bluuebunny/crossref_metadata_2025_split huggingface dataset:
Acute traumatic brain injury and the use of head computed tomography scans in the emergency department
Authors: Rogan Alice , Patel Vimal , Birdling Jane , Lockett Jessica , Simmonds Harnah , McQuade David , Larsen Peter 
Published: June 2021

Introduction The use of CT head scanning for traumatic brain injury (TBI) is a vital diagnostic tool, guided by risk stratification tools. This study aims to review the use of CT head scans and adherence to guidelines for TBI in two New Zealand emergency departments (EDs). Methods Retrospective observational study of patients referred for head CT from EDs to exclude a significant intracranial injury between 1st September 2018 and 31st August 2019. Clinical data were collected regarding presenting patterns, identification of injuries on CT scan and adherence to National Institute of Clinical Excellence (NICE) CT head guidelines. Results Out of 425 included cases, 41 (10%) patients had an intracranial injury seen on their CT head scan. Patients who reported loss (32% vs 20%, p < 0.05) or possible loss of consciousness (34% vs 22%, p < 0.05) and had a Glasgow Coma Score (GCS) <13 (17% vs 8%, p < 0.05) or focal neurology (10% vs 3%, p < 0.05) were more likely to have an intracranial injury on CT. Interestingly, 17 (41%) patients with CT diagnosed injuries had a GCS 15 and no focal neurology. NICE guidelines were adhered to in 364 (86%) of CT requests. In the 14% of cases that did not meet guideline criteria, all CT head scans were negative. Conclusion CT head scans are a valuable tool in TBI, and guidelines successfully identify those with significant intracranial injuries. However, the rate of significant injury for the total population requiring head CT remains low, with over 90% of head CTs in the population normal, despite high guideline compliance, perhaps identifying a role for novel objective tests in ED guidelines internationally.
Endovascular surgery is not protective against new persistent opioid use development compared to open vascular surgery
Authors: Brown Craig S , Osborne Nicholas H , Hu Hsou M , Coleman Dawn , Englesbe Michael J , Waljee Jennifer F , Brummett Chad M , Vemuri Chandu 
Published: June 2021

Objective Endovascular techniques continue to be increasingly utilized to treat vascular disease, but the effect of these minimally invasive techniques on opioid use following surgery is not known. Methods Using Medicare data, we identified opioid-naive patients undergoing vascular procedures between 2009 and 2017. We selected patients ≥65 years old with continuous enrollment 12 months before and 6 months after surgery and had no additional operations. We defined new persistent opioid use (NPOU) as one or more opioid prescription fills both between 4–90 and 91–180 days postoperatively. Multivariable regression was performed for risk adjustment, and frequencies of NPOU were estimated between endovascular and open techniques to compare surgical approach. Results A total of 77,767 patients were identified, with 2.6% of all patients developing new persistent use. In addition to the identification of several risk factors for new persistent use, patients undergoing endovascular carotid or vertebral interventions were found to have higher adjusted frequencies of persistent use compared to those undergoing open interventions (3.0% vs. 1.8%, p < 0.001) as did those undergoing endovenous compared to open vein procedures (2.2%, vs. 1.6%, p = 0.019). We found no difference for peripheral vascular or aortic/iliac procedures. Conclusions Patients undergoing vascular surgery are at high risk for new persistent use. Undergoing endovascular carotid or venous surgery was associated with an increased risk of NPOU, whereas no differences were found between endovascular and open approaches for peripheral arterial or aortic disease.
Cartilage Injuries and Posttraumatic Osteoarthritis in the Wrist: A Review
Authors: Andersson Jonny K. , Hagert Elisabet , Brittberg Mats 
Published: June 2021

Objective: Focal cartilage injuries, and posttraumatic osteoarthritis (OA) in the wrist are likely common and a cause of wrist pain. To estimate the incidence of cartilage lesions and to understand the pathomechanisms leading to wrist cartilage injuries and OA, a literature review on the subject was performed combined with a presentation of one of the authors’ own experience. Design: This study includes a literature review of the topic. As a comparison to the review findings, the observations of one of the authors’ consecutive 48 wrist arthroscopies, were assessed. PubMed, Scholar, and Cochrane databases were searched using the keywords “cartilage injury AND wrist AND treatment” and “wrist AND cartilage AND chondral AND osteochondral AND degenerative OA.” :Result A total of 11 articles, including 9 concerning chondral and osteochondral repair and treatment and 2 regarding posttraumatic OA, were retrieved. The cartilage repair treatments used in these articles were drilling, osteochondral autograft, juvenile articular cartilage allograft, and chondrocyte implantation. One article displayed concomitant cartilage injuries in displaced distal radius fractures in 32% of the patients. The review of our findings from a 1-year cohort of wrist arthroscopies showed 17% cartilage injuries. Conclusion: There is a lack of knowledge in current literature on cartilage injuries and treatment, as well as posttraumatic OA in the wrist. Cartilage injuries appear to be common, being found in 17% to 32% of all wrist arthroscopies after trauma, but no guidelines regarding conservative or surgical treatment can be recommended at the moment. Larger prospective comparative studies are needed.
Obesity and Spine Surgery: A Qualitative Review About Outcomes and Complications. Is It Time for New Perspectives on Future Researches?
Authors: Cofano Fabio , Perna Giuseppe Di , Bongiovanni Daria , Roscigno Vittoria , Baldassarre Bianca Maria , Petrone Salvatore , Tartara Fulvio , Garbossa Diego , Bozzaro Marco 
Published: June 2021

Study Design: Literature review. Objectives: An increasing number of obese patients requires operative care for degenerative spinal disorders. The aim of this review is to analyze the available evidence regarding the role of obesity on outcomes after spine surgery. Peri-operative complications and clinical results are evaluated for both cervical and lumbar surgery. Furthermore, the contribution of MIS techniques for lumbar surgery to play a role in reducing risks has been analyzed. Methods: Only articles published in English in the last 10 years were reviewed. Inclusion criteria of the references were based on the scope of this review, according to PRISMA guidelines. Moreover, only paper analyzing obesity-related complications in spine surgery have been selected and thoroughly reviewed. Each article was classified according to its rating of evidence using the Sacket Grading System. Results: A total number of 1636 articles were found, but only 130 of them were considered to be relevant after thorough evaluation and according to PRISMA checklist. The majority of the included papers were classified according to the Sacket Grading System as Level 2 (Retrospective Studies). Conclusion: Evidence suggest that obese patients could benefit from spine surgery and outcomes be satisfactory. A higher rate of peri-operative complications is reported among obese patients, especially in posterior approaches. The use of MIS techniques plays a key role in order to reduce surgical risks. Further studies should evaluate the role of multidisciplinary counseling between spine surgeons, nutritionists and bariatric surgeons, in order to plan proper weight loss before elective spine surgery.
Retinal Vasculitis Associated With Dermatomyositis Treated With Intravenous Steroids
Authors: Knapp Austen N. , Arshad Jawad I. , Martin Daniel F. , Hajj-Ali Rula , Baynes Kimberly , Lowder Careen Y. , Srivastava Sunil K. 
Published: June 2021

Purpose: This work aims to present treatment and long-term follow-up of a 31-year-old woman with dermatomyositis who presented with hemorrhagic retinal vasculitis and macular edema. Methods: A retrospective case report is presented. Results: A 31-year-old woman with dermatomyositis treated with systemic immunosuppression was evaluated for acute, reduced vision. Best-corrected visual acuity was hand motion in the right eye and 20/200 in the left eye. Fundus examination revealed diffuse intraretinal hemorrhages, cotton-wool spots, and vascular sheathing with a frosted branch angiitis–like appearance. Optical coherence tomography revealed significant macular edema and subretinal fluid that quickly resolved after admission and treatment with intravenous steroids. Multimodal imaging at 7-year follow-up disclosed long-term sequelae including peripheral nonperfusion and retinal neovascularization. Conclusions: When vasculitis associated with dermatomyositis is treated aggressively with intravenous steroids at initial presentation, good visual acuity outcomes can be achieved, but long-term consequences of retinal nonperfusion and neovascularization persist.
Design and Analysis of a Multi-Legged Robot with Pitch Adjustive Units
Authors: Ruan Qiang , Wu Jianxu , Yao Yan-an 
Published: June 2021

AbstractThe paper proposes a novel multi-legged robot with pitch adjustive units aiming at obstacle surmounting. With only 6 degrees of freedom, the robot with 16 mechanical legs walks steadily and surmounts the obstacles on the complex terrain. The leg unit with adjustive pitch provides a large workspace and empowers the legs to climb up obstacles in large sizes, which enhances the obstacle surmounting capability. The pitch adjustment in leg unit requires as few independent adjusting actuators as possible. Based on the kinematic analysis of the mechanical leg, the biped and quadruped leg units with adjustive pitch are analyzed and compared. The configuration of the robot is designed to obtain a compact structure and pragmatic performance. The uncertainty of the obstacle size and position in the surmounting process is taken into consideration and the parameters of the adjustments and the feasible strategies for obstacle surmounting are presented. Then the 3D virtual model and the robot prototype are built and the multi-body dynamic simulations and prototype experiments are carried out. The results from the simulations and the experiments show that the robot possesses good obstacle surmounting capabilities.
Identifying prognostic lncRNAs based on a ceRNA regulatory network in laryngeal squamous cell carcinoma
Authors: Shi Yong , Yang Dongli , Qin Yixiao 
Published: June 2021

Abstract
Purpose
Growing evidence demonstrates that long non-coding RNAs (lncRNAs) play a crucial role as competing endogenous RNAs (ceRNAs) in tumor occurrence. The lncRNAs’ functions and clinical significance in laryngeal squamous cell carcinoma (LSCC) remain unclear. The study aims to reveal the lncRNA-associated ceRNA regulatory network of LSCC and clarify its clinical relevance.

Methods
Here, we obtained LSCC transcriptome data from The Cancer Genome Atlas (TCGA) database and identified the differential expression profile of lncRNAs, miRNAs, and mRNAs by the EdgeR R package. The function enrichment analysis of mRNAs was performed using clusterProfiler R package and GSEA3.0. Then, we constructed a ceRNA network and prognosis model based on lncRNAs through bioinformatic methods. Moreover, we explored the functions of prognosis-related lncRNA in LSCC by CCK-8 and transwell assay.

Results
1961 lncRNAs, 69 miRNAs, and 2224 mRNAs were identified as differentially expressed genes in LSCC tissues. According to the transcriptome differential expression profile, a ceRNA network containing 61 lncRNAs, 21 miRNAs, and 77 mRNAs was established. Then, four lncRNAs (AC011933.2, FAM30A, LINC02086, LINC02575) were identified from the ceRNA network to build a prognosis model for LSCC patients. And we found that LINC02086 and LINC02575 promoted the proliferation, migration, and invasion of LSCC cells while AC011933.2 and FAM30A inhibited these biological functions in vitro. Furthermore, we validated that LINc02086/miR-770-5p/SLC26A2 axis promoted migration in LSCC.

Conclusion
Four lncRNAs of the ceRNA network were abnormally expressed and related to patient prognosis in LSCC. They played a significant role in the progress of LSCC via affecting the proliferation and metastasis of tumor cells.
Association of circulating omega 3, 6 and 9 fatty acids with gestational diabetes mellitus: a systematic review
Authors: Hosseinkhani Shaghayegh , Dehghanbanadaki Hojat , Aazami Hossein , Pasalar Parvin , Asadi Mojgan , Razi Farideh 
Published: June 2021

Abstract
Background
Gestational diabetes mellitus (GDM) is associated with increased risks of disease for mother and child during pregnancy and after that. Early diagnosis of GDM would promote both maternal and fetal health. Metabolomics can simplify and develop our understanding of the etiology, manifestation, or pathophysiology of the disease. This systematic review investigates the association of circulating omega 3, 6, and 9 fatty acids with GDM.

Methods
We conducted a systematic search of PubMed, Scopus, Web of Science, and EMBASE databases up to May 8, 2020, using the key term combinations of all types of omega fatty acids with gestational diabetes mellitus. Additional articles were identified through searching the reference lists of included studies.

Results
This systematic review included 15 articles. Five were cohort studies, four included nested case-control studies and four were case-control studies. The results of this study demonstrate an increasing trend in the amount of oleic acid and palmitoleic acid in the second trimester and an increase in decosahexanoic acid in the third trimester of GDM mothers. The changes in other fatty acids of interest are either not significant or if significant, their results are inconsistent with the other existing articles.

Conclusions
Omega fatty acids, as potential biomarkers, are considered to be associated with GDM risk and thus provide useful information regarding the prevention and early diagnosis of GDM. Moreover, existing metabolomic studies on GDM are shown to provide conflicting results about metabolite profile characteristics. This systematic review was registered at PROSPERO (www.crd.york.ac.uk/PROSPERO) as CRD42020196122.
Do assessments of cardiorespiratory and muscular fitness influence subsequent reported physical activity? A randomized controlled trial
Authors: Langland James T. , Sathnur Neeraj , Wang Qi , Olson Andrew P. J. 
Published: June 2021

Abstract
Background
Regular physical activity and exercise provide many health benefits. These health benefits are mediated in large part through cardiorespiratory fitness and muscular strength. As most individuals have not had an assessment of their personal cardiorespiratory fitness or muscular strength we investigated if measurements of cardiorespiratory fitness and muscular strength would influence an individual’s subsequent self-reported exercise and physical activity.

Methods
Volunteer subjects at a State Fair were randomized in 1:1 parallel fashion to control and intervention groups. The baseline Exercise Vital Sign (EVS) and type of physical activity were obtained from all subjects. The intervention group received estimated maximum oxygen uptake (VO2max) using a step test and muscular strength using a hand grip dynamometer along with age-specific norms for both measurements. All subjects were provided exercise recommendations. Follow up surveys were conducted at 3, 6 and 12 months regarding their EVS and physical activity.

Results
One thousand three hundred fifteen individuals (656 intervention, 659 control) were randomized with 1 year follow up data obtained from 823 subjects (62.5%). Baseline mean EVS was 213 min/week. No change in EVS was found in either group at follow-up (p = 0.99). Subjects who were less active at baseline (EVS < 150) did show an increase in EVS (86 to 146) at 6 months (p < 0.05). At 3 months the intervention group increased resistance training (29.1 to 42.8%) compared to controls (26.3 to 31.4%) (p < 0.05). Lifestyle physical activity increased in the intervention group at 3 months (27.7 to 29.1%) and 6 months (25%) whereas it declined in the control group at 3 months (24.4 to 20.1%) and 6 months (18.7%) (p < 0.05).

Conclusion
Providing VO2max estimates and grip strength did not produce an increase in overall physical activity. The EVS and exercise recommendations did however produce an increase in physical activity in less active individuals. In a very active population the VO2max estimate and measured grip strength did increase lifestyle activity and resistance training. Wider adoption of these measures could be effective in promoting physical activity and resistance training.

Trial registration
clinicaltrials.gov NCT03518931 Registered 05/08/2018 -retrospectively registered.
Documenting HIV research-utilization activities, outputs and outcomes: examples and lessons learned from Project SOAR
Authors: Kalibala Samuel , Sinai Irit , Nutley Tara 
Published: June 2021

AbstractThe importance of using research findings to inform policy and program decisions is well recognized, but the literature on measuring research utilization activities is scarce. As funding to support some areas of research wanes or remains stagnant, the need to document the value of investing in research by its’ effect on improved programs and policies becomes increasingly necessary. We present the experience of Project SOAR, a six-year USAID-funded project focusing on HIV/AIDS-related implementation research, to demonstrate measurement of research utilization. We follow the project’s research-utilization logic model, including inputs, activities, outputs, and outcomes. We present tools the project developed and examples from project studies and discuss what works, remaining challenges and how to overcome them, and lessons learned. We then make recommendations for incorporating research-utilization activities and measurement in implementation-research studies.
Impact of human disturbances on soil cyanobacteria diversity and distribution in suburban arid area of Marrakesh, Morocco
Authors: Hakkoum Z. , Minaoui F. , Douma M. , Mouhri K. , Loudiki M. 
Published: June 2021

Abstract
Background
Cyanobacteria are among the first photoautotrophic component of soil microorganism communities which play a key ecological role in nutrient cycles and soil productivity. However, the sustainability of these soil biodiversity ecosystem services is increasingly compromised, especially in urban and peri-urban areas where soils are heavily exploited and used for a wide range of human activities. The aim of this study is to assess the impact of different types of human disturbances on cyanobacteria diversity and distribution in suburban soils of Marrakesh. Soil and cyanobacteria sampling were carried out during two campaigns at six sites located along an anthropogenic gradient from the least urbanized suburbs of Marrakesh to the highly anthropized suburban area. In the laboratory, soil physicochemical characteristics were measured. The morphological identification of cyanobacteria species was based both on microscopic observation and on soil cultures in solid and liquid Z8 media.

Results
The results showed a total of 25 cyanobacteria taxa belonging to ten genera, four families, and two orders (Oscillatoriales 88% and Chroococcales 12% of taxa). Among the taxa identified, seven strains were isolated in soil culture in nutrient media and purified in monoalgal culture. The highest cyanobacterial diversity was recorded in irrigated soil with treated wastewater compared to the non-cultivated control soil. In Principal Component and Cluster Analysis, suburban soils were subdivided into three groups depending on the chemical properties and cyanobacteria composition. Cyanobacteria diversity was significantly associated with the soil moisture, total organic carbon (TOC), PO4-P, NO3-N, and NH4-N contents.

Conclusions
While diversity and microalgal biomass were significantly lower in the soils affected by municipal and mining solid wastes, the input of organic matter and nutrients from treated wastewater appears to be beneficial for the increasing of the biodiversity of soil cyanobacteria. This survey provides a first inventory of the soil cyanobacterial communities and shows their spatial variability and high sensitivity to the land-use practices and anthropogenic disturbances on urban soil in Moroccan drylands.
Anthropogenic climate change has changed frequency of past flood during 2010-2013
Authors: Hirabayashi Yukiko , Alifu Haireti , Yamazaki Dai , Imada Yukiko , Shiogama Hideo , Kimura Yuki 
Published: June 2021

AbstractThe ongoing increases in anthropogenic radiative forcing have changed the global water cycle and are expected to lead to more intense precipitation extremes and associated floods. However, given the limitations of observations and model simulations, evidence of the impact of anthropogenic climate change on past extreme river discharge is scarce. Here, a large ensemble numerical simulation revealed that 64% (14 of 22 events) of floods analyzed during 2010-2013 were affected by anthropogenic climate change. Four flood events in Asia, Europe, and South America were enhanced within the 90% likelihood range. Of eight snow-induced floods analyzed, three were enhanced and four events were suppressed, indicating that the effects of climate change are more likely to be seen in the snow-induced floods. A global-scale analysis of flood frequency revealed that anthropogenic climate change enhanced the occurrence of floods during 2010-2013 in wide area of northern Eurasia, part of northwestern India, and central Africa, while suppressing the occurrence of floods in part of northeastern Eurasia, southern Africa, central to eastern North America and South America. Since the changes in the occurrence of flooding are the results of several hydrological processes, such as snow melt and changes in seasonal and extreme precipitation, and because a climate change signal is often not detectable from limited observation records, large ensemble discharge simulation provides insights into anthropogenic effects on past fluvial floods.
Feasible techniques in robotic thoracoscopic repair of congenital esophageal atresia: case report and literature review
Authors: Li Shuai , Cao Guoqing , Zhou Rongchao , Zhang Xi , Zhou Ying , Tang Shao-tao 
Published: June 2021

Abstract
Background
Robotic repair for esophageal atresia (EA) using da Vinci system is challenging. Specific surgical techniques need to be explored to overcome the current hurdles.

Case presentation
Two cases with EA (type I and type III by Gross classification, respectively) were repaired using da Vinci robotic system. Step trocar insertion and asymmetric ports distribution techniques were used. The mean weight was 3.2 kg. Operative times were 95 min totally, with the anastomotic time of 27.5 min. Follow-up duration was 12 months. Esophageal fistula reoccurred in one case. None was confirmed anastomotic stricture.

Conclusion
Step trocar insertion procedure and asymmetric ports distribution technique are effective in robotic esophageal atresia.