bluuebunny/crossref_metadata_2025_split huggingface dataset:
Model-based reconstruction algorithm in the detection of acute trauma-related lesions in brain CT examinations
Authors: De Vito Andrea , Maino Cesare , Lombardi Sophie , Ragusi Maria , Talei Franzesi Cammillo , Ippolito Davide , Sironi Sandro 
Published: April 2021

Background and purpose To evaluate the added value of a model-based reconstruction algorithm in the assessment of acute traumatic brain lesions in emergency non-enhanced computed tomography, in comparison with a standard hybrid iterative reconstruction approach. Materials and methods We retrospectively evaluated a total of 350 patients who underwent a 256-row non-enhanced computed tomography scan at the emergency department for brain trauma. Images were reconstructed both with hybrid and model-based iterative algorithm. Two radiologists, blinded to clinical data, recorded the presence, nature, number, and location of acute findings. Subjective image quality was performed using a 4-point scale. Objective image quality was determined by computing the signal-to-noise ratio and contrast-to-noise ratio. The agreement between the two readers was evaluated using k-statistics. Results A subjective image quality analysis using model-based iterative reconstruction gave a higher detection rate of acute trauma-related lesions in comparison to hybrid iterative reconstruction (extradural haematomas 116 vs. 68, subdural haemorrhages 162 vs. 98, subarachnoid haemorrhages 118 vs. 78, parenchymal haemorrhages 94 vs. 64, contusive lesions 36 vs. 28, diffuse axonal injuries 75 vs. 31; all P<0.001). Inter-observer agreement was moderate to excellent in evaluating all injuries (extradural haematomas k=0.79, subdural haemorrhages k=0.82, subarachnoid haemorrhages k=0.91, parenchymal haemorrhages k=0.98, contusive lesions k=0.88, diffuse axonal injuries k=0.70). Quantitatively, the mean standard deviation of the thalamus on model-based iterative reconstruction images was lower in comparison to hybrid iterative one (2.12 ± 0.92 vsa 3.52 ± 1.10; P=0.030) while the contrast-to-noise ratio and signal-to-noise ratio were significantly higher (contrast-to-noise ratio 3.06 ± 0.55 vs. 1.55 ± 0.68, signal-to-noise ratio 14.51 ± 1.78 vs. 8.62 ± 1.88; P<0.0001). Median subjective image quality values for model-based iterative reconstruction were significantly higher ( P=0.003). Conclusion Model-based iterative reconstruction, offering a higher image quality at a thinner slice, allowed the identification of a higher number of acute traumatic lesions than hybrid iterative reconstruction, with a significant reduction of noise.
Game Spacing and Density in Relation to the Risk of Injuries in the National Hockey League
Authors: Blond Benjamin N. , Blond Joshua B. , Loscalzo Paul J. 
Published: April 2021

Background: Ice hockey has significant workload demands. Research of other sports has suggested that decreased rest between games as well as an increased workload may increase the risk of injuries. Purpose: To evaluate whether condensed game schedules increase the frequency and severity of injuries in the National Hockey League (NHL). Study Design: Descriptive epidemiology study. Methods: Data were obtained from publicly available online sources on game schedules and injuries for all NHL teams for the 2005-2006 through 2018-2019 seasons. Injury rates (per team per game) and the proportion of severe and nonsevere injuries were determined. The game-spacing analysis assessed the risk of injuries in relation to the number of days between games played (range, 0-≥6 days). The game-density analysis assessed the risk of injuries in relation to the number of games played within 7 days (range, 1-5 games). Results were assessed by analysis of variance, the post hoc Tukey test, and the chi-square test of distribution. Results: The game-spacing analysis included 33,170 games and 7224 injuries, and a significant group difference was found ( P = 1.44×10–5), with the post hoc test demonstrating an increased risk of injuries when games were spaced with <1 day of rest. There was no significant difference in the ratio of severe to nonsevere injuries. The game-density analysis included 33,592 games and 10,752 injuries, and a significant group difference was found ( P = 8.22×10–48), demonstrating an increased risk of injuries with an increased number of games in all conditions except for the comparison between 4 versus 5 games in 7 days. There was also a significant difference in injury severity ( P = .008), indicating that the least dense condition had a higher ratio of severe to nonsevere injuries compared with the other game-density conditions. Finally, the game-density analysis was repeated after excluding games played with <1 day of rest, and the finding of increased injury rates with increasingly condensed schedules remained significant ( P = 9.52×10–46), with significant differences between all groups except for the comparison between 1 versus 2 games in 7 days. Conclusion: We found that a condensed schedule and <1 day of rest between games were associated with an increased rate of injuries in the NHL. These findings may help in the design of future game schedules.
The complexity of early diagnostic decision making: A follow-up study of young children with language difficulties
Authors: Jansen Rianne , Maljaars Jarymke , Zink Inge , Steyaert Jean , Noens Ilse 
Published: April 2021

Background & aims Due to the complexity of early diagnostic decision making, we examined the predictive value of an early diagnostic classification and early abilities on later best estimate diagnosis for 22 clinically referred children with language difficulties. Methods and procedures Four years after initial evaluation (Time 1), the clinical files of these children were reviewed. A best-estimate (BE) diagnosis of language disorder (LD), intellectual disability (ID), or autism spectrum disorder (ASD) was established, with ASD being most common. Outcomes and results Early clinical classifications were relatively unstable or difficult to establish at a young age. The magnitude of children’s cognitive and receptive language delay was a significant predictor of a later BE diagnosis of ID and LD respectively. A BE diagnosis of ASD, by contrast, could not be predicted from children’s early social communication problems nor the presence of restricted and repetitive behaviors and interests. Conclusions Taken together, the results of this study suggest that language difficulties can be an early marker of a neurodevelopmental disorder which is often not identified at the age of first referral. Implications Eligibility for treatment should, therefore, be based on biopsychosocial case formulation rather than DSM or ICD diagnostic classification. What this paper adds? In this study a dimensional approach was used to characterize the abilities of young children referred with mild to profound receptive and/or expressive language difficulties. Later on, a categorical approach was adopted to establish best estimate diagnoses. Our clinical, broadly defined sample reflects the heterogeneous intake of young children referred for diagnostic assessment. Other studies on diagnostic stability often only focus on one diagnostic category (and are explicitly excluding children with specific other diagnoses), not taking into account the difficulties of early differential diagnostic decision making and stability across different categories over time. Investigations of differential diagnosis within a clinical group, instead of only differentiating children with a specific diagnosis from typically developing children, may be more informative for clinicians.
Fluid inclusions in amethyst quartz of different geological environments from Brazil
Authors: Heinis Dias Coralie , de Sá Carneiro Chaves Mario Luiz , Figueiredo e Silva Rosaline Cristina , Dutra Gomes Sylvio 
Published: April 2021

Abstract
Fluid-inclusion studies were conducted on amethyst quartz from three different geological environments: basalt cavities; hydrothermal veins; and granitic pegmatites of Eastern Brazil, to understand the conditions of amethyst crystallisation in each of these environments. In samples from basalt cavities, fluid inclusions are exclusively one-phase aqueous types suggesting a low-temperature formation environment. Crystals from the two other environments show that fluid inclusions can be either one-phase aqueous, two-phase aqueous, three-phase aqueous carbonic, or three-phase aqueous with the presence of precipitated solid halite. The carbonic composition of the system H2O–CO2–NaCl was confirmed by Raman spectroscopic analysis and suggests a metamorphic or magmatic fluid source. Fluid inclusions trapped in samples from hydrothermal veins reveal at least two different fluid generations based on homogenisation temperatures. The first generation has minimum trapping temperatures between 249°C and 391°C. The second generation of lower temperature fluids has minimum trapping temperatures varying from 82°C to 203°C. Fluid inclusions of this group record eutectic temperatures that indicate the presence of Ca and Fe cations in addition to Na. Fluid inclusions trapped in amethyst from a pegmatite body have moderate salinity values between 15 and 25 eq. wt.% NaCl, thus reflecting the elevated salt content in pegmatite-forming fluids. In this sample, the first fluid generation is represented by aqueous fluid inclusions with minimum trapping temperatures ranging from 268°C to 375°C. The estimated eutectic temperatures, generally below –50°C, indicate the presence of Ca cations in addition to Na. Minimum trapping temperatures correspond to temperatures of late-to-post-pegmatitic hydrothermal stages. The second generation records minimum trapping temperatures between 125°C and 247°C. Amethyst from both hydrothermal veins and pegmatite environments contain solid inclusions of hematite, an indication that the mineralising fluid was Fe rich and thus, possibly magmatic in origin.
Breathlessness in COPD: linking symptom clusters with brain activity
Authors: Finnegan Sarah L. , Harrison Olivia K. , Harmer Catherine J. , Herigstad Mari , Rahman Najib M. , Reinecke Andrea , Pattinson Kyle T.S. 
Published: April 2021

BackgroundCurrent models of breathlessness often fail to explain disparities between patients' experiences of breathlessness and objective measures of lung function. While a mechanistic understanding of this discordance has thus far remained elusive, factors such as mood, attention and expectation have all been implicated as important modulators of breathlessness. Therefore, we have developed a model to better understand the relationships between these factors using unsupervised machine learning techniques. Subsequently we examined how expectation-related brain activity differed between these symptom-defined clusters of participants.MethodsA cohort of 91 participants with mild-to-moderate chronic obstructive pulmonary disease (COPD) underwent functional brain imaging, self-report questionnaires and clinical measures of respiratory function. Unsupervised machine learning techniques of exploratory factor analysis and hierarchical cluster modelling were used to model brain–behaviour–breathlessness links.ResultsWe successfully stratified participants across four key factors corresponding to mood, symptom burden and two capability measures. Two key groups resulted from this stratification, corresponding to high and low symptom burden. Compared with the high symptom burden group, the low symptom burden group demonstrated significantly greater brain activity within the anterior insula, a key region thought to be involved in monitoring internal bodily sensations (interoception).ConclusionsThis is the largest functional neuroimaging study of COPD to date, and is the first to provide a clear model linking brain, behaviour and breathlessness expectation. Furthermore, it was possible to stratify participants into groups, which then revealed differences in brain activity patterns. Together, these findings highlight the value of multimodal models of breathlessness in identifying behavioural phenotypes and for advancing understanding of differences in breathlessness burden.
A rare case of difficult airway management in a Klippel-Feil syndrome pediatric patient with osseous torticollis undergone orthopedic surgery
Authors: Zhang Xiaoqing , Wang Jun , Liu Yajie , Li Zhengqian , Han Bin 
Published: April 2021

AbstractBackgroundOrthopedic surgery for cervical torticollis poses potential threat to airway management both in tracheal intubation and extubation. Klippel-Feil syndrome (KFS) is a complex syndrome of osseous and visceral anomalies. The anatomical characteristics of KFS might have significant implications for airway management.Case presentationThis is a rare case of an 8-year-old boy presenting with osseous torticollis, congenital occipito-atlantal deformity, congenital basilar invagination and KFS undergone elective torticollis correction surgery. Though with difficulty, tracheal intubation was successfully performed. Extubation failed twice on postoperative day 2 and 10, and required tracheostomy. Based on radiological findings, we speculated that prolonged airway edema accounted for the main reason of the failed extubation, the hypertrophic tonsil and occipito-cervical fusion resulted in reduced oropharyngeal space and limited cervical range of motion. Moreover, the Chiari malformation and KFS complicated the airway condition and lead to prolonged airway obstruction. The tracheostomy casing was removed 1 month later.ConclusionsCautions should be taken in extubation of pediatric patients undergone major osseous torticollis surgery. Reintubation should be prepared in case of failed extubation. Severe post-operative airway edema, complicated with hypertrophic tonsil, the structural abnormalities in the oropharyngeal cavity, and occipito-cervical deformities constituted the decreased oropharyngeal space and resulted in failed extubation. For severe airway compromise and prolonged intubation, tracheostomy should be considered.
Effectiveness of Wellbeing Intervention for Chronic Kidney Disease (WICKD): results of a randomised controlled trial
Authors: Dingwall Kylie M. , Sweet Michelle , Cass Alan , Hughes Jaquelyne T. , Kavanagh David , Howard Kirsten , Barzi Federica , Brown Sarah , Sajiv Cherian , Majoni Sandawana W. , Nagel Tricia 
Published: April 2021

Abstract
Background
End stage kidney disease (ESKD) is associated with many losses, subsequently impacting mental wellbeing. Few studies have investigated the efficacy of psychosocial interventions for people with ESKD and none exist for Indigenous people, a population in which the ESKD burden is especially high.

Methods
This three-arm, waitlist, single-blind randomised controlled trial examined efficacy of the Stay Strong App in improving psychological distress (Kessler distress scale; K10), depressive symptoms (adapted Patient Health Questionnaire; PHQ-9), quality of life (EuroQoL; EQ. 5D) and dialysis adherence among Indigenous Australians undergoing haemodialysis in central and northern Australia (Alice Springs and Darwin), with follow up over two 3-month periods. Effects of immediate AIMhi Stay Strong App treatment were compared with those from a contact control app (The Hep B Story) and treatment as usual (TAU). Control conditions received the Stay Strong intervention after 3 months.

Results
Primary analyses of the full sample (N = 156) showed statistically significant decreases in K10 and PHQ-9 scores at 3 months for the Hep B Story but not for the Stay Strong app or TAU. Restricting the sample to those with moderate to severe symptoms of distress or depression (K10 > =25 or PHQ-9 > =10) showed significant decreases in K10 and PHQ-9 scores for both Stay Strong and Hep B Story. No significant differences were observed for the EQ-5D or dialysis attendance.

Conclusions
Findings suggest that talking to people about their wellbeing and providing information relevant to kidney health using culturally adapted, locally relevant apps improve the wellbeing of people on dialysis. Further research is required to replicate these findings and identify active intervention components.

Trial registration
ACTRN12617000249358; 17/02/2017.
Dacryoendoscopy-assisted incision of Hasner’s valve under nasoendoscopy for membranous congenital nasolacrimal duct obstruction after probing failure: a retrospective study
Authors: Li Yue , Wei Min , Liu Xueru , Zhang Leilei , Song Xuefei , Xiao Caiwen 
Published: April 2021

Abstract
Background
To introduce a treatment option: dacryoendoscopy-assisted incision of Hasner’s valve under nasoendoscopy and assess its efficacy in treating membranous congenital nasolacrimal duct obstruction (CNLDO) in children older than 1 year with history of initial probing failure.

Methods
52 eyes of 43 children with membranous CNLDO who underwent dacryoendoscopy-assisted incision of Hasner’s valve under nasoendoscopy between May 2012 and October 2020 were enrolled in this retrospective study. All participants were older than 1 year and all the eyes had gone through probing at least once but still had symptoms of epiphora and discharge. Surgical success was defined as a normal fluorescein dye disappearance test (FDDT) and the absence of pre-operation complaints, including epiphora, muco-purulent discharge, increased tear lake or the symptoms of acute infection such as acute dacryocystitis. Patients’ demographics, clinical features and follow-up outcomes were evaluated.

Results
Of all these operated cases, surgical success was achieved in 52/52 eyes without any early or late complications. The overall success rate was 100%.

Conclusions
Dacryoendoscopy-assisted incision of Hasner’s valve under nasoendoscopy is an effective and minimally invasive surgical treatment in membranous CNLDO patients with initial probing failure.
Patent foramen ovale revealed by COVID-19 pneumonia
Authors: Vanhomwegen Charlotte , Taton Olivier , Selvais Nicolas , Vanhove Olivier , Leduc Dimitri 
Published: April 2021

Abstract
Background
Platypnea-orthodeoxia syndrome (POS) is a rare condition characterized by dyspnoea (platypnea) and arterial desaturation in the upright position resolved in the supine position (orthodeoxia). Intracardiac shunt, pulmonary ventilation–perfusion mismatch and others intrapulmonary abnormalities are involved.

Case presentation
We report a case of POS associated with two pathophysiological issues: one, cardiac POS caused by a patent foramen ovale (PFO) and second, pulmonary POS due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) interstitial pneumonia. POS has resolved after recovery of coronavirus disease 2019 (COVID-19) pneumonia.

Conclusions
Right-to-left interatrial shunt and intrapulmonary shunt caused by SARS-CoV-2 pneumonia contributed to refractory hypoxemia and POS. Therefore, in case of COVID-19 patient with unexplained POS, the existence of PFO must be investigated.
Impact of preconceptional serum thyroid stimulating hormone values ranging between 2.5 and 4.5 mIU/L on live birth rates following ovulation induction and intrauterine insemination treatment for unexplained infertility
Authors: Karakis Lale Susan , Kiyak Huseyin , Okmen Berfin , Ozdemir Cagdas , Turkgeldi Engin 
Published: April 2021

AbstractBackgroundContrary to overt hypothyroidism, the true impact of subclinical hypothyroidism on fertility has not been well established. This study aimed to investigate whether serum thyroid stimulating hormone (TSH) values between 2.5 and 4.5 mIU/L are associated with lower pregnancy rates compared to TSH levels between 0.3 and 2.5 mIU/L in women undergoing ovulation induction with gonadotropins and intrauterine insemination (IUI) for unexplained infertility.MethodsMedical records of couples with unexplained infertility who underwent IUI treatment between January 2013 and December 2018 were reviewed retrospectively. Cycle characteristics and pregnancy outcomes of patients with serum TSH levels between 0.3–2.5 mIU/L and 2.5–4.5 mIU/L were compared. Primary outcome measures were clinical pregnancy and live birth rate. Secondary outcome measures were total dose of gonadotropin administration, duration of ovulation induction and miscarriage rate.ResultsA total of 726 euthyroid women who underwent 1465 cycles of ovulation induction with gonadotropins and IUI were included in the analyses. Patient and cycle characteristics of the two study groups were similar. No statistically significant differences could be detected in the clinical pregnancy (p = 0.74) and live birth rates (p = 0.38) between the two groups. Duration of ovulation induction, total gonadotropin dosage, number of follicles > 17 mm on the trigger day and the miscarriage rates were similar in the two groups.ConclusionIn euthyroid women undergoing ovulation induction with gonadotropins and IUI for unexplained infertility, the range of preconceptional serum TSH values between 2.5 and 4.5 mIU/L is not associated with lower pregnancy rates when compared to TSH levels between 0.3 and 2.5 mIU/L.
Role of husband’s attitude towards the usage of contraceptives for unmet need of family planning among married women of reproductive age in Pakistan
Authors: Asif Muhammad Farhan , Pervaiz Zahid , Afridi Jawad Rahim , Abid Ghulam , Lassi Zohra S. 
Published: April 2021

Abstract
Background
Family planning services deliver a wide range of benefits to the well-being of females and the community. It can curtail the risk of maternal and neonatal mortality through the reduction in abortions and pregnancies. The government of Pakistan has been struggling to convince people about the usefulness of family planning programs. However, different factors related to social norms, values, and culture are important to determine the success of these programs. One such factor is the patriarchal structure of Pakistani society where most of the household decisions are made by men. The objective of this research is to examine the role of the husband’s attitude towards the usage of contraceptives for the unmet need of family planning (UMNFP) among married women of reproductive age (MWRA) in Pakistan.

Method
The dataset of Pakistan Demographic and Health Survey 2017–18 is utilized to examine the role of the husband’s attitude towards the usage of contraceptives in UMNFP among MWRA in Pakistan.

Results
The UMNFP was considerably lower among MWRA between 40 years and above compared to women 15–19 years. The odds of UMNFP were higher among women and men who were educated up to the primary level compared to those with no education. Odds of UMNFP were higher among women from the poor wealth quintile compared to the poorest wealth quintile; similarly, it was significantly lower among women who were from the richer and the richest wealth quintile compared to the poorest wealth quintile. The odds of UMNFP were lower among women who were employed compared to those who were not employed. Lastly, the odds of UMNFP were higher among women whose husbands opposed to using contraceptives, who perceived that there was a religious prohibition for such use and when a decision on the contraception use was solely made by the husband.

Conclusions
Husband’s attitude towards the usage of contraceptives is an important predictor of UMNFP. Liaising with the community and religious leaders to persuade people particularly men about the usefulness of family planning programs and encouraging men to understand their women’s say in using contraceptives should be encouraged.