bluuebunny/crossref_metadata_2025_split huggingface dataset:
Outcomes of Tissue Reconstruction in Distal Lower Leg Fractures: a Retrospective Cohort Study
Authors: Aydogan Emrah , Langer Stefan , Josten Christoph , Fakler Johannes Maria Karl , Henkelmann Ralf 
Published: May 2020

Abstract
Background:Open and closed fractures can be associated with posttraumatic or postoperative soft tissue defects caused by initial trauma, operative procedures or infections. This study evaluated the outcomes of postoperative qualities ofpatients with open or closed lower leg fractures,related softtissue defects, and subsequent flap coverage.Methods:We performed a retrospective single-center cohort study in a level 1 trauma center. We analyzed thepatients treated fromJanuary 2012 through December 2017 and recorded demographics, treatment, and outcome data.The outcome data were measured via patient-reported Foot and Ankle Outcomes Scores (FAOS) and EQ-5D-5L scores.Results: We included 22 patients with complicated fractures (11 open and 11 closed) and subsequent softtissue defects and flap coverages. The mean follow-up time was 41.2 months. Twenty-onepatients developed infections, and necrosis at the site of surgery manifested in all closed fractures. Therefore, all patients needed soft tissue reconstructions. Preoperatively, 16patients underwent arterial examinations via angiography and sixunderwent ultrasound examinations of the venous system. Ten patients had complications involving the flaps due to ischemia and consequent necrosis. The mean EQ-5D index was 0.62 ± 0.27, EQ-5DVAS score was 57.7 ± 20.2. The mean FAOS was 60.7 ± 22.2; in particular,quality of life was 32.3± 28.8. The rate of returning to work in our patient groupwas 37.5% after one year.Conclusions:Distal tibial fracturesoften require revisions and soft tissue reconstruction. The evaluated patient population had poor outcomes in terms of function, quality of life and return to work. Our results imply that the severity of associated soft tissue damage with many revision operations and flap complications lead to a poorer outcome with respect to patients without flap ischemia.
Norwegian Nurses’ Reflections Upon Experiences of Ethical Challenges in Older People Care - A Qualitative Thematic Analysis
Authors: Rykkje Linda , Holm Anne Lise , Hem Marit Helene 
Published: May 2020

Abstract
Background: Many countries face an increasingly older population in need of health care services. There are reports of lack of qualified staff and resources, resulting in poor quality and undignified care. Care quality is depended upon factors like organization and staffing, but it is also recommended to focus on what staff members experience in clinical practice. In addition, ethical competence is a precondition for high quality care. The aim of this study is to provide knowledge about ethically challenging situations in caring for older people in institutions such as nursing homes and hospitals, and to gain insight into nurses’ written reflections about their experiences and management of ethical challenges in clinical practice.Methods: The data material consist of reflection notes by continuous education students in advanced gerontology in Norway. Data was collected in 2017–2018. We included 42 of 83 notes and utilized qualitative thematic analysis.Findings: “Doing what is in the patients’ best interest” is the guiding principle for the participants, portrayed through three themes as follows: a) Meeting vulnerability, discomfort and emotional pain, b) Collaboration with relatives, and c) Struggling to perform professional care. Within each theme, we provide a variety of ethically challenging situations in older people care. The findings represent the participants’ written experiences and reflections upon how they manage the situation and their effort to provide the best possible care.Conclusions: Health care professionals’ ethical competences may develop when reflecting upon their care performance. Therefore, building ethical competence should be a priority in education of healthcare professionals and in clinical practice. We acknowledge that ethical reflection does not automatically improve care quality, although we find that it fosters increased awareness of one’s action, and as such, it can act as a potential for change.Implications for practice: How nurses reflect upon and manage challenging situations indicates that quality in care is possible despite scarce resources, and this may contribute to reduce ageism and encourage health care personnel to be willing to work in older people care.
Factors associated with the Uptake of Immediate Postpartum Intrauterine Contraceptive Devices(PPIUCD) in Rwanda: A Mixed Methods Study
Authors: Kanakuze Chris Adrien , Dan Kaye K , Musabirema Priscilla , Pascal Nkubito , Mbalinda Scovia Nalugo 
Published: May 2020

Abstract
Background: Rwanda has a high unmet need for family planning which could be reduced by improving access to postpartum intrauterine contraceptives device (PPIUCD) insertion. The objective of the study was to assess the prevalence and factors associated with the uptake of PPIUCD among postpartum women in Muhima Hospital.Methods: A concurrent mixed method study was used. Three hundred eight three (383) immediate postpartum mothers, and 10 health services providers were interviewed using structured questionnaire and in-depth interview respectively. Logistics regression was done to assess for factors associated with PPIUCD uptake and thematic analysis was used for qualitative data.Results: The prevalence for PPIUCD use was 28.1% , women who had normal delivery were more likely to take up PPIUCD (Adjusted Odds Ratio (AOR) 2.623, 95%CI=2.017-6.507 compared to those who had cesarean section; women who received PPIUCD counselling during antenatal period were more likely to use PPIUCD ((AOR 2.072, 95%CI=1.018-4.218) as compared to those who didn’t receive any form of counselling ; mothers who received spouse approval were more likely to use PPIUCD (AOR 2.591,95%CI= 1.485-4.492);as compared to those who didn’t receive any spousal approval; women who had more than one child were more likely to use PPIUCD (AOR =2.265, 95%CI=1.472-3.163) as compared to prime gravida; Mothers with birth to pregnancy interval less than two years were more likely to use PPIUCD (AOR =2.123, CI =1.477-2.706) as compared to those who had birth to pregnancy interval more than 2 years. From the qualitative, health education of mothers and partners on PPIUCD, training of health care providers and availability of supplies to provide PPIUCD influenced use of PPIUCD. Conclusion: The acceptability to use for PPIUCD was high in this population. PPIUCD uptake was associated with normal birth, PPIUCD counselling, spousal approval, parity, birth interval, level of education. Health education of mothers and partners on PPIUCD, training of health providers and availability of supplies to provide PPIUCD influenced use PPIUCD.
The prevalence of the Neglected Sexual Side Effects (NSSEs) after early prostate cancer treatment and the role of a questionnaire in its diagnosis: A Scoping Review Protocol
Authors: Roscher Pierre , Wyk Jacqueline M Van 
Published: May 2020

Abstract
Background: Early prostate cancer (PCa) treatment interventions may leave men with debilitating sexual side effects. These side effects may remain permanent, often undiagnosed and undermanaged. The objective of this study is to map the evidence pertaining to the prevalence, and use of questionnaires, related to the neglected sexual side effects (NSSE) after Pca treatment.Methods:This systematic scoping review’s search strategy will involve the following electronic databases: PubMed, Science Direct and Google Scholar. Following title searching, two-independent reviewers will conduct screening of abstracts and full articles. Thescreenings will be guided by the eligibility criteria. Data will be extracted from the included studies and the emerging themes will be analysed. The review team will analyse the implications of the findings in relation to the research question and aim of the study. The Mixed Method Appraisal Tool (MMAT) will be employed for quality appraisal of included studies.Discussion: We anticipate finding a small amount of studies pertaining to the prevalence and questionnaire use for NSSE after early PCa treatment. The study findings will be disseminated through publication in a peer-reviewed journal, peer presentations as well as presentations at relevant conferences
Prognostic Impact of Cancer Activity on Clinically Relevant Bleeding Events After Percutaneous Coronary Intervention: A Retrospective Study
Authors: Nishikawa Tatsuya , Morishima Toshitaka , Fujii Yuki , Okawa Sumiyo , Otsuka Tomoyuki , Kamada Risa , Yasui Taku , Shioyama Wataru , Oka Toru , Tabuchi Takahiro , Fujita Masashi 
Published: May 2020

Abstract
Background: Prevalence of cancer is a high risk factor for bleeding events related with antiplatelet therapy after percutaneous coronary intervention (PCI) in cancer patients. However, the long-term bleeding event rates have not been elucidated previously. Further risk stratification was not sufficiently assessed among cancer patients. This study aimed to evaluate the risk factors for clinically relevant bleeding events in cancer patients after PCI with stent implantation.Methods: Among 236 patients who received PCI between 2013 and 2018, 89 cancer patients with first PCI with stent implantation, without prior dual-antiplatelet therapy (DAPT), were analyzed. They were divided into the active cancer (n=44) and non-active cancer (n=45) groups. The active cancer group included non-operable patients currently on treatment or those with metastasis. The non-active cancer group included patients who had already undergone radical surgery or had planned radical surgery within 3 months after the index PCI. The primary endpoint was bleeding events, characterized as Bleeding Academic Research Consortium (BARC) types 2, 3, and 5. The secondary endpoint was 3-point major adverse cardiovascular events (3P-MACE) determined as the composite of cardiac death, nonfatal myocardial infarction, and nonfatal stroke.Results: During the median follow-up period of 2.2 years, there were 11 patients with bleeding events, with only 1 patient in the non-active cancer group. Of the other 10 patients, 5 experienced bleeding during the dual-antiplatelet therapy (DAPT) period, while the remaining 5 experienced bleeding during the single-antiplatelet therapy (SAPT) period. The Kaplan-Meier analysis showed that the active cancer group had a significantly greater number of bleeding events of BARC types 2, 3, and 5 (log-rank, P=0.010). Multivariate Cox regression hazards model analysis revealed that cancer activity was an independent significant risk factor (HR, 9.03; 95% CI, 1.33–176.69; P=0.023). During the 2.5-years [IQR: 0.7–3.0] follow-up period, there was no significant difference in the 3P-MACE between the active and non-active cancer patients.Conclusions: The non-active cancer group presented with significantly lower clinically relevant bleeding after PCI than the active cancer patients. However, the bleeding risk was high in the active cancer groups during both the DAPT and SAPT periods.
Evaluation of an organisational performance measurement implementation framework for health charities
Authors: Colbran Richard , Ramsden Robyn , Stagnitti Karen , Toumbourou John , Pepin Genevieve 
Published: May 2020

Abstract
BackgroundNon acute health charities form part of the global health services industry yet face concerns regarding performance and accountability. Organisational performance measurement (OPM) is enables performance however is under utilised in the non acute health charity sector. The Non-acute Health Charity Performance Implementation Framework (NCPI Framework) was developed to support OPM implementation in non acute health charities. The study goal was to assess whether NCPI Framework implementation could positively impact on the introduction of OPM to case study organisation. The hypothesis was that NCPI Framework implementation would positively impact on the introduction of OPM in a non acute health charity.MethodsA convergent parallel design mixed methods case study evaluation was conducted of the twelve-month implementation of the NCPI Framework in a non acute health charity. Pre and post survey quantitative and qualitative techniques were used to assess the infrastructure and systems used to support the NCPI Framework’s program design and implementation in addition to participant perception of OPM usefulness. This study analysed quantitative data collected using identical pre and post Likert scales surveys. Response rates were 74% at pre and 64% at post data collection times. The valid percentage was used to exclude incomplete responses. Then, data were analysed using descriptive statistics such as modes, means and standard deviation. Wilcoxon Signed Rank Test was used to examine changes between pre and post data. ResultsResults support the hypothesis that the implementation of the NCPI Framework positively impacted on the introduction of organisational performance measurement in the case study organisation. The results were statistically significant and demonstrated positive change in implementation infrastructure and participant perception of OPM usefulness. Board members (59%) reported a lower level of change in positive perception of usefulness than staff (93%) and salaried clinical advisors (93%).ConclusionThis is the first methodological evaluation of OPM implementation in the non acute health charity sector. Results suggest the NCPI Framework has potential to support the establishment of infrastructure, systems and participant engagement to enable OPM introduction in non acute health charities.
Identification of a Novel Mutation in the KITLG Gene in a Chinese Family with Familial Progressive Hyper- and Hypopigmentation
Authors: Wang Jianbo , Li Weisheng , Zhou Naihui , Zhang Shoumin , Li Xueli , Li Zhenlu , Yang Ziliang , Li Min , Sun Miao 
Published: May 2020

Abstract
Background Familial progressive hyper- and hypopigmentation (FPHH, MIM 145250) is a rare hereditary skin disorder that is predominantly characterized by progressive, diffuse, partly blotchy hyperpigmented lesions intermingled with scattered hypopigmented spots, lentigines and sometimes Cafe-au-lait spots (CALs). Heterozygous mutations of KIT ligand (KITLG, MIM 184745) gene, which encodes KIT ligand protein, is responsible for FPHH.Results A novel mutation c.104A > T (p.Asn35Ile) and a recurrent mutation c.101C > T (p.Thr34Ile) in the KITLG gene with two Chinese FPHH families were identified. So far, various pathogenic gain-of-function mutations in the KITLG gene have been described, which are located in or near the conserved VTNN motif (amino acid 33–37) in exon 2 of the KITLG gene. The reported mutations are only involved in 33V, 34T, 36N, 37V but not 35N. As SIFT and Polyphen-2 softwares showed, these two mutations were both predicted to be detrimental variations. Three-dimensional protein structures modeling indicated the mutant KITLG proteins might affect KITLG affinity to its receptor c-KIT. To date, only eight KITLG mutations were associated with FPHH and no clear genotype-phenotype correlations had been well established.Conclusions We have now identified a novel mutation c.104A > T (p.Asn35Ile) of KITLG gene, which was first reported in FPHH located within the conserved 35N of the motif. These results strengthen our understanding of FPHH and expand the mutational spectrum of the KITLG gene.
A retrospective study of potential influence factors on Helicobacter pylori infection treatment
Authors: Qi Xiaomei , Xia Luoluo , Xie Laiping , Huang Dingde , Yang Ying 
Published: May 2020

Abstract
BackgroundThe high prevalence of Helicobacter pylori (H. pylori) infection has been associated with overcrowding, poor housing, poor sanitation and unclean water supplies in developing countries.MethodsWe assessed records of symptomatic patients attending Southwest Hospital in 2017, collected patients’ information such as age, gender, education levels, income level, number of family members, frequency of hand washing after defecation, past history of gastropathy and so on. Chi square analysis, t-test and Odds Ratio (OR) were used to evaluate the effect of potential factors on treatment effect.ResultsAge, gender, number of family members, follow-up time, type of toilet, water source and past history of gastropathy seemed to be irrelevant to H. pylori infection control. Higher education level was benefit for patients (OR 0.315, 95% CI 0.134-0.741, P=0.008). Less frequency of hands washing after defecation was harmful factors for H. pylori-positive patients’ treatment (OR=3.438, 95% CI 1.679-7.039, P=0.001). Better income status was a protective factor only in Univariate analysis (OR=0.396 95% CI 0.197-0.795, P=0.01).ConclusionA better education background and strict habits of hands washing were both helpful for H. pylori-positive patients’ treatment.
A Novel Method for Internal Fixation of Fifth Metatarsal Tuberosity Avulsion Fractures
Authors: Zhan Taicheng , Zhu Kunpeng , Hu Jianping , Cai Tao , Zhang Lei , Zhang Chunlin 
Published: May 2020

Abstract
Background:The purpose of this study is to introduce a novel technique of fixation with a suture anchor combined with a headless cannulated screw.Patients and Methods: Ninepatients with fifth metatarsal tuberosity avulsion fractures were recruited and surgically treated witha suture anchor combined with headless cannulated screw fixation. Those patients were seen for follow-up visits monthly. Clinical and radiological outcomes were evaluated after surgery, at 4, 6 and 8 weeks, and monthly thereafter. The functional outcome was graded using the American Orthopedic Foot and Ankle Society (AOFAS) midfoot scoring system at the final follow-up visit.Results: The mean interval to bone union observed radiologically was 5.6 weeks (range 4–8 weeks). No case of delayed union/nonunion or refracture was detected. No screw migration or implant breakage occurred. The mean interval to daily living activities was 8.2 (range 6 to 12) weeks after surgery.The mean AOFASscore improved from 30.8 (range 10 to 45) points preoperatively to 92.3 (range 87 to 98) points at the final follow-up visit.Conclusions:A suture anchor combined with a headless cannulated screw is a reliable technique with good outcomes and can potentially allow for early bone union.
Evaluation of Right Myocardial Performance Index of In Vitro Fertilization Fetuses and Spontaneous Pregnancy Fetuses: A Cross-Sectional Study
Authors: Chen Shaoqi , Zhuang Zemin , Chen Qingzi , Du Xiya , Tan Xuerui 
Published: May 2020

Abstract
OBJECTIVETo establish normal reference range for the fetal right myocardial performance index (RMPI), and compare the reference range between in vitro fertilization (IVF) fetuses and spontaneous pregnancy (SP) fetuses by automatic measurement of the RMPI.METHODSFrom September 2019 to January 2020, 410 participants, who were at 19-40 weeks' gestation, were enrolled into the current study. Among 410 participants, there were 371 spontaneous pregnancies which were matched as control group, and the experimental group involved 39 singleton pregnancies conceived by IVF. RMPI was calculated as (a-b)/b. The three readings were obtained and averaged per examination, with intra-observer repeatability assessed by intraclass correlation coefficient (ICC) and 95% confidence interval (CI). The ‘a’ and ‘b’ intervals were measured at 3 different caliper positions in each fetus: beginning of the original valve clicks (‘original’), beginning of the reflected tricuspid and pulmonary closure clicks (‘reflected’), and peak of valve clicks (‘peak’).RESULTSThe RMPI of SP fetuses was 0.43±0.05 (mean ± standard deviation (SD)), and the RMPI of IVF fetuses was 0.42 ±0.05 (mean ± SD). There was no significant difference in normal reference range of right MPI between IVF fetuses and SP fetuses. No strong correlation was also noted between RMPI with gestational age and heart rate.CONCLUSIONNormal reference ranges of RMPI of IVF fetuses and SP fetuses were established, and no significant difference between IVF fetuses and SP fetuses was found.
Physiological Change Alters Endophytic Bacteria Community in Clubroot of Tumorous Stem Mustard Infected by Plasmodiophora Brassicae
Authors: Wang Diandong , Sun Tingting , Zhao Songyu , Pan Limei , Liu Hongfang , Tian Xueliang 
Published: May 2020

Abstract
Background: Endophytic bacteria are considered as symbionts living within plants and are influenced by abiotic and biotic environmemts. Here, we reveal how endophytic bacteria in tumorous stem mustard (Brassica juncea var. tumida) are affected by clubroot disease using 16S rRNA high-throughput sequencing.Results: The results showed that Proteobacteria was the dominant group in both healthy roots and clubroots, but their abundance differed. At the genus level, Pseudomonas was dominant in clubroots, whereas Rhodanobacter was the dominant in healthy roots. Hierarchical clustering, UniFrac-weighted principal component analysis (PCA), non-metric multidimensional scaling (NMDS) and analysis of similarities (ANOSIM) indicated significant differences between the endophytic bacteria communities in healthy roots and clubroots. The physiologcial properties including soluble sugar, soluble protein, methanol, POD and SOD significantly differed between healthy roots and clubroots. The distance-based redundancy analysis (db-RDA) and two-factor correlation network showed that soluble sugar, soluble protein and methanol were strongly related to the endophytic bacteria community in clubroots, wheares POD and SOD correlated with the endophytic bacteria community in healthy roots.Conclusions: Our results illustrate that physiologcial change caused by P. brassicae infection may alter the endophytic bacteria community in clubroots of tumorous stem mustard.
Coronavirus Disease 19 in Minority Populations of Newark, New Jersey
Authors: Okoh Alexis K , Sossou Christoph , Dangayach Neha S , Meledathu Sherin , Phillips Oluwakemi , Raczek Corrine , Patti Michael , Kang Nathan , Hirji Sameer , Cathcart Charles , Engell Christian , Cohen Marc , Bishburg Eliahu , Nagarakanti Sandhya , Grewal Harpreet 
Published: May 2020

Abstract
BACKGROUND:The purpose of this study is to report the clinical features and outcomes of Black/African American (AA) and Latino Hispanic patients with Coronavirus disease 2019 (COVID-19) hospitalized in an inter-city hospital in the state of New Jersey. METHODS: This is a retrospective cohort study of AA and Latino Hispanic patients with COVID-19 admitted to a 665-bed quaternary care, teaching hospital located in Newark, New Jersey. The study included patients who had completed hospitalization between March 10, 2020, and April 10, 2020. We reviewed demographics, socioeconomic variables and incidence of in-hospital mortality and morbidity. Logistic regression was used to identify predictor of in-hospital death.RESULTS: Out of 416 patients, 251 (60%) had completed hospitalization as of April 10, 2020. The incidence of In-hospital mortality was 38.6% (n=97). Most common symptoms at initial presentation were dyspnea 39% (n=162) followed by cough 38%(n=156) and fever 38% (n=143). Patients were in the highest quartile for population’s density, number of housing units and disproportionately fell into the lowest median income quartile for the state of New Jersey. The incidence septic shock, acute kidney injury (AKI) requiring hemodialysis and admission to an intensive care unit (ICU) was 24% (n=59), 21% (n=52), 33% (n=82) respectively. Independent predictors of in-hospital mortality were older age, lower serum Hemoglobin <10mg/dl, elevated serum Ferritin and Creatinine phosphokinase levels >1200U/L and >1000 U/L.CONCLUSIONS: Findings from an inter-city hospital’s experience with COVID-19 among underserved minority populations showed that, more than one of every three patients were at risk for in-hospital death or morbidity. Older age and elevated inflammatory markers at presentation were associated with in-hospital death.