bluuebunny/crossref_metadata_2025_split huggingface dataset:
Tranexamic Acid Treatment Reduces Blood Loss After Elective and Semi-Urgent Reverse Total Shoulder Arthroplasty
Authors: Beyth Shaul , Fraind-Maya Gabriel , Safran Ori 
Published: June 2023

Introduction Post operative blood loss after reverse shoulder arthroplasty (RSA) is associated with the need for blood transfusion and prolonged hospital stay, among other complications. Tranexamic acid (TXA) reduces perioperative blood loss and is effective when delivered systemically or locally. We compared the effects of TXA on perioperative blood loss between elective and semi-urgent RSA. Methods We retrospectively reviewed patients who underwent either elective or semi-urgent RSA for fracture repair, with and without TXA treatment. Demographics, clinical records, and laboratory results were collected and analyzed to compare peripheral blood hemoglobin concentrations before and after surgery, the need for blood transfusion, and length of hospital stay between the 2 groups. Results In a cohort of 158 patients, 91 (58%) underwent elective RSA. TXA was administered in 91 (58%) patients from the entire group. TXA administration was associated with a significant decrease in post operative hemoglobin concentration reduction in both the elective and fracture groups ( P = .026 and P = .018, respectively), a significant decrease in post operative blood transfusion rates ( P = .004 and P = .003, respectively), and a decrease in the need for prolonged hospitalization ( P = .038 and P = .009, respectively). Discussion The local application of TXA during RSA yielded a significant reduction in perioperative blood loss. We showed a significant positive effect of local TXA administration during RSA that is comparable for both elective and semi-urgent patients. Due to the baseline characteristics of fracture patients, their clinical benefits may be more notable. Conclusions The positive outcomes for surgical patients with the use of TXA during RSA can possibly cause future consideration in clinical practice.
Provincial policies affecting resident quality of life in Canadian residential long-term care
Authors: Irwin Pamela , Taylor Deanne , Keefe Janice M. 
Published: June 2023

AbstractBackgroundThe precautions and restrictions imposed by the recent Covid-19 pandemic drew attention to the criticality of quality of care in long-term care facilities internationally, and in Canada. They also underscored the importance of residents’ quality of life. In deference to the risk mitigation measures in Canadian long-term care settings during Covid-19, some person-centred, quality of life policies were paused, unused, or under-utilised. This study aimed to interrogate these existing but latent policies, to capture their potentiality in terms of positively influencing the quality of life of residents in long-term care in Canada.MethodsThe study analysed policies related to quality of life of long-term care residents in four Canadian provinces (British Columbia, Alberta, Ontario, and Nova Scotia). Three policy orientations were framed utilising a comparative approach: situational (environmental conditions), structural (organisational content), and temporal (developmental trajectories). 84 long term care policies were reviewed, relating to different policy jurisdictions, policy types, and quality of life domains.ResultsOverall, the intersection of jurisdiction, policy types, and quality of life domains confirms that some policies, particularly safety, security and order, may be prioritised in different types of policy documents, and over other quality of life domains. Alternatively, the presence of a resident focused quality of life in many policies affirms the cultural shift towards greater person-centredness. These findings are both explicit and implicit, and mediated through the expression of individual policy excerpts.ConclusionThe analysis provides substantive evidence of three key policy levers: situations–providing specific examples of resident focused quality of life policy overshadowing in each jurisdiction; structures–identifying which types of policy and quality of life expressions are more vulnerable to dominance by others; and trajectories–confirming the cultural shift towards more person-centredness in Canadian long-term care related policies over time. It also demonstrates and contextualises examples of policy slippage, differential policy weights, and cultural shifts across existing policies. When applied within a resident focused, quality of life lens, these policies can be leveraged to improve extant resource utilisation. Consequently, the study provides a timely, positive, forward-facing roadmap upon which to enhance and build policies that capitalise and enable person-centredness in the provision of long-term care in Canada.
Influencing factors of the treatment level of elderly care workers and their career development prospects
Authors: Cui Kaichang , Yang Fei , Qian Ruihan , Li Chenmei , Fan Mengting 
Published: June 2023

Abstract
Background
The increasingly aging population in current China has encouraged the emergence of the diversified and multi-level elderly care service industry, and the demand for high-quality elderly life with the help of elderly caregivers continues to grow.

Methods
Based on the existing questionnaire data, this article explores the influencing factors of the treatment level of care staff, and explores their future development prospects.

Results
The results show that whether they have participated in relevant vocational skills competitions, whether they have worked overtime, whether they have overtime wages, and their monthly income have significant effects on their satisfaction of treatment levels. Elderly care workers who have participated in skills competitions are more satisfied about their salary. In addition, workers who rarely and occasionally work overtime are more satisfied compared with those who have never worked overtime; Caregivers with a monthly income of 5,000–6,999 yuan are more satisfied with their salary and treatment than those with below 3,000 yuan.

Conclusion
Therefore, in order to better match the supply and demand of care workers, we should provide formal training and skill competitions for them, appropriately increase their salary level and reasonably arrange their working hours, so as to attract more professional talents into elderly care industry.
Association between allostatic load and adverse outcomes among older patients with heart failure with preserved ejection fraction
Authors: Hao Benchuan , Chen Jianqiao , Cai Yulun , Li Huiying , Zhu Zifan , Xu Weihao , Liu Hongbin 
Published: June 2023

Abstract
Background
The allostatic load (AL) refers to the cumulative weakening of multiple physiological systems caused by repeated adaptation of the body to stressors There are still no studies have focused on the association between AL and the prognosis of patients with heart failure with preserved ejection fraction (HFpEF). The present study aimed to investigate the association between AL and adverse outcomes, including mortality and HF admission, among elderly male patients with HFpEF.

Methods
We conducted a prospective cohort study of 1111 elderly male patients with HFpEF, diagnosed between 2015 and 2019 and followed up through 2021. We constructed an AL measure using a combination of 12 biomarkers. The diagnosis of HFpEF was made according to the 2021 European Society of Cardiology guidelines. A Cox proportional hazards model was used to determine the associations between AL and adverse outcomes.

Results
In multivariate analysis, AL was significantly associated with increased risk of all-cause mortality (medium AL: adjusted hazard ratio [HR] = 2.53; 95% confidence interval [CI] 1.37–4.68; high AL: HR = 4.21; 95% CI 2.27–7.83; per-score increase: HR = 1.31; 95% CI 1.18–1.46), cardiovascular mortality (medium AL: HR = 2.67; 95% CI 1.07–6.68; high AL: HR = 3.13; 95% CI 1.23–7.97; per-score increase: HR = 1.20; 95% CI 1.03–1.40), non-cardiovascular mortality (medium AL: HR = 2.45; 95% CI 1.06–5.63; high AL: HR = 5.81; 95% CI 2.55–10.28; per-score increase: HR = 1.46; 95% CI 1.26–1.69), and HF admission (medium AL: HR = 2.68; 95% CI 1.43–5.01; high AL: HR = 3.24; 95% CI 1.69–6.23; per-score increase: HR = 1.24; 95% CI 1.11–1.39). Consistent results were found in multiple subgroup analyses.

Conclusions
A higher AL was associated with poor prognosis in elderly men with HFpEF. AL relies on information that is easily obtained in physical examinations and laboratory parameters and can be assessed in various care and clinical settings to help risk stratification of HFpEF patients.
Frequency of HIV serodifferent couples within TB-affected households in a setting with a high burden of HIV-associated TB
Authors: Anguzu Godwin , Gupta Amanda J , Ochom Emmanuel , Tseng Ashley S. , Zhang Meixin , Barnabas Ruanne V. , Flaxman Abraham D. , Katamba Achilles , Davis J. Lucian , Ross Jennifer M. 
Published: June 2023

Abstract
Introduction
Strong epidemiological links between human immunodeficiency virus (HIV) and tuberculosis (TB) may make household TB contact investigation an efficient strategy for HIV screening and finding individuals in serodifferent partnerships at risk of HIV and linking them to HIV prevention services. We aimed to compare the proportions of HIV serodifferent couples in TB-affected households and in the general population of Kampala, Uganda.

Methods
We included data from a cross-sectional trial of HIV counselling and testing (HCT) in the context of home-based TB evaluation in Kampala, Uganda in 2016–2017. After obtaining consent, community health workers visited the homes of participants with TB to screen contacts for TB and offer HCT to household members ≥ 15 years. We defined index participants and their spouses or parents as couples. Couples were classified as serodifferent if confirmed by self-reported HIV status or by HIV testing results. We used a two-sample test of proportions to compare the frequency of HIV serodifference among couples in the study to its prevalence among couples in Kampala in the 2011 Uganda AIDS Indicator Survey (UAIS).

Results
We included 323 index TB participants and 507 household contacts aged ≥ 18 years. Most index participants (55%) were male, while most (68%) adult contacts were female. There was ≥ 1 couple in 115/323 (35.6%) households, with most couples (98/115, 85.2%) including the index participant and spouse. The proportion of households with HIV-serodifferent couples was 18/323 (5.6%), giving a number-needed-to-screen of 18 households. The proportion of HIV serodifference among couples identified in the trial was significantly higher than among couples in the UAIS (15.7% vs. 8%, p = 0.039). The 18 serodifferent couples included 14 (77.8%) where the index participant was living with HIV and the spouse was HIV-negative, and 4 (22.2%) where the index partner was HIV-negative, while the spouse was living with HIV.

Conclusions
The frequency of HIV serodifference among couples identified in TB-affected households was higher than in the general population. TB household contact investigation may be an efficient strategy for identifying people with substantial exposure to HIV and linking them to HIV prevention services.
Women’s experience of perinatal support in a high migrant Australian population during the COVID-19 pandemic: a mixed methods study
Authors: Melov Sarah J. , Galas Nelma , Swain Julie , Alahakoon Thushari I. , Lee Vincent , Cheung N Wah , McGee Therese , Pasupathy Dharmintra , McNab Justin 
Published: June 2023

Abstract
Background
As a COVID-19 risk mitigation measure, Australia closed its international borders for two years with significant socioeconomic disruption including impacting approximately 30% of the Australian population who are migrants. Migrant populations during the peripartum often rely on overseas relatives visiting for social support. High quality social support is known to lead to improved health outcomes with disruption to support a recognised health risk.

Aim
To explore women’s experience of peripartum social support during the COVID-19 pandemic in a high migrant population. To quantify type and frequency of support to identify characteristics of vulnerable perinatal populations for future pandemic preparedness.

Methods
A mixed methods study with semi-structured interviews and a quantitative survey was conducted from October 2020 to April 2021. A thematic approach was used for analysis.

Results
There were 24 participants interviewed both antenatally and postnatally (22 antenatal; 18 postnatal). Fourteen women were migrants and 10 Australian born. Main themes included; ‘Significant disruption and loss of peripartum support during the COVID-19 pandemic and ongoing impact for migrant women’; ‘Husbands/partners filling the support gap’ and ‘Holding on by a virtual thread’. Half of the participants felt unsupported antenatally. For Australian born women, this dissipated postnatally, but migrants continued to feel unsupported. Migrant women discussed partners stepped into traditional roles and duties of absent mothers and mothers-in-law who were only available virtually.

Conclusion
This study identified disrupted social support for migrant women during the pandemic, providing further evidence that the pandemic has disproportionately impacted migrant populations. However, the benefits identified in this study included high use of virtual support, which could be leveraged for improving clinical care in the present and in future pandemics. The COVID-19 pandemic impacted most women’s peripartum social support with migrant families having ongoing disruption. Gains in the pandemic included greater gender equity for domestic work as husbands/partners increased their contribution to domestic work and childcare.
Pan-cancer analysis of TASL: a novel immune infiltration-related biomarker for tumor prognosis and immunotherapy response prediction
Authors: Li Huanyu , Sun Xiaoyu , Zhao Yanyun , Zhang Changzhu , Jiang Kai , Ren Jie , Xing Lijuan , He Miao 
Published: June 2023

Abstract
Background
New immunotherapeutic strategies based on predictors are urgently needed. Toll-like receptor adaptor interacting with SLC15A4 on the lysosome (TASL) was recently confirmed to fulfill an important role in the innate immune response. However, whether TASL is involved in tumor development and immunotherapy response prediction has not been reported.

Methods
TCGA and GTEx were used to yield transcriptional, genetic, and epigenetic levels of TASL in 33 cancer types. CIBERSORT was used to explore the correlation between TASL expression and multiple immune-related signatures and tumor-infiltrating immune cell content in different cancer types. The ability of TASL to predict tumor immunotherapy response was analyzed in seven datasets. Finally, we tested TASL expression in human glioma cell lines and tissue samples and analyzed its correlation with clinicopathological parameters.

Results
TASL is widely heterogeneous at the transcriptional, genetic, and epigenetic levels. High TASL expression is an independent poor prognostic factor for immune “cold” tumor Low-Grade Glioma (LGG) but an opposite factor for “hot” tumors Lung Adenocarcinoma (LUAD) and Skin Cutaneous Melanoma (SKCM). TASL may affect tumor immune infiltration by mediating tumor-infiltrating lymphocytes and tumor-associated macrophages. It may differentially affect the prognosis of the three cancers by regulating the immunosuppressive microenvironment in LGG and the immunostimulatory microenvironment in LUAD and SKCM. High TASL expression is a potential biomarker for the positive response to immunotherapy in cancers such as SKCM and was also experimentally confirmed to be positively associated with adverse clinicopathological features of gliomas.

Conclusion
TASL expression is an independent prognostic factor for LGG, LUAD, and SKCM. High TASL expression is a potential biomarker for the positive response to immunotherapy in certain cancer types such as SKCM. Further basic studies focusing on TASL expression and tumor immunotherapy are urgently needed.
The self-assessment scale of cognitive complaints in Schizophrenia: validation of the Arabic version among a sample of lebanese patients
Authors: Haddad Chadia , Sacre Hala , Abboche Elie , Salameh Pascale , Calvet Benjamin 
Published: June 2023

Abstract
Background
Several subjective scales have been used to measure cognitive complaints in patients with schizophrenia, such as the Self-Assessment Scale of Cognitive Complaints in Schizophrenia (SASCCS), which was designed to be clear, simple, and easy to use. This study aimed to examine the ability of SASCCS as a validated tool to collect and assess subjective cognitive complaints of patients with schizophrenia.

Methods
A cross-sectional study among 120 patients with schizophrenia was performed between July 2019 and Mars 2020 at the Psychiatric Hospital of the Cross, Lebanon. The SASCCS was used to assess how patients with schizophrenia perceived their cognitive impairment.

Results
The internal consistency of the SASCCS scale was 0.911, and the intra-class correlation coefficient was 0.81 (p < 0.001), suggesting a good stability over time. The factor analysis of the SASCCS scale showed a 5-factor solution using the Varimax rotated matrix. The SASCCS total score positively correlated with their own factors. A negative correlation was found between the objective cognitive scale and subjective cognitive complaints, which were positively correlated with clinical symptoms and depression. No significant association was found between insight and subjective cognitive complaints.

Conclusion
The SASCCS scale showed appropriate psychometric properties, with high internal consistency, good construct validity, and adequate concurrent validity, which makes it valuable for the evaluation of subjective cognitive complaints in patients with schizophrenia.
An intersectional approach to exploring lived realities and harnessing the creativity of ethnic minority youth for health gains: protocol for a multiphase mixed method study
Authors: Ramalho Rodrigo , Sharma Vartika , Liang Renee , Simon-Kumar Rachel , Ameratunga Shanthi , Lee Arier , Kang Kristy , Peiris-John Roshini 
Published: June 2023

Abstract
Background
Understanding the diversity and multiplicity of identities experienced by youth in Aotearoa (Te reo Māori name of the country) New Zealand (NZ) is vital to promoting their wellbeing. Ethnic minority youth (EMY) in NZ (defined as those identifying with Asian, Middle Eastern, Latin American and African ethnic origins) have been historically under-studied and under-counted, despite reporting high levels of discrimination, a major determinant of mental health and wellbeing and potentially a proxy for other inequities. In this paper, we describe the protocol for a multi-year study that examines, using an intersectional approach, how multiple marginalised identities impact mental and emotional wellbeing of EMY.

Methods
This is a multiphase, multi-method study designed to capture the diversity of lived realities of EMY who self-identify with one or more additional marginalised intersecting identity (the population referred here as EMYi). Phase 1 (Descriptive study) will involve secondary analyses of national surveys to examine the prevalence and relationships between discrimination and wellbeing of EMYi. Phase 2 (Study on public discourse) will analyse data from media narratives, complemented by interviews with stakeholders to explore discourses around EMYi. Phase 3 (Study on lived experience) will examine lived experiences of EMYi to discuss challenges and sources of resilience, and how these are influenced by public discourse. Phase 4 (Co-design phase) will use a creative approach that is youth-centered and participatory, and will involve EMYi, creative mentors and health service, policy and community stakeholders as research partners and advisors. It will employ participatory generative creative methods to explore strengths-based solutions to discriminatory experiences.

Discussion
This study will explore the implications of public discourse, racism and multiple forms of marginalisation on the wellbeing of EMYi. It is expected to provide evidence on the impacts of marginalisation on their mental and emotional wellbeing and inform responsive health practice and policy. Using established research tools and innovative creative means, it will enable EMYi to propose their own strength-based solutions. Further, population-based empirical research on intersectionality and health is still nascent, and even more scarce in relation to youth. This study will present the possibility of expanding its applicability in public health research focused on under-served communities.
Preoperative predictors for return to physical activity following anterior cruciate ligament reconstruction (ACLR): a systematic review
Authors: Carter Hayley M. , Lewis Gwyn N. , Smith Benjamin E. 
Published: June 2023

Abstract
Background
Rates of return to physical activity after anterior cruciate ligament reconstruction surgery are sub-optimal. Optimising presurgical treatment may improve return rates. The purpose of this systematic review was to identify modifiable preoperative predictors for return to physical activity after anterior cruciate ligament reconstruction.

Methods
Seven electronic databases (CINAHL, MEDLINE and SPORTDiscus via EBSCOhost, AMED, PsycINFO and EMBASE via OVID and Web of Science) were searched from inception to 31 March 2023. The population of focus was adults aged 18–65 who had undergone primary anterior cruciate ligament reconstruction. Studies needed to identify at least one potential modifiable preoperative predictor variable and the relationship between the predictor(s) and return to physical activity. All time-points of assessment and study designs were included. Data extraction was completed by one reviewer and verified by a second reviewer. Two reviewers completed the risk of bias assessment using the Quality in Prognostic Studies tool and Grading of Recommendations Assessment, Development and Evaluation system.

Results
The search identified 2281 studies, eight met the inclusion criteria. Five studies scored ‘high’, and three studies scored ‘moderate’ risk-of-bias. All preoperative predictors were of very low-quality evidence. Five different outcome measures were used to assess return to physical activity including Tegner, Marx, Physical Activity Scale, return to play at the elite level and return to preinjury level (undefined). This was measured between 1- and 10-years post-surgery. Nine preoperative physical, six psychosocial and five demographic/clinical factors were assessed and four were found to be predictive. These included quadriceps strength, psychological profile, patient estimated ability to return and graft type (patella tendon, BPTB).

Conclusion
Very-low level evidence suggests that increasing quadriceps strength, managing patient expectations of their treatment outcomes, improving motivation to resume preinjury activity levels and considering the use of a BPTB graft will support return to physical activity after ACLR.

Trial registration
This study was prospectively registered in PROSPERO: CRD 42020222567.