bluuebunny/crossref_metadata_2025_split huggingface dataset:
Neutrophil-to-lymphocyte ratio is an independent predictor for neurological disability in patients with idiopathic transverse myelitis
Authors: Min Je Hong , Sohn Sung-Yeon , Lee Seung Yeon , Seo Sang Hyun , Kim Shin Yeop , Park Bumhee , Kim Seung Il , Joo In Soo 
Published: March 2023

Abstract
Introduction:The neutrophil-to-lymphocyte ratio (NLR) has been found to be useful in the prognostication of immune-mediated neurological disorders because it roughly reflects the systemic innate immune response compared to the adaptive immune response. However, studies on the validity of NLR in demyelinating disorders of the central nervous system have shown conflicting results. Therefore, we aimed to investigate NLR in the idiopathic transverse myelitis (ITM) cohort.
Methods:We retrospectively analyzed the cohort data of patients with ITM between January 2006 and February 2020. The medical data of all patients with myelitis were reviewed to exclude patients with disease-associated myelopathyaccording to predefined exclusion criteria. The relationship between the natural log-transformed NLR (lnNLR) and the clinical, paraclinical, and imaging data was evaluated. Factors associated with neurological disability were analyzed using a linear mixed-effects model. Predictive factors for moderate-to-severe neurological disability (Expanded Disability Status Scale [EDSS] score ≥ 4) were investigated.
Results:A total of 124 participants were included in the analysis. The lnNLR correlated with EDSS and lesion length. Linear mixed-effects analysis showed that age, lesion length, and lnNLR were independently associated with neurological disabilities. Multivariable logistic regression revealed that lnNLR (odds ratio [OR] = 4.266, 95% confidence interval [CI] = 1.220–14.912, p = 0.023) and lesion length (OR = 1.848, 95% CI = 1.249–2.734, p = 0.002) were independent predictive factors of the worst neurological disability.
Conclusion: NLR may be used as an independent prognostic factor for predicting poor neurological outcomes in patients with ITM.
Assessing the Impact of Social, Demographic, and Economic Factors on the Economic Empowerment of Rural Women in Agricultural Activitie : A Partial Proportional Odds Model Analysis in Dire Dawa Administration, Ethiopia
Authors: Hordofa Dereje Fedasa , Badore Melekamu Ayele 
Published: March 2023

Abstract
The study examined the impact of social, demographic, and economic factors on the economic empowerment of rural women in agricultural activities in Ethiopia's Dire Dawa region, using a mixed-methods research approach. The research team collected data from a sample of 419 women engaged in agricultural activities and used the proportional odds model (POM) and the partial proportional odds model (PPOM) to identify the factors associated with economic empowerment. The study found that age, property ownership, and education and training had a negative effect, while social networks and media had a positive effect on economic empowerment. The results also showed that women aged 40 and above had a lower likelihood of being economically empowered, and lack of property ownership and limited contact with extension agents hurt economic empowerment. The study recommended improving women's access to credit, land ownership, and training opportunities to promote gender equity and women's economic empowerment in the agricultural sector in Ethiopia. This study contributes to the literature by using a mixed-methods approach that integrated qualitative data with quantitative data, which has not been used before in Ethiopia. The findings provide important implications for policymakers and development practitioners in promoting gender equity and women's economic empowerment in the agricultural sector. The study highlights the need to address the challenges that women face in achieving economic empowerment, including limited access to credit, training, and land ownership. By improving access to these resources, policymakers and development practitioners can create an enabling environment that fosters women's economic empowerment and promotes gender equity in Ethiopia's agricultural sector.
The impact on clinical outcomes after one year of implementation of an artificial intelligence solution for the detection of intracranial hemorrhage
Authors: Kotovich Dmitry , Twig Gilad , Itsekson-Hayosh Zeev , Klug Maximiliano , Ben-Simon Asaf , Yaniv Gal , Konen Eli , Tau Noam , Raskin Daniel , Chang Paul J , Orion David 
Published: March 2023

Abstract
Objectives: To assess the effect of a commercial Artificial Intelligence (AI) solution implementation in the emergency department on clinical outcomes in a single Level 1 Trauma Center.
Methods: A retrospective cohort study for two time periods – Pre-AI (1.1.2017-1.1.2018) and Post-AI (1.1.2019-1.1.2020), in a Level 1 Trauma Center was performed.
Participants older than 18 years with a confirmed diagnosis of ICH on head CT upon admission to the emergency department were collected. Study variables included demographics, patient outcomes, and imaging data. Participants admitted to the emergency department during the same time periods for other acute diagnoses (ischemic stroke –IS; and myocardial infarction - MI) served as control groups. Primary outcomes were 30- and 120-day all-cause mortality. Secondary outcome was morbidity based on Modified Rankin Scale for Neurologic Disability (mRS) at discharge.
Results: 587 participants (289 Pre-AI – age 71 ± 1, 169 men; 298 Post-AI – age 69 ± 1, 187 men) with ICH were eligible for the analyzed period. Demographics, comorbidities, Emergency Severity Score, type of ICH and length of stay were not significantly different between the two time periods. The 30- and 120-day all-cause mortality weresignificantly reduced in the Post-AI group when compared to the Pre-AI group (27.7% vs 17.5%; p=0.004 and 31.8% vs 21.7%; p=0.017 respectively).Modified Rankin Scale (mRS) at discharge was significantly reduced Post-AI implementation (3.2 vs 2.8; p=0.044).
Conclusion:Implementation of an AI based computer aided triage and prioritization solution for flagging participants with ICH in an emergent care setting coincided with significant reductions of 30- and 120-day all-cause mortality and morbidity.
To teach is to learn twice, revisited: A qualitative study of how residents learn through teaching in clinical environments
Authors: Kondo Takeshi , Takahashi Noriyuki , Aomatsu Muneyoshi , Nishigori Hiroshi 
Published: March 2023

Abstract

Background
As the saying goes, ‘to teach is to learn twice’; the teaching role contributes to one’s own learning as a professional. Near-peer teaching in clinical practice has been shown to contribute to the development of not only teaching skills but also necessary competencies for doctors. Research on how near-peer teachers learn through their teaching roles has mainly focused on classroom learning. Understanding how the phenomenon of ‘teaching is learning twice’ occurs in clinical settings and its influencing factors is important for the development of a quality workplace learning environment. We, therefore, investigated how residents learn through teaching in clinical practice and the factors influencing this process.
Methods
The study was conducted using a methodology based on grounded theory and from a social constructivist perspective. Several teaching hospitals in Japan were included, and the study participants were post-graduate year 2 residents (PGY2s) from these hospitals. The interviews were recorded, transcribed into text, and analysed by the first author.
Results
From January 2016 to July 2022, we conducted 13 interviews with 11 PGY2s from nine educational hospitals. PGY2s played diverse educational roles in clinical settings and learned competencies in almost all areas as physicians through such roles. Knowledge transfer and serving as role models stimulated their intrinsic motivation, encouraged reflection on their own experiences, and promoted self-regulated learning. Educating on procedural skills and clinical reasoning prompted reflection on their own procedural skills and thought processes, and supporting post-graduate year 1 residents’ reflections led to the refinement of their own knowledge and thought processes through the verbal expression of their learning experiences. Such processes required the formation of a community of practice. Education promoted learning through reflection and made the image of the expert that PGY2s aspired to be clearer.
Conclusions
We found that residents acquire various physician competencies through multiple processes by teaching as near-peer teachers in clinical settings, that a community of practice must be formed for near-peer teaching to occur in a clinical setting, and that teaching brings learning to those who teach by promoting reflection and helping them envision the professionals they seek to be.
The presence of wolves leads to spatial differentiation in deer browsing pressure on forest regeneration
Authors: Wójcicki Adam , Borowski Zbigniew 
Published: March 2023

Abstract
With the recent return of large carnivores to forest ecosystems, the question for forest owners and managers is how large predators influence the behaviour of their natural prey and, consequently, cervid browsing pressure on forest regeneration. To address this question, we analyzed deer pressure on Scots pine and European beech plantations in northern Poland's ecosystems with and without permanent wolf populations. Two characteristics were used to describe deer browsing patterns in plantations: distance from the forest edge (spatial pattern of browsing) and number of saplings browsed (browsing intensity). Beech saplings were more intensively browsed by deer compared to pine saplings. In a forest ecosystem not inhabited by wolves, spatial variation in browsing patterns on small beech plantations was the same between the edge and the center. In contrast, browsing pressure by deer was greater at the edges in large pine plantations. The presence of wolves reduced deer browsing on beech and increased browsing on pine saplings. In addition, deer foraging behaviour changed in large pine plantations, and browsing pressure increased only in the central areas of the plantations. We conclude that the presence of wolves in a forest landscape is an important factor that alters browsing pressure on the youngest stands and their spatial pattern, and that this may be a major factor in forest stand regeneration, especially in small gaps.
Comparing Medical Record Abstraction (MRA) Error Rates in an Observational Study to Pooled Rates Identified in the Data Quality Literature
Authors: Garza Maryam Y. , Williams Tremaine B. , Ounpraseuth Songthip , Hu Zhuopei , Lee Jeannette , Snowden Jessica , Walden Anita C. , Simon Alan E. , Devlin Lori A. , Young Leslie W. , Zozus Meredith N. 
Published: March 2023

Abstract

Background: Medical record abstraction (MRA) is a commonly used method for data collection in clinical research, but is prone to error, and the influence of quality control (QC) measures is seldom and inconsistently assessed during the course of a study. We employed a novel, standardized MRA-QC framework as part of an ongoing observational study in an effort to control MRA error rates. In order to assess the effectiveness of our framework, we compared our error rates against traditional MRA studies that had not reported using formalized MRA-QC methods. Thus, the objective of this study was to compare the MRA error rates derived from the literature with the error rates found in a study using MRA as the sole method of data collection that employed an MRA-QC framework.
Methods: Using a moderator meta-analysis employed with Q-test, the MRA error rates from the meta-analysis of the literature were compared with the error rate from a recent study that implemented formalized MRA training and continuous QC processes.
Results: The MRA process for data acquisition in clinical research was associated with both high and highly variable error rates (70 – 2,784 errors per 10,000 fields). Error rates for the study using our MRA-QC framework were between 1.04% (optimistic, all-field rate) and 2.57% (conservative, populated-field rate) (or 104 – 257 errors per 10,000 fields), 4.00 – 5.53 percentage points less than the observed rate from the literature (p<0.0001).
Conclusions: Review of the literature indicated that the accuracy associated with MRA varied widely across studies. However, our results demonstrate that, with appropriate training and continuous QC, MRA error rates can be significantly controlled during the course of a clinical research study.
Correlation of Calf Circumference in Relation to Other Anthropometric Measurements in Low Birth Weight Babies
Authors: Mandloi Deepshikha , Thomas Justin , Peter Preethy 
Published: March 2023

Abstract
Background
India having 3rd highest incidence of low birth weight (LBW) infants(28%) in the world. In India most of the deliveries are performed at home by untrained Dhais and midwifes. So if we train them to use alternative approach for estimating low birth weight like simple anthropometric indicators such as calf circumference, which can be easily implemented by rural communities.
Methods
We conducted a cross-sectional, prospective study at a tertiary care hospital in Kerala, a southern state in India, during a one-year period in 2021–2022. We included 80 neonates without any congenital malformations who were delivered at the hospital, irrespective of gestational age, and subjected them to anthropometric measurements. We measured calf circumference, chest circumference, mid-arm circumference, thigh circumference, and head circumference using non-stretchable measuring tape. Birth weight was recorded on an electronic weighing machine. Correlation coefficients were calculated using Pearson's correlation coefficient.
Results
From different anthropometric measurements, calf circumference did not show significant correlation with birth weight. The best correlation was observed in mid arm circumference and chest circumference for identifying babies with birth weight group. Birth weight can be roughly calculated from derived formula weight (kg) = 0.06(CC + MAC)-1.76
Conclusions
In the absence of a weighing machine, simple measurements like chest and mid arm circumference can identify babies with low birth weights. Calf circumference was not well correlated with birth weight in our study.
Comparison of nonanatomical reduction of femoral neck fractures in young patients treated with femoral neck system: a retrospective cohort study
Authors: Jiang QiLong , Liu Yang , Cao Yong , Bai Xinwen , Deng Yu , Yu Chengxiang , Song Qizhi , Li Yan 
Published: March 2023

Abstract
Purpose

Negative buttress reduction should be avoided in the treatment of femoral neck fractures (FNFs) using conventional implant devices. As the femoral neck system (FNS) has been recently developed and utilized widely to treat FNFs, the clinical efficacy of reduction quality has not been clarified. The purpose of this study was to evaluate clinical effects of nonanatomical reduction in young FNFs treated with FNS.

Methods

This multicenter, retrospective cohort study included 58 patients diagnosed as FNFs between September 2019 and December 2021. According to radiographs immediate following surgery, reduction quality were classified into positive, anatomical and negative buttress reduction groups. Assessment of postoperative hip function using Harris hip scores (HHS) system and postoperative complication rate was performed. Logistic regression model was used to analyses risk factors.

Results

Postoperative complication rate and Harris hip scores showed no significant difference in groups (P ＞0.05). Adjusted smoking status [OR = 1.991, 95%CI (1.063, 3.698)], Pauwels classification [OR = 2.012, 95%CI (1.216, 4.325)] were independent risk factors for postoperative complications. Compared with anatomical reduction, negative buttress reduction [OR = 2.987, 95%CI (1.101, 6.337)] was found to be significantly associated with complications after surgery in femoral neck fractures treated with FNS.

Conclusion

Negative buttress reduction should be constantly avoided in young FNFs treated with FNS or conventional implant devices.
A systematic review of the cost-effectiveness of maternity models of care
Authors: Martin Elizabeth , Ayoub Bassel , Miller Yvette D 
Published: March 2023

Abstract
Objectives: In this systematic review, we aimed to identify the full extent of cost-effectiveness evidence available for evaluating alternative Maternity Models of Care (MMC) and to summarize findings narratively.
Methods: Articles that included a decision tree or state-based (Markov) model to explore the cost-effectiveness of an MMC, and at least one comparator MMC, were identified from a systematic literature review. The MEDLINE, Embase, Web of Science, CINAHL and Google Scholar databases were searched for papers published in English, Arabic, and French. A narrative synthesis was conducted to analyse results.
Results: Three studies were included; all using cost-effectiveness decision tree models with data sourced from a combination of trials, databases, and the literature. Study quality was fair to poor. Each study compared midwife-led or doula-assisted care to obstetrician- or physician-led care. The findings from these studies indicate that midwife and doula led MMCs may provide value.
Conclusion: The findings of these studies indicate weak evidence that midwife and doula models of care may be a cost-effective or cost-saving alternative to standard care. However, the poor quality of evidence, lack of standardised MMC classifications, and the dearth of research conducted in this area are barriers to conclusive evaluation and highlight the need for more research incorporating appropriate models and population diversity.
CaCl 2 -HCl electrolyzed water promotes glucosinolates metabolism in broccoli sprouts via calcium signal
Authors: Li Cui , Song Shuhui , He Yanan , Han Siyu , Liu Haijie 
Published: March 2023

AbstractBackground Electrolyzed water, an invention of green chemistry, is a novel disinfectant that has been widely used in the food field. Previous studies have found that slightly acidic electrolyzed water not only has a bactericidal effect, but also promotes the accumulation of active substances in many types of sprouts. We have developed a new type of electrolyzed water - CaCl2-HCl electrolyzed water (CHEW), which is an effective method to enhance the formation of glucosinolates and isothiocyanates of broccoli sprouts. Molecular mechanism of CaCl2-HCl electrolyzed water promoting glucosinolate metabolism in broccoli sprout during the growth was investigated in this study. Results On the 4th day, the total glucosinolates’ content of broccoli sprouts reached 195.50 µmol/g DW under CHEW treatment. On the 8th day, compared to tap water, the contents of 3 isothiocyanates (sulforaphane, erucin, 4-isothiocyanato-1-buene) in broccoli sprouts under CHEW treatment were significantly increased by 45.93%, 34.04% and 185.15% respectively. The results of calcium distribution and RT-qPCR indicated that CHEW treatment activated calcium signal in broccoli sprouts and promoted the relative expressions of glucosinolate biosynthesis-related genes through calcium sensors (calmodulin (CaM), calmodulin-like protein (CML), calcium-dependent protein kinase (CDPK)) and calcium-binding nuclear protein IQD1. Conclusion Our research provides new insights into the molecular mechanism of glucosinolate metabolism and also provided a theoretical basis for cultivating high-quality broccoli sprouts.
Prognostic visualization model for primary pulmonary sarcoma: a SEER-based study
Authors: Huang Qian , Li Wenqiang , He Xiaoyu , Yuan Quan , Deng Zhiping 
Published: March 2023

Abstract
Background
Primary pulmonary sarcoma (PPS) is a rare and poor prognostic malignancy. This study aimed to investigate the prognostic factors of PPS and to construct a predictive nomogram to predict the overall survival (OS) rate of PPS.
Methods
We extracted data on patients diagnosed with pulmonary sarcoma from 2010–2019 in the SEER database. We used univariate and multivariate COX regression analysis to identify independent influences affecting the prognosis of patients with PPS. Then, we constructed a predictive nomogram based on the above prognostic factors. Finally, we assessed the validity of the predictive nomogram by receiver operating characteristic (ROC) curves, calibration curves, and decision analysis curves (DCA).
Results
Univariate and multivariate COX regression analyses showed that age, pathological grade, liver metastasis, surgical intervention, and chemotherapy were independent influences on the prognosis of PPS patients. The results of ROC curves, calibration curves, and DCA plots confirmed that the nomogram obtained in this study to predict the prognosis of PPS have good discrimination, accuracy, and clinical practice efficacy.
Conclusion
The study explores the factors affecting the prognosis of PPS. Moreover, we established a novel prognostic nomogram to predict the OS rate of PPS patients, which can help to make proper clinical decisions.
The burden of tuberculosis among adolescents and young adults in five Asian countries from 1990 to 2019
Authors: Yu Siyu , Li Shihong , Xu Qiufang , Cai Fengzhu , Liu Jingyi , Xiao Shaotan , He Gengsheng 
Published: March 2023

Abstract
Background Previous studies have shown that the risk of tuberculosis (TB) increases dramatically during adolescence. However, the burdens and trends of tuberculosis (TB) are poorly understood among them, especially in high-prevalence countries.
Methods Based on the Global Burden of Disease (GBD) 2019, we analyzed the incidence and mortality of TB among young people globally and in five Asian countries from 1990 to 2019. The annual percentage change was calculated by joinpoint regression analysis to estimate the trends in the age-standardized incidence rate (ASIR) and age-standardized death rate (ASDR).
Results The highest ASIR per 100,000 person-years in 2019 was in Mongolia [74 (95% uncertainty interval (UI), 51 to 105)], while the lowest was in Japan [4 (95% UI, 2 to 6)]. The highest ASDR per 100,000 person-years was in Mongolia [2 (95% UI, 1 to 3)], while the lowest was in Japan [0.009 (95% UI, 0.008 to 0.010)]. As the absolute number of cases and deaths decreased from 1990 to 2019, the ASIRs and ASDRs in all five countries also decreased. The decreasing trends were particularly significant in developed regions and varied across geographic regions.
Conclusions This study may be crucial in helping policymakers make decisions and allocate appropriate resources toadolescent TB control strategies.