bluuebunny/crossref_metadata_2025_split huggingface dataset:
Accuracy of ultrasound in diagnosing ankle injuries in emergency care
Authors: Deutekom Fenna E , Ridderikhof Milan L , Van Etten-Jamaludin Faridi , Schepers Tim 
Published: May 2023

BackgroundAnkle injuries are one of the most common presentations in the ED. Although fractures can be ruled out using the Ottawa Ankle Rules, the specificity is low, which means many patients may still receive unnecessary radiographs. Even once fractures are ruled out, assessment of ankle stability is recommended to rule out ruptures, but the anterior drawer test has only moderate sensitivity and low specificity and should be performed only after swelling has receded. Ultrasound could be a reliable, cheap and radiation free alternative to diagnose fractures and ligamentous injuries. The purpose of this systematic review was to investigate the accuracy of ultrasound in diagnosing ankle injuries.MethodsMedline, Embase and the Cochrane Library were searched up to 15 February 2022 to include studies of patients of 16 years or older presenting to the ED with acute ankle or foot injury, who underwent ultrasound and had diagnostic accuracy as outcome. No restrictions were applied for date and language. Risk of bias and quality of evidence using the Grading of Recommendations, Assessment, Development and Evaluations approach were assessed.ResultsThirteen studies evaluating 1455 patients with bony injuries were included. In 10 studies, the reported sensitivity for fracture was >90%, but varied among studies between 76% (95% CI 63% to 86%) and 100% (95% CI 29% to 100%). In nine studies, the reported specificity was at least 91%, but varied between 85% (95% CI 74% to 92%) and 100% (95% CI 88% to 100%).Six studies including 337 patients examined the use of ultrasound for ligamentous injuries and found a sensitivity and specificity >94% and 100%. Overall quality of evidence for both bony and ligamentous injuries was low and very low.ConclusionUltrasound has the potential to be a reliable method for diagnosing foot and ankle injuries, however, higher grade evidence is needed.PROSPERO registration numberCRD42020215258.
Phenotypical differences ofC9ORF72gene-positive and negative amyotrophic lateral sclerosis: a comparative case series
Authors: White Laura Michelle , Boardman Jeremy , Lilleker James , Chaouch Amina , Kargwell Haga , Ealing John , Hamdalla Hisham 
Published: May 2023

BackgroundHexanucleotide repeat expansions ofC9ORF72account for a significant proportion of autosomal dominant neurodegenerative diseases in the amyotrophic lateral sclerosis (ALS)–frontotemporal dementia spectrum. In the absence of a family history, clinical identification of such patients remains difficult. We aimed to identify differences in demographics and clinical presentation between patients withC9ORF72gene-positive ALS (C9pALS) versusC9ORF72gene-negative ALS (C9nALS), to aid identification of these patients in the clinic and examine differences in outcomes including survival.MethodsWe retrospectively reviewed the clinical presentations of 32 patients with C9pALS and compared their characteristics with a cohort of 46 patients with C9nALS from the same tertiary neurosciences centre.ResultsPatients with C9pALS more commonly presented with mixed upper and lower motor signs (C9pALS 87.5%, C9nALS 65.2%; p=0.0352), but less frequently presented with purely upper motor neuron signs (C9pALS 3.1%, C9nALS 21.7%; p=0.0226). The C9pALS cohort had a higher frequency of cognitive impairment (C9pALS 31.3%, C9nALS 10.9%; p=0.0394) and bulbar disease (C9pALS 56.3%, C9nALS 28.3%; p=0.0186). There were no differences between cohorts in age at diagnosis, gender, limb weakness, respiratory symptoms, presentation with predominantly lower motor neuron signs or overall survival.DiscussionAnalysis of this ALS clinic cohort at a UK tertiary neurosciences centre adds to the small but growing understanding of the unique clinical features of patients with C9pALS. In the age of precision medicine with expanding opportunities to manage genetic diseases with disease-modifying therapies, clinical identification of such patients is increasingly important as focused therapeutic strategies become available.
Patient perspectives on the use of indwelling pleural catheters in malignant pleural effusions
Authors: Mitchell Michael A , Deschner Emilie , Dhaliwal Inderdeep , Robinson Michael , Li Pen , Kwok Chanel , Cake Lorraine , Dawson Emily , Veenstra James , Stollery Daniel , Gillson Ashley-Mae , Amjadi Kayvan 
Published: May 2023

BackgroundIndwelling pleural catheters are an effective treatment option for patients with malignant pleural effusions. Despite their popularity, there remains a paucity of data on the patient experience and key patient-centred outcomes.ObjectiveTo investigate the experience of patients receiving an indwelling pleural catheter to better inform and identify potential areas for improvement in care.MethodsThis was a multicentre survey study at three academic, tertiary-care centres in Canada. Patients with a diagnosis of malignant pleural effusion who had an indwelling pleural catheter inserted were included. An adapted questionnaire specific to indwelling pleural catheters was used with responses recorded on a 4-point Likert scale. Patients completed the questionnaire in-person or by phone at 2-week and 3-month follow-up appointments.ResultsA total of 105 patients were enrolled in the study with 84 patients included in the final analysis. At the 2-week follow-up, patient-reported improvements in dyspnoea and quality of life from indwelling pleural catheter were high at 93% and 87%, respectively. The predominant issues identified were discomfort at time of insertion (58%), itching (49%), difficulty with sleeping (39%), discomfort with home drainage (36%) and the pleural catheter reminding patients of their disease (63%). Avoiding hospitalisation for the management of dyspnoea was important to 95% of patients. Findings were similar at 3 months.ConclusionsIndwelling pleural catheters are an effective intervention to directly improve dyspnoea and quality of life but have important disadvantages for some; clinicians and patients should be aware of these when making an informed decision regarding treatment.
Survey of venous thromboembolism prophylaxis in trauma patients: current prescribing practices and concordance with clinical practice guidelines
Authors: Alexander Kaitlin M , Butts Charles Caleb , Lee Yan-Leei Larry , Kutcher Matthew E , Polite Nathan , Haut Elliott R , Spain David , Berndtson Allison E , Costantini Todd W , Simmons Jon D 
Published: May 2023

ObjectivesPharmacological venous thromboembolism (VTE) prophylaxis is recommended in the vast majority of trauma patients. The purpose of this study was to characterize current dosing practices and timing of initiation of pharmacological VTE chemoprophylaxis at trauma centers.MethodsThis was an international, cross-sectional survey of trauma providers. The survey was sponsored by the American Association for the Surgery of Trauma (AAST) and distributed to AAST members. The survey included 38 questions about practitioner demographics, experience, level and location of trauma center, and individual/site-specific practices regarding the dosing, selection, and timing of initiation of pharmacological VTE chemoprophylaxis in trauma patients.ResultsOne hundred eighteen trauma providers responded (estimated response rate 6.9%). Most respondents were at level 1 trauma centers (100/118; 84.7%) and had >10 years of experience (73/118; 61.9%). While multiple dosing regimens were used, the most common dose reported was enoxaparin 30 mg every 12 hours (80/118; 67.8%). The majority of respondents (88/118; 74.6%) indicated adjusting the dose in patients with obesity. Seventy-eight (66.1%) routinely use antifactor Xa levels to guide dosing. Respondents at academic institutions were more likely to use guideline-directed dosing (based on the Eastern Association of the Surgery of Trauma and the Western Trauma Association guidelines) of VTE chemoprophylaxis compared with those at non-academic centers (86.2% vs 62.5%; p=0.0158) and guideline-directed dosing was reported more often if the trauma team included a clinical pharmacist (88.2% vs 69.0%; p=0.0142). Wide variability in initial timing of VTE chemoprophylaxis after traumatic brain injury, solid organ injury, and spinal cord injuries was found.ConclusionsA high degree of variability exists in prescribing and monitoring practices for the prevention of VTE in trauma patients. Clinical pharmacists may be helpful on trauma teams to optimize dosing and increase prescribing of guideline-concordant VTE chemoprophylaxis.
Regulation of immune function in healthy adults: one-stop guide on the role of dietary fatty acids, gut microbiota-derived short chain fatty acids, and select micronutrients in combination with physical activity
Authors: Patel Dhruvesh , Evanchuk Jenna , Wang Ren , Dunbar Carolyn L. , Munhoz Jaqueline , Field Catherine J. 
Published: May 2023

The immune system requires an adequate supply of nutrients, although current dietary recommendations may not account for optimal immune function in healthy adults. Nutrient inadequacies due to the growing influence of the western diet pose a risk for immune dysfunction. This review aims to determine the beneficial effects of supplementing dietary fats, nutrients that modulate gut microbiota, and specific micronutrients on systemic immune functions (concentrations of plasma cytokines, antibodies, and acute phase proteins) during health and acute inflammatory conditions, including COVID-19. We discussed micronutrients (selenium, zinc, and vitamin D) with compelling evidence supporting immunomodulatory properties. Additionally, the synergistic effects of physical activity and dietary interventions on systemic immune markers are explored. Briefly, evidence suggests that dietary consumption of monounsaturated (oleic and palmitoleic acids) and omega-3 polyunsaturated fatty acids (eicosapentaenoic and docosahexaenoic acids) promotes anti-inflammatory properties. Food sources (fiber, prebiotics, probiotics, omega-3) and patterns (Mediterranean diet) increase the production of short-chain fatty acids, beneficially altering gut microbiota composition, which subsequently enhances the immunomodulatory properties of circulating immune cells. A positive synergistic role of nutrient supplementation (omega-3 and fiber) and physical activity on circulating C-reactive protein and interleukin-6 levels has been observed. Lastly, omega-3 supplementation during COVID-19 infection may reduce circulating C-reactive protein and pro-inflammatory cytokines and improves pain and fatigue symptoms. This review highlights recent findings that support the beneficial role of specific nutrients in promoting systemic immune function in healthy adults. However, to establish specific dietary recommendations to support optimal immune function, more research is required. Key takeaway: Increasing dietary fats (fish and olive oils) and specific micronutrients may positively impact systemic immune function in healthy adults. Evidence suggests that these nutrients promote immunomodulatory properties useful in resolving acute infection.
Observational constraints on two cosmological models of f(Q) theory
Authors: Koussour M. , De Avik 
Published: May 2023

AbstractIn the past few years, f(Q) theories have drawn a lot of research attention in replacing Einstein’s theory of gravity successfully. The current study examines the novel cosmological possibilities emerging from two specific classes of f(Q) models using the parametrization form of the equation of state (EoS) parameter as $$\omega \left( z\right) =-\frac{1}{1+3\beta \left( 1+z\right) ^{3}}$$

ω

z

=
-

1

1
+
3
β

1
+
z

3

, which displays quintessence behavior with the evolution of the Universe. We do statistical analyses using the Markov chain Monte Carlo (MCMC) method and background datasets like Type Ia Supernovae (SNe Ia) luminosities and direct Hubble datasets (from cosmic clocks), and Baryon Acoustic Oscillations (BAO) datasets. This lets us compare these new ideas about the Universe to the $$\Lambda $$
Λ
CDM model in a number of different possible ways. We have come to the conclusion that, at the current level of accuracy, the values of their specific parameters are the best fits for our f(Q) models. To conclude the accelerating behavior of the Universe, we further study the evolution of energy density, pressure, and deceleration parameter for these f(Q) models.
Spinor wave function of the Universe in non-minimally coupled varying constants cosmologies
Authors: Balcerzak Adam , Lisaj Mateusz 
Published: May 2023

AbstractIn this paper, we introduce a non-minimally coupled varying speed of light and varying gravitational constant cosmological toy model. Using the Eisenhart–Duval lifting method, we extend the original minisuperspace of the model and depict the evolution of the system in the presence of the potential term as a geometrical flow associated with the lifted metric. We write the Dirac–Wheeler–DeWitt equation, which solution is a spinor wave function of the Universe. Then we find the solution of the Dirac–Wheeler–DeWitt equation, which describes the emergence of two early universe–antiuniverse pairs that differ with the conserved quantity, which is an analog of the spin.
Sex Differences in Ambulatory Blood Pressure Levels and Subtypes in a Large Italian Community Cohort
Authors: Omboni Stefano , Khan Nadia A. , Kunadian Vijay , Olszanecka Agnieszka , Schutte Aletta E. , Mihailidou Anastasia S. 
Published: May 2023

Background:
Sex differences in blood pressure control are recognized. We systematically investigated sex differences in specific components of ambulatory blood pressure (ABP), including variability, day-night changes, morning surge, and hypertension types.

Methods:
We analyzed ABPs of 52 911 participants (45.6% male, 54.4% female, 37.0% treated for hypertension) visiting 860 Italian community pharmacies. Sex differences in ABP levels and patterns were evaluated in the whole group and 4 risk groups (antihypertensive-treated patients, patients with diabetes, dyslipidemia, or cardiovascular disease).

Results:

Average 24-hour, day-time, and night-time blood pressure values were consistently higher in males than females (
P
<0.001). Variability in ABP was higher in females, except during the night. Nondippers and an abnormal morning surge were more common among males (odds ratio and 95% CI, 1.282 [1.230–1.335] and 1.244 [1.159–1.335];
P
<0.001). The prevalence of 24-hour and masked hypertension was higher in males (odds ratio and 95% CI, 2.093 [2.019–2.170] and 1.347 [1.283–1.415];
P
<0.001) and that of white-coat hypertension in females (0.719 [0.684–0.755];
P
<0.001). Ambulatory heart rate mean values were higher (
P
<0.001) in females. Day-time HR variability was higher and night-time heart rate variability lower in females (
P
<0.001). Sex differences in ABP levels and patterns detected in the whole population were replicated in all risk groups, except for the prevalence of abnormal morning surge (between sexes difference in antihypertensive-treated participants only).

Conclusions:
Females show better ABP control than males, but with an increased blood pressure variability and a greater prevalence of white-coat hypertension. These findings support tailored management of hypertension.

Registration:

URL:
https://www.clinicaltrials.gov
; Unique identifier: NCT03781401
Different Mechanisms for Visual Attention at the Hand-movement Goal and Endogenous Visual Attention
Authors: Wu Wei , Li Zhan , Miura Takumi , Hatori Yasuhiro , Tseng Chia-huei , Kuriki Ichiro , Sato Yoshiyuki , Shioiri Satoshi 
Published: May 2023

Abstract
Visual perception is closely related to body movements and action, and it is known that processing visual stimuli is facilitated at the hand or at the hand-movement goal. Such facilitation suggests that there may be an attentional process associated with the hands or hand movements. To investigate the underlying mechanisms of visual attention at a hand-movement goal, we conducted two experiments to examine whether attention at the hand-movement goal is a process independent from endogenous attention. Endogenous attention is attention that is intentionally focused on a location, feature, or object. We controlled the hand-movement goal and endogenous attention separately to investigate the spatial profiles of the two types of attention. A visual target was presented either at the goal of hand movement (same condition) or at its opposite side (opposite condition) while steady-state visual-evoked potential (SSVEP) was used to estimate the spatial distributions of the facilitation effect from the 2 types of attention around the hand-movement goal and around the visual target through EEG. We estimated the spatial profile of attentional modulation for the hand-movement goal by taking the difference in SSVEP amplitude between conditions with and without hand movement, thereby obtaining the effect of visual endogenous attention alone. The results showed a peak at the hand-movement goal, independent of the location of the visual target where participants intentionally focused their attention (endogenous attention). We also found differences in the spatial extent of attentional modulation. Spatial tuning was narrow around the hand-movement goal (i.e., attentional facilitation only at the goal location) but was broadly tuned around the focus of endogenous attention (i.e., attentional facilitation spreading over adjacent stimulus locations), which was obtained from the condition without hand movement. These results suggest the existence of two separate mechanisms, one underlying the attention at the hand-movement goal and another underlying endogenous attention.
Sentential Contextual Facilitation of Auditory Word Processing Builds Up during Sentence Tracking
Authors: Wu Min , Bosker Hans Rutger , Riecke Lars 
Published: May 2023

Abstract
While listening to meaningful speech, auditory input is processed more rapidly near the end (vs. beginning) of sentences. Although several studies have shown such word-to-word changes in auditory input processing, it is still unclear from which processing level these word-to-word dynamics originate. We investigated whether predictions derived from sentential context can result in auditory word-processing dynamics during sentence tracking. We presented healthy human participants with auditory stimuli consisting of word sequences, arranged into either predictable (coherent sentences) or less predictable (unstructured, random word sequences) 42-Hz amplitude-modulated speech, and a continuous 25-Hz amplitude-modulated distractor tone. We recorded RTs and frequency-tagged neuroelectric responses (auditory steady-state responses) to individual words at multiple temporal positions within the sentences, and quantified sentential context effects at each position while controlling for individual word characteristics (i.e., phonetics, frequency, and familiarity). We found that sentential context increasingly facilitates auditory word processing as evidenced by accelerated RTs and increased auditory steady-state responses to later-occurring words within sentences. These purely top–down contextually driven auditory word-processing dynamics occurred only when listeners focused their attention on the speech and did not transfer to the auditory processing of the concurrent distractor tone. These findings indicate that auditory word-processing dynamics during sentence tracking can originate from sentential predictions. The predictions depend on the listeners' attention to the speech, and affect only the processing of the parsed speech, not that of concurrently presented auditory streams.
Identifying the Neural Bases of Math Competence Based on Structural and Functional Properties of the Human Brain
Authors: Ren Xueying , Libertus Melissa E. 
Published: May 2023

Abstract
Human populations show large individual differences in math performance and math learning abilities. Early math skill acquisition is critical for providing the foundation for higher quantitative skill acquisition and succeeding in modern society. However, the neural bases underlying individual differences in math competence remain unclear. Modern neuroimaging techniques allow us to not only identify distinct local cortical regions but also investigate large-scale neural networks underlying math competence both structurally and functionally. To gain insights into the neural bases of math competence, this review provides an overview of the structural and functional neural markers for math competence in both typical and atypical populations of children and adults. Although including discussion of arithmetic skills in children, this review primarily focuses on the neural markers associated with complex math skills. Basic number comprehension and number comparison skills are outside the scope of this review. By synthesizing current research findings, we conclude that neural markers related to math competence are not confined to one particular region; rather, they are characterized by a distributed and interconnected network of regions across the brain, primarily focused on frontal and parietal cortices. Given that human brain is a complex network organized to minimize the cost of information processing, an efficient brain is capable of integrating information from different regions and coordinating the activity of various brain regions in a manner that maximizes the overall efficiency of the network to achieve the goal. We end by proposing that frontoparietal network efficiency is critical for math competence, which enables the recruitment of task-relevant neural resources and the engagement of distributed neural circuits in a goal-oriented manner. Thus, it will be important for future studies to not only examine brain activation patterns of discrete regions but also examine distributed network patterns across the brain, both structurally and functionally.
Ethnic Reconciliation from the Margins
Authors: Ndereba Kevin Muriithi 
Published: May 2023

Abstract
The Kenyan post-election violence of 2007 deepened the ethnic differences that have been growing for the past decades after independence. While the August 2022 elections revealed political maturity, the October 2017 re-elections indicated that the hostility was not a settled issue. Kenyan churches in the post-democratic space have courted with political alliances along ethnic blocs. Additionally, some of the protestant churches in Kenya such as Presbyterian, Methodist and Friends, are largely monoethnic despite their long history. To what extent can these churches follow the biblical vision of a multi-cultural and multi-ethnic church? This topic has generated theological interest yet few have assessed the role of the youth in ethnic reconciliation. This article will 1) survey the issue of ethnicity and the church; 2) offer a biblical-theological reflection on ethnicity, and 3) suggest how an inclusive-congregational youth ministry model can revitalize ethnic reconciliation in the church and by extension, society.
Nomads and Warlords, Chadian Forces in African Peace Operations
Authors: Tchie Andrew E. Yaw 
Published: May 2023

Abstract
Despite criticism of the United Nations (UN) as peacekeepers “hiding behind sandbags,” by the former president of Chad, the Chadian military has become a critical enabler of African-led and UN peace operations. This paper posits that the effectiveness of the Chadian forces stems from refined and modified nomad and warlord structures and attributes used during Chad’s various conflicts to build and improve its national army. This has allowed the Chadian regime to exercise and project power, thus, producing one of Africa’s most effective forces for current conflicts and challenges. Thus, Chad’s military leadership reflects a trend of states that use military prowess to project force, while maintaining international partnerships with permanent members of the unsc (the US and France), UN peacekeeping missions and African ad hoc security initiatives. Finally, the paper examines the implications of this trend for the evolving nature of African Peace and Security Architecture.