to female physicians report worse physical and behavioral health.DesignCross‐sectional study.SettingTertiary academic medical center.PatientsConsecutive 21 980 adult patients who presented to a musculoskeletal medicine specialist for initial evaluation of a musculoskeletal condition between April 1, 2016 and November 1, 2017.Main Outcome MeasuresPhysical Function, Pain Interference, Anxiety, and Depression Computer Adaptive Test domains of the Patient‐Reported Outcomes Measurement Information System (PROMIS). The primary study outcome was the mean difference (MD) in PROMIS scores by physician gender.ResultsPatients who presented to female physicians self‐reported slightly worse health in all domains: Physical Function (female physicians 40.2, male physicians 42.4, MD ‐2.1; 95% confidence interval [CI] ‐2.5 to −1.8), Pain Interference (female physicians 61.6, male physicians 60.4, MD 1.3 [1.0‐1.5]), Anxiety (female physicians 52.5, male physicians 51.4, MD 1.1 [0.8‐1.5]), and Depression (female physicians 47.5, male physicians 46.2, MD 1.3 [0.9‐1.6]) (all P < .001). Patients who presented to female physicians were also slightly younger (51.9 vs 52.4 years, P = .034) and more likely to be female (63% vs 56%, P < .001).ConclusionsPatients who presented to female physicians self‐reported slightly worse physical and behavioral health compared to those patients who presented to male physicians. Further investigation into this finding may provide insight into drivers of patients' preferences, which may enable physicians of both genders to optimize patient care.
Unmet need for family planning after internal migration: Analysis of Ethiopia 2017–2018 PMA survey data
Authors: Groene Emily A. , Kristiansen Devon 
Published: August 2020

AbstractInternal migration's effect on family planning behaviour depends upon migration circumstances. While many studies describe instability and displacement's effect on family planning access, fewer studies consider the positive association between internal migration and family planning behaviour. Using Performance Monitoring for Action (PMA) survey data, we examine the relationship between internal migration and unmet need for family planning in Ethiopia from 2017 to 2018. We describe determinants of family planning behaviour by migrant status and model migration's effect on unmet need for family planning using multilevel logistic regression. Internal migrants tend to be more educated and wealthier and have less unmet need than nonmigrants, likely due to different fertility preferences and human capital. This contributes to existing research by illustrating how rural–urban migration in Ethiopia relates to family planning behaviour. Findings will be of interest to social scientists and policymakers evaluating family planning resource allocation to reduce unmet need in African contexts.
Medical laboratory wastewater treatment by electro‐fenton process: Modeling and optimization using central composite design
Authors: Basturk Irfan , Varank Gamze , Murat Hocaoglu Selda , Yazici Guvenc Senem 
Published: August 2020

AbstractMedical laboratory wastewaters arising from diagnosis and examination units show highly toxic characteristic. Within the scope of the study, removal of the wastewater’s toxicity and increasing BOD5/COD ratio of the medical laboratory wastewaters through electro‐Fenton (EF) process were investigated. In the study, central composite design was applied to optimize the process parameters of EF for COD, BOD5, and toxicity unit (TU) removal. Based on ANOVA, H2O2/COD was found to be significant parameter for COD removal, whereas current, reaction time, and H2O2/COD were determined to be significant parameters for BOD5 and TU removal. Optimum conditions (pH value of 3.4, current 3 A, reaction time 33.9 min, and H2O2/COD of 1.29) were determined, and predicted removals of COD, BOD5, and TU were found to be 55.1%, 42.5%, and 99.7% and experimental removals were found to be 53.4%, 41.2%, and 99.5%, respectively. TU value of the wastewater decreased from the value of 163–0.815, and BOD5/COD value increased from the value of 0.32–0.39. The results of the study indicate that EF process is an effective treatment option for COD, BOD5, and especially toxicity removal from medical laboratory wastewater.Practitioner points

Electro‐Fenton process was applied medical laboratory wastewater with highly toxic characteristic.

Response surface methodology approach using central composite design was employed for modeling.

53.4%, 41.2%, and 99.5% of COD, BOD5, and toxicity removals were achieved under statistically optimized conditions.

TU value of the wastewater decreased from the value of 163–0.815.

BOD5/COD value increased from the value of 0.32–0.39.
Anterior knee pain and functional outcome following different surgical techniques for tibial nailing: a systematic review
Authors: Leliveld Mandala S. , Verhofstad Michael H. J. , Van Bodegraven Eduard , Van Haaren Jules , Van Lieshout Esther M. M. 
Published: August 2020

Abstract
Purpose
The aim of this systematic review was to compare knee pain and function after tibial nail insertion through an infrapatellar, semi-extended and suprapatellar technique.

Methods
A search was carried out to identify articles with an exact description of the method used for insertion of the tibial nail and description of the outcome parameters (knee pain or function). Data on study design, population, rate and severity of anterior knee pain and function scores were extracted. Pooled rates and scores were calculated.

Results
67 studies with 3,499 patients were included. The pooled rate of patients with anterior knee pain was 38% (95% CI 32–44) after nail insertion through an infrapatellar approach and 10% (95% CI 1–26) after insertion through a suprapatellar approach. Pooled analysis was not possible for the semi-extended technique. Knee pain scores as measured by visual analogue score (0–10) ranged from 0.2 (95% CI − 0.1–0.5) for general knee pain to 3.7 (95% CI 1.3–6.1) for pain during kneeling. Pooled estimates for the Lysholm score were 87 points (range 77–97) for the infrapatellar technique and 85 points (range 82–85) for the suprapatellar technique. Iowa Knee scores were 94 (range 86–96) and Anterior Knee Pain Scale scores were 76 (range 75–80) after infrapatellar nail insertion.

Discussion
Depending on the technique used, the proportion of patients with knee pain after tibial nailing varied between 10 and 38%. The actual measured knee pain scores were, however, surprisingly low. Knee function was good for both the infra- and suprapatellar technique.
Ranking by weighted sum
Authors: Mitra Tapan , Ozbek Kemal 
Published: August 2020

AbstractWhen choosing an alternative that has multiple attributes, it is common to form a weighted sum ranking. In this paper, we provide an axiomatic analysis of the weighted sum criterion using a general choice framework. We show that a preference order has aweakweighted sum representation if it satisfies three basic axioms: Monotonicity, Translation Invariance, and Substitutability. Further, these three axioms yield astrongweighted sum representation when the preference order satisfies a mild condition, which we call Partial Representability. A novel form of non-representable preference order shows that partial representability cannot be dispensed in establishing our strong representation result. We consider several related conditions each of which imply a partial representation, and therefore a strong weighted sum representation when combined with the three axioms. Unlike many available characterizations of weighted sums, our results directly construct a unique vector of weights from the preference order, which makes them useful for economic applications.
Validation of computed tomography angiography using mean arterial pressure gradient as a reference in stented superior mesenteric artery
Authors: Lundin Niklas , Lehti Leena , Ekberg Olle , Acosta Stefan 
Published: August 2020

Abstract
Purpose
The aim of this prospective study was to validate the diagnostic performance of computed tomography angiography (CTA) in endoprosthesis stenosis in the superior mesenteric artery (SMA) using mean arterial pressure (MAP) gradients during angiography as a reference method.

Methods
Twenty-nine patients with mesenteric atherosclerotic disease underwent 45 paired measurements of endoprosthesis stenosis in the SMA with CTA and MAP gradients between March 2009 and July 2015. The grade of endoprosthesis stenosis in the SMA at CTA using the TeraRecon Aquarius workstation was correlated with MAP gradients.

Results
Grade of endoprosthesis stenosis in the SMA (r = 0.37, p = 0.013) correlated with MAP gradients. The intraclass correlations between the first and second CTA rater was 0.76 (95% CI 0.56–0.87) for estimation of grade of endoprosthesis stenosis in the SMA. The area under the receiver operating characteristics curve was 0.79 for diagnosis of significant endoprosthesis stenosis in the SMA at CTA for different threshold values using MAP gradient of ≥ 10 mmHg as reference. Sensitivity, specificity and positive predictive value for endoprosthesis stenosis in the SMA ≥ 50% at CTA were 52.4% (95% CI 31.0–73.7), 87.5% (95% CI 74.3–100.0) and 78.6 (95% CI 57.1–1.00), respectively.

Conclusion
Grading endoprosthesis stenosis in the SMA with CTA performed fair when using trans-stenotic MAP gradient as reference. Software development towards reduction of endoprosthesis artefacts may result in more accurate CTA assessment of the narrowest part.
Outcomes of combined hip procedure with dual mobility cup versus osteosynthesis for acetabular fractures in elderly patients: a retrospective observational cohort study of fifty one patients
Authors: Lannes Xavier , Moerenhout Kevin , Duong Hong Phuoc , Borens Olivier , Steinmetz Sylvain 
Published: August 2020

Abstract
Purposes
Acetabular fractures are more and more common in the elderly. Open reduction and internal fixation (ORIF) may lead to poor outcomes and high revision rates. Primary total hip arthroplasty (THA) combined with internal fixation, also known as the combined hip procedure (CHP), associated with dual mobility cup (DM-CHP) could be an efficient procedure in selected elderly patients. The aim of this study is to compare functional and radiological outcomes between ORIF and DM-CHP.

Methods
Between 2007 and 2018, 51 patients older than 65 years were surgically treated for acetabular fractures. Twenty-six patients were treated by DM-CHP and 25 by ORIF. Each group was divided into two subgroups regarding a single or combined approach. Hospital stay, surgical time, intraoperative blood loss, and complications were documented. The Harris Hip Score (HHS) was used for measuring the functional outcome. Radiological analysis was used to assess the centre of rotation in the DM-CHP group.

Results
Median surgery time and intra-operative blood loss were higher in DM-CHP than those in ORIF. Early medical complication rate was higher for a combined approach as compared with a single posterior approach in DM-CHP (p = 0.003). Dislocation rate was 7.7% in DM-CHP. Revision rate was higher in ORIF (20% versus 7.7%). HHS was similar in both groups.

Conclusions
DM-CHP leads to similar functional outcomes and less revision than ORIF. This study strengthens the practice of using only the posterior approach for primary THA in the elderly. Dual mobility is a valid therapeutic option for acetabular fractures in elderly patients.
“First Do No Harm”: Significance of Delays from Diagnosis to Surgery in Patients with Non‐metastatic Breast Cancer
Authors: Xu Jennifer , Bromley Luke , Chew Grace , Yeo Belinda 
Published: August 2020

AbstractBackgroundThe majority of patients with non‐metastatic breast cancer will undergo surgery. This involves complex decisions that inevitably increase time from diagnosis to surgery beyond the currently recommended 30 days. This study aims to analyse factors that increase time to surgery and establish whether it is justifiable in the context of improved individualised breast cancer management.MethodsA retrospective analysis of all patients at Austin Health surgically managed for non‐metastatic invasive breast carcinoma between 2013 and 2019 was conducted. Time to surgery (TTS) was defined as time between informed diagnosis and cancer surgery. The patients were grouped into TTS groups of ≤30 days and >30 days. Kaplan–Meier survival analysis and Cox proportional hazards regression model were used to evaluate the impact of time interval between diagnosis and surgery.ResultsSeven hundred and thirty‐one patients were included in our TTS analysis, only half of this cohort received surgery within the recommended 30 days. Many of the factors identified to be associated with increased TTS are the key to optimal management. Median follow‐up for the cohort was 30 months. Between wait groups of ≤30 and >30 days, there were no significant association found between TTS and survival outcomes for DFS (HR 1.20 95% CI 0.56–2.60) and OS (HR 1.58 95% CI 0.82–3.03).ConclusionBreast cancer management involves complex factors that significantly increase TTS. Surgery within 30 days of diagnosis is not associated with improved DFS and OS. Outcomes from this study support a revision of current recommendations for TTS in non‐metastatic breast cancer care.
Differential approach to peripheral blood cell ratios in patients with systemic lupus erythematosus and various manifestations
Authors: Suszek Dorota , Górak Anna , Majdan Maria 
Published: August 2020

AbstractNew markers of systemic lupus erythematosus (SLE) activity are under investigation. In recent years, the researchers have been focusing increased attention on the role of haematological indicators in assessing the disease activity. Specifically, neutrophil-, basophil-, eosinophil-, monocyte- and platelet-to-lymphocyte ratios (NLR, BLR, ELR, MLR and PLR) have been considered. The specific objective of this study was to determine the suitability of the haematological markers for the assessment of SLE activity and SLE-related organ damage. This study is a retrospective analysis of 136 patients with SLE (124 women and 12 men) who received chloroquine/hydroxychloroquine (HQ/HCQ) monotherapy or HQ/HCQ therapy combined with low/medium doses of glucocorticoid. All patients were assessed for disease activity using the Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2K) scale. In addition, erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) inflammatory parameters were determined in each patient. NLR, BLR, ELR, MLR and PLR were evaluated and correlated with the SLE activity parameters and inflammatory markers. The mean values of the haematological indicators were compared in particular manifestations of SLE-induced organ damage. For numerical variables, descriptive statistics were calculated: median, standard deviation, minimum and maximum values. The Mann–Whitney U test was used for the comparison of continuous variables in the two groups. The Spearman rank correlation test was used to search for any relationships between variables. A p value < 0.05 was considered to be statistically significant. We have found a positive correlation between ELR, MLR and the SLEDAI scale (r = 0.22 and r = 0.27, respectively). NLR, MLR and PLR ratios were significantly correlated with ESR and CRP. Considerably higher NLR values were found in patients with cutaneous and/or mucosal symptoms and with kidney involvement compared to patients without such involvement (4.26 ± 4.2 vs 3.27 ± 2.7; p = 0.05 and 5.45 ± 5.6 vs 3.05 ± 2.0; p < 0.001 respectively). BLR and MLR were significantly higher in patients manifesting symptoms of vasculitis (0.09 ± 0.1 vs 0.02 ± 0.01; p < 0.001 and 3.1 ± 4.2 vs 0.3 ± 0.1; p < 0.001 respectively), arthritis and/or myositis (0.04 ± 0.09 vs 0.02 ± 0.01; p = 0.01 and 1.02 ± 2.6 vs 0.35 ± 0.4; p = 0.01 respectively), whereas elevated ELR ratios were observed in patients with vasculitis (0.4 ± 0.5 vs 0.08 ± 0.06; p < 0.001) compared to patients without such organ involvement. The PLR marker was substantially higher in patients exhibiting haematological disorders in the course of SLE (276.6 ± 226.4 vs 192.6 ± 133.5; p = 0.01). The results indicate that ELR and MLR are effective markers of SLE activity. The haematological indicators may predict SLE-dependent organ damage, particularly cutaneous, mucosal, arthritic, myositic, haematological and kidney involvement.
Hydroelasticity effects on water-structure impacts
Authors: Mai T. , Mai C. , Raby A. , Greaves D. M. 
Published: August 2020

Abstract
Local and global loadings, which may cause the local damage and/or global failure and collapse of offshore structures and ships, are experimentally investigated in this study. The research question is how the elasticity of the structural section affects loading during severe environmental conditions. Two different experiments were undertaken in this study to try to answer this question: (i) vertical slamming impacts of a square flat plate, which represents a plate section of the bottom or bow of a ship structure, onto water surface with zero degree deadrise angle; (ii) wave impacts on a truncated vertical wall in water, where the wall represents a plate section of a hull. The plate and wall are constructed such that they can be either rigid or elastic by virtue of a specially designed spring system. The experiments were carried out in the University of Plymouth’s COAST Laboratory. For the cases considered here, elasticity of the impact plate and/or wall has an effect on the slamming and wave impact loads. Here the slamming impact loads (both pressure and force) were considerably reduced for the elastic plate compared to the rigid one, though only at high impact velocities. The total impact force on the elastic wall was found to reduce for the high aeration, flip-through and slightly breaking wave impacts. However, the impact pressure decreased on the elastic wall only under flip-through wave impact. Due to the elasticity of the plates, the impulse of the first positive phase of pressure and force decreases significantly for the vertical slamming impact tests. This significant effect of hydroelasticity is also found for the total force impulse on the vertical wall under wave impacts.

Graphic abstract
Hydroelasticity effects on water-structure impacts: a impact pressures on dropped plates; b impact forces on dropped plates; c, d, e, f wave impact pressures on the vertical walls; g wave impact forces on the vertical walls; h wave force impulses on the vertical walls: elastic wall 1 vs. rigid wall (filled markers); elastic wall 2 vs. rigid wall (empty markers)