bluuebunny/crossref_metadata_2025_split huggingface dataset:
“Is my culture influencing me?”: Client experiences of mental illness and psychotherapy in a transitional Indian culture
Authors: Gopal Baiju , Charles Deborah Yazhini , Raval Vaishali V , P Padmakumari , Thomas Elizabeth 
Published: December 2023

The client therapy experience has been the focus of many bodies of literature in psychotherapy, even across cultures. While researchers have emphasized on the use of indigenous approaches in Indian psychotherapy, how much of this is applicable in the present scenario? The experience has become increasingly tricky to understand given the complexities arising from the influence of urbanization and westernization. Thus, the present study aimed to explore the experience of mental illness and psychotherapy in modern day India. Using the integrated, holistic idea of the person and their needs, the study conducted semi-structured interviews with ten cis-gender, urban Indian participants between 21 and 39 years of age. Data analysis using thematic analysis uncovered the global theme of “Transitional Culture Impacting the Therapeutic Experience.” The major organizing themes and basic themes have been elaborated as well. In essence, the study concludes that the increased awareness and acceptance of psychotherapy in urban India, combined with the exposure to Western methodologies, may be related to an increase in the expectations for similar therapeutic services. Implications and recommendations have been discussed.
Effect of electron beam radiation on the mechanical, electrical, heat shrinkable and morphological properties of linear low-density polyethylene/polyolefin elastomer blends
Authors: Agarwal Rohini , Singh Manjeet , Ray Chowdhury Subhendu , Pant Harish Jagat 
Published: December 2023

The blending of polymers is an efficient means for developing new materials in a less hazardous and more economical way compared to the synthetic route. Polymers with different properties are blended to obtain a new material with combined properties. In this study, a thermoplastic elastomer blend is prepared by melt mixing a metallocene-based polyolefin elastomer (Engage 8003, abbreviated as EN) with linear low-density polyethylene (LLDPE, abbreviated as LL) using a twin-screw extruder in various compositions. To investigate the effect of the electron beam on the properties, LL, EN and their blends are irradiated in the 50–250 kGy dose range. The samples are subjected to gel fraction, mechanical, dynamic mechanical, hardness, heat shrinkability, volume resistivity and morphological studies. The % gel fraction, hardness and heat shrinkability of a sample increase with an increase in the irradiation dose. With increasing LL content, Young’s modulus and ultimate tensile strength of the blends are increased, maintaining the % elongation at break in an attractive region. LE64 (60 wt% LL and 40 wt% EN) and LE46 (40 wt% LL and 60 wt% EN) blends show optimized mechanical and dynamic mechanical properties. Irradiation further increases the tensile strength and Young’s modulus of LE64 up to 150 kGy and LE46 up to 200 kGy. The volume resistivity of the LE64 blend increases tenfold and quadruples for LE46 compared to non-irradiated blends when irradiated at 200 kGy. The morphological structures of the non-irradiated and crosslinked blends support the outcome of the obtained properties nicely.
Comparing the Intensity of Pain and Incidence of Flare Reaction Following Trigger Finger Injections Using Betamethasone and Methylprednisolone: A Double-Blinded, Randomized Controlled Trial
Authors: Sraj Shafic , Schick Samuel , Wasef Kareem , Haft Mark , Braga Skylar , Taras John S. , Lese Andréa B. , Prud’homme B. Joseph 
Published: December 2023

Background: Considerable evidence supports corticosteroid injection as an effective treatment for trigger finger. One common side effect, the flare reaction, is a well-documented phenomenon of increased pain following steroid injections. Its incidence and intensity may be related to steroid composition. The purpose of this study was to determine whether betamethasone and methylprednisolone injections for trigger fingers have differing intensity of pain or incidence flare reaction. Methods: Patients with symptomatic trigger finger were recruited during their hand surgery visits. Patients were randomized into 2 treatment groups: betamethasone (40 mg) and methylprednisolone (6 mg) mixed with lidocaine 1%. Treatment group assignment was blinded to the patients and investigators. Visual analog scale pain measurements were taken prior to injection, 5 minutes postinjection, and daily thereafter for 7 days. Results: Sixty-four patients were randomized into the 2 treatment groups. Patients in the betamethasone group reported slightly higher baseline pain compared with the methylprednisolone group, but lower pain on day 1. None of the following days showed a statistically significant difference. Conclusions: The incidence of flare and severe flare reactions of betamethasone injections for trigger finger management was roughly double that of methylprednisolone, but this difference was not statistically significant. Further studies are required to evaluate the relative course of nonflare postinjection pain for different corticosteroid injections for trigger finger injections.
Maternal and umbilical cord blood levels of leptin in pre-eclamptic and healthy pregnant women: A comparative cross-sectional study
Authors: Okafor Lazarus Ugochukwu , Eleje George Uchenna , Ikechebelu Joseph Ifeanyichukwu , Ugwu Emmanuel Onyebuchi , Nwosu Obi Betrand , Ikpeze Okechukwu Christian , Udigwe Gerald Okanandu , Eke Ahizechukwu Chigoziem , Okoli Samuel A , Oguejiofor Charlotte Blanche , Ogabido Chukwudi Anthony , Malachy Divinefavour Echezona , Ofor Ifeanyichukwu Jude , Okafor Chigozie Geoffrey 
Published: December 2023

Background: Pre-eclampsia is a multi-systemic disease with its attendant increased maternal and perinatal morbidities and mortality. It has been hypothesized that leptin contributes immensely to the natural history of pre-eclampsia. However, there is considerable disagreement in the reports of existing research work on the link between fetomaternal serum leptin levels and pre-eclampsia. Objective: To determine and compare the maternal and umbilical cord sera levels of leptin in women with pre-eclampsia and healthy pregnant women. Study design: This is an analytical cross-sectional study. Methods: The study involved consenting 120 pregnant participants (60 on each arm). Pregnant women diagnosed with pre-eclampsia constituted the investigation group, while the controls were normotensive pregnant women. They were matched for maternal age and body mass index. Venous blood specimens were obtained from the participants for assessment of the serum leptin concentration while umbilical cord blood samples were obtained following delivery of the neonate in advance of the removal of the placenta. The collected blood samples were analysed for the levels of leptin in a blinded pattern. The primary outcome measures were maternal serum leptin levels and umbilical cord serum leptin levels. Results: Mean maternal serum leptin concentration in the pre-eclampsia group was significantly higher than that in the control group (24.88 ± 3.92 vs. 15.03 ± 2.98ng/mL, p < 0.001). Similarly, maternal serum leptin concentration was significantly higher in participants with severe pre-eclampsia compared with those with mild pre-eclampsia (25.91 ± 3.5 vs. 22.83 ± 4.02ng/mL, p = 0.003). However, the mean umbilical cord serum leptin level in the pre-eclampsia group was significantly lower than in the control group (6.43 ± 2.08 vs. 7.27 ± 2.24; p = 0.034). There was a weak positive correlation between maternal serum leptin level and neonatal umbilical serum leptin level in the pre-eclamptic group ( r = 0.21, p = 0.04). Conclusion: Maternal serum leptin concentration is significantly increased in women with pre-eclampsia, compared with their normotensive counterparts. This increase becomes even more pronounced as the severity of the disease progresses. Maternal serum leptin assessment has the potential to become a veritable tool in the diagnosis and monitoring of pregnancies complicated by pre-eclampsia.
Intercostal Nerve Transfer for Biceps Reinnervation in Obstetrical Brachial Plexus Palsy: A Preferred Reporting Items for Systematic Reviews and Meta-Analysis for Individual Patient Data Systematic Review using Individualized Fusion and Comparison to Supraclavicular Exploration and Nerve Grafting
Authors: Abdelmalek George , Mina George Ehab , Pant Krittika , Zheng Zheshi , Mahajan Jasmine , Srinivasan Nivetha , Gupta Shivani , Shafei Jasmine , Levidy Michael F , McGrath Aleksandra , Chu Alice 
Published: December 2023

Introduction: The objective of this study was to search existing literature on nerve reconstruction surgery in patients with obstetric brachial plexus palsy to determine whether treatment with supraclavicular exploration and nerve grafting produced better elbow flexion outcomes compared to intercostal nerve transfer. Methods: This study was a systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis for Individual Patient Data guidelines. A systematic search was conducted using multiple databases. An ordinal regression model was used to analyze the effect of using supraclavicular exploration and nerve grafting or intercostal nerve on elbow flexion with the two scores measured: elbow flexion Medical Research Council scores and Toronto active movements scale scores for elbow flexion. Results: A final patient database from 6 published articles consisted of 83 supraclavicular exploration and nerve grafting patients (73 patients with Medical Research Council and 10 patients with Toronto score) and 7 published articles which consisted of 131 intercostal nerve patients (84 patients with Medical Research Council and 47 patients with Toronto scores). Patients who underwent supraclavicular exploration and nerve grafting presented with an average Medical Research Council score of 3.9 ± 0.72 and an average Toronto score of 6.2 ± 2.2. Patients who underwent intercostal nerve transfer presented with an average Medical Research Council score of 3.9 ± 0.71 and an average Toronto score of 6.4 ± 1.2. There was no statistical difference between supraclavicular exploration and nerve grafting and intercostal nerve transfer when utilizing Medical Research Council elbow flexion scores (ordinal regression: 0.3821, standard error: 0.4590, p = 0.2551) or Toronto Active Movement Scale score for elbow flexion (ordinal regression: 0.7154, standard error: 0.8487, p = 0.2188). Conclusion: Regardless of surgical intervention utilized (supraclavicular exploration and nerve grafting or intercostal nerve transfers), patients had excellent outcomes for elbow flexion following obstetric brachial plexus palsy when utilizing Medical Research Council or Toronto scores for elbow flexion. The difference between these scores was not statistically significant. Type of study/Level of evidence: Therapeutic Study: Investigating the Result of Treatment/level III.
Comparison of the diagnostic utility of CHOKAI, STONE and STONE PLUS scores in predicting ureteral stones larger than 5 mm
Authors: Tatliparmak Ali Cankut , Yilmaz Sarper , AK Rohat , Hokenek Nihat Mujdat 
Published: December 2023

Objective: The objective of this study is to assess the diagnostic accuracy of CHOKAI, STONE, and STONE plus scores in detecting ureteral stones larger than 5 mm. Methods: This comparative diagnostic accuracy study was performed in a tertiary care emergency department (ED) and included consecutive patients who presented to the ED with flank pain over a 1-year period. The performance of these scoring scales in detecting ureteral stones measuring >5 mm was determined by area under the receiver operating characteristics (AUROC) comparison. Results: Ureteral stones were detected in 270 (70.3%) of 384 patients included in the study. While 146 patients (54.1%) had ureteral stones measuring <5 mm, 124 patients (54.1%) had stones measuring 5 mm or more in size. The performance of the CHOKAI score in predicting ureteral stones was superior to that of the STONE PLUS score; STONE PLUS score was also superior to STONE score ( p < 0.001). Analysis of the diagnostic value of CHOKAI score and STONE PLUS scores in predicting >5-mm stones showed no statistically significant difference ( p = 0.59). Conclusion: CHOKAI and STONE PLUS scores are useful in predicting >5-mm ureteral stones and have similar diagnostic utility to each other. STONE score does not provide accurate diagnostic information about ureteral stones larger than 5 mm. Level of evidence: Level 2b
Construction of a predictive model based on MIV-SVR for prognosis and length of stay in patients with traumatic brain injury: Retrospective cohort study
Authors: Pan Yifeng , Fang Cheng , Zhu Xueling , Wan Jinghai 
Published: December 2023

Objective To investigate the mean impact value (MIV) method for discerning the most efficacious input variables for the machine learning (ML) model. Subsequently, various ML algorithms are harnessed to formulate a more accurate predictive model that can forecast both the prognosis and the length of hospital stay for patients suffering from traumatic brain injury (TBI). Design Retrospective cohort study. Participants The study retrospectively accrued data from 1128 cases of patients who sought medical intervention at the Neurosurgery Center of the Second Affiliated Hospital of Anhui Medical University, within the timeframe spanning from May 2017 to May 2022. Methods We performed a retrospective analysis of patient data obtained from the Neurosurgery Center of the Second Hospital of Anhui Medical University, covering the period from May 2017 to May 2022. Following meticulous data filtration and partitioning, 70% of the data were allocated for model training, while the remaining 30% served for model evaluation. During the construction phase of the ML models, a gamut of 11 independent variables—including, but not limited to, in-hospital complications and patient age—were utilized as input variables. Conversely, the length of stay (LOS) and the Glasgow Outcome Scale (GOS) scores were designated as output variables. The model architecture was initially refined through the MIV methodology to identify optimal input variables, whereupon five distinct predictive models were constructed, encompassing support vector regression (SVR), convolutional neural networks (CNN), backpropagation (BP) neural networks, artificial neural networks (ANN) and logistic regression (LR). Ultimately, SVR emerged as the most proficient predictive model and was further authenticated through an external dataset obtained from the First Hospital of Anhui Medical University. Results Upon incorporating the optimal input variables as ascertained through MIV, it was observed that the SVR model exhibited remarkable predictive prowess. Specifically, the Mean Absolute Percentage Error (MAPE) of the SVR model in predicting the GOS score in the test dataset is only 6.30%, and the MAPE in the external validation set is only 7.61%. In terms of predicting hospitalization time, the accuracy of the test and external validation sets were 9.28% and 7.91%, respectively. This error indicator is significantly lower than the error of other prediction models, thus proving the excellent efficacy and clinical reliability of the MIV-optimized SVR model. Conclusion This study unequivocally substantiates that the incorporation of MIV for selecting optimal input variables can substantially augment the predictive accuracy of machine learning models. Among the models examined, the MIV-SVR model emerged as the most accurate and clinically applicable, thereby rendering it highly conducive for future clinical decision-making processes.
Do Corporate Consolidations Affect the Competitive Positioning of Non-Financial Firms in China?
Authors: Osiichuk Dmytro , Wnuczak Paweł 
Published: December 2023

In a quest for economies of scale, access to technologies, and, most importantly, expansion of market share, Chinese public companies have been engaged in several consecutive waves of mergers and acquisitions (M&As) involving mostly domestically domiciled non-listed targets from the same or adjacent industries. Relying on a comprehensive panel dataset of 7,998 transactions completed between 1993 and 2020 by 2,842 publicly listed acquirers domiciled in China, the paper attempts to establish whether M&A deals allow acquirers to improve their market share and, consequently, their relative market position. We use dynamic panel regression and ordered logit models to establish and quantify the link between deal characteristics and the post-deal market share of the combined entities. Our empirical findings demonstrate that corporate consolidations exercise no significant impact on the relative competitive positioning of firms. Only acquisitions by industry leaders produce a sizeable increase in the latter’s market share and lead to higher industry concentration. Most consolidations occur among outsiders exhibiting a high degree of similarity, relatively lower profitability, and stagnant market shares within the more competitive industries with higher rates of firm creation. These consolidations, often in the form of mergers, are not effective in advancing the combined entities’ competitive positioning. Despite the fact that the bulk of corporate consolidations appears unlikely to constitute a threat to competition in the medium term, careful regulatory oversight may be warranted within the currently fragmented and highly commoditized industries, which appear likely to consolidate at the fastest pace. JEL Classification: G30, G32.
Utilization of PROMIS Neuropathic Pain Quality for Detection and Monitoring Neuropathic Pain in Heel Pain Patients
Authors: Joo Peter Y. , Lee Wonyong , Hoffman Samantha , Baumhauer Judith , Oh Irvin 
Published: December 2023

Background: Diagnosis and management of neuropathic pain (NP) in foot and ankle patients remain challenging. We investigated the plausibility of using Patient-Reported Outcomes Measurement Information System (PROMIS) Neuropathic Pain Quality (PQ-Neuro) as an initial screening tool to detect NP and track the treatment effects. Methods: Patients with heel pain were prospectively recruited and grouped to no-NP, mild-NP, and severe-NP based on the initial PROMIS PQ-Neuro t scores. Pain Interference (PI), Physical Function (PF), and Self-Efficacy (SE) scores were evaluated at baseline, 30-day, and 90-day follow-up. Other factors such as age, smoking, body mass index (BMI), low back/neck pain, anxiety/depression, and medications were analyzed. Linear mixed modeling was used to assess the main effects of time and NP on PROMIS t scores, comparing minimal clinically important difference (MCID). Results: Forty-eight patients with mean age of 52.4 years were recruited. Using the PROMIS PQ-Neuro as the assessment tool, 33 patients (69%) were detected to have NP at baseline—23 (48%) mild and 10 (21%) severe. BMI was the only independent factor associated with NP ( P = .011). Higher baseline PQ-Neuro t score was significantly associated with higher follow-up PQ-Neuro ( P < .001), PI ( P = .005), and lower SE ( P = .04) across time points. Patients with NP showed lower PF at baseline with significantly less improvement in PF (3 vs 9.9, P = .035) and did not meet MCID. Conclusion: Baseline PROMIS PQ-Neuro ≥46 was significantly associated with worse PI and SE across all time points, with less clinically significant improvements in PF. Prevalence of NP in heel pain patients was high. The PROMIS PQ-Neuro may serve as a valuable tool for detection of NP and guiding clinical treatment decision pathways for heel pain patients. Level of Evidence: Level III, prospective cohort study.
Transcatheter Device Closure of Postsurgical Residual Left to Right Shunt Lesions in Children during the Immediate Postoperative Period
Authors: Kidwai Mohammad Moaaz , Abqari Shaad , Kamran Mohammad Mirza , Haseen Mohammad Azam , Yadav Mayank , Rabbani Shamayal , Ghazanfar Md 
Published: December 2023

Objectives Postoperative residual shunts in the form of ventricular septal defects (VSD) and patent ductus arteriosus (PDA), if hemodynamically significant, can lead to symptoms of left ventricular volume overload and delayed recovery. The standard management is redo surgery, which can lead to significant morbidity and mortality. Device closure of such defects offers an alternative management strategy in selected cases. This study aims to examine the utility of device closure of residual left-to-right shunts in the pediatric age group in the immediate postoperative period. Method A retrospective analysis of hospital records was done from March 2018 to December 2022 to analyze the device closure in postoperative residual shunts. The success rate, complications, hospital length of stay, and midterm follow-up were analyzed. Results A total of four postoperative patients underwent VSD device closure and one patient underwent PDA device closure. The median age at transcatheter procedure was 6 years (range 3–10 years). The median time interval between the surgical procedure and the device closure procedure was 4 days (range 2–15 days). The indication for device closure was left ventricular volume overload in three patients and two patients had persistent pleural effusion. Qp:Qs was more than 1.5:1 in all five patients. The amplatzer duct occluder I (ADO-I) device was used in four patients and the ADO-II in one patient. There was no residual shunt post-deployment, with no major complication. The mean follow-up period was 2 years and all the patients had no residual shunt. Conclusion This case series, with its limitation of only five cases, has shown that device closure of hemodynamically significant residual postoperative left-to-right shunt lesions is an effective alternative strategy to redo surgery in older children. Further study is required with a larger sample size, and a longer follow-up is needed to evaluate its long-term safety and efficacy.