bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluating the Association Between Fibrinogen and Rotational Thromboelastometry and the Progression to Severe Obstetric Hemorrhage
Authors: Yurashevich Mary , Rosser Morgan , Small Maria , Grotegut Chad , Kota Nancy , Toffaletti John , Allen Terrence 
Published: May 2023

Aim This study aims to investigate the ability of fibrinogen and rotational thromboelastometry (ROTEM) parameters measured at obstetric hemorrhage protocol initiation to predict severe hemorrhage. Methods In this retrospective study we included patients whose hemorrhage was managed with an obstetric massive transfusion protocol. Fibrinogen and ROTEM parameters EXTEM clotting time (CT), clot formation time (CFT), alpha angle, A10, A20, lysis index 30 min after CT (LI30), FIBTEM A10, A20, were measured at initiation of the protocol with transfusion based on a predefined algorithm. Patients were grouped into either severe or nonsevere hemorrhage based on: peripartum fall in hemoglobin ≥4 g/dL, transfusion of ≥4 units of blood product, invasive procedures for hemorrhage control, intensive care unit admission, or death. Results Of the 155 patients included, 108 (70%) progressed to severe hemorrhage. Fibrinogen, EXTEM alpha angle, A10, A20, FIBTEM A10, A20 were significantly lower in the severe hemorrhage group while the CFT was significantly prolonged in the severe hemorrhage group. In univariate analysis, predicted progression to severe hemorrhage yielded areas under the receiver operating characteristic curve (95% confidence interval [CI]) of: fibrinogen: 0.683 (0.591-0.776), CFT: 0.671 (0.553, 0.789), EXTEM alpha angle: 0.690 (0.577-0.803), A10: 0.693 (0.570-0.815), A20: 0.678 (0.563-0.793), FIBTEM A10: 0.726 (0.605-0.847), and A20: 0.709 (0.594-0.824). In a multivariable model, fibrinogen was independently associated with severe hemorrhage (odds ratio [95% CI] = 1.037 [1.009-1.066]) for every 50 mg/dL decrease in fibrinogen drawn at obstetric hemorrhage massive transfusion protocol initiation. Conclusion Both fibrinogen and ROTEM parameters measured at the initiation of an obstetric hemorrhage protocol are useful parameters for predicting severe hemorrhage.
Acceptability of an existing online sexually transmitted and blood-borne infection testing model among gay, bisexual and other men who have sex with men in Ontario, Canada
Authors: Dulai Joshun JS , Gilbert Mark , Lachowsky Nathan J , Card Kiffer G , Klassen Ben , Dame Jessy , Burchell Ann N , Worthington Catherine , Ablona Aidan , Anand Praney , Blaque Ezra , Ryu Heeho , Stewart MacKenzie , Brennan David J , Grace Daniel 
Published: May 2023

Objectives Gay, bisexual and other men who have sex with men (GBM) are disproportionately affected by sexually transmitted and blood-borne infections (STBBI) due to stigma and other factors such as structural barriers, which delay STBBI testing in this population. Understanding acceptability of online testing is useful in expanding access in this population, thus we examined barriers to clinic-based testing, acceptability of a potential online testing model, and factors associated with acceptability among GBM living in Ontario. Methods Sex Now 2019 was a community-based, online, bilingual survey of GBM aged ≥15. Prevalence ratios (PR) and 95% confidence intervals (95%CI) were calculated using modified Poisson regression with robust variances. Multivariable modelling was conducted using the Hosmer-Lemeshow-Sturdivant approach. Results Among 1369 participants, many delayed STBBI testing due to being too busy (31%) or inconvenient clinic hours (29%). Acceptability for online testing was high (80%), with saving time (67%) as the most common benefit, and privacy concerns the most common drawback (38%). Statistically significant predictors of acceptability for online testing were younger age (PR  =  0.993; 95%CI: 0.991–0.996); a greater number of different sexual behaviours associated with STBBI transmission (PR  =  1.031; 95%CI: 1.018–1.044); identifying as an Indigenous immigrant (PR  =  1.427; 95%CI: 1.276–1.596) or immigrant of colour (PR  = 1.158; 95%CI: 1.086–1.235) compared with white non-immigrants; and currently using HIV pre-exposure prophylaxis (PrEP) compared to not currently using PrEP (PR  =  0.894; 95%CI: 0.828–0.965). Conclusions Acceptability of online testing was high among GBM in Ontario. Implementing online STBBI testing may expand access for certain subpopulations of GBM facing barriers to current in-person testing.
Assessment of 30 Years of Randomized Controlled Trials in The American Journal of Sports Medicine: 1990-2020
Authors: Shah Ajay , Hoit Graeme , Lan Lucy , Whelan Daniel B. 
Published: May 2023

Background: Randomized controlled trials (RCTs) stand atop the evidence-based hierarchy of study designs for their ability to arrive at results with the lowest risk of bias. Even for RCTs, however, critical appraisal is essential before applying results to clinical practice. Purpose: To analyze the quality of reporting of RCTs published in The American Journal of Sports Medicine ( AJSM) from 1990 to 2020 and to identify trends over time and areas of improvement for future trials. Study Design: Systematic review; Level of evidence, 1. Methods: We queried the AJSM database for RCTs published between January 1990 and December 2020. Data pertaining to study characteristics were recorded. Quality assessments were conducted using the Detsky quality-of-reporting index and the modified Cochrane risk-of-bias (mROB) tool. Univariate and multivariable models were generated to establish factors with associations to study quality. The Fragility Index was calculated for eligible studies. Results: A total of 277 RCTs were identified with a median sample size of 70 patients. A total of 19 RCTs were published between 1990 and 2000 (t1); 82 RCTs between 2001 and 2010 (t2); and 176 RCTs between 2011 and 2020 (t3). From t1 to t3, significant increases were observed in the overall mean-transformed Detsky score (from 68.2% ± 9.8% to 87.4% ± 10.2%, respectively; P < .001) and mROB score (from 4.7 ± 1.6 to 6.9 ± 1.6, respectively; P < .001). Multivariable regression analysis revealed that trials with follow-up periods of <5 years clearly stated primary outcomes, and a focus on the elbow, shoulder, or knee were associated with higher mean-transformed Detsky and mROB scores. The median Fragility Index was 2 (interquartile range, 0-5) for trials with statistically significant. Studies with small sample sizes (<100 patients) were more likely to have low Fragility Index scores and less likely to have a statistically significant finding in any outcome. Conclusion: The quantity and quality of published RCTs published in AJSM increased over the past 3 decades. However, single-center trials with small sample sizes were prone to fragile results.
COVID-19 Incidence and Disease Course Among Patients at an Allergy Department
Authors: van der Aa Louise E. , van Egmond Inge S. , van der Sluijs Martijn , den Otter A.A. Sophie , Bosmans Nadie H.M. , van Beek Sabine E. , Hartman Angela , Guchelaar Niels A.D. , van Daele Paul L.A. , van Maaren Maurits S. , van Hagen P. Martin , Hermans Maud A.W. , Rombach Saskia M. 
Published: May 2023

Background Since the coronavirus pandemic in 2020, there is not much reported about the disease course of COVID-19 in patients with allergic diseases. Objectives The aim of this study was to investigate the cumulative incidence and severity of COVID-19 among patients from the allergy department compared with the general Dutch population and people from their household. Design We conducted a comparative longitudinal cohort study. Methods In this study patients of the allergy department were included with their household members as a control group. Data from the beginning of the pandemic were systematically obtained through questionnaires by telephonic interviews and retrieved from electronic patient files between October 15, 2020 and January 29, 2021. Main outcomes were confirmed SARS-CoV-2 infection, disease duration, hospitalization, intensive care admission, and mortality. Questions regarding applied social distancing measures were inventoried as well. Results Three hundred and eighty nine patients (median age 39.1 (18.7-84.7) years, 69.9% female) and 441 household members (median age 42.0 (18.0-91.5), 44.1% female) were included. The cumulative COVID-19 incidence in patients was higher compared with the general population (10.5% vs 5.6%, P < .001). In total, 41 (10.5%) patients attending the allergy clinic compared to 38 (8.6%) household members were infected with SARS-CoV-2 ( P = .407). Median disease duration was 11.0 (0.0-61.0) days in patients compared to 10.5(1.0-232.0) days in household members ( P = .996). Conclusion The cumulative COVID-19 incidence in patients from the allergy cohort was higher compared with the general Dutch population, but similar compared with household members. There was no difference in symptoms, disease duration, or hospitalization rate between the allergy cohort and their household members.
Application of magnetic resonance image compilation (MAGiC) in the diagnosis of middle-aged and elderly women with osteoporosis
Authors: Chen Yiming , Mei Xiuting , Liang Xuqian , Cao Yi , Peng Cong , Fu Yang , Zhang Yulong , Liu Cuifang , Liu Yang 
Published: May 2023

Abstract
Objective
To investigate the feasibility of diagnosing osteoporosis (OP) in women through magnetic resonance image compilation (MAGiC).

Methods
A total of 110 patients who underwent lumbar magnetic resonance imaging and dual X-ray absorptiometry examinations were collected and divided into two groups according bone mineral density: osteoporotic group (OP) and non-osteoporotic group (non-OP). The variation trends of T1 (longitudinal relaxation time), T2 (transverse relaxation time) and BMD (bone mineral density) with the increase of age, and the correlation of T1 and T2 with BMD were examined by establishing a clinical mathematical model.

Results
With the increase of age, BMD and T1 value decreased gradually, while T2 value increased. T1 and T2 had statistical significance in diagnosing OP (P < 0.001), and there is moderate positive correlation between T1 and BMD values (R = 0.636, P < 0.001), while moderate negative correlation between T2 and BMD values (R=-0.694, P < 0.001). Receiver characteristic curve test showed that T1 and T2 had high accuracy in diagnosing OP (T1 AUC = 0.982, T2 AUC = 0.978), and the critical values of T1 and T2 for evaluating osteoporosis were 0.625s and 0.095s, respectively. Besides, the combined utilization of T1 and T2 had higher diagnostic efficiency (AUC = 0.985). Combined T1 and T2 had higher diagnostic efficiency (AUC = 0.985). Function fitting results of OP group: BMD=-0.0037* age − 0.0015*T1 + 0.0037*T2 + 0.86, sum of squared error (SSE) = 0.0392, and non-OP group: BMD = 0.0024* age − 0.0071*T1 + 0.0007*T2 + 1.41, SSE = 0.1007.

Conclusion
T1 and T2 value of MAGiC have high efficiency in diagnosing OP by establishing a function fitting formula of BMD with T1, T2 and age.
The impact of the COVID-19 pandemic restrictions on the health care utilization of cancer patients
Authors: Schneider Nico , Strauss Bernhard , Hübner Jutta , Keinki Christian , Brandt Florian , Rubai Sabine , Altmann Uwe 
Published: May 2023

Abstract
Background
COVID-19 has impacted both society and medical care. While Germany entered the first lockdown in spring 2020, the PIKKO study (Patient information, communication and competence empowerment in oncology) was still active. The intervention modules, patient navigator (PN), services of the Saarland Cancer Society (SCS), psycho-social counseling and different courses, and online knowledge database (ODB) continued to be offered, but in an adapted form. It was the aim of this supplementary survey to identify the restrictions and burdens of the pandemic containment strategies on the PIKKO patients and thus on the PIKKO study itself. Furthermore, this work shows how the PIKKO modules were used during the lockdown.

Methods
All patients in the PIKKO intervention group (IG) were invited to complete a questionnaire, n = 503. Furthermore, utilization of the SCS and log files of the ODB were analyzed. For socio-demographic data and contacts with the PN, data from the regular PIKKO surveys were used. In addition to descriptive statistics, chi²-tests, F-tests and linear regression analyses were performed.

Results
356 patients participated in this supplemental survey. 37.6% reported restrictions. “Restrictions on accompanying persons”, “ban on visits to the wards” and “protective mouth-nose-mask” were reported as the greatest burdens. 39.0% expressed fears that the restrictions would have an impact on the course of their disease. Linear regression analyses showed differences in feelings of burden among age groups (more among < 60-year-olds), gender (more among women), children in the household (more with children), and preexisting financial stress (more with financial worries). In April 2020, there was more patient contact with PNs by phone, more SCS psycho-social counseling by phone, adapted SCS course offering, but with significantly fewer participants, and high activity on the ODB.

Conclusion
Cancer patients in the IG reported restrictions from the pandemic containment strategies and feared an impact on their recovery. However, whether a burden is perceived as heavy depends more on gender, age, or pre-existing burdens than on whether the lockdown affects PIKKO or not. The utilization of counseling, courses or the ODB despite lockdown shows the need for such services, especially in times of crisis.

Trial registration
This study was retrospectively registered in the German Clinical Trial Register under DRKS00016703 (21 Feb 2019, retrospectively registered). https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00016703.
Effects of a Massive Open Online Course on osteoarthritis knowledge and pain self-efficacy in people with hip and/or knee osteoarthritis: protocol for the MOOC-OA randomised controlled trial
Authors: Nelligan Rachel K. , Hinman Rana S. , Egerton Thorlene , Gregory Maya , Bidgood Neil , McManus Ms Fiona , De Silva Anurika P. , Lamb Karen E. , Bennell Kim L. 
Published: May 2023

Abstract
Background
Osteoarthritis (OA) is a prevalent, chronic joint condition that commonly affects the knee and hip causing pain, impaired function, and reduced quality of life. As there is no cure, the main goal of treatment is to alleviate symptoms via ongoing self-management predominantly consisting of exercise and weight loss (if indicated). However, many people with OA do not feel adequately informed about their condition and management options to self-manage effectively. Patient education is recommended by all OA Clinical Practice Guidelines to support appropriate self-management, but little is known about the optimal delivery method and content. Massive Open Online Courses (MOOCs) are free, interactive, e-learning courses. They have been used to deliver patient education in other chronic health conditions but have not been used in OA.

Methods
A two-arm parallel-design, assessor- and participant-blinded superiority randomised controlled trial. People with persistent knee/hip pain consistent with a clinical diagnosis of knee/hip OA (n = 120) are being recruited from the Australia-wide community. Participants are randomly allocated into one of two groups i) electronic information pamphlet (control group) or ii) MOOC (experimental group). Those allocated to the control group receive access to an electronic pamphlet about OA and its recommended management, currently available from a reputable consumer organisation. Those allocated to the MOOC receive access to a 4-week 4-module interactive consumer-facing e-Learning course about OA and its recommended management. Course design was informed by behaviour theory and learning science, and consumer preferences. The two primary outcomes are OA knowledge and pain self-efficacy with a primary endpoint of 5 weeks and a secondary endpoint of 13 weeks. Secondary outcomes include measures of fear of movement, exercise self-efficacy, illness perceptions, OA management and health professional care seeking intentions, physical activity levels, and actual use of physical activity/exercise and weight loss, pain medication, and health professional care seeking to manage joint symptoms. Clinical outcomes and process measures are also collected.

Discussion
Findings will determine whether a comprehensive consumer-facing MOOC improves OA knowledge and confidence to self-manage joint pain compared to a currently available electronic OA information pamphlet.

Trial registration
Prospectively registered (Australian New Zealand Clinical Trials Registry ID: ACTRN12622001490763).
Inflammatory blood parameters as prognostic factors for implant-associated infection after primary total hip or knee arthroplasty: a systematic review
Authors: Domecky Petr , Rejman Patkova Anna , Mala-Ladova Katerina , Maly Josef 
Published: May 2023

AbstractBackgroundImplant-associated infection (IAI) is a potential complication following total hip (THA) or knee arthroplasty (TKA). The initial phase of the inflammatory process can be measured by applying one of the inflammatory blood parameters (IBP). This systematic review aims to assess the response of IBP to trauma caused by orthopedic surgery and evaluate the clinical utility of quantitative measurements of IBP as prognostic factors for infection.MethodsAll studies indexed in Ovid MEDLINE (PubMed), Ovid EMBASE, the Cochrane Library and the ISI Web of Science databases, from inception until January 31, 2020, were analyzed. Studies included were those on adults who underwent THA or TKA with minimum follow up of 30 days after surgery. In addition to minimum follow up, data on the prognostic factors for pre- or post-THA/TKA IAI were mandatory. The Quality Assessment of Diagnostic Accuracy tool (version 2) (QUADAS-2) and Standards for Reporting of Diagnostic Accuracy Studies guideline 2015 (STARD) were used for quality assessment.ResultsTwelve studies fulfilled the inclusion and exclusion criteria. C-reactive protein was analyzed in seven studies, interleukin-6 in two studies and erythrocyte sedimentation rate in eight studies. White blood cell count and procalcitonin were analyzed in the only study. The overall quality of included studies was low. A potential for other cytokines (IL-1ra, IL-8) or MCP-1 was observed.ConclusionsThis is the first systematic review of IBP response to orthopedic surgery which identified some IBP for pre/post-operative screening, despite insufficient data supporting their prognostic potential for patient risk stratification.
Evaluation of root and canal morphology of mandibular premolar amongst Saudi subpopulation using the new system of classification: a CBCT study
Authors: Karobari Mohmed Isaqali , Iqbal Azhar , Syed Jamaluddin , Batul Rumesa , Adil Abdul Habeeb , Khawaji Sara Akili , Howait Mohammed , Khattak Osama , Noorani Tahir Yusuf 
Published: May 2023

AbstractBackgroundThe clinician should have complete knowledge of the normal anatomy of the root as well as complexities in the root canal configuration for a better outcome, as missed or improper handling of the canal system can lead to the failure of an entire endodontic procedure. The present study aims to assess the morphology of roots and canals in permanent mandibular premolars in the Saudi subpopulation with a new classification system.MethodsThe present study includes 1230 mandibular premolars (645 first premolars and 585-second premolars) from 500 CBCT images of the patients, including retrospective data. iCAT scanner system (Imaging Sciences International, Hatfield, PA, USA) was used to obtain the images; scanning of 8 × 8 cm images was performed at 120 KVp and 5–7 mA with a voxel size of 0.2 mm. The new method of classification presented by Ahmed et al. 2017 was used to record and classify the root canal morphology, followed by recording the differences regarding the age and gender of the patients. Comparison of canal morphology in lower permanent premolars and its association with gender and age of the patients was done by Chi-square test/ Fisher exact test; the significance level was set at 5% (p ≤ 0.05).ResultsThe left mandibular 1st and 2nd premolars with one root were 47.31%, with two roots were 2.19%. However, three roots (0.24%) and C-shaped canals (0.24%) were reported only in the left mandibular 2nd premolar. The right mandibular 1st and 2nd premolars with one root were 47.56%, with two roots were 2.03%. The overall percentage of the number of roots and canals in the first and second premolars1PM1(88.38%),2PM1B1 L1(3.5%),2PM B1 L1(0.65%),1PM1–2−1(3.08%),1PM1–2(3.17%),1PM1–2−1–2(0.24%),3PMMB1DB1L1(0.48%). However, the C-shaped canals (0.40%) were reported in right and left mandibular second premolars. No statistically significant difference was reported between mandibular premolars and gender. A statistically significant difference was reported between mandibular premolars and the age of the study subjects.ConclusionType I (1TN1) was the major root canal configuration in permanent mandibular premolars, which was higher among males. The CBCT imaging provides thorough details about the root canal morphology of lower premolars. These findings could support diagnosis, decision-making, and root canal treatment, for dental professionals.
Differential expression of serum mir-363-3p in patients with polycystic ovary syndrome and its predictive value for their pregnancy
Authors: Sang Min , Yu Ying , Zhou Zhi , Zhang Yaqi , Chang Haiping 
Published: May 2023

Abstract
Background
This study aimed to investigate the expression of serum miR-363-3p in patients with polycystic ovary syndrome (PCOS) and its predictive value for pregnancy after ovulation induction therapy.

Methods
The expression of serum miR-363-3p was detected by Reverse transcription quantitative polymerase chain reaction (RT-qPCR). PCOS patients were treated with ovulation induction therapy, and after the successful pregnancy was confirmed, they were followed up for 1 year in outpatient department to record the pregnancy outcomes of the patients. The Pearson correlation coefficient was used to evaluate the correlation between the expression level of miR-363-3p and biochemical indicators of PCOS patients. Logistic regression analysis was used to analyze the risk factors of pregnancy failure after ovulation induction therapy.

Results
The serum level of miR-363-3p in PCOS group was significantly lower than that in control group. Compared with the control group, both pregnant and non-pregnant groups had lower miR-363-3p levels, while the non-pregnant group had a greater reduction in miR-363-3p levels than the pregnant group. Low levels of miR-363-3p showed high accuracy in distinguishing pregnant and non-pregnant patients. Logistic regression analysis showed that high levels of luteinizing hormone, testosterone (T), prolactin (PRL) and low level of miR-363-3p were independent risk factors for pregnancy failure after ovulation induction in PCOS patients. Additionally, compared with pregnancy outcomes of healthy women, the incidence of premature delivery, macrosomia, and gestational diabetes in PCOS patients increased.

Conclusions
The expression of miR-363-3p in PCOS patients was reduced and correlated with abnormal hormone levels, suggesting that miR-363-3p may be involved in the occurrence and development of PCOS.