bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Impact of Global Spinal Alignment on Standing Spinopelvic Alignment Change After Total Hip Arthroplasty
Authors: Jain Deeptee , Vigdorchik Jonathan M. , Abotsi Edem , Montes Dennis Vasquez , Delsole Edward M. , Lord Elizabeth , Zuckerman Joseph D. , Protopsaltis Themistocles , Passias Peter G. , Buckland Aaron J. 
Published: June 2021

Study Design: Retrospective cohort study. Objectives: The interactions between hip osteoarthritis (OA) and spinal malalignment are poorly understood. The purpose of this study was to assess the influence of total hip arthroplasty (THA) on standing spinopelvic alignment. Methods: In this retrospective cohort study, patients undergoing THA for OA with pre-and postoperative full-body radiographs were included. Standing spinopelvic parameters were measured. Contralateral hip was graded on the Kellgren-Lawrence scale. Pre-and postoperative alignment parameters were compared by paired t-test. The severity of preoperative thoracolumbar deformity was measured using TPA. Linear regression was performed to assess the impact of preoperative TPA and changes in spinal alignment. Patients were separated into low and high TPA (<20 or >/=20 deg) and change in parameters were compared between groups by t-test. Similarly, the influence of K-L grade, age, and PI were also tested. Results: 95 patients were included (mean age 58.6 yrs, BMI 28.7 kg/m2, 48.2% F). Follow-up radiographs were performed at mean 220 days. Overall, the following significant changes were found from pre-to postoperative: SPT (14.2 vs. 16.1, P = 0.021), CL (−8.9 vs. −5.3, P = .001), TS-CL (18.2 vs. 20.5, P = .037) and SVA (42.6 vs. 32.1, P = .004). Preoperative TPA was significantly associated with the change in PI-LL, SVA, and TPA. High TPA patients significantly decreased SVA more than low TPA patients. There was no significant impact of contralateral hip OA, PI, or age on change in alignment parameters. Conclusion: Spinopelvic alignment changes after THA, evident by a reduction in SVA. Preoperative spinal sagittal deformity impacts this change. Level of evidence: III.
Insights into shopping travel behavior: latent classes in relation to attitudes towards shopping
Authors: Bönisch Lisa , von Behren Sascha , Chlond Bastian , Vortisch Peter 
Published: June 2021

Abstract
Background
The car has so far played an important role for transporting goods. However, new services emerging from e-commerce may increasingly reduce its relevance as the transporting of goods might no longer be a reason for car use. As a result, e-commerce or the delivery of goods by third-parties can function as potential supplement for car-free households and support a car-free lifestyle. To assess this potential, appropriate segmentation to subgroups is needed to better understand differences in shopping behavior and the linked role of the car.

Methods
The presented study from Munich (Germany) provides a comprehensive approach by applying a latent class analysis. The classification revealed six distinct classes with differences in shopping behavior as well as sociodemographic and spatial characteristics. To asses underlying motivations, this approach is complemented through relating the latent classes to attitudes towards shopping and mode choice.

Findings
Results show that those people who frequently use their cars also have an affinity for frequent online shopping. This relationship should be considered when discussing whether e-commerce can promote a car-free lifestyle.
Gall-forming aphids are protected (and benefit) from defoliating caterpillars: the role of plant-mediated mechanisms
Authors: Kurzfeld-Zexer Lilach , Inbar Moshe 
Published: June 2021

Abstract
Background
Interspecific interactions among insect herbivores are common and important. Because they are surrounded by plant tissue (endophagy), the interactions between gall-formers and other herbivores are primarily plant-mediated. Gall-forming insects manipulate their host to gain a better nutrient supply, as well as physical and chemical protection form natural enemies and abiotic factors. Although often recognized, the protective role of the galls has rarely been tested.

Results
Using an experimental approach, we found that the aphid, Smynthurodes betae, that forms galls on Pistacia atlantica leaves, is fully protected from destruction by the folivorous processionary moth, Thaumetopoea solitaria. The moth can skeletonize entire leaves on the tree except for a narrow margin around the galls that remains intact (“trimmed galls”). The fitness of the aphids in trimmed galls is unharmed. Feeding trials revealed that the galls are unpalatable to the moth and reduce its growth. Surprisingly, S. betae benefits from the moth. The compensatory secondary leaf flush following moth defoliation provides new, young leaves suitable for further gall induction that increase overall gall density and reproduction of the aphid.

Conclusions
We provide experimental support for the gall defense hypothesis. The aphids in the galls are protracted by plant-mediated mechanisms that shape the interactions between insect herbivores which feed simultaneously on the same host. The moth increase gall demsity on re-growing defoliated shoots.
Patients’ experiences of the use of point-of-care ultrasound in general practice – a cross-sectional study
Authors: Andersen Camilla Aakjær , Brodersen John , Rudbæk Torsten Rahbek , Jensen Martin Bach 
Published: June 2021

AbstractBackgroundThe use of point-of-care ultrasonography (POCUS) performed by general practitioners (GPs) in primary care settings is increasing. Previous studies have focused on GP-reported outcomes and little is known about patients’ perspectives on the use of POCUS technology within the general practice consultation. The purpose of this study was to examine patients’ experiences with POCUS in general practice within the areas where GPs have indicated that POCUS affected aspects of the consultation.MethodsA questionnaire was developed using a mixed methods sequential design. Analytical themes from interviews with GPs were converted into items in a questionnaire by the research team. The questionnaire was then further developed in several rounds of pilot tests involving both patients and GPs. The final questionnaire was used in a cohort study conducted in 18 Danish office-based general practice clinics from January 2018 to August 2018. All patients examined with POCUS were asked to complete the questionnaire on tablets immediately after their consultation.ResultsOut of 691 patients examined, 564 (81.6%) questionnaires were available for analysis. The patients reported that they were well informed about the purpose (98%) and the results (97%) of the POCUS examination; however, 29% reported that they were not informed about the difference between POCUS and an imaging-specialist’s ultrasound examination. Almost all patients (99%) reported that POCUS was integrated naturally into the consultation, and 45% reported that POCUS improved the doctor-patient relationship.The majority of patients felt that they had been more thoroughly examined (92%) and taken more seriously (58%) when POCUS was part of the consultation. They felt POCUS gave them a better understanding of their health problem (82%), made them feel more secure (86%) and increased their trust in the physician’s assessment (65%). Moreover, the patients reported that POCUS use improved the level of service (95%) they experienced and the quality of care (94%) in general practice.ConclusionWe found that an examination including POCUS in general practice was a positive experience overall for the majority of patients. Future research should further explore reasons for patient confidence in POCUS and whether or not the reassuring value of POCUS is valid.Trial registrationClinicalTrials.gov Identifier:NCT03416608
Association between physical activity and mortality in end-stage kidney disease: a systematic review of observational studies
Authors: Martins Pedro , Marques Elisa A. , Leal Diogo V. , Ferreira Aníbal , Wilund Kenneth R , Viana João L. 
Published: June 2021

Abstract
Background
End-stage Kidney Disease patients have a high mortality and hospitalization risk. The association of these outcomes with physical activity is described in the general population and in other chronic diseases. However, few studies examining this association have been completed in end-stage Kidney Disease patients, raising the need to systematically review the evidence on the association of physical activity with mortality and hospitalization in this population.

Methods
Electronic databases (EBSCO, Scopus and Web of Science) and hand search were performed until March 2020 for observational studies reporting the association of physical activity with mortality or hospitalization in adult end-stage Kidney Disease patients on renal replacement therapy (hemodialysis, peritoneal dialysis and kidney transplant). Methodological quality of the included studies was assessed using the Quality in Prognosis Studies tool. The review protocol was registered in PROSPERO (CRD42020155591).

Results
Eleven studies were included: six in hemodialysis, three in kidney transplant, and two in hemodialysis and peritoneal dialysis patients. Physical activity was self-reported, except in one study that used accelerometers. All-cause mortality was addressed in all studies and cardiovascular mortality in three studies. Nine studies reported a significant reduction in all-cause mortality with increased levels of physical activity. Evidence of a dose-response relationship was found. For cardiovascular mortality, a significant reduction was observed in two of the three studies. Only one study investigated the association of physical activity with hospitalization.

Conclusions
Higher physical activity was associated with reduced mortality in end-stage Kidney Disease patients. Future studies using objective physical activity measures could strengthen these findings. The association of physical activity with hospitalization should be explored in future investigations.
Incidence, pattern and mechanisms of injuries and fractures in children under two years of age
Authors: Rosendahl Karen , Myklebust Ramona , Ulriksen Kjersti Foros , Nøttveit A. , Eide Pernille , Djuve Åsmund , Brudvik Christina 
Published: June 2021

Abstract
Background
Fractures in children under 2 years of age are rare, and little has been published on their mechanisms. We aimed at examining the incidence, mechanisms, pattern and fracture characteristics in a large, population-based cohort of otherwise healthy children.

Methods
This retrospective, cross-sectional study includes all children aged 0–2 years, attending the Accident and Emergency department in Bergen between 2010 and 2015, due to an injury warranting radiography. Clinical data was categorized from the medical notes, and all radiographs were reviewed by an experienced paediatric radiologist.

Results
In total 408 children (212 male), 3–23 months of age (mean 17.7 months), were included. 149 (77 male) children had a total of 162 fractures, yielding an annual incidence of 5.4 per 1000, varying from 0.7 per 1000 for those under 12 months of age, increasing tenfold to 7.3 per 1000 for children aged 12–24 months of age. More than half of the fractures (53.1%) were seen in children aged 18–23 months, while none was found in those under 7 months of age. The youngest age group had mostly femur and tibia fractures, the oldest mostly forearm fractures (n = 55, 33.9%), followed by tibia fractures (21.6%) and fractures to the clavicle (14.8%). The reported mechanisms for the 162 fractures were fall from a chair/bed/table (41.4%), fall from own height (18.5%) or crush injury (15.4%). In 8 of 162 (4.9%) fractures, the history was clearly inconsistent and suspicious of non-accidental injury (NAI).

Conclusion
Injuries and fractures in young children in general, and non-ambulant children in particular, are rare and should be thoroughly assessed for NAI. Level of evidence: Retrospective, population based cross-sectional study. Level 3.
Evaluation of biofilm colonization on multi-part dental implants in a rat model
Authors: Blank Eva , Grischke Jasmin , Winkel Andreas , Eberhard Joerg , Kommerein Nadine , Doll Katharina , Yang Ines , Stiesch Meike 
Published: June 2021

Abstract
Background
Peri-implant mucositis and peri-implantitis are highly prevalent biofilm-associated diseases affecting the tissues surrounding dental implants. As antibiotic treatment is ineffective to fully cure biofilm mediated infections, antimicrobial modifications of implants to reduce or prevent bacterial colonization are called for. Preclinical in vivo evaluation of the functionality of new or modified implant materials concerning bacterial colonization and peri-implant health is needed to allow progress in this research field. For this purpose reliable animal models are needed.

Methods
Custom made endosseous dental implants were installed in female Sprague Dawley rats following a newly established three-step implantation procedure. After healing of the bone and soft tissue, the animals were assigned to two groups. Group A received a continuous antibiotic treatment for 7 weeks, while group B was repeatedly orally inoculated with human-derived strains of Streptococcus oralis, Fusobacterium nucleatum and Porphyromonas gingivalis for six weeks, followed by 1 week without inoculation. At the end of the experiment, implantation sites were clinically assessed and biofilm colonization was quantified via confocal laser scanning microscopy. Biofilm samples were tested for presence of the administered bacteria via PCR analysis.

Results
The inner part of the custom made implant screw could be identified as a site of reliable biofilm formation in vivo. S. oralis and F. nucleatum were detectable only in the biofilm samples from group B animals. P. gingivalis was not detectable in samples from either group. Quantification of the biofilm volume on the implant material revealed no statistically significant differences between the treatment groups. Clinical inspection of implants in group B animals showed signs of mild to moderate peri-implant mucositis (4 out of 6) whereas the mucosa of group A animals appeared healthy (8/8). The difference in the mucosa health status between the treatment groups was statistically significant (p = 0.015).

Conclusions
We developed a new rodent model for the preclinical evaluation of dental implant materials with a special focus on the early biofilm colonization including human-derived oral bacteria. Reliable biofilm quantification on the implant surface and the symptoms of peri-implant mucositis of the bacterially inoculated animals will serve as a readout for experimental evaluation of biofilm-reducing modifications of implant materials.
Mental health service preferences of patients and providers: a scoping review of conjoint analysis and discrete choice experiments from global public health literature over the last 20 years (1999–2019)
Authors: Larsen Anna , Tele Albert , Kumar Manasi 
Published: June 2021

Abstract
Background
In designing, adapting, and integrating mental health interventions, it is pertinent to understand patients’ needs and their own perceptions and values in receiving care. Conjoint analysis (CA) and discrete choice experiments (DCEs) are survey-based preference-elicitation approaches that, when applied to healthcare settings, offer opportunities to quantify and rank the healthcare-related choices of patients, providers, and other stakeholders. However, a knowledge gap exists in characterizing the extent to which DCEs/CA have been used in designing mental health services for patients and providers.

Methods
We performed a scoping review from the past 20 years (2009–2019) to identify and describe applications of conjoint analysis and discrete choice experiments. We searched the following electronic databases: Pubmed, CINAHL, PsychInfo, Embase, Cochrane, and Web of Science to identify stakehold,er preferences for mental health services using Mesh terms. Studies were categorized according to pertaining to patients, providers and parents or caregivers.

Results
Among the 30 studies we reviewed, most were published after 2010 (24/30, 80%), the majority were conducted in the United States (11/30, 37%) or Canada (10/30, 33%), and all were conducted in high-income settings. Studies more frequently elicited preferences from patients or potential patients (21/30, 70%) as opposed to providers. About half of the studies used CA while the others utilized DCEs. Nearly half of the studies sought preferences for mental health services in general (14/30, 47%) while a quarter specifically evaluated preferences for unipolar depression services (8/30, 27%). Most of the studies sought stakeholder preferences for attributes of mental health care and treatment services (17/30, 57%).

Conclusions
Overall, preference elicitation approaches have been increasingly applied to mental health services globally in the past 20 years. To date, these methods have been exclusively applied to populations within the field of mental health in high-income countries. Prioritizing patients’ needs and preferences is a vital component of patient-centered care – one of the six domains of health care quality. Identifying patient preferences for mental health services may improve quality of care and, ultimately, increase acceptability and uptake of services among patients. Rigorous preference-elicitation approaches should be considered, especially in settings where mental health resources are scarce, to illuminate resource allocation toward preferred service characteristics especially within low-income settings.
How to sustainably build capacity in quality improvement within a healthcare organisation: a deep-dive, focused qualitative analysis
Authors: Hibbert Peter D. , Basedow Martin , Braithwaite Jeffrey , Wiles Louise K. , Clay-Williams Robyn , Padbury Robert 
Published: June 2021

Abstract
Background
A key characteristic of healthcare systems that deliver high quality and cost performance in a sustainable way is a systematic approach to capacity and capability building for quality improvement. The aim of this research was to explore the factors that lead to successful implementation of a program of quality improvement projects and a capacity and capability building program that facilitates or support these.

Methods
Between July 2018 and February 2020, the Southern Adelaide Local Health Network (SALHN), a network of health services in Adelaide, South Australia, conducted three capability-oriented capacity building programs that incorporated 82 longstanding individual quality improvement projects. Qualitative analysis of data collected from interviews of 19 project participants and four SALHN Improvement Faculty members and ethnographic observations of seven project team meetings were conducted.

Results
We found four interacting components that lead to successful implementation of quality improvement projects and the overall program that facilitates or support these: an agreed and robust quality improvement methodology, a skilled faculty to assist improvement teams, active involvement of leadership and management, and a deep understanding that teams matter. A strong safety culture is not necessarily a pre-requisite for quality improvement gains to be made; indeed, undertaking quality improvement activities can contribute to an improved safety culture. For most project participants in the program, the time commitment for projects was significant and, at times, maintaining momentum was a challenge.

Conclusions
Healthcare systems that wish to deliver high quality and cost performance in a sustainable way should consider embedding the four identified components into their quality improvement capacity and capability building strategy.
Using syndromic measures of mortality to capture the dynamics of COVID-19 in Java, Indonesia, in the context of vaccination rollout
Authors: Djaafara Bimandra A. , Whittaker Charles , Watson Oliver J. , Verity Robert , Brazeau Nicholas F. , Widyastuti  , Oktavia Dwi , Adrian Verry , Salama Ngabila , Bhatia Sangeeta , Nouvellet Pierre , Sherrard-Smith Ellie , Churcher Thomas S. , Surendra Henry , Lina Rosa N. , Ekawati Lenny L. , Lestari Karina D. , Andrianto Adhi , Thwaites Guy , Baird J. Kevin , Ghani Azra C. , Elyazar Iqbal R. F. , Walker Patrick G. T. 
Published: June 2021

Abstract
Background
As in many countries, quantifying COVID-19 spread in Indonesia remains challenging due to testing limitations. In Java, non-pharmaceutical interventions (NPIs) were implemented throughout 2020. However, as a vaccination campaign launches, cases and deaths are rising across the island.

Methods
We used modelling to explore the extent to which data on burials in Jakarta using strict COVID-19 protocols (C19P) provide additional insight into the transmissibility of the disease, epidemic trajectory, and the impact of NPIs. We assess how implementation of NPIs in early 2021 will shape the epidemic during the period of likely vaccine rollout.

Results
C19P burial data in Jakarta suggest a death toll approximately 3.3 times higher than reported. Transmission estimates using these data suggest earlier, larger, and more sustained impact of NPIs. Measures to reduce sub-national spread, particularly during Ramadan, substantially mitigated spread to more vulnerable rural areas. Given current trajectory, daily cases and deaths are likely to increase in most regions as the vaccine is rolled out. Transmission may peak in early 2021 in Jakarta if current levels of control are maintained. However, relaxation of control measures is likely to lead to a subsequent resurgence in the absence of an effective vaccination campaign.

Conclusions
Syndromic measures of mortality provide a more complete picture of COVID-19 severity upon which to base decision-making. The high potential impact of the vaccine in Java is attributable to reductions in transmission to date and dependent on these being maintained. Increases in control in the relatively short-term will likely yield large, synergistic increases in vaccine impact.
Is functional fitness performance a useful predictor of risk of falls among community-dwelling older adults?
Authors: Ho Hsin-Hung , Fang I-Yao , Yu Yi-Chien , Huang Yi-Ping , Kuo I-Ling , Wang Li-Ting , Tsai Ming-Chueh , Chang Shao-Hsi , Hsueh Ming-Chun 
Published: June 2021

Abstract
Background
Falls among older adults are a serious public health problem. Many studies indicate that positive functional fitness performance decreases the risk of falls. A limited amount of previous study has investigated the association between broad functional fitness and the fall risk. This study examines the associations between functional fitness and the risk of falling among community-dwelling older adults.

Methods
Three waves of cross-sectional data were collected from 2017 to 2019 in Taipei City, Taiwan. Six hundred sixty-five participants aged ≥65 years were randomly recruited from 12 districts of Taipei. Eight functional fitness tests (i.e., back scratch, chair-sit and-reach, 8-ft up-and-go, 30-s sit-to-stand, 30-s arm curl, 30-s single-leg stance, 2-min step, and hand grip strength tests) were performed to record the physical performance of older subjects. A Chinese version of the fall-risk questionnaire (FRQ) was used to calculate the fall risk scores. Linear regression and logistic regression were utilized to estimate the relationships of each functional fitness and fall risk.

Result
The results showed that 37.45% of older adults had a high risk of falling. It was found for each functional fitness that performance was linearly associated with the risk of falling. Moreover, older adults with low-performance levels in all functional fitness except back-scratching were more likely to have a higher risk of falling.

Conclusions
Our study indicated that functional fitness performance appears to provide valid predictive guidance for reducing the risk of falling among the older population.