bluuebunny/crossref_metadata_2025_split huggingface dataset:
The concordance between preoperative aspiration and intraoperative synovial fluid culture results: intraoperative synovial fluid re-cultures are necessary whether the preoperative aspiration culture is positive or not
Authors: Li Hao , Xu Chi , Hao LiBo , Chai Wei , Jun Fu , Chen Jiying 
Published: September 2021

Abstract
Aims
Preoperative aspiration culture and intraoperative cultures play pivotal roles in periprosthetic joint infection (PJI) diagnosis and pathogen identification. But the discordance between preoperative aspiration culture and intraoperative synovial fluid culture remains unknown. We aim to determine (1) the discordance between preoperative and intraoperative synovial fluid (SF) culture and. (2) compared to intraoperative synovial fluid cultures, the sensitivity of preoperative aspiration fluid culture. Then the following question is tried to be answered: Are intraoperative synovial fluid re-cultures necessary if the preoperative aspiration culture is positive?

Materials and methods
Between 2015 and 2019, 187 PJI patients managed with surgeries were included in this study. Compared to intraoperative synovial fluid culture, the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of preoperative aspiration culture were calculated. Then, the discordance between preoperative aspiration culture and intraoperative SF culture was analyzed.

Results
The sensitivity of preoperative aspiration culture was 81.29% compared to intraoperative synovial fluid cultures. Concordance was identified in 147 PJI (78.61%) patients and culture discordance occurred in 40 patients (21.39%). In these discordant PJI patients, 24 patients (60%) were polymicrobial and no intraoperative synovial fluid culture growth was found in 16 PJI cases (40%). Preoperative monomicrobial staphylococcus results had a sensitivity of and a specificity of 80.43% and 83.16%, respectively. Preoperative polymicrobial results had the lowest sensitivity.

Conclusions
The intraoperative synovial fluid re-cultures are necessary if the preoperative aspiration culture is positive and the discordance between preoperative aspiration culture and intraoperative synovial fluid culture should be noted especially when Streptococcus spp. and more than one pathogen was revealed by preoperative aspiration culture.
Level of evidence: Level III.
Rasch analysis of the Brain Injury Screening Tool (BIST) in mild traumatic brain injury
Authors: Shaikh Nusratnaaz , Theadom Alice , Siegert Richard , Hardaker Natalie , King Doug , Hume Patria 
Published: September 2021

Abstract
Objective
To evaluate the psychometric properties of the Brain Injury Screening Tool (BIST) symptom scale in a sample of people with a mild Traumatic Brain Injury (mTBI) through Rasch analysis, and to obtain an interval level measurement score for potential clinical use.

Materials and methods
Data were obtained from 114 adults aged over 16 years, who had experienced at least one mTBI in the past 10 years. Participants were recruited via social media, concussion clinics and sports organisations over a 4-month period between May and September 2020. Participants were asked to compete the symptom scale of the BIST tool via an anonymous online questionnaire. Internal construct validity, dimensionality, person separation index, and differential item functioning of the BIST were examined with Rasch analysis.

Results
BIST in its original form produced a satisfactory item-trait interaction, and good reliability, but was found to be multi-dimensional. Rasch analysis of the full scale with three domains as subtests resulted in acceptable model fit (χ2(6) =3.8, p >  0.05), with good reliability (Person Separation Index = 0.84), and uni-dimensionality. Differential Item Functioning (DIF) analysis displayed no significant DIF effects for sex or age revealing that people responded consistently and similarly to the individual BIST items based on severity of symptom burden.

Conclusions
The 15-item symptom scale of the BIST tool is a psychometrically sound measure of symptom burden following mTBI. The findings provide support for use of both total and sub scale scores for clinical use. Ordinal to interval score conversions are recommended for use when using the scores for research purposes in mTBI.
Hybrid Oxford unicompartmental knee arthroplasty has lower residual cement extrusion than cemented arthroplasty in treating end-stage unicompartmental knee osteoarthritis
Authors: Yang Guangzhong , Jiao Xufeng , Li Qianli , Li Zheng , An Shuai , Feng Mingli , Gao Guanghan , Huang Jiang , Cao Guanglei 
Published: September 2021

Abstract
Background
Hybrid Oxford unicompartmental knee arthroplasty (OUKA) consists of cementless femoral prostheses and cemented tibial prostheses. Although a hybrid OUKA has been used in clinical practice, the clinical outcome has not been reported. The purpose of this study was to compare the short-term clinical outcomes and rate of residual bone cement extrusion between hybrid and cemented prostheses and analyse the possible reasons for differences between outcomes.

Methods
A total of 128 knees (118 patients) with end-stage osteoarthritis were included in this study, of which underwent consecutive operations using unicondylar Oxford phase 3 implants from July 2017 and September 2019 in our centre. Follow-up was performed at 6 weeks, 3 and 6 months, 1 year and every year after operation, and complications and changes in the Oxford knee score (OKS) were recorded. The OKS of the two groups was analysed by the generalized estimating equation approach. Prosthesis-based standard fluoroscopy was performed in a timely manner after each operation, and the rate of residual cement extrusion of the two groups was estimated using T-tests and a multivariate regression analysis.

Results
Excluding the cases that lost follow-up, a total of 120 knees (65 in hybrid group and 55 in cemented group) were included in the analysis. There was no statistically significant difference in patient characteristics between the two groups (p > 0.05). The average follow-up time was 23.4 months (and ranged from 12 to 38 months). As of the last follow-up, there were no complications, such as dislocation, fracture, prosthesis loosening and subsidence, but one patient in the cemented group experienced symptoms caused by residual loose cement. Postoperative OKS in both groups improved significantly (p < 0.001). There was no significant difference in the OKS at any point during the follow-up or in the improvement of the OKS between the two groups (p > 0.05). Residual cement was mainly extruded behind the tibial prosthesis. The rate of hybrid periprosthetic residual cement extrusion was significantly lower in the hybrid group than in the cemented group, and the difference was statistically significant (OR = 3.38; p = 0.014).

Conclusions
Hybrid OUKA is as effective as cemented OUKA in the short term after operation and can significantly reduce the residual cement extrusion rate around the tibial prosthesis.
Acceptance of COVID-19 vaccination and its determinants among Lebanese dentists: a cross-sectional study
Authors: Nasr Lara , Saleh Nadine , Hleyhel Mira , El-Outa Abbass , Noujeim Ziad 
Published: September 2021

Abstract
Background
Dentists are at high risk of exposure to occupational Coronavirus Disease 2019 (COVID-19). Since vaccination is crucial to control COVID-19 pandemic, we aimed to assess COVID-19 vaccination acceptance and its determinants among Lebanese practicing dentists.

Methods
A cross-sectional online study was conducted between February 15 and 22, 2021, among dentists practicing in Lebanon. Prevalence of COVID-19 vaccine acceptance was estimated. A multivariable modified Poisson regression model was used to explore determinants of COVID-19 vaccine acceptance.

Results
In total, 86% of participants were willing to receive or have already received a COVID-19 vaccine. Having received the influenza vaccine during the COVID-19 pandemic was linked to a 12% increase in the COVID-19 vaccination acceptance rate. In addition, participants having moderate and high COVID-19 vaccination knowledge levels were more likely to accept receiving the vaccine, and participants whose fear of COVID-19 level was high were more likely to accept receiving the vaccine compared to those having a low fear level. Contrarily, those who visit the medical doctor only when needed and once a year were less likely to accept COVID-19 vaccine compared to participants who routinely visit the medical doctor.

Conclusions
Our study showed a high level of acceptance of COVID-19 vaccination among Lebanese practicing dentists. And since knowledge about COVID-19 vaccination was associated with the vaccine acceptance, it should be improved and updated to further increase the acceptance rate. High acceptability of COVID-19 vaccination among dentists is expected to have a positive impact among the population in terms of increasing awareness and vaccine uptake.
Interprofessional survey on communication skills in veterinary and veterinary-related education in Germany
Authors: Rauch Michèle , Wissing Sandra , Tipold Andrea , Kleinsorgen Christin 
Published: September 2021

Abstract
Background
Communication is an indispensable skill in the everyday working life of a veterinary team. In German higher educational institutions, communication skills training is explicitly mentioned in the curricula of veterinary assistants, including veterinary nurses and veterinary technicians, and of animal keepers, but not for undergraduate veterinary medicine. Little is known about interprofessional education in veterinary medicine and related professions. Therefore, the purpose of this study is to describe and explore the current interprofessional state of knowledge regarding communication skills of the aforementioned groups in Germany.

Methods
To explore the perception, assess the knowledge and identify the attitude regarding communication skills and interprofessional training, an online survey was distributed. The survey was sent to all five veterinary higher educational institutions, 38 schools for veterinary assistants and 15 schools for animal keepers throughout Germany.

Results
In total, 294 veterinary students, 111 veterinary assistant trainees and 62 animal keeper trainees participated. The majority of participants (98.07%, n = 458) perceived communication skills as highly important for their everyday work. In total, 413 participants (88.44%) felt that their communication skills needed improvement and more than half admitted having difficulties in effective communication (59.31%; n = 277). In addition, 62.74% of respondents (n = 293) were not sufficiently informed about the training content of their future colleagues. Most were convinced that training could positively influence on their communication with clients (95.72%; n = 447) and the team (92.29%; n = 431), and 76.45% of respondents (n = 357) wished to participate in an interprofessional training.

Conclusions
Results of this study confirm that communication skills are perceived as highly important for professional life. Students and trainees show a great interest in communication skills and interprofessional training. The findings indicate that appropriate adjustments to existing curricula are necessary in Germany.
Inequalities in catastrophic health expenditures in conflict-affected areas and the Colombian peace agreement: an oaxaca-blinder change decomposition analysis
Authors: León-Giraldo Sebastián , Cuervo-Sánchez Juan Sebastián , Casas Germán , González-Uribe Catalina , Kreif Noemi , Bernal Oscar , Moreno-Serra Rodrigo 
Published: September 2021

Abstract
Background
The present study analyzes inequalities in catastrophic health expenditures in conflict-affected regions of Meta, Colombia and socioeconomic factors contributing to the existence and changes in catastrophic expenditures before and after the sign of Colombian Peace Agreement with FARC-EP guerilla group in 2016.

Methods
The study uses the results of the survey Conflicto, Paz y Salud (CONPAS) conducted in 1309 households of Meta, Colombia, a territory historically impacted by armed conflict, for the years 2014 and 2018. We define catastrophic expenditures as health expenditures above 20% of the capacity to pay of a household. We disaggregate the changes in inequalities in catastrophic expenditures through the Oaxaca-Blinder change decomposition method.

Results
The incidence of catastrophic expenditures slightly increased between 2014 to 2018, from 29.3 to 30.7%. Inequalities in catastrophic expenditures, measured through concentration indexes (CI), also increased from 2014 (CI: -0.152) to 2018 (CI: -0.232). Results show that differences in catastrophic expenditures between socioeconomic groups are mostly attributed to an increased influence of specific sociodemographic variables such as living in rural zones, being a middle-aged person, living in conflict-affected territories, or presenting any type of mental and physical disability.

Conclusions
Conflict-deescalation and the peace agreement may have facilitated lower-income groups to have access to health services, especially in territories highly impacted by conflict. This, consequently, may have led to higher levels of out-of-pocket expenditures and, therefore, to higher chances of experiencing catastrophic expenditures for lower-income groups in comparison to higher-income groups. Therefore, results indicate the importance of designing policies that guarantee access to health services for people in conflict -affected regions but also, that minimize health care inequalities in out-of-pocket payments that may arouse between people at different socioeconomic groups.
Association between the APOE gene polymorphism and lipid profile and the risk of atrial fibrillation
Authors: Deng Xunwei , Hou Jingyuan , Deng Qiaoting , Zhong Zhixiong 
Published: September 2021

Abstract
Background
The relationship between the APOE gene polymorphism and lipid profiles and atrial fibrillation (AF) remains controversial. The current study purposed to investigate how the APOE gene SNPs (rs429358 and rs7412) and lipid profile are associated with the risk for AF among the Hakka population in southern China.

Methods
Finally, 1367 patients were enrolled in this study, including 706 participants with AF (41 ~ 98 years old, 58.64 % male) and 661 non-AF subjects (28 ~ 95 years old, 59.46 % male). The collected data included baseline characteristics, medical history, laboratory tests and echocardiography parameters. A general linear model (two-way analysis of variance (ANOVA)) and Tukey post-hoc tests were applied to identify an APOE allele, AF group, and interaction effect on lipid profiles. Logistic regression analysis was performed to identify risk factors for AF.

Results
For AF group, the most common genotype was E3/E3 (53.82 %), followed by E3/E4 (28.19 %), E2/E3 (13.60 %), E4/E4 (1.98 %), E2/E4 (1.84 %) and E2/E2 (0.57 %). The two-way ANOVA followed by the Tukey procedure showed the following: the lipid levels depended significantly on AF and APOE allele groups for TG, TC, LDL-C and Apo-B (all P < 0.001), and statistically significant interactions between AF and APOE allele were observed in the above 4 variables (all P < 0.05). Multivariate regression analysis indicated that age ≥ 65years (P < 0.001), high diastolic blood pressure (DBP ≥ 90mm Hg, P = 0.018), a high levels of total cholesterol (TC ≥ 5.2mmol/L, P < 0.001) and triglyceride (TG ≥ 1.7mmol/L, P = 0.028), but not the two SNPs of the APOE gene (rs7412 and rs429358) (OR 1.079, P = 0.683), were significant independent risk factors for AF in the study population.

Conclusions
The principal findings of this study showed that individuals at high risk for AF were those over 65 years of age, higher DBP as well as high levels of TC and TG among the southern China Hakka population. The levels of TG, TC, LDL-C and Apo-B depended significantly on AF and APOE allele groups, and statistically significant interactions between AF and APOE allele were observed in the above 4 variables, although the APOE gene SNPs (rs429358 and rs7412) were no significant risk for AF incidence. Further investigation is needed to elucidate whether other SNPs of the APOE gene have a bearing on AF incidents.
Main differences between two highly effective lipid-lowering therapies in subclasses of lipoproteins in patients with acute myocardial infarction
Authors: Pinto Leticia C. S. , Mello Ana P. Q. , Izar Maria C. O. , Damasceno Nagila R. T. , Neto Antonio M. F. , França Carolina N. , Caixeta Adriano , Bianco Henrique T. , Póvoa Rui M. S. , Moreira Flavio T. , Bacchin Amanda S. F. , Fonseca Francisco A. 
Published: September 2021

Abstract
Background
Large observational studies have shown that small, dense LDL subfractions are related to atherosclerotic cardiovascular disease. This study assessed the effects of two highly effective lipid-lowering therapies in the atherogenic subclasses of lipoproteins in subjects with ST-segment elevation myocardial infarction (STEMI).

Methods
Patients of both sexes admitted with their first myocardial infarction and submitted to pharmacoinvasive strategy (N = 101) were included and randomized using a central computerized system to receive a daily dose of simvastatin 40 mg plus ezetimibe 10 mg or rosuvastatin 20 mg for 30 days. Intermediate-density lipoprotein (IDL) and low-density lipoprotein (LDL) subfractions were analysed by polyacrylamide gel electrophoresis (Lipoprint System) on the first (D1) and 30th days (D30) of lipid-lowering therapy. Changes in LDL and IDL subfractions between D1 and D30 were compared between the lipid-lowering therapies (Mann-Whitney U test).

Results
The classic lipid profile was similar in both therapy arms at D1 and D30. At D30, the achievement of lipid goals was comparable between lipid-lowering therapies. Cholesterol content in atherogenic subclasses of LDL (p = 0.043) and IDL (p = 0.047) decreased more efficiently with simvastatin plus ezetimibe than with rosuvastatin.

Conclusions
Lipid-lowering therapy with simvastatin plus ezetimibe was associated with a better pattern of lipoprotein subfractions than rosuvastatin monotherapy. This finding was noted despite similar effects in the classic lipid profile and may contribute to residual cardiovascular risk.

Trial registration
ClinicalTrials.gov, NCT02428374, registered on 28/09/2014.
Association between thyroid disorders and COVID-19: a protocol for a systematic review and meta-analysis
Authors: Doustmohammadian Soraya , Doustmohammadian Azam , Momeni Marjan 
Published: September 2021

Abstract
Background
The novel coronavirus (COVID-19) epidemic initially appeared in Wuhan, Hubei Province, China, on 31 December 2019 and was spread rapidly worldwide. Most underlying diseases reported with COVID-19 patients are diabetes, hypertension, coronary heart diseases, and cerebrovascular disease. We do not know whether individuals with thyroid disease are at increased risk of COVID-19 infection.

Methods
Two experienced researchers will conduct an electronic search of the databases including PubMed/MEDLINE, the Cochrane Reviews, and the Cochrane Central Register of Controlled Trials (CENTRAL), Web of Science, Scopus, and ProQuest, for articles published since October 2019. Clinical trials and observational studies will be included. Studies will be screened after de-duplication. A standardized data extraction form will be developed through discussions with the review team and will be revised after piloting. An appropriate risk of bias assessment tool will be used to assess the quality of studies. Two independent reviewers will assess the eligibility, extraction of detailed information, and quality assessment of studies. The results will be pooled for meta-analysis, subgroup analysis and/or descriptive analysis based on the included data conditions.

Conclusion
Results of this study will provide current evidence on the association of COVID-19 diseases with any thyroid disorders such as hypothyroidism, thyrotoxicosis, and thyroid cancer with or without radioiodine therapy. Findings will be disseminated in peer-reviewed publications and conference presentations.

Trial registration

PROSPERO registration number: CRD42020184289.
https://www.crd.york.ac.uk/PROSPERO/#recordDetails
Increasing the power of interpretation for soil metaproteomics data
Authors: Jouffret Virginie , Miotello Guylaine , Culotta Karen , Ayrault Sophie , Pible Olivier , Armengaud Jean 
Published: September 2021

Abstract
Background
Soil and sediment microorganisms are highly phylogenetically diverse but are currently largely under-represented in public molecular databases. Their functional characterization by means of metaproteomics is usually performed using metagenomic sequences acquired for the same sample. However, such hugely diverse metagenomic datasets are difficult to assemble; in parallel, theoretical proteomes from isolates available in generic databases are of high quality. Both these factors advocate for the use of theoretical proteomes in metaproteomics interpretation pipelines. Here, we examined a number of database construction strategies with a view to increasing the outputs of metaproteomics studies performed on soil samples.

Results
The number of peptide-spectrum matches was found to be of comparable magnitude when using public or sample-specific metagenomics-derived databases. However, numbers were significantly increased when a combination of both types of information was used in a two-step cascaded search. Our data also indicate that the functional annotation of the metaproteomics dataset can be maximized by using a combination of both types of databases.

Conclusions
A two-step strategy combining sample-specific metagenome database and public databases such as the non-redundant NCBI database and a massive soil gene catalog allows maximizing the metaproteomic interpretation both in terms of ratio of assigned spectra and retrieval of function-derived information.
Cultural dimensions of sacred forests in the Western Ghats Biodiversity Hot Spot, Southern India and its implications for biodiversity protection
Authors: Patwardhan Ankur , Ghate Pooja , Mhaskar Monali , Bansude Amit 
Published: September 2021

AbstractSacred groves are relict forests dedicated to local deities that have been informally protected and managed by local communities over centuries. To gain greater insights into underlying sociocultural reasons for protection, and possibilities of strengthening such efforts, a study has been undertaken in 66 sacred groves in the Maharashtra State of Western Ghats biodiversity hot-spot in India, which shows different facets of human-nature relationships. Primary data on size, ownership, deity, religious aspects and awareness amongst the local people was collected through site visits, semi-structured interviews, and by participating in village meetings. It was observed that village councils owned 48% of the groves as against temple trusts (41%) and forest department plus individually owned groves (11%). Nearly 52% of the groves have an area less than one-half hectare. Forty-seven percent of the groves have male deities, 29% female deities and 26% were dedicated to spirits. Eighty percent of the local people were aware of cultural and religious aspects associated with the groves, whereas awareness about ecological and utilitarian values declined steeply to less than 20% of the population, necessitating the explanation of scientific conservation values of these critical ecosystems to the local people. The paper also discusses the significance of such studies in connection with the relevant UN Sustainable Development Goals and AICHI Biodiversity targets. In addition, it also discusses links with national biodiversity targets and how legal provisions under India’s Biological Diversity Act (2002) can be used to benefit both the ecosystem and the cultural values of the people, and how such informal institutions can be strengthened under formal protection mechanisms.