bluuebunny/crossref_metadata_2025_split huggingface dataset:
Risk Factors for Sustaining a Second ACL Injury after Primary ACL Reconstruction in Female Football Players: A Study Investigating the Effects of Follow-Up Time and the Statistical Approach
Authors: Fältström Anne , Hägglund Martin , Kvist Joanna , Mendonça Luciana D. 
Published: May 2023

AbstractBackgroundStudies evaluating risk factors for sustaining an anterior cruciate ligament (ACL) injury have different, sometimes contrasting, results. Different follow-up times and statistical approaches may be a reason for these differences. The aim of this study was to explore if different follow-up times and statistical approaches, classification and regression tree (CART) analysis and Cox regression, would impact on the association between various candidate risk factors and ACL injury in female football players. In total, 112 active female football players, 18 ± 8 months after ACL reconstruction (mean age ± SD, 20 ± 2 years), were included and followed for at least 36 months. At baseline, all players underwent assessment of range of motion of knee and ankle joints, functional tests, and answered questionnaires regarding knee function, psychological and personality traits. Nineteen independent variables were included for the CART analysis and for univariable Cox regression and compared using four different follow-up times: 0–12, 0–24, 0–36, and 0–>36 months.ResultsForty-three (38%) players sustained a second ACL injury. The identified risk factors varied depending on follow-up time both with CART analysis and with Cox regression. CART identified 12 of the 19 independent variables and selected between 5 and 6 of the variables in the four different follow-up times associated with second ACL injury. The accuracy of the different follow-up times for the CART varied between 86 and 93% with 77–96% sensitivity and 70–81% specificity. Cox regression identified two risk factors: knee extension at 0–36 months and 0–>36 months, and time between primary injury and surgery at 0–>36 months. The accuracy varied between 54 and 64% with 44–88% sensitivity and 32–71% specificity.ConclusionsThe identified risk factors associated with a second ACL injury varied depending on the follow-up time and statistical approach used. Thus, in future research on risk factors, the time athletes are followed up and the type of statistical methods used are important to discuss.
Intracranial pressure monitoring in neurosurgery: the present situation and prospects
Authors: He Chenqi , Teng Chubei , Xiong Zujian , Lin Xuelei , Li Hongbo , Li Xuejun 
Published: May 2023

AbstractIntracranial pressure (ICP) is one of the most important indexes in neurosurgery. It is essential for doctors to determine the numeric value and changes of ICP, whether before or after an operation. Although external ventricular drainage (EVD) is the gold standard for monitoring ICP, more and more novel monitoring methods are being applied clinically.Invasive wired ICP monitoring is still the most commonly used in practice. Meanwhile, with the rise and development of various novel technologies, non-invasive types and invasive wireless types are gradually being used clinically or in the testing phase, as a complimentary approach of ICP management. By choosing appropriate monitoring methods, clinical neurosurgeons are able to obtain ICP values safely and effectively under particular conditions.This article introduces diverse monitoring methods and compares the advantages and disadvantages of different monitoring methods. Moreover, this review may enable clinical neurosurgeons to have a broader view of ICP monitoring.
The state of current research on COVID-19 and antibiotic use: global implications for antimicrobial resistance
Authors: Zyoud Sa’ed H. 
Published: May 2023

AbstractBackgroundDuring the initial stages of the coronavirus disease 2019 (COVID-19) pandemic, the administration of antibiotics to patients was prevalent in numerous countries. Despite this, the rising threat of antimicrobial resistance (AMR) presents a significant public health concern. The escalation of AMR has been exacerbated by the ongoing COVID-19 pandemic. Against this backdrop, the primary aim of this study was to conduct a bibliometric and visual analysis of research pertaining to the use of antibiotics in COVID-19.MethodsThis study examined documents indexed in Scopus between 2020 and 2022. To visualize the trends and hotspots of research related to antibiotics and COVID-19, as well as collaborative networks, the researcher utilized version 1.6.18 of the VOSviewer software. Scopus data were analysed to extract information on the types of publications, annual research output, countries, institutions, funding agencies, journals, citations, and highly cited references. Microsoft Excel 2019 was used to process and organize the extracted data.ResultsThis study analysed 1137 documents related to COVID-19 and antibiotics and found that the number of publications increased from 130 in 2020 to 527 in 2022. These publications included 777 (68.34%) articles and 205 (18.03%) reviews. The top five countries in terms of scientific production were the United States (n = 231; 20.32%), the United Kingdom (n = 156; 13.72%), China (n = 101; 8.88%), India (n = 100; 8.8%), and Italy (n = 63; 5.54%), and the leading institutions wereImperial College London(n = 21; 1.85%),University of Oxford(n = 20; 1.76%), andUniversity College London(n = 15; 1.32%). TheNational Natural Science Foundation of Chinaprovided funding for the highest number of articles (n = 48; 4.22%), followed by theNational Institutes of Health(n = 32; 2.81%). The most productive journals wereAntibiotics(n = 90; 7.92%),Journal of Antimicrobial Chemotherapy(n = 30; 2.64%), andInfection Control and Hospital Epidemiology(n = 26; 2.29%). Finally, the research hotspots identified in this study were ‘antimicrobial stewardship during the COVID-19 outbreak’ and ‘implicationsof the COVID-19 pandemic on the emergence of antimicrobial resistance.’ConclusionsThis is the first bibliometric analysis of COVID-19-related research on antibiotics. Research was carried out in response to global requests to increase the fight against AMR and awareness of the issue. More restrictions on the use of antibiotics are urgently needed from policy makers and authorities, more so than in the current situation.
The Ragulator complex: delving its multifunctional impact on metabolism and beyond
Authors: Tsujimoto Kohei , Takamatsu Hyota , Kumanogoh Atsushi 
Published: May 2023

AbstractOur understanding of lysosomes has undergone a significant transformation in recent years, from the view that they are static organelles primarily responsible for the disposal and recycling of cellular waste to their recognition as highly dynamic structures. Current research posits that lysosomes function as a signaling hub that integrates both extracellular and intracellular stimuli, thereby regulating cellular homeostasis. The dysregulation of lysosomal function has been linked to a wide range of diseases. Of note, lysosomes contribute to the activation of mammalian target of rapamycin complex 1 (mTORC1), a key regulator of cellular metabolism. The Ragulator complex, a protein complex anchored on the lysosomal membrane, was initially shown to tether the mTORC1 complex to lysosomes. Recent research has substantially expanded our understanding of the roles of the Ragulator complex in lysosomes, including roles in the regulation of metabolism, inflammation, cell death, cell migration, and the maintenance of homeostasis, via interactions with various proteins. This review summarizes our current knowledge on the diverse functions of the Ragulator complex, highlighting important protein interactions.
Three-stage day-ahead scheduling strategy for regional thermostatically controlled load aggregators
Authors: Fan Dejin , Zhang Shu , Huang He , Zhou Liping , Wang Yang , Xiao Xianyong 
Published: May 2023

AbstractThermostatically controlled loads (TCLs) are regarded as having potential to participate in power grid regulation. This paper proposes a scheduling strategy with three-stage optimization for regional aggregators jointly participating in day-ahead scheduling to support demand response. The first stage is on the profit of aggregators and peak load of the grid. The line loss and voltage deviation of regulation are considered to ensure stable operation of the power grid at the second stage, which guarantees the fairness of the regulation and the comfort of users. A single temperature adjustment strategy is used to control TCLs to maximize the response potential in the third stage. Finally, digital simulation based on the IEEE 33-bus distribution network system proves that the proposed three-stage scheduling strategy can keep the voltage deviation within ± 5% in different situations. In addition, the Gini coefficient of distribution increases by 20% and the predicted percentage of dissatisfied is 48% lower than those without distribution.
Outpatient physical therapy bundled payment models are feasible for total hip arthroplasty patients: an evaluation of utilization, cost and outcomes
Authors: Stock Laura A. , Johnson Andrea H. , Brennan Jane C. , Turcotte Justin J. , King Paul J. , MacDonald James H. 
Published: May 2023

Abstract
Background
Various episode-of-care bundled payment models for patients undergoing total joint arthroplasty have been implemented. However, participation in bundled payment programs has dropped given the challenges of meeting continually lower target prices. The purpose of our study is to investigate the cost of outpatient physical therapy (PT) and the potential for stand-alone outpatient PT bundled payments for patients undergoing total hip arthroplasty (THA).

Methods
A retrospective review of 501 patients who underwent primary unilateral THA from November 2017 to February 2020 was performed. All patients included in this study received postoperative PT care at a single hospital-affiliated PT practice. Patients above the 75th percentile of therapy visits were then classified as high-PT utilizers and compared with the rest of the population using univariate statistics. Stepwise multivariate logistic regression was used to assess the predictors of high therapy utilization.

Results
Patients averaged 65 ± 10 years of age and a BMI of 29 ± 5 kg/m2. Overall, 80% of patients were white and 53% were female. The average patient had 11 ± 8 total therapy sessions in 42 days: one initial evaluation, one re-evaluation and 9 standard sessions. High-PT utilizers incurred estimated average costs of $1934 ± 431 per patient, compared to $783 ± 432 (P < 0.001) in the rest of the population. Further, no significant differences in 90-day outcomes including lower extremity functional scale scores, emergency department returns, readmissions, or returns to the operating room were observed between high utilizers and the rest of the population (all P > 0.08). In the multivariate analysis, women (OR = 1.68, P = 0.017) and those with sleep apnea (OR = 2.02, P = 0.012) were nearly twice as likely to be high utilizers, while white patients were 42% less likely to be high utilizers than patients of other races (OR = 0.58, P = 0.028).

Conclusions
Outpatient PT utilization is highly variable in patients undergoing THA. However, despite using more services and incurring increased cost, patients in the top quartile of utilization experienced similar outcomes to the rest of the population. If outpatient therapy bundles are to be developed, 16 visits appear to be a reasonable target for pricing, given this provides adequate coverage for 75% of THA patients.
The Echo of Voices after the Fall of the Aztec Empire
Authors: Hidalgo Alex 
Published: May 2023

AbstractThe recent quincentennial of the Mexica forces' defeat at the hands of a Spanish-led coalition invites us to reflect on the changes in the region's acoustic ecology, the layers of sound that reverberated across geographic spaces. Expressions of sound allow us to consider the actions of past actors in relation to their physical surroundings, the stimulation of the senses, and patterns of religious conversion that guided social behavior. Vocal sounds produced by people of various ethnic and racial backgrounds formed part of this aural environment, and they carried meaning that has often escaped the attention of scholars. An analysis of routines of indoctrination centered on vocal modulations reveals that authorities hierarchized different forms of sounds, from singing and praying—which they encouraged—to screams and muffled noises such as murmur and chatter—which they attempted to silence. These routines took shape during daily masses, theater presentations, civic and religious rituals, confession, and, in some cases, formal training.
Family Norms and Declining First-Marriage Rates: The Role of Sibship Position in the Japanese Marriage Market
Authors: Uchikoshi Fumiya , Raymo James M. , Yoda Shohei 
Published: May 2023

AbstractThis study explores how changes in sibship composition associated with fertility decline may, in conjunction with entrenched family norms and expectations associated with specific sibship positions, impact marriage rates and further reduce fertility. We evaluate this possibility by focusing on Japan, a society characterized by half a century of below-replacement fertility and widely shared family norms that associate eldest (male) children with specific family obligations. Harmonic mean models allow us to quantify the contribution of changes in both marriage market composition with respect to sibship position and sibship-specific pairing propensities to the observed decline in marriage rates between 1980 and 2010. One important finding is that marriage propensities are lower for those pairings involving men and women whose sibship position signals a higher potential of caregiving obligations, especially only-children. Another is that changes in marriage propensities, rather than changing sibship composition, explain most of the observed decline in marriage rates. We also found that marriage propensity changes mitigate the impact of the changing sibship composition to some extent. However, the limited contribution of changing sibship composition to the decline in first-marriage rates provides little support for a self-reinforcing fertility decline via the relationship between changing sibship composition and marriage behavior.
Archaeology of the Eyeball: Lu Xun, Eye-Gouging Myth, and Ocular Anatomy
Authors: Teng Tim Shao-Hung 
Published: May 2023

Abstract
This article situates Lu Xun at the intersection of late-Qing folkloric discourse and medical science by studying his 1925 essay “Lun zhaoxiang zhilei” (“On Photography”). “On Photography” is a rich yet enigmatic piece of writing that has yet to receive critical attention on its own terms in the scholarship of either Lu Xun or Chinese visual culture. Lu Xun's essay includes a folklore account of “foreign devils” plucking out locals’ eyes and pickling them in a jar. Bracketing the magic lantern incident held by many as the primal scene of modern Chinese literature, this article suggests that Lu Xun's account of the eyeball offers a no less significant example of how an alternate optical device can be employed to reflect China's encounter with colonial modernity. Adopting the method of media archaeology, this article argues that Lu Xun's essay holds the key to tracing a genealogy of the eyeball from its embedment in feudal superstition to its embodiment of antimissionary sentiments, from figurative representation in Chinese medical classics to physiological simulation in anatomical treatises, and from anatomical visualization to optical abstraction and modulation. This genealogy constructs the eye as a historically valid subject that morphs from the eye to the eyeball and then to the eye again, a genealogy that is revealing of how China grappled through a crucial period of political, cultural, and scientific sea changes.
Nalanda Rising
Authors: Marston John , Geary David 
Published: May 2023

Abstract
While the memory of the ancient Nalanda University has often been invoked in recent years as a symbol of educational excellence and pan-Asian unity, particularly with reference to the creation of a new international university in Bihar, India, these discourses often overlook and erase the significance of Nava Nalanda Mahviahra that was created in India's postindependence period as an institute devoted to the study of Buddhist texts and languages near the archeological site of the ancient university. This article looks at the Indian Buddhist scholar Jagdish Kashyap and his role in creating the state-sponsored institute, the symbolism of cultural revival it represented, and the excitement it generated in international Buddhism, attracting monks and lay students from around the Buddhist world. The article also discusses the institute's links to China and its sensitive relation to the dynamics of the Cold War in the 1950s and ’60s. It then discusses how these two Nalanda insitutions speak to issues of heritage diplomacy and the politics of revival in contemporary India and beyond.
Perceived Utility of Intracranial Pressure Monitoring in Traumatic Brain Injury: A Seattle International Brain Injury Consensus Conference Consensus-Based Analysis and Recommendations
Authors: Chesnut Randall M. , Aguilera Sergio , Buki Andras , Bulger Eileen M. , Citerio Giuseppe , Cooper D. Jamie , Arrastia Ramon Diaz , Diringer Michael , Figaji Anthony , Gao Guoyi , Geocadin Romergryko G. , Ghajar Jamshid , Harris Odette , Hawryluk Gregory W. J. , Hoffer Alan , Hutchinson Peter , Joseph Mathew , Kitagawa Ryan , Manley Geoffrey , Mayer Stephan , Menon David K , Meyfroidt Geert , Michael Daniel B. , Oddo Mauro , Okonkwo David O. , Patel Mayur B. , Robertson Claudia , Rosenfeld Jeffrey V. , Rubiano Andres M. , Sahuquillo Juain , Servadei Franco , Shutter Lori , Stein Deborah M. , Stocchetti Nino , Taccone Fabio Silvio , Timmons Shelly D. , Tsai Eve C. , Ullman Jamie S. , Videtta Walter , Wright David W. , Zammit Christopher 
Published: May 2023

BACKGROUND:
Intracranial pressure (ICP) monitoring is widely practiced, but the indications are incompletely developed, and guidelines are poorly followed.

OBJECTIVE:
To study the monitoring practices of an established expert panel (the clinical working group from the Seattle International Brain Injury Consensus Conference effort) to examine the match between monitoring guidelines and their clinical decision-making and offer guidance for clinicians considering monitor insertion.

METHODS:
We polled the 42 Seattle International Brain Injury Consensus Conference panel members' ICP monitoring decisions for virtual patients, using matrices of presenting signs (Glasgow Coma Scale [GCS] total or GCS motor, pupillary examination, and computed tomography diagnosis). Monitor insertion decisions were yes, no, or unsure (traffic light approach). We analyzed their responses for weighting of the presenting signs in decision-making using univariate regression.

RESULTS:
Heatmaps constructed from the choices of 41 panel members revealed wider ICP monitor use than predicted by guidelines. Clinical examination (GCS) was by far the most important characteristic and differed from guidelines in being nonlinear. The modified Marshall computed tomography classification was second and pupils third. We constructed a heatmap and listed the main clinical determinants representing 80% ICP monitor insertion consensus for our recommendations.

CONCLUSION:
Candidacy for ICP monitoring exceeds published indicators for monitor insertion, suggesting the clinical perception that the value of ICP data is greater than simply detecting and monitoring severe intracranial hypertension. Monitor insertion heatmaps are offered as potential guidance for ICP monitor insertion and to stimulate research into what actually drives monitor insertion in unconstrained, real-world conditions.
Small studies in systematic reviews: To include or not to include?
Authors: El Alayli Abdallah , Thomas Preston , Jdiaa Sara , Mansour Razan , Gautam Archana , Phadnis Millind A. , El Mikati Ibrahim K. , Mustafa Reem A. 
Published: May 2023

Background: COVID-19 provided a real challenge for evidence synthesis due to the rapid growth of evidence. We aim to assess the impact of including all studies versus including larger studies only in systematic reviews when there is plethora of evidence. We use a case study of COVID-19 and chronic kidney disease (CKD). Methods: The review team conducted a systematic review of multiple databases. The review assessed the effect of CKD on mortality in patients with COVID-19. We performed a sensitivity analysis to assess the effect of study size on the robustness of the results based on cutoffs of 500, 1000 and 2000 patients. Results: We included 75 studies. Out of which there were 40 studies with a sample size of >2,000 patients, seven studies with 1,000-2,000 patients, 11 studies with 500-1,000 patients, and 17 studies with <500 patients. CKD increased the risk of mortality with a pooled hazard ratio (HR) 1.57 (95% confidence interval (CI) 1.42 - 1.73), odds ratio (OR) 1.86 (95%CI 1.64 - 2.11), and risk ratio (RR) 1.74 (95%CI 1.13 - 2.69). Across the three cutoffs, excluding the smaller studies resulted in no statistical significance difference in the results with an overlapping confidence interval. Conclusions: These findings suggested that, in prognosis reviews, it could be acceptable to limit meta-analyses to larger studies when there is abundance of evidence. Specific thresholds to determine which studies are considered large will depend on the context, clinical setting and number of studies and participants included in the review and meta-analysis.
Exploring Ghanaian medical students’ learning experiences during the COVID-19 lockdown: a case study of the University for Development Studies Medical School
Authors: Amalba Anthony , Amoore Bright Yammaha , Kpebu Sophia Ewuenye Adwoa , Abugri Bruce Ayabilla , Mogre Victor 
Published: May 2023

Background: Coronavirus disease (COVID-19) continues to affect health professions education, especially in developing and middle-income countries, even though alternative educational measures have been sanctioned to continue educating students in their homes while observing physical distancing. Methods: A qualitative cross-sectional study design was adopted for the study. Participants among the four departments of a Ghanaian medical school were treated as clusters, and a voluntary response sampling approach was used to recruit students across the clusters to respond to self-administered online Google interview questions on students’ learning experiences during the COVID-19 pandemic. Results: The study found that lack of supervision, lack of access to school library resources, overload of syllabi and the interference of household chores were major factors that made online learning difficult and ineffective during the COVID-19 lockdown. Most participants (n=133, 67%) described online learning as completely inadequate, ineffective and an expensive mode of learning which may not develop the necessary competence and skills required for effective clinical practice. Conclusions: Notwithstanding this, almost all students believed that combining face-to-face and online learning will significantly improve medical education. The COVID-19 pandemic brought about the increased use of online learning in the health professions that was accompanied with significant challenges for students.