bluuebunny/crossref_metadata_2025_split huggingface dataset:
Choice of Arm Use in Stroke Survivors is Largely Driven by the Energetic Cost of the Movement
Authors: Nguyen Hien , Phan Thanh , Shadmehr Reza , Lee Sang Wook 
Published: April 2023

Background The decision of which arm to use to achieve a goal depends on energetic costs and performance abilities of each arm. Following a stroke, there is a reduction in the use of the more-impaired arm. Is it because the energetic costs of the more-impaired arm are increased, or because its use dictates a lower chance of success? Objective We sought to elucidate the impact of energetic cost and task success on the arm choice of stroke survivors. Methods Thirteen chronic stroke survivors and thirteen neurologically-intact subjects participated in an experiment where they reached towards visual targets in a virtual-reality environment. Energetic cost of reaching with their less-used arm (nondominant/more-impaired) was adjusted by amplifying the range of motion, while task accuracy requirement was independently modulated by changing target size. Results Reducing the energic cost of reaching increased the use of the less-used arms in both groups, but by a greater amount in the stroke survivors. In contrast, lowering task accuracy requirement altered arm choice similarly in the two groups. The time spent in decision-making (reaction time) reflected different impacts of energetic cost and task success on the arm choice of the two groups. Conversely, velocity changes were similar between the groups. Conclusions The impact of energetic cost on arm choice of stroke survivors is greater than neurologically-intact subjects. Thus, the reduction in the use of the impaired arm following stroke may be primarily due to a subjective increase in the effort it takes to use that arm.
Effect of probiotic administration in inflammatory responses of thermal burns
Authors: Masoumi Sanaz , Mahdavi-Roshan Marjan , Majidiniya Ardalan , Ghaffari Mohammad Ebrahim , Pirdastan Sepideh , Hajian Abbas , Mobayen Mohammadreza 
Published: April 2023

Objectives & Introduction It is possible to damage the natural intestinal barrier following severe burn injuries. Oral probiotics' positive effects on the innate immune system or intestinal epithelial layer are proven. This research aimed to evaluate the role of probiotics on plasma inflammatory changes and bacterial colonization in the burned wound after high-grade thermal trauma. Methods This double-blinded randomized controlled trial was conducted on 80 patients with a total body surface area of 20–70%. Patients were allocated to two groups based on four blocks randomization model. Intervention and control groups received daily LactoCare and placebo capsules for 14 consecutive days. Obtaining demographic data, burn and gastrointestinal symptoms were registered by filling out a questionnaire. Additionally, measuring plasma levels of highly sensitive C-reactive protein(hs-CRP), IgA, absolute neutrophilic, and lymphocytic count were performed cumulatively four times prior to and after the intervention. Results Considering eligible data, following the study period analysis showed significant mitigation of inflammatory status in probiotic receivers. The hs-CRP reduced following probiotic (21.38 ± 44.45) consumption compared with placebo (−36.36 ± 79.03) intake ( p < 0.001). Also, the plasma level of IgA significantly decreased in the intervention group (0.88 ± 0.65) than in the control group (0.79 ± 0.18) ( p < 0.001). Wound cultures showed no significant difference between groups, although the incidence rate of bacterial colonization was slightly lower after using probiotics ( p = 0.159). Regarding wound healing, data illustrated that probiotics could accelerate wound healing after 14 days of regular consumption ( p < 0.001). Conclusion Probiotics have advantages for the mitigation of inflammation and wound healing following severe thermal burn injuries. Trends toward Improvement Immune system by increasing IgA level and lymphocytic count and possible Reduction of wound area with exogenous probiotic administration in patients with burns suggest that further investigation in larger sample size is necessary to corroborate our initial, promising findings.
Results of arthroscopic cancellous bone grafting for treatment of scaphoid nonunion in comparison with open cancellous bone grafting
Authors: Gvozdenovic Robert , Kongensgaard Trine Broenden 
Published: April 2023

This study primarily aimed to report the outcome of the arthroscopic cancellous bone grafting technique for treating scaphoid nonunion. The secondary aim was to compare the bone union rate and time, and the ability to correct the angulation of the scaphoid, between arthroscopically treated patients ( n = 27), and patients treated with open cancellous bone grafting ( n = 27). Nine surgeons (two in the arthroscopic and seven in the open group) with Level III experience operated on the patients. The pain score, grip strength and Quick Disability of the Arm, Shoulder and Hand score improved significantly after the arthroscopic treatment ( p = 0.0001). Arthroscopic cancellous bone grafting achieved union in 25 out of 27 patients. A retrospective comparison with open cancellous bone grafting showed four nonunions. Arthroscopically treated patients healed 5.4 weeks faster compared with the open group ( p = 0.033). Patients treated with open grafting had a higher risk of failure (odds ratio = 2.17), although this was not found significant ( p = 0.39). The open method corrected the angulation deformity better (dorsal cortical angle correction of 4°) than the arthroscopic method (dorsal cortical angle correction of 1°), but this was not statistically significant neither within the groups ( p = 0.55, p = 0.87) nor postoperatively between the groups ( p = 0.98). The height-to-length ratio was not different before and after the surgery for the arthroscopic group ( p = 0.44) and the open group ( p = 0.27), or postoperatively between the groups ( p = 0.44). Level of evidence: III
A salvage procedure: Radial head excision in children and adolescents—short-to-midterm outcomes and overview of the literature
Authors: Kruppa Christiane , Brinkemper Alexis , Cibura Jana , Königshausen Matthias , Cibura Charlotte , Schildhauer Thomas A. , Dudda Marcel 
Published: April 2023

Purpose: Purpose of the study was to report the outcomes after radial head excision in children and adolescents in addition with a review of the current literature. Methods: We report a series of five children and adolescents, who had undergone a post-traumatic radial head excision. Clinical outcomes were evaluated in terms of elbow/wrist range of motion, stability, deformity and discomforts or restrictions at two follow-up points. Radiographic changes were evaluated. Results: Patient’s age at time of the radial head excision averaged 14.6 (13–16) years. Mean time from the injury to the radial head excision was 3.6 (0–9) years. Follow-up I averaged 4.4 (1–8) years and follow-up II 8.5 (7–10) years. At follow-up I, patients showed an average elbow range of motion of 0-10-120° Ext/Flex and 90-0-80° Pro/Sup. Two patients reported discomfort or pain at the elbow. Four (80%) patients had a symptomatic wrist with pain or crepitation at the distal radio ulnar joint. In three (60%) of them, an ulna plus at the wrist was present. Two patients required ulna shortening and autograft stabilization of the interosseous membrane. At final follow-up, all patients reported full functioning with daily activities. Restrictions were present with sport activities. Conclusion: Functional results at the elbow joint might be improved and pain syndromes lessen due to the radial head excision. Problems at the wrist are likely secondary to the procedure. A critical analysis of other options should be performed ahead of the procedure and a careless application should be avoided by all means. Level of evidence: IV
Risk of Depression in a Suburban Primary Care Setting Before and During the COVID-19 Pandemic
Authors: Whiting Carman H. , Yousefi Pouran , des Bordes Jude K. A. , Rianon Nahid J. 
Published: April 2023

Introduction: Major depression is a common disorder affecting millions of adults each year. Many population-based surveys showed an increase in the number people with symptoms of depression at the onset of the COVID-19 pandemic. Our aim was to determine and compare the prevalence of depression risk in a primary care setting before and during the COVID-19 pandemic. Methods: We conducted a cross-sectional study based on retrospective review of medical records from a large suburban primary care clinic. Records of adults 18 years and older, seen between January 1, 2019 and December 31, 2020 and who had also been screened for depression using the 9-item Patient Health Questionnaire (PHQ-9) were analyzed. Results: Adults 18 years and older who completed the PHQ-9 assessment in 2019 and 2020 were 5078 and 4338, respectively. Risk of depression was 18.2% in 2019 and 14.8% in 2020 ( P < .001). In adults under 50 years and those 50 years and older, depression risk was 20.7% versus 15.3% in 2019 ( P < .001) and 17.3% versus 12.6% in 2020 ( P < .001), respectively. In females, depression risk was 20.0% in 2019 and 16.8% in 2020 ( P < .01), and in males, 14.1% in 2019 and 10.6% in 2020 ( P < .01). Conclusion: Although our results did not reflect the published literature reporting a higher prevalence of depression during the COVID-19 pandemic, they were consistent with reports of increased risk in females and younger adults.
Effect of Heading a Soccer Ball as an External Focus During a Drop Vertical Jump Task
Authors: Akbari Hadi , Kuwano Satoshi , Shimokochi Yohei 
Published: April 2023

Background: Research has demonstrated that performing a secondary task during a drop vertical jump (DVJ) may affect landing kinetics and kinematics. Purpose: To examine the differences in the trunk and lower extremity biomechanics associated with anterior cruciate ligament (ACL) injury risk factors between a standard DVJ and a DVJ while heading a soccer ball (header DVJ). Study Design: Descriptive laboratory study. Methods: Participants comprised 24 college-level soccer players (18 female and 6 male; mean ± SD age, 20.04 ± 1.12 years; height, 165.75 ± 7.25 cm; weight, 60.95 ± 8.47 kg). Each participant completed a standard DVJ and a header DVJ, and biomechanics were recorded using an electromagnetic tracking system and force plate. The difference (Δ) in 3-dimensional trunk, hip, knee, and ankle biomechanics between the tasks was analyzed. In addition, for each biomechanical variable, the correlation between the data from the 2 tasks was calculated. Results: Compared to the standard DVJ, performing the header DVJ led to significantly reduced peak knee flexion angle (Δ = 5.35°; P = .002), knee flexion displacement (Δ = 3.89°; P = .015), hip flexion angle at initial contact (Δ = −2.84°; P = .001), peak trunk flexion angle (Δ = 13.11°; P = .006), and center of mass vertical displacement (Δ = −0.02m; P = .010), and increased peak anterior tibial shear force (Δ = −0.72 N/kg; P = .020), trunk lateral flexion angle at initial contact (Δ = 1.55°; P < .0001), peak trunk lateral flexion angle (Δ = 1.34°; P = .003), knee joint stiffness (Δ = 0.002 N*m/kg/deg; P = .017), and leg stiffness (Δ = 8.46 N/kg/m; P = .046) compared to those in standard DVJs. In addition, individuals' data for these variables were highly and positively correlated between conditions ( r = 0.632-0.908; P < .001). Conclusion: The header DVJ task showed kinetic and kinematic parameters that suggested increased risk of ACL injury as compared with the standard DVJ task. Clinical Relevance: Athletes may benefit from acquiring the ability to safely perform header DVJs to prevent ACL injury. To simulate real-time competition situations, coaches and athletic trainers should incorporate such dual tasks in ACL injury prevention programs.
Mortality Rate and Predictors Among Women With Obstructed Labor in a Tertiary Academic Medical Center of Ethiopia: A Retrospective Cohort Study
Authors: Desta Melaku , Ferede Addisu Andualem 
Published: April 2023

Introduction Obstructed labor is one of the most common preventable causes of maternal morbidity and mortality. In Ethiopia, 36% of maternal mortality was due to obstructed labor with uterine rupture. Thus, this study proposed to measure predictors of maternal mortality among women with obstructed labor in a tertiary academic medical center in Southern Ethiopia. Methods An institution-based retrospective cohort study was conducted at Hawassa University Specialized Hospital from July 25 to September 30, 2018. Women who had obstructed labor from 2015 to 2017 were recruited. A pretested checklist was used to retrieve data from the woman's chart. A multivariable logistic regression model was employed to identify variables associated with maternal mortality, and variables with a p-value <.05 were considered significant at 95% CI. Results With a response rate of 96.3%, 156 moms who experienced labor obstruction were included in the study. Obstructed labor caused the deaths of 14 women, resulting in a maternal mortality rate of 8.9% (95% CI: 7.15, 16.4). Maternal mortality from obstructed labor was reduced in women who received antenatal care visits (AOR = 0.25, 95% CI: 0.13, 0.76) and blood transfusions (AOR =  0.49, 95% CI: 0.03, 0.89). Women who experienced uterine rupture (AOR =  6.25, 95% CI: 5.3, 15.6) and antepartum hemorrhage (AOR = 14, 95% CI: 2.45, 70.5) had a greater risk of maternal mortality than women who did not have the corresponding morbidity. Conclusions The center had a higher rate of maternal mortality due to obstructed labor. Early screening and improving the care for women at greatest risk of antenatal and postnatal co-morbidities like uterine rupture and shock were the major priorities and fundamental strategies to decreasing maternal mortality. It also showed that antenatal care visits, early referral, and blood transfusion for women with obstructed labor should be amended in order to lower maternal mortality.
Moral Distress, Health and Intention to Leave: Critical Care Nurses’ Perceptions During COVID-19 Pandemic
Authors: Andersson Maria , Fredholm Angelica , Nordin Anna , Engström Åsa 
Published: April 2023

Introduction Moral distress increases the risk that critical care nurses will lose the ability to provide quality nursing care. Aims To describe person-related conditions and perceptions of moral distress, health and intention to leave among critical care nurses in intensive care units, and to examine the relationship between person-related conditions, moral distress, health and intention to leave. Method Cross-sectional, with 220 critical care nurses in 15 Swedish ICUs, and data gathered via a self-reported questionnaire. Results Highest moral distress scores were reported in futile care and poor teamwork and 21% reported entertaining an intention to leave. Self-reported health was lower than before the COVID-19 pandemic and 4.1% reported pronounced exhaustion disorder. Self-reported health, reduced capacity to tolerate demands under time pressure, emotional instability or irritability, physical weakness, or being more easily fatigued and with decreased well-being were factors that had a relationship with futile care. Sleeping problems and intention to leave had a relationship with poor teamwork. Conclusions Different strategies are needed to reduce moral distress and the leadership is crucial for managing crises such as the COVID-19 pandemic.
Adaptation of the collaborative care model to integrate behavioral health care into a low-barrier HIV clinic
Authors: Dombrowski Julia C. , Halliday Scott , Tsui Judith I. , Rao Deepa , Sherr Kenneth , Ramchandani Meena S. , Emerson Ramona , Fleming Mark , Wood Teagan , Chwastiak Lydia 
Published: April 2023

Background The collaborative care management (CoCM) model is an evidence-based intervention for integrating behavioral health care into nonpsychiatric settings. CoCM has been extensively studied in primary care clinics, but implementation in nonconventional clinics, such as those tailored to provide care for high-need, complex patients, has not been well described. Method We adapted CoCM for a low-barrier HIV clinic that provides walk-in medical care for a patient population with high levels of mental illness, substance use, and housing instability. The Exploration, Preparation, Implementation, and Sustainment model guided implementation activities and support through the phases of implementing CoCM. The Framework for Reporting Adaptations and Modifications to Evidence-Based Interventions guided our documentation of adaptations to process-of-care elements and structural elements of CoCM. We used a multicomponent strategy to implement the adapted CoCM model. In this article, we describe our experience through the first 6 months of implementation. Results The key contextual factors necessitating adaptation of the CoCM model were the clinic team structure, lack of scheduled appointments, high complexity of the patient population, and time constraints with competing priorities for patient care, all of which required substantial flexibility in the model. The process-of-care elements were adapted to improve the fit of the intervention with the context, but the core structural elements of CoCM were maintained. Conclusions The CoCM model can be adapted for a setting that requires more flexibility than the usual primary care clinic while maintaining the core elements of the intervention.
Surgical Treatment of the Cranial Basis Teratoma in a Newborn and Palatal Reconstruction With Tongue Flap a 17-Years Follow-Up: A Case Report
Authors: Costa De-Moraes Sylvio Luiz , Fares Raissa Dias , Maurity de Paula Afonso Alexandre , Mattos Ricardo Pereira , Gomes dos Santos Roberto , Pereira Rayssa Lima , Ribeiro da Silva Jonathan 
Published: April 2023

Epignathus or Tessier fissure 0-14 is a rare teratoma composed of the three embryonic germ layers. Clinically, it appears as a mass covered with skin and mucosa, originating from pluripotential stem cells. According to the latest classification by the World Health Organization teratoma represents the main benign Germ cell tumors of the sinus region and presents similar histological aspects with its counterparts in the gonads and other extragonadal sites. The purpose of this study is to present a case of epignathus originating from the base of the skull in a Caucasian female patient with a cleft palate after the incisive foramen, not affecting the nasal floor. During physical examination, via intraoral route, in the region below the base of the skull, an extensive solid mass, covered by mucosa and with the presence of hair. Computed tomography confirmed the lesion, in the region corresponding to the base of the patient’s skull. The first surgical approach of resection occurred at the 40th day of the patient’s life, under general anesthesia and subsequent primary closure of the palatal defect. The second surgery was performed 10 months later, when tissue expanders were used on the palate to increase the mucosal surface. At the age of 5, the patient underwent surgery with a tongue flap, from the lingual dorsum, with an anterior pedicle. The patient was kept under sedation and relaxation for a period of 10 days for flap autonomy. After this period, the section of the flap and the reconstruction of the tongue dorsum were performed. The patient had a good evolution and was maintained under outpatient treatment. Pediatricians and pediatric dentists should be aware of the importance of prenatal exams and soon after birth, to identify possible deformities in neonatal patients, which favors the diagnosis. The 17-year postoperative follow-up of complete surgical removal of the teratoma and reconstruction of the cleft palate, combining the use of a tissue expander on the palate and a flap on the dorsum of the tongue, proved to be a viable resource for improving the patient’s quality of life.
Modelling charring of timber exposed to natural fire
Authors: Pečenko Robert , Hozjan Tomaž , Huč Sabina 
Published: April 2023

AbstractCharring of timber structural elements in fire is one of the most fundamental phenomena that affect the fire resistance of these elements. For an accurate and safe design of structural fire resistance, it is important to consider charring of timber in natural fire exposures, since determining charring for standard fire exposure, which is a common practice, is outdated and in some cases unsafe, due to the fact that some natural fires can be much more severe. Currently, the prescriptive approach and simplified design methods fail to give information about charring of timber elements exposed to natural fire and thus, a performance-based design is needed. Therefore, this paper presents an upgrade and extension of a recently developed heat-mass-pyrolysis model named PYCIF. Originally, PYCIF model was developed only for standard fire conditions. In the present paper, several studies and analyses are performed to extend model application to natural fire conditions. Firstly, the sensitivity study is performed, where the impact of model parameters on the charring development is investigated. It is discovered, that the kinetic parameters for the reaction rate of the active cellulose production, namely activation energy E1 and pre-exponential factor A1, are the most influential. In the next analyses the model calibration for small-scale cone calorimeter tests and large-scale natural fire tests of cross-laminated timber (CLT) floor system is performed. A robust nature of the model is identified since minor parameter calibration is required for an accurate prediction of the charring depth and temperatures in timber elements exposed to various fire conditions. Furthermore, a strong connection between the heating rate of fire and kinetic parameters is discovered. In cases of faster heating rate, the kinetic parameters govern slower reaction rate of active cellulose.
Optimization study of the adsorption of malachite green removal by MgO nano-composite, nano-bentonite and fungal immobilization on active carbon using response surface methodology and kinetic study
Authors: Hussien Hamad Mohammed Taha Moustafa 
Published: April 2023

AbstractMalachite green a typical organic dye containing triarylmethane, is discharged in wastewater by textile and leather manufacturing plants. MG can pollute the environment, and it represents a major hazard to humans and various living organisms. We have thus worked toward developing the optimum dye-absorptive material, which should possess the following characteristics: excellent adsorption capacity, good selectivity, favorable recycling and reuse potential, and ease and quickness of adsorption. In this study, nano-bentonite, novel hybrid MgO-impregnated clay, and fungal composites were synthesized for Malachite green removal from aqueous solution. Response surface methodology (RSM) was used for the optimization of the synthesis of adsorbents to achieve simultaneous maximum malachite green removal. The composites were characterized by Fourier transform infrared spectroscopy (FTIR), scanning electron microscopy (SEM) and X-ray diffraction (XRD). According to the obtained results, MgO-impregnated clay exhibits a exhibited a higher adsorption capacity of MG than nano-bentonite and pure bentonite. The malachite green adsorption isotherm on MgO-impregnated clay corresponded with the Freundlich isotherm. However, the Langmuir adsorption isotherm was a superior fit for nano-bentonite. The adsorption activities of nano-bentonite and MgO-impregnated clay were fitted into a pseudo-second-order kinetic model. Based on the root-mean-square error, bias, and accuracy, statistical research has shown that the Halden model has optimal accuracy. In addition, despite being recycled numerous times, the adsorbent maintained its high structural stability and removal effectiveness for nano-bentonite (94.5–86%) and MgO-impregnated clay (92–83%).