bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparative Therapeutic Effectiveness of Anticoagulation and Conservative Management in Traumatic Cerebral Venous Sinus Thrombosis
Authors: Kim Kevin T. , Wessell Aaron P. , Oliver Jeffrey , Boulter Jason H. , Stokum Jesse A. , Lomangino Cara , Scarboro Maureen , Aarabi Bizhan , Chryssikos Timothy , Schwartzbauer Gary 
Published: March 2022

BACKGROUND:
Consensus is currently lacking in the optimal treatment for blunt traumatic cerebral venous sinus thrombosis (tCVST). Anticoagulation (AC) is used for treating spontaneous CVST, but its role in tCVST remains unclear.

OBJECTIVE:
To investigate the characteristics and outcomes of patients treated with AC compared with patients managed conservatively.

METHODS:
We retrospectively reviewed patients who presented to a Level 1 trauma center with acute skull fracture after blunt head trauma who underwent dedicated venous imaging.

RESULTS:
There were 137 of 424 patients (32.3%) presenting with skull fractures with tCVST on venous imaging. Among them, 82 (60%) were treated with AC while 55 (40%) were managed conservatively. Analysis of baseline characteristics demonstrated no significant difference in age, sex, admission Glasgow Coma Scale, admission Injury Severity Score, rates of associated intracranial hemorrhage, or neurosurgical interventions. New or worsening intracranial hemorrhage was seen in 7 patients treated with AC. Patients on AC had significantly lower mortality than non-AC (1% vs 15%; P = .003). There was no difference in the Glasgow Coma Scale or Glasgow Outcome Scale at last clinical follow-up. On follow-up venous imaging, patients treated with AC were more likely to experience full thrombus recanalization than non-AC (54% vs 32%; P = .012), and subsequent multiple regression analysis revealed that treatment with AC was a significant predictor of full thrombus recanalization (odds ratio, 5.18; CI, 1.60-16.81; P = .006).

CONCLUSION:
Treatment with AC for tCVST due to blunt head trauma may promote higher rates of complete thrombus recanalization when compared with conservative management.
Body Mass Index and the Risk of Poor Outcome in Surgically Treated Patients With Good-Grade Aneurysmal Subarachnoid Hemorrhage
Authors: Rautalin Ilari , Juvela Seppo , Macdonald R. Loch , Korja Miikka 
Published: March 2022

BACKGROUND:
Heterogeneity among study populations and treatment procedures has led to conflicting results on outcome predictors for patients with aneurysmal subarachnoid hemorrhage (aSAH). One such conflicting predictor is body mass index (BMI).

OBJECTIVE:
To clarify whether high BMI values protect patients from poor outcome after aSAH, as previously suggested.

METHODS:
We surveyed 6 prospective studies conducted in 14 different countries (93 healthcare units) between 1985 and 2016 and pooled the data on surgically treated patients with good-grade (Glasgow Coma Scale 13-15 on admission) aSAH. We calculated BMI for each patient and created 4 balanced categories based on the BMI quartiles of each cohort. We calculated adjusted odds ratios (ORs) with 95% CIs for the 3-month poor outcome (Glasgow Outcome Scale 1-3) by BMI.

RESULTS:
The pooled study cohort included 1692 patients with good-grade aSAH (mean age 51 years; 64% female). At 3 months, 288 (17%) had poor outcomes. The risk for poor outcomes increased with increasing BMI values (OR = 1.15 [1.02-1.31] per each standard deviation increase of BMI). The risk for poor outcome was over 1.6 times higher (OR = 1.66 [1.13-2.43]) in the highest BMI category (range 27.1-69.2) compared with the lowest BMI category (range 14.4-23.8). These associations were found in each of the 6 study cohorts in both men and women, regardless of age.

CONCLUSION:
Because higher BMI values seem to associate with poor outcomes in surgically treated patients with good-grade aSAH, it seems unlikely that obesity protects patients with aSAH from poor outcomes.
Case Series in the Utility of Invasive Blood Pressure Monitoring in Microvascular Decompression
Authors: Xu Risheng , Nair Sumil K. , Materi Josh , Raj Divyaansh , Medikonda Ravi , Shah Pavan P. , Kannapadi Nivedha V. , Wang Andrew , Mintz David , Gottschalk Allan , Antonik Laurie J. , Huang Judy , Bettegowda Chetan , Lim Michael 
Published: March 2022

BACKGROUND:
The utility of arterial lines in microvascular decompression (MVD) is not well described.

OBJECTIVE:
To examine the safety and costs of arterial lines compared with noninvasive blood pressure (NIBP) monitoring in MVDs.

METHODS:
We retrospectively reviewed patients undergoing MVD from 2012 to 2020. Patients were grouped by procedure date from 2012 to 2014 and 2015 to 2020, reflecting our institution's decreasing trend in arterial line placement around 2014 to 2015. Patient features, intraoperative characteristics, and postoperative complications were collected for all cases. Statistical differences were evaluated using chi-squared analyses and t-tests.

RESULTS:
Eight hundred fifty-eight patients underwent MVDs, with 204 between 2012 and 2014 and 654 between 2015 and 2020. Over time, the frequency of arterial line placement decreased from 64.2% to 30.1%, P < .001. Arterial lines involved 11 additional minutes of preincision time, P < .001. Patients with arterial lines required both increased doses and costs of vasoactive medications intraoperatively. Patients receiving arterial lines demonstrated no significant differences in complications compared with patients with NIBP monitoring. On average, patients with arterial lines incurred $802 increased costs per case compared with NIBP monitoring.

CONCLUSION:
NIBP monitoring in MVDs provides neurologically and hemodynamically safe outcomes compared with invasive blood pressure monitoring. For patients without significant cardiopulmonary risk factors, NIBP monitoring may be a cost-effective alternative in MVDs.
Itavastatin and resveratrol increase triosephosphate isomerase protein in a newly identified variant of TPI deficiency
Authors: VanDemark Andrew P. , Hrizo Stacy L. , Eicher Samantha L. , Kowalski Jules , Myers Tracey D. , Pfeifer Megan R. , Riley Kacie N. , Koeberl Dwight D. , Palladino Michael J. 
Published: March 2022

ABSTRACT
Triosephosphate isomerase (TPI) deficiency (TPI Df) is an untreatable glycolytic enzymopathy that results in hemolytic anemia, progressive muscular impairment and irreversible brain damage. Although there is a ‘common’ mutation (TPIE105D), other pathogenic mutations have been described. We identified patients who were compound heterozygous for a newly described mutation, TPIQ181P, and the common TPIE105D mutation. Intriguingly, these patients lacked neuropathy or cognitive impairment. We then initiated biochemical and structural studies of TPIQ181P. Surprisingly, we found that purified TPIQ181P protein had markedly impaired catalytic properties whereas crystallographic studies demonstrated that the TPIQ181P mutation resulted in a highly disordered catalytic lid. We propose that genetic complementation occurs between the two alleles, one with little activity (TPIQ181P) and one with low stability (TPIE105D). Consistent with this, TPIQ181P/E105D fibroblasts exhibit a significant reduction in the TPI protein. These data suggest that impaired stability, and not catalytic activity, is a better predictor of TPI Df severity. Lastly, we tested two recently discovered chemical modulators of mutant TPI stability, itavastatin and resveratrol, and observed a significant increase in TPI in TPIQ181P/E105D patient cells.
Monitoring and reporting gaps in spine surgery education through an international needs assessment survey
Authors: Guiroy Alfredo , Cheng Joseph , Thomé Claudius , Falavigna Asdrubal , Cunningham Michael , Ghidinelli Monica , Acaroğlu Emre , Ashman Bryan 
Published: March 2022

Background A critical step in curriculum development is conducting a needs assessment of learners. In spine surgery, the educational needs of trainees, and especially of practicing surgeons, evolve frequently due to changes in practice, technology, etc. To monitor these changes and adapt the educational offerings, organizations delivering continuing medical education (CME) and continuing professional development (CPD) periodically repeat needs assessments. Methods An international needs assessment in the form of a set of 15 online questions was designed and circulated in 2017 and in 2021 to the AO Spine community of members and registered users to gather input in five main areas: educational needs in spine pathologies and techniques, required improvements in practice, preferences for types of educational offerings, and profiling information. Results We received and analyzed 1,204 responses in English during the main reporting period in the 2017 needs assessment from residents, fellows, and practicing surgeons in orthopedics and neurosurgery, and 1,845 in 2021. Spine surgeons wish to improve their knowledge related to all the common pathologies, with some variability among regions and stage of career. Minimally invasive spine surgery (MISS) was the highest-rated need within surgical techniques in all regions (except North America) and all stages of career. Data show a strong preference for face-to-face courses with hands-on training, high demand for mentorship/fellowship/observership, and solid interest in online and blended education. Conclusions The needs assessment process pointed out general trends but also identified varying needs depending on the local situation and stage of career. For this reason, CME/CPD providers must adapt to the local situation to provide educational offerings that meet learner needs.
Population Ageing and Future Demand for Old-Age and Disability Pensions in Germany – A Probabilistic Approach
Authors: Vanella Patrizio , Rodriguez Gonzalez Miguel , Wilke Christina B. 
Published: March 2022

Industrialised economies are experiencing a decline in mortality alongside low fertility rates – a situation that puts social security systems under severe pressure. Population ageing is associated not only with longer periods of pension claims but also smaller cohorts eventually entering the labour market. This threatens the sustainability of pay-as-you-go social security systems for implementing or further improving appropriate reform measures; adequate forecasts of the future population structure are needed.
We propose a probabilistic approach to forecast the number of pensions in Germany up to 2040. Our model considers trends in population development, labour force participation, and early retirement, as well as the effects of pension reforms. Principal component analysis is used to manage the high degree of complexity involved in forecasting trends in old-age and disability pension claims, which arises because of cross-correlations between old-age and disability pension rates, different age groups, and gender. Time series methods enable the inclusion of autocorrelations of the pension rate time series in the model. Monte Carlo simulation is used to quantify future risk. The latter is an important feature of our model, as the future development of the population and, eventually, the pension claims and the financial burden resulting from those claims, are highly stochastic.
The model predicts that, in the median trajectory, the number of old-age pensions will increase by almost 5 million between 2017 and 2036, alongside increases in the number of disability pensions by 2036. These numbers take account of the increase in legal retirement ages as part of the 2007 pension reform. After the mid-2030s, however, a moderate decrease can be expected. The results show a clear need for further reforms, especially in the medium term.
Porphyromonas Gingivalis - A Periodontal Pathogen with Potential Role in Rheumatoid Arthritis and its Association with Anti-CCP and Anti-MCV Antibodies Positivity
Authors: Selimov Pavel , Firkova Elena , Damjanovska Ljubinka , Delcheva Ginka , Stankova Teodora , Stefanova Katya , Maneva Ana , Batalov Anastas 
Published: March 2022

Background: In recent studies, a strong association between rheumatoid arthritis (RA) and chronic periodontal disease (CPD) has been identified, indicating common disease pathogenesis and risk factors. One of them is the presence of the pathogen Porphyromonas gingivalis (PG), which can initiate the process of citrullination, by secreting the enzyme Porphyromonas Peptydil Arginine Deminase (PPAD).
The aim of the study is to show the presence of PG in RA patients, and to evaluate the association of the PG presence with anti-citrullinated proteins/peptides (ACPA) positivity i.e. anti CCP and anti MCV positivity.
Methods: The study included 80 participants - 30 patients which fulfilled 2010 ACR/EULAR RA classification criteria and 50 controls, which were genetically analyzed for the presence of PG by Chelex®100 method and polymerase chain reaction (PCR) and for the presence of anti CCP and anti MCV autoantibodies with the ELISA method.
Results: Twenty out of thirty RA patients (80 %) and 16 out of 50 controls (32%) were positive for PG. (χ 2 = 11.461, p <0.001 for OA and χ2 = 13.91, p <0.001 for HC). Of the PG-positive RA patients, 83% had positive anti-CCP and 79% had positive anti-MCV test. The odds ratios OR of 25 and 19 were statistically significant (p = 0.008 and p =0,014 respectfully).
Conclusions: PG was present more frequently in RA patients and there was a statistically significant association with anti CCP and anti MCV antibodies.
Laser-cooled 171Yb+ microwave frequency standard with a short-term frequency instability of 8.5 × 10−13/√τ
Authors: Xin N. C. , Qin H. R. , Miao S. N. , Chen Y. T. , Zheng Y. , Han J. Z. , Zhang J. W. , Wang L. J. 
Published: March 2022

We report on the development of a microwave frequency standard based on a laser-cooled

171

Y

b

+

ion trap system. The electronics , lasers, and magnetic shields are integrated into a single physical package. With over 105 ions are stably trapped, the system offers a high signal-to-noise ratio Ramsey line-shape. In comparison with previous work, the frequency instability of a

171

Y

b

+

microwave clock was further improved to

8.5
×

10

−
13

/

τ

for averaging times between 10 and 1000 s. Essential systematic shifts and uncertainties are also estimated.
Age-related decline in function of ON and OFF visual pathways
Authors: Hathibelagal Amithavikram R. , Prajapati Vishal , Jayagopi Indrani , Jalali Subhadra , Ganeshrao Shonraj Ballae 
Published: March 2022

Purpose
A simple psychophysical paradigm is available as a digital application in iOS devices such as iPad to measure the function of ON and OFF visual pathways. However, an age-matched normative database is not readily available. The purpose of the study is to evaluate the response of ON and OFF visual pathways as a function of age.

Methods
158 normal healthy adults (84 males and 74 females) whose age ranged 18–80 years participated in the study. None of them had any ocular disease (except cataract of grade II or less) and visual acuity of ≤ 20/25. Monocular testing (only one eye) was performed on the ‘EyeSpeed’ application on an iPad at 40cm distance. The targets ranged between 1 to 3 light or dark squares presented randomly in a noise background and participants responded by indicating the number of squares by touching the screen as fast as possible. The main outcome variables are reaction time, accuracy and performance index (1 / speed * accuracy).

Results
The median reaction time was shorter (Median (IQR): 1.53s (0.49) [dark] Vs 1.76s (0.58) [light], p < 0.001) and accuracy was higher (97.21% (3.30) [dark] Vs 95.15% (5.10) [light], p < 0.001) for dark targets than the light targets. Performance index and reaction time for both target types significantly correlated with age (ρ = -0.41 to -0.43; p < 0.001).

Conclusions
This normative database will be useful to quantify disease-specific defects. More importantly, the ON pathway function can potentially serve as a surrogate for rod photoreceptor function.
Utilization of machine learning methods for predicting surgical outcomes after total knee arthroplasty
Authors: Mohammed Hina , Huang Yihe , Memtsoudis Stavros , Parks Michael , Huang Yuxiao , Ma Yan 
Published: March 2022

BackgroundPredictive models could help clinicians identify risk factors that cause adverse events after total knee arthroplasty (TKA), allowing for appropriate preoperative preventive interventions and allocation of resources.MethodsThe National Inpatient Sample datasets from 2010–2014 were used to build Logistic Regression (LR), Gradient Boosting Method (GBM), Random Forest (RF), and Artificial Neural Network (ANN) predictive models for three clinically relevant outcomes after TKA—disposition at discharge, any post-surgical complications, and blood transfusion. Model performance was evaluated using the Brier scores as calibration measures, and area under the ROC curve (AUC) and F1 scores as discrimination measures.ResultsGBM-based predictive models were observed to have better calibration and discrimination than the other models; thus, indicating comparatively better overall performance. The Brier scores for GBM models predicting the outcomes under investigation ranged from 0.09–0.14, AUCs ranged from 79–87%, and F1-scores ranged from 41–73%. Variable importance analysis for GBM models revealed that admission month, patient location, and patient’s income level were significant predictors for all the outcomes. Additionally, any post-surgical complications and blood transfusions were significantly predicted by deficiency anemias, and discharge disposition by length of stay and age groups. Notably, any post-surgical complications were also significantly predicted by the patient undergoing blood transfusion.ConclusionsThe predictive abilities of the ML models were successfully demonstrated using data from the National Inpatient Sample (NIS), indicating a wide range of clinical applications for obtaining accurate prognoses of complications following orthopedic surgical procedures.
Inclusion strategies in multi-stakeholder dialogues: The case of a community-based participatory research on immunization in Nigeria
Authors: Akwataghibe Ngozi N. , Ogunsola Elijah A. , Broerse Jacqueline E. W. , Agbo Adanna I. , Dieleman Marjolein A. 
Published: March 2022

Background
Community-Based Participatory Research (CBPR) has been used to address health disparities within several contexts by actively engaging communities. Though dialogues are recognized as a medium by which community members and other actors can make their voices heard through processes that support shared-decision making, power asymmetries often impede the achievement of this objective. Traditionally such relationship asymmetries exist between communities, health workers, and other professionals resulting in the exclusion of communities from decision making in participatory practices and dialogues. This study aimed to explore the experiences in the dialogues between different groups within communities, health workers and local government officials in a CBPR project on immunization in Nigeria. We adapted the framework by Elberse et al. (2011) to structure the possible exclusion mechanisms that could exist in dialogues between the three groups and we set up inclusion strategies to diminish the inequalities as much as possible.

Methods and findings
This is an exploratory and descriptive case study, using qualitative methods. Data was collected through observation and semi-structured interviews (SSI) with dialogue participants. All 24 participants in the multi-stakeholder dialogues were interviewed. Inclusion strategies involved creating enabling circumstances; influencing behaviour; and influencing use of language. Verbal and circumstantial strategies were of limited value in reducing exclusion. Behavioural inclusion strategies created more awareness of the importance of inclusion; and enabled different community stakeholders to direct their influences towards achieving the collective goals of the collaboration. An important learning is that if evidence is used in the dialogues, even when exclusion of certain individuals occurs, the outcomes could still favour them. A key issue is the difference between participation and representation and the need for more efficient ways of carrying out such interactive processes to ensure that the participation of the vulnerable groups is not merely symbolic. The study makes a case for the use of ‘boundary spanners’ in this dynamic—these are ‘elite’ individuals (or community champions) who can be a voice for the minorities and who could have the opportunity to influence decision making.

Conclusion
CBPR can enable local governments to develop effective partnerships with health workers and communities to achieve health-related goals even in the presence of asymmetries in relationships. Inclusion strategies in dialogues can improve participation and enable shared decision making, however exclusion of vulnerable groups may still occur. Intra-community dynamics and socio-cultural contexts can drive exclusion and less privileged community members require proper representation to enable their issues to be captured effectively.
Biosocial correlates of adolescent’s knowledge on pubertal changes in rural Bangladesh: A structural equation model
Authors: Methun Md Injamul Haq , Uddin M. Sheikh Giash , Hossain Md. Ismail , Habib Md. Jakaria , Saleheen Ahmed Abdus Saleh , Haq Iqramul 
Published: March 2022

BackgroundThe present study aimed to identify factors that are associated with puberty knowledge among school-going rural adolescents in Bangladesh.MethodsThis cross-sectional study was conducted on 2724 school-going (grades VI-IX) adolescents who were aged between 10–24 years. The adolescents resided only in rural areas of Bangladesh. In this study, relationship between socio-demographic factors and controlling behaviour was assessed considering Bronfenbrenner’s bioecological model. Considering the complex nature of Bronfenbrenner’s bioecological model the structural equation model to explore factors related to the Adolescents’ knowledge of pubertal changes.ResultsThe structural equation model result showed a significant association among gender, education, age, and parental limit setting on daily activities with student’s knowledge on pubertal changes. peer connection, and peer regulation were associated with adolescent knowledge on puberty directly as well as through the mediator variables year of schooling, academic performance and, parental behavioural control.ConclusionAdolescents Age, years of schooling, and teachers concerns are positively associated with adolescents’ knowledge on puberty. Whereas, parents’ and peers’ controlling behaviors are negatively associated with adolescents’ understanding of pubertal changes. Therefore, there is needed an effective plan to raise the attention of parents and teachers on adolescents’ pubertal issues to ensure adolescents’ informed pubertal period.