bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pediatric Facial Fractures: A Multi-Institutional Level 1 Trauma Center Analysis of Incidence, Interventions, and Outcomes
Authors: Hinson Madison , Wright Avery , Davidson Amelia , Kogan Samuel , Runyan Christopher 
Published: August 2024

Study Design Retrospective chart review. Objective The management of pediatric facial fractures presents distinctive considerations compared to adults. This study aims to provide a unique perspective on the correlations between the mechanism of injury, types of facial fractures, and fracture interventions and management utilized in 2 North Carolina Level 1 Trauma Centers to determine the optimal management options for this patient population. Methods An IRB-approved retrospective chart review was performed of pediatric facial trauma patients ages <18 years old between January 2020 and December 2022 at Atrium Health Wake Forest Baptist Medical Center and Atrium Health Charlotte Medical Center. Data on patient demographics, mechanism of injury, facial fractures, interventions, and outcomes were collected. Results Of 2,977 pediatric facial trauma patients, 582 patients sustained at least 1 facial fracture at the time of injury. Adolescents were significantly less likely to be transferred from outside institutions and to be admitted for further care ( P = 0.002). Adolescents experienced higher levels of residual symptoms following initial discharge ( P = 0.001) and were less likely to have a symptom resolution within 1 year ( P < 0.0001). Neonates and infants were significantly more likely to receive conservative interventions and to sustain calvarium and skull base fractures ( P < 0.0001). Conclusions This study identifies differences in pediatric age groups related to transfers, admittance, fracture type, management, and outcomes. Our data suggests adolescent patients may experience a higher incidence of residual symptoms with lower levels of symptom resolution within 1 year. Further investigation into these differences may elicit optimized methods of fracture management in pediatric age groups and allow for effective, individualized care with improved long-term outcomes.
Clinical characteristics and outcomes of adult alveolar rhabdomyosarcoma patients on first-line systemic therapies: A single-institution cohort
Authors: Nakazawa Michael S , Livingston J Andrew , Zarzour Maria A , Bishop Andrew J , Ratan Ravin , Ludwig Joseph A , Araujo Dejka M , Somaiah Neeta , Ravi Vinod , Nassif Elise F , Roland Christina L , Lazar Alexander J , Guadagnolo B Ashleigh , Harrison Douglas J , Benjamin Robert S , Patel Shreyaskumar R , Conley Anthony P 
Published: August 2024

Background: Rhabdomyosarcomas are the most common soft tissue sarcoma in children, and pediatric alveolar rhabdomyosarcoma (ARMS) prognosis has improved based on cooperative studies. However, in adults, ARMS is significantly rarer, has poorer outcomes, and currently lacks optimal treatment strategies. Objective: This study aimed to evaluate the clinical outcome of an adult ARMS population with different front-line systemic chemotherapies and determine if any chemotherapy regimen is associated with improved survival. Materials and methods: This is a retrospective study of histologically confirmed fusion-positive ARMS patients over 18 years of age, who were treated at MD Anderson Cancer Center (MDACC) from 2004 to 2021 and received systemic chemotherapy. Descriptive clinical statistics were performed, including staging, front-line chemotherapy, multimodal therapy usage, response rates, and survival analyses. Results: 49 ARMS patients who received upfront chemotherapy were identified. Locoregional treatments included radiotherapy (RT) alone (29%, n = 14), surgery alone (10%, n = 5), or both (45%, n = 22). Median overall survival (OS) for the entire cohort was 3.6 years, and the overall response rate to systemic therapy was 89%. No chemotherapy regimen showed OS benefit, specifically analyzing the pediatric-based vincristine, actinomycin-D, cyclophosphamide (VAC) or adult-based vincristine, doxorubicin, ifosfamide (VDI) regimens, even when controlled for other clinical risk factors. Conclusion: In this single-center contemporary series, adult ARMS patient outcomes remain poor. There was no statistically significant OS difference in patients who did or did not receive adult or pediatric based ARMS regimens, although a high overall response rate to chemotherapy was seen across the entire cohort. Based on these observations, further randomized prospective studies are necessary to delineate which frontline chemotherapy regimen is most beneficial in this rare adult cancer.
A real-time interactive restoration system for intraoral digital videos using segment anything model
Authors: Wu Yongjia , Zeng Li , Hong Yaya , Li Xiaojun , Chen Xuepeng 
Published: August 2024

Objective Poor conditions in the intraoral environment often lead to low-quality photos and videos, hindering further clinical diagnosis. To restore these digital records, this study proposes a real-time interactive restoration system using segment anything model. Methods Intraoral digital videos, obtained from the vident-lab dataset through an intraoral camera, serve as the input for interactive restoration system. The initial phase employs an interactive segmentation module leveraging segment anything model. Subsequently, a real-time intraframe restoration module and a video enhancement module were designed. A series of ablation studies were systematically conducted to illustrate the superior design of interactive restoration system. Our quantitative evaluation criteria contain restoration quality, segmentation accuracy, and processing speed. Furthermore, the clinical applicability of the processed videos was evaluated by experts. Results Extensive experiments demonstrated its performance on segmentation with a mean intersection-over-union of 0.977. On video restoration, it leads to reliable performances with peak signal-to-noise ratio of 37.09 and structural similarity index measure of 0.961, respectively. More visualization results are shown on the https://yogurtsam.github.io/iveproject page . Conclusion Interactive restoration system demonstrates its potential to serve patients and dentists with reliable and controllable intraoral video restoration.
Respiratory Symptoms and Psychological Distress in Farmers Living With Chronic Obstructive Pulmonary Disease
Authors: Kham-ai Prasert , Li Peng , Wheeler Pariya , Witt Cheryl , Sanderson Wayne , Heaton Karen 
Published: August 2024

Background: Farmers with chronic obstructive pulmonary disease (COPD) often face both respiratory issues and psychological distress, which can exacerbate their condition. However, no prior research has examined how the frequency of respiratory symptoms is associated to psychological distress in these individuals. Therefore, this study aimed to explore this relationship among U.S. farmers living with COPD. Methods: A cross-sectional study involved 101 participants, a mix of on-site and online recruits, assessing respiratory symptoms and psychological distress in farmers with COPD. The study employed standard self-reported measures and utilized both simple and multiple linear regression to analyze the association between respiratory symptoms and psychological distress. Findings: Participants reported notably higher levels of respiratory symptoms (61.6 [ SD = 13.3]) compared to the reference score of 12, along with elevated psychological distress (25.9 [ SD = 10.6]). Factors like COPD duration, income, smoking, and emergency department (ED) visits correlated with respiratory symptoms, while age, COPD duration, income, smoking, pesticide exposure, and farm type were associated to psychological distress. Notably, even after accounting for age, smoking, and pesticide exposure, a significant association remained between respiratory symptoms and psychological distress (β = 0.46, p < .001). Conclusion: Respiratory symptoms were significantly associated to psychological distress, even when considering other factors. While this aligns with existing research, a future longitudinal study is crucial to establish the cause-effect relationship between these variables. Understanding this relationship could inform the development of targeted interventions to alleviate psychological distress in individuals with respiratory symptoms. Implications for Occupational Health Nursing Practice: The correlation between COPD symptoms and psychological distress in farmers emphasizes the need for integrated nursing care. Occupational health nurses should prioritize combined respiratory and mental health assessments.
Prediction models for retinopathy of prematurity occurrence based on artificial neural network
Authors: Wu Rong , Chen He , Bai Yichen , Zhang Yu , Feng Songfu , Lu Xiaohe 
Published: August 2024

Abstract
Introduction
Early prediction and timely treatment are essential for minimizing the risk of visual loss or blindness of retinopathy of prematurity, emphasizing the importance of ROP screening in clinical routine.

Objective
To establish predictive models for ROP occurrence based on the risk factors using artificial neural network.

Methods
A cohort of 591 infants was recruited in this retrospective study. The association between ROP and perinatal factors was analyzed by univariate analysis and multivariable logistic regression. We developed predictive models for ROP screening using back propagation neural network, which was further optimized by applying genetic algorithm method. To assess the predictive performance of the models, the areas under the curve, sensitivity, specificity, negative predictive value, positive predictive value and accuracy were used to show the performances of the prediction models.

Results
ROP of any stage was found in 193 (32.7%) infants. Twelve risk factors of ROP were selected. Based on these factors, predictive models were built using BP neural network and genetic algorithm-back propagation (GA-BP) neural network. The areas under the curve for prediction models were 0.857, and 0.908 in test, respectively.

Conclusions
We developed predictive models for ROP using artificial neural network. GA-BP neural network exhibited superior predictive ability for ROP when dealing with its non-linear clinical data.
Health and non-health benefits and equity impacts of individual-level economic relief programs during epidemics/pandemics in high income settings: a scoping review
Authors: Ogunbameru Adeteju , Gebretekle Gebremedhin Beedemariam , Perryman Adrianna , Hassan Marian , Farrell Ashley , Liu Kuan , Mishra Sharmistha , Sander Beate 
Published: August 2024

Abstract
Background
Economic relief programs are strategies designed to sustain societal welfare and population health during a regional or global scale infectious disease outbreak. While economic relief programmes are considered essential during a regional or global health crisis, there is no clear consensus in the literature about their health and non-health benefits and their impact on promoting equity.

Methods
We conducted a scoping review, searching eight electronic databases from January 01, 2001, to April 3, 2023, using text words and subject headings for recent pathogens (coronavirus (COVID-19), Ebola, Influenza, Middle East Respiratory Syndrome (MERS), severe acute respiratory syndrome (SARS), HIV, West Nile, and Zika), and economic relief programs; but restricted eligibility to high-income countries and selected diseases due to volume. Title and abstract screening were conducted by trained reviewers and Distiller AI software. Data were extracted in duplicates by two trained reviewers using a pretested form, and key findings were charted using a narrative approach.

Results
We identified 27,263 de-duplicated records, of which 50 were eligible. Included studies were on COVID-19 and Influenza, published between 2014 and 2023. Zero eligible studies were on MERS, SARS, Zika, Ebola, or West Nile Virus. We identified seven program types of which cash transfer (n = 12) and vaccination or testing incentive (n = 9) were most common. Individual-level economic relief programs were reported to have varying degrees of impact on public health measures, and sometimes affected population health outcomes. Expanding paid sick leave programs had the highest number of studies reporting health-related outcomes and positively impacted public health measures (isolation, vaccination uptake) and health outcomes (case counts and the utilization of healthcare services). Equity impact was most often reported for cash transfer programs and incentive for vaccination programs. Positive effects on general well-being and non-health outcomes included improved mental well-being and quality of life, food security, financial resilience, and job security.

Conclusions
Our findings suggest that individual-level economic relief programs can have significant impacts on public health measures, population health outcomes and equity. As countries prepare for future pandemics, our findings provide evidence to stakeholders to recognize health equity as a fundamental public health goal when designing pandemic preparedness policies.
Benefits of budesonide/glycopyrronium/formoterol fumarate dihydrate on lung function and exacerbations of COPD: a post-hoc analysis of the KRONOS study by blood eosinophil level and exacerbation history
Authors: Muro Shigeo , Kawayama Tomotaka , Sugiura Hisatoshi , Seki Munehiro , Duncan Elizabeth A. , Bowen Karin , Marshall Jonathan , Megally Ayman , Patel Mehul 
Published: August 2024

Abstract
Background
Japanese guidelines recommend triple inhaled corticosteroid (ICS)/long-acting muscarinic antagonist (LAMA)/long-acting β2-agonist (LABA) therapy in patients with chronic obstructive pulmonary disease (COPD) and no concurrent asthma diagnosis who experience frequent exacerbations and have blood eosinophil (EOS) count ≥ 300 cells/mm3, and in patients with COPD and asthma with continuing/worsening symptoms despite receiving dual ICS/LABA therapy. These post-hoc analyses of the KRONOS study in patients with COPD and without an asthma diagnosis, examine the effects of fixed-dose triple therapy with budesonide/glycopyrronium/formoterol fumarate dihydrate (BGF) versus dual therapies on lung function and exacerbations based on blood EOS count – focusing on blood EOS count 100 to < 300 cells/mm3 – as a function of exacerbation history and COPD severity.

Methods
In KRONOS, patients were randomized to receive treatments that included BGF 320/14.4/10 µg, glycopyrronium/formoterol fumarate dihydrate (GFF) 14.4/10 µg, or budesonide/formoterol fumarate dihydrate (BFF) 320/10 µg via metered dose inhaler (two inhalations twice-daily for 24 weeks). These post-hoc analyses assessed changes from baseline in morning pre-dose trough forced expiratory volume in 1 s (FEV1) over 12–24 weeks and moderate or severe COPD exacerbations rates over 24 weeks. The KRONOS study was not prospectively powered for these subgroup analyses.

Results
Among patients with blood EOS count 100 to < 300 cells/mm3, least squares mean treatment differences for lung function improvement favored BGF over BFF in patients without an exacerbation history in the past year and in patients with moderate and severe COPD, with observed differences ranging from 62 ml to 73 ml across populations. In this same blood EOS population, moderate or severe exacerbation rates were reduced for BGF relative to GFF by 56% in patients without an exacerbation history in the past year, by 47% in patients with moderate COPD, and by 50% in patients with severe COPD.

Conclusions
These post-hoc analyses of patients with moderate-to-very severe COPD from the KRONOS study seem to indicate clinicians may want to consider a step-up to triple therapy in patients with persistent/worsening symptoms with blood EOS count > 100 cells/mm3, even if disease severity is moderate and there is no recent history of exacerbations.

Trial registration
ClinicalTrials.gov registry number NCT02497001 (registration date, 13 July 2015).
Kerala’s progress towards universal health coverage: the road travelled and beyond
Authors: Adithyan G.S. , Ranjan Alok , Muraleedharan V. R. , Sundararaman T. 
Published: August 2024

Abstract
Background
Kerala has initiated many Universal Health Coverage (UHC) reforms in the last decade. The Aardram Mission launched in 2017 stands out owing to its scope, objectives, and commitments for strengthening Primary Health Care (PHC) in the State. The current study proposes to explore access and financial protection through the lens of equity in Kerala especially in the context of major UHC reforms carried out during the last decade. This paper will also highlight the key lessons from Kerala’s approach towards UHC and health systems strengthening through a political economy approach.

Methods
Data from the Kerala state sample of 75th Round (2017-18) National Sample Survey is used for this study. Comparison is also drawn from the 71st Round Sample Survey, 2014, to measure the state’s progress in terms of access and financial protection. Logistic regression was used for the calculation. The findings were further explored through a political economy approach.

Results
The share of public facilities for outpatient care is 47.5%, which is a significant increase from 34.0% (in 2014) in the state. The share of public sector for out-patient care has increased for the lower socio-economic population in the state. The share of public sector for in-patient care has also increased to 37.3% in 2017-18 from 33.9% in 2014, but not to the extent as the increase shown in outpatient care. The average out-of-pocket-expenditure during hospitalization has increased more in private facilities as compared to public for both outpatient care and hospitalization.

Conclusions
Overall increase in the share of public facilities for both outpatient care and hospitalization is indicative of the enhanced trust among the people at large of the public healthcare delivery system in Kerala, post the launch of UHC reforms in the State. The insurance linked UHC reforms would be insufficient for the State to progress further towards UHC. Kerala with a long and successful history in ‘public provisioning’ should focus more on strengthening PHC through Aardram Mission in its journey towards pursuit of UHC.
Metformin enhances endogenous neural stem cells proliferation, neuronal differentiation, and inhibits ferroptosis through activating AMPK pathway after spinal cord injury
Authors: Xing Cong , Liu Song , Wang Liyue , Ma Hongpeng , Zhou Mi , Zhong Hao , Zhu Shibo , Wu Qiang , Ning Guangzhi 
Published: August 2024

Abstract
Background
Inadequate nerve regeneration and an inhibitory local microenvironment are major obstacles to the repair of spinal cord injury (SCI). The activation and differentiation fate regulation of endogenous neural stem cells (NSCs) represent one of the most promising repair approaches. Metformin has been extensively studied for its antioxidative, anti-inflammatory, anti-aging, and autophagy-regulating properties in central nervous system diseases. However, the effects of metformin on endogenous NSCs remains to be elucidated.

Methods
The proliferation and differentiation abilities of NSCs were evaluated using CCK-8 assay, EdU/Ki67 staining and immunofluorescence staining. Changes in the expression of key proteins related to ferroptosis in NSCs were detected using Western Blot and immunofluorescence staining. The levels of reactive oxygen species, glutathione and tissue iron were measured using corresponding assay kits. Changes in mitochondrial morphology and membrane potential were observed using transmission electron microscopy and JC-1 fluorescence probe. Locomotor function recovery after SCI in rats was assessed through BBB score, LSS score, CatWalk gait analysis, and electrophysiological testing. The expression of the AMPK pathway was examined using Western Blot.

Results
Metformin promoted the proliferation and neuronal differentiation of NSCs both in vitro and in vivo. Furthermore, a ferroptosis model of NSCs using erastin treatment was established in vitro, and metformin treatment could reverse the changes in the expression of key ferroptosis-related proteins, increase glutathione synthesis, reduce reactive oxygen species production and improve mitochondrial membrane potential and morphology. Moreover, metformin administration improved locomotor function recovery and histological outcomes following SCI in rats. Notably, all the above beneficial effects of metformin were completely abolished upon addition of compound C, a specific inhibitor of AMP-activated protein kinase (AMPK).

Conclusion
Metformin, driven by canonical AMPK-dependent regulation, promotes proliferation and neuronal differentiation of endogenous NSCs while inhibiting ferroptosis, thereby facilitating recovery of locomotor function following SCI. Our study further elucidates the protective mechanism of metformin in SCI, providing new mechanistic insights for its candidacy as a therapeutic agent for SCI.
Assessing post-abortion care using the WHO quality of care framework for maternal and newborn health: a cross-sectional study in two African hospitals in humanitarian settings
Authors: Pasquier Estelle , Owolabi Onikepe O. , Powell Bill , Fetters Tamara , Ngbale Richard Norbert , Lagrou Daphne , Fotheringham Claire , Schulte-Hillen Catrin , Chen Huiwu , Williams Timothy , Moore Ann M. , Adame Gbanzi Mariette Claudia , Debeaudrap Pierre , Filippi Veronique , Benova Lenka , Degomme Olivier 
Published: August 2024

Abstract
Background
Abortion-related complications remain a main cause of maternal mortality. There is little evidence on the availability and quality of post-abortion care (PAC) in humanitarian settings. We assessed the quality of PAC in two hospitals supported by an international organization in Jigawa State (Nigeria) and Bangui (Central African Republic, CAR).

Methods
We mapped indicators corresponding to the eleven domains of the WHO Maternal and Newborn Health quality-of-care framework to assess inputs, processes (provision and experience of care), and outcomes of PAC. We measured these indicators in four components of a cross-sectional multi-methods study: 1) an assessment of the hospitals’ PAC signal functions, 2) a survey of the knowledge, attitudes, practices, and behavior of 140 Nigerian and 84 CAR clinicians providing PAC, 3) a prospective review of the medical records of 520 and 548 women presenting for abortion complications and, 4) a survey of 360 and 362 of these women who were hospitalized in the Nigerian and CAR hospitals, respectively.

Results
Among the total 27 PAC signal functions assessed, 25 were available in the Nigerian hospital and 26 in the CAR hospital. In both hospitals, less than 2.5% were treated with dilatation and sharp curettage. Over 80% of women received blood transfusion or curative antibiotics when indicated. However, antibiotics were given to about 30% of patients with no documented indication. Among discharged women in CAR, 99% received contraceptive counseling but only 39% did in Nigeria. Over 80% of women in Nigeria reported positive experiences of respect and preservation of dignity. Conversely, in CAR, 37% reported that their privacy was always respected during examination and 62% reported short or very short waiting time before seeing a health provider. In terms of communication, only 15% felt able to ask questions during treatment in both hospitals. The risk of abortion-near-miss happening ≥ 24h after presentation was 0.2% in Nigeria and 1.1% in CAR. Only 65% of women in the Nigerian hospital and 34% in the CAR hospital reported that the staff provided them best care all the time.

Conclusion
Our comprehensive assessment identified that these two hospitals in humanitarian settings provided lifesaving PAC. However, hospitals need to strengthen the patient-centered approach engaging patients in their own care and ensuring privacy, short waiting times and quality provider-patient communication. Health professionals would benefit from instituting antibiotic stewardships to prevent antibiotic-resistance.