bluuebunny/crossref_metadata_2025_split huggingface dataset:
More Harm Than Good: It is Time to Reconsider Prophylactic Fasciotomy in Lower-Extremity Vascular Injury
Authors: Rao Appajosula S. , Scalea Thomas M. , Feliciano David V. , Harfouche Melike N. 
Published: April 2024

Introduction Four-compartment calf fasciotomy (CF) can be limb-saving. Prophylactic fasciotomy (PP) is advised in high-risk situations to prevent limb loss. Calf fasciotomy can cause significant morbidity, particularly if performed unnecessarily. We hypothesized that selective use of fasciotomies (SF) after lower-extremity vascular injury would lead to a lower rate of overall fasciotomies without an increase in limb complications than prophylactic fasciotomies (PFs). Methods Trauma patients who sustained lower-extremity vascular injury that required operative repair at a high-volume trauma center were retrospectively reviewed and grouped by SF or PF (2016-2022). SF were individuals who were observed and underwent CF only if signs of compartment syndrome developed, whereas PF were individuals who underwent CF without signs of compartment syndrome. The primary outcome was amputation rate. Secondary outcomes were fasciotomy rate, need for reoperative vascular surgery, and clinical characteristics predisposing use of PF. Results Of 101 overall patients, 30 patients (29.4%) had PF. Of the remaining 71 (SF group), 43.7% (n = 31) were spared CF. The median time from injury to vascular repair in both groups was the same (7 hours, P = .15). There was no difference in rate of vascular reoperation per group (PF = 26.7% vs SF = 23.9%, P = .77). The only clinical characteristic associated with PF was need for arterial shunt (OR 4.2, P = .028). Conclusions In trauma patients with lower-extremity vascular injury undergoing vascular repair, selective use of fasciotomy can spare almost half of patients the need for fasciotomy without an increase in limb complications.
iPad-Based Neurocognitive Testing (ImPACT-QT) in Acute Adult Mild Traumatic Brain Injury/Concussion: Study on Practicality and Bedside Cognitive Scores in a Level-1 Trauma Center
Authors: Chen Patrick M. , Lee Sean , Cruz Lillian D. , Lopez Michael , Thomas Aaron , Chen Jefferson W. , Grigorian Areg , Nahmias Jeffry , Lekawa Michael 
Published: April 2024

Background There lacks rapid standardized bedside testing to screen cognitive deficits following mild traumatic brain injury (mTBI). Immediate Post-Concussion Assessment & Cognitive Testing-Quick Test (ImPACT-QT) is an abbreviated-iPad form of computerized cognitive testing. The aim of this study is to test ImPACT-QT utility in inpatient settings. We hypothesize ImPACT-QT is feasible in the acute trauma setting. Method Trauma patients ages 12-70 were administered ImPACT-QT (09/2022-09/2023). Encephalopathic/medically unstable patients were excluded. Mild traumatic brain injury was defined as documented-head trauma with loss-of-consciousness <30 minutes and arrival Glasgow Coma Scale 13-15. Patients answered Likert-scale surveys. Bivariate analyses compared demographics, attention, motor speed, and memory scores between mTBI and non-TBI controls. Multivariable logistic regression assessed memory score as a predictor of mTBI diagnosis. Results Of 233 patients evaluated (36 years [IQR 23-50], 71% [166/233] female), 179 (76%) were mTBI patients. For all patients, mean test-time was 9.3 ± 2 minutes with 93% (73/76) finding the test “easy to understand.” Mild traumatic brain injury patients than non-TBI control had lower memory scores (25 [IQR 7-100] vs 43 [26-100], P = .001) while attention (5 [1-23] vs 11 [1-32]) and motor score (14 [3-28] vs 13 [4-32]) showed no significant differences. Multivariable-regression (adjustment: age, sex, race, education level, ISS, and time to test) demonstrated memory score predicted mTBI positive status (OR .96, CI .94-.98, P = .004). Discussion Immediate Post-Concussion Assessment & Cognitive Testing-Quick Test is feasible in trauma patients. Preliminary findings suggest acute mTBIs have lower memory but not attention/motor scores vs non-TBI trauma controls.
A Comparative Study of Regional Disparities in the Districts of West Bengal
Authors: Sengupta Panchali , Chakrabarti Anjan 
Published: April 2024

In the post-economic reform period, the overall economic growth of West Bengal has been increasing. However, agricultural growth has become sluggish since the 1990s. The relatively low contribution of the secondary sector reveals an absence of a strong manufacturing base in the state. The high contribution of the tertiary sector indicates diversification and expansion of services. The time dimension for district-level analysis has been constricted by data availability. The inequality among the district is increasing, with a divergence of growth. Three development indices and a composite index reveal a significant disparity in development outcomes across districts between 2001 and 2013. The developmental gap between districts in the southern and northern parts of West Bengal has become prominent. JEL Codes: R11, 047, D63
Asymmetric Volatility in Stock  Market: Evidence from Selected  Export-based Countries
Authors: Gupta Himani 
Published: April 2024

In a country, the financial markets depend on several economic factors. One of these important factors is the export of the country. The stock index of the country tends to be raised due to the exports, though it may occur after some time rather than immediately. In this study, an attempt has been made to predict the best model of volatility in top export countries, Germany, China, the United States, Japan and Hong Kong by taking into account the closing price of the stock index of the sampled countries for a period ranging from the year 2000 to 2020. The returns from the stock markets are asymmetric; negative returns are found to be followed by a greater increase in volatility than the corresponding positive returns. Therefore, both symmetric and asymmetric generalised autoregressive conditional heteroscedasticity (GARCH) models have been applied to predict the volatility. The symmetric model used is GARCH (1,1) and asymmetric models used in the study are exponential GARCH (1,1) and GJR-GARCH (1,1). The study shows that EGARCH model has outperformed the GARCH and GJR-GARCH models in estimating the volatility in four stock indices ( Hanif & Pok, 2010 ; Kışınbay, 2010 ; Lin, 2018 ), and GJR-GARCH has outperformed in estimating volatility in one stock index ( Oberholzer & Venter, 2015 ; Shamiri & Hassan, 2007 ). The benefit of this study is to help portfolio managers, investors and corporations in making investment-related decisions. JEL Codes: C20, C31, C58, G12
Value of radiomics-based automatic grading of muscle edema in polymyositis/dermatomyositis based on MRI fat-suppressed T2-weighted images
Authors: Zhang Yumei , Zou Yuefen , Tan Wenfeng , Lv Chengyin 
Published: April 2024

Background The precise and objective assessment of thigh muscle edema is pivotal in diagnosing and monitoring the treatment of dermatomyositis (DM) and polymyositis (PM). Purpose Radiomic features are extracted from fat-suppressed (FS) T2-weighted (T2W) magnetic resonance imaging (MRI) of thigh muscles to enable automatic grading of muscle edema in cases of polymyositis and dermatomyositis. Material and Methods A total of 241 MR images were analyzed and classified into five levels using the Stramare criteria. The correlation between muscle edema grading and T2-mapping values was assessed using Spearman’s correlation. The dataset was divided into a 7:3 ratio of training (168 samples) and testing (73 samples). Thigh muscle boundaries in FS T2W images were manually delineated with 3D-Slicer. Radiomics features were extracted using Python 3.7, applying Z-score normalization, Pearson correlation analysis, and recursive feature elimination for reduction. A Naive Bayes classifier was trained, and diagnostic performance was evaluated using receiver operating characteristic (ROC) curves and comparing sensitivity and specificity with senior doctors. Results A total of 1198 radiomics parameters were extracted and reduced to 18 features for Naive Bayes modeling. In the testing set, the model achieved an area under the ROC curve of 0.97, sensitivity of 0.85, specificity of 0.98, and accuracy of 0.91. The Naive Bayes classifier demonstrated grading performance comparable to senior doctors. A significant correlation (r = 0.82, P <0.05) was observed between Stramare edema grading and T2-mapping values. Conclusion The Naive Bayes model, utilizing radiomics features extracted from thigh FS T2W images, accurately assesses the severity of muscle edema in cases of PM/DM.
Epidemiology and Healthcare Expenditure for Skin Disease in Emergency Departments in Alberta, Canada
Authors: Ma Bryan , Park Ye-Jean , Ramien Michele 
Published: April 2024

Background: There are limited data on the epidemiology and costs associated with managing dermatologic conditions in emergency departments (EDs). Objective: To assess the incidence and mean cost per case of skin diseases in EDs in Alberta. Methods: Alberta Health Services’ Interactive Health Data Application was used to determine the epidemiology and costs associated with nonneoplastic dermatologic diseases in EDs in the province of Alberta, Canada, from 2018 to 2022. Skin conditions were identified using the International Classification of Disease 10th edition diagnostic groupings. Results: Skin disease represented 3.59% of all ED presentations in Alberta in 2022. The total costs associated with managing dermatologic conditions have remained stable over time at approximately 15 million Canadian Dollars (CAD) annually, but the mean cost per case has risen from 188.88 (SD 15.42) in 2018 to 246.25 CAD (SD 27.47) in 2022 (7.59%/year). Infections of skin and subcutaneous tissue were the most expensive diagnostic grouping. The most common dermatologic diagnostic groupings presenting to the ED were infections of skin and subcutaneous tissue [mean age-standardized incidence rate (ASIR) of 143.67 per 100,000 standard population (SD 241.99)], urticaria and erythema [mean ASIR 33.57 per 100,000 standard population (SD 59.13)], and dermatitis and eczema [mean ASIR 18.59 per 100,000 standard population (SD 23.65)]. Cellulitis was both the most common and the costliest individual diagnosis. The majority of patients were triaged as less urgent or nonurgent. Conclusions: Skin disease represents a substantial public health burden in EDs. Further research into drivers of cost change and areas for cost savings is essential.
Breast Cancer Prediction Based on Multiple Machine Learning Algorithms
Authors: Zhou Sheng , Hu Chujiao , Wei Shanshan , Yan Xiaofan 
Published: April 2024

Introduction The incidence of breast cancer has steadily risen over the years owing to changes in lifestyle and environment. Presently, breast cancer is one of the primary causes of cancer-related deaths among women, making it a crucial global public health concern. Thus, the creation of an automated diagnostic system for breast cancer bears great importance in the medical community. Objectives This study analyses the Wisconsin breast cancer dataset and develops a machine learning algorithm for accurately classifying breast cancer as benign or malignant. Methods Our research is a retrospective study, and the main purpose is to develop a high-precision classification algorithm for benign and malignant breast cancer. To achieve this, we first preprocessed the dataset using standard techniques such as feature scaling and handling missing values. We assessed the normality of the data distribution initially, after which we opted for Spearman correlation analysis to examine the relationship between the feature subset data and the labeled data, considering the normality test results. We subsequently employed the Wilcoxon rank sum test to investigate the dissimilarities in distribution among various breast cancer feature data. We constructed the feature subset based on statistical results and trained 7 machine learning algorithms, specifically the decision tree, stochastic gradient descent algorithm, random forest algorithm, support vector machine algorithm, logistics algorithm, and AdaBoost algorithm. Results The results of the evaluation indicated that the AdaBoost-Logistic algorithm achieved an accuracy of 99.12%, outperforming the other 6 algorithms and previous techniques. Conclusion The constructed AdaBoost-Logistic algorithm exhibits significant precision with the Wisconsin breast cancer dataset, achieving commendable classification performance for both benign and malignant breast cancer cases.
Knowledge, attitudes, and practices of Jamaican healthcare workers on nosocomial infection control
Authors: Jolly Pauline E , Li Yihong , Thomas Avanelle , Braun Andrew , Padilla Luz A , Thompson Symone , Aung Maung 
Published: April 2024

Objectives The emergence of deadly infections such as methicillin-resistant Staphylococcus aureus and COVID-19 ( SARS-CoV-2) highlights the need for effective infection control (IC) procedures in healthcare facilities. The aim of the study was to assess the knowledge, attitudes, and practices (KAP) of healthcare workers (HCWs) on IC procedures. Methods A cross-sectional survey was conducted among HCWs in western Jamaica from May to August 2015. A questionnaire based on the Jamaican Health Facilities Infection and Control Policies and Procedures Manual was used to collect data on staff training in IC, and their KAP of IC. Summary statistics, ANOVA, and multiple linear regression were applied for data analyses. Results Among 227 participants, the mean knowledge scores were statistically higher among the younger HCWs, Physicians/Nurses, and those in clinical units. Older HCWs, non-physicians/nurses, non-clinical unit workers, HCWs at Western Regional Hospital A, and those who received ongoing IC training scored higher on attitude. The practice scores were significantly correlated with the attitude scores but not the knowledge scores. The attitude score was a significant predictor for IC practices. Conclusions Six knowledge and three attitude variables were significant predictors of IC practices that the Western Regional Health Authority Officials can use to implement measures to improve IC practices among HCWs.
Development and validation of D-PATH website to improve hypertension management among hypertensive patients in Malaysia
Authors: Ab Hamid Mohd Ramadan , Buhari Siti Sabariah , Noor Harrinni Md , Azizan Nurul ‘Ain , Malek Khasnur Abd , Mohd Asmawi Ummi Mohlisi , Nor Norazmir Md 
Published: April 2024

ObjectiveThis study aimed at developing and validating a web application on hypertension management called the D-PATH website.MethodsThe website development involved three stages: content analysis, web development, and validation. The model of Internet Intervention was used to guide the development of the website, in addition to other learning and multimedia theories. The content was developed based on literature reviews and clinical guidelines on hypertension. Then, thirteen experts evaluated the website using Fuzzy Delphi Technique.ResultsThe website was successfully developed and contains six learning units. Thirteen experts rated the website based on content themes, presentation, interactivity, and instructional strategies. All experts reached a consensus that the web is acceptable to be used for nutrition education intervention.ConclusionD-PATH is a valid web-based educational tool ready to be used to help disseminate information on dietary and physical activity to manage hypertension. This web application was suitable for sharing information on dietary and physical activity recommendations for hypertension patients.
Active involvement in scientific research of persons living with dementia and long-term care users: a systematic review of existing methods with a specific focus on good practices, facilitators and barriers of involvement
Authors: Groothuijse Janneke M. , van Tol Lisa S. , Leeuwen C. C. M. Hoeksel-van , van Delden Johannes J. M. , Caljouw Monique A. A. , Achterberg Wilco P. 
Published: April 2024

Abstract
Background
Active involvement of persons living with dementia (PLWD) and long-term care (LTC) users in research is essential but less developed compared to other patient groups. However, their involvement in research is not only important but also feasible. This study aims to provide an overview of methods, facilitators, and barriers for involving PLWD and LTC users in scientific research.

Methods
A systematic literature search across 12 databases in December 2020 identified studies involving PLWD, LTC users, or their carers beyond research subjects and describing methods or models for involvement. Qualitative descriptions of involvement methods underwent a risk of bias assessment using the Critical Appraisal Skills Programme (CASP) Qualitative Checklist 2018. A data collection sheet in Microsoft Excel and thematic analysis were used to synthesize the results.

Results
The eighteen included studies delineated five core involvement methods spanning all research phases: advisory groups, formal and informal research team meetings, action groups, workshops, and co-conducting interviews. Additionally, two co-research models with PLWD and carers were found, while only two studies detailed LTC user involvement methods. Four distinct involvement roles were identified: consulting and advisory roles, co-analysts, co-researchers, and partners. The review also addressed barriers, facilitators, and good practices in the preparation, execution, and translation phases of research, emphasizing the importance of diversity, bias reduction, and resource allocation. Trust-building, clear roles, ongoing training, and inclusive support were highlighted.

Conclusions
Planning enough time for active involvement is important to ensure that researchers have time to build a trusting relationship and meet personal needs and preferences of PLWD, LTC users and carers. Researchers are advised not to presume the meaning of burden and to avoid a deficit perspective. A flexible or emergent design could aid involved persons’ ownership of the research process.

Trial registration
Prospero 2021: CRD42021253736.
Prognostic factors associated with early recurrence following liver resection for colorectal liver metastases: a systematic review and meta-analysis
Authors: Tian Yuan , Wang Yaoqun , Wen Ningyuan , Wang Shaofeng , Li Bei , Liu Geng 
Published: April 2024

Abstract
Background
Colorectal cancer (CRC) is the 3rd most common malignancy with the liver being the most common site of metastases. The recurrence rate of colorectal liver metastases (CRLM) after liver resection (LR) is notably high, with an estimated 40% of patients experiencing recurrence within 6 months. In this context, we conducted a meta-analysis to synthesize and evaluate the reliability of evidence pertaining to prognostic factors associated with early recurrence (ER) in CRLM following LR.

Methods
Systematic searches were conducted from the inception of databases to July 14, 2023, to identify studies reporting prognostic factors associated with ER. The Quality in Prognostic Factor Studies (QUIPS) tool was employed to assess risk-of-bias for included studies. Meta-analysis was then performed on these prognostic factors, summarized by forest plots. The grading of evidence was based on sample size, heterogeneity, and Egger’s P value.

Results
The study included 24 investigations, comprising 12705 individuals, during an accrual period that extended from 2007 to 2023. In the evaluation of risk-of-bias, 22 studies were rated as low/moderate risk, while two studies were excluded because of high risk. Most of the studies used a postoperative interval of 6 months to define ER, with 30.2% (95% confidence interval [CI], 24.1–36.4%) of the patients experiencing ER following LR. 21 studies were pooled for meta-analysis. High-quality evidence showed that poor differentiation of CRC, larger and bilobar-distributed liver metastases, major hepatectomy, positive surgical margins, and postoperative complications were associated with an elevated risk of ER. Additionally, moderate-quality evidence suggested that elevated levels of carcinoembryonic antigen (CEA) and carbohydrate antigen 19–9 (CA199), lymph node metastases (LNM) of CRC, and a higher number of liver metastases were risk factors for ER.

Conclusion
This review has the potential to enhance the efficacy of surveillance strategies, refine prognostic assessments, and guide judicious treatment decisions for CRLM patients with high risk of ER. Additionally, it is essential to undertake well-designed prospective investigations to examine additional prognostic factors and develop salvage therapeutic approaches for ER of CRLM.
Eukaryotic initiation factor 3a promotes the development of diffuse large B-cell lymphoma through regulating cell proliferation
Authors: Sun Hongkun , Shang Juanjuan , Liu Xiao , Ren Shuai , Hu Shunfeng , Wang Xin 
Published: April 2024

Abstract
Background
One-third of diffuse large B-cell lymphoma (DLBCL) patients suffer relapse after standard treatment. Eukaryotic initiation factor 3a (eIF3a) is a key player in the initial stage of translation, which has been widely reported to be correlated with tumorigenesis and therapeutic response. This study aimed to explore the biological role of eIF3a, evaluate its prognostic and therapeutic potential in DLBCL.

Methods
RNA-seq datasets from GEO database were utilized to detect the expression and prognostic role of eIF3a in DLBCL patients. Protein level of eIF3a was estimated by western blot and immunohistochemical. Next, DLBCL cells were transfected with lentiviral vector either eIF3a-knockdown or empty to assess the biological role of eIF3a. Then, samples were divided into 2 clusters based on eIF3a expression and differentially expressed genes (DEGs) were identified. Function enrichment and mutation analysis of DEGs were employed to detect potential biological roles. Moreover, we also applied pan-cancer and chemosensitivity analysis for deep exploration.

Results
eIF3a expression was found to be higher in DLBCL than healthy controls, which was associated with worse prognosis. The expression of eIF3a protein was significantly increased in DLBCL cell lines compared with peripheral blood mononuclear cells (PBMCs) from healthy donors. eIF3a knockdown inhibited the proliferation of DLBCL cells and the expression of proliferation-related proteins and increase cell apoptosis rate. Besides, 114 DEGs were identified which had a close linkage to cell cycle and tumor immune. eIF3a and DEGs mutations were found to be correlated to chemosensitivity and vital signal pathways. Pan-cancer analysis demonstrated that high eIF3a expression was associated with worse prognosis in several tumors. Moreover, eIF3a expression was found to be related to chemosensitivity of several anti-tumor drugs in DLBCL, including Vincristine and Wee1 inhibitor.

Conclusions
We firstly revealed the high expression and prognostic role of eIF3a in DLBCL, and eIF3a might promote the development of DLBCL through regulating cell proliferation and apoptosis. eIF3a expression was related to immune profile and chemosensitivity in DLBCL. These results suggest that eIF3a could serve as a potential prognostic biomarker and therapeutic target in DLBCL.