bluuebunny/crossref_metadata_2025_split huggingface dataset:
Hangman’s Fracture in Geriatric Population: A Nationwide Multicenter Study in Japan
Authors: Yunde Atsushi , Furuya Takeo , Orita Sumihisa , Ohtori Seiji , Yokogawa Noriaki , Nakashima Hiroaki , Segi Naoki , Funayama Toru , Ikegami Shota , Nakajima Hideaki , Watanabe Kota , Hasegawa Tomohiko , Tonomura Hitoshi , Terashima Yoshinori , Hashimoto Ko , Suzuki Nobuyuki , Uei Hiroshi , Kiyasu Katsuhito , Tominaga Hiroyuki , Sakai Daisuke , Kaito Takashi , Inoue Gen , Okada Seiji , Imagama Shiro , Kato Satoshi 
Published: November 2023

Study Design Retrospective multicenter study. Objectives To investigate the treatments of the geriatric population with hangman’s fractures using a multicenter database under the Japan Association of Spine Surgeons with Ambition (JASA). Methods The multicenter database included data from 1512 patients. We employed the Levine and Edwards classification for categorizing hangman’s fractures. The study incorporated epidemiological data, including the prevalence of hangman’s fractures, patient age, and follow-up duration. Bony fusion rates and length of hospitalization were recorded for Type I and Type II fractures, and the degree of neurological impairment was assessed. Results Hangman’s fractures represented 62 cases, accounting for 7.4% of all cervical spine injuries. The patients had an average age of 76.6 ± 6.5 years, and the mean duration of follow-up was 21.5 ± 23.6 months. The study found that the bony fusion rate for hangman’s fractures in the geriatric population was 88.9%. Surgical treatment was associated with a shorter hospitalization period for Type II fractures compared to conservative treatment. Thirteen cases of hangman’s fractures in the geriatric population, accounting for 21%, were complicated by spinal cord injury. Conclusions This is the largest study to date on hangman’s fractures in geriatric population ≥65 years. Type I and Type II fractures, according to the Levine and Edwards classification, had a bony fusion rate of up to 90%. In patients with Type II fractures, surgical treatment led to a shorter initial hospital stay. Geriatric patients are at risk of spinal cord injury due to hangman’s fractures.
Oxygen gradient ektacytometry–derived biomarkers are associated with acute complications in sickle cell disease
Authors: Rab Minke A. E. , Kanne Celeste K. , Boisson Camille , Bos Jennifer , van Oirschot Brigitte A. , Houwing Maite E. , Renoux Céline , Bartels Marije , Rijneveld Anita W. , Nur Erfan , Cnossen Marjon H. , Joly Philippe , Nader Elie , Fort Romain , Connes Philippe , van Wijk Richard , Sheehan Vivien A. , van Beers Eduard J. 
Published: November 2023

Abstract
We investigated the potential of the point of sickling (PoS; the pO2 tension at which red cells start to sickle), determined by oxygen gradient ektacytometry to serve as a biomarker associated with the incidence of acute sickle cell disease–related complications in 177 children and 50 adults. In the pediatric cohort, for every 10 mmHg increase in PoS reflecting a greater likelihood of sickling, the likelihood of an individual experiencing &gt;1 type of acute complication increased; the adjusted odds ratio (aOR) was 1.65. For every 0.1 increase in minimum elongation index (EImin; reflecting improved red blood cell deformability at hypoxia), the aOR was 0.50. In the adult cohort, for every 10 mmHg increase in PoS, we found an aOR of 3.00, although this was not significant after correcting for multiple testing. There was a trend for an association between higher PoS and greater likelihood of vaso-occlusive episodes (VOEs; children aOR, 1.35; adults aOR, 2.22). In children, only EImin was associated with VOEs (aOR, 0.68). When data of both cohorts were pooled, significant associations with PoS and/or EImin were found for all acute complications, independently and when &gt;1 type of acute complication was assessed. These findings indicate that oxygen gradient ektacytometry generates novel biomarkers and provides a rationale for further development of these biomarkers in the assessment of clinical severity, evaluation of novel therapies, and as surrogate clinical trial end points. These biomarkers may be useful in assessing efficacy of novel therapies like pyruvate kinase activators, voxelotor, and L-glutamine.
Optimizations of exopolysaccharide production by Fusarium nygamai strain AJTYC1 and its potential applications as an antioxidant, antimicrobial, anticancer, and emulsifier
Authors: El-Mahdy Omima M. , Mohamed Heba I. , El-Ansary Abeer E. 
Published: November 2023

Abstract
Background
Exopolysaccharides (EPSs) produced by microbes are recognized as biomacromolecules of great significance. EPSs from fungi are widely used in a variety of biotechnological fields, including medicine, bioremediation, and agriculture.

Results
In this study, ten fungal isolates were isolated from Kafir El-Dair, Qalubia Governorate, Egypt. Isolate 5 produced more exopolysaccharides than the other examined fungi. According to microscopic morphological traits and genetic confirmation by the 18S rRNA gene, isolate 5 was identified as Fusarium nygamai strain AJTYC1. The present study showed that Czapek’s broth media, which contains 6 g/100 ml of sucrose, 10 g/100 ml of peptone, pH 6, and 1.8 × 105 CFU/ml of inoculum size and is incubated at 30 °C for 9 days, was suitable for the production of EPSs from Fusarium nygamai strain AJTYC1 by using static conditions. Fourier transform infrared (FT-IR) was employed in the characterization of EPSs, which exhibited the presence of carboxyl groups, hydroxyl groups, carbonyl groups, and glycosidic bonds. High-performance liquid chromatography (HPLC) detected that EPSs consist of sucrose and glucose. The scavenging activity indicates that EPSs have good antioxidant activity. The partially purified exopolysaccharides produced from F. nygamai strain AJTYC1 exhibited excellent antioxidant and antimicrobial activity against gram positive, gram negative and fungal strains. The EPSs at a dose of 1000 µg/ml exhibited anticancer activity against colorectal colon cancer (HCT116), breast cancer (MCF7), and hepatocellular cancer cell lines. Moreover, EPSs is an effective emulsifier of a variety of vegetable oils, and the emulsion it produces is generally stable for up to 168 h.

Conclusions
The production of EPSs from F. nygamai strain AJTYC1 can be used as antioxidants, antimicrobials, anticancer, and emulsifiers.
Culture-dependent screening of endospore-forming clostridia in infant feces
Authors: Ingribelli Eugenio , Modrackova Nikol , Tejnecky Vaclav , Killer Jiri , Schwab Clarissa , Neuzil-Bunesova Vera 
Published: November 2023

Abstract
Background
Only a few studies dealt with the occurrence of endospore-forming clostridia in the microbiota of infants without obvious health complications.

Methods
A methodology pipeline was developed to determine the occurrence of endospore formers in infant feces. Twenty-four fecal samples (FS) were collected from one infant in monthly intervals and were subjected to variable chemical and heat treatment in combination with culture-dependent analysis. Isolates were identified by MALDI-TOF mass spectrometry, 16S rRNA gene sequencing, and characterized with biochemical assays.

Results
More than 800 isolates were obtained, and a total of 21 Eubacteriales taxa belonging to the Clostridiaceae, Lachnospiraceae, Oscillospiraceae, and Peptostreptococcaceae families were detected. Clostridium perfringens, C. paraputrificum, C. tertium, C. symbiosum, C. butyricum, and C. ramosum were the most frequently identified species compared to the rarely detected Enterocloster bolteae, C. baratii, and C. jeddahense. Furthermore, the methodology enabled the subsequent cultivation of less frequently detectable gut taxa such as Flavonifractor plautii, Intestinibacter bartlettii, Eisenbergiella tayi, and Eubacterium tenue. The isolates showed phenotypic variability regarding enzymatic activity, fermentation profiles, and butyrate production.

Conclusions
Taken together, this approach suggests and challenges a cultivation-based pipeline that allows the investigation of the population of endospore formers in complex ecosystems such as the human gastrointestinal tract.
Environmental sustainability from anesthesia providers’ perspective: a qualitative study
Authors: Gasciauskaite Greta , Lunkiewicz Justyna , Spahn Donat R. , Von Deschwanden Corinna , Nöthiger Christoph B. , Tscholl David W. 
Published: November 2023

Abstract
Background
The world faces a significant global health threat – climate change, which makes creating more environmentally sustainable healthcare systems necessary. As a resource-intensive specialty, anesthesiology contributes to a substantial fraction of healthcare’s environmental impact. This alarming situation invites us to reconsider the ecological health determinants and calls us to action.

Methods
We conducted a single-center qualitative study involving an online survey to explore the environmental sustainability from anesthesia providers’ perspectives in a center implementing internal environmentally-sustainable anesthesia guidelines. We asked care providers how they perceive the importance of environmental issues in their work; the adverse effects they see on ecological sustainability in anesthesia practice; what measures they take to make anesthesia more environmentally friendly; what barriers they face in trying to do so; and why they are unable to adopt ecologically friendly practices in some instances. Using a thematic analysis approach, we identified dominating themes in participants’ responses.

Results
A total of 62 anesthesia providers completed the online survey. 89% of the participants stated that environmental sustainability is essential in their work, and 95% reported that they implement measures to make their practice greener. A conscious choice of anesthetics was identified as the most common step the respondents take to reduce the environmental impact of anesthesia. Waste production and improper waste management was the most frequently mentioned anesthesia-associated threat to the environment. Lacking knowledge/teaching in sustainability themes was recognized as a crucial barrier to achieving ecology goals.

Conclusions
Sustainable anesthesia initiatives have the potential to both encourage engagement among anesthesia providers and raise awareness of this global issue. These findings inspire opportunities for action in sustainable anesthesia and broaden the capacity to decrease the climate impact of health care.
Estimating the number of probable new SARS-CoV-2 infections among tested subjects from the number of confirmed cases
Authors: Diarra YM , Wimba PM , Katchunga PB , Bengehya J , Miganda B , Oyimangirwe M , Tshilolo L , Ahuka SM , Iwaz J , Étard JF , Écochard R , Vanhems P , Rabilloud M 
Published: November 2023

Abstract
Objectives
In most African countries, confirmed COVID-19 case counts underestimate the number of new SARS-CoV-2 infection cases. We propose a multiplying factor to approximate the number of biologically probable new infections from the number of confirmed cases.

Methods
Each of the first thousand suspect (or alert) cases recorded in South Kivu (DRC) between 29 March and 29 November 2020 underwent a RT-PCR test and an IgM and IgG serology. A latent class model and a Bayesian inference method were used to estimate (i) the incidence proportion of SARS-CoV-2 infection using RT-PCR and IgM test results, (ii) the prevalence using RT-PCR, IgM and IgG test results; and, (iii) the multiplying factor (ratio of the incidence proportion on the proportion of confirmed –RT-PCR+– cases).

Results
Among 933 alert cases with complete data, 218 (23%) were RT-PCR+; 434 (47%) IgM+; 464 (~ 50%) RT-PCR+, IgM+, or both; and 647 (69%) either IgG + or IgM+. The incidence proportion of SARS-CoV-2 infection was estimated at 58% (95% credibility interval: 51.8–64), its prevalence at 72.83% (65.68–77.89), and the multiplying factor at 2.42 (1.95–3.01).

Conclusions
In monitoring the pandemic dynamics, the number of biologically probable cases is also useful. The multiplying factor helps approximating it.
Sustainability of integrated hypertension and diabetes with HIV care for people living with HIV at primary health care in South Ethiopia: implication for integration
Authors: Badacho Abebe Sorsa , Mahomed Ozayr Haroon 
Published: November 2023

Abstract
Background
People living with human immunodeficiency virus (PLWH) have an increased risk of developing noncommunicable diseases (NCDs) compared with people without HIV. The multimorbidity of NCDs and HIV increases the need for integrated care. However, there is a paucity of evidence on the implementation of integrated sustained hypertension and diabetes with HIV care to address the multiple chronic care needs of PLWH in Ethiopia.

Objective
This study aimed to determine the sustainability of integrated hypertension and diabetes within HIV care for PLWH in primary healthcare (PHC) in southern Ethiopia.

Methods
The National Health Service Institute for Innovation and Improvement Sustainability Model (NHS- SM) self-assessment tool was used to assess sustainability. HIV care and NCD team members from five PHC facilities in South Ethiopia were included. Participants completed the self-administered NHS-SM assessment tool independently.

Result
The overall mean sustainability was 43.74 (95% CI: 42.15–45.33). All facilities had an overall sustainability score of less than 55. The perceived benefit beyond helping the patient, the likelihood of adaptability, and perceived alignment with the organizational goal were identified as potential factors promoting sustainability. The perceived lack of an effective system to monitor progress, staff behavior, inadequate staff involvement and training, inadequate senior leadership support and clinical leadership engagement, and infrastructure limitations could negatively affect sustainability.

Conclusions
Integrating hypertension and diabetes with HIV care sustainably at PHC requires staff involvement and training, staff behavior change communication, ensuring PHC management and clinical leadership (doctors and senior clinicians) engagement, and addressing infrastructure limitations.
Reversing frailty in older adults: a scoping review
Authors: Kolle Aurélie Tonjock , Lewis Krystina B. , Lalonde Michelle , Backman Chantal 
Published: November 2023

Abstract
Background
Individuals 65 years or older are presumably more susceptible to becoming frail, which increases their risk of multiple adverse health outcomes. Reversing frailty has received recent attention; however, little is understood about what it means and how to achieve it. Thus, the purpose of this scoping review is to synthesize the evidence regarding the impact of frail-related interventions on older adults living with frailty, identify what interventions resulted in frailty reversal and clarify the concept of reverse frailty.

Methods
We followed Arksey and O’Malley’s five-stage scoping review approach and conducted searches in CINAHL, EMBASE, PubMed, and Web of Science. We hand-searched the reference list of included studies and conducted a grey literature search. Two independent reviewers completed the title, abstract screenings, and full-text review using the eligibility criteria, and independently extracted approximately 10% of the studies. We critically appraised studies using Joanna Briggs critical appraisal checklist/tool, and we used a descriptive and narrative method to synthesize and analyze data.

Results
Of 7499 articles, thirty met the criteria and three studies were identified in the references of included studies. Seventeen studies (56.7%) framed frailty as a reversible condition, with 11 studies (36.7%) selecting it as their primary outcome. Reversing frailty varied from either frail to pre-frail, frail to non-frail, and severe to mild frailty. We identified different types of single and multi-component interventions each targeting various domains of frailty. The physical domain was most frequently targeted (n = 32, 97%). Interventions also varied in their frequencies of delivery, intensities, and durations, and targeted participants from different settings, most commonly from community dwellings (n = 23; 69.7%).

Conclusion
Some studies indicated that it is possible to reverse frailty. However, this depended on how the researchers assessed or measured frailty. The current understanding of reverse frailty is a shift from a frail or severely frail state to at least a pre-frail or mildly frail state. To gain further insight into reversing frailty, we recommend a concept analysis. Furthermore, we recommend more primary studies considering the participant’s lived experiences to guide intervention delivery.
Prescribing differences among older adults with differing health cover and socioeconomic status: a cohort study
Authors: Prendergast Ciaran , Flood Michelle , Murry Logan T. , Clyne Barbara , Fahey Tom , Moriarty Frank 
Published: November 2023

Abstract
Introduction
As health reforms move Ireland from a mixed public-private system toward universal healthcare, it is important to understand variations in prescribing practice for patients with differing health cover and socioeconomic status. This study aims to determine how prescribing patterns for patients aged ≥ 65 years in primary care in Ireland differ between patients with public and private health cover.

Methods
This was an observational study using anonymised data collected as part of a larger study from 44 general practices in Ireland (2011–2018). Data were extracted from electronic records relating to demographics and prescribing for patients aged ≥ 65 years. The cohort was divided between those with public health cover (via the General Medical Services (GMS) scheme) and those without. Standardised rates of prescribing were calculated for pre-specified drug classes. We also analysed the number of medications, polypharmacy, and trends over time between groups, using multilevel linear regression adjusting for age and sex, and hospitalisations.

Results
Overall, 42,456 individuals were included (56% female). Most were covered by the GMS scheme (62%, n = 26,490). The rate of prescribing in all drug classes was higher for GMS patients compared to non-GMS patients, with the greatest difference in benzodiazepine anxiolytics. The mean number of unique medications prescribed to GMS patients was 10.9 (SD 5.9), and 8.1 (SD 5.8) for non-GMS patients. The number of unique medications prescribed to both GMS and non-GMS cohorts increased over time. The increase was steeper in the GMS group where the mean number of medications prescribed increased by 0.67 medications/year. The rate of increase was 0.13 (95%CI 0.13, 0.14) medications/year lower for non-GMS patients, a statistically significant difference.

Conclusion
Our study found a significantly larger number of medications were prescribed to patients with public health cover, compared to those without. Increasing medication burden and polypharmacy among older adults may be accelerated for those of lower socioeconomic status. These findings may inform planning for moves towards universal health care, and this would provide an opportunity to evaluate the effect of expanding entitlement on prescribing and medications use.
The association of hearing loss with frailty among community-dwelling older adults: findings from the National Health and Aging Trends Study
Authors: Assi Sahar , Zhang Wuyang , Carey John P. , Deal Jennifer A. , Huang Alison , Oh Esther S. , Martinez-Amezcua Pablo , Reed Nicholas S. 
Published: November 2023

Abstract
Background
The identification of modifiable risk factors is crucial for the prevention and/or reversal of frailty, which is associated with significant morbidity and mortality. Hearing loss affects two-thirds of older adults in the United States (U.S.) and is associated with physical and cognitive decline which may increase frailty risk. We investigated the association of hearing loss and hearing aid use with frailty and pre-frailty in a nationally representative sample of older adults in the U.S.

Methods
Cross-sectional analysis of the National Health and Aging Trends Study (2021 round). The better-hearing ear pure-tone average (BPTA) at speech-frequencies (0.5–4 kHz) was modeled continuously (per 10 dB) and categorically (no ≤ 25 dB, mild 26–40 dB, moderate or greater > 40 dB hearing loss). Hearing aid use was self-reported. The physical frailty phenotype (frail, pre-frail, robust) was determined based on Fried criteria: unintentional weight loss, exhaustion, low physical activity, weakness, slow walking speed. We used multinomial multivariable regression adjusted for sociodemographic and health characteristics (odds ratios [95% Confidence Intervals]).

Results
Among 2,361 participants (mean age = 81 years, 56% female, 19% Black), 860 (36%) had mild and 864 (37%) had moderate or greater hearing loss. Worse hearing was associated with greater odds of being frail versus robust (OR = 1.20 [1.05–1.38] per 10 dB difference). Categorically, moderate or greater hearing loss was associated with greater odds of being frail (OR = 1.84 [1.01–3.08]) and pre-frail (OR = 1.46 [1.01–2.10]) versus robust. Among 1,724 participants with hearing loss, compared to hearing aid users (N = 522), nonusers had greater odds of being frail (OR = 2.54 [1.54–4.18]) and pre-frail (OR = 1.51 [1.05–2.17]) versus robust, and frail versus pre-frail (OR = 1.68 [1.04–2.72]).

Conclusions
In a nationally representative sample of older adults in the U.S., using gold-standard hearing measures and a validated frailty phenotype, hearing loss and lack of hearing aid use was cross-sectionally associated with frailty and pre-frailty. Future longitudinal studies are needed to establish if hearing loss is a risk factor for frailty, which may have significant clinical importance.