bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Richmond Acute Subdural Hematoma Score: A Validated Grading Scale to Predict Postoperative Mortality
Authors: Dincer Alper , Stanton Amanda N. , Parham Kevin J. , Carr Matthew T. , Opalak Charles F. , Valadka Alex B. , Broaddus William C. 
Published: February 2022

BACKGROUND:
Traumatic acute subdural hematomas (aSDHs) are common, life-threatening injuries often requiring emergency surgery.

OBJECTIVE:
To develop and validate the Richmond acute subdural hematoma (RASH) score to stratify patients by risk of mortality after aSDH evacuation.

METHODS:
The 2016 National Trauma Data Bank (NTDB) was queried to identify adult patients with traumatic aSDHs who underwent craniectomy or craniotomy within 4 h of arrival to an emergency department. Multivariate logistic regression modeling identified risk factors independently associated with mortality. The RASH score was developed based on a factor's strength and level of association with mortality. The model was validated using the 2017 NTDB and the area under the receiver operating characteristic curve (AUC).

RESULTS:
A total of 2516 cases met study criteria. The patients were 69.3% male with a mean age of 55.7 yr and overall mortality rate of 36.4%. Factors associated with mortality included age between 61 and 79 yr (odds ratio [OR] = 2.3, P < .001), age ≥80 yr (OR = 6.3, P < .001), loss of consciousness (OR = 2.3, P < .001), Glasgow Coma Scale score of ≤8 (OR = 2.6, P < .001), unilateral (OR = 2.8, P < .001) or bilateral (OR = 3.9, P < .001) unresponsive pupils, and midline shift >5 mm (OR = 1.7, P < .001). Using these risk factors, the RASH score predicted progressively increasing mortality ranging from 0% to 94% for scores of 0 to 8, respectively (AUC = 0.72). Application of the RASH score to 3091 cases from 2017 resulted in similar accuracy (AUC = 0.74).

CONCLUSION:
The RASH score is a simple and validated grading scale that uses easily accessible preoperative factors to predict estimated mortality rates in patients with traumatic aSDHs who undergo surgical evacuation.
An enriched environment re-establishes metabolic homeostasis by reducing obesity-induced inflammation
Authors: Díaz de León-Guerrero Sol , Salazar-León Jonathan , Meza-Sosa Karla F. , Valle-Garcia David , Aguilar-León Diana , Pedraza-Alva Gustavo , Pérez-Martínez Leonor 
Published: February 2022

ABSTRACT
Obesity can lead to chronic inflammation in different tissues, generating insulin and leptin resistance and alterations in glucose and lipid metabolism, favoring the development of degenerative diseases, including type II diabetes. Congruently, the inflammatory signaling inhibition prevents the development of obesity and restores insulin sensitivity. Via the enhancement of central nervous system activity, an enriched environment (EE) has beneficial effects on learning and memory as well as on immune cell functions and inflammation in different disease models. Here, we explored whether an EE can restore energy balance in obese mice that previously presented metabolic alterations. We discovered that an EE improved glucose metabolism, increased insulin signaling in liver, and reduced hepatic steatosis and inflammation, and increased lipolysis and browning in the white adipose tissue of high-fat diet (HFD)-fed mice. Finally, we found reduced inflammatory signaling and increased anorexigenic signaling in the hypothalamus of HFD-fed mice exposed to an EE. These data indicate that an EE is able to restore the metabolic imbalance caused by HFD feeding. Thus, we propose EE as a novel therapeutic approach for treating obesity-related metabolic alterations.
This article has an associated First Person interview with the first author of the paper.
Sexual inactivation induced by the mucus that covers land snail love darts: sexual selection and evolution of allohormones in hermaphrodites
Authors: Shibuya Kaito , Chiba Satoshi , Kimura Kazuki 
Published: February 2022

ABSTRACT
The transfer of male accessory gland secretions is a well-investigated reproductive strategy for winning in sexual selection. An example of such a strategy is the conspicuous mating behaviour of simultaneously hermaphroditic land snails, the so-called shooting of love darts, whereby a snail drives a love dart(s) into the body of its mating partner. In the land snail Euhadra quaesita, it has been shown that a specific mucus which coats the love dart is transferred into the partner's haemolymph and that it suppresses subsequent matings in the darted individual. However, how the mucus of the love dart suppresses rematings remains unclear. In the present study, we tested the hypothesis that by injection of the dart mucus, love-dart shooters manipulate the physiology of a dart recipient and make the individual sexually inactive. In an experiment in which snails were provided with opportunities to encounter a potential mating partner, we found that the latency period to achieve sexual arousal was longer in snails injected with the dart mucus than in snails of the control treatments. This finding indicates that the dart mucus delays sexual arousal in injected snails. This delay in arousal is a novel example of the effects of the mucus in simultaneously hermaphroditic land snails. The remating suppression effect of the dart mucus is likely to occur through sexual inactivation.
Segmentation of metastatic cervical lymph nodes from CT images of oral cancers using deep-learning technology
Authors: Ariji Yoshiko , Kise Yoshitaka , Fukuda Motoki , Kuwada Chiaki , Ariji Eiichiro 
Published: February 2022

Objective: The purpose of this study was to establish a deep-learning model for segmenting the cervical lymph nodes of oral cancer patients and diagnosing metastatic or non-metastatic lymph nodes from contrast-enhanced computed tomography (CT) images. Methods: CT images of 158 metastatic and 514 non-metastatic lymph nodes were prepared. CT images were assigned to training, validation, and test datasets. The colored images with lymph nodes were prepared together with the original images for the training and validation datasets. Learning was performed for 200 epochs using the neural network U-net. Performance in segmenting lymph nodes and diagnosing metastasis were obtained. Results: Performance in segmenting metastatic lymph nodes showed recall of 0.742, precision of 0.942, and F1 score of 0.831. The recall of metastatic lymph nodes at level II was 0.875, which was the highest value. The diagnostic performance of identifying metastasis showed an area under the curve (AUC) of 0.950, which was significantly higher than that of radiologists (0.896). Conclusions: A deep-learning model was created to automatically segment the cervical lymph nodes of oral squamous cell carcinomas. Segmentation performances should still be improved, but the segmented lymph nodes were more accurately diagnosed for metastases compared with evaluation by humans.
Human Proteinase 3, an important autoantigen of c-ANCA associated vasculitis, shares cross-reactive epitopes with serine protease allergens from mites: an in silico analysis
Authors: Buendía Emiro , Marlon Múnera , Parra Orlando , Sánchez María , Sánchez Andrés , Sánchez Jorge , Viasus Diego 
Published: February 2022

Background: In autoimmune vasculitis, autoantibodies to Human Proteinase 3 (PR3), a human serine protease, seems to have a role on the inception of c-ANCA associated vasculitis. The origin of this autoreactive response remains unclear. However, for several autoreactive responses, molecular mimicry between environmental antigens and human proteins is key to trigger autoantibodies and finally autoimmunity manifestations. Considering that PR3 is a serine protease and house dust mite (HDM) group 3 allergens share this biochemical activity, the aim of this study was to identify cross-reactive epitopes between serine proteases from human and mites using an in silico approach. Methods: Multi alignment among amino acid sequences of PR3 and HDM group 3 allergens was performed to explore identity and structural homology. ElliPro and BepiPred in silico tools were used to predict B and T cell epitopes. Consurf tool was used to conduct identification of conserved regions in serine proteases family. Results: PR3 and HDM group 3 allergens shared moderate identity and structural homology (root mean square deviation < 1). One B cell cross reactive epitope among serine proteases was identified (29I, 30V, 31G, 32G, 34E, 36K, 37A, 38L, 39A and 54C) and two T cell epitopes. Conclusions: PR3 have structural homology and share cross reactive epitopes with HDM group 3 allergens.
Polio health economics: assessing the benefits and costs of polio, non-polio, and integrated activities of the Global Polio Eradication Initiative
Authors: Thompson Kimberly M. , Kalkowska Dominika A. , Badizadegan Kamran 
Published: February 2022

Background: Investments made by countries and donors to support polio eradication and the Global Polio Eradication Initiative (GPEI) over the past 35 years provided financial support for significant health interventions beyond the prevention of polio. Prior economic analyses that sought to quantify the economic benefits of some interventions encountered insufficient data and evidence associated with non-polio-specific activities. The 2022-2026 GPEI Strategic Plan explicitly identified integration and gender equity as funded mandates that must move forward in parallel with polio eradication, but these goals remain vaguely defined from a health economic perspective. Methods: To ensure unambiguous and full accounting for all financial investments in the GPEI, polio eradication, and other desirable objectives, we identify the health economic analysis methods and inputs needed to ensure transparent financial accountability and cost-effective use of funds. Results: Sufficient inputs and methods exist to characterize the health and economic benefits of polio-specific activities, but we identified the need for additional information and method development for some non-polio-specific and cost-sharing activities. Donors who seek to support non-polio-specific objectives as part of the GPEI may want to provide dedicated support financing for which it may be difficult to apply typical health economic criteria and to expect net health and/or net economic benefits. Conclusions: Given the mixture of funding sources provided to the GPEI, which includes support by governments and private donors, we recommend that the GPEI separately account for financial needs that represent necessities for polio eradication from those used for other stated objectives. An added layer of specificity that identifies all funds according to each activity, the accountable party and/or parties, and the associated measurable health or other outcome(s), will enable improved health economic analyses and reporting to donors who seek to track returns on their investments.
Investigating progressive muscle relaxation and guided imagery in pre-eclampsia treatment
Authors: Puspitasari Yenny , Santoso Budi , Nursalam Nursalam , Sulistyono Agus 
Published: February 2022

BackgroundProgressive muscle relaxation with guided imagery may positively reduce clinical symptoms in individuals with pre-eclampsia. However, these relationships require clarification. This study aimed to examine the effects of progressive muscular relaxation and guided imagery on blood pressure and urine protein during conservative treatment for pre-eclampsia.MethodsThis was a quasi-experimental study of women receiving conservative treatment for pre-eclampsia. Participants received either progressive muscular relaxation and guided imagery alongside standard care (n=30) or only standard care (n=30). Chi-squared and Fisher's exact tests were used to analyse the differences in systolic and diastolic blood pressure and proteinuria between baseline and after 3 and 7 days.ResultsRespondents showed significant declines in systolic pressure and proteinuria after 3 and 7 days. All respondents showed significant declines in diastolic pressure after 7 days. The differences in systolic and diastolic pressure and proteinuria between groups after 7 days was statistically significant (P<0.001, P=0.008, P<0.001 respectively).ConclusionsA 7-day progressive muscular relaxation intervention and guided imagery combination can effectively lower blood pressure and proteinuria during conservative treatment for preeclampsia.
How professional quality of life is influenced by perceptions of empowerment in midwives
Authors: Hajiesmaello Maryam , Hajian Sepideh , Riazi Hedyeh , Majd Hamid Alavi , Yavarian Roya 
Published: February 2022

IntroductionProfessional quality of life is affected by various factors, such as people's perception of professional empowerment. This study aimed to investigate the role of midwives' personal perception of empowerment in their professional quality of life.MethodsThis cross-sectional study was conducted with 380 midwives providing maternal and neonatal care services across five provinces of Iran. Data were collected using virtual platforms and analysed using descriptive and analytical tests including regression analysis.ResultsThe mean professional quality of life was high (59.7%) in most participants. Midwives' personal perception of empowerment alone predicted 17% of professional quality of life.ConclusionsGiven midwives' role in maintaining and improving maternal and neonatal outcomes, it is important to devise policies and plans to enhance midwives' perception of empowerment, especially with regards to autonomous practice and management.
Rehabilitation of a young girl with acute transverse myelitis and prolonged lower motor neuron features: a longitudinal case report over 12 months
Authors: Hossain K M Amran , Sakel Mohamed , Saunders Karen , Kabir M Feroz , Hasnat M Abu Khayer 
Published: February 2022

BackgroundThis report describes an effective rehabilitation programme for a 13-year-old girl, diagnosed with acute transverse myelitis, as an example of best clinical practice.Case descriptionMiss A was admitted to the National Institute of Neurosciences and Hospital in Dhaka, where she was diagnosed with acute transverse myelitis, in September 2018. She was discharged and referred for intensive rehabilitation over 3 months as an outpatient at the Centre for the Rehabilitation of the Paralysed in Bangladesh. The therapy team conducted a baseline assessment before starting treatment, which included the following outcome measures: the International Standards for Neurological Classification of Spinal Cord Injury Scale; Spinal Cord Independence Measure; and the Spinal Cord Injury Functional Ambulation Inventory. After 3 months, Miss A was discharged home to continue with a home exercise programme supported by her parents. Outcome measurements were repeated at 3-, 6- and 12-month time points.ResultsMiss A regained muscle power in her legs and normal sensation in S4/5 dermatomes, in addition to regaining voluntary anal muscle contraction. Her mobility and transfers improved so that she was able to transfer in and out of her wheelchair independently and use two elbow crutches to walk short distances outdoors.ConclusionsThis report shows that it is possible for a child who had been severely disabled by acute transverse myelitis to make substantial physical improvements up to 12 months after diagnosis when provided with effective rehabilitation. It also identifies that rehabilitation can provide multiple benefits and value for the individual patient, family, community and society.
Community reintegration of people with traumatic brain injury in south India: role of a comprehensive transdisciplinary rehabilitation programme
Authors: Samuelkamaleshkumar Selvaraj , Reethajanetsureka Stephen , Elango Arumugam , Padankatti Sanjeev M , John Judy Ann , George Jacob , Thomas Raji 
Published: February 2022

Background/aims Successful community reintegration is the ultimate goal of traumatic brain injury rehabilitation and care. The aim of this study was to explore the community reintegration of people with a traumatic brain injury living in south India who had completed a comprehensive holistic rehabilitation programme. The level of community reintegration based on the demographic variables of the patients was also investigated. Methods A total of 104 community-dwelling people with a traumatic brain injury, and a minimum of 1 year post injury, received treatment from a rehabilitation team in a therapeutic centre for 7 hours a day, 6 days a week for a maximum of 16 weeks. A usual care, transdisciplinary service delivery model was implemented, and the Craig Handicap Assessment and Reporting Technique was used to quantify the main outcome measures. Results The mean and standard deviation scores for each Craig Handicap Assessment and Reporting Technique domain were physical independence (91 ± 23), social integration (87 ± 20), cognitive independence (70 ± 33), economic self-sufficiency (67 ± 40), occupation (66 ± 40) and mobility (63 ± 29). The participants who had gone back to work after their traumatic brain injury showed significantly higher scores in all the domains of the Craig Handicap Assessment and Reporting Technique than those who were unemployed. Only the occupation and mobility domain scores were influenced by the severity of the traumatic brain injury. The economic self-sufficiency, occupation and mobility domain scores were higher among married patients compared to those who were unmarried. Conclusions A significant proportion of the participants were able to return to work and reintegrate into community life through this service delivery model. This comprehensive, holistic approach, which targets physical, cognitive and psychosocial needs and then provides adequate vocational rehabilitation, can result in good outcomes in people with a traumatic brain injury.
Effect of session frequency of radial extracorporeal shockwave therapy on gastrocnemius muscle spasticity in children with spastic cerebral palsy: a double-blinded, randomised clinical trial
Authors: Wardhani Rizky Kusuma , Wahyuni Luh Karunia , Laksmitasari Budiati , Lakmudin Alvin 
Published: February 2022

Background/aims Extracorporeal shockwave therapy has been effective in reducing spasticity in patients with spastic cerebral palsy, but there has yet to be a recommended guideline for the treatment of spasticity in children using extracorporeal shockwave therapy. The aim of this study was to evaluate the effect of session frequency of radial extracorporeal shockwave therapy on gastrocnemius muscle spasticity in children with spastic cerebral palsy. Methods This was a double-blinded, randomised controlled trial consisting of 14 patients with spastic cerebral palsy (8 boys and 6 girls), aged 5 to 12 years, who were divided into two groups. Group 1 received five true radial extracorporeal shockwave therapy sessions. Group 2 received three true radial extracorporeal shockwave therapy sessions and two sham extracorporeal shockwave therapy sessions. The Australian Spasticity Assessment Scale was measured at nine time points: 1) pre-extracorporeal shockwave therapy, 2–6) immediately after each radial extracorporeal shockwave therapy session, 7) 4 weeks after the fifth radial extracorporeal shockwave therapy session, 8) 8 weeks after the fifth radial extracorporeal shockwave therapy session, and 9) 12 weeks after the fifth radial extracorporeal shockwave therapy session. Results Both groups had a significant reduction in degree of resistance to passive movements of ankle plantar-flexor muscles measured using the Australian Spasticity Assessment Scale at all time points, relative to baseline. The mean ankle Australian Spasticity Assessment Scale in the two groups were not significantly different after the fifth extracorporeal shockwave therapy treatment (group 1: 1.13 ± 0.62; group 2: 1.50 ± 0.90, P=0.28), 4 weeks after the fifth radial extracorporeal shockwave therapy treatment (group 1: 1.12 ± 0.66; Group 2: 1.50 ± 0.90, P=0.40), 8 weeks after the fifth radial extracorporeal shockwave therapy treatment (group 1: 1.25 ± 0.68; group 2: 1.50 ± 0.90, P=0.54) and 12 weeks after the fifth radial extracorporeal shockwave therapy treatment (group 1: 1.19 ± 0.75; Group 2: 1.58 ± 0.90, P=0.28). Conclusions: The effect of radial extracorporeal shockwave therapy on spastic gastrocnemius in children with spastic cerebral palsy is not dependent on session frequency. There has yet to be a recommended guideline and research showing the factors that affect the efficacy of radial extracorporeal shockwave therapy on spastic gastrocnemius muscles in children with spastic cerebral palsy.
Investigation of the lasing performance of a crystalline-coated Yb:YAG thin-disk directly bonded onto a silicon carbide heatsink
Authors: Cvrček Jan , Cimrman Martin , Vojna David , Štěpánková Denisa , Foršt Ondřej , Smrž Martin , Novák Ondřej , Slezák Ondřej , Chyla Michal , Jelínek Michal , Mocek Tomáš 
Published: February 2022

We investigated the use of crystalline coatings as the highly reflective coating of an Yb:YAG thin disk directly bonded onto a silicon carbide heatsink. Compared to commonly used ion-beam-sputtered coatings, it possesses lower optical losses and higher thermal conductivity, resulting in better heat management and laser outputs. We pumped the disk up to 1.15 kW at 969 nm and reached 665 W of average output power, and disk temperature of 107 °C with a highly multi-modal V-cavity. These promising results were reached with this novel design despite the adoption of a cheap silicon carbide substrate having more than 3 times lower thermal conductivity compared to frequently used CVD diamond.
Pretravel plans and discrepant trip experiences among travelers attending a tertiary care centre family travel medicine clinic
Authors: Wong Jacqueline K. , Nashid Nancy , Pell Lisa G. , Lam Ray E. , Louch Debra M. , Science Michelle E. , Morris Shaun K. 
Published: February 2022

Background
International travel can expose travelers to a number of health risks. Pretravel consultation (PC) helps mitigate risk and prepare travelers for health concerns that might arise. The assessment of risk, mitigation strategies, and relevance of pretravel advice is dependent on how closely travelers adhere to their planned travel itinerary and activities. We determined the proportion of returned travelers whose completed travel experiences differed from their stated travel itineraries, and identified discrepancies that significantly altered the traveler’s health risk and would have required alternative counseling during their PC.

Methods
We conducted a prospective cohort study at the SickKids’ Family Travel Clinic between October 2014 and November 2015. Returned travelers who completed a post-travel survey were included. Pretravel consultation assessments and post-trip surveys were compared to identify discrepant trip experiences.

Results
A total of 389 travelers presented to the clinic for a PC during the study period and 302 (77.6%) were enrolled. Post-travel surveys were received from 119 (39.4%) participants, representing 101 unique itineraries. The median participant age was 36.3 years (IQR 26.6–47.5) and there were 73 female travelers (61%). Most participants (n = 87,73%) were healthy as well as Canadian born (n = 84, 71%). A quarter of travelers were visiting friends and relatives (VFR) (n = 30, 25.2%). The vast majority of returned travelers (n = 109, 92%) reported discrepant trip experiences involving trip duration, countries visited, accommodations, environmental surroundings and/or activities. Almost two thirds of these individuals (n = 68, 62%) would have required alternative pretravel counseling. We did not identify any demographic or planned trip characteristics that predicted discrepant trip experiences requiring alternative pretravel counseling.

Conclusions
The majority of travelers reported discrepant trip experiences and the discrepancies often affected health risk. Therefore, clinicians should consider providing broader counselling during the PC as discrepancies from planned travel are common.