bluuebunny/crossref_metadata_2025_split huggingface dataset:
Self-Trephination in Cranial Excoriation Disorder
Authors: Riordan Coleman P. , Owusu-Adjei Brittany , Daci Rrita , Phelan Alannah , Mietus Constance J. , Kosarchuk Jacob , Lambert William , Qureshi Hanya M. , Lim Jeewoo Chelsea , Mihalek Olivia , Li Danielle , Sorour Omar , Homsy Christopher , Kryzanski James , Aulet Ricardo , Johnson Mark D. 
Published: June 2024

BACKGROUND AND IMPORTANCE:
Trephination is a procedure in which a small hole is made in the skull. Rare cases of self-trephination by individuals seeking medical benefit have been reported. Excoriation disorder is a compulsive skin-picking condition in which an individual self-inflicts cutaneous lesions. Left untreated, severe excoriation disorder can pose significant health risks.

CLINICAL PRESENTATION:
Here, we describe 5 patients who presented with self-trephination due to a severe form of compulsive cranial excoriation at 2 neighboring academic medical centers over a 4-year period. We review the clinical presentation of self-trephination in cranial excoriation disorder and associated risk factors, surgical and nonsurgical interventions, complications of the disease, treatments, and mortality. Defining clinical characteristics include repetitive self-induced destruction of the scalp and skull with entry into the intracranial compartment, frequent psychiatric comorbidities, infection or injury of the brain with consequent neurological morbidity or mortality, and frequent treatment failures because of poor adherence.

CONCLUSION:
Self-trephination in cranial excoriation disorder is a severe neuropsychological disorder and neurosurgical emergency that exposes the brain and is often life-threatening. Appropriate therapy requires antibiotics, surgical debridement and repair of the wound, and concomitant effective psychiatric management of the underlying compulsion, including the use of antidepressants and behavioral therapy.
PARTIAL ACHILLES TENDON TEAR: A FIGURE OF OUR IMAGINATION?
Authors: Seyed-Safi P. , Naji O. , Faroug R. , Beer A. , Vijapur A. , Oduoza U. , Johal K. , Mordecai S. , Deol R. , Davda K. , Sivanadarajah N. , Ieong E. , Rudge B. 
Published: June 2024

AimOur collaborative study aims to demonstrate that acute partial Achilles Tendon Tears (ATTs) are not separate diagnostic entities from full ATTs. and should be thought of as a continuum rather than binary partial or full.MethodsWe pooled anonymised data from four hospitals, identifying patients with acute partial ATTs on USS reports from 2019–2021. Patients were only included if they had an acute injury and no previous background Achilles tendinopathy.Results91 patients had acute partial ATTs reported on USS. 74/91 (81%) of patients had clinical findings in keeping with a full ATT (positive Simmonds test, palpable gap). 88/91 (97%) of patients were managed according to local full ATT protocols. 2 patients had MRIs – one showed no tear, the other showed a full rupture. 2 patients underwent surgical repair and both intra-operatively were found to have full ATTs.ConclusionOur regional data suggests that a significant proportion (81%) of USS diagnosed partial ATTs may in fact be misdiagnosed full ATTs. All injuries clinically suspicious for an ATT should be managed according to local Achilles Protocol. USS is useful to diagnose the presence or absence of a tear but is not good at differentiating partial vs full tear. There is significant tendon end fibrillation and overlap on USS of an acute full ATT, which can give the impression of a partial ATT. More research is needed into whether any threshold exists to support the current distinction of “partial” and “full” as relates to management and outcomes.
IS INTERNAL BRACE AUGMENTATION (IBA) BETTER THAN ISOLATED MODIFIED BROSTROM GOULD (MBG) REPAIR FOR CHRONIC LATERAL LIGAMENT INJURY? A RETROSPECTIVE ANALYSIS
Authors: Sethi M. , Limaye R. , Limaye N. 
Published: June 2024

IntroductionAcute ankle injuries are commonly seen in musculoskeletal practice. Surgical management is the gold standard for lateral ligament injury in those with failed conservative treatment for a minimum of six months. Several studies have shown good functional outcome and early rehabilitation after MBG repair with an internal brace augmentation which is a braided ultrahigh molecular weight polyethylene ligament used to enhance the repair that acts as a secondary stabiliser. Hence the aim of the study was to compare the results with and without augmentation.MethodsA single centre retrospective review conducted between November 2017 and October 2019 and this included 172 patients with symptomatic chronic lateral ligament instability with failed conservative management. The diagnosis was confirmed by MRI. All patients had an ankle arthroscopy followed by open ligament repair. Patients were grouped into isolated MBG and internal brace groups for analyses and all had dedicated rehabilitation.ResultsA total of 148 patients were available for final follow up with 87 patients in the MBG group and 61 patients in the IBA group. Mean Age was 38 years and mean follow up was 22 months. The internal brace group showed better Manchester Oxford foot and ankle score (19.7 vs 18.2) and more patients returning to preinjury activity levels (73 vs 55) as compared to isolated repair.ConclusionInternal brace augmentation with MBG repair facilitated early rehabilitation and return to pre injury activity level in majority of patients compared to isolated MBG repair.
A COMPARISON OF FUNCTIONAL OUTCOME SCORES FOR PRIMARY AND REVISION ANKLE ARTHROPLASTIES
Authors: Moriarity A. , Raglan M. , Dhar S. 
Published: June 2024

BackgroundPatients who undergo either primary or revision total ankle replacement (TAR) expect improvements in pain, function and quality of life. The goal of this study was to measure the functional outcome improvements and the difference in patient-reported outcomes in patients undergoing primary total ankle replacements compared to revision TAR.MethodsA single-center prospective cohort study was undertaken between 2016 and 2022. All patients were followed up for a minimum of 6 months. Patients undertook the Manchester Oxford Foot Questionnaire (MoxFQ) and EQ-5D health quality questionnaires pre-operatively, at 6 months and yearly for life. The Mann Whitney test was undertaken for statistical analysis.ResultsA total of 165 primary and 71 revision ankle replacements were performed between 2016 and 2022. The mean age was 71 years for primary replacements and 69 years for revisions. The INFINITY was utilized in the majority of primary total ankle replacements. Revision replacements were either the INBONE II or INVISION and they were most often revising the MOBILITY implant. The main indication for revision was aseptic loosening (83%). Other causes included infection, malalignment and insert wear. The overall MoxFQ improved by a mean of 46.5 for primaries and 40.2 for revisions. The EQ-5D score also showed overall improvements with the mean difference in mobility increasing by 1.6.ConclusionBoth primary and revision ankle replacements result in improved functional scores at 6 months, 1 year and 2 years. In this cohort with the implants used, both primary and revision ankle replacements demonstrate similar improvements in functional scores.
CAZAC-based adaptative modulation scheme for the MB-OFDM UWBoF system
Authors: Xiang Changqing , Zhou Jingyang , Tan Benxiang , Deng Shuanglong , Tian Dandan , Liu Siyuan , Zhang Kang , Li Jingming , Zhou Xuan 
Published: June 2024

A scheme that combines 256/128/64 quadrantal amplitude modulation (QAM)
adaptive modulation with constant amplitude zero autocorrelation
sequence (CAZAC) precoding in a multi-band orthogonal frequency
division multiplexing (MB-OFDM) ultra-wideband over fiber (UWBoF)
system is proposed in this paper. CAZAC precoding enables a relatively
balanced signal-to-noise ratio (SNR) within each band, and the use of
adaptive modulation optimizes the upper limit of transmission
performance in each subband. Simulation results show that CAZAC
precoding combined with 256/128/64QAM and conventional 64QAM reduces
the peak-to-average power ratio (PAPR) by 1 dB and
0.5 dB, respectively. The proposed scheme achieves PAPR
performance comparable to conventional 64QAM. It confirms that CAZAC
precoding performs better in the reduction of PAPR and bit error rate
(BER) when combined with the 256/128/64QAM scheme.
Interhospital variation in the nonoperative management of acute cholecystitis
Authors: Ali Konmal , Chervu Nikhil L. , Sakowitz Sara , Bakhtiyar Syed Shahyan , Benharash Peyman , Mohseni Shahin , Keeley Jessica A. 
Published: June 2024

Background
Cholecystectomy remains the standard management for acute cholecystitis. Given that rates of nonoperative management have increased, we hypothesize the existence of significant hospital-level variability in operative rates. Thus, we characterized patients who were managed nonoperatively at normal and lower operative hospitals (>90th percentile).

Methods
All adult admissions for acute cholecystitis were queried using the 2016–2019 Nationwide Readmissions Database. Centers were ranked by nonoperative rate using multi-level, mixed effects modeling. Hospitals in the top decile of nonoperative rate (>9.4%) were classified as Low Operative Hospitals (LOH; others:nLOH). Separate regression models were created to determine factors associated with nonoperative management at LOH and nLOH.

Results
Of an estimated 418,545 patients, 9.9% were managed at 880 LOH. Multilevel modeling demonstrated that 20.6% of the variability was due to hospital factors alone. After adjustment, older age (Adjusted Odds Ratio [AOR] 1.02/year, 95% Confidence Interval [CI] 1.01–1.02) and public insurance (Medicare AOR 1.31, CI 1.21–1.43 and Medicaid AOR 1.43, CI 1.31–1.57; reference: Private Insurance) were associated with nonoperative management at LOH. These were similar at nLOH. At LOH, SNH status (AOR 1.17, CI 1.07–1.28) and small institution size (AOR 1.20, CI 1.09–1.34) were associated with increased odds of nonoperative management.

Conclusion
We noted a significant variability in the interhospital variation of the nonoperative management of acute cholecystitis. Nevertheless, comparable clinical and socioeconomic factors contribute to nonoperative management at both LOH and non-LOH. Directed strategies to address persistent non-clinical disparities are necessary to minimize deviation from standard protocol and ensure equitable care.
The relationship between hamstring strength tests and sprint performance in female Gaelic footballers: A correlation and linear regression analysis
Authors: Whyte Enda , O’Connor Siobhán , Tobin Jones Hannah , McBride Cian , O’Flynn Aisling , Quinn Oisin , Behan Fearghal 
Published: June 2024

Objectives
To investigate the relationships between handheld dynamometer (HHD), isokinetic and Nordic hamstrings exercise (NHE) measurements of knee flexor strength and their association with sprinting performance.

Design
Cross-sectional

Methods
The relationships between HHD (prone isometric, prone break and supine break knee flexor strength tests), isokinetic and NHE peak knee flexor strength measures were examined using Pearson product correlations on 38 female footballers. A linear regression analysis was also performed for each pair of dependent variables (10 and 30 metre sprint times) and independent predictor variables (average relative peak torque for HHD, isokinetic and NHE testing).

Results
There were good correlations between HHD tests (r = 0.81–0.90, p < 0.001, R2 = 0.65–0.82), moderate correlations between HHD and isokinetic peak torque, (r = 0.61–0.67, p < 0.001, R2 = 0.37–0.44) and poor association between the HHD peak torques and isokinetic work (r = 0.44–0.46, p = 0.005–0.007, R2 = 0.20–0.21) and average power (r = 0.39–0.45, n = 36, p = 0.006–0.019, R2 = 0.15–0.22). There was a poor association between NHE peak torque and isokinetic total work (r = 0.34, p = 0.04, R2 = 0.12). No associations between knee flexor strength and sprint times were observed (p = 0.12–0.79, r2 = 0.002–0.086).

Conclusions
Moderate to good correlations within HHD testing and poor to moderate correlations between HHD and isokinetic testing were observed. HHD knee flexor torque assessment may be useful to regularly chart the progress of hamstring rehabilitation for female footballers. Knee flexor strength assessments were not associated with sprint times in female footballers. Other aspects of knee flexor strength and sprint performance should be investigated to assist clinicians in making return to running and sprinting decisions in this population.
Health care prioritization process for the elderly in rural Tanzania under decentralized system: Prospects and challenges
Authors: Tungu Malale , Sirili Nathanael , Frumence Gasto , Kagaigai Alphoncina , Anaeli Amani , Mwangu Mughwira A. , Kiwara Angwara D. 
Published: June 2024

Introduction
Beginning the early 1990s, many countries globally adopted the third-generation health sector reforms with a focus of strengthening the primary health care system through community participation. On the contrary, three decades later, primary health care systems in many Low- and Middle-Income countries (LMICs) including Tanzania have remained weak. Specifically, priority setting for the vulnerable groups including the elderly have been weak. We aimed to analyse the prospects and challenges of the priority setting process for the elderly health care services following the 1990s health sector reforms in Tanzania.

Methods
We conducted an exploratory case study on priority setting process for the elderly healthcare services in Igunga and Nzega Tanzania. We carried out 24 Key Informant Interviews (KIIs) with the positions of District medical officers, social welfare, Medical Officers in-charge (MOI), planning officers and health system information focal person. Additionally, we carried out two focus group discussions (FGDs), one from each district with six participants from each group. Participants for the FGDs were MOI, health secretary, representative members of Health Facility Governing Committee (HFGC) and Council Health Management Team (CHMT). Data were analyzed using the qualitative content analysis.

Results
Two categories emerged from the analysis of the transcripts. These were the prospects and challenges in priority setting for the elderly population under the decentralized health sector in rural Tanzania. The prospects included; the capacity of the LGAs on priority setting; existence of strategies used by LGAs; availability of teamwork spirit and the existence of guidelines for priority setting at LGAs. The challenges included difficulties of elderly identification, insufficient resources to implement the planned activities at the LGAs, unintegrated digitalized government health information tools or programs at the LGAs, interference of LGAs by the Central Government and low interest of stakeholders on elderly health care.

Conclusion
This study highlights the prospects and challenges facing priority setting for elderly care at the centralized health system in rural Tanzania. From the results the process is well organized but faces some challenges which if not addressed jeopardized and has potential to continue affecting the priority setting. Addressing the challenges highlighted requires joint efforts from both the elderly population in the community, healthcare providers and decision makers across all levels of the health system. This study serves as an eye-opener and calls for a bigger study to get a comprehensive picture of priority setting of the elderly health care in Tanzania.
Association of body image perception and (dis)satisfaction with adiposity in adults: The Pró-Saúde study
Authors: Cabral Magno C. , Coelho Gabriela M. O. , Oliveira Natalia , Canella Daniela S. , Brasil Raiane L. O. , Campos Tatiana A. M. , Faerstein Eduardo , Bezerra Flávia F. 
Published: June 2024

Introduction
Body image distortion and/or dissatisfaction may occur primarily due to body fat accumulation and/or distribution. The aim of this study was to evaluate the frequency of body image perception and (dis)satisfaction categories in adult men and women according to the adiposity classification.

Methods
This is a cross-sectional study (n = 514; 33–79 years; 265 women) that is part of a prospective cohort (Pró-Saúde study). Adiposity measurements were determined by two methods: anthropometry, used to calculate the body mass index (BMI) and dual-energy X-ray absorptiometry (DXA), to estimate body fat percentage. Participants were grouped as “no excess adiposity” and “excess adiposity”, considering BMI and body fat percentage (>30% for men, >40% for women). Perception and (dis)satisfaction with body image were evaluated using the Kakeshita scale, composed by 15 silhouettes, developed for the Brazilian population. Degree of distortion (perceived BMI ‐ real BMI) and dissatisfaction (perceived BMI ‐ desired BMI) were calculated.

Results
A high proportion of men (58.6%; 74.3%), and especially of women (82.6%; 86.8%), presented body size overestimation and dissatisfaction due to excess weight, respectively. A relevant fraction of the women (32.6%) and men (30.8%) who were dissatisfied due to excess weight did not present excess adiposity, especially if classified by DXA. Variability in degree of distortion was hardly explained by anthropometric and DXA variables in women (<5%) and men (∼22%). Both anthropometric and DXA measurements accounted for ∼30% and ∼50% of the variability in degree of dissatisfaction among women and men, respectively.

Conclusion
Our results suggest a high frequency of body image distortion in Brazilian adult individuals, as well as dissatisfaction with excess weight, especially among women with excess adiposity. The findings indicate that anthropometric measurements explain much of the variability in degree of body image dissatisfaction in men, with no apparent advantage of the use of more refined DXA measurements.
Trends of Mycobacterium tuberculosis and rifampicin resistance at the Ho Teaching Hospital in Ghana
Authors: Deku John Gameli , Aninagyei Enoch , Bedzina Israel , Nudo Gameli , Ativi Emmanuel , Mensah Prosper , Wireko Solomon , Osei-Tutu Aaron , Duker Emmanuel , Afeke Innocent 
Published: June 2024

Background
Tuberculosis remains a major public health threat worldwide, causing significant morbidity and mortality, particularly in low- and middle-income countries. In recent years, efforts to combat tuberculosis have focused on strengthening healthcare systems and increasing access to diagnostics and treatment services. There is scarcity of data on the prevalence of Mycobacterium tuberculosis and rifampicin-resistant tuberculosis in the Volta region of Ghana. Therefore, the aim of this study was to determine the trends of Mycobacterium tuberculosis and rifampicin resistance in a major teaching hospital in Ghana spanning a six-year period.

Methodology
A retrospective cross-sectional hospital study was conducted at Ho Teaching Hospital, Ho, Ghana. Study data included archived results on tuberculosis testing using GeneXpert from 2016–2021. Archived data on tuberculosis testing were collected and entered using Microsoft Excel 2019. IBM SPSS (v26) was used for a statistical analysis of the prevalence of tuberculosis. P-value <0.05 was considered statistically significant.

Results
The study included 5128 presumptive tuberculosis cases from 2016 to 2021, of which 552 were positive, revealing an overall prevalence of 10.76%. Males exhibited a significantly higher prevalence of tuberculosis (14.20%) compared to females (7.48%), with a male-to-female ratio of 2:1. The burden of tuberculosis varied significantly between age groups, with those aged 30–45 years and 46–60 years facing twice the risk compared to those under 15 years (p<0.001). Rainy seasons correlated with heightened tuberculosis occurrences (12.12%) compared to dry seasons (8.84%) (p = 0.008). Rifampicin-resistant tuberculosis was prevalent at 3.45%, slightly higher in women, particularly in the 45–59 age group (5.97%). In particular, tuberculosis prevalence exhibited fluctuations, peaking in 2016 (17.1%) and 2020 (11.5%), with a trough in 2019 (4.6%).

Conclusion
The overall prevalence of laboratory confirmed tuberculosis was 10.76%, and resistance to rifampicin, 3.45%, indicating high infection and possible treatment failure. Considering its infectious nature, this calls for concerted efforts to curb the spread of the infection.
Making sense of student feedback and engagement using artificial intelligence
Authors: Dann Christopher , Redmond Petrea , Fanshawe Melissa , Brown Alice , Getenet Seyum , Shaik Thanveer , Tao Xiaohui , Galligan Linda , Li Yan 
Published: June 2024

Making sense of student feedback and engagement is important for informing pedagogical decision-making and broader strategies related to student retention and success in higher education courses. Although learning analytics and other strategies are employed within courses to understand student engagement, the interpretation of data for larger data sets is more challenging and rarely pursued. This is concerning as data offers the potential for critical insights into engagement behaviour and the value students place on engagement. Artificial intelligence (AI) offers a revolutionary ability to make sense of data, with capacity for prediction and classification, by consuming vast amounts of structured and unstructured data sets. This paper reports on how AI methodologies (specifically, deep learning and natural language processing) were used to leverage labelled student feedback in terms of online engagement in five courses in a regional Australian university. This paper reinforces the value of AI as a viable and scalable multilayered analysis tool for analysing and interpreting student feedback, particularly for categorising student responses as to the types of engagement that they most valued to support their learning. The paper concludes with a discussion of suggested further refinement, including how the AI-derived data may add insights for informing pedagogical practice.

Implications for practice or policy:

AI offers an ability to make sense of large data sets in higher education courses.
Teachers can use student feedback data categorised into types of engagement by AI to support reflection on what students value in their courses.
Educators and key stakeholders can use the insights AI analysed data offers for informing pedagogical practice and decision-making in higher education to enhance student experiences.
Hot deformation behaviors and microstructure characteristics of Cr–Mo–Ni–V steel with a banded structure
Authors: Du Yunfei , Bai Rui , Wang Bo , Zhang Li , Li Guodong 
Published: June 2024

Abstract
On a Gleeble-3800 thermal simulator, the hot deformation behavior of Cr–Mo–Ni–V steel was studied, with the designed deformation temperature varying from 900 to 1,200°C and the strain rate in the range of 0.01–10 s−1. It was observed that as the strain rate was increased and the hot working temperature was reduced, the flow stress of the experimental steel increased. The study also evaluated the safe parameters for deformation of the Cr–Mo–Ni–V steel in the hot working process, based on the established processing maps. It was found that the deformation temperature window varying from 1,050 to 1,150°C and the reasonable strain rate in the range of 0.01–1 s−1 are beneficial to the hot deformation of the steel. In this research, the effect of processing parameters of the hot working process on the microstructure evolution of the banded structure was also investigated. According to the research result, the banded structure in the steel remained visible under the conditions of a strain rate of 10 s−1 and the hot working temperature in the range of 900–1,200°C. However, it should be noted that the banded structure in the steel then gradually disappeared when the hot working temperature was increased to 1,200°C.