bluuebunny/crossref_metadata_2025_split huggingface dataset:
Fewer native and periprosthetic femoral fracture patients receive an orthogeriatric review and expedited surgery compared to hip fracture patients
Authors: Farhan-Alanie Muhamed M , Jonas Sam C , Gallacher Daniel , Whitehouse Michael R , Chesser Tim JS 
Published: September 2023

Introduction: Disproportionate emphasis has been attributed to hip fracture over other femoral fractures through implementation of Best Practice Tariff (BPT). This retrospective comparative observational cohort study aimed to evaluate the epidemiology of native and periprosthetic femoral fractures and establish any disparities in their management relative to hip fractures. Methods: All patients ⩾60 years admitted with a native or periprosthetic femoral fracture during July 2016–June 2018 were identified using our hospital database. Results were compared to National Hip Fracture Database data over the same period. Results: 58 native femoral, 87 periprosthetic and 1032 hip fractures were identified. (46/58) 79% and 76/87 (89%) of native and periprosthetic femoral fractures were managed operatively. Surgery was performed <36 hours for 34/46 (74%) of native femoral and 33/76 (43%) of periprosthetic fractures compared to 826/1032 (80%) for hips. Median time to surgery was longer in periprosthetic femoral than hip fracture patients (44.7 vs. 21.6 hours; p  < 0.0001). Orthogeriatrician review occurred in 24/58 (41%) and 48/87 (55%) of native and periprosthetic fractures compared to 1017/1032 (99%) for hips ( p  < 0.0001). One year mortality was 35%, 20% and 26% for native femoral, periprosthetic and hip fracture patients. Cox proportional hazard ratio was higher for native femoral than hip fracture patients (1.75; 95% CI, 1.12–2.73). Conclusions: This study demonstrates large disparities in management of other femoral and periprosthetic fractures compared to hip fractures, specifically time to surgery and orthogeriatrician review. This may have resulted in the comparatively higher mortality rate of native femoral fracture patients. Expansion of the BPT to include the whole femur is likely to improve outcomes.
Association of affected and non-affected side ability with postoperative outcomes in patients undergoing total hip arthroplasty
Authors: Nozaki Kohei , Nanri Yuta , Kawabata Masashi , Shibuya Manaka , Nihei Manami , Shirota Takehiro , Masuma Hiroyoshi , Maeda Takuya , Fukushima Kensuke , Uchiyama Katsufumi , Takahira Naonobu , Takaso Masashi 
Published: September 2023

Background: Although several reports have examined the association between preoperative function and postoperative outcomes in patients undergoing total hip arthroplasty (THA), it is unclear whether the ability of the affected or non-affected side particularly impacts on outcomes. We aimed to investigate the association between affected and non-affected side ability and walking independence. Methods: We prospectively enrolled 721 consecutive patients who underwent THA. Preoperatively, quadriceps isometric strength (QIS) and one-leg standing time (OLST) were measured. The endpoints were walking independence within 3, 5, 7, 10, and 14 days postoperatively. The associations between preoperative abilities and outcomes were examined using multivariate Cox hazard model, and the area under the curves (AUCs) for outcomes were compared. Results: We analysed 540 patients after excluding patients who met the exclusion criteria. Both affected and non-affected QIS predicted walking independence within 3 ( p  = 0.006 and 0.001, respectively), 5, 7, 10, and 14 (both p  < 0.001) days postoperatively. For OLST, only the affected side did not predict walking independence within 3 days postoperatively ( p  = 0.154 and 0.012, respectively), and both sides did at days 5 ( p  = 0.019 and <0.001, respectively), 7, 10, and 14 (both p  < 0.001). The AUCs of the non-affected side ability for walking independence were significantly greater than those of the affected side on postoperative days 3 (0.66 vs. 0.73; p  = 0.021) and 5 (0.67 vs. 0.71; p  = 0.040), with no significant difference after day 7. Conclusions: Both sides abilities were associated with walking independence after THA, but non-affected side was found to be particularly crucial for early walking independence.
A Laboratory Study of the Effect of pH on Solubility of Bulk-Fill and Conventional Composites
Authors: Farahat Farnaz , Jafari Abbas Ali , Ardakani Tayebe Sadat Baghaee , Shojasadati Shima Sadat 
Published: September 2023

Aim: Factors such as the low pH of acidic foods and beverages can affect long-term clinical success of restorative materials in the oral cavity. The aim of this study was to compare the solubility of Bulk-fill and Conventional Nano-Hybrid Resin Based Composites (RBCs) in different solutions. Material and Methods: A total of 60 cylindrical specimens were prepared from two RBCs (Tetric N-Ceram, Tetric N-Ceram Bulk-fill) and their constant weight was measured. The specimens were divided into six groups ( N = 10) in accordance with RBC type and pH solution (solution 1, 2, 3 with pH = 2.5, 5, 7, respectively), and were immersed in desired solutions for 30 days. Then they were weighed again and solubility levels of the specimens were calculated according to ISO 4049. Data were analysed by two-way ANOVA. The test power was considered at 80%. Results: The type of RBC had no significant effect on solubility; while the effect of PH was significant. Solution 1 caused significantly the highest solubility. No statistically significant differences were found among other groups. Conclusions: Considering the limitations of the laboratory investigations, it was concluded that solubility rate of Bulk-fill and Conventional RBCs was higher in solutions with lower pH. There was no difference among the RBCs. However, the solubility rates of all groups are within the clinically normal range.
Article Commentary: Another challenge worth acknowledging
Authors: Avery Derek R. 
Published: September 2023

I commend Evelyn R. Carter, Ivuoma N. Onyeador, and Neil A. Lewis, Jr., on their thorough, compelling, and thought-provoking article, “Developing & Delivering Effective Anti-Bias Training: Challenges & Recommendations,” which reviewed the challenges that organizations face in using diversity training to develop employee competence at interacting with people who differ from them.1 Although I recognize each of the challenges they present and respect the solutions they offer, I want to address an additional important challenge to developing a workforce that embraces diversity—namely, that organizations are dependent on the labor market to provide prospective employees who possess the knowledge, skills, abilities, and other competencies needed to fulfill job responsibilities, yet too much of the labor force seems to start off with little inclination or skill for interacting constructively with diverse groups. Roughly 20 years have passed since Nancy E. Day and Betty J. Glick published the results of a national assessment detailing the level of employer satisfaction with the diversity-related competency of typical college graduates in the United States.2 They concluded that “HR managers who responded believe that college graduates do not possess the critical skills that are needed to handle diversity” and that “a minority of the organizations surveyed attempt to fill the diversity KSA [knowledge, skills, and abilities] gaps through corporate training.”2 A good deal of anecdotal evidence suggests that these conditions persist today; hence, one could argue that organizations are being forced to do the best they can with the little they have been given.
Results of VOICE: a global survey of disease-specific knowledge and perspectives of real-world patients with CLL
Authors: Tam Constantine , Pinilla-Ibarz Javier , Castillo Carolina G. , Fenili Ana Cristina , Huntley Kathryn , Karakus Volkan , Mattar Mervat , Miroli Miguel A. , Moura Catherine , Pavlovsky Miguel , Piotrowski Fernando , Šimkovič Martin , Stilgenbauer Stephan 
Published: September 2023

Abstract
The Virtual Opinions poll Independent Centered on CLL patients’ Experience (VOICE) evaluated patients’ knowledge about chronic lymphocytic leukemia (CLL), their perspectives on diagnosis and treatment, and their unmet needs. Clinicians and patient advocacy group representatives developed and distributed the survey from March through December 2022 in 12 countries, and 377 patients with ≥1 line of previous CLL treatment responded from Europe, Latin America, the United States, Australia, Egypt, and Turkey. A majority of them (90%; 336/374) relied on their physicians for information regarding CLL and treatment. If at high risk, respondents prefer oral medications to intravenous (78%; 232/296), fixed duration treatment over treatment until progression (69%; 185/270), outpatient over inpatient treatments (91%; 257/283). Over three-fourths of respondents (78%; 286/368) wanted to be involved in treatment decisions, but a minority actually participated (44%; 138/313). COVID-19 vaccinations were widely available (97%; 273/281), but one-fifth (19%; 63/331) were unaware that CLL increases vulnerability to infections. Most patients’ physicians explained their treatment options (84%; 297/355), and 90% (271/301) understood their treatment. Notably, &gt;10% would continue treatment normally if they experienced cardiac problems or arrhythmias, whereas 23% would consider stopping treatment if they developed skin cancer. Treatment–associated side effects affected 27% to 43% of patients. These results in a global patient population highlight gaps in patients’ knowledge of risk groups, their susceptibility to infections including COVID, and the side effects of common treatments. Such knowledge can guide the appropriate targeting of patient education initiatives by clinicians, advocates, and policymakers.
DeepCAC: a deep learning approach on DNA transcription factors classification based on multi-head self-attention and concatenate convolutional neural network
Authors: Zhang Jidong , Liu Bo , Wu Jiahui , Wang Zhihan , Li Jianqiang 
Published: September 2023

AbstractUnderstanding gene expression processes necessitates the accurate classification and identification of transcription factors, which is supported by high-throughput sequencing technologies. However, these techniques suffer from inherent limitations such as time consumption and high costs. To address these challenges, the field of bioinformatics has increasingly turned to deep learning technologies for analyzing gene sequences. Nevertheless, the pursuit of improved experimental results has led to the inclusion of numerous complex analysis function modules, resulting in models with a growing number of parameters. To overcome these limitations, it is proposed a novel approach for analyzing DNA transcription factor sequences, which is named as DeepCAC. This method leverages deep convolutional neural networks with a multi-head self-attention mechanism. By employing convolutional neural networks, it can effectively capture local hidden features in the sequences. Simultaneously, the multi-head self-attention mechanism enhances the identification of hidden features with long-distant dependencies. This approach reduces the overall number of parameters in the model while harnessing the computational power of sequence data from multi-head self-attention. Through training with labeled data, experiments demonstrate that this approach significantly improves performance while requiring fewer parameters compared to existing methods. Additionally, the effectiveness of our approach is validated in accurately predicting DNA transcription factor sequences.
Functional and clinical outcomes of delusional disorder and schizophrenia patients after first episode psychosis: a 4-year follow-up study
Authors: Hui Christy Lai Ming , Chan Evie Wai Ting , Hui Priscilla Wing Man , Tao Tiffany Junchen , Ho Elise Chun Ning , Lam Bertha Sze Ting , Wah See Sally Hiu , Suen Yi Nam , Chang Wing Chung , Wa Sherry Kit , Lee Edwin Ho Ming , Chen Eric Yu Hai 
Published: September 2023

AbstractBackgroundLiterature has typically associated delusional disorder with a poorer prognosis relative to schizophrenia, without considering the confounding effect of age despite the differential age of onset. This study therefore aims to investigate the diagnostic stability, clinical, functional, and neurocognitive differences of Chinese first-episode psychosis age-matched patients with delusional disorder and schizophrenia at four years.Methods71 delusional disorder and 71 age-matched schizophrenia patients were followed up for four years after their initial episode. Their symptoms, insight in psychosis, side effects of medication, medication compliance, functioning, and neurocognitive performance were assessed at four years.ResultsAt four years, 65% of DD patients maintained the same diagnosis, while the rest shifted to SZ. Only those without a diagnostic shift were included in the analysis. Delusional disorder patients (n = 46) experienced greater general psychopathology and poorer insight, but better attitude towards medication than schizophrenia patients (n = 71). Social and occupational functioning, quality of life, and cognitive functioning, however, were similar in delusional disorder and schizophrenia patients.ConclusionsResults indicate that delusional disorder is less diagnostically stable than schizophrenia. Their outcomes in a Chinese population were largely similar at four years after removing the confounding age factor, implying that delusional disorder and schizophrenia may not be as distinct as previously thought.
Tai Chi for the prophylaxis of episodic migraine: protocol of a non-inferiority randomized controlled trial with mechanism exploration
Authors: Xie Yao Jie , Liao Xiaoli , Hui Stanley Sai-chuen , Tian Longben , Yeung Wing Fai , Lau Alexander Yuk-lun , Tyrovolas Stefanos , Gao Yang , Chen Xiangyan 
Published: September 2023

Abstract
Background
Migraine is a complex neurovascular disorder with considerable clinical, social and economic issues. Tai chi has the potential to be an alternative prophylactic treatment for migraine with high safety since the adverse effects and limited efficacy of available medications.

Aims
The proposed study aims to compare the prophylaxis efficacy of 24-week Tai Chi training on migraine attacks with the standard prophylactic medication; and to explore the mechanism of Tai Chi in preventing migraine attacks by analyzing the associations between changes of migraine attacks and changes of neurovascular functions and inflammatory makers.

Method
This is a two-arm parallel non-inferiority randomized controlled trial. In total 220 Hong Kong Chinese women aged 18–65 years with diagnosis of episodic migraine will be recruited and randomized to either the Tai Chi training group or the standard prophylactic medication group with 1:1 ratio, and receive the 24 weeks of modified 33-short form Yang-style Tai Chi training and the standard prophylactic medications, respectively. A 24-week follow-up will be implemented for both groups. For efficacy examination, the primary outcome was the frequency of migraine attacks measured by the migraine diary; and for the mechanism exploration, the primary outcome was the volume and number of white matter hyperintensity (WMH) measured by magnetic resonance imaging (MRI). The measurements will be conducted at the baseline, 24th weeks, and 48th weeks. Linear mixed model will be adopted to comprehensively analyze the changes of variables within and between groups.

Discussion
Given the importance of reducing disease burden and financial cost of migraine attacks, the findings of this study will provide new insights regarding the role of Tai Chi in alleviating migraine burden and further shed light on the mechanism action of Tai Chi on preventing headache attacks.

Trial registration
ClinicalTrials.gov NCT05690737. Registered on January 28, 2023.
Exploring the relationship between burnout and emotional intelligence among academics and clinicians at King Saud University
Authors: Almeneessier Aljohara S. , Azer Samy A. 
Published: September 2023

Abstract
Background
Academics and clinicians are exposed to significant workload pressures and are at a high risk of stress and burnout.

Objectives
This study aimed to examine the relationship between burnout and emotional intelligence (EI) by comparing and corelating burnout and EI scores among academics and clinicians against several factors.

Methods
In this cross-sectional study, academics and clinicians at King Saud University and King Saud University Medical City and Affiliated Hospitals were invited to complete anonymous questionnaires: Maslach Burnout Inventory-Human Services Survey and the Trait Emotional Intelligence Questionnaire Short Form. The collected data were analyzed using the SPSS software for descriptive studies, group comparisons, regression analyses, and Pearson's (r) correlation tests.

Results
Study participants included 126 individuals (men = 65, 51.6%; women = 61, 48.4%). Of these, 65% were Saudi nationals and 35% were expatriates, and 76 were academics while 50 were clinicians. The mean (minimum to maximum) burnout total score was 55 ± 18.9 (8 to 97) and the global TEIQue-SF score ranged between 2.8 and 6.7 (5.04 ± 0.7). Burnout scores varied between departments and were higher among younger participants and non-Saudis. Age had a small direct correlation with self-control (r = .17, p = .05), and there was no statistically significant correlation with other EI factors. However, there was a moderate inverse correlation between age and emotional exhaustion (EE) (r = -0.33, p < 0.0001), and a small inverse correlation with depersonalization (DP) (r = -0.21, p = 0.02). T-tests demonstrated a statistically significant difference in EI factor "emotionality" among Saudis (5.2 ± .8) and non-Saudis (4.9 ± .8) (t124 = 2.2, p = 0.03), and for burnout subscales, there was a statistically significant difference in DP among Saudis (6.4 ± 4.8) and non-Saudis (8.5 ± 5.6), (p = 0.03). Moderate (r = -0.3, p = 0.01) and weak (r = -0.2, p = 0.05) negative correlations were found between EI factors and burnout subscales (EE, DP).

Conclusion
This study confirmed an inverse relationship between burnout and EI scores among academics and clinicians. The findings suggest the need for introducing measures and implementing a system for early detection of burnout among staff and providing support to enhance EI and requisite care for those undergoing burnout episodes.
The role of health insurance literacy in the process and outcomes of choosing a health insurance policy in the Netherlands
Authors: Holst Laurens , Brabers Adriana Elisabeth Maria , Rademakers Jeannette Josepha Dingena Johanna M , de Jong Judith Danielle 
Published: September 2023

AbstractIn several countries, citizens are expected to be critical consumers when choosing a health insurance policy. However, there are indications that citizens do not always have the sufficient skills, so called health insurance literacy (HIL), to do this. We investigated whether the level of HIL among Dutch citizens is related to the way in which they experience the process of choosing a policy, and furthermore whether it is related to their health insurance choices. We obtained information by sending questionnaires to members of the Nivel Dutch Health Care Consumer Panel in 2020. Of the 1,500 approached, 806 panel members participated (response rate 54%). Our results indicate that, compared to those with a high HIL, respondents with a low HIL more often find choosing a health insurance policy difficult, not interesting, and boring, and less often consider it important and worthwhile. Furthermore, they make less use of the opportunity to switch from one health insurer to another. However, they do still opt for a supplementary insurance policy and a voluntary deductible to the same extent as citizens with a high HIL. We conclude that the HIL level among Dutch citizens is related to the way in which they experience the process of choosing a health insurance policy and to the extent to which they switch from one insurer to another. But it is not related to their health insurance choices. Follow-up research should focus on how citizens with a low HIL can be better supported when choosing a health insurance policy.
Reconstruction with a double-constrained implant design after complex shoulder extra-articular resection
Authors: Lesensky Jan , Belzarena Ana C. , Daniel Matej 
Published: September 2023

Abstract
Background
Approximately, one-third of patients with tumors of proximal humerus will require an extra-articular resection to achieve oncologic margins. This procedure yields poor functional outcomes with a considerable rate of revisions. Unconstrained implants are prone to instability hindering also function of the elbow and hand, whereas constrained shoulder reconstructions suffer from early aseptic loosening of the glenoid component due to bone overload. The purpose of this study was to develop a constrained implant suitable for extra-articular resection with loss of function in deltoid and rotator cuff, which would provide both stability and passive motion, whilst also decreasing the risk of aseptic loosening of the glenoid component.

Methods
In cooperation with Czech Technical University in Prague, we devised an implant consisting of two constrained joints in series connected by a dumbbell piece. The biomechanical analysis showed a reduction of load transfer to the glenoid component with a torque of 8.6 Nm capable of generating an 865-N pulling force on bone screw to just 0.07 Nm, hence shielding the glenoid component from undesired forces and decreasing the risk of aseptic loosening. Three patients with extra-articular resection with a total loss of function of both rotator cuff and deltoid muscle received this type of reconstruction. The average follow-up was 16 months.

Results
The surgical technique is straightforward. The surgery took 175 min on average with average blood loss of 516 ml. There were no surgical- or implant-related complications. All three patients were pain-free and had a stable shoulder joint after the reconstruction. All had fully functional elbow, wrist, and hand joints. The average Musculoskeletal Tumor Society (MSTS) score was 21/30 (70%). All patients were pleased with the results.

Conclusion
The presented innovative implant design has demonstrated to be a promising alternative for reconstruction in these challenging cases.