bluuebunny/crossref_metadata_2025_split huggingface dataset:
Long-term Clinical Outcomes After TightRope Versus Hook Plate Fixation for Acute Acromioclavicular Joint Dislocation
Authors: Ko Sang Hun , Lee Chae-Chill , Jeon Young Dae , Han Jung Won , Lee Kyung Joo 
Published: April 2023

Background: There is limited information regarding the long-term efficacy of techniques for surgical fixation after acromioclavicular (AC) joint dislocation. Purpose: To evaluate the efficacy of hook plate (HP) and TightRope (TR) fixation for acute AC joint dislocations by comparing the long-term clinical and radiological patient outcomes. Study Design: Cohort study, Level of evidence, 3. Methods: This study retrospectively analyzed data from 61 patients with acute AC joint dislocation between July 2011 and November 2015. The patients were grouped according to surgical procedure: HP (n = 36) and TR (n = 25). Clinical outcomes at final follow-up were evaluated using the visual analog scale (VAS) for pain; the American Shoulder and Elbow Surgery score; the Korean Shoulder Score; and the University of California, Los Angeles (UCLA) shoulder score. Side-to-side coracoclavicular (CC) distance on radiographs, postoperative complications, and the rate of subacromial erosion in the HP group were also assessed between procedures. Results: The mean follow-up period was 7.0 ± 1.0 years, and there were no significant differences in pain or outcome scores between the HP and TR groups (all P > .05). Forward flexion was better in the TR group (172.6° ± 5.6°) versus the HP group (166.0° ± 10.8°; P = .002). The percentages of patients with a difference in the side-to-side CC distance of <5 mm were 83.3% and 72.0% in the HP and TR groups, respectively ( P = .288). Complications were found in 2 patients in the HP group and 1 in the TR group ( P ≥ .999). Subacromial erosion was observed in 41.7% of patients after HP fixation, with no difference in VAS pain scores at the final follow-up in patients with versus without subacromial erosion ( P = .719). Conclusion: When comparing HP with TR fixation for the treatment of acute AC joint dislocations, there were no significant differences in functional outcome scores, final CC distance, or complications. Slightly better forward flexion was seen after TR fixation. Subacromial erosion occurred in 40% of patients after HP fixation, but this did not affect long-term VAS pain scores. Both surgical techniques are effective treatment options for AC joint dislocation.
Factors Associated with Handwashing Behaviors During the COVID-19 Pandemic: An Analysis of the Community Health Survey in Korea
Authors: Jo Soojung , Han Soo-Yeon , Howe Nancy 
Published: April 2023

Introduction Handwashing is the most effective preventive behavior for coronavirus disease-19 (COVID-19) infection. However, research has shown the lower handwashing behaviors among Korean adults. Objectives This study aims to analyze factors associated with handwashing as a preventive behavior for COVID-19 infection based on the health belief model (HBM) and the theory of planned behavior (TPB) behavioral theories. Methods This secondary data analysis utilized the Community Health Survey developed by Disease Control and Prevention Agency conducted in 2020. Sampling method was stratified and targeted 900 people living in the territory of each community public health center. In total, 228,344 cases were used in the analysis. Handwashing behavior, perceived susceptibility, perceived severity, subjective norm, and influenza vaccine uptake were used in the analysis. Regression analysis using weighing strategy by stratification and domain analysis was used. Results Less washing hand was associated with older age ( B = 0.01, p < .001), males ( B = 0.42, p < .001), not receiving an influenza vaccine ( B = 0.09, p < .001), perceived susceptibility ( B = 0.12, p < .001), subjective norm ( B = 0.05, p < .001), and perceived severity ( B = −0.04, p < .001). Conclusion While perceived susceptibility and social norm had positive association, perceived severity had a negative association with handwashing. Considering the Korean culture, creating a shared norm for frequent handwashing could be beneficial to promote handwashing rather than emphasizing the disease and its consequences.
Civic Engagement in Neighbourhoods regarding serious illness, death and loss (CEIN): a study protocol for a convergent-parallel mixed-methods process and outcome evaluation that balances control and flexibility
Authors: D’Eer Louise , Chambaere Kenneth , Van den Block Lieve , Dury Sarah , Deliens Luc , Cohen Joachim , Smets Tinne 
Published: April 2023

Background: New public health approaches in palliative care attribute an active role to civic society in providing care for those who are seriously ill, caring, or bereaved. Accordingly, Civic Engagement In Neighbourhoods regarding serious illness, dying and loss (CEIN) are emerging worldwide. However, study protocols that advise on how to evaluate the impact and complex social change processes underlying these civic engagement initiatives are lacking. Objectives: The main objective of this study is to describe the study protocol for the evaluation of civic engagement initiatives in serious illness, dying, and loss in two neighbourhoods in Flanders, Belgium. Design: A convergent-parallel mixed-method process and outcome evaluation for the CEIN study. Methods & analysis: We look at the evaluation of CEIN through a critical realist lens, thereby including the social, political, and economic determinants of social change in CEIN, the mechanisms to achieve this social change, the outcomes, and the mutual connection between these three aspects. We will conduct a convergent-parallel mixed-method process and outcome evaluation in which qualitative (i.e. observations, interviews, group discussions, and ego network mapping) and quantitative data (i.e. a pre–post survey) are simultaneously but separately collected and analysed and in the last stage combined by narrative synthesis. Discussion: This protocol illustrates the difficulty of operationalising the desired long-term impact of social changes regarding serious illness, dying, and loss into more manageable outcomes. We recommend a well-cogitated logic model that connects the outcomes of the study to its potential actions. Applying this protocol in practice is a constant exercise between providing sufficient flexibility to meet feasibility, desirability, and context-specific needs in the CEIN study and providing sufficient guidelines to structure and control the evaluation process.
Patient Perspectives on the Burden and Prevention of Diabetes-Related Foot Disease
Authors: Crowley Benjamin , Drovandi Aaron , Seng Leonard , Fernando Malindu E. , Ross Diane , Golledge Jonathan 
Published: April 2023

Purpose: The purpose of the study was to understand patient perspectives about the impact and prevention of diabetes-related foot disease (DFD). Methods: An online survey was distributed to patients with a history of DFD during 2020. The survey was designed alongside clinical specialists and DFD patients and utilized the health belief model. It asked about the impact of DFD on health, perceptions on preventive strategies, perceived need for additional support, and patient preferences for telehealth in DFD management. Quantitative data were summarized descriptively and compared between groups. Open-text responses were analyzed using conceptual content analysis. Results: Of 80 participants with a history of DFD, foot ulcers were the complication most often experienced, with over two-thirds having been admitted to hospital for a DFD-related issue and over one-third having a DFD-related amputation. Participants had ranging perceptions on the effect of DFD on health, from minimal to crippling. Those with previous severe DFD complications leading to hospital admission found a lack of mobility and independence the consequences of most concern. Using offloading footwear was perceived as very important for preventing DFD complications, although the use of offloading footwear was low, with participants citing issues relating to cost, comfort, appearance, and access to footwear as barriers to better adherence. Perceptions on telehealth were mixed, with many participants not having access to or being comfortable with the use of digital technologies. Conclusions: Patients with DFD require additional supports for effective prevention, including offloading footwear.
The paramedic role in caring for people who use illicit and controlled drugs: A scoping review
Authors: Bolster Jennifer , Armour Richard , O’Toole Michelle , Lysko Meghan , Batt Alan M. 
Published: April 2023

Introduction As the paramedic profession continues to grow and evolve, a shift from purely reactive to holistic patient care models is required. As the first and often the only point of medical contact for many patients from marginalised and under-served populations, the paramedic role and its potential future implications in caring for these patients need to be explored. Aim The objective of this scoping review was to explore the paramedic's role in caring for people who use illicit and controlled drugs. Methods A scoping review of English language literature published since 2002 was conducted using CINAHL, Medline, Embase and Google Scholar. We used a previously published paramedic search term filter for sensitivity combined with search terms related to illicit and controlled drug use and addiction. Studies were selected based on relevance to the research question. Results A total of 104 peer-reviewed and 14 grey literature articles were selected for inclusion. The main finding of this scoping review is the notable lack of evidence base surrounding the contemporary paramedic role in the care provision of people who use drugs. The results highlight high rates of mortality following a paramedic-attended drug poisoning event, presenting a unique opportunity for paramedics to approach care in meaningful ways that extend past traditional drug poisoning response. Conclusions The interface between the community of people who use drugs and the paramedic may be a highly influential encounter during a patient's journey through the healthcare system. The evolving role of the paramedic in this encounter requires focused study and should be viewed as a research priority in response to the ongoing drug poisoning crisis.
Pedestrian mobility in Mobility as a Service (MaaS): sustainable value potential and policy implications in the Paris region case
Authors: Reyes Madrigal Laura Mariana , Nicolaï Isabelle , Puchinger Jakob 
Published: April 2023

AbstractPedestrian mobility remains neglected in MaaS solutions, yet it has the potential to become a tool for promoting public policies and more sustainable lifestyles away from excessive private car use. This research identifies the potential for sustainable value creation and the transversal implications for policymakers and other MaaS stakeholders of overlooking walking in innovations like MaaS. To do so, we explore how walking is currently integrated into four MaaS solutions in the Paris region. Our main findings show heterogeneity in the hierarchy given to walking in the user interfaces and the determinant roles of governance and policy in supporting the prioritization of pedestrian mobility in MaaS.
New insights into the occurrence of continuous cropping obstacles in pea (Pisum sativum L.) from soil bacterial communities, root metabolism and gene transcription
Authors: Ma Lei , Ma Shaoying , Chen Guiping , Lu Xu , Wei Ruonan , Xu Ling , Feng Xiaojie , Yang Xiaoming , Chai Qiang , Zhang Xucheng , Li Sheng 
Published: April 2023

Abstract
Background
Continuous cropping is a significant obstacle to sustainable development in the pea (Pisum sativum L.) industry, but the underlying mechanisms of this remain unclear. In this study, we used 16 S rDNA sequencing, transcriptomics, and metabolomics to analyze the response mechanism of roots and soil bacteria to continuous cropping and the relationship between soil bacteria and root phenotypes of different pea genotypes (Ding wan 10 and Yun wan 8).

Results
Continuous cropping inhibited pea growth, with a greater effect on Ding wan 10 than Yun wan 8. Metabolomics showed that the number of differentially accumulated metabolites (DAMs) in pea roots increased with the number of continuous cropping, and more metabolic pathways were involved. Transcriptomics revealed that the number of differentially expressed genes (DEGs) increased with the number of continuous cropping. Continuous cropping altered the expression of genes involved in plant-pathogen interaction, MAPK signal transduction, and lignin synthesis pathways in pea roots, with more DEGs in Ding wan 10 than in Yun wan 8. The up-regulated expression of genes in the ethylene signal transduction pathway was evident in Ding wan 10. Soil bacterial diversity did not change, but the relative abundance of bacteria significantly responded to continuous cropping. Integrative analysis showed that the bacteria with significant relative abundance in the soil were strongly associated with the antioxidant synthesis and linoleic acid metabolism pathway of pea roots under continuous cropping once. Under continuous cropping twice, the bacteria with significant relative abundance changes were strongly associated with cysteine and methionine metabolism, fatty acid metabolism, phenylpropanoid biosynthesis, terpenoid backbone biosynthesis, linoleic acid, and amino sugar and nucleotide sugar metabolism.

Conclusion
Ding wan 10 was more sensitive to continuous cropping than Yun wan 8. Continuous cropping times and pea genotypes determined the differences in root metabolic pathways. There were common metabolic pathways in the two pea genotypes in response to continuous cropping, and the DEGs and DAMs in these metabolic pathways were strongly associated with the bacteria with significant changes in relative abundance in the soil. This study provides new insights into obstacles to continuous cropping in peas.
Differences in the longitudinal change of behaviours related to dementia in long-term care: a growth mixture modelling approach
Authors: Robitaille Annie , Garcia Linda , Terrera Graciela Muniz 
Published: April 2023

Abstract
Background
There is still a need for more information about the different trajectories of responsive behaviours that people living with dementia present in long-term care homes (LTC). Objective. This study identified subgroups of individuals with similar trajectories of responsive behaviours related to dementia in LTC and evaluated the role of demographic variables, depressive symptomatology, social engagement, cognitive functioning, and activities of daily living (ADL) on class membership.

Methods
Growth mixture models were run using data from the Continuing Care Reporting System.

Results
Results suggest that change in responsive behaviours is best represented by seven classes of trajectories. The largest class was composed of individuals who presented the lowest frequency of behaviours upon entry in LTC that increased at a slow linear rate. The other classes were composed of individuals who presented different frequencies of behaviours upon entry in LTC and varying rates of change (e.g., individuals who presented a low frequency of behaviours upon entry in LTC that increased at a linear rate followed by a decrease in the later months, individuals who presented a high frequency of responsive behaviours upon entry in LTC and that remained stable). Cognitive functioning, social engagement, depressive symptomatology, and ADL were markers of class membership.

Conclusions
These findings can help identify individuals at increased risk of presenting a high frequency of responsive behaviours and highlight interventions that could decrease behaviours in LTC.
Predicting mortality in patients diagnosed with advanced dementia presenting at an acute care hospital: the PROgnostic Model for Advanced DEmentia (PRO-MADE)
Authors: Kaur Palvinder , Kannapiran Palvannan , Ng Sheryl Hui Xian , Chu Jermain , Low Zhi Jun , Ding Yew Yoong , Tan Woan Shin , Hum Allyn 
Published: April 2023

Abstract
Background
Challenges in prognosticating patients diagnosed with advanced dementia (AD) hinders timely referrals to palliative care. We aim to develop and validate a prognostic model to predict one-year all-cause mortality (ACM) in patients with AD presenting at an acute care hospital.

Methods
This retrospective cohort study utilised administrative and clinical data from Tan Tock Seng Hospital (TTSH). Patients admitted to TTSH between 1st July 2016 and 31st October 2017 and identified to have AD were included. The primary outcome was ACM within one-year of AD diagnosis. Multivariable logistic regression was used. The PROgnostic Model for Advanced Dementia (PRO-MADE) was internally validated using a bootstrap resampling of 1000 replications and externally validated on a more recent cohort of AD patients. The model was evaluated for overall predictive accuracy (Nagelkerke’s R2 and Brier score), discriminative [area-under-the-curve (AUC)], and calibration [calibration slope and calibration-in-the-large (CITL)] properties.

Results
A total of 1,077 patients with a mean age of 85 (SD: 7.7) years old were included, and 318 (29.5%) patients died within one-year of AD diagnosis. Predictors of one-year ACM were age > 85 years (OR:1.87; 95%CI:1.36 to 2.56), male gender (OR:1.62; 95%CI:1.18 to 2.22), presence of pneumonia (OR:1.75; 95%CI:1.25 to 2.45), pressure ulcers (OR:2.60; 95%CI:1.57 to 4.31), dysphagia (OR:1.53; 95%CI:1.11 to 2.11), Charlson Comorbidity Index ≥ 8 (OR:1.39; 95%CI:1.01 to 1.90), functional dependency in ≥ 4 activities of daily living (OR: 1.82; 95%CI:1.32 to 2.53), abnormal urea (OR:2.16; 95%CI:1.58 to 2.95) and abnormal albumin (OR:3.68; 95%CI:2.07 to 6.54) values. Internal validation results for optimism-adjusted Nagelkerke’s R2, Brier score, AUC, calibration slope and CITL were 0.25 (95%CI:0.25 to 0.26), 0.17 (95%CI:0.17 to 0.17), 0.76 (95%CI:0.76 to 0.76), 0.95 (95% CI:0.95 to 0.96) and 0 (95%CI:-0.0001 to 0.001) respectively. When externally validated, the model demonstrated an AUC of 0.70 (95%CI:0.69 to 0.71), calibration slope of 0.64 (95%CI:0.63 to 0.66) and CITL of -0.27 (95%CI:-0.28 to -0.26).

Conclusion
The PRO-MADE attained good discrimination and calibration properties. Used synergistically with a clinician’s judgement, this model can identify AD patients who are at high-risk of one-year ACM to facilitate timely referrals to palliative care.
Monoclonal antibodies against CGRP (R): non-responders and switchers: real world data from an austrian case series
Authors: Kaltseis Katharina , Filippi Vera , Frank Florian , Eckhardt Christine , Schiefecker Alois , Broessner Gregor 
Published: April 2023

Abstract
Objective
Assessement of the responder and non-responder rate to consecutive monoclonal CGRP-antibody (CGRP-mAb) treatment, the presence of side effects, analysis of predictors of response and loss-of-effectiveness evaluation over time.

Methods
We conducted a retrospective analysis including 171 patients with episodic (EM) or chronic migraine (CM), who received one, two or three different CGRP-mAbs. Non-response was defined as ≤ 50% reduction of monthly migraine days (MMDs) in EM and ≤ 30% reduction of MMDs in CM after 3 months of treatment.

Results
123 (71.9%) responded to the first mAb. Side effects led to treatment discontinuation in 9 (5.3%) patients. Of the 26 patients who did not respond to the first mAb or experienced a loss of efficacy over time, 11 (42.3%) responded to the second and two (28.6%) of 7 to the third monoclonal antibody. Poor response to therapy was associated with a higher monthly migraine frequency (p = 0.028), a higher number of prior preventive migraine therapies (p = 0.011) and medication overuse (p = 0.022).

Conclusion
Our findings support mAb-class switch in non-responders or in patients experiencing a loss of effectiveness. The use of a third CGRP-mAb could be beneficial for some patients.
Impact of community health interventions on maternal and child health indicators in the upper east region of Ghana
Authors: Sakeah Evelyn , Bawah Ayaga A. , Asuming Patrick O. , Debpuur Cornelius , Welaga Paul , Awine Timothy , Anyorikeya Maria , Kuwolamo Irene , Oh Juhwan , Lee Hoon Sang , Lee Hwa-Young , Lee Inseok , Kim Myeong Seon , Hong Seoyeon , Awoonor-Williams John Koku , Phillips James F. , Aboagye Patrick , Oduro Abraham R. 
Published: April 2023

Abstract
Background
This paper reports on results of a health system strengthening implementation research initiative conducted the Upper East Region of northern Ghana. Transformative interventions to accelerate and strengthen the health delivery were implemented that included empowering community leaders and members to actively participate in health delivery, strengthening the referral systems through the provision of community transport systems, providing basic medical equipment to community clinics, and improving the skills of critical health staff through training.

Methods
A mixed method design was used to evaluate the impact of the interventions. A quantitative evaluation employed a flexible research design to test the effects of various component activities of the project. To assess impact, a pre-versus–post randomized cluster survey design was used. Qualitative research was conducted with focus group data and individual in depth interviews to gauge the views of various stakeholders associated with the implementation process.

Results
After intervention, significant improvements in key maternal and child health indicators such as antenatal and postnatal care coverage were observed and increases in the proportion of deliveries occurring in health facilities and assisted by skilled health personnel relative to pre-intervention conditions. There was also increased uptake of oral rehydration salts (ORS) for treatment of childhood diarrhoea, as well as marked reductions in the incidence of upper respiratory infections (URI).

Conclusions
A pre-and post-evaluation of impact suggests that the programme had a strong positive impact on the functioning of primary health care. Findings are consistent with the proposition that the coverage and content of the Ghana Community-based Health Planning and Services programme was improved by program interventions and induced discernable changes in key indicators of health system performance.