bluuebunny/crossref_metadata_2025_split huggingface dataset:
The incidence and characteristics of clinically relevant blunt cerebrovascular injury at an adult level 1 trauma centre: A retrospective cohort study
Authors: Stanislaus Vimal , Mitra Biswadev , Zhang Wen Wen , Richardson Tom E , Ng Nico , Picker Bjoern , Madan Anoop , Mathew Joseph , Fitzgerald Mark , Cloud Geoffrey 
Published: July 2023

Introduction Blunt cerebrovascular injuries (BCVIs) are uncommon but associated with ischemic stroke and disability, particularly in younger adults. There is a paucity of literature on the incidence and risk factors for BCVI. The aim of this study was to report the incidence and clinical characteristics of patients diagnosed with BCVI at an adult level 1 trauma centre. Methods This was a registry-based cohort study. The accessible sample was all patients in the Alfred Hospital Trauma Registry (AHTR) who presented from January 2014 to June 2021 and were recorded to have BCVI. The diagnosis of BCVI was confirmed by independent, blinded neuroradiologists prior to study inclusion. Demographics, injury mechanism and associated injuries of patients were extracted from the AHTR and patient medical records. Results There were 20,954 blunt trauma patients in the AHTR during the study period, of which 300 patients were confirmed to have 428 BCVIs. The incidence of BCVI was 1.4% (95%CI: 1.3–1.6). The mortality rate was 14% with a median survival time of 86 h from the time of injury. More men (65%) were diagnosed with BCVI than women and motor vehicle crashes (n  =  180; 60%) were the most common mechanism of injury. Younger age, high transfer mechanisms, high injury severity, brain and chest trauma were associated with carotid artery injuries, while vertebral artery injuries were associated with older age, higher presenting GCS and cervical spinal injuries. Conclusion The incidence of BCVI was low. The risk profile for patients with CAIs and VAIs were different. Consistent with the modified Denver criteria, high energy transfer mechanisms and cervical spinal injuries were identified to be high-risk features, but they impacted carotid and vertebral arteries differently. Any trauma involving these mechanisms should trigger investigation for the detection of BCVIs.
A novel endoleak classification for intracranial aneurysm flow diversion: A retrospective case series
Authors: Kashkoush Ahmed , Moore Nina Z. , El-Abtah Mohamed E. , Achey Rebecca , Toth Gabor , Bain Mark 
Published: July 2023

Background Although flow diversion (FD) is safe and effective in the treatment of intracranial aneurysms, a subset tends to continue filling on serial angiography. Risk factors for failed flow diversion include old age, large aneurysm size, and overstenting an adjacent end-arterial vessel. The hemodynamic modes of persistent aneurysm filling, or ‘endoleaks’, after FD are poorly understood. This study aims to characterize the various types of endoleaks following aneurysmal FD. Methods We performed a retrospective review of a prospectively maintained database of all endovascular procedures performed at a single institution between 2017 and 2021. Patients were included if they demonstrated evidence of unique modes of intracranial aneurysm filling after FD. Data regarding treatment, follow-up angiography, as well as clinical course were collected. Results Five patients (mean age 50 years, four females) were included with mean 19-month angiographic follow-up. Five major endoleak types are proposed: Type 1 – due to graft porosity (A – low flow, B – high flow), Type 2 –through an overstented branch vessel, Type 3 – via stent migration no longer covering aneurysmal neck, Type 4 – endoleak due to malapposition of the stent wall, and Type 5 – endoleak via collateralization from adjacent blood vessels. All endoleak types were represented, except for the Type 4 endoleak. Conclusion We propose an endoleak classification scheme to describe the hemodynamic modes of failure following FD of intracranial aneurysms. Future studies are needed to evaluate the natural history of aneurysmal filling following FD and retreatment success according to endoleak type.
An Analysis of Medical Malpractice Litigation Involving Mandibular Fractures
Authors: Brozynski Martina , Seyidova Nargiz , Oleru Olachi , Rew Curtis , Roy Nikita , Taub Peter J. 
Published: July 2023

Background: With an increase in medical litigation, fractures of the mandible are not an uncommon source of legal action. The present study sought to conduct a comprehensive analysis of mandibular fracture malpractice cases. Specifically, the aim was to focus on the reasons a suit is brought, the outcomes, and the compensatory damages of litigation. The information is valuable to physicians as it may serve to minimize the risk of malpractice suits. Methods: The Westlaw and Lexis Nexis databases were searched for jury verdicts and settlements related to mandibular fracture malpractice lawsuits. Cases that did not meet the inclusion criteria, duplicate cases, and those for which enough information was not available were excluded. The data included reasons, outcomes, and monetary outcomes of litigations, as well as defendant specialty, location, year, and plaintiff demographics. Results: A total of 55 included cases spanned between 1970 and 2019. Of these, the most common reason a suit was brought included the defendant’s failure to make the diagnosis, which was noted in 27%. In 71% of the cases, the defendant was a surgeon; with 25% of these cases involving a plastic surgeon. Cases were resolved in favor of the defendant 51% of the time. Regarding outcome, 53% had a monetary outcome of $0. Conclusions: Although a slight majority of cases (51%) resulted in an outcome favoring the defendant, significant monetary consequences against the defendant were possible in cases when the plaintiff prevailed. Since failure to diagnose was the most common reason for a plaintiff to pursue litigation, physicians should thoroughly evaluate patients with suspected mandibular fractures to avoid litigation.
Evaluation of newly developed wearable ear canal thermometer, mimicking the application to activities on sports and labor fields
Authors: Kato Issei , Watanabe Hironori , Nagashima Kei 
Published: July 2023

AbstractWe evaluated the reliability of a newly developed wearable ear canal thermometer based on three different experiments, in which ear canal and rectal temperature (Tear and Trec, respectively) were simultaneously monitored. In Experiment 1, participants sat at 28 °C and 50% relative humidity (RH), during which fanning or 41 °C lower legs water immersion was conducted. In Experiment 2, participants conducted a 70-min treadmill exercise (4 km/h, 0.5% slope) at 35 °C and 50% RH with intermittent fanning. In Experiment 3, participants completed a 20 min treadmill exercise (6 km/h, 5% slope) at 35 °C and 65% RH. Bland–Altman analysis for Tear and Trec showed the difference of − 0.2–0.3 °C and the limit of agreement of the mean ± 0.3–0.6 °C. The intraclass correlation coefficient was 0.44–0.83. The results may suggest that the ear canal thermometer is useful to assess core body temperature in sports and/or labor fields.
New silicate-substituted hydroxyapatite materials doped with silver ions as potential antifungal agents
Authors: Piecuch Agata , Targońska Sara , Rewak-Sorczyńska Justyna , Ogórek Rafał , Wiglusz Rafal J. 
Published: July 2023

Abstract
Background
Hydroxyapatites (HAp) are widely used as medical preparations for e.g., bone replacement or teeth implants. Incorporation of various substrates into HAp structures could enhance its biological properties, like biocompatibility or antimicrobial effects. Silver ions possess high antibacterial and antifungal activity and its application as HAp dopant might increase its clinical value.

Results
New silicate-substituted hydroxyapatites (HAp) doped with silver ions were synthesized via hydrothermal methods. The crystal structure of HAp was investigated by using the X-ray powder diffraction. Antifungal activity of silver ion-doped HAp (with 0.7 mol%, 1 mol% and 2 mol% of dopants) was tested against the yeast-like reference and clinical strains of Candida albicans, C. glabrata, C. tropicalis, Rhodotorula rubra, R. mucilaginosa, Cryptococcus neoformans and C. gattii. Spectrophotometric method was used to evaluate antifungal effect of HAp in SD medium. It was shown that already the lowest dopant (0.7 mol% of Ag+ ions) significantly reduced fungal growth at the concentration of 100 µg/mL. Increase in the dopant content and the concentration of HAp did not cause further growth inhibition. Moreover, there were some differences at the tolerance level to Ag+ ion-doped HAp among tested strains, suggesting strain-specific activity.

Conclusions
Preformed studies confirm antimicrobial potential of hydroxyapatite doped with silver. New Ag+ ion-HAp material could be, after further studies, considered as medical agent with antifungal properties which lower the risk of a surgical-related infections.
Happy people live longer because they are healthy people
Authors: Song Cai Feng , Tay Peter Kay Chai , Gwee Xinyi , Wee Shiou Liang , Ng Tze Pin 
Published: July 2023

Abstract
Objectives
Higher levels of happiness are associated with longer life expectancy. Our study assessed the extent to which various factors explain the protective effect of happiness on all-cause mortality risk, and whether the association differs between older men and women.

Methods
Using data from the Singapore Longitudinal Aging Studies (N = 6073) of community-dwelling older adults aged ≥ 55 years, we analyzed the association of baseline Likert score of happiness (1 = very sad to 5 = very happy) and mortality from mean 11.7 years of follow up. Cox regression models were used to assess the extent to which confounding risk factors attenuated the hazard ratio of association in the whole sample and sex-stratified analyses.

Results
Happiness was significantly associated with lower mortality (p < .001) adjusted for age, sex and ethnicity: HR = 0.85 per integer score and HR = 0.57 for fairly-or-very happy versus fairly-or-very sad. The HR estimate (0.90 per integer score) was modestly attenuated (33.3%) in models that included socio-demographic and support, lifestyle or physical health and functioning factor, but remained statistically significant. The HR estimate (0.94 per integer score) was substantially attenuated (60%) and was insignificant in the model that included psychological health and functioning. Including all co-varying factors in the model resulted in statistically insignificant HR estimate (1.04 per integer score). Similar results were obtained for HR estimates for fairly-to-very happy versus fairly-to- very sad).

Discussion
Much of the association between happiness and increased life expectancy could be explained by socio-demographic, lifestyle, health and functioning factors, and especially psychological health and functioning factors.
Social participation of older people in urban and rural areas: Canadian Longitudinal Study on Aging
Authors: Jones C. Allyson , Jhangri Gian S. , Yamamoto Shelby S. , Hogan David B. , Hanson Heather , Levasseur Mélanie , Morales Ernesto , Légaré France 
Published: July 2023

Abstract
Background and objectives
Although the positive influence of social activity on health is now well-established, a complex relationship exists among social participation, personal, social and the environment. Social participation of older adults was examined in rural and urban settings to identify features of the built-environment and perception of neighborhood specific to the locale.

Research Design and methods
Using cross-sectional data from the Canadian Longitudinal Study on Aging (CLSA), we examined social participation and health of older people (65 + yrs) in relation to the built environment and sociocultural contexts for urban and rural areas. A social participation index was derived from responses on the frequency of participating in 8 social activities over the past 12 months. Personal, household and neighborhood indicators were examined to develop multivariable regression models for social participation in urban and rural cohorts.

Results
No meaningful differences were seen with the frequency of social participation between rural and urban settings; however, the type of community-related activities differed in that a greater proportion of urban participants reported sports and educational/cultural events than rural participants. Service club activities were greater for rural than urban participants. Different neighborhood features were statistically significant factors in explaining social participation in rural than in urban locales, although transportation was a significant factor regardless of locale. Trustworthiness, belonging and safety were perceived factors of the neighborhood associated with higher social participation for rural participants.

Discussion and implications
The relationship between home and health becomes stronger as one ages. Social and physical features of built environment specific to urban and rural settings need to be considered when implementing appropriate social activities for older people.
Intervention patterns and preliminary effectiveness on Social Participation following stroke: a scoping review
Authors: Zhou Xuan , Du Minxia , Dai Xiaojie , Zhu Shenghui , Zhou Lanshu , Li Xuemei 
Published: July 2023

Abstract
Background
Stroke survivors suffer an overall loss of social participation. However, the interventions aiming at improving social participation have not yet been well-established. There is a need to synthesize existing knowledge on clinical interventions aiming at improving social participation among people with stroke.

Objective
To describe the patterns of intervention that have been applied to stroke survivors to improve social participation and to determine the preliminary effects of these patterns.

Methods
Eight online databases, including Cochrane Library, PubMed, Web of Science, Embase, Medline, CINAHL plus, PsycINFO, and Scoups were searched with predefined search terms from inception to September 22, 2022. References of included articles and previous reviews were also checked to identify additional studies. Two reviewers independently selected eligible studies and extracted data from the included articles.

Results
A total of 98 studies were included, of which only 25 studies considered social participation as primary outcome of clinical interventions. The patterns of intervention were various, consisting of exercise-based intervention, occupational therapy, self-management program, and complex intervention. Of the 25 studies, eight studies found a positive effect of relative clinical intervention on social participation for stroke survivors. Of note, the same modality of intervention such as exercise-based intervention and self-management program produced paradoxical conclusion on social participation.

Conclusion
Exercised-based intervention, occupational therapy, self-management program, and complex intervention were important intervention modalities for the improvement of social participation among stroke survivors. Even though the preliminary effectiveness on social participation seems to be potentially positive, further high-quality researches are still required to reach a consensus to achieve optimal social participation among stroke survivors.
Adrenocortical pheochromocytoma diagnosed during pregnancy: a case report
Authors: Qiang Xiaoteng , Li Yin , Bai Qing , Huang Jing , Ma Xuemei , Wang Weiwei 
Published: July 2023

AbstractThis paper reports a rare case of adrenocortical carcinoma (ACC) diagnosed during pregnancy presenting with gestational hypertension. Hypertensive disorders in pregnancy should receive enough attention to identify and exclude the possibility of adrenal diseases, thereby making a timely diagnosis and active treatment.
Uncharted territory: a narrative review of parental involvement in decision-making about late preterm and early term delivery
Authors: Mielewczyk Frances J , Boyle Elaine M 
Published: July 2023

AbstractAlmost 30% of live births in England and Wales occur late preterm or early term (LPET) and are associated with increased risks of adverse health outcomes throughout the lifespan. However, very little is known about the decision-making processes concerning planned LPET births or the involvement of parents in these. This aim of this paper is to review the evidence on parental involvement in obstetric decision-making in general, to consider what can be extrapolated to decisions about LPET delivery, and to suggest directions for further research.A comprehensive, narrative review of relevant literature was conducted using Medline, MIDIRS, PsycInfo and CINAHL databases. Appropriate search terms were combined with Boolean operators to ensure the following broad areas were included: obstetric decision-making, parental involvement, late preterm and early term birth, and mode of delivery.This review suggests that parents’ preferences with respect to their inclusion in decision-making vary. Most mothers prefer sharing decision-making with their clinicians and up to half are dissatisfied with the extent of their involvement. Clinicians’ opinions on the limits of parental involvement, especially where the safety of mother or baby is potentially compromised, are highly influential in the obstetric decision-making process. Other important factors include contextual factors (such as the nature of the issue under discussion and the presence or absence of relevant medical indications for a requested intervention), demographic and other individual characteristics (such as ethnicity and parity), the quality of communication; and the information provided to parents.This review highlights the overarching need to explore how decisions about potential LPET delivery may be reached in order to maximise the satisfaction of mothers and fathers with their involvement in the decision-making process whilst simultaneously enabling clinicians both to minimise the number of LPET births and to optimise the wellbeing of women and babies.
Malaysian burden of disease: years of life lost due to premature deaths
Authors: Khaw Wan-Fei , Chan Yee Mang , Nasaruddin Nur Hamizah , Alias Nazirah , Tan LeeAnn , Ganapathy Shubash Shander 
Published: July 2023

Abstract
Background
In Malaysia, the previous mortality burden has been a significant concern, particularly due to the high prevalence of noncommunicable diseases (NCDs) as the leading cause of death. Estimates of mortality are key indicators for monitoring population health and determining priorities in health policies and health planning. The aim of this study was to estimate the disease burden attributed to 113 major diseases and injuries in Malaysia in 2018 using years of life lost (YLL) method.

Methods
This study included all deaths that occurred in Malaysia in 2018. The YLL was derived by adding the number of deaths from 113 specific diseases and multiplying it by the remaining life expectancy for that age and sex group. Data on life expectancy and mortality were collected from the Department of Statistics Malaysia.

Results
In 2018, there were 3.5 million YLL in Malaysia. Group II (NCDs) caused 72.2% of total YLL. Ischaemic heart disease was the leading cause of premature mortality among Malaysians (17.7%), followed by lower respiratory infections (9.7%), road traffic injuries (8.7%), cerebrovascular disease (stroke) (8.0%), and diabetes mellitus (3.9%).

Conclusions
NCDs are a significant health concern in Malaysia and are the primary contributor to the overall burden of disease. These results are important in guiding the national health systems on how to design and implement effective interventions for NCDs, as well as how to prioritise and allocate healthcare resources. Key strategies to consider include implementing health promotion campaigns, adopting integrated care models, and implementing policy and regulatory measures. These approaches aim to enhance health outcomes and the managements of NCDs in Malaysia.
Does intramedullary nail have advantages over dynamic hip screw for the treatment of AO/OTA31A1-A3? A meta-analysis
Authors: Yu Fei , Tang Yang-Wei , Wang Ju , Lin Zhi-Cheng , Liu Yu-Bin 
Published: July 2023

Abstract
Background
Hip fractures are still unsolved problems nowadays. We evaluated the functional outcomes and complications in the treatment of hip fractures (AO/OTA31A1-A3) to find potential difference and risk between intramedullary nail (IMN) and dynamic hip screw (DHS).

Method
We searched PubMed, Embase, Cochrane library up to 19 June 2023 and retrieved any studies comparing IMN and DHS in treatment of Hip fractures. The main outcomes and complications were extracted from the included studies. The fixed-effect model was selected to pool the data for homogeneous studies (I2 < 50%). Otherwise, the random effects model was selected (heterogeneity, I2 > 50%). The analysis of sensitivity and subgroup was performed to explore the homogeneous studies among studies. The p-value of less than 0.05 was considered statistically significant.

Results
30 RCT studies were included in this meta-analysis. There were significant difference of in the items of blood loss, screening time, femoral neck shortening, non-union, and femoral fractures (p < 0.05). Significant difference was found in the parameter of open reduction of fracture after sensitive analysis (p < 0.05). No significant difference was found in the parameter of Mobility Score at the last follow-up after sensitive analysis (p ≥ 0.05). There was no significant difference in the parameters of open reduction of fracture, required blood transfusion, mean surgical time, hospital stays, time to healing, mean Harris Hip Score, infection, cut out, poor reduction, breakage of implant, failure of fixation, reoperation, and systemic complications of chest infection, decubital ulcer, urinary tract infection and persistent pain in the hip (p ≥ 0.05).

Conclusions
Our meta-analysis revealed that hip fractures treated with IMN have merits with lower rate of blood loss, femoral neck shortening and non-union; shortcoming of increased risk of femoral fractures. It is suggested that special attention should be paid to the risk of femoral fracture when intramedullary nail was inserted in the intraoperative.
Anticancer properties of red beetroot hydro-alcoholic extract and its main constituent; betanin on colorectal cancer cell lines
Authors: Saber Amir , Abedimanesh Nasim , Somi Mohammad-Hossein , Khosroushahi Ahmad Yari , Moradi Shima 
Published: July 2023

AbstractColorectal cancer (CRC) is the third most common type of cancer worldwide. Red beetroot (Beta vulgaris) contains Betanin as its major betacyanin, possessing wide proapoptotic effects. This study aimed to investigate the anticancer and pro-papoptotic effects of beetroot hydro-alcoholic extract (BHE) and betanin, on colorectal cancer cell lines. BHE and betanin were used to treat Caco-2 and HT-29 colorectal cancer cells. MTT assay, DAPI staining, and FACS-flow cytometry tests were used to determine the half-maximal inhibitory concentration (IC50) and apoptosis-inducing evaluations. Intended genes were assessed by real-time polymerase chain reaction (RT-PCR). The IC50 for HT-29 and Caco-2 cell lines were 92 μg/mL, 107 μg/mL for BHE, and 64 μg/mL, 90 μg/mL for betanin at 48 h, respectively. BHE and betanin significantly inhibited the growth of both cancer cell lines time and dose-dependently. DAPI staining and flow cytometry results revealed significant apoptosis symptoms in treated cancerous cell lines. The expression level of proapoptotic genes (BAD, Caspase-3, Caspase-8, Caspase-9, and Fas-R) in treated HT-29 and Caco-2 cells was higher than in untreated and normal cells. In contrast, the anti-apoptotic gene (Bcl-2) was significantly downregulated. BHE and betanin effectively inhibited cancer cell proliferation and induced apoptosis via the modification of effective genes.