bluuebunny/crossref_metadata_2025_split huggingface dataset:
Feasibility of recruiting adolescents into a prospective cohort study of the effects of social isolation during COVID-19
Authors: Kim Kain , Jergel Andrew , Bai Shasha , Bradley Kolbi , Karim Brianna , Shah Amit , Suglia Shakira , Ugboh Ngozi , Gooding Holly C. 
Published: November 2023

Abstract
Background
Social connection and loneliness in adolescence are increasingly understood as critical influences on adult mental and physical health. The unique impact of the social isolation imposed by the COVID-19 lockdown on emerging adults is therefore expected to be especially profound. We sought to investigate the feasibility of using ecological momentary assessment (EMA) and wearable accelerometers to characterize the effects of social isolation and/or loneliness experienced by adolescents during the COVID-19 pandemic.

Methods
We recruited 19 participants aged 13–18 from an Adolescent Medicine practice in Atlanta, GA. Participants completed surveys at baseline and throughout a 2-week study period using EMA regarding their degree of social isolation, loneliness, family functioning, school climate, social media use, and COVID-19 experiences surrounding their physical, mental, and social domains. Six participants agreed to wear an activity tracker and heart rate measurement device for 14 days to monitor their emotional state and physical health. Participant feedback was collected via open-ended exit interviews. Feasibility of recruitment/retention, adherence, and outcome measures were investigated. Implementation was also assessed by evaluating the barriers and facilitators to study delivery. Associations between the social isolation and loneliness variables and all other variables were performed with univariate linear regression analysis with significance set at p < 0.05. The progression criteria were a recruitment rate of > 30% and a retention rate of > 80%.

Results
Progression criteria were met for recruitment (76%) of participants, but not retention (38%). Adherence to EMA survey completion was highly variable with only 54% completing ≥ 1 survey a day, and accelerometry use was not feasible. Social isolation was significantly correlated with lower school climate, higher COVID-19 experiences, higher depression scores, and lower sleep quality. Loneliness also showed a significant correlation with all these factors except COVID-19 experiences.

Conclusions
EMA and wearable accelerometer use was not feasible in this longitudinal study of adolescents during the COVID-19 pandemic. Future research should further investigate barriers to conducting long-term research with adolescents and the potential effects of the pandemic on subject recruitment and retention.
Association between interleg systolic blood pressure difference and apparent peripheral neuropathy in US adults with diabetes: a cross-sectional study
Authors: Lin Xipeng , Liu Zhihao , Weng Haoyu , Liu Xu , Liu Shengcong , Li Jianping 
Published: November 2023

Abstract
Background
Interleg systolic blood pressure difference (ILSBPD) is associated with peripheral artery disease, but the relationship between ILSBPD and apparent peripheral neuropathy in diabetic patients remains unclear. We explored the relationship between ILSBPD and apparent peripheral neuropathy and examined the possible effect modifiers in US adults with diabetes.

Methods
One thousand and fifty-one diabetic participants were included in the study with complete data on systolic blood pressure of the lower extremities and Semmes–Weinstein 10-g monofilament testing from the 1999–2004 National Health and Nutritional Examination Surveys. Systolic blood pressure in the lower extremities was measured using an oscillometric blood pressure device with the patient in the supine position. Apparent peripheral neuropathy was defined as the presence of monofilament insensitivity.

Results
Every 5-mmHg increment in ILSBPD is associated with an about 14% increased risk of apparent peripheral neuropathy in crude model, but after adjustment for covariates, the correlation became nonsignificant (P = 0.160). When participants were divided into groups based on ILSBPD cutoffs of 5, 10 and 15 mmHg in different analyses, there was a significantly increased risk of apparent peripheral neuropathy in the ILSBPD ≥ 15 mmHg group (OR 1.79, 95% CI 1.11–2.91, P = 0.018), even after adjusting for confounders. In subgroup analysis, no interaction effect was found (all P for interaction > 0.05).

Conclusions
In US adults with diabetes, an increase in the ILSBPD (≥ 15 mmHg) was associated with a higher risk of apparent peripheral neuropathy.
Hypoglycemia rates and glycemic hormonal response after laparoscopic Roux-en-Y gastric bypass versus sleeve gastrectomy: a meta-analysis of comparative studies
Authors: Artsitas Sotirios , Artsitas Dimitrios , Smparounis Spyridon , Theodorou Dimitrios , Zografos George C. 
Published: November 2023

Abstract
Background
This study aims to quantify the difference between Roux-en-Y gastric bypass (RYGB) and laparoscopic sleeve gastrectomy (LSG) concerning the incidence of post-bariatric surgery hypoglycemia (PBSH) and variations in glycemic homeostasis.

Main body of the abstract
A literature search was conducted between July and August 2023. Inclusion criteria involved studies exclusively in the English language that comparatively investigated the occurrence of postoperative hypoglycemia in patients undergoing the above two bariatric approaches. A total of 16 studies, comprising data from 1806 patients, were identified and classified based on 39 primary and secondary outcomes pertaining to the period following the first postoperative semester. Our findings reveal that patients undergoing gastric bypass have a 50% higher risk of developing postoperative hypoglycemia compared to those undergoing sleeve gastrectomy. Moreover, this risk doubles when questionnaire data are taken into account. Lower glucose levels (MD = − 10.54 mg/dl, CI95% = [− 16.63; − 4.45]) were observed in the RYGB group at 2 h after an oral glucose tolerance test (OGTT), which is considered a precursor to the development of PBSH. Higher zenith (MD = 49.11 mg/dl, CI95% = [16.12; 82.10]) and lower nadir plasma glucose levels (MD = − 5.70 mg/dl, CI95% = [− 10.03; − 1.37]) were also noted in the same group, with a wider glucose range (MD = 52.22 mg/dl, CI95% = [18.25; 86.19]). Lastly, no differences were observed in insulin and C-peptide levels, glycosylated hemoglobin (HbA1c), as well as insulin sensitivity score (HOMA-IR).

Short conclusion
Patients in the RYGB group are at least 50% more likely to develop postoperative hypoglycemia compared to those in the LSG group. Our analysis suggests a more unstable glycemic homeostasis mechanism, with a strong contribution from late dumping syndrome.
Lymphatic malformations: a 9-year experience at the vascular anomaly clinic
Authors: AbouZeid Amr Abdelhamid , Mohammad Shaimaa Abdelsattar , Aly Nihal Hussein , Ghanem Wael Ahmed , Seada Mohammad , Ragab Iman A. , El-Naggar Osama , AbdelBaky Mohamed Aly 
Published: November 2023

Abstract
Purpose
To share our experience in the management of a specific type of vascular malformations (lymphatic) at a specialized multidisciplinary clinic for vascular anomalies.

Methods
Data of patients attending the vascular anomaly clinic during the period 2015 through 2023 were retrospectively analyzed. The study included cases diagnosed primarily as lymphatic malformations (LMs). We excluded cases associated with complex/syndromic vascular malformations. Available data included regional distribution of the LMs, age at presentation, sex, imaging studies, and different modes of treatment.

Results
The study included 131 cases of LMs whose data were available for retrospective analysis. Generally, LMs had a benign course with good prognosis apart from two recorded mortalities (1.5%) during the 9-year period of the study. In this series, 93 cases were managed by injection sclerotherapy (Bleomycin). About 57 cases showed satisfactory response to injection sclerotherapy alone without the need to add other treatment modalities. Forty cases underwent surgical excision/debulking. Postoperative wound complications were recorded in 5 cases (12.5%). Sirolimus was offered for patients with LMs after the failure of conventional treatment (injection/surgery) to control associated significant complications.

Conclusion
Lymphatic malformations represent a common presentation at the vascular anomaly clinic, which usually have a benign course. Complications are mainly cosmetic especially when involving the face, and sometimes superadded infections may occur. Airway compromise is a potential serious complication with submandibular lymphatic malformations in the neck.
X-chromosome inactivation: a historic topic that's still hot
Authors: Rodriguez Yolanda Moyano , Borensztein Maud 
Published: November 2023

ABSTRACT
The last edition of the X-chromosome inactivation (XCI) meeting was held as an EMBO workshop in Berlin on 19-22 June 2023. The conference took place at the Harnack-haus in the Dahlem district, birthplace of the first modern research campus, where notable scientists such as Lise Meitner, Hans Krebs and, briefly, Albert Einstein conducted their research. This special edition, also accessible online, was organized by Rafael Galupa (Centre for Integrative Biology of Toulouse, France), Joost Gribnau (Erasmus MC Rotterdam, The Netherlands), Claire Rougeulle (Université Paris Cité/CNRS, Epigenetics and Cell Fate Center, Paris, France), Edda Schulz (Max Planck Institute for Molecular Genetics, Berlin, Germany) and James Turner (The Francis Crick Institute, London, UK). Originally scheduled for 2021, to commemorate the 60th anniversary of Mary Lyon's hypothesis on X-chromosome inactivation in mammals and the 30th anniversary of XIST/Xist discovery, the meeting had to be postponed because of the COVID-19 pandemic. Seven years after the latest XCI meeting in London, the enthusiasm and expectations of the community were at their highest, bringing together over 160 scientists from around the world to share and discuss their research. Eighty posters and more than 40 talks were presented at this event, in a collegial and collaborative atmosphere. A historical session and several breakout discussions were also organized, as well as the now traditional boat trip, all thanks to great organization. Here, we debrief readers on this fantastic conference.
Wybrane czynniki kształtujące natężenie dojazdów do różnych typów szkół ponadpodstawowych w Poznaniu
Authors: Bajerski Artur , Kisiała Wojciech 
Published: November 2023

The aim of the research presented in this article is to examine the impact of selected socio-economic and spatial factors on the intensity of commuting to different types of secondary schools in Poznań (i.e. general secondary schools, technical secondary schools and first cycle vocational schools). Three econometric models were created on the basis of detailed data on the journey to school, in which the explained variable was the proportion of students from a given municipality who attended a selected type of school in Poznań (depending on the model: a vocational school, a technical secondary school or a general secondary school). The set of explanatory variables was common to all models and consisted of: 1) the proportion of people with higher education in the municipality, 2) the distance between the municipality and Poznań, and 3) the indicator of the availability of local education in the municipality (an indicator created for the purposes of this article). The models explained between 64% and 81% of the variation in the intensity of commuting to schools from different municipalities to Poznań (least in the case of commuting to vocational schools, most in the case of commuting to general secondary schools). The study showed a varied impact of the variables used on the intensity of commuting to Poznań for different types of schools. The level of education in the student’s municipality played the most important role in explaining commuting to general secondary schools (compared to other types of schools), while the distance to Poznań and the availability of local educational opportunities had the greatest impact on commuting to vocational schools.
Taxonomic additions of the Brazilian fauna of Prosierola (Hymenoptera, Bethylidae)
Authors: Pereira Leonardo Rezeda , Brito Chirlei Dias de , Azevedo Celso Oliveira 
Published: November 2023

Prosierola is characterized by having a pair of conspicuous anteromedial metapostnotal foveae on the metapectal-propodeal disc. Little is known about this genus because it is rarely sampled in collections. Therefore, the main goal of this contribution is to expand the knowledge of intraspecific morphological variations and geographical distribution of its species that occur in Brazil. We sorted material from the main collections and obtained 69 specimens of Prosierola nasalis (Westwood) recorded for the first time from Maranhão, Minas Gerais, Pará, Rio Grande do Norte and Rio Grande do Sul; one of Prosierola obliqua Evans recorded for the first time from Distrito Federal; five of Prosierola rotunda Schiffler & Azevedo recorded for the first time from Pará; and 13 of Prosierola rufescens Evans recorded for the first time from Brazil (Amazonas, Bahia, Espírito Santo, Minas Gerais). The mesoscuto-scutellar foveae placed on the dorsal surface of the mesoscutellum shown to be highly variable in size, distance, and shape at both the intra- and interspecific levels.
INCIDENCE OF RIFAMPICIN-RESISTANCE IN STAPHYLOCOCAL PERIPROSTHETIC JOINT INFECTION: A SINGLE-CENTRE COHORT STUDY OF 238 PATIENTS
Authors: Lazarinis Stergios , Järhult Josef , Hailer Nils , Brüggemann Anders 
Published: November 2023

AimRifampicin as a biofilm-active antibiotic drug has a significant role in the treatment of periprosthetic joint infection (PJI). However, rifampicin resistance is an increasing threat to PJI treatment. This study aimed to evaluate the prevalence of rifampicin resistant staphylococci over time and its association with infection-free survival after PJI in a single centre in Sweden.MethodsWe included 238 PJIs in 238 patients who had undergone PJI revision surgery from 2001 to 2020 on whom the causative bacteria were staphylococci, and the agent was tested for rifampicin resistance. Data regarding agents, rifampicin resistance, treatment and outcome was obtained. Kaplan-Meier survival analysis and a Cox regression model with adjustment for age, sex, localisation (hip or knee) and type of prosthesis (primary or revision) were used to calculate infection-free survival rates and adjusted risk ratios (HRs) of the risk of treatment failure. Treatment failure was defined as any reoperation or suppression treatment with antibiotics due to prolonged infection.ResultsAmong the included 238 PJIs, 40 rifampicin-resistant staphylococci [93% Coagulase Negative Staphylococci (CoNS)] and 29 treatment failures were identified. The proportion of rifampicin resistant agents decreased from 25% in 2010–2015 to 12% in 2016–2020. The 2-year infection-free survival rates were 79.0% (95% CI 0.66–0.92) for the rifampicin resistant and 90% (95% CI 0.86–0.94) for the rifampicin sensitive group. Patients with PJI caused by rifampicin resistant bacteria had a significantly higher risk of treatment failure than those caused by sensitive bacteria (HR 2.5; 95% CI 1.0–6.2).ConclusionsThe incidence of PJI caused by rifampicin resistant staphylococci decreased in Uppsala, Sweden over the past 20 years. PJI caused by rifampicin-resistant staphylococci has a two-fold risk for treatment failure compared to PJI caused by rifampicin-sensitive staphylococci, which stresses the importance of retaining rifampicin resistance low. Additionally, the increased risk of treatment failure when PJI is caused by a rifampicin-resistant bacteria warrants consideration of a more conservative treatment strategy.
MICROBIOLOGIC EPIDEMIOLOGY OF HIP PROSTHETIC JOINT INFECTIONS IN ELDERLY PATIENTS CAUSED BY MULTIDRUG-RESISTANT GRAM-NEGATIVE BACTERIA: A RETROSPECTIVE COHORT
Authors: Soares Fernanda , Santos Ingrid Nayara Marcelino , Seriacopi Lais Sales , Durigon Thomas Stravinkas , Cunha Carolina Coelho , Dell Aquila Adriana Macedo , Salles Mauro 
Published: November 2023

AimCurrently, gram-negative bacteria (GNB), including multidrug-resistant (MDR-GNB) pathogens, are gaining importance in the aetiology of prosthetic joint infection (PJI). To characterize the antimicrobial resistance patterns of Gram-negative bacteria (GNB) causing hip prosthetic joint infections in elderly patients treated at a Brazilian tertiary academic hospital.MethodThis is a retrospective, cross-sectional study of patients over 60 years of age undergoing hip arthroplasty from 2018 to 2023 at a tertiary academic trauma, which were diagnosed with hip prosthetic joint infection. PJI diagnosed was based on EBJIS criteria, in which intraoperative tissue cultures identified the pathogens. Demographics, reason for arthroplasty, type of implant and susceptibility patterns using disk diffusion method were analysed.ResultsOverall, among 17 elderly patients diagnosed with hip infected arthroplasty, 45 bacterial isolated were identified. Debridement, irrigation, antibiotic and implant retention (DAIR) procedures due to uncontrolled infection occurred in 47.0% (n=8/17), and five patients underwent more than two DAIR surgeries. Tissue cultures yielded eleven different bacterial species, with GNB accounted for 64.4% (n=29/45) of pathogens. Klebsiella pneumoniae, Acinetobacter baumannii, Escherichia coli, and Pseudomonas aeruginosa were identified in 34.5% (n=10/29), 17.25% (n=5/29), 13.8% (n=4/29), and 13.8% (n=4/29), respectively. In the resistance profile analysis, E. coli was most sensitive to antibiotics, whereas K. pneumoniae showed resistance rates higher than 70% for cephalosporins, carbapenems, and quinolones. All A. baumannii isolates were resistant to meropenem, and 80% of these isolates were resistant to amikacin.ConclusionsThis study emphasizes the role of GNB in the microbiological profile of PJI among elderly patients at a tertiary hospital in a Brazilian centre. The present study portrays a worryingly higher rates of MDR-GNB, mainly to quinolones and cephalosporins resistance which have been the cornerstone of PJI antibiotic treatment. In addition, higher rates carbapenems and aminoglycosides resistance shows a threat to antibiotic treatment of PJI. More global studies need to be carried out to show a likely change in the microbial epidemiology of PJI.
THE CLINICAL RELEVANCE OF LOW-GRADE INFECTION IN THE DEVELOPMENT AND MANAGEMENT OF FRACTURE-RELATED NONUNION
Authors: Trenkwalder Katharina , Erichsen Sandra , Weisemann Ferdinand , Augat Peter , Militz Matthias , Hackl Simon 
Published: November 2023

AimTreatment algorithms for fracture-related nonunion depend on the presence or absence of bacterial infection. However, the manifestation of septic nonunion varies. Low-grade infections, unlike manifest infections, lack clinical signs of infection and present similarly to aseptic nonunion. The clinical importance of low-grade infection in nonunion is not entirely clear. Therefore, the aim of this study was to evaluate the clinical relevance of low-grade infection in the development and management of femoral or tibial nonunion.MethodA prospective, multicenter clinical study enrolled patients with nonunion and regular healed fractures. Preoperatively, complete blood count without differential, C-reactive protein (CRP), and procalcitonin were obtained, clinical signs of infection were recorded, and a suspected septic or aseptic diagnosis was made based on history and clinical examination. During surgical nonunion revision or routine implant removal, tissue samples were collected for microbiology and histopathology, and osteosynthesis material for sonication. Nonunion patients were followed for 12 months. Definitive diagnosis of “septic” or “aseptic” nonunion was made according to diagnostic criteria for fracture-related infection, considering the results of any further revision surgery during follow-up.Results34 patients with regular healed fractures were included. 62 nonunion patients were diagnosed as aseptic, 22 with manifest, and 23 with low-grade infection. The positive predictive value was 88% and the negative predictive value 72% for the suspected diagnosis. The nonunion groups had significantly higher CRP levels than the regular healer group. Differentiation between septic and aseptic nonunion based on blood values was not possible. Low-grade infection demonstrated less frequently histopathologic signs of infection than manifest infection (22% vs. 50%, p=0.048), with 15% of regular healers having histopathologic signs of infection. Cutibacterium acnes was less present in manifest compared to low-grade infection (p=0.042). Healing rates for septic nonunion involving C. acnes were significantly lower for manifest infection (20%) than for low-grade infection (100%, p=0.002). Patients with low-grade infection were treated with systemic antibiotics less frequently than patients with manifest infection (p=0.026), with no significant difference in healing rate (83% vs. 64%), which was slightly lower for low-grade infection than for aseptic nonunion (90%).ConclusionsLow-grade infections play a significant role in nonunion development and are difficult to diagnose preoperatively due to the lack of clinical signs of infection and unremarkable blood counts. However, our results imply that for low-grade infections, antibiotic therapy may not always be mandatory to heal the nonunion. This study was supported by the German Social Accident Insurance (FF-FR0276).
A NEW CLASSIFICATION OF FRACTURE-RELATED INFECTION
Authors: McNally Martin , Alt Volker , Wouthuyzen Marjan , Marais Leonard , Metsemakers Willem-Jan , Zalavras Charalampos , Morgenstern Mario 
Published: November 2023

AimTo classify Fracture-related Infection (FRI) allowing comparison of clinical studies and to guide decision-making around the main surgical treatment concepts.MethodAn international group of FRI experts met in Lisbon, June 2022 and proposed a new FRI classification. A core group met during the EBJIS Meeting in Graz, 2022 and on-line, to determine the preconditions, purpose, primary factors for inclusion, format and the detailed description of the elements of an FRI Classification.ResultsHistorically, FRI was classified by time from injury alone (early, delayed or late). Time produces pathophysiological changes which affect the bone, the soft-tissues and the patient general health, over a continuum. No definitive cut-off is therefore possible. Also, in several studies, time was not identified as an independent predictor of outcome.The most important primary factors were characteristics of the fracture (F), relevant systemic co-morbidities of the patient (R) and impairment of the soft-tissue envelope (I). These factors determine FRI severity, choice of treatment method and are predictors of outcome. For the fracture (F), the state of healing, the potential for bone healing and the presence or absence of a bone defect are critical factors. Co-morbidities are listed and the degree of end-organ damage is important (R). The ability to close the wound directly or the need for soft tissue reconstruction determines the impairment of the soft tissue component (I). Hence the FRI Classification was designed.The final proposal of the FRI Classification is presented here. The new classification has five stages; from simple cases of infected healed fractures, in healthy individuals with good soft tissues (Stage 1), through unhealed fractures with variable potential for bone healing (Stages 2, 3 or 4) to Stage 5, with no limb-sparing or reconstructive options. For instance, the need for a free flap (I4), over a well-healed fracture (F1), in a patient with 2 co-morbidities (R2) gives a classification of F1R2I4 for that patient.ConclusionsThis novel approach to FRI classification builds on previous work in osteomyelitis, PJI and chronic medical conditions. It focusses attention on the elements of the disease which need treatment. It now requires validation in large patient cohorts.On behalf of the FRI Classification Consensus Group.