bluuebunny/crossref_metadata_2025_split huggingface dataset:
The effect of autism phenotype and diagnosis disclosure on students’ desire for social distance from autistic peers
Authors: Muraškaitė Indrė , Žardeckaitė-Matulaitienė Kristina 
Published: February 2024

Autistic students report feeling lonely, rejected by peers which is associated with poorer well-being and lower academic results. This study aims to evaluate the effect of autism phenotype and diagnosis disclosure on students’ desire for social distance from autistic students and factors related to social distancing. 303 students (72.3% women; mean age = 22.37 years) participated in this study. Each participant was assigned to one of the six vignettes depicting students of different gender and diagnostic status. Respondents’ willingness to engage in different social situations, type and quality of prior contact with autism, autism knowledge and social desirability bias were measured. Results showed that students desired greater social distance from autistic males compared to autistic females, as well as from peers with non-disclosed diagnosis compared to those with disclosed diagnosis. Greater autism knowledge was related to less desire for social distance in non-disclosure, disclosure and in male autism phenotype conditions. Higher quality of contact was associated with less desire for social distance from autistic students with disclosed diagnosis. Type of contact was not related to social distance. Findings suggest that autistic male students and individuals with non-disclosed diagnosis might be more vulnerable to social exclusion. Lay abstract Autistic students experience loneliness, rejection from peers, which might negatively affect both their well-being, as well as academic results. Others have studied this topic, however, the existing research does not analyze the desire for social distance from autistic female students in higher education. The goal of this study was to evaluate whether the way autism is expressed and disclosing the autism diagnosis had an effect on students’ willingness to interact with autistic male and female students. We also analyzed participants’ knowledge about autism, contact with autistic people in the past and its pleasantness in relation to their willingness to interact with autistic students described in the scenarios of the present study. We found that students were less willing to interact with autistic male students compared to autistic female students, as well as with autistic students whose diagnosis was not disclosed compared to autistic students whose diagnosis was disclosed to the raters. In addition, students who reported more pleasant contact with autistic individuals in the past were more willing to socially interact with autistic students if their diagnosis was disclosed. Students with higher knowledge of autism expressed greater willingness to interact with autistic males and autistic students regardless of diagnosis disclosure. Findings suggest that autistic males and individuals who prefer not to disclose their diagnosis are more vulnerable to social exclusion. More subtle expressions of autism need to be researched further.
A Cost-Consequence Analysis Comparing Balloon-Expandable Covered Stents for the Management of Aortoiliac Occlusive Disease
Authors: Warburton Thomas M. , Thomas Shannon D. , Holden Andrew , Katib Nedal , Varcoe Ramon L. 
Published: February 2024

Purpose: To compare procedural and long-term costs associated with the use of Balloon-Expandable Covered Stents (BECS) in the management of Aortoiliac Occlusive Disease (AIOD). Materials and Methods: A cost-consequence model was developed to simulate the intra- and post-operative management of patients with AIOD from the perspective of private health-payers. The study assessed the costs of the LifeStream (BD, Franklin Lakes, New Jersey), iCAST/Advanta V12 (Getinge, Goteborg, Sweden), BeGraft Peripheral (Bentley, Hechingen, Germany), and Viabahn Balloon Expandable (VBX) (W.L. Gore, Flagstaff, Arizona) BECS devices. Device costs were identified from the Australian Prosthesis List, whereas clinical outcomes of BECS were estimated from a systematic review of the literature. Costs were calculated over 24 and 36 month time horizons and reported in US dollars. Results: Long-term, per-patient cost of each device at 24 and 36 months was $6253/$6634 for the LifeStream; $6359/$6869 for the iCAST/Advanta V12; $4806 (data available to 24 months) for the BeGraft Peripheral; and $4839/$5046 for the Viabahn VBX, respectively. Most of the cost difference was attributed to the number of stents required per treated limb and frequency of clinically-driven target lesion revascularization events. Conclusions: Best-available clinical evidence and economic modeling demonstrates that the BeGraft Peripheral and Viabahn VBX were of similar cost and the least costly options at 24 months, whereas at 36 months, the lowest cost BECS option for the treatment of AIOD was the Viabahn VBX. Clinical Impact This analysis supports economically informed decision-making for health-payers managing systems that care for patients with AIOD. Stent length and avoiding reintervention were identified as key areas of cost-saving for future BECS development.
Economic Analysis of AbClo, a Novel Abdominal Fascia Closure Device, for Patients With an Open Abdomen Following Trauma or Acute Abdominal Surgery
Authors: Chew Derek S. , Dayal Taranvir 
Published: February 2024

Background Open Abdomen (OA) cases represent a significant surgical and resource challenge. AbClo is a novel non-invasive abdominal fascial closure device that engages lateral components of the abdominal wall muscles to support gradual approximation of the fascia and reduce the fascial gap. The study objective was to assess the economic implications of AbClo compared to negative pressure wound therapy (NPWT) alone on OA management. Methods We conducted a cost-minimization analysis using a decision tree comparing the use of the AbClo device to NPWT alone among patients with midline laparotomy for trauma or acute abdominal surgery who were ineligible for primary fascial closure. The time horizon was limited to the length of the inpatient hospital stay, and costs were considered from the perspective of the US Medicare payer. Clinical effectiveness data for AbClo was obtained from a randomized clinical trial. Cost data was obtained from the published literature. Probabilistic and deterministic sensitivity analyses were performed. The primary outcome was incremental cost. Results The mean cumulative costs per patient were $76 582 for those treated with NPWT alone and $70,582 for those in the group treated with the AbClo device. Compared to NPWT alone, AbClo was associated with lower incremental costs of −$6012 (95% CI −$19 449 to +$1996). The probability that AbClo was cost-savings compared to NPWT alone was 94%. Conclusions The use of AbClo is an economically attractive strategy for management of OA in in patients with midline laparotomy for trauma or acute abdominal surgery who were ineligible for primary fascial closure.
The Impact of Social Determinants of Health on the Treatment of Distal Radius Fracture
Authors: Grogan Graham , Stephens Kristen L. , Chou Jesse , Abdalla Jasmina , Wagner Ryan , Peek Kacy J. , Freilich Aaron M. , DeGeorge Brent R. 
Published: February 2024

Background: Disparities in social determinants of health (SDH) have been shown to play an increasingly important role in the equitable delivery of health care. Distal radius fractures (DRFs) are among the most common upper-extremity injuries encountered. This study aims to examine the influence of economic, educational, social, environmental, and healthcare disparities on management of these injuries. Methods: PearlDiver Mariner insurance claims database was analyzed for treatment patterns of DRF in patients aged 18 to 65 years based on the presence or absence of social determinants of health disparities (SDHDs). Outcome variables included the primary mode of management of DRF, including operative versus non-operative, as well as concomitant procedures. Multivariate logistic regression was used to compare fracture management modality in patients with and without SDHDs. Results: Of 161 704 patients identified with DRF, 38.3% had at least 1 reported SDHD. The majority of SDHDs were economic. Patients identified with 1 or more SDHDs had a higher medical comorbidity index. Patients with environmental SDHD were more likely to receive non-operative management. Within any SDHD and economic subgroups, odds of operative management were higher. No relationship was identified between SDHD and concomitant procedures. Conclusions: The presence of environmental disparities in SDH may predispose patients disproportionately to non-operative management. The presence of SDHDs may influence medical decision-making in favor of open reduction and internal fixation in patients with DRF treated operatively. In treating at-risk populations, providers should be aware of the potential for implicit bias associated with SDHDs and prioritize shared decision-making between patients and physicians.
Pre-operative virtual three-dimensional planning for proximal humerus fractures: A proof-of-concept study
Authors: Spek Reinier WA , van den Bekerom Michel PJ , Jutte Paul C , IJpma Frank FA , Jaarsma Ruurd L , Doornberg Job N ,   the Traumaplatform 3D Consortium 7*
Published: February 2024

Purpose To (1) evaluate surgeon agreement on plating features (position and screw length) in virtual 3D planning software, (2) describe outcomes (fracture reduction, plate position, malpositioning of calcar screws and screw lengths) of plate fixations planned with routine pre-operative assessment (2D- and 3D CT imaging) and those planned with dedicated virtual 3D software of the same proximal humerus fracture. Methods Fourteen proximal humerus fractures were retrospectively reduced and fixed with virtual planning software by eight attending orthopaedic surgeons and compared to the true surgical fixation with post-operative computed tomography (CT) scans. Reduction differences were quantified using CT micromotion analysis. Results Intraclass correlation for screw lengths was 0.97 (95% CI: 0.96–0.98) and 0.90 (95% CI: 0.79–0.96) for plate position. Mean difference in total fracture rotation of the head between the virtual and conventional group was 22.0°. Plate position in the virtual planning group was 3.2 mm more proximal. There were no differences in inferomedial quadrant calcar screw positioning and, apart from the superior posterior converging screw, no significant differences in screw lengths. Conclusion Reproducibility on plate position and screw length with virtual planning software is adequate. Apart from fracture reduction, virtual planning yielded similar plate positions, screw malpositioning rates and lengths compared to routine pre-operative assessment.
Association of Concomitant MRI-Determined Anterolateral Complex Injury With Quantitative Measurements of Altered Rotational Tibiofemoral Position on MRI in Patients With ACL Injury
Authors: Zhang Zhi-yu , Yin Yu , Bai Wen-bin , Shi Wei-li , Pan Xiao-yu , Huang Hong-jie , Zhang Xin , Wang Cheng , Wang Jian-quan 
Published: February 2024

Background: Reduced graft failure rates have been reported after anterior cruciate ligament (ACL) reconstruction combined with anterolateral complex (ALC) augmentation. However, the preoperative diagnosis of concomitant ALC injury remains a clinical challenge. Purpose: To identify the altered rotational tibiofemoral position on magnetic resonance imaging (MRI) in ACL-injured patients with concomitant ALC injury. Study Design: Cross-sectional study; Level of evidence, 3. Methods: Based on the evaluation of ALC abnormalities on MRI scans by experienced surgeons, 123 patients with nonchronic (<3 months) ACL injury confirmed by arthroscopy were included. The patients were divided into 2 groups—an ALC-injured group (n = 57) and an ALC-intact group (n = 66). The altered rotational tibiofemoral position was evaluated and compared by quantitatively measuring internal rotational tibial subluxation (IRTS) and axial internal tibial rotation (ITRa) on MRI. Multivariate logistic regression and receiver operating characteristic (ROC) analyses were performed to identify the factors associated with concomitant MRI-determined ALC injury. Results: The ALC-injured group showed significantly increased IRTS ( P < .001), ITRa ( P < .001), lateral anterior tibial subluxation (ATS) ( P < .001), and global ATS (GATS) ( P = .002) compared with the ALC-intact group, while no significant difference in medial ATS ( P = .810) was observed. A strong positive correlation was identified between IRTS and ITRa ( rP = 0.809; P < .001). Multivariate analyses revealed that IRTS ( P < .001) and GATS ( P = .016) were associated factors for the presence of concomitant MRI-determined ALC injury. IRTS (area under the curve [AUC] = 0.734) was more strongly associated with the outcome than GATS (AUC = 0.658) in ROC analyses, suggesting a more significant internal rotational subluxation than anterior subluxation of the tibia. An IRTS threshold of 3.1 mm demonstrated a specificity of 84.2% for indicating the presence of concomitant MRI-determined ALC injury. Conclusion: The presence of concomitant MRI-determined ALC injury in ACL-injured patients was associated with a significant increase in IRTS and ITRa compared with those with intact ALC, indicating that these MRI measurements of the altered rotational tibiofemoral position could serve as potential quantifiable indicators for identifying concomitant ALC injury in clinical practice.
Factors Associated With Residual Pivot Shift After ACL Reconstruction: A Quantitative Evaluation of the Pivot-Shift Test Preoperatively and at Minimum 12-Month Follow-up
Authors: Kawanishi Yusuke , Kobayashi Makoto , Yasuma Sanshiro , Fukushima Hiroaki , Kato Jiro , Murase Atsunori , Takenaga Tetsuya , Yoshida Masahito , Kuroyanagi Gen , Kawaguchi Yohei , Murakami Hideki , Nozaki Masahiro 
Published: February 2024

Background: Postoperative residual rotatory laxity remains despite improvement in surgical techniques for anterior cruciate ligament (ACL) reconstruction (ACLR). Purpose: To evaluate factors associated with residual pivot shift after ACLR by quantitative measurement of the pivot shift before and after surgery. Study Design: Case-control study; Level of evidence, 3. Methods: A total of 97 patients who underwent primary double-bundle ACLR between June 2016 and March 2021 and underwent surgery to remove staples, with at least 12 months of follow-up evaluation, were enrolled. Quantitative measurements were performed under general anesthesia immediately before ACLR (preoperatively), after temporary fixation of the ACL graft (intraoperatively), and immediately before staple removal (postoperatively). The laxity of pivot shift was assessed using inertial sensors to measure acceleration and external rotational angular velocity (ERAV). Descriptive data were assessed for associations with postoperative acceleration and ERAV in a univariate analysis. A multiple linear regression analysis was performed to identify factors associated with postoperative acceleration and ERAV. Results: Anterior tibial translation, acceleration, and ERAV increased from intra- to postoperatively ( P < .05). Factors significantly associated with postoperative acceleration were age (β = −0.238; P = .021), lateral posterior tibial slope (PTS) (β = 0.194; P = .048), and preoperative acceleration (β = 0.261; P = .008). Factors significantly affecting postoperative ERAV were age (β = −0.222; P = .029), ramp lesions (β = 0.212; P = .027), and preoperative ERAV (β = 0.323; P = .001). Conclusion: Greater preoperative laxity in the pivot shift was the factor having the most significant association with residual pivot shift after ACLR using quantitative measurements under general anesthesia. Younger age, higher lateral PTS, and concomitant ramp lesions were significant predictors of residual pivot shift. These findings can help pre- and intraoperative decision-making regarding whether an anterolateral structure augmentation should be added.
Variation in multimorbidity by sociodemographics and social drivers of health among patients seen at community-based health centers
Authors: Bensken Wyatt P , Navale Suparna M , McGrath Brenda M , Cook Nicole , Nishiike Yui , Mertes Gretchen , Goueth Rose , Jones Matthew , Templeton Anna , Zyzanski Stephen J , Koroukian Siran M , Stange Kurt C 
Published: February 2024

Purpose Understanding variation in multimorbidity across sociodemographics and social drivers of health is critical to reducing health inequities. Methods From the multi-state OCHIN network of community-based health centers (CBHCs), we identified a cross-sectional cohort of adult (> 25 years old) patients who had a visit between 2019-2021. We used generalized linear models to examine the relationship between the Multimorbidity Weighted Index (MWI) and sociodemographics and social drivers of health (Area Deprivation Index [ADI] and social risks [e.g., food insecurity]). Each model included an interaction term between the primary predictor and age to examine if certain groups had a higher MWI at younger ages. Results Among 642,730 patients, 28.2% were Hispanic/Latino, 42.8% were male, and the median age was 48. The median MWI was 2.05 (IQR: 0.34, 4.87) and was higher for adults over the age of 40 and American Indians and Alaska Natives. The regression model revealed a higher MWI at younger ages for patients living in areas of higher deprivation. Additionally, patients with social risks had a higher MWI (3.16; IQR: 1.33, 6.65) than those without (2.13; IQR: 0.34, 4.89) and the interaction between age and social risk suggested a higher MWI at younger ages. Conclusions Greater multimorbidity at younger ages and among those with social risks and living in areas of deprivation shows possible mechanisms for the premature aging and disability often seen in community-based health centers and highlights the need for comprehensive approaches to improving the health of vulnerable populations.
Shinrin-Yoku 森林浴 (Forest Bathing): A Scoping Review of the Global Research on the Effects of Spending Time in Nature
Authors: Vermeesch Amber L. , Ellsworth-Kopkowski Alexis , Prather Jenifer G. , Passel Cheryl , Rogers Heidi Honegger , Hansen Margaret M. 
Published: February 2024

Background This Scoping review (ScR) builds upon the 2017 review conducted by Hansen et al which contributed to evidence base shinrin-yoku (SY), also known as forest bathing (FB), has many positive health effects and is becoming a prescribed dose (specific time spent in nature) by health care providers. Practice and research regarding SY, has been historically based in Asian countries with a recent increase in Europe. The need and call for more research worldwide continues to further the evidence of SY as a health promotion modality. Through this ScR the authors identified programmatic components, health information monitored and screened, time spent in nature, geographical regions, trends, and themes in SY research worldwide. Methods Following PRISMA-ScR guidelines we searched across 7 electronic databases for SY or FB research articles from 2017 through 2022. PubMed, CINAHL, PsycInfo, ScienceDirect, SCOPUS, Embase, JSTOR were included due to the interdisciplinary nature of SY or FB research. Each database provided unique strengths ensuring a capture of a wide range of articles. The resulting articles were screened and extracted through Covidence. Results Database searches returned 241 results, with 110 references removed during the deduplication process, 131 were initially screened in the title and abstract review stage. Resulting in 82 unique results deemed relevant and screened in full text. During the final stage of the review, 63 articles met all inclusion criteria and were extracted for data. Conclusions The practice of SY has physiological (PHYS) and psychological (PSYCH) benefits across age groups. Research findings indicate either the natural or the virtual environment (VW) has significant health benefits. Continued research is encouraged globally for short- and long-term health outcomes for all individuals. The connection with nature benefits the mind, body and soul and is supported by Henry David Thoreau’s philosophy: “Our livesneed the relief of where the pine flourishes and the jay still scream.”
Physicians’ challenges when working in the prehospital environment - a qualitative study using grounded theory
Authors: Bäckström Denise , Alvinius Aida 
Published: February 2024

Abstract
Background
In the rapid development in prehospital medicine the awareness of the many challenges in prehospital care is important as it highlights which areas need improvement and where special attention during education and training should be focused. The purpose of this study is to identify challenges that physicians face when working in the prehospital environment. The research question is thus; what challenges do physicians face when working in prehospital care?

Method
This is a qualitative study with an inductive approach and is based on individual interviews. The interviews were analyzed using the Classic Grounded Theory (GT) method as an approach. The interviews were conducted as semi-structured interviews via the digital platform Zoom during winter / early spring 2022.

Results
Challenges for prehospital physicians can be understood as a process that involves a balancing act between different factors linked to the extreme environment in which they operate. This environment creates unique challenges not usually encountered in routine hospital practice, which results in trade-offs that they would not otherwise be faced with. Their individual situation needs to be balanced against organizational conditions, which means, among other things, that their medical decisions must be made based on limited information as a result of the constraints that exist in the prehospital environment. They must, both as individuals and as part of a team, manoeuvre in time and space for decision-making and practical tasks. This theory of balancing different entities is based on four themes; thus the theory is the relation between the four themes: leadership, environment, emotion management and organization.

Conclusions
With the help of previous studies and what we have found, it is reasonable to review what training is needed before starting to work prehospital as a physician. This should include components of the themes we have described: organization, environment, leadership and emotional management.