bluuebunny/crossref_metadata_2025_split huggingface dataset:
Rural African American Women With Severe Obesity: A Cross-Sectional Analysis of Lifestyle Behaviors and Psychosocial Characteristics
Authors: Alick Candice L. , Braxton Danielle , Skinner Harlyn , Alexander Ramine , Ammerman Alice S. , Keyserling Thomas C. , Samuel-Hodge Carmen D. 
Published: July 2023

Purpose To examine differences in lifestyle behavioral and psychosocial factors between rural African American women with Class 3 obesity and those with overweight, and Class 1-2 obesity. Design Cross-sectional study. Setting Rural Southeastern United States. Subjects Participants included 289 African American women with a mean age of 56 years, 66% with a high school education or less, and a mean body mass index (BMI) of 38.6 kg/m2; 35% (n = 102) were classified with Class 3 obesity. Measures We objectively measured height, weight, and physical activity steps/day. Self-reported dietary and physical activity behaviors, general health-related quality of life, mental health, and social support were measured with validated surveys. Analysis Chi-Square analysis for categorical variables and analysis of variance (ANOVA) – via multiple linear regression – for continuous variables. Results There were no significant demographic differences between BMI groups, except for age, where women with Class 3 obesity were on average younger (51 vs 58 y, P < .001). Although dietary behaviors did not differ significantly between groups, we observed significant group differences in self-reported and objective measures of physical activity. The age-adjusted difference in means for self-reported total physical activity minutes/wk. was 91 minutes, with women categorized with Class 3 obesity reporting significantly fewer weekly minutes than those with overweight/Class 1-2 obesity (64.3 vs 156.4 min/wk. respectively, P < .01). Among psychosocial variables, only in the physical component scores of health-related quality of life did we find significant group differences – lower physical well-being among women with Class 3 obesity compared to those with overweight/Class 1-2 obesity ( P = .02). Conclusion For African American women with Class 3 obesity living in rural setting, these findings suggest behavioral weight loss interventions may need to target physical activity strategies that address physical, psychosocial, and environmental barriers.
Exploring the role of point-of-care ultrasound for people with HIV in a resource affluent setting: A prospective observational study
Authors: Huson Mischa , Rokx Casper 
Published: July 2023

Background In low resource settings point of care ultrasound (POCUS) has proven value for the detection of opportunistic diseases in HIV, especially tuberculosis. Few studies have explored POCUS in people with HIV and potential opportunistic infections in resource affluent settings. Methods We performed a prospective observational study in the Netherlands. Outpatients newly diagnosed with HIV and a CD4 T-cell count below 350 cells/mm3 and inpatients with HIV on the infectious diseases ward were included. POCUS of chest and abdomen were performed to detect opportunistic diseases and patients were followed for 1 year to register the presence or absence of opportunistic diseases as detected during routine care. Primary outcome was the number of HIV-related and unrelated conditions detected by POCUS and interobserver variation ( ClinicalTrials.gov registration NCT04246983). Results We included 34 patients (79% males, median CD4 T-cell count 115/mm3). Observers had 97.5% agreement (Cohen’s kappa for interobserver reliability 0.75). POCUS examination indicated at least one new opportunistic disease in 11 patients. In all these patients additional investigations confirmed opportunistic disease, predominantly Pneumocystis jirovecii pneumonia, bacterial pneumonia, Mycobacterium avium complex infection and lymphoma. In four patients an opportunistic disease was diagnosed in foci inaccessible for POCUS and a normal POCUS correctly excluded opportunistic diseases of the investigated structures in all patients, yielding a sensitivity of 73% and a specificity of 100%. Conclusions POCUS can be a reliable, valuable addition to physical examination of people with HIV and advanced immune suppression. The data support further exploration of POCUS in people with HIV in resource affluent settings.
Need for Neonatal Resuscitation: Does Maternal COVID-19 Affect It?
Authors: Kumar Surendra , Agrawal Karnika , Bansal Neetika , Rana Suman , Kumar Rakesh , Rawal Manoj 
Published: July 2023

Background Maternal COVID-19 infection acquired during late pregnancy carries a potential risk for adverse neonatal outcomes. There is still a paucity of data on its effect on the transition from intrauterine to extrauterine life. Objectives The objectives of this study were to determine the impact of maternal COVID-19 infection on neonates for the risk and need for resuscitation at birth, Apgar scores at 1- and 5-minutes, and the need of NICU admission during early neonatal period. Materials and method In this hospital-based prospective matched cohort study, 100 COVID-positive pregnant women presenting for delivery were enrolled. We also included 100 non-COVID pregnant women after the best possible matching of their major baseline parameters with the study group. Neonates of both groups were followed-up till 7 days of life. Results The two groups were comparable for all baseline variables except for the mode of delivery. The requirement of neonatal resuscitation was 30% and 21% in the study and control groups (RR = 1.429; 95% CI 0.88–2.32; p = 0.149). Apgar scores at 1- and 5- minutes were also unaffected by maternal COVID-19 infection with mean scores of 8.8 ± 0.651 vs. 8.87 ± 0.562 (p = 0.42) in the study and control groups, respectively. COVID-exposed neonates had a higher incidence of NICU admission when compared with the unexposed group (RR =1.616; 95% CI 1.002–2.606; p = 0.047). Among neonates born to COVID-positive mothers, 11% demonstrated evidence of SARS-CoV-2 positivity within first 5 days of life. The risk for need of resuscitation and mean Apgar scores were comparable among SARS-CoV-2 positive and negative neonates (p > 0.05). Conclusion COVID-19 infection in pregnant women is not associated with an increased risk of neonatal resuscitation.
The relationship of C-reaktif protein level after knee artroplasty with gender difference and type of artroplasty
Authors: Altinayak Harun , Karatekin Yavuz Selim , Balta Orhan 
Published: July 2023

Purpose It was aimed to reveal the relationship between CRP level after knee arthroplasty and gender difference and arthroplasty type. Methods Preoperative and postoperative (1st and 7th day, 1st and 3rd months) CRP values of the patients who underwent TKA or UKA were examined. The data were compared by categorizing them into primary male-female, secondary TKA-UKA groups. Results 967 patients were included in the study (151 male, 685 female in the TKA group and 25 male, 106 female in the UKA group) In the TKA group, the mean age was 67.38 in males and 65.54 in females. In the UKA group, the mean age was 58.72 in males and 57,63 in females. CRP values were found to be statistically significantly lower in females compared to males in the preoperative period, postoperative 1st and 3rd months in patients who underwent TKA ( p < .05). In the UKA group, it was found to be significantly lower in females in the preoperative period and at the postoperative 3rd month, p < .05). When the CRP values and their effect on the course of arthroplasty were evaluated according to the type of arthroplasty, there was no significant difference between the CRP values of the preoperative patients ( p = .686). In addition, in the comparison made on the postoperative 1st day, 1st week, 1st month, and 3rd month, CRP values of the patient who underwent UKA were found to be significantly lower ( p < .05). When analyzed separately by arthroplasty type, postoperative CRP values decreased to normal limits in 96.3% of patients who underwent TKA and 98.5% of patients who underwent UKA in the third month. Conclusions Our study showed that the uncomplicated course of CRP after TKA and UKA is gender-specific, and higher CRP values are observed in males than in females. The UKA group exhibited significantly lower postoperative CRP levels than the TKA group.
Single center evaluation on the use of conditionally ordered low molecular weight heparins in malignant hematology patients with venous thromboembolism
Authors: Pun Henry , Pang Ian , Leblanc Kori , Dhillon Patwant , McEwan Cassandra , Patel Priya , Kumar Rajat 
Published: July 2023

Background Cancer and cancer-related treatments are significant independent risk factors for malignant hematology (MH) patients in developing venous thromboembolism (VTE). Treatment of VTE in MH patients at the Princess Margaret Cancer Centre is predominantly initiated with low molecular weight heparin (LMWH) in accordance with guidelines. While guidelines recommend against LMWH use in patients with thrombocytopenia, prescribers may order LMWH conditionally based on platelet values. Currently, there is a lack of consistent practice with variation in both the use of conditional orders as well as the threshold of platelet values for conditional orders. The objectives of the study were to (a) describe the use of conditionally ordered LMWH based on platelet values; (b) determine its safety by measuring administration concordance with conditional orders and bleeding event rates during inpatient admission; and (c) determine its efficacy by measuring the rate of worsening VTE or recurrence during inpatient admission. Methods Electronic records of MH inpatients admitted between January 2017 and December 2019 and who were administered at least one dose of an LMWH for the treatment of VTE were screened. Results One hundred and eight patients were screened to obtain 50 eligible patients with a median age of 59 years (SD = ±18.8 years). The most frequent MH diagnosis was acute lymphoblastic leukemia (30%). Sixty percent ( n = 30) of patients received conditional orders. Out of 571 administrations, 543 (95%) were administered concordantly ( Χ2(1) = 472, p < 0.0001). In this group of patients, 8 patients had either documented bleeding or experienced a drop in hemoglobin >10 g/L within a 72 h time frame. No patients experienced a recurrent VTE during inpatient treatment (for up to 40 days post-admission). Conclusions It appears that conditionally ordered LMWH can be concordantly administered and is safe and effective in the treatment of VTE in MH patients experiencing thrombocytopenia. There were no reports of worsening or new VTE in our small sample.
Enhancing the Responsiveness of Bids in Public Procurement: The Case of Sri Lanka
Authors: Uduwage-Don Nuwantha Lasitha Sampath , Hadiwattage Chandanie , Panuwatwanich Kriengsak 
Published: July 2023

Bid Responsiveness in the public procurement process (PPP) is a crucial aspect of public construction projects. A responsive bid materially complies with the form or content requirements of the bidding documents; the responsiveness of a bid is determined during the bid evaluation period. Accepting low-responsive bids can lead to project failures and unexpected adverse consequences. The Public Procurement Systems (PPS) in developed countries frequently used systematic mechanisms to enhance the quality of the PPP which includes enhancing the responsiveness of bids. This study revealed six dominant factors impacting responsiveness and five systematic mechanisms more prominently discussed in the PPS in developed countries to enhance the quality of the PPP. The population of this study consists of procurement specialists in Sri Lankan public construction procurement at the pre-contract stage and among those who have more than 20 years of experience in PPP were considered as the sampling frame. The fuzzy-set theory was used to determine the ranking order of these systematic mechanisms based on their influence to enhance responsiveness by overcoming the impact of dominant factors. Suggestions were made for Sri Lankan PPS to implement these systematic mechanisms.
Predicting employment deterioration with the Processing Speed Test (PST) and SDMT in multiple sclerosis
Authors: Jaworski Michael G , Gillies John K , Youngs Margaret , Wojcik Curtis , Santivasci Celeste , Jakimovski Dejan , Bergsland Niels , Weinstock-Guttman Bianca , Benedict Ralph HB 
Published: July 2023

Background: Employment deterioration is common in people with multiple sclerosis (PwMS). Clinicians often learn of job loss after its occurrence, leaving no opportunity for preventive measures. Objectives: Identify which neuropsychological measures discriminate between healthy volunteers (HVs) and employed/disabled PwMS at baseline and predict work deterioration over 2 years. Methods: We examined 198 PwMS with computerized tests such as the Processing Speed Test (PST) and conventional tests such as the Symbol-Digit Modalities Test (SDMT), administered at baseline. Employment was assessed via Buffalo Vocational Monitoring Survey. Univariate and regression analyses identified significant predictors of PwMS categorized as work-stable versus work-deteriorated status. Results: PwMS were impaired on all baseline assessments relative to HVs ( p’s < 0.001). Post hoc analyses showed that employed PwMS and HVs performed similarly and better than work-disabled PwMS. At the univariate level, both PST and SDMT discriminated between work-deteriorated and work-stable PwMS ( p’s < 0.01). The logistic regression model accounting for all measures retained PST and the computerized Walking Speed Test. PwMS with increased negative work events had lower PST ( p < 0.001), SDMT ( p < 0.001), and BVMT- R ( p < 0.01) scores than stable PwMS. The related regression model retained PST and BVMT- R ( p < 0.001). Conclusion: Cognition, as measured by the PST and BVMT-R, are predictive of job deterioration in PwMS and may be a useful screening tool to identify those at high risk of unemployment.
Outcomes and Resource Utilization in Liver Transplant Recipients Who Underwent Expedited Transplant Evaluation
Authors: Lin Emily , Patel Anish , Young Ericka , Gao Yinglin , Peng Jiahao , Woloszyn Jakub , Volk Michael L , Rakoski Mina O. 
Published: July 2023

Background Expedited liver transplant evaluations of critically ill patients can be challenging due to limited time for data gathering and psychosocial evaluation. Aims To compare clinical outcomes between expedited and traditional transplant evaluation patients and assess for differences in outpatient resource utilization and staff burden between groups. Design Adult liver transplant recipients who underwent transplant from 2015 to 2019 were included. Expedited evaluation was defined as time from initiating transplant evaluation to transplant listing <2 weeks. Primary outcomes included rates of graft rejection, graft failure, and death within 1-year posttransplant. Secondary outcomes included number of acute care visits, office visits, and medical record documentation made by transplant staff within 1-year posttransplant. Outcomes were compared using Cox regression models. Results Of the 335 patients included, 92 (27.5%) were expedited and 243 (72.5%) were traditional. Expedited patients were significantly younger, had greater MELD scores, and required more inpatient care and life support at time of transplant. There was no significant difference in risk of graft rejection (HR 1.3, P = .4), graft failure (HR 1.3, P = .6), or mortality (HR 1.0, P = .9) between groups. Expedited transplant was not associated with increased healthcare or staff utilization: acute care visits (rate ratio 0.9, P = .7), office visits (β = −1.05, P = .2), and medical record documentation (β = 3.4, P = 0.4). Conclusions Despite being more critically ill, patients requiring expedited transplant evaluation have favorable outcomes after transplant and do not require more intensive staff time and resources compared to traditional candidates.
The effects of electronic-based lifestyle interventions on nonalcoholic fatty liver disease: A systematic review
Authors: Seifi Najmeh , Bahari Hossein , Soltani Sanaz , Nikoumanesh Mahya , Hajipoor Mojtaba , Ferns Gordon A. , Ghayour-Mobarhan Majid 
Published: July 2023

Objective Lifestyle interventions are increasingly becoming an integrated part of nonalcoholic fatty liver disease (NAFLD) management. Electronic lifestyle interventions may be able to expand the access and utility of this approach. This study aimed to synthesize the evidence for the effects of electronic-based lifestyle interventions on weight, anthropometric, and liver enzyme measurements in patients with NAFLD. Methods Medline, Scopus, and Web of Science were searched up to February 2023. Clinical trials investigating the effects of electronic lifestyle interventions on weight, body mass index (BMI), waist circumference (WC), and liver enzymes in NAFLD patients were reviewed. After reviewing full-text articles, seven clinical trials were included in the systematic review. Results Two articles included telephone calls, one was based on text messaging, two studies were based on web-based lifestyle modifications, and two used mobile apps. Except for one, all other six studies indicated a significant impact on weight loss. BMI was reported in six of seven studies. Except for one, BMI was significantly reduced in the group receiving e-health. WC was reported in four studies, which indicated a significant reduction in the e-health intervention group. Alanine transaminase (ALT) was reported in all the included studies. Except for two, others demonstrated a significant improvement in ALT in the e-health intervention groups. As reported in four studies, Aspartate transaminase (AST) significantly decreased in the group receiving e-health interventions, except in one study. Conclusions The results support applying electronic lifestyle interventions in NAFLD patients to reduce weight, BMI, WC, AST, and ALT.
Improving Domestic Violence Screening and Follow-Up in a Community Health Clinic
Authors: Collins Katherine , Kochuparambil Sebastian Silviya , Franck Gwyneth 
Published: July 2023

Purpose: To implement an improved DV screening and follow-up protocol at a suburban community health clinic that is consistently used by staff with appropriate female patients as well as to assess provider/staff barriers to this. Methods: The project was completed at a community health clinic and included 2 presentations: the first to outline current practices as well as the intervention plan at the pre-intervention time point and then to review results of the intervention and elicit feedback post intervention. Provider/staff barrier surveys were completed at both time points. The intervention consisted of completion of the HITS DV screening tool on all appropriate female patients and a system-level algorithm-based follow-up care plan for positive cases. Results: Eligible patient screening increased by 3.1% and patients screening positive increased from 0 to 1 from baseline to intervention. Average scores on the barrier surveys improved for all questions and improved significantly for 3 of the questions. The algorithm implemented was utilized for the positive screening. Conclusions: Use of a DV screening tool, that has shown good concurrent and construct validity in the literature, a system-level algorithm for follow-up care and addressing provider/staff barriers to screening and follow-up are essential components of a successful DV screening and follow-up program.
Comparison of Outcomes After Arthroscopic Superior Capsule Reconstruction Versus Arthroscopic Partial Repair or Arthroscopic Debridement for Irreparable Rotator Cuff Tears
Authors: Schanda Jakob E. , Eigenschink Martin , Laky Brenda , Frank Julia K. , Pauzenberger Leo , Anderl Werner , Heuberer Philipp R. 
Published: July 2023

Background: Arthroscopic superior capsule reconstruction (SCR), arthroscopic partial repair (PR), and arthroscopic debridement (DB) are valid treatment options for irreparable rotator cuff (RC) tears. Purpose/Hypothesis: The purpose of this study was to compare clinical, functional, and radiological outcomes of arthroscopic SCR with arthroscopic PR and arthroscopic DB in patients with irreparable posterosuperior RC tears. It was hypothesized that SCR would lead to superior clinical and functional outcomes compared with PR or DB. Study Design: Cohort study; Level of evidence, 3. Methods: Clinical and functional outcomes of this single-center retrospective study included range of motion, strength, and the age- and sex-adjusted Constant-Murley score. Patient-reported outcome measures (PROMs) involved the quick Disabilities of the Arm, Shoulder and Hand score, the Subjective Shoulder Value, and the visual analog scale for pain. Graft and repaired tendon integrity was evaluated by magnetic resonance imaging (MRI) at 12 months of follow-up. Results: In total, 57 patients treated with SCR (n = 20), PR (n = 17), and DB (n = 20) were included. The mean clinical follow-up was 33.8 ± 17.9 months. Preoperative clinical and functional characteristics were comparable among the 3 groups. The range of motion and clinical and functional scores of all 3 groups significantly improved from pre- to postoperatively. Postoperative PROMs showed no differences among all 3 study groups. SCR revealed significantly higher postoperative strength compared with PR ( P = .001) and DB ( P = .004). Postoperative MRI revealed a rerupture in 4 patients with SCR (20%). Postoperative MRI showed a rerupture in 9 patients with PR ( 53%). Fatty muscle infiltration of the supraspinatus and infraspinatus significantly progressed within all 3 study groups in postoperative MRI scans. No clinical and functional differences were observed between intact and reruptured PR. Conclusion: Patients who underwent SCR had better postoperative strength recovery than patients who underwent PR or DB.
Assessment of Iron–Folate Adherence and Associated Factors Among Pregnant Women in Public Health Facilities of Durame Town, Southern Ethiopia
Authors: Abeje Seblework , Yosef Yirgalem , Fikadu Yohannes 
Published: July 2023

Introduction Iron deficiency anemia during pregnancy is a significant public health problem in low- and middle-income countries. The World Health Organization recommended a daily oral dose of iron and folic acid supplements throughout pregnancy. Poor adherence to iron and folic acid supplementation arises in pregnant women associated with serious adverse health outcomes. Objective This study aimed to assess iron–folate adherence and associated factors among pregnant women in public health facilities of Durame town, Southern Ethiopia, in 2022. Methods An institution-based cross-sectional study was conducted from March 1–30, 2022. A structured interviewer-administered questionnaire was used to interview a total sample size of 317 participants. Logistic regression analysis was computed, and variables with a p-value of less than 0.25 in the bivariate logistic regression analysis were selected for multivariable logistic regression analysis. Finally, significance was declared at p < .05 with 95%CI. Results The findings of this study showed that adherence to iron–folate among pregnant women was 180 (60%) (95%CI: 54–65.7). The odds of iron–folate adherence among women who had not had anemia in their current pregnancy were 63% (AOR = 0.37, 95%CI: 0.14–0.99) less likely to have adherence, and the odds of iron–folate adherence among women who had not heard about the disease anemia were 58% (AOR = 0.42, 95%CI: 0.22–0.81) less likely to have adherence. Conclusion Iron–folate adherence in Durame public health facilities was better compared to other studies even if it was not high enough to prevent anemia and folate deficiency. Women who had not had anemia in their current pregnancy and women who had not heard about the disease anemia were significantly associated with adherence to iron–folate. Thus, healthcare providers should provide health education on the enhancement of adherence to iron–folate utilization and the means how to prevent iron–folate deficiency during their clients’ pregnancy.