bluuebunny/crossref_metadata_2025_split huggingface dataset:
Radiographic cortical thickness parameters as predictors of rotational alignment in proximal tibial shaft fractures: a cadaveric study
Authors: Keppler Alexander M. , Küßner Konstantin , Schulze Anna-Lena , Suero Eduardo M. , Neuerburg Carl , Weigert Maximilian , Braun Christian , Böcker Wolfgang , Kammerlander Christian , Zeckey Christian 
Published: June 2021

Abstract
Aim
The treatment of tibial fractures with an intramedullary nail is an established procedure. However, torsional control remains challenging using intraoperatively diagnostic tools.
Radiographic tools such as the Cortical Step Sign (CSS) and the Diameter Difference Sign (DDS) may serve as tools for diagnosing a relevant malrotation. The aim of this study was to investigate the effect of torsional malalignment on CSS and DDS parameters and to construct a prognostic model to detect malalignment.

Methods
A proximal tibial shaft fracture was set in human tibiae. Torsion was set stepwise from 0° to 30° in external and internal torsion. Images were obtained with a C-arm and transferred to a PC for measuring the medical cortical thickness (MCT), lateral cortical thickness (LCT), tibial diameter (TD) in AP and the anterior cortical thickness (ACT) as well as the posterior cortical thickness (PCT) and the transverse diameter (TD) of the proximal and the distal main fragment.

Results
There were significant differences between the various degrees of torsion for each of the absolute values of the examined variables. The parameters with the highest correlation were TD, LCT and ACT. A model combining ACT, LCT, PCT and TD lateral was most suitable model in identifying torsional malalignment. The best prediction of clinically relevant torsional malalignment, namely 15°, was obtained with the TD and the ACT.

Conclusion
This study shows that the CSS and DDS are useful tools for the intraoperative detection of torsional malalignment in proximal tibial shaft fractures and should be used to prevent maltorsion.
Validity of classification of distal radial fractures in the Swedish fracture register
Authors: Bergvall Malena , Bergdahl Carl , Ekholm Carl , Wennergren David 
Published: June 2021

Abstract
Background
Distal radial fractures (DRF) are one of the most common fractures with a small peak in incidence among young males and an increasing incidence with age among women. The reliable classification of fractures is important, as classification provides a framework for communicating effectively on clinical cases. Fracture classification is also a prerequisite for data collection in national quality registers and for clinical research. Since its inception in 2011, the Swedish Fracture Register (SFR) has collected data on more than 490,000 fractures. The attending physician classifies the fracture according to the AO/OTA classification upon registration in the SFR. Previous studies regarding the classification of distal radial fractures (DRF) have shown difficulties in inter- and intra-observer agreement. This study aims to assess the accuracy of the registration of DRF in adults in the SFR as it is carried out in clinical practice.

Methods
A reference group of three experienced orthopaedic trauma surgeons classified 128 DRFs, randomly retrieved from the SFR, at two classification sessions 6 weeks apart. The classification the reference group agreed on was regarded as the gold standard classification for each fracture. The accuracy of the classification in the SFR was defined as the agreement between the gold standard classification and the classification in the SFR. Inter- and intra-observer agreement was evaluated and the degree of agreement was calculated as Cohen’s kappa.

Results
The accuracy of the classification of DRF in the SFR was kappa = 0.41 (0.31–0.51) for the AO/OTA subgroup/group and kappa = 0.48 (0.36–0.61) for the AO/OTA type. This corresponds to moderate agreement. Inter-observer agreement ranged from kappa 0.22–0.48 for the AO/OTA subgroup/group and kappa 0.48–0.76 for the AO/OTA type. Intra-observer agreement ranged from kappa 0.52–0.70 for the AO/OTA subgroup/group and kappa 0.71–0.76 for the AO/OTA type.

Conclusions
The study shows moderate accuracy in the classification of DRF in the SFR. Although the degree of accuracy for DRF appears to be lower than for other fracture locations, the accuracy shown in the current study is similar to that in previous studies of DRF.
Debridement and corpectomy via single posterior approach to treat pyogenic spondylitis after vertebral augmentation
Authors: Zhang Shuai , Wang Song , Wang Qing , Yang Jin , Xu Shuang 
Published: June 2021

Abstract
Background
Infection after vertebral augmentation (VA) often limits the daily activities of patients and even threatens their life. The operation may be one of the effective treatments if the patient suffers from intolerable severe pain, neurological deficits, and damage to spinal stability. This study aimed to investigate the clinical efficacy of the treatment of pyogenic spondylitis after vertebral augmentation (PSVA) with Single posterior debridement, vertebral body resection, and intervertebral bone graft fusion and internal fixation (sPVRIF).

Methods
The study was performed on 19 patients with PSVA who underwent VA at 4 hospitals in the region between January 2010 and July 2020. Nineteen patients were included. Among them, 16 patients underwent sPVRIF to treat the PSVA.

Results
A total of 2267 patients underwent VA at 4 hospitals in the region. Of the 19 patients with postoperative PSVA, suppurative spondylitis was misdiagnosed as an osteoporotic vertebral fracture(OVF) in 4 patients and they underwent VA. Besides osteoporosis, 18 patients had other comorbidities. The average interval between the first surgery and the diagnosis of PSVA was 96.4 days. Of the 19 patients, 16 received surgical treatment. The surgical time was 175.0±16.8 min, and the intraoperative blood loss was 465.6±166.0 mL. Pathogenic microorganisms were cultured in 12 patients.

Conclusion
PSVA is a severe complication that can even threaten the life of the patients. sPVRIF may be one of the effective treatments if the patient suffers from intolerable severe pain, neurological deficits, and damage to spinal stability.
Risk factors for developing high-output ileostomy in CRC patients: a retrospective study
Authors: Bai Dongxiao , Li Lei , Shen Zhiling , Huang Tianchen , Wang Qingbing , Wang Yanjun , Zhang Yong , Guo Zhipeng , Li Kan , Xiao Jian an 
Published: June 2021

Abstract
Background
Anastomotic leakage is one of the most serious postoperative complications of rectal cancer. Prophylactic ileostomy has been widely used to reduce the risk and severity of complications of anastomotic leakage. However, prophylactic ileostomy itself has some complications, and ileostomy high output syndrome (HOS) is one of them. This study was performed to explore the risk factors of HOS in ileostomy.

Methods
A total of 114 patients with HOS were screened out from 494 eligible ileostomy patients in the last 5 years. The relationship between HOS and the clinicopathological data was analyzed using the Chi-square test and Fisher’s exact probability. Multivariate analysis was performed by logistic regression.

Results
The incidence of HOS was 23.07% in this study. Dehydration was the most common symptom of HOS (37.7%). There was no clear correlation between HOS occurrence with sex, age, gross typing, histological grade, tumor location, lymph node metastasis, and TNM stage (p > 0.05). The incidence of HOS was 14/18 in inflammatory bowel disease patients, 18/28 in diabetes mellitus patients, and 23/72 in neoadjuvant chemoradiotherapy patients, 13/17 in total colectomy and abdominal infection patients. Multivariate analysis showed that they are risk factors for HOS (p < 0.05).

Conclusion
HOS occurred occasionally but rarely studied and lacks attention. Inflammatory bowel disease, diabetes mellitus, neoadjuvant radiotherapy chemotherapy, total colectomy and abdominal infection are the risk factors for HOS.
Similar immunogenicity profiles between the proposed biosimilar MYL-1501D and reference insulin glargine in patients with diabetes mellitus: the phase 3 INSTRIDE 1 and INSTRIDE 2 studies
Authors: Sun Bin , Sengupta Nilanjan , Rao Anita , Donnelly Charles , Waichale Vinit , Roy Arnab Sinha , Ramaswamy Shilpa , Pathak Divya , Bowsher Ronald R. , Raiter Yaron , Aubonnet Patrick , Barve Abhijit 
Published: June 2021

Abstract
Background
MYL-1501D is a proposed biosimilar to insulin glargine. The noninferiority of MYL-1501D was demonstrated in patients with type 1 diabetes and type 2 diabetes in 2 phase 3 trials. Immunogenicity of MYL-1501D and reference insulin glargine was examined in both studies.

Methods
INSTRIDE 1 and INSTRIDE 2 were multicenter, open-label, randomized, parallel-group studies. In INSTRIDE 1, patients with type 1 diabetes received MYL-1501D or insulin glargine over a 52-week period. In INSTRIDE 2, patients with type 2 diabetes treated with oral antidiabetic drugs, insulin naive or not, received MYL-1501D or reference insulin glargine over a 24-week period. Incidence rates and change from baseline in relative levels of antidrug antibodies (ADA) and anti–host cell protein (anti-HCP) antibodies in both treatment groups were determined by a radioimmunoprecipitation assay and a bridging immunoassay, respectively. Results were analyzed using a mixed-effects model (INSTRIDE 1) or a nonparametric Wilcoxon rank sum test (INSTRIDE 2).

Results
Total enrollment was 558 patients in INSTRIDE 1 and 560 patients in INSTRIDE 2. The incidence of total and cross-reactive ADA was comparable between treatment groups in INSTRIDE 1 and INSTRIDE 2 (P > 0.05 for both). A similar proportion of patients had anti-HCP antibodies in both treatment groups in INSTRIDE 1 at week 52 (MYL-1501D, 93.9 %; reference insulin glargine, 89.6 %; P = 0.213) and in INSTRIDE 2 at week 24 (MYL-1501D, 87.3 %; reference insulin glargine, 86.9 %; P > 0.999).

Conclusions
In INSTRIDE 1 and INSTRIDE 2, similar immunogenicity profiles were observed for MYL-1501D and reference insulin glargine in patients with type 1 diabetes and type 2 diabetes, respectively.

Trial registration
ClinicalTrials.gov, INSTRIDE 1 (NCT02227862; date of registration, August 28, 2014); INSTRIDE 2 (NCT02227875; date of registration, August 28, 2014).
NUrsing Homes End of Life care Program (NUHELP): developing a complex intervention
Authors: Mota-Romero Emilio , Esteban-Burgos Ana Alejandra , Puente-Fernández Daniel , García-Caro María Paz , Hueso-Montoro Cesar , Herrero-Hahn Raquel Mercedes , Montoya-Juárez Rafael 
Published: June 2021

Abstract
Background
Nursing homes are likely to become increasingly important as end-of-life care facilities. Previous studies indicate that individuals residing in these facilities have a high prevalence of end-of-life symptoms and a significant need for palliative care. The aim of this study was to develop an end-of-life care program for nursing homes in Spain based on previous models yet adapted to the specific context and the needs of staff in nursing homes in the country.

Methods
A descriptive study of a complex intervention procedure was developed. The study consisted of three phases. The first phase was a prospective study assessing self-efficacy in palliative care (using the SEPC scale) and attitudes towards end-of-life care (using the FATCOD-B scale) among nursing home staff before and after the completion of a basic palliative care training program. In the second phase, objectives were selected using the Delphi consensus technique, where nursing home and primary care professionals assessed the relevance, feasibility, and level of attainment of 42 quality standards. In phase 3, interventions were selected for these objectives through two focus group sessions involving nursing home, primary care, and palliative care professionals.

Results
As a result of the training, an improvement in self-efficacy and attitudes towards end-of-life care was observed. In phase 2, 14 standards were selected and grouped into 5 objectives: to conduct a comprehensive assessment and develop a personalized care plan adapted to the palliative needs detected; to provide information in a clear and accessible way; to request and record advance care directives; to provide early care with respect to loss and grief; to refer patients to a specialized palliative care unit if appropriate, depending on the complexity of the palliative care required. Based on these objectives, the participants in the focus group sessions designed the 22 interventions that make up the program.

Conclusions
The objectives and interventions of the NUHELP program constitute an end-of-life care program which can be implemented in nursing homes to improve the quality of end-of-life care in these facilities by modifying their clinical practice, organization, and relationship with the health system as well as serving as an example of an effective health intervention program.
Using NLP in openEHR archetypes retrieval to promote interoperability: a feasibility study in China
Authors: Sun Bo , Zhang Fei , Li Jing , Yang Yicheng , Diao Xiaolin , Zhao Wei , Shu Ting 
Published: June 2021

AbstractBackgroundWith the development and application of medical information system, semantic interoperability is essential for accurate and advanced health-related computing and electronic health record (EHR) information sharing. The openEHR approach can improve semantic interoperability. One key improvement of openEHR is that it allows for the use of existing archetypes. The crucial problem is how to improve the precision and resolve ambiguity in the archetype retrieval.MethodBased on the query expansion technology and Word2Vec model in Nature Language Processing (NLP), we propose to find synonyms as substitutes for original search terms in archetype retrieval. Test sets in different medical professional level are used to verify the feasibility.ResultApplying the approach to each original search term (n = 120) in test sets, a total of 69,348 substitutes were constructed. Precision at 5 (P@5) was improved by 0.767, on average. For the best result, the P@5 was up to 0.975.ConclusionsWe introduce a novel approach that using NLP technology and corpus to find synonyms as substitutes for original search terms. Compared to simply mapping the element contained in openEHR to an external dictionary, this approach could greatly improve precision and resolve ambiguity in retrieval tasks. This is helpful to promote the application of openEHR and advance EHR information sharing.
Interaction of porcine circovirus-like virus P1 capsid protein with host proteins
Authors: Wen Libin , Zhu Jiaping , Zhang Fengxi , Xiao Qi , Xie Jianping , He Kongwang 
Published: June 2021

Abstract
Background
Porcine circovirus-like virus P1 is a relatively new kind of virus that is closely related to the post-weaning multisystemic wasting syndrome, congenital tremors, and abortions in swine. The molecular mechanisms of P1 virus infection and pathogenesis are fully unknown. To analyze P1 and its host interactions, we used a yeast two-hybrid (Y2H) assay to identify cellular proteins interacting with the Cap of the P1 virus. In this study, the Cap of the P1 virus exhibited no self-activation and toxicity to yeast cells and was used as bait to screen the Y2H library prepared from the pancreas tissue.

Results
Five cellular proteins (EEP, Ral GDS, Bcl-2-L-12, CPS1, and one not identified) were found to interact with P1 Cap. The interaction between Cap and Ral GDS was confirmed by co-immunoprecipitation.

Conclusions
Our data are likely to support the future investigation of the underlying mechanism of P1 infection and pathogenesis.
A critical review on various feedstocks as sustainable substrates for biosurfactants production: a way towards cleaner production
Authors: Mohanty Swayansu Sabyasachi , Koul Yamini , Varjani Sunita , Pandey Ashok , Ngo Huu Hao , Chang Jo-Shu , Wong Jonathan W. C. , Bui Xuan-Thanh 
Published: June 2021

AbstractThe quest for a chemical surfactant substitute has been fuelled by increased environmental awareness. The benefits that biosurfactants present like biodegradability, and biocompatibility over their chemical and synthetic counterparts has contributed immensely to their popularity and use in various industries such as petrochemicals, mining, metallurgy, agrochemicals, fertilizers, beverages, cosmetics, etc. With the growing demand for biosurfactants, researchers are looking for low-cost waste materials to use them as substrates, which will lower the manufacturing costs while providing waste management services as an add-on benefit. The use of low-cost substrates will significantly reduce the cost of producing biosurfactants. This paper discusses the use of various feedstocks in the production of biosurfactants, which not only reduces the cost of waste treatment but also provides an opportunity to profit from the sale of the biosurfactant. Furthermore, it includes state-of-the-art information about employing municipal solid waste as a sustainable feedstock for biosurfactant production, which has not been simultaneously covered in many published literatures on biosurfactant production from different feedstocks. It also addresses the myriad of other issues associated with the processing of biosurfactants, as well as the methods used to address these issues and perspectives, which will move society towards cleaner production.
Diet quality in relation to the risk of hypertension among Iranian adults: cross-sectional analysis of Fasa PERSIAN cohort study
Authors: Motamedi Amir , Ekramzadeh Maryam , Bahramali Ehsan , Farjam Mojtaba , Homayounfar Reza 
Published: June 2021

AbstractBackgroundHypertension is a common chronic disease with various complications and is a main contributing factor to cardiovascular disease (CVD). This study aimed to assess the association of diet quality, assessed by dietary diversity score (DDS), Mediterranean dietary score (MDS), diet quality index-international (DQI-I), and healthy eating index-2015 (HEI-2015) with the risk of hypertension.MethodsThis study recruited a total of 10,111 individuals (45.14% male) with mean age of 48.63 ± 9.57 years from the Fasa Cohort Study, Iran. Indices of diet quality, including MDS, HEI-2015, DQI-I, and DDS were computed by a 125-item Food Frequency Questionnaire. Participants were diagnosed as hypertensive if they had a diastolic blood pressure (DBP) ≥90 mmHg, systolic blood pressure (SBP) ≥140 mmHg,, or used antihypertensive drugs.ResultsHypertension was prevalent in 28.3% of the population (21.59% in males and 33.74% in females). In the whole population, after adjustment for potential covariates, including daily energy intake, age, gender, physical activity, smoking, family history of hypertension, body mass index, and the level of education, higher adherence to the MDS (OR: 0.86, 95%CI = 0.75–0.99) and HEI-2015 (OR: 0.79, 95%CI = 0.68–0.90) was significantly associated with decreased risk of hypertension. The protective effect of HEI-2015 against hypertension remained significant for both males (OR: 0.80, 95%CI = 0.64–0.99) and females (OR: 0.78, 95%CI = 0.66–0.94), while, for MDS, this relationship disappeared in the subgroup analysis by gender. DQI-I and DDS were not related to the odds of hypertension.ConclusionsAdhering to MDS and HEI-2015 diets could contribute to the prevention of hypertension.
Associations between remnant lipoprotein cholesterol and central systolic blood pressure in a Chinese community-based population: a cross-sectional study
Authors: Li Kaiyin , Fan Fangfang , Zheng Bo , Jia Jia , Liu Bo , Liu Jiahui , Chen Chuyun , Zhou Jing , Zhang Yan , Huo Yong 
Published: June 2021

Abstract
Background
The lipid profile is reportedly related to peripheral blood pressure or pulse wave velocity. However, no studies have investigated the associations between lipid parameters, especially remnant lipoprotein cholesterol (RLP-C), and central systolic blood pressure (cSBP).

Methods
This study used baseline data of a community-based cohort in Beijing, China. Participants who had been treated with anti-hypertensive or lipid-lowering agents were excluded. RLP-C is equal to total cholesterol (TC) minus the sum of low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C). An Omron HEM-9000AI device was used to measure non-invasive cSBP. The associations between blood lipid profile and non-invasive cSBP were evaluated using multivariable regression models.

Results
The 5173 included participants were 55.0 ± 8.5 years old; 35.7% (1845) of participants were men. Increased cSBP was significantly associated with increased TC, LDL-C, non-high-density lipoprotein cholesterol (non-HDL-C), triglyceride (TG), and RLP-C but with decreased HDL-C, even after adjusting for possible covariates. When simultaneously entering individual pairs of RLP-C and other blood lipid parameters into the multivariable regression model, RLP-C remained significantly associated with cSBP, even after adjusting for other lipids. Compared with participants who had RLP-C levels in the first quartile (Q1), cSBP for those with RLP-C in Q4 was increased to 4.57 (95% confidence interval [CI]: 3.08–6.06) mmHg after adjusting for LDL-C, 4.50 (95%CI: 2.98–6.02) mmHg after adjusting for TC, 3.91 (95%CI: 1.92–5.89) mmHg after adjusting for TG, 5.15 (95%CI: 3.67–6.63) mmHg after adjusting for HDL-C, and 4.10 (95%CI: 2.36–5.84) mmHg after adjusting for non-HDL-C.

Conclusions
Increased blood RLP-C level was significantly associated with higher cSBP in a Chinese population, independently of other lipids, which indicates its importance in individual cardiovascular risk assessment.