bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Role of Active Rehabilitation in Concussion Management: A Systematic Review and Meta-analysis
Authors: CARTER KATHRYN M. , PAUHL ALEXANDRA N. , CHRISTIE ANITA D. 
Published: March 2021

ABSTRACT

Purpose
This study aimed to conduct a systematic review and meta-analysis of active rehabilitation on concussion management. We also examined moderator variables that may contribute to differences across studies: symptom scale, physical activity type, time of injury to recruitment, and mechanism of injury.

Methods
The standardized effect size of physical activity on concussion management was computed for 23 studies (29 effect sizes). Effect sizes were coded as positive when studies reported an improvement in symptom scores, which was represented by a decrease in postconcussive symptom scores.

Results
The overall effect size of physical activity on concussion recovery was large and positive (g = 1.03). Subthreshold aerobic activity provided the largest effect size (g = 1.71), whereas multimodal interventions had a moderate effect size (g = 0.70). All other moderator variables produced positive effect sizes ranging from g = 0.59 to g = 1.46.

Conclusions
This systematic review and meta-analysis demonstrates that current evidence supports the notion that physical activity is beneficial in decreasing postconcussive symptoms in both the acute and chronic phases after concussion. The results indicate that unimodal subthreshold aerobic activity may be the best course of action compared with multimodal interventions. Despite this growing body of evidence, additional research is needed to determine the optimal intensity, duration, and time to initiation of aerobic exercise after concussion.
W′ Recovery Kinetics after Exhaustion: A Two-Phase Exponential Process Influenced by Aerobic Fitness
Authors: CAEN KEVIN , BOURGOIS GIL , DAUWE CHARLES , BLANCQUAERT LAURA , VERMEIRE KOBE , LIEVENS ELINE , VAN DORPE JO , DERAVE WIM , BOURGOIS JAN G. , PRINGELS LAUREN , BOONE JAN 
Published: March 2021

ABSTRACT

Purpose
The aims of this study were 1) to model the temporal profile of W′ recovery after exhaustion, 2) to estimate the contribution of changing V˙O2 kinetics to this recovery, and 3) to examine associations with aerobic fitness and muscle fiber type (MFT) distribution.

Methods
Twenty-one men (age = 25 ± 2 yr, V˙O2peak = 54.4 ± 5.3 mL·min−1·kg−1) performed several constant load tests to determine critical power and W′ followed by eight trials to quantify W′ recovery. Each test consisted of two identical exhaustive work bouts (WB1 and WB2), separated by a variable recovery interval of 30, 60, 120, 180, 240, 300, 600, or 900 s. Gas exchange was measured and muscle biopsies were collected to determine MFT distribution. W′ recovery was quantified as observed W′ recovery (W′
OBS), model-predicted W′ recovery (W′
BAL), and W′ recovery corrected for changing V˙O2 kinetics (W′
ADJ). W′
OBS and W′
ADJ were modeled using mono- and biexponential fitting. Root-mean-square error (RMSE) and Akaike information criterion (∆AICC) were used to evaluate the models’ accuracy.

Results
The W′
BAL model (τ = 524 ± 41 s) was associated with an RMSE of 18.6% in fitting W′
OBS and underestimated W′ recovery for all durations below 5 min (P < 0.002). Monoexponential modeling of W′
OBS resulted in τ = 104 s with RMSE = 6.4%. Biexponential modeling of W′
OBS resulted in τ
1 = 11 s and τ
2 = 256 s with RMSE = 1.7%. W′
ADJ was 11% ± 1.5% lower than W′
OBS (P < 0.001). ∆AICC scores favored the biexponential model for W′
OBS, but not for W′
ADJ. V˙O2peak (P = 0.009) but not MFT distribution (P = 0.303) was associated with W′
OBS.

Conclusion
We showed that W′ recovery from exhaustion follows a two-phase exponential time course that is dependent on aerobic fitness. The appearance of a fast initial recovery phase was attributed to an enhanced aerobic energy provision resulting from changes in V˙O2 kinetics.
Competitive Entry of Information Goods Under Quality Uncertainty
Authors: Zhang Zan , Nan Guofang , Li Minqiang , Tan Yong 
Published: March 2021

When confronted with a new product, consumers often find it difficult to predict how it will perform, and such uncertainty reduces consumers’ willingness to adopt the product. In this paper, we consider a market whereby consumers decide when and which product to buy, given that they know the product quality of the incumbent but are uncertain about that of the entrant. We investigate how consumer uncertainty about product quality affects firms’ behavior-based pricing and customer acquisition and retention dynamics. Using a two-period vertical model, we find that, under high-end encroachment, an increase in consumer uncertainty reduces the entrant’s profit and hurts the incumbent’s profit when the quality differential between the products is relatively small, whereas, under low-end encroachment, increasing uncertainty not only benefits the incumbent but also can favor the entrant. An important implication for entrants is that the marketing activities, which aim to reduce consumer uncertainty about product functionalities, may fail to improve profitability. We also find that the entrant lowers the price for uninformed customers and raises the price for repeat buyers under high-end encroachment but lowers the price for all customers under low-end encroachment. We further examine the subsidy strategy and show that, when the entrant’s product has a significant quality advantage and consumer uncertainty is high but not very high, the optimal strategy for the entrant is to acquire all consumers who do not buy from the incumbent by providing subsidies and to drop the low-valuation customers by means of a high price after their uncertainty is resolved. This paper was accepted by Anandhi Bharadwaj, information systems.
Tension band plates have greater risks of complications in temporary epiphysiodesis
Authors: Cheng You-Hung , Lee Wei-Chun , Tsai Yi-Feng , Kao Hsuan-Kai , Yang Wen-E , Chang Chia-Hsieh 
Published: March 2021

Purpose This study aimed to compare the efficacy of decreasing leg-length discrepancy (LLD) and postoperative complications between tension band plates (TBP) and percutaneous transphyseal screws (PETS). Methods This retrospective study reviewed LLD patients who underwent temporary epiphysiodesis at the distal femur and/or proximal tibia from 2010 to 2017 (minimum two years follow-up). Efficacy of decreasing LLD was assessed one and two years postoperatively. Complications were classified with the modified Clavien-Dindo-Sink complication classification system. Knee deformities were assessed by percentile and zone of mechanical axis across the tibial plateau. Results In total, 53 patients (25 boys, 28 girls) underwent temporary epiphysiodesis (mean age, 11.4 years). The efficacy of decreasing LLD at two years between the TBP (n = 38) and PETS (n = 15) groups was comparable. Seven grade III complications were recorded in six TBP patients and in one PETS patient who underwent revision surgeries for knee deformities and physis impingement. Four grade I and two grade II complications occurred in the TBP group. The mechanical axis of the leg shifted laterally in the PETS group and medially in the TBP groups (+7.1 percentile versus -4.2 percentile; p < 0.05). Shifting of the mechanical axis by two zones was noted medially in four TBP patients and laterally in two PETS patients. Conclusion More implant-related complications and revision surgeries for angular deformities were associated with TBP. A tendency of varus and valgus deformity after epiphysiodesis using TBP and PETS was observed, respectively. Patients and families should be informed of the risks and regular postoperative follow-up is recommended. Level of evidence Level III
Modified method for reconstruction of thumb abduction function in children undergoing surgical treatment of thumb duplication
Authors: Zhou Tong , Zhang Xu , Yu Xiaofei , Bai Yanbin , Chen Huan , Li Jia , Li Hongjie , Yu Yadong 
Published: March 2021

Purpose This study was performed to evaluate a modified method of reconstructing the thumb abduction function in children undergoing surgical treatment of thumb duplication. Methods This retrospective study included 33 children (38 thumbs) with Wassel type III to VII thumb duplication who underwent excision of the polydactylism and osteotomy of the preserved thumb. Among them, 16 children (19 thumbs) underwent reconstruction of the attachment of the articular capsule and collateral ligament of the metacarpophalangeal joint, abductor pollicis brevis and flexor pollicis brevis by the anchor technique (Group A), while 17 children (19 thumbs) underwent suturing the attachment of the above-mentioned soft tissues to the periosteum (Group B). All children were followed up for six years after surgery. The appearance, function and joint stability of the preserved thumb were compared between the two groups; the bone alignment and development were observed. Results The deformity rate of preserved thumbs and the positive rate of lateral stress test were significantly lower in Group A than B (p < 0.05). The modified Tada score and the distance of first web were significantly higher in Group A than B (p < 0.05). Flexion, extension, adduction, abduction and palmar movement of the thumbs were good; bone alignment and development were good and no osteophyte or anchor shadow was left in the preserved thumbs in Group A. Conclusion Reconstruction of the abduction function using the anchor technique is effective in children undergoing surgical treatment for Wassel type III to VII thumb duplication and it may be superior to the conventional technique. Level of evidence III
Elevated extracellular CO<sub>2</sub> level affects the adaptive transcriptional response and survival of human peripheral blood mononuclear cells toward hypoxia and oxidative stress
Authors: Wanandi Septelia Inawati , Arumsari Sekar , Afitriansyah Edwin , Syahrani Resda Akhra , Dewantara Idham Rafly , Nurachman Luthfian Aby , Amin Ihya Fakhrurizal , Haryono Putera Dewa , Budiman Kenny , Sugiharta Adrianus Jonathan , Remedika Amino Aytiwan , Tafikulhakim Farhan Hilmi , Iswanti Febriana Catur , Lee Jason Youngbin , Banerjee Debabrata 
Published: March 2021

BACKGROUND High carbon dioxide (CO2) level from indoor environments, such as classrooms and offices, might cause sick building syndrome. Excessive indoor CO2 level increases CO2 level in the blood, and over-accumulation of CO2 induces an adaptive response that requires modulation of gene expression. This study aimed to investigate the adaptive transcriptional response toward hypoxia and oxidative stress in human peripheral blood mononuclear cells (PBMCs) exposed to elevated CO2 level in vitro and its association with cell viability.
METHODS PBMCs were treated in 5% CO2 and 15% CO2, representatives a high CO₂ level condition for 24 and 48 hours. Extracellular pH (pHe) was measured with a pH meter. The levels of reactive oxygen species were determined by measuring superoxide and hydrogen peroxide with dihydroethidium and dichlorofluorescin-diacetate assay. The mRNA expression levels of hypoxia-inducible factor (HIF)-1α, HIF-2α, nuclear factor (NF)-κB, and manganese superoxide dismutase (MnSOD) were analyzed using a real-time reverse transcriptase-polymerase chain reaction (qRT-PCR). Cell survival was determined by measuring cell viability.
RESULTS pHe increased in 24 hours after 15% CO₂ treatment, and then decreased in 48 hours. Superoxide and hydrogen peroxide levels increased after the 24- and 48-hour of high CO₂ level condition. The expression levels of NF-κB, MnSOD, HIF-1α, and HIF-2α decreased in 24 hours and increased in 48 hours. The increased antioxidant mRNA expression in 48 hours showed that the PBMCs were responsive under high CO2 conditions. Elevated CO2 suppressed cell viability significantly in 48 hours.
CONCLUSIONS After 48 hours of high CO₂ level condition, PBMCs showed an upregulation in genes related to hypoxia and oxidative stress to overcome the effects of CO2 elevation.
Validation of EuroSCORE II to predict mortality in post-cardiac surgery patients in East Java tertiary hospital
Authors: Sembiring Yan Efrata , Ginting Adhitya , Puruhito  , Budiono  
Published: March 2021

BACKGROUND The European system for cardiac operative risk evaluation (EuroSCORE) II is one of the established risk models used to predict mortality after cardiac surgery. However, its application as a mortality predictor for Indonesian adult cardiac surgery is still unknown. This study aimed to examine the validation of EuroSCORE II in predicting the mortality following adult cardiac surgery in Indonesian adults.
METHODS This retrospective cohort study collected data from the medical records and the database of the Department of Thoracic Cardiac and Vascular Surgery at Soetomo General Hospital, Surabaya. Data on the EuroSCORE II variables were collected for patients aged >18 years who underwent coronary artery bypass, heart valve, heart tumors, aortic surgeries, or a combination of these surgeries between January 2016 and December 2018. In-hospital mortality prediction was calculated using the online calculator at www.euroscore.org. The calibration of the EuroSCORE II model was conducted using the Hosmer–Lemeshow test, and discrimination analysis was done using receiver operating characteristic (ROC) curves with area under the ROC curve (AUC) calculation.
RESULTS A total of 213 patients met the inclusion criteria and were analyzed for this study. Mortality was 8.9%. The predicted and actual mortalities were 1.74% and 8.9%, respectively. The significance (p-value) of the Hosmer–Lemeshow test was 0.55, indicating good calibration. The AUC of ROC curve was 0.85 (95% CI = 0.77–0.92, p<0.001), suggesting good discrimination.
CONCLUSIONS EuroSCORE II has a good calibration and discrimination for cardiac surgery in Indonesian adults.
Disability and family violence prevention: a case study on participation in evidence making
Authors: Robinson Sally , valentine kylie , Idle Jan 
Published: March 2021

Background: The paper draws on empirical evidence from a project investigating service responses to disabled women and children experiencing domestic and family violence (DFV). Service provision in these sectors is often rationed due to resource constraints, and increasingly marketised, and disabled people often do not have their needs met. Their opportunities for participation in policy and practice are also constrained.
Aims and objectives: Our aim is to bring critical studies of intersectionality into dialogue with ‘evidence-making’ scholarship on policy implementation, to allow for new analyses of the inclusion of lived experience expertise in policy.
We ask: What are the potential drivers for new forms of practice and evidence making in policy and service settings?
Methods: The multi-method study comprised literature and policy review and qualitative research about the experience and implementation of an early intervention violence prevention support programme. Semi-structured interviews were conducted with mothers (n=27) and children (n=7), and service providers (n=28).
Findings: Many mothers did not identify as disabled, although they discussed the effects of impairment. However, children were all diagnosed, and diagnosis was a means of accessing funding and services. The service was focused on brokering responses to family needs, and formal participation mechanisms for clients were not prioritised.
Discussion and conclusion: Resource constraints and workforce capacity are ongoing concerns in the disability and violence prevention sectors. Relationships that facilitate trust, agency and choice remain key. Insights from critical policy scholarship suggest opportunities to recognise existing relationships as participation, with implications for policy and practice.
Understanding knowledge brokerage and its transformative potential: a Bourdieusian perspective
Authors: Chew Sarah , Armstrong Natalie , Martin Graham P. 
Published: March 2021

Background:Knowledge brokering is promoted as a means of enabling exchange between fields and closer collaboration across institutional boundaries. Yet examples of its success in fostering collaboration and reconfiguring boundaries remain few.
Aims and objectives:We consider the introduction of a dedicated knowledge-brokering role in a partnership across healthcare research and practice, with a view to examining the interaction between knowledge brokers’ location and attributes and the characteristics of the fields across which they work.
Methods:We use qualitative data from a four-year ethnographic study, including observations, interviews, focus groups, reflective diaries and other documentary sources. Our analysis draws on Pierre Bourdieu’s conceptual framework.
Findings:In efforts to transform the boundaries between related but disjointed fields, a feature posited as advantageous – knowledge brokers’ liminality – may in practice work to their disadvantage. An unequal partnership between two fields, where the capitals (the resources, relationships, markers of prestige and forms of knowledge) valued in one are privileged over the other, left knowledge brokers without a prior affiliation to either field adrift between the two.
Discussion and conclusions:Lacking legitimacy to act across fields and bridge the gap between them, knowledge brokers are likely to seek to develop their skills on one side of the boundary, focusing on more limited and conservative activities, rather than advance the value of a distinctive array of capitals in mediating between fields. We identify implications for the construction and deployment of knowledge-brokering interventions towards collaborative objectives.
The long-term impact of the Leprosy Post-Exposure Prophylaxis (LPEP) program on leprosy incidence: A modelling study
Authors: Blok David J. , Steinmann Peter , Tiwari Anuj , Barth-Jaeggi Tanja , Arif Mohammad A. , Banstola Nand Lal , Baskota Rabindra , Blaney David , Bonenberger Marc , Budiawan Teky , Cavaliero Arielle , Gani Zaahira , Greter Helena , Ignotti Eliane , Kamara Deusdedit V. , Kasang Christa , Manglani Pratap R. , Mieras Liesbeth , Njako Blasdus F. , Pakasi Tiara , Saha Unnati R. , Saunderson Paul , Smith W. Cairns S. , Stäheli René , Suriyarachchi Nayani D. , Tin Maung Aye , Shwe Tin , van Berkel Jan , van Brakel Wim H. , Vander Plaetse Bart , Virmond Marcos , Wijesinghe Millawage S. D. , Aerts Ann , Richardus Jan Hendrik 
Published: March 2021

Background
The Leprosy Post-Exposure Prophylaxis (LPEP) program explored the feasibility and impact of contact tracing and the provision of single dose rifampicin (SDR) to eligible contacts of newly diagnosed leprosy patients in Brazil, India, Indonesia, Myanmar, Nepal, Sri Lanka and Tanzania. As the impact of the programme is difficult to establish in the short term, we apply mathematical modelling to predict its long-term impact on the leprosy incidence.

Methodology
The individual-based model SIMCOLEP was calibrated and validated to the historic leprosy incidence data in the study areas. For each area, we assessed two scenarios: 1) continuation of existing routine activities as in 2014; and 2) routine activities combined with LPEP starting in 2015. The number of contacts per index patient screened varied from 1 to 36 between areas. Projections were made until 2040.

Principal findings
In all areas, the LPEP program increased the number of detected cases in the first year(s) of the programme as compared to the routine programme, followed by a faster reduction afterwards with increasing benefit over time. LPEP could accelerate the reduction of the leprosy incidence by up to six years as compared to the routine programme. The impact of LPEP varied by area due to differences in the number of contacts per index patient included and differences in leprosy epidemiology and routine control programme.

Conclusions
The LPEP program contributes significantly to the reduction of the leprosy incidence and could potentially accelerate the interruption of transmission. It would be advisable to include contact tracing/screening and SDR in routine leprosy programmes.
An assessment of risk factors for contracting rabies among dog bite cases recorded in Ward 30, Murewa district, Zimbabwe
Authors: Chikanya Enica , Macherera Margaret , Maviza Auther 
Published: March 2021

Background
Zoonoses are a major threat to human health. Worldwide, rabies is responsible for approximately 59 000 deaths annually. In Zimbabwe, rabies is one of the top 5 priority diseases and it is notifiable. It is estimated that rabies causes 410 human deaths per year in the country. Murewa district recorded 938 dog bite cases and 4suspected rabies deaths between January 2017 and July 2018, overshooting the threshold of zero rabies cases. Of the 938dog bite cases reported in the district, 263 were reported in Ward 30 and these included all the 4suspected rabies deaths reported in the district. This necessitated a study to assess risk factors for contracting rabies in Ward 30, Murewa.

Methodology/ Principal findings
A descriptive cross sectional survey was used for a retrospective analysis of a group of dog bite cases reported at Murewa Hospital, in Ward 30. Purposive sampling was used to select dog bite cases and snowball sampling was used to locate unvaccinated dogs and areas with jackal presence. The dog bite cases and relatives of rabies cases were interviewed using a piloted interviewer-administered questionnaire. Geographical Positioning System (GPS) coordinates of dog bite cases, vaccinated and unvaccinated dogs and jackal presence were collected using handheld GPS device. QGIS software was used to spatially analyse and map them. Dog owners were 10 times more likely to contract rabies compared to non-dog owners (RR = 10, 95% CI 1.06–93.7). Owners of unvaccinated dogs were 5 times more likely to contract rabies compared to owners of vaccinated dogs (RR = 5.01, 95% CI 0.53–47.31). Residents of the high density cluster (area with low cost houses and stand size of 300 square meters and below) were 64 times more likely to contract rabies compared to non-high density cluster residents (RR = 64.87, 95% CI 3.6039–1167.82). Participants who were not knowledgeable were 0.07 times more likely to contract rabies, compared to those who had knowledge about rabies. (RR = 0.07, 95% CI 0.004–1.25).
Our study shows that the risk factors for contacting rabies included; low knowledge levels regarding rabies, dog ownership residing in the high density cluster, owning unvaccinated dogs and spatial overlap of jackal presence with unvaccinated dogs.