bluuebunny/crossref_metadata_2025_split huggingface dataset:
Differences Between Patient and Surgeon Perspectives: A Long-Term Follow-Up of 180 Patients With Zygomaticomaxillary Complex Fractures Following Either Conservative or Surgical Treatment
Authors: Rahbin Samin , Sunnergren Ola , McBride Ellen , Darabi Hatef , Alinasab Babak 
Published: October 2023

Study Design Retrospective with follow-up. Objective This study described the long-term outcomes of patients who received either conservative or surgical treatment for zygomaticomaxillary complex (ZMC) fractures. It accounted for the perspectives of both patients and surgeons, and explored factors associated with patient satisfaction. Methods Patients with unilateral ZMC fractures 2007–2018 were invited to follow-up clinical examinations and photographic documentation. Patient experiences were recorded using a questionnaire. A review panel assessed computed tomography (CT) scans and photographs. Patient and surgeon perspectives of detecting functional sequelae were assessed, and a correlation matrix was used to evaluate different perspectives of perceiving malar asymmetry. Results The study sample consisted of 180 patients, of which conservative treatment was given to 43 patients and surgical treatment to 137 patients. Median follow-up time was 72.5 months after trauma. Overall satisfaction was 92.8%, with no significant difference between treatment groups. Patients and surgeons showed marked differences in detecting functional sequelae. Predicted malar asymmetry on CT scans did not correlate to findings on photographs or reports by patients. Conclusions A predicted sunken cheek on CT imaging does not necessarily lead to long-term visible asymmetry of the malar region. Surgeons should acknowledge different perspectives when predicting and assessing long-term sequelae of ZMC fractures, and seek consensus on when to perform surgical reconstructions.
Subacute and Chronic Spinal Cord Injury: A Scoping Review of Epigenetics and Secondary Health Conditions
Authors: Graves Letitia Y , Keane Kayla F , Taylor Jacquelyn Y , Wang Tzu-fang , Saligan Leorey , Bogie Kath M 
Published: October 2023

Background: Epigenetics studies the impact of environmental and behavioral factors on stable phenotypic changes; however, the state of the science examining epigenomic mechanisms of regulation related to secondary health conditions (SHCs) and neuroepigenetics in chronic spinal cord injury (SCI) remain markedly underdeveloped. Objective: This scoping review seeks to understand the state of the science in epigenetics and secondary complications following SCI. Methods: A literature search was conducted, yielding 277 articles. The inclusion criteria were articles (1) investigating SCI and (2) examining epigenetic regulation as part of the study methodology. A total of 23 articles were selected for final inclusion. Results: Of the 23 articles 52% focused on histone modification, while 26% focused on DNA methylation. One study had a human sample, while the majority sampled rats and mice. Primarily, studies examined regeneration, with only one study looking at clinically relevant SHC, such as neuropathic pain. Discussion: The findings of this scoping review offer exciting insights into epigenetic and neuroepigenetic application in SCI research. Several key genes, proteins, and pathways emerged across studies, suggesting the critical role of epigenetic regulation in biological processes. This review reinforced the dearth of studies that leverage epigenetic methods to identify prognostic biomarkers in SHCs. Preclinical models of SCI were genotypically and phenotypically similar, which is not reflective of the heterogeneity found in the clinical population of persons with SCI. There is a need to develop better preclinical models and more studies that examine the role of genomics and epigenomics in understanding the diverse health outcomes associated with traumatic SCI.
Perfluorooctane sulfonic acid exposure and diabetes: a cross-sectional analysis of American adults and in vitro experiments
Authors: Liu Keliang , Sun Linqing , Xu Haiming , Li Sirui , Sun Lei , Tian Yuhui , Liu Zhihong 
Published: October 2023

Abstract
Background
Perfluorooctane sulfonic acid (PFOS) exposure has a negative impact on the environment and biological health. However, the relationship between PFOS exposure and diabetes in adults is not clear.

Objective
In this study, we included two distinct components: (1) in the cross-sectional analysis, we used data from the National Health and Nutrition Inspection Survey (NHANES) from 2015 to 2018 and eventually included 2539 subjects. The association between PFOS exposure and the risk of diabetes in adults was assessed by a logistic regression model, and further subgroup analysis was carried out according to sex, hypertension status and high cholesterol status. We adjusted for all covariates and found that the positive association between higher PFOS exposure and diabetes remained stable. (2) In vitro experiments were conducted as follows, rat insulinoma β cells (INS-1) were used as experimental materials; cell proliferation activity was detected using the MTT assay; quantitative real-time PCR was used to detect the mRNA expression of insulin; and Western blotting was used to detect insulin protein expression levels.

Results
Compared with Q1, the OR of the highest exposure level group (Q4) of PFOS was 1.342(95% CI 0.940, 1.916). We conducted a logistic regression analysis based on sex, hypertension, and high cholesterol stratification. Stratified by sex, we found that the exposure level of PFOS was significantly positively associated with diabetes (P for trend < 0.05). Subgroup analysis showed that the positive association between PFOS exposure and diabetes was more significant in nonhypertensive individuals (P for trend < 0.01) and those with normal cholesterol levels (P for trend < 0.001). To further determine the causal relationship between PFOS exposure and diabetes, we used rat insulinoma β cells (INS-1) as experimental materials to study the effect of PFOS exposure on insulin secretion. We found that PFOS exposure significantly affected insulin secretion and insulin mRNA and protein expression.

Conclusions
In summary, PFOS exposure is positively associated with the risk of diabetes. However, further studies are needed to confirm our results.
Composition of pathogenic microorganism in chronic osteomyelitis based on metagenomic sequencing and its application value in etiological diagnosis
Authors: Zhang Kang , Bai Yu-zhe , Liu Chang , Liu Shan-shan , Lu Xin-xin , Yang Run-gong 
Published: October 2023

Abstract
Background
Traditionally, conventional microbiological culture methods have been used to detect pathogenic microorganisms in chronic osteomyelitis. However, these methods have been found to have a low detection rate, complicating the precise guidance of infection treatment. This study employed metagenomic next-generation sequencing (mNGS) to detect these microorganisms in chronic osteomyelitis with three main objectives: 1). Gain a deeper understanding of the composition of pathogenic microorganisms in chronic osteomyelitis. 2). Compare the microbial detection rates between mNGS and the standard culture methods used in laboratories to enhance the effectiveness of the traditional culture methods. 3). Explore the potential of mNGS in etiological diagnosis.

Methods
Fifty clinically confirmed intraoperative bone tissue samples of chronic osteomyelitis from January 2021 to December 2021 were collected and subjected to mNGS and microbiological testing, respectively. The orthopaedic surgeon combined clinical manifestations and related examinations to determine the causative pathogens.

Results
The culture method obtained 29 aerobic and parthenogenic anaerobic bacteria, 3 specific anaerobic bacteria, and 1 yeast-like fungus. Thirty-six aerobic and parthenogenic anaerobic bacteria, 11 specific anaerobic bacteria, and 1 yeast-like fungus were obtained by mNGS, and 2 Mycobacterium tuberculosis(MTB) strains were detected. However, there was no significant difference in the overall positive detection rate between mNGS and the culture method (P = 0.07), and the two were not statistically significant in detecting aerobic and partly anaerobic bacteria (P = 0.625). But, mNGS was significantly superior to culture in detecting anaerobic bacteria and Mycobacterium tuberculosis (P<0.05).

Conclusions
The mNGS method has enhanced our understanding of the distribution of pathogenic microorganisms in chronic osteomyelitis. Traditional culture methods help isolate and cultivate aerobic and facultative anaerobic bacteria, and fungi, and are also utilized for antibacterial drug sensitivity tests. However, mNGS has shown superior capabilities in detecting anaerobic bacteria, MTB, and mixed infection bacteria. This finding offers invaluable guidance for improving laboratory microbial culture and detection conditions. Hence, mNGS should be judiciously used for chronic osteomyelitis, and PCR can be implemented for certain difficult-to-culture microorganisms, such as MTB.
Antiemetic prophylaxis with droperidol in morphine-based intravenous patient-controlled analgesia: a propensity score matched cohort study
Authors: Tan Jia Qi , Wu Hsiang-Ling , Wang Yi-Chien , Cata Juan P. , Chen Jui-Tai , Cherng Yih-Giun , Tai Ying-Hsuan 
Published: October 2023

Abstract
Background
There are limited real-world data regarding the use of droperidol for antiemetic prophylaxis in intravenous patient-controlled analgesia (IV-PCA). This study aimed to evaluate the antiemetic benefits and sedation effects of droperidol in morphine-based IV-PCA.

Methods
Patients who underwent major surgery and used morphine-based IV-PCA at a medical center from January 2020 to November 2022 were retrospectively analyzed. The primary outcome was the rate of any postoperative nausea and/or vomiting (PONV) within 72 h after surgery. Propensity score matching was used to match patients with and without the addition of droperidol to IV-PCA infusate in a 1:1 ratio. Multivariable conditional logistic regression models were used to calculate adjusted odds ratios (aORs) with 95% confidence intervals (CIs).

Results
After matching, 1,104 subjects were included for analysis. The addition of droperidol to IV-PCA reduced the risk of PONV (aOR: 0.49, 95% CI: 0.35–0.67, p < 0.0001). The antiemetic effect of droperidol was significant within 36 h after surgery and attenuated thereafter. Droperidol was significantly associated with a lower risk of antiemetic uses (aOR: 0.58, 95% CI: 0.41–0.80, p = 0.0011). The rate of unintentional sedation was comparable between the patients with (9.1%) and without (7.8%; p = 0.4481) the addition of droperidol. Postoperative opioid consumption and numeric rating scale acute pain scores were similar between groups.

Conclusions
The addition of droperidol to IV-PCA reduced the risk of PONV without increasing opiate consumption or influencing the level of sedation. However, additional prophylactic therapies are needed to prevent late-onset PONV.
Can peer effects explain prescribing appropriateness? a social network analysis
Authors: Wang Sophie Y. , Larrain Nicolas , Groene Oliver 
Published: October 2023

AbstractBackgroundOptimizing prescribing practices is important due to the substantial clinical and financial costs of polypharmacy and an increasingly aging population. Prior research shows the importance of social relationships in driving prescribing behaviour. Using social network analysis, we examine the relationship between a physician practices’ connectedness to peers and their prescribing performance in two German regions.MethodsWe first mapped physician practice networks using links established between two practices that share 8 or more patients; we calculated network-level (density, average path length) and node-level measures (degree, betweenness, eigenvector). We defined prescribing performance as the total number of inappropriate medications prescribed or appropriate medications not prescribed (PIMs) to senior patients (over the age of 65) during the calendar year 2016. We used FORTA (Fit fOR The Aged) algorithm to classify medication appropriateness. Negative binomial regression models estimate the association between node-level measures and prescribing performance of physician practices controlling for patient comorbidity, provider specialization, percentage of seniors in practice, and region. We conducted two sensitivity analyses to test the robustness of our findings – i) limiting the network mapping to patients younger than 65; ii) limiting the network ties to practices that share more than 25 patients.ResultsWe mapped two patient-sharing networks including 436 and 270 physician practices involving 28,508 and 20,935 patients and consisting of 217,126 and 154,274 claims in the two regions respectively. Regression analyses showed a practice’s network connectedness as represented by degree, betweenness, and eigenvector centrality, is significantly negatively associated with prescribing performance (degree—bottom vs. top quartile aRR = 0.04, 95%CI: 0.035,0.045; betweenness—bottom vs. top quartile aRR = 0.063 95%CI: 0.052,0.077; eigenvector—bottom vs. top quartile aRR = 0.039, 95%CI: 0.034,0.044).ConclusionsOur study provides evidence that physician practice prescribing performance is associated with their peer connections and position within their network. We conclude that practices occupying strategic positions at the edge of networks with advantageous access to novel information are associated with better prescribing outcomes, whereas highly connected practices embedded in insulated information environments are associated with poor prescribing performance.
Activities of daily living limitations and family doctor contract services among overweight and obese older adults: is there a rural-urban difference?
Authors: Luo Jingjing , Zhao Dan , Gao Tingting , Sun Jingjie , Li Peilong , Wang Xuehong , Wang Xueqing , Chai Shujun , Li Jiayan , Zhou Chengchao 
Published: October 2023

Abstract
Background
The purpose of this study was to evaluate the relationship between activities of daily living (ADL) limitations and family doctor contract services among overweight and obese older adults, as well as to examine whether this association varies by urban-rural residence.

Methods
Data for the present study were obtained from the sixth Health Service of Shandong province, China. A total of 4,249 overweight and obese older adults were included in this study. Binary logistic regression models were used to evaluate the relationship between ADL limitations and family doctor contract services, to examine the potential differences between urban and rural areas.

Results
Of 4,249 overweight and obese older adults, the prevalence of limitations in ADL and family doctor service contracting rate in Shandong province were 12.47% and 66.46%, respectively. The results of the regression analyses revealed that overweight and obese older adults with ADL limitations were more likely to sign up for family doctor services than those without ADL limitations (OR = 1.27, 95%CI: 1.02–1.58, P = 0.033). Only among rural overweight and obese older adults, the relationship between ADL limitations and family doctor contract services was statistically significant (OR = 1.50, 95%CI: 1.13–1.99, P = 0.005).

Conclusions
Our study found a significant association between ADL limitations and family doctor contract services among overweight and obese older adults in Shandong, China. This relationship differed by urban-rural residence. To promote the positive development of the family doctor contract service system, the government should increase publicity, provide personalized contracted services, and prioritize the healthcare needs of overweight and obese older adults with ADL limitations, with special attention to rural areas.
Multimodal agility-based exercise training (MAT) versus strength and endurance training (SET) to improve multiple sclerosis-related fatigue and fatigability during inpatient rehabilitation: a randomized controlled pilot and feasibility study [ReFEx]
Authors: Wolf Florian , Nielsen Jörn , Saliger Jochen , Hennecken Eva , Kröber Philipp , Eschweiler Mareike , Folkerts Ann-Kristin , Karbe Hans , Zimmer Philipp 
Published: October 2023

Abstract
Background
Multimodal agility-based exercise training (MAT) is a group-based exercise training framework for persons with multiple sclerosis (pwMS) with a potential to impact fatigue and fatigability. In a mixed-methods design, this study evaluated the feasibility of implementing MAT in an inpatient rehabilitation setting and the feasibility of a randomized controlled trial (RCT) study protocol with ‘traditional’ strength and endurance training (SET) as an active control condition. Secondarily, preliminary outcome data was acquired.

Methods
PwMS with low to moderate disability and self-reported fatigue were randomly allocated to either MAT or SET when starting inpatient rehabilitation (4–6 weeks). The MAT-participants exercised in a group following a MAT-manual (sessions were gym- (5x/week) and pool-based (3x/week)). SET-participants exercised individually 5x/week on a cycle ergometer, and 3x/week on strength training machines. Feasibility assessments focused on processes, resources, management, time, and scientific domains. Assessed clinical outcomes at admission and discharge included perceived fatigue, motor and cognitive fatigability, cognitive performance, motor function, and balance confidence. Perceived fatigue was reassessed 1, 4, and 12 weeks after discharge. Feasibility was determined regarding predetermined progression criteria.

Results
Twenty-two participants were randomized. Both groups performed the minimum number of sessions (> 18), and retention was adequate (73–91%). SET-participants performed more sessions than MAT-participants (30.8 vs. 22.7) and stayed longer in the facility (34.2 vs. 31.6 days). Non-eligibility of admitted pwMS was high (74% non-eligible), mainly due to high EDSS and inability to attend pool-based sessions. Consequently, recruitment (1.8/month) was slower than the predetermined progression criterium. Baseline assessments took longer than required (only 50% completed within 3 days). Short-term fatigue reduction was similar for both groups. Motor fatigability also improved in both groups, whereas cognitive fatigability deteriorated. In MAT, average improvement in walking endurance (43.9 m) exceeded minimal important change values for individuals (> 26.9 m).

Conclusions
Progressing to a definitive RCT necessitates adaptation of eligibility criteria. In the present design it will also be difficult to attain similar dosing of interventions. A multicenter RCT focused only on gym-based MAT might be another option to assess the effect of MAT. The primary outcome measure should be able to measure change in perceived fatigue more robustly.

Trial registration
German Clinical Trials Register: DRKS00023943, date of registration: 23 September 2021.
You & Me: Test and Treat study protocol for promoting COVID-19 test and treatment access to underserved populations
Authors: D’Agostino Emily M. , Rosenberg Lauren M. , Richmond Alan , Damman Allyn , Brown-Lowery Camille , Abbot-Grimes Princess , Siddiqui Saira , Fadika Tigidankay , Ward Mark , Cooper Mia , Sutton Sonya , Kenton Lindsay , Spaziano Bob , Kasper Janet , Barnes Nicole , Hornik Christoph 
Published: October 2023

Abstract
Background
Infections and deaths from the COVID-19 pandemic have disproportionately affected underserved populations. A community-engaged approach that supports decision making around safe COVID-19 practices is needed to promote equitable access to testing and treatment. You & Me: Test and Treat (YMTT) will evaluate a systematic and scalable community-engaged protocol that provides rapid access to COVID-19 at-home tests, education, guidance on next steps, and information on local resources to facilitate treatment in underserved populations.

Methods
This direct-to-participant observational study will distribute at-home, self-administered, COVID-19 testing kits to people in designated communities. YMTT features a Public Health 3.0 framework and Toolkit prescribing a tiered approach to community engagement. We will partner with two large community organizations, Merced County United Way (Merced County, CA) and Pitt County Health Department (Pitt County, NC), who will coordinate up to 20 local partners to distribute 40,000 COVID tests and support enrollment, consenting, and data collection over a 15-month period. Participants will complete baseline questions about their demographics, experience with COVID-19 infection, and satisfaction with the distribution event. Community partners will also complete engagement surveys. In addition, participants will receive guidance on COVID-19 mitigation and health-promoting resources, and accessible and affordable therapeutics if they test positive for COVID-19. Data collection will be completed using a web-based platform that enables creation and management of electronic data capture forms. Implementation measures include evaluating 1) the Toolkit as a method to form community-academic partnerships for COVID-19 test access, 2) testing results, and 3) the efficacy of a YMTT protocol coupled with local resourcing to provide information on testing, guidance, treatment, and links to resources. Findings will be used to inform innovative methods to address community needs in public health research that foster cultural relevance, improve research quality, and promote health equity.

Discussion
This work will promote access to COVID-19 testing and treatment for underserved populations by leveraging a community-engaged research toolkit. Future dissemination of the toolkit can support effective community-academic partnerships for health interventions in underserved settings.

Trial registration
ClinicalTrials.gov Identifier: NCT05589376. Registered 21 October 2022.