bluuebunny/crossref_metadata_2025_split huggingface dataset:
Positive outcome reporting in orthopaedic literature
Authors: Filtes Peter , Sobol Keenan , Lin Charles , Anil Utkarsh , Roberts Timothy , Pargas-Colina Carlos , Castañeda Pablo 
Published: February 2024

AimsPerthes' disease (PD) is a relatively rare syndrome of idiopathic osteonecrosis of the proximal femoral epiphysis. Treatment for Perthes' disease is controversial due to the many options available, with no clear superiority of one treatment over another. Despite having few evidence-based approaches, many patients with Perthes' disease are managed surgically. Positive outcome reporting, defined as reporting a study variable producing statistically significant positive (beneficial) results, is a phenomenon that can be considered a proxy for the strength of science. This study aims to conduct a systematic literature review with the hypothesis that positive outcome reporting is frequent in studies on the treatment of Perthes' disease.MethodsWe conducted a systematic review of all available abstracts associated with manuscripts in English or with English translation between January 2000 and December 2021, dealing with the treatment of Perthes' disease. Data collection included various study characteristics, surgical versus non-surgical management, treatment modality, mean follow-up time, analysis methods, and clinical recommendations.ResultsOur study included 130 manuscripts. Overall, 110 (85%) reported positive (beneficial) results, three (2%) reported negative results, and 17 (13%) reported no significant difference. Despite only 10/130 studies (8%) having a testable hypothesis, 71 (55%) recommended the use of their studied treatment methods for the patients, five (4%) made recommendations against the use of the studied treatment modality, and 54 (42%) did not make any recommendations.ConclusionThe overall rate for positive outcomes among included manuscripts regarding different treatment methods for Perthes' disease (85%) is higher than the 74% positive outcome rate found among studies for other surgically treated disorders and significantly higher than most scientific literature. Despite the lack of testable hypotheses, most manuscripts recommended their studied treatment method as a successful option for managing patients solely based on the reporting of retrospective data.Cite this article: Bone Joint J 2024;106-B(2):121–127.
Robotic trials in arthroplasty surgery
Authors: Khatri Chetan , Metcalfe Andrew , Wall Peter , Underwood Martin , Haddad Fares S. , Davis Edward T. 
Published: February 2024

Total hip and knee arthroplasty (THA, TKA) are largely successful procedures; however, both have variable outcomes, resulting in some patients being dissatisfied with the outcome. Surgeons are turning to technologies such as robotic-assisted surgery in an attempt to improve outcomes. Robust studies are needed to find out if these innovations are really benefitting patients. The Robotic Arthroplasty Clinical and Cost Effectiveness Randomised Controlled Trials (RACER) trials are multicentre, patient-blinded randomized controlled trials. The patients have primary osteoarthritis of the hip or knee. The operation is Mako-assisted THA or TKA and the control groups have operations using conventional instruments. The primary clinical outcome is the Forgotten Joint Score at 12 months, and there is a built-in analysis of cost-effectiveness. Secondary outcomes include early pain, the alignment of the components, and medium- to long-term outcomes. This annotation outlines the need to assess these technologies and discusses the design and challenges when conducting such trials, including surgical workflows, isolating the effect of the operation, blinding, and assessing the learning curve. Finally, the future of robotic surgery is discussed, including the need to contemporaneously introduce and evaluate such technologies.Cite this article: Bone Joint J 2024;106-B(2):114–120.
Geographic characteristics of HTLV-1 molecular subgroups and genetic substitutions in East Asia: Insights from complete genome sequencing of HTLV-1 strains isolated in Taiwan and Japan
Authors: Nozuma Satoshi , Yoshimura Akiko , Pai Shun-Chung , Chen Hung-Jen , Matsuura Eiji , Tanaka Masakazu , Kodama Daisuke , Dozono Mika , Matsuzaki Toshio , Takashima Hiroshi , Yang Ya-Chien , Kubota Ryuji 
Published: February 2024

Background
Although Japan is a major endemic area for human T-lymphotropic virus type 1 (HTLV-1) and the virus has been well-studied in this region, there is limited research on HTLV-1 in surrounding regions. In this study, we determined the complete genome sequences of HTLV-1 strains isolated from Taiwan and Japan and investigated the geographic characteristics of molecular subgroups and substitution mutations to understand the spread of HTLV-1 and its correlation with human migration.

Methodology/Principal findings
The complete genome sequences of 26 HTLV-1 isolates from Taiwan were determined using next-generation sequencing and were compared with those of 211 isolates from Japan in terms of subgroup and genetic mutations. In total, 15/26 (58%) isolates from Taiwan belonged to the transcontinental subgroup and 11/26 (42%) isolates belonged to the Japanese subgroup. The transcontinental subgroup was significantly more prevalent among Taiwanese isolates than Japanese isolates (58% vs 18%, P < 0.0001). The mutation rate for the complete HTLV-1 sequence was as low as 0.2%. On examining individual base substitutions, the G-to-A mutation was predominant. Bayesian phylogenetic tree analysis estimated the time to the most recent common ancestor for the transcontinental and Japanese subgroups to be 28447 years. The transcontinental subgroups from Taiwan and Japan appeared to form clusters according to their respective regions.

Conclusions/Significance
The transcontinental subgroup of HTLV-1 is predominant in Taiwan, while the Japanese subgroup is common in Japan. The difference in subgroup distribution may be attributed to the initial spread of the transcontinental subgroup in East Asia, followed by the influx of the Japanese subgroup.
Covid-19 demography in France and South Africa: A comparative study of morbidity and mortality in 2020–2022
Authors: Garenne Michel , Stiegler Nancy 
Published: February 2024

BackgroundCovid-19 epidemics raged around the world in years 2020–2022. The dynamics of the epidemics and their mortality varied by country depending on prevention, treatments, vaccination and health status of the population.ObjectiveThe study compares Covid-19 morbidity and mortality in South-Africa and in France, two countries with similar population size and with reliable reporting systems, in order to better understand the dynamics and impacts of the epidemics and the effects of health policies and programs.Data and methodsData on cases, deaths, hospitalizations, vaccinations were drawn from national statistics. Published data on cases and deaths were corrected for undercount.ResultsResults show a different epidemiology in the two countries in the first three years of the epidemic (2020–2022). Incidence was higher in South Africa, and some 44% more people were infected by December 2022 than in France. Mortality and case-fatality were also higher in South Africa despite a favourable age structure. The age pattern of mortality showed higher values in South Africa among the young adults. Young women appeared somewhat disadvantaged in South Africa. Lastly, vaccination appeared to have had no effect on incidence, but a large effect on case-fatality in France.ConclusionsDespite about the same population size and the same crude death rate at baseline, South Africa exhibited more cases and more deaths from Covid-19 over the 2020–2022 period. Prevention strategies (lockdown and vaccination) appear to have had large impacts on morbidity and mortality.
Factors associated with frequent buprenorphine / naloxone initiation in a national survey of Canadian emergency physicians
Authors: MacKinnon Nathalie , Lane Daniel , Scheuermeyer Frank , Kaczorowski Janusz , Dong Kathryn , Orkin Aaron M. , Daoust Raoul , Moe Jessica , Andolfatto Gary , Klaiman Michelle , Yan Justin , Koh Justin J. , Crowder Kathryn , Atkinson Paul , Savage David , Stempien James , Besserer Floyd , Wale Jason , Kestler Andrew 
Published: February 2024

Objective
To identify individual and site-related factors associated with frequent emergency department (ED) buprenorphine/naloxone (BUP) initiation. BUP initiation, an effective opioid use disorder (OUD) intervention, varies widely across Canadian EDs.

Methods
We surveyed emergency physicians in 6 Canadian provinces from 2018 to 2019 using bilingual paper and web-based questionnaires. Survey domains included BUP-related practice, demographics, attitudes toward BUP, and site characteristics. We defined frequent BUP initiation (the primary outcome) as at least once per month, high OUD prevalence as at least one OUD patient per shift, and high OUD resources as at least 3 out of the following 5 resources: BUP initiation pathways, BUP in ED, peer navigators, accessible addiction specialists, and accessible follow-up clinics. We excluded responses from sites with <50% participation (to minimize non-responder bias) and those missing the primary outcome. We used univariate analysis to identify associations between frequent BUP initiation and factors of interest, stratifying by OUD prevalence.

Results
We excluded 3 responses for missing BUP initiation frequency and 9 for low response rate at one ED. Of the remaining 649 respondents from 34 EDs, 374 (58%) practiced in metropolitan areas, 384 (59%) reported high OUD prevalence, 312 (48%) had high OUD resources, and 161 (25%) initiated BUP frequently. Age, gender, board certification and years in practice were not associated with frequent BUP initiation. Site-specific factors were associated with frequent BUP initiation (high OUD resources [OR 6.91], high OUD prevalence [OR 4.45], and metropolitan location [OR 2.39],) as were individual attitudinal factors (willingness, confidence, and responsibility to initiate BUP.) Similar associations persisted in the high OUD prevalence subgroup.

Conclusions
Individual attitudinal and site-specific factors were associated with frequent BUP initiation. Training to increase physician confidence and increasing OUD resources could increase BUP initiation and benefit ED patients with OUD.
Integrating rehabilitation into health systems: A comparative study of nine middle-income countries using WHO’s Systematic Assessment of Rehabilitation Situation (STARS)
Authors: Kleinitz Pauline , Sabariego Carla , Llewellyn Gwynnyth , Taloafiri Elsie , Mangar Ariane , Baskota Rabindra , Marahatta Kedar , Maduwage Shiromi , Khin Myo Hla , Wonanji Vivian , Sampa George , Al-Rjoub Ali , Al-Daod Jaber , Cieza Alarcos 
Published: February 2024

Background and objective
The need for rehabilitation is growing due to health and demographic trends, especially the rise of non-communicable diseases and the rapid ageing of the global population. However, the extent to which rehabilitation is integrated into health systems is mostly unclear. Our objective is to describe and compare the nature and extent of integration of rehabilitation within health systems across nine middle-income countries using available Systematic Assessment of Rehabilitation Situation (STARS) reports.

Methods
Cross-country comparative study with variable-oriented design using available rehabilitation health system assessment reports from nine middle income countries.

Findings
The integration of rehabilitation into health systems is limited across countries. Governance and financing for rehabilitation are mostly established within health ministries but weakly so, while health information systems are characterized by no available data or data that is insufficient or not routinely generated. The overall numbers of rehabilitation workforce per capita are low, with frequent reports of workforce challenges. In most countries the availability of longer-stay, high-intensity rehabilitation is extremely low, the availability of rehabilitation in tertiary hospitals is modest and in government supported primary care its almost non-existent. Multiple concerns about rehabilitation quality arose but the lack of empirical data hinders formal appraisal.

Conclusion
The study sheds light on the limited integration of rehabilitation in health systems and common areas of difficulty and challenge across nine middle income countries. All countries were found to have a basis on which to strengthen rehabilitation and there were often multiple areas within each health system building block that required action in order to improve the situation. Findings can inform governments, regional and global agencies to support future efforts to strengthen rehabilitation. Additionally, our study demonstrates the value of STARS reports for health policy and systems research and can serve as a model for further comparative studies.
Forecasting the Incidence and Prevalence of Inflammatory Bowel Disease: A Canadian Nationwide Analysis
Authors: Coward Stephanie , Benchimol Eric I. , Bernstein Charles N. , Avina-Zubieta Antonio , Bitton Alain , Carroll Matthew W. , Cui Yungsong , Hoentjen Frank , Hracs Lindsay , Jacobson Kevan , Jones Jennifer L. , King James , Kuenzig M. Ellen , Lu Na , El-Matary Wael , Murthy Sanjay K. , Nugent Zoann , Otley Anthony R. , Panaccione Remo , Peña-Sánchez Juan Nicolás , Singh Harminder , Targownik Laura E. , White Dominic , Windsor Joseph W. , Kaplan Gilaad G. ,   on behalf of the Canadian Gastro-Intestinal Epidemiology Consortium (CanGIEC)
Published: February 2024

INTRODUCTION:
Canada has a high burden of inflammatory bowel disease (IBD). Historical trends of IBD incidence and prevalence were analyzed to forecast the Canadian burden over the next decade.

METHODS:
Population-based surveillance cohorts in 8 provinces derived from health administrative data assessed the national incidence (2007–2014) and prevalence (2002–2014) of IBD. Autoregressive integrated moving average models were used to forecast incidence and prevalence, stratified by age, with 95% prediction intervals (PI), to 2035. The average annual percentage change (AAPC) with 95% confidence interval (CI) was calculated for the forecasted incidence and prevalence.

RESULTS:
The national incidence of IBD is estimated to be 29.9 per 100,000 (95% PI 28.3–31.5) in 2023. With a stable AAPC of 0.36% (95% CI −0.05 to 0.72), the incidence of IBD is forecasted to be 31.2 per 100,000 (95% PI 28.1–34.3) in 2035. The incidence in pediatric patients (younger than 18 years) is increasing (AAPC 1.27%; 95% CI 0.82–1.67), but it is stable in adults (AAPC 0.26%; 95% CI −0.42 to 0.82). The prevalence of IBD in Canada was 843 per 100,000 (95% PI 716–735) in 2023 and is expected to steadily climb (AAPC 2.43%; 95% CI 2.32–2.54) to 1,098 per 100,000 (95% PI 1,068–1,127) by 2035. The highest prevalence is in seniors with IBD (1,174 per 100,000 in 2023; AAPC 2.78%; 95% CI 2.75–2.81).

DISCUSSION:
Over the next decade, the Canadian health care systems will contend with the juxtaposition of rising incidence of pediatric IBD and a rising prevalence of overall IBD driven by the aging population.
Diagnostic Ability of Simple Noninvasive Blood Tests to Predict Increased Liver Stiffness in People Living With HIV and Steatotic Liver Disease
Authors: Sterling Richard K. , Vilar-Gomez Eduardo , Wilson Laura A. , Loomba Rohit , Gawrieh Samer , Price Jennifer , Naggie Susanna , Lake Jordan E. , Heath Sonya , Tonascia James , Sulkowski Mark , Chalasani Naga ,   for the HIV-NASH CRN
Published: February 2024

INTRODUCTION:
Steatotic liver disease is common in people with HIV (PWH). Identifying those with advanced fibrosis (AF, bridging fibrosis or cirrhosis), F3-4, is important. We aimed to examine the performance of FIB-4 and nonalcoholic fatty liver disease (NAFLD) fibrosis score (NFS) in PWH to identify those with AF assessed by liver stiffness measurement (LSM).

METHODS:
We prospectively collected data on adults participating in 2 National Institute of Health–sponsored HIV NAFLD networks. All had HIV on antiretroviral therapy (ART) ≥6 months with HIV RNA <200 copies/mL. Those with viral hepatitis, other liver disease, excessive alcohol use, or hepatic decompensation were excluded. Vibration-controlled transient elastrography for LSM was performed, and AF defined as ≥11 kPa was compared with FIB-4 and NFS at predefined thresholds (<1.3 and >2.67 for FIB-4 and <−1.455 and >0.675 for NFS).

RESULTS:
A total of 1,065 participants were analyzed: mean age 51.6 years, 74% male, 28% White, 46% Black, 22% Hispanic, with 34% overweight (body mass index 25–29 kg/m2) and 43% obese (body mass index ≥30 kg/m2). Features of the metabolic syndrome were common: hyperlipidemia 35%, type 2 diabetes 17%, and hypertension 48%. The median CD4+ T-cell count was 666 cells/mm3, 74% had undetectable HIV RNA, and duration of HIV-1 was 17 years with most taking a nucleoside reverse transcriptase inhibitor (92%) and an integrase inhibitor (83%). The mean LSM was 6.3 kPa, and 6.3% had AF. The area under the receiver characteristic curve for FIB-4 and NFS to identify AF were 0.70 and 0.75, respectively. While both had high negative predictive values (97%–98%), the sensitivity at low thresholds and specificity at high thresholds were 64% and 97% for FIB-4 and 80% and 96% for NFS, respectively. Neither FIB-4 nor NFS at either threshold had good positive predictive value to detect AF.

DISCUSSION:
FIB-4 and NFS have excellent specificity and negative predictive value for detecting AF, and thus can be used as screening tools in PWH to exclude those with AF who do not need further testing (LSM) or referral to hepatologist.
Long-Term Risk of Myocarditis in Patients With Inflammatory Bowel Disease: A Nationwide Cohort Study in Sweden
Authors: Sun Jiangwei , Yao Jialu , Olén Ola , Halfvarson Jonas , Bergman David , Ebrahimi Fahim , Roelstraete Bjorn , Rosengren Annika , Sundström Johan , Ludvigsson Jonas F. 
Published: February 2024

INTRODUCTION:
Despite a suggested link between inflammatory bowel disease (IBD) and myocarditis, the association has not been well established. This study aimed to investigate the long-term risk of myocarditis in patients with IBD.

METHODS:
This nationwide cohort involved all patients with biopsy-confirmed IBD in Sweden (1969–2017) (n = 83,264, Crohn's disease [CD, n = 24,738], ulcerative colitis [UC, n = 46,409], and IBD-unclassified [IBD-U, n = 12,117]), general population reference individuals (n = 391,344), and IBD-free full siblings (n = 96,149) and followed until 2019. Primary outcome was incident myocarditis, and secondary outcome was severe myocarditis (complicated with heart failure, death, or readmission). Flexible parametric survival models were used to estimate adjusted hazard ratios (aHRs) and cumulative incidence of outcomes, along with 95% confidence intervals.

RESULTS:
During a median follow-up of 12 years, there were 256 myocarditis cases in patients with IBD (incidence rate [IR] = 22.6/100,000 person-years) and 710 in reference individuals (IR = 12.9), with an aHR of 1.55 (95% confidence interval 1.33–1.81). The increased risk persisted through 20 years after IBD diagnosis, corresponding to 1 extra myocarditis case in 735 patients with IBD until then. This increased risk was observed in CD (aHR = 1.48 [1.11–1.97]) and UC (aHR = 1.58 [1.30–1.93]). IBD was also associated with severe myocarditis (IR: 10.1 vs 3.5; aHR = 2.44 [1.89–3.15]), irrespective of IBD subtypes (CD: aHR = 2.39 [1.43–4.01], UC: aHR = 2.82 [1.99–4.00], and IBD-U: aHR = 3.14 [1.55–6.33]). Sibling comparison analyses yielded similar results.

DISCUSSION:
Patients with IBD had an increased risk of myocarditis, especially severe myocarditis, for ≥20 years after diagnosis, but absolute risks were low.
Subclinical cognitive impairment in chronic pancreatitis is associated with reduced mobility and quality of life
Authors: Damm Marko , George Katharina , Rosendahl Jonas , Greinert Robin 
Published: February 2024

Objectives:
This study explores how chronic pancreatitis (CP) relates to subclinical cognitive impairment (SCI), its prevalence, characteristics, risk factors, impact on patients’ quality of life (QoL) and physical performance.

Methods:
Patients with fulfilled CP criteria in imaging were prospectively enrolled. Overt encephalopathy, neurodegenerative disorders, decompensated cirrhosis or sepsis were exclusion criteria. All patients underwent psychometric testing, assessment of health-related QoL, such as mobility and strength. SCI was diagnosed when at least one test of the psychometric test battery was pathological.

Results:
Seventy-one patients were enrolled. The etiology was toxic (alcohol/ smoking) in most (49%) of the cases. SCI was prevalent in 41% of the patients, while 25% had only one and 16% had two or more pathological tests. Patients with SCI exhibited diminished overall QoL scores (p=0.048), primarily affecting physical functionality (p<0.001). This was reaffirmed in mobility tests, where patients with SCI were slower in the timed up-and-go test (p=0.008) and showed increased prevalence of abnormal chair rising tests (p=0.004). Among all variables analyzed, only alcohol abuse was an independent risk factor of SCI (OR 3.46; p=0.02) in a multivariable regression model together with the variables age, gender, education and compensated cirrhosis. Despite SCI affecting global QoL, sleep disturbance appeared to be the strongest variable independently associated with impaired QoL (OR 9.9; p=0.001).

Conclusion:
The largest study to the subject to date shows that SCI is common in CP patients and linked to significant morbidity. These findings suggest the need for addressing modifiable risk factors in CP patients to improve outcomes.
Loss and Damage Financing in the Climate Justice Debate
Authors: Ikporukpo Chris O. , Ikporukpo Ninane Nina 
Published: February 2024

The concept of Loss and Damage (L & D) emerged as a contentious issue during the negotiations for the United Nations Framework Convention on Climate Change (UNFCCC). The framing of the concept and the demand for a Loss and Damage Fund were both controversial. It is these controversial dimensions of the climate change regime that are analysed in this article. The data were obtained from mainly publications of UNFCCC Secretariat, the Intergovernmental Panel on Climate Change, climate negotiation blocs and civil society organisations. Based on a sample of thirty-six sources, the varied conceptualisations of L & D are examined. The concept was politicised. Be that as it may, it was in the demand for L & D financing that the influence of politics was particularly apparent. The demand brought into conflict the Global South and the Global North. The basic argument of the Global South in its demand for a L & D Fund was based on the need for climate justice. In spite of the fact that the demand started as early as 1991, it was only in 2022 during COP 27 in Egypt that the Global North accepted in principle, based on an understanding that liability and compensation were not involved. The Fund was formally established during COP 28 in Dubai in 2023. However, issues of effective funding remain.