bluuebunny/crossref_metadata_2025_split huggingface dataset:
DiffErential attainment and Factors AssoCiated with Training applications and Outcomes (DE FACTO) study: Trauma & Orthopaedic surgery in the UK
Authors: Raj Siddarth , Grover Sarika , Spazzapan Martina , Russell Beth , Jaffry Zahra , Malde Sachin , Vig Stella , Fleming Simon 
Published: August 2024

AimsThe aims of this study were to describe the demographic, socioeconomic, and educational factors associated with core surgical trainees (CSTs) who apply to and receive offers for higher surgical training (ST3) posts in Trauma & Orthopaedics (T&O).MethodsData collected by the UK Medical Education Database (UKMED) between 1 January 2014 and 31 December 2019 were used in this retrospective longitudinal cohort study comprising 1,960 CSTs eligible for ST3. The primary outcome measures were whether CSTs applied for a T&O ST3 post and if they were subsequently offered a post. A directed acyclic graph was used for detecting confounders and adjusting logistic regression models to calculate odds ratios (ORs), which assessed the association between the primary outcomes and relevant exposures of interest, including: age, sex, ethnicity, parental socioeconomic status (SES), domiciliary status, category of medical school, Situational Judgement Test (SJT) scores at medical school, and success in postgraduate examinations. This study followed STROBE guidelines.ResultsCompared to the overall cohort of CSTs, females were significantly less likely to apply to T&O (OR 0.37, 95% CI 0.30 to 0.46; n = 155/720 female vs n = 535/1,240 male; p < 0.001). CSTs who were not UK-domiciled prior to university were nearly twice as likely to apply to T&O (OR 1.99, 95% CI 1.39 to 2.85; n = 50/205 vs not UK-domiciled vs n = 585/1,580 UK-domiciled; p < 0.001). Age, ethnicity, SES, and medical school category were not associated with applying to T&O. Applicants who identified as ‘black and minority ethnic’ (BME) were significantly less likely to be offered a T&O ST3 post (OR 0.70, 95% CI 0.51 to 0.97; n = 165/265 BME vs n = 265/385 white; p = 0.034). Differences in age, sex, SES, medical school category, and SJT scores were not significantly associated with being offered a T&O ST3 post.ConclusionThere is an evident disparity in sex between T&O applicants and an ethnic disparity between those who receive offers on their first attempt. Further high-quality, prospective research in the post-COVID-19 pandemic period is needed to improve equality, diversity, and inclusion in T&O training.Cite this article: Bone Jt Open 2024;5(8):697–707.
Synergistic patient factors are driving recent increased pediatric urgent care demand
Authors: Lehan Emily , Briand Peyton , O’Brien Eileen , Hafeez Aleena Amjad , Mulder Daniel J. 
Published: August 2024

Objectives
We aimed to use the high fidelity urgent care patient data to model the factors that have led to the increased demand at our local pediatric urgent care centre.

Methods
The dataset for this retrospective cohort study was obtained from our local healthcare centre’s national reporting data for pediatric urgent care visits from 2006 to 2022. Variables analyzed included: basic patient demographics, chief complaint, triage urgency, date and time of registration/discharge, discharge diagnosis, and discharge destination. Statistical analysis of non-linear trends was summarized by locally estimated scatterplot smoothing splines. For machine learning, we used the tidymodels R package. Models were validated in training using k-fold cross validation with k = 5. We used univariate linear regression as a baseline model. After the data was standardized, correlation and homoscedasticity were evaluated between all parameter permutations.

Results
This dataset consisted of 164,660 unique visits to our academic centre’s pediatric urgent care. Over the study period, there was an overall substantial increase in the number of urgent care visits per day, with a rapid increase beyond previous levels in 2021 and further in 2022. The increased length of stay trend was consistent across presenting complaint categories. The proportion of patients without primary care in 2022 was 2.5 times higher than in 2013. A random forest machine learning model revealed the relative importance of features to predicting a visit in 2022 were: longer stay, later registration in the day, diagnosis of an infectious illness, and younger age.

Conclusions
This study identified a combination of declining primary care access, circulating viral infections, and shifting chief complaints as factors driving the recent increase in frequency and duration of visits to our urgent care service.
Laying the foundation for iCANmeditate: A mixed methods study protocol for understanding patient and oncologist perspectives on meditation
Authors: Lalani Yasmin , Godinho Alexandra , Ellison Kirsten , Joshi Krutika , Curtin Wach Aisling , Rana Punam , Wegier Pete 
Published: August 2024

Background
People with cancer experience heightened levels of stress and anxiety, including psychological or physical. In recent years, digitally delivered complimentary therapies, such as meditation, have gained attention in cancer research and advocacy communities for improving quality of life. However, most digital meditation resources are commercially available and are not tailored to the unique needs of cancer patients (addressing fears of recurrence). As such, this study lays the foundation to co-design a publicly available digital meditation program called iCANmeditate that contains cancer-specific meditation content.

Aims
To understand: (1) cancer patients’ perceptions and practices of meditation, as well as their needs in addressing the stress that accompanies their cancer diagnosis and (2) current knowledge of meditation and prescribing trends amongst oncologists in Canada.

Methods and analysis
A mixed-methods design comprised of online patient and oncologist surveys and interviews with patients will be used. Survey data analysis will use multivariate logistic regressions to examine predictors of: (1) interest in using a meditation app among patients and (2) prescribing meditation among oncologists. Patient interviews will gather insights about the contexts of daily living where meditation would be most beneficial for people with cancer; this data will be analyzed thematically.

Discussion
The results of this study will inform iterative co-design workshops with cancer patients to build the digital meditation program iCANmeditate; interview results will be used to develop vignettes or “personas” that will supply the initial stimulus material for the iterative co-design workshops. Once the program has been finalized in partnership with cancer patient participants, a usability and pilot study will follow to test the functionality and efficacy of the tool. Results from the oncologist survey will form the basis of knowledge mobilization efforts to facilitate clinical buy-in and awareness of the benefits of meditation to cancer patients.
Investigation of eye movement characteristics during free throws at varying intensities among basketball players and its correlation with free throw percentage
Authors: Zhao Chunzhou , Liu Na , Li Sunnan , Zhao Xuetong 
Published: August 2024

Background
Free throws serve as a crucial scoring mechanism in basketball games. As the level of basketball and the intensity of competition continue to improve, the frequency of free throw attempts gradually rises. However, with heightened game intensity, maintaining a consistent free throw success rate becomes increasingly challenging. The aim of this study was to investigate the eye movement characteristics exhibited by basketball players during free throws of varying intensities, as well as explore the relationship between these eye movement characteristics and free throw percentage.

Methods
Twenty elite female basketball players were recruited to perform free throws at varying exercise intensities (low, moderate, and high) while wearing an eye tracker device. Eye tracking data was collected using the Tobii Glasses 3 eye tracker. Additionally, the Polar team pro, a heart rate monitoring system manufactured in Finland, was utilized to monitor participants’ heart rates during different exercise intensities.

Results
The average number of fixations on the hoop and net during free throws of varying intensities exhibited statistically significant differences (P < 0.05). The fixation durations of the hoop, backboard, and net exhibited statistically significant differences (P < 0.05). Notably, the hoop accounted for the highest proportion of the overall average fixation duration. high-intensity free throws necessitate lengthier processing durations compared to low-intensity and medium-intensity free throws. Furthermore, for free throws of moderate intensity, there was a significant negative correlation between the number of fixations on the hoop and free throw percentage (P < 0.05). Conversely, for high intensity free throws, there was a significant positive correlation between the fixation duration on the hoop and free throw percentage (P < 0.05).

Conclusions
Under the three kinds of sports intensity, the players mainly focus on the hoop position, the moderate intensity free throw has the best stability, and the information search strategy and information processing efficiency are the highest. In high intensity free throws, the longer the fixation duration at the hoop, the higher the free throw percentage; The higher the number of fixations at the hoop, the lower the percentage of free throws.
Blocking IL-33 decelerates cartilage degeneration in knee osteoarthritis through mice model
Authors: Wu Fan , Zhang Siyuan , Zhuang Rujie , Hu Chuanxiao , Zhu Kangxiang 
Published: August 2024

Introduction
Osteoarthritis (OA) is a chronic inflammatory disease where pro-inflammatory cytokines, damage-associated molecular patterns and macrophages play a crucial role. However, the interaction of these mediators, the exact cause, and the treatment of knee osteoarthritis (KOA) are still unclear. Moreover, the interaction of interleukin (IL)-33, platelet-derived growth factor-BB (PDGF-BB), and matrix metalloproteinase-9 (MMP-9) with other factors in the pathogenesis of KOA has not been elaborately explored.

Method
Therefore, in this study, we analyzed the expression of IL-33, PDGF-BB, and MMP-9 in the knee cartilage tissue of model mice, murine KOA was induced by using the destabilization of the medial meniscus (DMM) model.

Results
Compared with the sham operation control group, the expression levels of PDGF-BB, IL-33, and MMP-9 were increased significantly, and the pathological sections showed obvious cartilage damage. Additionally, we assessed the levels of IL-33 and MMP-9 expression in the knee joint of KOA model mice following intervention with PDGF-BB antibody, and we found that the expression level of MMP-9 was reduced following intervention with IL-33 antibody. When the effects of the three antibodies were compared in a mouse disease model, it was discovered that the IL-33 antibody could dramatically lower the relative expression level of MMP-9, resulting in the least amount of cartilage damage and improved protection. In conclusion, inhibiting IL-33 can significantly lower inflammatory factor levels in the knee joint, including IL-33 and MMP-9, and it can improve cartilage breakdown in osteoarthritis of the knee.

Conclusion
Overall, the results indicate that IL-33 has a therapeutic function in the treatment of knee osteoarthritis and may be a novel target for treatment of the underlying causes of KOA. Additionally, PDGF-BB might be an upstream pathway of IL-33, and KOA’s MMP-9 is an downstream pathway of IL-33.
Menstrual hygiene management interventions and their effects on schoolgirls’ menstrual hygiene experiences in low and middle countries: A systematic review
Authors: Betsu Balem Demtsu , Medhanyie Araya Abrha , Gebrehiwet Tesfay Gebregzabher , Wall L. Lewis 
Published: August 2024

Background
Inadequate menstrual hygiene management can result in physical, social, psychological, and educational challenges for schoolgirls. To address these issues, researchers have conducted intervention studies, but the impact on school attendance has varied. This review has systematically collected and evaluated evidence about the effects of menstrual hygiene interventions on schoolgirls.

Method
A systematic search of the literature was done and reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA statement). Both peer-reviewed journals and gray literature were searched using PubMed and Google Scholar. The search included individual, or cluster randomized controlled trials, and quasi-experimental studies, and covered the period from the date of indexing until January 3, 2023.

Result
A review of sixteen trial studies showed that menstrual hygiene interventions have a positive effect on schoolgirls’ school attendance, performance, and dropout rates, as well as on their menstrual knowledge, attitudes, practices, and emotional well-being. There was a low to medium risk of bias in most of the studies. Additionally, the literature overlooked the impact of interventions that involve parental and male engagement, interventions correcting community misperceptions about menstruation, and the impact of infrastructure improvements on water, sanitation, and hygiene.

Conclusion
Interventions aimed at improving menstrual hygiene management can enhance schoolgirls’ educational outcomes, and can improve their menstrual knowledge, attitudes, and practices by helping them manage their periods more effectively. Most interventions have focused on the provision of menstrual products and menstrual education but have neglected improvements in the physical environment at home and school and the social norms surrounding menstruation. Trial studies should take a holistic approach that considers the total socio-cultural environment in which menstrual hygiene management takes place, thus enabling stakeholders and policymakers to develop sustainable, long-term solutions to these problems.
The relationship between mechanical power normalized to dynamic lung compliance and weaning outcomes in mechanically ventilated patients
Authors: Yan Yao , Du Zhiqiang , Chen Haoran , Liu Suxia , Chen Xiaobing , Li Xiaomin , Xie Yongpeng 
Published: August 2024

Background
Prolonged mechanical ventilation is associated with an increased risk of mortality in these patients. However, there exists a significant clinical need for novel indicators that can complement traditional weaning evaluation methods and effectively guide ventilator weaning.

Objectives
To investigate the specific relationship between mechanical power normalized to dynamic lung compliance (Cdyn-MP) and weaning outcomes in patients on mechanical ventilation for more than 24 hours, as well as those who underwent a T-tube weaning strategy.

Methods
A retrospective cohort study was conducted using the Medical Information Mart for Intensive Care-IV v1.0 database (MIMIC-IV v1.0). Patients who received invasive mechanical ventilation for more than 24 hours and underwent a T-tube ventilation strategy for weaning were enrolled. Patients were divided into two groups based on their weaning outcome: weaning success and failure. Ventilation parameter data were collected every 4 hours during the first 24 hours before the first spontaneous breathing trial (SBT).

Results
Of all the 3,695 patients, 1,421 (38.5%) experienced weaning failure. Univariate logistic regression analysis revealed that the risk of weaning failure increased as the Cdyn-MP level rose (OR 1.34, 95% CI 1.31–1.38, P<0.001). After adjusting for age, body mass index, disease severity, and pre-weaning disease status, patients with high Cdyn-MP quartiles in the 4 hours prior to the SBT had a significantly greater risk of weaning failure than those with low Cdyn-MP quartiles (odds ratio 10.37, 95% CI 7.56–14.24). These findings were robust and consistent in both subgroup and sensitivity analyses.

Conclusion
The increased Cdyn-MP before SBT was independently associated with a higher risk of weaning failure in mechanically ventilated patients. Cdyn-MP has the potential to be a useful indicator for guiding the need for ventilator weaning and complementing traditional weaning evaluation methods.
One-year experience with latanoprostene bunod ophthalmic solution 0.024% in clinical practice: A retrospective observational study
Authors: Hsueh Chun-Mei , Tsai Chen-Hsin , Huang Jou-Chen , Lee Si-Huei , Wang Tsung-Jen , Guo Siao-Pei 
Published: August 2024

Purpose
We evaluated the IOP-lowering efficacy and safety of latanoprostene bunod (LBN) ophthalmic solution 0.024% (Vyzulta®), the first topical nitric oxide-donating prostaglandin analog (PGA), in clinical practice.

Materials and methods
A retrospective medical chart review from July 2021 to July 2023 of patients with open-angle glaucoma receiving LBN with at least 1 year follow–up was conducted. All included patients received LBN 0.024% as a replacement for a PGA, with examinations at 1-, 3-, 6-and 12-months follow-up. Main outcome measures were IOP, retinal nerve fiber layer thickness, visual fields before/after LBN use and adverse effects. Subgroup analysis with glaucoma types and PGA use were performed for additional IOP reduction after LBN use.

Results
Among 78 included patients, 47 patients (81 eyes), 60% with open-angle glaucoma (OAG) remained on LBN throughout 12-month follow-up. Baseline IOP was 18.2±4.2 mm Hg, and Prostaglandin analog (PGA)-IOP was 14.4 ± 3.0 mm Hg (21% mean IOP reduction). After switched to LBN, mean additional IOP reduction was 1.0 mm Hg at month 1, and the greatest reduction was 1.6 mm Hg (8.8% additional mean IOP reduction) at month 12 (P<0.0001). Subgroup analysis (NTG, 73%) showed that mean additional IOP reduction at month 12 was 1.3±2.0 mm Hg in NTG group and 2.1±3.2 mm Hg in POAG group (7.7% vs. 8.7% additional IOP reduction rates, P = 0.23). Subgroup analysis of PGA use at month 12 was 1.8±2.3 mm Hg in tafluoprost group and 0.5±1.7 mm Hg in travoprost group (9.5% vs.2.6% additional IOP reduction rates, P = 0.02). Tolerable ocular adverse effects included irritation (n = 16, 19.8%), mild conjunctival hyperemia (n = 11, 13.6%), dark circles (n = 4, 4.9%) and blurred vision (n = 2, 2.5%). There were no significant visual field and retinal nerve fiber layer thickness changes after 12 months of treatment with LBN 0.024%.

Conclusions
Although high intolerable adverse effects including conjunctival hyperemia and eye irritation happened in the first month, remaining sixty percent of patients exhibited statistically significant additional IOP reductions in the replacement of other PGAs during 12 months of clinical use of LBN 0.024%.
Knowledge of abortion legality among health facility staff in Ghana
Authors: Sheehy Grace , Polis Chelsea , Otupiri Easmon , Moreau Caroline 
Published: August 2024

Background
Abortion has been legal for multiple indications in Ghana since 1985, and efforts have been made to expand the availability of safe abortion care in the years since. However clandestine, and potentially unsafe, abortions remain common, suggesting numerous barriers to access persist; one possible barrier is poor knowledge of the abortion law among those working in health facilities. Our study aimed to identify levels of legal knowledge among health facility staff across Ghana.

Methods
Data for this paper are drawn from a nationally representative cross-sectional health facility survey conducted in 2018; our analytic sample includes 340 facilities that provide induced abortion and/or postabortion care (PAC). The survey collected data on provision of abortion and PAC, as well as knowledge of abortion legality and recommendations for reducing unsafe abortion. We used descriptive statistics to examine levels of knowledge and recommendations, and logistic regression to assess associations with individual and facility characteristics.

Findings
Comprehensive knowledge of the legal indications for abortion was low among health facility staff; just 6% identified all legal indications, and the majority (83%) underestimated the number of conditions under which abortion is legal. Knowledge was higher for more restrictive indications, such as a woman’s life being at risk, which was identified by 72% of respondents, than more broadly interpretable indications, such as mental health, identified by 29%. Respondents in facilities providing both induced abortion and PAC had better knowledge of several legal indications than those in facilities providing PAC only.

Conclusions
Health facility staff have significant gaps in their knowledge of abortion legality. Knowledge of the law among this population is highly important for ensuring that abortion care is made available to the fullest extent of the law. Efforts are needed to improve knowledge of the law among providers and facility staff, particularly for indications with broad interpretability.
MRI paraspinous skeletal muscle enhancement: A potential imaging biomarker for assessing clinical liver cirrhosis severity
Authors: du Pisanie Johannes L. , Ramakrishnan Venkateswaran , Patel Vedang , Commander Clayton , Yu Hyeon 
Published: August 2024

Purpose
To evaluate for correlation between MRI paraspinous muscle (PSM) enhancement and clinical measures of cirrhosis severity (CMCS) utilizing established imaging biomarkers of sarcopenia as comparison.

Materials and methods
Retrospective evaluation of 224 patients (mean age 59.6± 9.7 years, 135 males and 89 females) with liver cirrhosis who underwent contrast-enhanced MRI between August 2021 and August 2022 was performed. Assessed variables included: body mass index (BMI), varices and ascites present on imaging (VPI and API), albumin, total bilirubin (Tbili), international normalized ratio (INR), creatinine, MELD score, as well as history of paracentesis (PH), spontaneous bacterial peritonitis, and variceal bleed (VBH). These variables were compared to PSM skeletal muscle index (SMI), PSM signal fat fractions (sFF), and PSM contrast enhancement fraction (CEFR) calculated on arterial (CEFR-ART), portal venous (CEFR-PV), and delayed (CEFR-DEL) phases collected on MRI.

Results
Patients with MELD>17, PH, and VPI had lower PSM CEFR-ART (0.06vs. 0.11, p = 0.01; 0.07vs. 0.11, p = 0.01; and 0.09vs. 0.13, p = 0.03, respectively). PSM CEFR-ART correlated negatively with MELD. Patients with MELD>17 and PH had lower PSM CEFR-PV (0.16vs. 0.23, p = 0.02; 0.18 vs. 0.23, p = 0.01, respectively). PSM CEFR-PV correlated positively with albumin and negatively with Tbili, INR, and MELD. PSM CEFR-DEL correlated negatively with Tbili and MELD. Patients with API, PH, and VBH had lower PSM SMI (4.68vs. 5.59, p<0.001; 4.37vs. 5.48, p<0.001; 4.78vs. 5.35, p = 0.04, respectively). PSM SMI correlated negatively with Tbili and positively with BMI. PSM sFF correlated positively with BMI, PSM CEFR-PV, and PSM CEFR-DEL.

Conclusion
PSM CEFR is significantly reduced on MRI in patients with clinical manifestations of severe liver cirrhosis. Further investigation into PSM CEFR’s usefulness as an imaging biomarker for evaluating liver disease severity is warranted.
Ecoarte
Authors: Quiñonero Ortuño Sergi 
Published: August 2024

Este artículo propone una aproximación crítica a diversas cuestiones: el espacio que nuestra especie ocupa en el planeta Tierra, los impactos que provoca, o la relación que mantenemos con la naturaleza. Y, sobre todo, cómo reflexionar acerca de estos temas a través del arte, entendido desde una perspectiva ecológica.

Se plantean también casos de estudio, en los que ha estado vinculado el autor, y con los que se pone de manifiesto la difícil relación entre los conceptos de arte y ecología.