bluuebunny/crossref_metadata_2025_split huggingface dataset:
347 A Bit of a Headache: Management of Head Injuries in a District General Hospital
Authors: Bruce N. , Young J. 
Published: February 2022

Abstract

Aim
Head Injury is a common presentation in our DGH, which covers a large rural area and is now a regional trauma centre. We audited our management of head injuries against current guidelines and planned a new pathway to ensure patients receive the correct advice and follow up on discharge.

Method
Data was requested from IT for all head injury episodes in 2019, to reflect usual numbers pre-pandemic.
Electronic letters, radiology and notes were used to identify whether imaging criteria was met/carried out, discharge destinations, re-presentations, specialty discussions, and head injury advice on discharge.

Results
307 individual patients identified. 13 re-presentations. 10 required neurosurgical discussions

Destinations
226 (73.6%) discharged direct from ED. Admissions: Surgical - 37 (12%), Medical - 6 (2%), Paeds – 14 (4.5%), ITU 2 (0.7%), Did not wait – 2 (0.7%), Not Recorded – 7 (2.3%)

Imaging
100 patients met NICE criteria for CT, 100% were documented in notes and had CT. 76% reported normal, 18% had a bleed, contusion, or haematoma.

HI advice
90% of ED discharges, 16% of Surgical and 16% of medical discharges had head injury discharge advice documented

Conclusions
Guidelines were met for 100% of patients requiring imaging. Head injury advice was well documented in ED but fell down in ward paperwork. We have written a robust pathway where all inpatients have a proforma completed during admission with prompts for discharge advice and rehab referral where appropriate, this is currently undergoing a re-audit to ensure improvement and if successful will become an established part of the trauma pathway in our hospital.
68 Exploring Subconscious Bias: How Implicit Biases Can Affect Accessibility to Healthcare
Authors: Ranford D. , Miu K. , Surda P. 
Published: February 2022

Abstract

Aim
Implicit biases involve associations outside conscious awareness that lead to a negative evaluation of a person on the basis of irrelevant characteristics such as race or gender. This article reviews healthcare professional's display of implicit bias towards patients in a tertiary centre.

Method
We retrospectively analysed a database of 285 patients who missed surgical outpatient appointments at a London tertiary hospital. Judges were asked to categorise all 285 patients into predefined ethnic categories: White British vs Black, Asian and Minority Ethnic vs White Non-British after reading the patient’s names.

Results
In the group where ethnicity was defined based on assessed origin of names, we report significant difference in discharge rates between White British vs Non-White British groups (34 vs 48%). There was also significant difference between White British vs Black, Asian and Minority Ethnic group (34% vs 57%). Discharge rates between males and females did not differ.

Conclusions
Clinicians are more likely to provide patients with another opportunity to attend an outpatient clinic after missing a booked appointment based on the patient having a perceived ethnicity of White British, whether deliberate or not. This study shows a bias of accessibility in healthcare dependent on ethnicity with greater flexibility given to White British patients.
404 Can MRI Non-Invasively Measure Blood-Brain-Barrier Permeability?
Authors: Ali T. , Blamire A. , Parikh J. 
Published: February 2022

Abstract

Aim
Blood brain barrier (BBB) integrity in neurological disease is tested with gadolinium-enhanced Magnetic Resonance Imaging (MRI). Pathology studies have shown gadolinium deposits in brains with intact BBBs, thus raising concern. We propose a novel use of Arterial Spin Labelling (ASL) –a MRI technique which ‘tags’ blood-water making it a tracer– as a safer alternative in assessing BBB permeability. ASL’s ability to capture T2 (transverse relaxation time) changes of tagged water in blood vs. in tissue (post-exchange across the BBB) supports its feasibility.

Method
We developed an ASL protocol and collected data from healthy volunteers (n=5) on a 3T Achieva Scanner with the parameters: echo times (TEs) 30, 40, 50, 60, 70ms; repetition time 4200ms; field of view 240x240x47mm and post label delays (PLDs) 1,000ms and 1,500ms. We calculated mean ASL signal (arb units) from the images at each TE, and then extracted T2(ms) values for each volunteer at each PLD. The primary outcome was the change in T2 across PLDs.

Results
Calculated mean T2s demonstrated a majority of increasing T2s across longer PLDs (n=3) with mean T2 of 55.3+5.3ms at PLD 1,000ms and 62.1+10.8ms at PLD 1,500ms. However, the results are inconclusive as the sample size precluded statistical testing.

Conclusions
We developed an ASL protocol that demonstrated changes in T2 of blood water with time passage, indicating water exchange through the BBB. This supports the use of ASL in assessing BBB permeability, but more wide-scale studies need to be performed.
36 Predicting Long-Term Survival and Time-to-Recurrence After Oesophagectomy in Patients with Oesophageal Cancer
Authors: Gujjuri R. , Clarke J. , Elliot J. , Reynolds J. , Markar S. ,   ENSURE Study Group
Published: February 2022

Abstract

Aim
Long-term survival after oesophagectomy remains poor, with recurrence a feared common outcome. Prediction tools can identify high-risk patients and optimise treatment decisions based on their prognostic factors. This study developed a prediction model to predict long-term survival and time-to-recurrence following surgery for oesophageal cancer.

Method
Patients undergoing curative surgery from the European iNvestigation of SUrveillance After Resection for Esophageal Cancer study were included. Prediction models were developed for overall survival (OS) and disease-free survival (DFS) using Cox proportional hazards (CPH) and Random Survival Forest (RSF). Model performance was evaluated using discrimination (time-dependent area under the curve (tAUC)) and calibration (visual comparison of predicted and observed survival probabilities).

Results
This study included 4719 patients with an OS of 47.7% and DFS of 48.4% at 5 years. Sixteen variables were included. CPH and RSF demonstrated good discrimination with a tAUC of 78.2% (95% CI 77.4–79.1%) and 77.1% (95% CI 76.1–78.1%) for OS and a tAUC of 79.4% (95% CI 78.5–80.2%) and 78.6% (95% CI 77.5–79.5%) respectively for DFS at 5 years. CPH showed good agreement between predicted and observed probabilities in all quintiles. RSF showed good agreement for patients with survival probabilities between 20–80%.

Conclusions
This study demonstrated that a statistical model can accurately predict long-term survival and time-to-recurrence after oesophagectomy. Identification of patient groups at risk of recurrence and poor long-term survival can improve patient outcomes by optimising treatment methods and surveillance strategies. Future work evaluating prediction-based decisions against standard decision-making is required to understand the clinical utility derived from prognostic model use.
Knowledge and Interdisciplinary Communication of Gastroenterologists and Dentists in the Netherlands About Gastrointestinal Diseases With Oral Manifestations
Authors: Tan Christopher X W , Brand Henk S , Qaddour Oumaima , van der Bijl Paulette M L , De Boer Nanne K H , Forouzanfar Tymour , de Visscher Jan G A M 
Published: February 2022

Abstract

Background
Gastrointestinal diseases can have oral manifestations. The aim of this study was to investigate the knowledge of gastroenterologists and dentists about gastrointestinal diseases with oral manifestations and to assess the frequency, extent and content of communication between gastroenterologists and oral healthcare professionals.

Methods
Separate questionnaires were developed and sent to all 523 gastroenterologists and a random selection of 500 dentists in the Netherlands. Both questionnaires contained questions about demographic characteristics of the participants, 10 statements about gastrointestinal diseases with possible oral manifestations and questions about the communication between gastroenterologists and oral healthcare professionals. Additionally, the questionnaire for gastroenterologists contained 9 statements about general dentistry and the questionnaire for dentist had 9 questions about gastrointestinal diseases.

Results
Gastroenterologists answered 47.6% ± 31.9% of the questions correct about gastrointestinal diseases with possible oral manifestations and 57.5% ± 27.9% of the questions correct about general dentistry. Dentists answered 26.6% ± 20.5% of the questions correct about possible oral manifestations of gastrointestinal diseases and 50.3% ± 18.7% of the questions correct about gastrointestinal diseases. Gastroenterologists and dentists valued interdisciplinary consultation as very useful with scores of 4.07 ± 0.70 and 4.67 ± 0.49 on a 5-point Likert scale, respectively, but the frequency of consultation was considered insufficiently with a mean score of 2.88 ± 1.01 and 2.24 ± 1.05 on a 5-point Likert scale, respectively.

Conclusions
This study suggests that the knowledge of gastroenterologists and dentists about gastrointestinal diseases with oral manifestations could be improved. Interdisciplinary consultation was considered valuable for the optimal treatment of their patients but was assessed as insufficient.
Serum antibodies to surface proteins ofChlamydia trachomatisas candidate biomarkers of disease: results from the Baltimore Chlamydia Adolescent/Young Adult Reproductive Management (CHARM) cohort
Authors: Marques Patricia X , Wand Handan , Nandy Melissa , Tan Chun , Shou Huizhong , Terplan Mishka , Mark Katrina , Brotman Rebecca M , Wilson David P , Ravel Jacques , Hsia Ru-ching , Bavoil Patrik M 
Published: February 2022

AbstractWe previously observed that the nine-member family of autotransported polymorphic membrane proteins (Pmps) of Chlamydia trachomatis is variably expressed in cell culture. Additionally, C. trachomatis-infected patients display variable Pmp-specific serum antibody profiles indirectly suggesting expression of unique Pmp profiles is an adaptive response to host-specific stimuli during infection. Here, we propose that the host response to Pmps and other outer surface proteins may correlate with disease severity. This study tests this hypothesis using an ELISA that measures serum IgG antibodies specific for the nine C. trachomatis Pmp subtypes and four immunodominant antigens (MOMP, OmcB, Hsp60, ClpP) in 265 participants of the Chlamydia Adolescent/Young Adult Reproductive Management (CHARM) cohort. More C. trachomatis-infected females displayed high Pmp-specific antibody levels (cut-off Indexes) than males (35.9%–40.7% of females vs. 24.2%–30.0% of males), with statistical significance for PmpC, F and H (P &lt; 0.05). Differences in Pmp-specific antibody profiles were not observed between C. trachomatis-infected females with a clinical diagnosis of pelvic inflammatory disease (PID) and those without. However, a statistically significant association between high levels of OmcB-specific antibody and a PID diagnosis (P&lt; 0.05) was observed. Using antibody levels as an indirect measure of antigen expression, our results suggest that gender- and/or site-specific (cervix in females vs. urethra in males) stimuli may control pmp expression in infected patients. They also support the possible existence of immune biomarkers of chlamydial infection associated with disease and underline the need for high resolution screening in human serum.
Financial Stressors and Resources Associated With Financial Exploitation
Authors: Hall LaToya , Moray Juno , Gross Evan , Lichtenberg Peter A 
Published: February 2022

Abstract

Background and Objectives
The prevalence of older adult financial exploitation (FE) is increasing. Population-based survey estimates of FE in the older adult population range from 5% to 11%. Given the growing prevalence of FE victimization in older adult populations, understanding the population’s vulnerability to FE has increased in importance. This study investigates a conceptual framework in an attempt to understand how financial stressors and resources are associated with substantiated FE in a sample consisting largely of Black older adults.

Research Design and Methods
The study uses a cross-sectional design to investigate group differences among a total sample of 142 community-dwelling older adult participants, 62 of whom sought services to address FE and 80 with no history of FE.

Results
The group of older adults who sought services to address FE was more likely to be unmarried and had fewer years of education. Measures of financial literacy and perceived financial vulnerability had protective and risk effects, respectively.

Discussion and Implications
The present study found that sociodemographic and financial stress and resource measures have significant relationships with FE. These findings support the conceptual framework describing their relationship. This new conceptual framework provides a guiding factor in better understanding vulnerability to FE in older adults. The study also adds to the paucity of research completed on FE with Black older adults.
Iterates of Blaschke Products and Peano Curves
Authors: Donaire Juan Jesús , Nicolau Artur 
Published: February 2022

AbstractLet $f$ be a finite Blaschke product with $f(0)=0$, which is not a rotation and let $f^{n}$ be its $n$-th iterate. Given a sequence $\{a_{n}\}$ of complex numbers consider $F= \sum a_n f^{n}$. If $\{a_n\}$ tends to $0$ but $\sum |a_n| = \infty $, we prove that for any complex number $w$ there exists a point $\xi $ in the unit circle such that $\sum a_{n}f^{n}(\xi )$ converges and its sum is $w$. If $\sum |a_n| &lt; \infty $ and the convergence is slow enough in a certain precise sense, then the image of the unit circle by $F$ has a non-empty interior. The proofs are based on inductive constructions which use the beautiful interplay between the dynamics of $f$ as a self-mapping of the unit circle and those as a self-mapping of the unit disk.
Effects of seed morphology and orientation on secondary seed dispersal by wind
Authors: Zhu Jinlei , Buchmann Carsten M , Schurr Frank M 
Published: February 2022

Abstract
Understanding how diaspore (hereafter ‘seed’) morphology and orientation affect secondary seed dispersal by wind is important to link seed dispersal and post-dispersal processes, such as seed lodging, predation and germination. This study aims to describe the effects of seed morphology and orientation on secondary seed dispersal by wind via mechanistic modelling. We extend the mechanistic model of Schurr et al. (2005) in order to describe how secondary seed dispersal by wind is affected by wind conditions, ground surface, seed morphology and orientation. The model simulates the initial landing orientations, dispersal distances and stopping orientations of individual seeds. To parameterize the model, we measured orientation-specific vertical seed projection and seed lift-off velocity (the wind speed at which a seed starts moving on the ground) of the asymmetric seeds of heterocarpous Zygophyllum xanthoxylon, and determined orientation-specific model parameters that depend on properties of seeds and/or the environment. To validate the model, we conducted wind channel experiments in which we released seeds of Z. xanthoxylon onto a sand-coated tar paper, and recorded the initial landing orientations, dispersal distances and stopping orientations of the seeds. The extended model could precisely predict secondary dispersal distance, and explain up to 99% of variation in the observed proportions of seeds which stopped in various orientations. The model predicts that secondary dispersal distance increases with wind speed and decreases with aerodynamic roughness length, and that there might be a positive correlation between dispersal distance and germination success.
Forming young and hypervelocity stars in the Galactic Centre via tidal disruption of a molecular cloud
Authors: Generozov A , Nayakshin S , Madigan A M 
Published: February 2022

ABSTRACT
The Milky Way Galaxy hosts a four million solar mass black hole, Sgr A*, that underwent a major accretion episode approximately 3–6 Myr ago. During the episode, hundreds of young massive stars formed in a disc orbiting Sgr A* in the central half parsec. The recent discovery of a hypervelocity star (HVS) S5-HVS1, ejected by Sgr A* five Myr ago with a velocity vector consistent with the disc, suggests that this event also produced binary star disruptions. The initial stellar disc has to be rather eccentric for this to occur. Such eccentric discs can form from the tidal disruptions of molecular clouds. Here, we perform simulations of such disruptions, focusing on gas clouds on rather radial initial orbits. As a result, stars formed in our simulations are on very eccentric orbits ($\bar{e}\sim 0.6$) with a lopsided configuration. For some clouds, counterrotating stars are formed. As in previous work, we find that such discs undergo a secular gravitational instability that leads to a moderate number of particles obtaining eccentricities of 0.99 or greater, sufficient for stellar binary disruption. We also reproduce the mean eccentricity of the young disc in the Galactic Centre, though not the observed surface density profile. We discuss missing physics and observational biases that may explain this discrepancy. We conclude that observed S-stars, HVSs, and disc stars tightly constrain the initial cloud parameters, indicating a cloud mass between a few × 104 and $10^5\, {\rm M}_{\odot }$, and a velocity between ∼40 and 80 km s−1 at 10 pc.
The low emission mode in PSR B0329+54
Authors: Tu Z Y , Yuen R , Wen Z G , Wang N , Yan W M , Yuan J P , Chen J L , Wang H G 
Published: February 2022

ABSTRACT
We investigate properties of the low emission mode in PSR B0329+54 based on four single-pulse observations at frequency centred at 1.54 GHz using Nanshan radio telescope in Urumqi. The low emission mode is characterized by an intensity drop in the central component below that of the other two components. Referred here as the low mode, it has an average duration of 3P0 and is observed in both abnormal and normal emission modes of the pulsar occupying 3.6 per cent of the observed pulses. We demonstrate that the properties of low modes are related to the two modes. We find that the integrated profile of low modes is unique to the two modes, and that low modes occur more frequently when the pulsar is in the normal mode. Analysis of the energy distribution for normal low modes suggests that the cause for the intensity drop in the central component is separated from the emission of the other two components. We demonstrate that the pulse emission characteristics in the normal emission mode shortly after a low-mode bears some similarities with the abnormal mode and gradually recovering to the original normal emission in about three pulsar periods. In addition, the occurrence rate for low modes in different normal modes is mostly consistent, which implies that the duration of low modes is related to a normal mode for this pulsar. Our results imply profile modes each corresponds to specific magnetospheric plama density in particular geometric configuration, and profile mode changing signifies distinct changes of both at different parts of the profile.
The nature of blindsight: implications for current theories of consciousness
Authors: Derrien Diane , Garric Clémentine , Sergent Claire , Chokron Sylvie 
Published: February 2022

AbstractBlindsight regroups the different manifestations of preserved discriminatory visual capacities following the damage to the primary visual cortex. Blindsight types differentially impact objective and subjective perception, patients can report having no visual awareness whilst their behaviour suggests visual processing still occurs at some cortical level. This phenomenon hence presents a unique opportunity to study consciousness and perceptual consciousness, and for this reason, it has had an historical importance for the development of this field of research. From these studies, two main opposing models of the underlying mechanisms have been established: (a) blindsight is perception without consciousness or (b) blindsight is in fact degraded vision, two views that mirror more general theoretical options about whether unconscious cognition truly exists or whether it is only a degraded form of conscious processing. In this article, we want to re-examine this debate in the light of recent advances in the characterization of blindsight and associated phenomena. We first provide an in-depth definition of blindsight and its subtypes, mainly blindsight type I, blindsight type II and the more recently described blindsense. We emphasize the necessity of sensitive and robust methodology to uncover the dissociations between perception and awareness that can be observed in brain-damaged patients with visual field defects at different cognitive levels. We discuss these different profiles of dissociation in the light of both contending models. We propose that the different types of dissociations reveal a pattern of relationship between perception, awareness and metacognition that is actually richer than what is proposed by either of the existing models. Finally, we consider this in the framework of current theories of consciousness and touch on the implications the findings of blindsight have on these.
Meditation-Based Therapy for Chronic Low Back Pain Management: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
Authors: Lin Ting-Han , Tam Ka-Wai , Yang Yu-Ling , Liou Tsan-Hon , Hsu Tzu-Herng , Rau Chi-Lun 
Published: February 2022

Abstract

Background
Chronic low back pain (CLBP) is among the most common types of pain in adults. Currently, injections and analgesic and nonsteroidal anti-inflammatory drugs are often provided for patients with CLBP. However, their effectiveness remains questionable, and the safest approach to CLBP remains debated. Meditation-based therapies constitute an alternative treatment with high potential for widespread availability. We evaluated the applicability of meditation-based therapies for CLBP management.

Methods
We performed a systematic review and meta-analysis of randomized controlled trials to evaluate the efficacy of meditation-based therapies for CLBP management. The primary outcomes were pain intensity, quality of life, and pain-related disability; the secondary outcomes were the experienced distress or anxiety and pain bothersomeness in the patients. The PubMed, Embase, and Cochrane databases were searched for studies published from the databases’ inception dates until July 2021, without language restrictions.

Results
We reviewed 12 randomized controlled trials with 1,153 patients. In 10 trials, meditation-based therapies significantly reduced the CLBP pain intensity compared with nonmeditation therapies (standardized mean difference [SMD] −0.27, 95% confidence interval [CI] = −0.43 to −0.12, P = 0.0006). In seven trials, meditation-based therapies also significantly reduced CLBP bothersomeness compared with nonmeditation therapies (SMD −0.21, 95% CI = −0.34 to −0.08, P = 0.002). In three trials, meditation-based therapies significantly improved patient quality of life compared with nonmeditation therapies (SMD 0.27, 95% CI = 0.17 to 0.37, P &lt; 0.00001).

Conclusions
In conclusion, meditation-based therapies constitute a safe and effective alternative approach to CLBP management.