bluuebunny/crossref_metadata_2025_split huggingface dataset:
Person-centred care in osteoarthritis and inflammatory arthritis: a scoping review of people’s needs outside of healthcare
Authors: Fairley Jessica L. , Seneviwickrama Maheeka , Yeh Sabrina , Anthony Shane , Chou Louisa , Cicuttini Flavia M. , Sullivan Kaye , Briggs Andrew M. , Wluka Anita E. 
Published: April 2021

Abstract
Background
Arthritis, regardless of cause, has significant physical, social and psychological impacts on patients. We aimed to identify the non-healthcare needs perceived by patients with inflammatory arthritis (IA) and osteoarthritis (OA), and to determine if these differ.

Methods
We electronically searched MEDLINE, PsycINFO, EMBASE and CINAHL (1990–2020) systematically to identify non-healthcare-related needs of people with IA or OA. All citations were screened and quality appraised by two reviewers. Data was extracted by a single reviewer.

Results
The search identified 7853 citations, with 31 studies included (12 for OA, 20 for IA). Six areas of need emerged and these were similar in both group These were: 1) Assistance with activities of daily living especially related to a lack of independence; 2) Social connectedness: need for social participation; 3) Financial security: worry about financial security and increased costs of health-seeking behaviours; 4) Occupational needs: desire to continue work for financial and social reasons, facilitated by flexibility of workplace conditions/environment; 5) Exercise and leisure: including limitation due to pain; 6) Transportation: limitations in ability to drive and take public transport due to mobility concerns. Many areas of need were linked; e.g. loss of employment and requiring support from family was associated with a sense of “failure” and loss of identity, as social isolation.

Conclusions
This review highlights the pervasive impact of arthritis on peoples’ lives, regardless of aetiology, albeit with a limited evidence base. Improved identification and targeting of non-healthcare needs of people with arthritis is likely to improve person-centred care.
Risk factors of ankle osteoarthritis in the treatment of critical bone defects using ilizarov technique
Authors: Liu Kai , Cai Feiyu , Liu Yanshi , Abulaiti Alimujiang , Ren Peng , Yusufu Aihemaitijiang 
Published: April 2021

Abstract
Background
Distraction osteogenesis using the Ilizarov external circular fixator has been applied in lower limb reconstructive surgery widely. The increasing ankle osteoarthritis (OA) progression and severity are often associated with the period of external fixator and the greater relative instability of the ankle joint, but few studies have quantified risk factors directly during this technique.

Methods
The study was conducted on 236 patients who underwent bone transport surgery for tibias using the Ilizarov external circular fixator from 2008 to 2018. The cumulative incidence of ankle OA diagnoses in patients after the Ilizarov technique treatment was calculated and stratified by risk factors from preoperative and postoperative management. After the data were significant through the Mann-Whitney U test analyzed, odds ratios were calculated using logistic regression to describe factors associated with the OA diagnosis including gender, age, BMI, location of bone defect, diabetes, hypertension, osteoporosis, the history of metal allergy and glucocorticoid intake, the American Orthopaedic Foot & Ankle Society (AOFAS) ankle-HF scale scores, defect size (DS), the type of bone transport, the bone union time, external fixator time (EFT), and external fixator index (EFI).

Results
There were 199 males and 37 females with a mean age of 47 years (range 28–59 years). Out of 236 patients, 49 had an additional treatment for ankle OA after the Ilizarov technique treatment of bone defects (average follow-up time 2.1 years, range 1.6–4.2 years). The incidence of postoperative ankle OA was 20.8 %, with 19 patients classified as K&L grade 3 and seven patients as grade 4. The top five risk factors included double-level bone transport (OR3.79, P = 0.005), EFI > 50days/cm (OR3.17, P = 0.015), age > 45years (OR2.29, P = 0.032), osteoporosis (OR1.58, P < 0.001), BMI > 25 (OR1.34, P < 0.001). Male, BMI > 25, diabetes, osteoporosis, and AOFAS ankle-HF scale scores are the independent risk factors.

Conclusions
Ilizarov external circular fixator is a safe and effective method of treatment for critical bone defects. The double level bone transport, EFI > 50days/cm, age > 45years, osteoporosis, BMI > 25 are the top five relevant risk factors of ankle OA. The probability of developing ankle OA among patients having three or more risk factors is 50–70 %.
Biofilm reduction potential of 0.02% polyhexanide irrigation solution in several types of urethral catheters
Authors: Brill Florian H. H. , Hambach Julia , Utpatel Christian , Mogrovejo Diana C. , Gabriel Henrik , Klock Jan-Hendrik , Steinmann Joerg , Arndt Andreas 
Published: April 2021

Abstract
Background
Long-term use of urethral catheters is associated with high risk of urinary tract infection (UTI) and blockage. Microbial biofilms are a common cause of catheter blockage, reducing their lifetime and significantly increasing morbidity of UTIs. A 0.02% polyhexanide irrigation solution developed for routine mechanical rinsing shows potential for bacterial decolonization of urethral catheters and has the potential to reduce or prevent biofilm formation.

Methods
Using an in vitro assay with standard market-leading types of catheters artificially contaminated with clinically relevant bacteria, assays were carried out to evaluate the biofilm reduction and prevention potential of a 0.02% polyhexanide solution versus no intervention (standard approach) and irrigation with saline solution (NaCl 0.9%). The efficiency of decolonization was measured through microbial plate count and membrane filtration.

Results
Irrigation using a 0.02% polyhexanide solution is suitable for the decolonization of a variety of transurethral catheters. The effect observed is significant compared to irrigation with 0.9% saline solution (p = 0.002) or no treatment (p = 0.011). No significant difference was found between irrigation with 0.9% saline solution and no treatment (p = 0.74).

Conclusions
A 0.02% polyhexanide solution is able to reduce bacterial biofilm from catheters artificially contaminated with clinically relevant bacteria in vitro. The data shows a reduction of the viability of thick bacterial biofilms in a variety of commercially available urinary catheters made from silicone, latex-free silicone, hydrogel-coated silicone and PVC. Further research is required to evaluate the long-term tolerability and efficacy of polyhexanide in clinical practice.
Thyroid-stimulating hormone decreases the risk of osteoporosis by regulating osteoblast proliferation and differentiation
Authors: Deng Tuo , Zhang Wenwen , Zhang Yanling , Zhang Mengqi , Huan Zhikun , Yu Chunxiao , Zhang Xiujuan , Wang Yan , Xu Jin 
Published: April 2021

Abstract
Background
As the incidence of secretory osteoporosis has increased, bone loss, osteoporosis and their relationships with thyroid-stimulating hormone (TSH) have received increased attention. In this study, the role of TSH in bone metabolism and its possible underlying mechanisms were investigated.

Methods
We analyzed the serum levels of free triiodothyronine (FT3), free thyroxine (FT4), and TSH and the bone mineral density (BMD) levels of 114 men with normal thyroid function. In addition, osteoblasts from rat calvarial samples were treated with different doses of TSH for different lengths of time. The related gene and protein expression levels were investigated.

Results
A comparison of the BMD between the high-level and low-level serum TSH groups showed that the TSH serum concentration was positively correlated with BMD. TSH at concentrations of 10 mU/mL and 100 mU/mL significantly increased the mRNA levels of ALP, COI1 and Runx2 compared with those of the control (P < 0.05, P < 0.01). Bone morphogenetic protein (BMP)2 activity was enhanced with both increased TSH concentration and increased time. The protein levels of Runx2 and osterix were increased in a dose-dependent manner.

Conclusions
The circulating concentrations of TSH and BMD were positively correlated with normal thyroid function in males. TSH promoted osteoblast proliferation and differentiation in rat primary osteoblasts.
The effects of oral health education regarding periodontal health on non-dental undergraduates in southwestern China—exploring the feasibility of an e-learning course for oral health promotion
Authors: Wu Zhiwu , Li Mingming , Zhu Fangzhi , Lei Lei , Cheng Ran , Hu Tao 
Published: April 2021

Abstract
Background
The high prevalence of periodontal diseases is an important oral health problem worldwide. It is necessary to increase public knowledge on and influence attitudes towards periodontal diseases in order to prevent them. However, the effect of oral health education (OHE) as a primary preventive method in China is unsatisfactory. The aim of this study is to investigate the feasibility of extending an e-learning course regarding periodontal health by comparing the effects of oral health education regarding periodontal health (OHE-PH) on dental and non-dental students and the effects between a traditional course and an e-learning course among non-dental students at Sichuan University.

Methods
A quasi-experimental study with a pre-test and a post-test was performed. A total of 217 dental students and 134 non-dental students attended a traditional course; 69 non-dental students attended an e-learning course. Before- and after-course questionnaires about periodontal health knowledge, attitudes and behaviours were administered.

Results
After the traditional/e-learning course, the knowledge of both dental and non-dental students about periodontal diseases and self-reported behaviours for gingival bleeding and oral care improved. The non-dental students reached or surpassed the level of dental students before the course. The non-dental students taking the e-learning course performed better in some areas than those taking the traditional course.

Conclusions
OHE-PH was effective for dental and non-dental students. The e-learning course on OHE-PH was sufficient for improving knowledge and self-reported behaviours among non-dental undergraduates and was even better than the traditional course in some areas. The e-learning course may be an effective method for periodontal health education and oral health promotion among undergraduates.
Use of 360° virtual reality video in medical obstetrical education: a quasi-experimental design
Authors: Arents Vera , de Groot Pieter C. M. , Struben Veerle M. D. , van Stralen Karlijn J. 
Published: April 2021

AbstractBackgroundVideo-based teaching has been part of medical education for some time but 360° videos using a virtual reality (VR) device are a new medium that offer extended possibilities. We investigated whether adding a 360° VR video to the internship curriculum leads to an improvement of long-term recall of specific knowledge on a gentle Caesarean Sections (gCS) and on general obstetric knowledge.MethodsTwo weeks prior to their Obstetrics and Gynaecology (O&G) internship, medical students were divided in teaching groups, that did or did not have access to a VR-video of a gCS. Six weeks after their O&G internship, potentially having observed one or multiple real-life CSs, knowledge on the gCS was assessed with an open questionnaire, and knowledge on general obstetrics with a multiple-choice questionnaire. Furthermore we assessed experienced anxiety during in-person attendance of CSs, and we asked whether the interns would have wanted to attend more CSs in-person. The 360° VR video group was questioned about their experience directly after they watched the video. We used linear regression analyses to determine significant effects on outcomes.ResultsA total of 89 medical students participated, 41 in the 360° VR video group and 48 in the conventional study group. Watching the 360° VR video did not result in a difference in either specific or general knowledge retention between the intervention group and the conventional study group. This was both true for the grade received for the internship, the open-ended questions as well as the multiple-choice questions and this did not change after adjustment for confounding factors. Still, 83.4% of the 360° VR video-group reported that more videos should be used in training to prepare for surgical procedures. In the 360° VR video-group 56.7% reported side effects like nausea or dizziness. After adjustment for the number of attended CSs during the practical internship, students in the 360° VR video-group stated less often (p = 0.04) that they would have liked to attend more CSs in-person as compared to the conventional study group.ConclusionEven though the use of 360° VR video did not increase knowledge, it did offer a potential alternative for attending a CS in-person and a new way to prepare the students for their first operating room experiences.
Unsupervised phenotyping of sepsis using nonnegative matrix factorization of temporal trends from a multivariate panel of physiological measurements
Authors: Ding Menghan , Luo Yuan 
Published: April 2021

AbstractBackgroundSepsis is a highly lethal and heterogeneous disease. Utilization of an unsupervised method may identify novel clinical phenotypes that lead to targeted therapies and improved care.MethodsOur objective was to derive clinically relevant sepsis phenotypes from a multivariate panel of physiological data using subgraph-augmented nonnegative matrix factorization. We utilized data from the Medical Information Mart for Intensive Care III database of patients who were admitted to the intensive care unit with sepsis. The extracted data contained patient demographics, physiological records, sequential organ failure assessment scores, and comorbidities. We applied frequent subgraph mining to extract subgraphs from physiological time series and performed nonnegative matrix factorization over the subgraphs to derive patient clusters as phenotypes. Finally, we profiled these phenotypes based on demographics, physiological patterns, disease trajectories, comorbidities and outcomes, and performed functional validation of their clinical implications.ResultsWe analyzed a cohort of 5782 patients, derived three novel phenotypes of distinct clinical characteristics and demonstrated their prognostic implications on patient outcome. Subgroup 1 included relatively less severe/deadly patients (30-day mortality, 17%) and was the smallest-in-size group (n = 1218, 21%). It was characterized by old age (mean age, 73 years), a male majority (male-to-female ratio, 59-to-41), and complex chronic conditions. Subgroup 2 included the most severe/deadliest patients (30-day mortality, 28%) and was the second-in-size group (n = 2036, 35%). It was characterized by a male majority (male-to-female ratio, 60-to-40), severe organ dysfunction or failure compounded by a wide range of comorbidities, and uniquely high incidences of coagulopathy and liver disease. Subgroup 3 included the least severe/deadly patients (30-day mortality, 10%) and was the largest group (n = 2528, 44%). It was characterized by low age (mean age, 60 years), a balanced gender ratio (male-to-female ratio, 50-to-50), the least complicated conditions, and a uniquely high incidence of neurologic disease. These phenotypes were validated to be prognostic factors of mortality for sepsis patients.ConclusionsOur results suggest that these phenotypes can be used to develop targeted therapies based on phenotypic heterogeneity and algorithms designed for monitoring, validating and intervening clinical decisions for sepsis patients.
Validation of nursing documentation regarding in-hospital falls: a cohort study
Authors: Krakau Karolina , Andersson Helene , Dahlin Åsa Franzén , Egberg Louise , Sterner Eila , Unbeck Maria 
Published: April 2021

Abstract
Background
In-hospital fall incidents are common and sensitive to nursing care. It is therefore important to have easy access to valid patient data to evaluate and follow-up nursing care. The aim of the study was to validate the nursing documentation, using a specific term in the registered nurses´ (RNs´) discharge note, regarding inpatient falls according to the outcome of a digitalized data extraction tool and the discharge note itself.

Methods
At a teaching hospital, 31,571 episodes of care were eligible for inclusion in this retrospective cohort study. A stratified sampling including five groups was used, two with random sampling and three with total sampling. In total, 1232 episodes of care were reviewed in the electronic patient record using a study-specific protocol. Descriptive statistics were used.

Results
In total, 590 episodes of care in the study cohort included 714 falls. When adjusted for the stratified sampling the cumulative incidence for the study population was 1.9%.
The positive predictive value in total for the data extraction tool regarding the presence of any fall, in comparison with the record review, was 87.4%. Discrepancies found were, for example, that the RNs, at discharge, stated that the patient had fallen but no documented evidence of that could be detected during admission. It could also be the opposite, that the RNs correctly had documented that no fall had occurred, but the data extraction tool made an incorrect selection. When the latter had been withdrawn, the positive predictive value was 91.5%.
Information about minor injuries due to the fall was less accurate. In the group where RNs had stated that the patient had fallen without injury, minor injuries had actually occurred in 28.3% of the episodes of care.

Conclusions
The use of a specific term regarding fall in the RNs´ discharge note seems to be a valid and reliable data measurement and can be used continuously to evaluate and follow-up nursing care.
Capacity and site readiness for hypertension control program implementation in the Federal Capital Territory of Nigeria: a cross-sectional study
Authors: Orji Ikechukwu A. , Baldridge Abigail S. , Omitiran Kasarachi , Guo Mainzhao , Ajisegiri Whenayon Simeon , Ojo Tunde M. , Shedul Gabriel , Kandula Namratha R. , Hirschhorn Lisa R. , Huffman Mark D. , Ojji Dike B. 
Published: April 2021

Abstract
Background
Nigeria faces an increase in the burden of non-communicable diseases (NCDs), including cardiovascular diseases (CVDs), leading to an estimated 29% of all deaths in the country. Nigeria has an estimated hypertension prevalence ranging from 25 to 40% of her adult population. Despite this high burden, awareness (14–30%), treatment (< 20%), and control (9%) rates of hypertension are low in Nigeria. Against this backdrop, we sought to perform capacity and readiness assessments of public Primary Healthcare Centers (PHCs) to inform Nigeria’s system-level hypertension control program’s implementation and adaptation strategies.

Methods
The study employed a multi-stage sampling to select 60 from the 243 PHCs in the Federal Capital Territory (FCT) of Nigeria. The World Health Organization (WHO) Service Availability and Readiness Assessment was adapted to focus on hypertension diagnosis and treatment and was administered to PHC staff from May 2019 – October 2019. Indicator scores for general and cardiovascular service readiness were calculated based on the proportion of sites with available amenities, equipment, diagnostic tests, and medications.

Results
Median (interquartile range [IQR]) number of full-time staff was 5 (3–8), and were predominantly community health extension workers (median = 3 [IQR 2–5]). Few sites (n = 8; 15%) received cardiovascular disease diagnosis and management training within the previous 2 years, though most had sufficient capacity for screening (n = 58; 97%), diagnosis (n = 56; 93%), and confirmation (n = 50; 83%) of hypertension. Few PHCs had guidelines (n = 7; 13%), treatment algorithms (n = 3; 5%), or information materials (n = 1; 2%) for hypertension. Most sites (n = 55; 92%) had one or more functional blood pressure apparatus. All sites relied on paper records, and few had a functional computer (n = 10; 17%) or access to internet (n = 5; 8%). Despite inclusion on Nigeria’s essential medicines list, 35 (59%) PHCs had zero 30-day treatment regimens of any blood pressure-lowering medications in stock.

Conclusions
This first systematic assessment of capacity and readiness for a system-level hypertension control program within the FCT of Nigeria demonstrated implementation feasibility based on the workforce, equipment, and paper-based information systems, but a critical need for essential medicine supply strengthening, health-worker training, and protocols for hypertension treatment and control in Nigeria.
Providing safe maternity care under challenging conditions in rural Ethiopia: a qualitative study
Authors: Mordal Elin , Hanssen Ingrid , Biratu Andargachew Kassa , Vatne Solfrid 
Published: April 2021

Abstract
Background
Women’s health and the reduction in the global maternal mortality rate is a research priority worldwide. The aim of this study was to investigate the structural conditions that influence the maternity care provided for women in rural Ethiopia.

Methods
A qualitative descriptive study was conducted, composed of 28 individual in-depth interviews with midwives and women who had given birth during the past 8 months, and observations of maternity care at health centres and a primary hospital. A thematic analysis was conducted.

Results
The midwives do their utmost to save the lives of mothers and prioritise saving lives over providing compassionate care. Inadequate resources, such as equipment, medicine and water, affect the quality of care they provide for the birthing women. This creates a conflict between the midwives’ ideals and what conditions allow them to do. Families and the women’s network play important roles in providing care and support to the women who give birth in health facilities.

Conclusions
Structural conditions make it difficult for Ethiopian midwives in rural areas to provide optimal maternity care. In addition to the availability of professional midwifery care, the expectant mothers’ families and networks also tend to provide important support and care. Further studies on how to improve the quality of maternity care from the women’s perspective are needed.
Preliminary analysis of whether mosquitoes can carry and transmit African swine fever
Authors: Qin Weiyun , Gao Zhongcheng , Wu Shenglong , Bao Wenbin 
Published: April 2021

Abstract
Background
Mosquitoes are important insect vectors, but whether they can carry and transmit African swine fever virus (ASFV) in large-scale pig farms in China is unknown.

Results
In this study, probe-based qPCR analysis was performed on mosquitoes from five pig farms with ASF virus (ASFV). Analysis of ASFV in 463 mosquitoes yielded negative cycle threshold (CT) value), and detection remained negative after mixing samples from all five pig farms.

Conclusions
Therefore, mosquitoes appear unlikely to transmit ASFV, and pose little threat to large-scale pig farms. Thus, farms should continue to follow normal mosquito control procedures when formulating strategies for the prevention and control of ASF.