bluuebunny/crossref_metadata_2025_split huggingface dataset:
Diagnostic accuracy of strain cervical elastography as a predictor for preterm delivery: A single tertiary care centre study
Authors: Sharma Abhinash , Thakur Shruti , Tomar Ashwani , Mittal Rita , Surya Mukesh 
Published: November 2024

Introduction: Preterm delivery is a grave and demanding problem that accounts for the major cause of neonatal deaths and long-term morbidities. It remains an unresolved health issue of global dimensions. Cervical elastography is evolving as a useful diagnostic tool for its timely prediction so that individualised management can be done. Aim: To assess the diagnostic accuracy of transvaginal strain cervical elastography in prediction of preterm delivery. Methods: This prospective observational study was conducted from June 2021 to August 2022 in a tertiary care institute of North India. A total of 75 low-risk asymptomatic women were included. Transvaginal ultrasound was performed for the cervical length in the second and third trimesters. In addition, we collected strain elastography data such as colour codes from six regions of the cervix, that is, at the anterior and posterior lips of internal os, middle one-third of the cervix and the external os, and the strain ratios from these three cervical levels were also calculated. Then these parameters were compared with cervical length, second and third trimester groups and also with preterm and term delivery groups. Result: The red colour (soft colour) at the anterior lip of internal os was the best predictor of preterm delivery in our study with a sensitivity and specificity of 63.64% and 96.87%, respectively. The elastography strain ratio of >2 at the internal os and cervical length ⩽2.8 cm were the additional predictors for the same. Conclusion: Cervical elastography can serve as a potential and reliable predictor for preterm delivery.
Preoperative knee hyperextension is the most relevant predictor for ACL reconstruction objective failure: a machine learning analysis of 680 patients
Authors: Helito CP , Silva AGM , Pecora JR , Gobbi RG , Alaiti RK , Vallio CS 
Published: November 2024

Objectives To evaluate the predictive performance of different machine learning algorithms for the occurrence of objective failure in ACL reconstruction and to identify the most relevant predictors associated with this outcome. Methods We evaluated 680 patients submitted submitted to ACL reconstruction between January 2012 and July 2021. The study outcome was ACL objective failure, defined as a complete tear confirmed by MRI or arthroscopy evaluation or clinically ACL insufficiency. Routinely collected imaging, clinical, and demographic data were used to train 9 machine learning algorithms (k-nearest neighbors (KNN) classifier, decision tree classifier, random forest classifier, extra trees classifier, gradient boosting classifier, Light Gradient Boosting Machine (LightGBM), eXtreme Gradient Boosting (XGBoost), CatBoost classifier, and logistic regression). We used a random sample of 70% of patients to train the algorithms, and 30% were left for performance assessment, simulating new data. The performance of the models was evaluated with the area under the receiver operating characteristic curve (AUC). Results The predictive performance of all models was good, with AUC’s ranging from 0.81 to 0.88. The models with the best AUC metric were the Gradient Boosting Classifier (0.88 [95% CI, 0.81 to 0.92]) and Random Forest Classifier (0.88 [ 95% CI, 0.81 to 0.92). Knee hyperextension consistently emerged as the primary predictor across all models subjected to our analysis. Conclusion Machine learning algorithms demonstrated good performance to predict ACL reconstruction objective failure. Additionally, knee hyperextension consistently emerged as the primary predictor across all models subjected to our analysis.
Evaluation of the diagnostic performance of different criteria in identification of periprosthetic infection after knee arthroplasty
Authors: Corrêa VK , Mozella AP , Oliveira Filho NG , De Oliveira ACL 
Published: November 2024

Objectives The objective was to identify the best performance among the criteria most currently used for the diagnosis of PPI using the database of patients undergoing revision TKA surgery in a SUS hospital specializing in highly complex orthopedic surgeries. Methods A retrospective study was carried out by collecting data from patients undergoing TKA revision for PPI. Patients who did not have sufficient data to confirm or exclude the diagnosis of PJI and insufficient information that did not allow comparison of systems were exclude. An analysis of the variables of the study participants was carried out, the microbiological profile was evaluated and the different diagnostic systems were compared. Results A total of 188 participants were included, with 67 cases excluded. At the end, 121 cases of revisions due to chronic infection were analyzed. The average age of patients undergoing revision was 71 years, with the majority being women. The microbiological profile converged with previous literature. MSIS 2018 (standard) identified 39 cases of infection, with 10 (25%) culture-negative cases. The 2013 MSIS diagnosed 35 infections, with 6 (17%) showing no bacterial growth. EBJIS identified 47 cases of infection, of which 20 (38%) were culture-negative cases. Of the cases considered infected by MSIS 2018, all were also considered infected by EBJIS 2021. However, of the 47 cases considered confirmed infection by EBJIS, 39 patients were considered confirmed infection by MSIS 2018, 4 possibly infected and 4 not infected, which makes the european system positive a greater number of cases in addition to confirming more cases without bacterial growth. Conclusion EBJIS demonstrated more cases of infection when compared to MSIS 2018 and more inconclusive/possibly infected cases. MSIS 2013 would not change the management of all patients who confirmed infection.
Youth Soccer Players Undergoing Anterior Cruciate Ligament Reconstruction Demonstrate High Rates of Continuation of Sport and Progression to Professional Level Soccer: A Seven Season Analysis in Twenty-Nine Brazilian Professional Soccer Teams
Authors: DC Astur , M Moises Cohen 
Published: November 2024

Objectives To evaluate the progression of youth male soccer athletes who undergo ACL reconstruction and track their progression from youth up to professional level play Methods 163 male players from 29 soccer teams underwent ACL reconstruction and were followed from 2015 to 2023. They were evaluated regarding category progression (under-13 to professional), type of graft used, presence of re- rupture, and return to sport/continuation of sport. Results Most injuries occurred in players in the under-17 (31.3%) and under-20 (47.2%) categories. A total of 111 patients continued playing after ligament reconstruction (68.1%), and 52 patients discontinued their careers (31.9%). Of the 163 athletes who underwent ACL reconstruction, 40 still play professionally (24.5%) and 71 are continuing participation in youth soccer and may still become professionals (43.6%). Among the professionals, 8 underwent an ACL revision reconstruction. The graft of choice in 77.3% of the reconstructions were the hamstring tendons. Conclusion Athletes from professional soccer teams who underwent ACL reconstruction while still playing in the youth teams of their clubs demonstrated a return to sport rate of 68.1%. Among players who returned to sport and became adult league professionals, 40 (83.3%) continued to play at the adult professional level, and 8 (16.7%) have discontinued their careers.
Transcriptomics of interstitial lung disease: a systematic review and meta-analysis
Authors: He Daniel , Guler Sabina A. , Shannon Casey P. , Ryerson Christopher J. , Tebbutt Scott J. 
Published: November 2024

ObjectiveGene expression (transcriptomics) studies have revealed potential mechanisms of interstitial lung disease (ILD), yet sample sizes of studies are often limited and between-subtype comparisons are scarce. The aim of this study was to identify and validate consensus transcriptomic signatures of ILD subtypes.MethodsWe performed a systematic review and meta-analysis of fibrotic ILD transcriptomics studies using an individual participant data approach, and included studies examining bulk transcriptomics of human adult ILD samples and excluding those focusing on individual cell populations. Patient-level data and expression matrices were extracted from 43 studies and integrated using a multivariable integrative algorithm to develop ILD classification models.ResultsUsing 1459 samples from 24 studies, we identified transcriptomic signatures for idiopathic pulmonary fibrosis (IPF), hypersensitivity pneumonitis (HP), idiopathic nonspecific interstitial pneumonia (NSIP), and systemic sclerosis-associated ILD (SSc-ILD) against control samples, which were validated on 308 samples from 8 studies (area under receiver operating curve [AUC]=0.99 [95% CI: 0.99–1.00], HP AUC=0.91 [0.84–0.99], NSIP AUC=0.94 [0.88–0.99], SSc-ILD AUC=0.98 [0.93–1.00]). Significantly, meta-analysis allowed, for the first time, identification of robust lung transcriptomics signatures to discriminate IPF (AUC=0.71 [0.63–0.79]) and HP (AUC=0.76 [0.63–0.89]) from other fibrotic ILDs, and unsupervised learning algorithms identified putative molecular endotypes of ILD associated with decreased forced vital capacity (FVC) and diffusing capacity of the lungs for carbon monoxide (DLCO) % predicted. Transcriptomics signatures were reflective of both cell-specific and disease-specific changes in gene expression.ConclusionWe present the first systematic review and largest meta-analysis of fibrotic ILD transcriptomics to date, identifying reproducible transcriptomic signatures with clinical relevance.
Association between e-cigarette exposure and ventilation homogeneity in young adults: A cross-sectional study
Authors: Stanojevic Sanja , Ha Yung Mei , Sahin Berke , Johnson Noah , Stewart Hanna , Laflamme Olivier D. , Maksym Geoffrey , Mateos-Corral Dimas , Asbridge Mark 
Published: November 2024

BackgroundThe number of young people who use electronic cigarettes (e-cigarettes) is rising. It remains unclear whether e-cigarettes use impairs lung function. We aimed to compare ventilation distribution between young adults exposed to e-cigarettes with an unexposed group.MethodsStudy participants included otherwise healthy young adults (18 to 24 years) who self-reported e-cigarette use, and participates who had no history of e-cigarette, tobacco or cannabis exposure. Exposure to e-cigarettes was defined using three measures 1) ever exposed, 2) daily use, and 3) puff frequency, which includes: none (unexposed), low (1–2 puffs/hour), moderate (3–4 puffs/hour) and heavy (5+ puffs/hour). Ventilation distribution was measured using the multiple breath washout test and reported as lung clearance index (LCI).ResultsA total of 93 participants were recruited, 38 unexposed and 41 exposed participants had LCI measures. The exposed group consisted predominately of participants who used flavoured e-liquids (94.5%) that contained nicotine (93.5%). The magnitude and direction of the difference in LCI across the exposure definitions was similar. Compared with the unexposed group, in the unadjusted models LCI was higher in those with any e-cigarette use (mean difference 0.16 units; 95% CI 0.004; 0.31), daily users (mean difference 0.11; 95% CI 0.06; 0.28) and heavy users (mean difference 0.22; 95% CI 0.03; 0.41).ConclusionThis preliminary work suggests that LCI may be a useful biomarker to measure the effects of e-cigarette use on ventilation distribution and to track early functional impairment of the small airways.
Effect of Atracurium versus Cisatracurium on QT interval changes in patients undergoing cataract surgery: a randomized clinical trial
Authors: Karimi Mehdi , Ghaheri Ali , Saleh Kianmehr , Cheraghi Zahra , Farahanchi Afshin 
Published: November 2024

Abstract
Background
Muscle relaxants are used during surgery, but their impact on ECG may differ, potentially affecting cardiac safety. This study aimed to compare the effects of Atracurium versus Cisatracurium on QT interval changes in patients undergoing cataract surgery.

Method
This double-blind, parallel-group randomized clinical trial (RCT) was conducted in 2023 in Hamadan, Iran. A total of 80 patients undergoing cataract surgery under general anesthesia were randomly assigned to receive either Atracurium (n = 40) or Cisatracurium (n = 40). QT interval changes were measured at four time points to assess and compare the corrected QT interval (QTc) between the two groups. Data were analyzed using SPSS version 29, and a p-value < 0.05 was deemed significant.

Results
Cisatracurium demonstrated significant reductions in QTc from pre-anesthesia to post-anesthesia and through recovery, with values of -9.325 ms (P = 0.045), -9.925 ms (P = 0.038), and − 19.359 ms (P = 0.016), respectively. Atracurium also showed reductions but a notable increase in QTc after anesthesia to the end of surgery (32.322 ms, P = 0.0019). Throughout the procedure, Cisatracurium maintained shorter QTc intervals compared to Atracurium (e.g., T0: 420.07 ms vs. 434.75 ms, P = 0.03), but post-recovery, no significant differences were observed (Cisatracurium: 440.05 ms; Atracurium: 439.80 ms, P = 0.489).

Conclusions
Atracurium causes more QT prolongation than Cisatracurium. While both affect QTc intervals, Cisatracurium has a more stable impact on cardiac repolarization, making it safer for patients at risk of QT prolongation. Cisatracurium’s minimal impact on cardiovascular function, especially in patients with low ejection fraction, makes it the preferred choice for maintaining cardiac stability.

Trial registration
IRCT20120215009014N441.
Sociodemographic determinants of mobility decline among community-dwelling older adults: findings from the Canadian longitudinal study on ageing
Authors: Onyeso Ogochukwu Kelechi , Alumona Chiedozie James , Odole Adesola Christiana , Victor Janice , Doan Jon , Awosoga Oluwagbohunmi A. 
Published: November 2024

Abstract
Background
Mobility is fundamental to healthy ageing and quality of life. Mobility decline has been associated with functional impairment, falls, disability, dependency, and death among older adults. We explored the sociodemographic determinants of mobility decline among community-dwelling older Canadians.

Methods
This study was a secondary analysis of a six-year follow-up of the Canadian Longitudinal Study on Ageing (CLSA). Our analysis was based on 3882 community-dwelling older adults 65 years or older whose mobility was measured using timed-up and go (TUG) and 4-meter walk (4MWT) tests at baseline and follow-ups 1 and 2 after three- and six-year intervals, respectively. We analysed the cross-sectional and longitudinal association, main and interaction effects of the participants’ sociodemographic characteristics on mobility decline using chi-square, Pearson’s correlation, mixed-design repeated measures ANOVA, and bivariate and multivariate linear regression tests.

Results
At baseline, 52% of the participants were female, 70.4% were married, and the average age was 68.82 ± 2.78 years. Mean TUG and 4MWT scores were 9.59 ± 1.98 s and 4.29 ± 0.95 s, respectively. There was a strong positive longitudinal correlation between TUG and 4MWT (r = 0.65 to 0.75, p < 0.001), indicating concurrent validity of 4MWT. The multivariate linear regression (for TUG) showed that older age (β = 0.088, p < 0.001), being a female (β=-0.035, p < 0.001), retired (β=-0.058, p < 0.001), Canadian born (β=-0.046, p < 0.001), non-Caucasian (β=-0.063, p < 0.001), tenant (β = 0.050, p < 0.001), having no spouse/partner (β=-0.057, p < 0.001), household income of $50,000-$99,999 (β = 0.039, p < 0.001), wealth/investment lower than $50,000 (β=-0.089, p < 0.001), lower social status (β=-0.018,p = 0.025), secondary education and below (β = 0.043, p < 0.001), and living in certain provinces compared to others, were significant predictors of a six-year mobility decline.

Conclusion
Our study underscored the impact of modifiable and non-modifiable sociodemographic determinants of mobility trajectory. There is a need for nuanced ageing policies that support mobility in older adults, considering sociodemographic inequalities through equitable resource distribution, including people of lower socioeconomic backgrounds.
The relationship between ethnicity and place of birth in England: a mixed-methods study
Authors: Rivers Frances , Grollman Christopher , Khan Zahra , Daniele Marina A. S. 
Published: November 2024

Abstract
Background
UK maternity policy advocates a choice of birthplace in an obstetric-led unit (OU), a midwife-led unit (MLU) or at home. Although robust evidence supports the safety of birth in midwife-led settings, particularly for women with uncomplicated pregnancies, most births are in the OU. Women and babies from ethnic minority communities experience major health disparities and inequitable care, but there is limited research examining birthplace choices through an ethnicity lens. This study investigated the association between ethnicity and place of birth at an urban NHS Trust in England.

Methods
A mixed-methods sequential explanatory study. Analysis of births from 2014–2023 at a London NHS Trust included multivariable logistic regression analysis of birthplace by ethnicity. Planned or pre-labour Caesareans, pre-term, and multiple births were excluded. Significant disparities between White and South Asian women were identified which informed the focus of the qualitative study. Semi-structured interviews with 10 women of South Asian heritage who had given birth in the OU, the alongside MLU or at home were conducted and analysed thematically.

Results
More White women gave birth in midwife-led settings (27.5%) than all other ethnicities, particularly South Asian women (20.6%). South Asian women had fewer homebirths (0.8%) than White women (2.7%) and were much less likely to birth in a midwife-led setting after adjusting for parity, maternal age, BMI, previous Caesarean, presence of diabetes or hypertensive disorders and onset of labour (aOR 0.61, 95% CI 0.51–0.73, p < 0.001). Places of birth were similar for Black and White women, although the number of Black women in the population was too low to detect significant differences.
Themes generated from interviews included the assumption that birth is hospital-based and doctor-led; choosing a midwife-led birth setting went against the cultural norm, but felt safe – physically, psychologically and culturally.

Conclusions
There are ethnic disparities in place of birth. Cultural factors seem influential, but barriers to choice, such as limited evidence-sharing by midwives, may disproportionately affect women from ethnic minority communities, who may particularly benefit from midwife-led birth settings. Women need personalised information about options. Improving choice of birthplace is a step towards reducing health inequalities and promoting optimal health.
Remote school instruction in Fall 2020 and psychiatric emergencies among adolescents in Los Angeles County
Authors: Huo Shutong , Ro Annie , Du Senxi , Young Andrew , Bruckner Tim A. 
Published: November 2024

Abstract
Objective
Schools play an essential role in providing mental health care for adolescents. School closures during COVID-19, as well as re-opening to remote-only instruction in Fall 2020, may indirectly affect the utilization of emergency psychiatric care. We examine COVID-19-related changes in emergency psychiatric care among youth during the school closure and after school reopening (with remote instruction).

Methods
We use Box-Jenkins interrupted time series methods to analyze psychiatric emergency department (ED) visits among patients 10–19 years at LAC + USC Medical Center (LAC + USC) between January 5th, 2018, and December 31st, 2020. We control for the 1st societal shutdown in LA County (i.e., the nine weeks from March 13 to May 14, 2020) when analyzing the potential “return to remote school” shock.

Results
Youth psychiatric ED visits fell by 15.3 per week during the Spring 2020 school closure (p < .05). The “return to remote school” coefficient (i.e., August 14th to September 10, 2020), by contrast, is positive but does not reach statistical detection above expected values (p = .11). However, the proportion of psychiatric ED visits rises 38% among youth during the “return to remote school” period (p = 0.006).

Conclusion
The initiation of Fall 2020 remote instruction corresponded with a greater proportion of youth ED visits that are classified as psychiatric.
Association between tobacco smoking and prevalence of HIV, tuberculosis, hypertension and diabetes in rural South Africa: a cross-sectional study
Authors: Chidumwa Glory , Olivier Stephen , Ngubane Hloniphile , Zulu Thando , Sithole Mareca , Gunda Resign ,   The Vukuzazi Team, Sewpaul Ronel , Kruse Gina , Rigotti Nancy A. , Hanekom Willem A. , Siedner Mark J. , Reddy Krishna P. , Wong Emily B. 
Published: November 2024

Abstract
Background
South Africa is facing a convergence of communicable diseases (CDs) and non-communicable diseases (NCDs). There are limited data about how tobacco use contributes to the burden of these conditions, especially in rural populations.

Methods
We analyzed the associations between current tobacco smoking and four important CDs and NCDs in Vukuzazi, a cross-sectional study of individuals aged 15 years and older conducted between 2018–2020 in a demographic surveillance area in KwaZulu-Natal, South Africa. Data on HIV, active tuberculosis (TB), hypertension and diabetes mellitus were collected via direct measurement from participants.

Results
Of 18,024 participants (68% female, median age 37 years [interquartile range 23–56 years]), 1,301 (7.2%) reported current smoking. Prevalence of HIV infection was similarly high among people who currently smoked (34.6%) and people who had never smoked (33.9%). However, among people living with HIV (PLWH), there was a higher prevalence of detectable viremia in people reporting current smoking compared to people who reported never smoking (28.8% vs. 16.6%; p-value < 0.001). Active TB was more prevalent in people who currently smoked than in people who never smoked (3.1% vs 1.3%, p < 0.001). In contrast, the prevalence of hypertension and diabetes mellitus were lower in people reporting current smoking than in people reporting never smoking (17.1% vs 26.0% (p < 0.001), and 2.5% vs 10.2% (p < 0.001), respectively). In sex-stratified multiple logistic regression analyses that were adjusted for potential confounding factors (including body mass index for the NCDs), the magnitude of differences in CD prevalence between people who currently smoked and people who never smoked decreased, whereas the lower prevalence of NCDs among people reporting current smoking persisted.

Conclusions
In rural South Africa, smoking is associated with higher prevalence of active TB, and people with HIV who smoke have worse disease control. In contrast, hypertension and diabetes mellitus are less common in those who smoke. Interventions to screen for TB among those who smoke and to address smoking among people with HIV may be particularly impactful.