bluuebunny/crossref_metadata_2025_split huggingface dataset:
ONE- AND TWO-YEAR RESULTS OF A NOVEL CERAMIC-ON-CERAMIC HIP RESURFACING IMPLANT IN AUSTRALIA
Authors: Lin D. , Xu J. , Weinrauch P. , Yates P. , Young D. , Walter W. 
Published: February 2023

Hip resurfacing arthroplasty (HRA) is a bone conserving alternative to total hip arthroplasty. We present the early 1 and 2-year clinical and radiographical follow-up of a novel ceramic-on-ceramic (CoC) HRA in a multi-centric Australian cohort.Patient undergoing HRA between September 2018 and April 2021 were prospectively included. Patient-reported outcome measures (PROMS) in the form of the Forgotten Joint Score (FJS), HOOS Jr, WOMAC, Oxford Hip Score (OHS) and UCLA Activity Score were collected preoperatively and at 1- and 2-years post-operation. Serial radiographs were assessed for migration, component alignment, evidence of osteolysis/loosening and heterotopic ossification formation.209 patients were identified of which 106 reached 2-year follow-up. Of these, 187 completed PROMS at 1 year and 90 at 2 years. There was significant improvement in HOOS (p< 0.001) and OHS (p< 0.001) between the pre-operative, 1-year and 2-years outcomes. Patients also reported improved pain (p<0.001), function (p<0.001) and reduced stiffness (p<0.001) as measured by the WOMAC score. Patients had improved activity scores on the UCLA Active Score (p<0.001) with 53% reporting return to impact activity at 2 years. FJS at 1 and 2-years were not significantly different (p=0.38). There was no migration, osteolysis or loosening of any of the implants. The mean acetabular cup inclination angle was 41.3° and the femoral component shaft angle was 137°. No fractures were reported over the 2-year follow-up with only 1 patient reporting a sciatic nerve palsy.There was early return to impact activities in more than half our patients at 2 years with no early clinical or radiological complications related to the implant. Longer term follow-up with increased patient numbers are required to restore surgeon confidence in HRA and expand the use of this novel product.In conclusion, CoC resurfacing at 2-years post-operation demonstrate promising results with satisfactory outcomes in all recorded PROMS.
COST AND OUTCOME ANALYSIS OF DISTAL INTERPHALANGEAL JOINT ARTHRODESIS BETWEEN K-WIRES AND HEADLESS COMPRESSION SCREWS
Authors: Kim K. , Wang A. , Coomarasamy C. , Foster M. 
Published: February 2023

Distal interphalangeal joint (DIPJ) fusion using a k-wire has been the gold standard treatment for DIPJ arthritis. Recent studies have shown similar patient outcomes with the headless compression screws (HCS), however there has been no cost analysis to compare the two. Therefore, this study aims to 1) review the cost of DIPJ fusion between k-wire and HCS 2) compare functional outcome and patient satisfaction between the two groups.A retrospective review was performed over a nine-year period from 2012-2021 in Counties Manukau. Cost analysis was performed between patients who underwent DIPJ fusion with either HCS or k-wire. Costs included were surgical cost, repeat operations and follow-up clinic costs. The difference in pre-operative and post-operative functional and pain scores were also compared using the patient rate wrist/hand evaluation (PRWHE).Of the 85 eligible patients, 49 underwent fusion with k-wires and 36 had HCS. The overall cost was significantly lower in the HCS group which was 6554 New Zealand Dollars (NZD), whereas this was 10408 NZD in the k-wire group (p<0.0001). The adjusted relative risk of 1.3 indicate that the cost of k-wires is 1.3 times more than HCS (P=0.0053). The patients’ post-operative PRWHE pain (−22 vs −18, p<0.0001) and functional scores (−38 vs −36, p<0.0001) improved significantly in HCS group compared to the k-wire group.Literatures have shown similar DIPJ fusion outcomes between k-wire and HCS. K-wires often need to be removed post-operatively due to the metalware irritation. This leads to more surgical procedures and clinic follow-ups, which overall increases the cost of DIPJ fusion with k-wires.DIPJ fusion with HCS is a more cost-effective with a lower surgical and follow-up costs compared to the k-wiring technique. Patients with HCS also tend to have a significant improvement in post-operative pain and functional scores.
WHAT IMAGING IS REQUIRED TO PLAN TKA? A COMPARISON BETWEEN EOS AND CT SCAN TO ASSESS CORONAL ALIGNMENT
Authors: Sundaraj K , Corbett J , Yong Yau Tai J , Salmon L , Roe J 
Published: February 2023

The emergence of patient specific instrumentation has seen an expansion from simple radiographs to plan total knee arthroplasty (TKA) with modern systems using computed tomography (CT) or magnetic resonance imaging scans. Concerns have emerged regarding accuracy of these non-weight bearing modalities to assess true mechanical axis. The aim of our study was to compare coronal alignment on full length standing AP imaging generated by the EOS acquisition system with the CT coronal scout image.Eligible patients underwent unilateral or bilateral primary TKA for osteoarthritis under the care of investigating surgeon between 2017 and 2022, with both EOS X-Ray Imaging Acquisition System and CT scans performed preoperatively. Coronal mechanical alignment was measured on the supine coronal scout CT scan and the standing HKA EOS.Pre-operative lower limb coronal alignment was assessed on 96 knees prior to TKA on the supine coronal scout CT scan and the standing HKA EOS. There were 56 males (56%), and 44 right knees (44%). The mean age was 68 years (range 53-90). The mean coronal alignment was 4.7 degrees (SD 5.3) on CT scan and 4.6 degrees (SD 6.2) on EOS (p=0.70). There was a strong positive correlation of coronal alignment on CT scan and EOS (pearson0.927, p=0.001). The mean difference between EOS and CT scan was 0.9 degrees (SD 2.4). Less than 3 degrees variation between measures was observed in 87% of knees. On linear regression for every 1° varus increase in CT HKA alignment, the EOS HKA alignment increased by 0.93° in varus orientation. The model explained 86% of the variability.CT demonstrates excellent reliability for assessing coronal lower limb alignment compared to EOS in osteoarthritic knees. This supports the routine use of CT to plan TKA without further weight bearing imaging in routine cases.
Women experiencing homelessness and mental illness in a Housing First multi-site trial: Looking beyond housing to social outcomes and well-being
Authors: O’Campo Patricia , Nisenbaum Rosane , Crocker Anne G. , Nicholls Tonia , Eiboff Faith , Adair Carol E. 
Published: February 2023

Objective
There is scant research on the effectiveness of permanent supportive housing for homeless women with mental illness. This study examines the effectiveness of Housing First with an unprecedentedly large sample of homeless women from five Canadian cities, and explore baseline risk factors that predict social, health and well-being outcomes over a 24 month-period.

Methods
The At Home/Chez Soi multi-site randomized controlled Housing First trial recruited over 600 women between October 2009 and July 2011. This is a post-hoc subgroup exploratory analysis of self-identified women with at least one follow-up interview who were randomized to Housing First (HF) (n = 374) or treatment-as-usual (TAU) (n = 279) and had at least one follow-up interview. Linear mixed models and generalized estimating equations were used after multiple imputation was applied to address missing data.

Results
At the end of follow-up, the mean percentage of days spent stably housed was higher for women in the intervention 74.8% (95%CI = 71.7%–77.8%) compared with women in the treatment-as-usual group, 37.9% (95%CI = 34.4%–41.3%), p<0.001. With few exceptions, social and mental health outcomes were similar for both groups at 6-, 12-, 18- and 24-months post-enrollment. Suicidality was a consistent predictor of increased mental health symptoms (beta = 2.85, 95% CI 1.59–4.11, p<0.001), decreased quality of life (beta = -3.99, 95% CI -6.49 to -1.49, p<0.001), decreased community functioning (beta = -1.16, 95% CI -2.10 to -0.22, p = 0.015) and more emergency department visits (rate ratio = 1.44, 95% CI 1.10–1.87, p<0.001) over the study period. Lower education was a predictor of lower community functioning (beta = -1.32, 95% CI -2.27 to -0.37, p = 0.006) and higher substance use problems (rate ratio = 1.27, 95% CI 1.06–1.52, p = 0.009) during the study.

Conclusions
Housing First interventions ensured that women experiencing homelessness are quickly and consistently stably housed. However, they did not differentially impact health and social measures compared to treatment as usual. Ensuring positive health and social outcomes may require greater supports at enrolment for subgroups such as those with low educational attainment, and additional attention to severity of baseline mental health challenges, such as suicidality.

Trial registration
International Standard Randomized Control Trial Number Register Identifier: ISRCTN42520374.
Physical body experiences questionnaire simplified for active aging (PBE-QAG): Rasch validation
Authors: Deng Wei , Carpentier Sydney , Van de Winckel Ann 
Published: February 2023

Purpose
To validate the Physical Body Experiences Questionnaire simplified for Active aGing (PBE-QAG) with Rasch Measurement Theory. PBE-QAG measures body awareness during physical activity.

Methods
Community-dwelling adults were recruited at the Minnesota State Fair, Highland Fest, and in the Brain Body Mind Lab (University of Minnesota). They completed demographic, clinical, and behavioral questionnaires and the PBE-QAG, which has 12 items, with scoring options ranging between 0 (totally true) and 4 (totally false). A lower total PBE-QAG score on reflects better body awareness. We validated the structural validity of PBE-QAG in community-dwelling older adults, and in community-dwelling adults (18–99 years of age). We also performed a pilot structural validity in community-dwelling adults with chronic stroke. We evaluated item and person fit, targeting, unidimensionality, person separation reliability, differential item functioning for demographic and clinical characteristics, principal component of residuals, and local item dependence.

Results
We obtained unidimensionality and item fit after deleting and rescoring items in older adults (n = 133), adults (n = 530), and adults with chronic stroke (n = 36). In community-dwelling adults, 7 participants did not fit the model (1.13%). There was minimal floor (5.28%), no ceiling effect (0.00%), and no local item dependence or differential item functioning. The person mean location was -1.77±1.22 logits.

Conclusions
PBE-QAG demonstrated good item and person fit, but the targeting is off. Therefore, the current version of PBE-QAG is not recommended for use in community-dwelling adults. We encourage further validation of PBE-QAG by adding more difficult items. We also recommend evaluating the PBE-QAG in a larger group of adults with stroke.
Factors associated with elder abuse and neglect in rural Uganda: A cross-sectional study of community older adults attending an outpatient clinic
Authors: Atim Letizia Maria , Kaggwa Mark Mohan , Mamum Mohammed A. , Kule Moses , Ashaba Scholastic , Maling Samuel 
Published: February 2023

BackgroundElderlies are vulnerable to abuse, and evidence suggests that one in three elderlies experience abuse. Abuse can impact the well-being of older persons, decreasing their quality of life, leading to mental health challenges, and increasing morbidity and mortality rates. Evidence on older person/elder abuse and neglect is vital to facilitate initiatives, but there are fewer studies on elder abuse and neglect in Africa, particularly in Uganda. Thus, this study aimed to determine the prevalence of different types of abuse and neglect, and their associated factors among older persons (aged 60 years and above) attending an outpatient clinic.MethodsIn this cross-sectional study, information on sociodemographic characteristics, functional impairment using the Barthel Index, and elder abuse severity using the Hwalek-Sengstock Elder Abuse Screening Test were collected. In addition, types of abuse were assessed using questions adapted from the US National Research Council on elder mistreatment monograph. Linear and logistic regression analyses were used to determine the factors associated with elder abuse severity and the different types of abuse, respectively.ResultsOverall, the prevalence of elder abuse was 89.0%. Neglect was the most common type of elder abuse (86%), followed by emotional abuse (49%), financial abuse (46.8%), physical mistreatment (25%), and sexual abuse (6.8%). About 30.4% of the abused elders experienced at least two forms of abuse. Factors associated with elder abuse severity were having a secondary level of education and physical impairment. Moderate to severe functional dependence was associated with almost all forms of abuse. Individuals who reported the presence of a perpetrator were likely to experience neglect, emotional, and physical mistreatment. However, those who reported their perpetrators to the police had a higher likelihood of experiencing emotional abuse but were less likely to experience financial abuse. Emotional abuse was also associated with age above 80 years and attaining education (primary and secondary). Physical impairment and chronic medical conditions reduced the likelihood of experiencing neglect and financial abuse, and physical abuse, respectively.ConclusionsUganda has a high prevalence of elder abuse and neglect. There is a need to design interventions for older adults at risk to prevent elder abuse from escalating further, where the present findings can be worthy of help.
Real-world utilization of SARS-CoV-2 serological testing in RNA positive patients across the United States
Authors: Rodriguez-Watson Carla V. , Sheils Natalie E. , Louder Anthony M. , Eldridge Elizabeth H. , Lin Nancy D. , Pollock Benjamin D. , Gatz Jennifer L. , Grannis Shaun J. , Vashisht Rohit , Ghauri Kanwal , Valo Gina , Chakravarty Aloka G. , Lasky Tamar , Jung Mary , Lovell Stephen L. , Major Jacqueline M. , Kabelac Carly , Knepper Camille , Leonard Sandy , Embi Peter J. , Jenkinson William G. , Klesh Reyna , Garner Omai B. , Patel Ayan , Dahm Lisa , Barin Aiden , Cooper Dan M. , Andriola Tom , Byington Carrie L. , Crews Bridgit O. , Butte Atul J. , Allen Jeff 
Published: February 2023

Background
As diagnostic tests for COVID-19 were broadly deployed under Emergency Use Authorization, there emerged a need to understand the real-world utilization and performance of serological testing across the United States.

Methods
Six health systems contributed electronic health records and/or claims data, jointly developed a master protocol, and used it to execute the analysis in parallel. We used descriptive statistics to examine demographic, clinical, and geographic characteristics of serology testing among patients with RNA positive for SARS-CoV-2.

Results
Across datasets, we observed 930,669 individuals with positive RNA for SARS-CoV-2. Of these, 35,806 (4%) were serotested within 90 days; 15% of which occurred <14 days from the RNA positive test. The proportion of people with a history of cardiovascular disease, obesity, chronic lung, or kidney disease; or presenting with shortness of breath or pneumonia appeared higher among those serotested compared to those who were not. Even in a population of people with active infection, race/ethnicity data were largely missing (>30%) in some datasets—limiting our ability to examine differences in serological testing by race. In datasets where race/ethnicity information was available, we observed a greater distribution of White individuals among those serotested; however, the time between RNA and serology tests appeared shorter in Black compared to White individuals. Test manufacturer data was available in half of the datasets contributing to the analysis.

Conclusion
Our results inform the underlying context of serotesting during the first year of the COVID-19 pandemic and differences observed between claims and EHR data sources–a critical first step to understanding the real-world accuracy of serological tests. Incomplete reporting of race/ethnicity data and a limited ability to link test manufacturer data, lab results, and clinical data challenge the ability to assess the real-world performance of SARS-CoV-2 tests in different contexts and the overall U.S. response to current and future disease pandemics.
Health system response to COVID-19 among primary health care units in Ethiopia: A qualitative study
Authors: Mitike Getnet , Nigatu Frehiwot , Wolka Eskinder , Defar Atkure , Tessema Masresha , Nigussie Tezita 
Published: February 2023

Introduction
There was limited data on the experiences and roles of sub-national health systems in the response against COVID-19 in Ethiopia. This study explored how sub-national primary health care units and coordinating bodies in Ethiopia responded to COVID-19 during the first 6 months of pandemic.

Methods
We conducted a qualitative study with descriptive phenomenological design using 59 key informants that were purposively selected. The interviews included leaders across Ethiopia’s 10 regions and 2 administrative cities. Data were collected using a semi-structured interview guide that was translated into a local language. The interviews were conducted in person or by phone. Coding and categorizing led to the development of themes and subthemes. Data were analyzed using thematic analysis.

Results
Local administrators across different levels took the lead in responding to COVID-19 by organizing multisectoral planning and monitoring committees at regional, zonal and woreda (district) levels. Health leaders reacted to the demand for an expanded workforce by reassigning health professionals to COVID-19 surveillance and case management activities, adding COVID-19-related responsibilities to their workloads, temporarily blocking leave, and hiring new staff on contractual basis. Training was prioritized for: rapid response teams, laboratory technicians, healthcare providers assigned to treatment centers where care was provided for patients with COVID-19, and health extension workers. COVID-19 supplies and equipment, particularly personal protective equipment, were difficult to obtain at the beginning of the pandemic. Health officials used a variety of means to equip and protect staff, but the quantity fell short of their needs. Local health structures used broadcast media, print materials, and house-to-house education to raise community awareness about COVID-19. Rapid response teams took the lead in case investigation, contact tracing, and sample collection. The care for mild cases was shifted to home-based isolation as the number of infections increased and space became limited. However, essential health services were neglected at the beginning of the pandemic while the intensity of local multisectoral response (sectoral engagement) declined as the pandemic progressed.

Conclusions
Local government authorities and health systems across Ethiopia waged an early response to the pandemic, drawing on multisectoral support and directing human, material, and financial resources toward the effort. But, the intensity of the multisectoral response waned and essential services began suffering as the pandemic progressed. There is a need to learn from the pandemic and invest in the basics of the health system–health workers, supplies, equipment, and infrastructure–as well as coordination of interventions.
Influence of circumferential ankle pressure of shoe collar on the kinematics, dynamic stability, electromyography, and plantar pressure during normal walking
Authors: Nasirzadeh Alireza , Yang Seung-Tae , Yun Juseok , Yang Jaeha , Yoon Bae Young , Park Juyeon , Ahn Jooeun , Lee Giuk 
Published: February 2023

Background
The shoe’s collar plays a significant role in supporting the ankle during walking. Since the protective effect of the collar requires the circular embracing of the ankle and shank, a stiffer collar might be involved with increased circumferential ankle pressure (CAP). It is not clear how collar CAP affects walking performance. Therefore, this study was aimed at examining the influence of the collar CAP on the kinematics, dynamic stability, electromyography (EMG), and plantar pressure during normal walking.

Method
Sixteen healthy male participants walked on a treadmill while wearing a custom-designed high-collar shoe with 10 (low), 30 (medium), and 60 mmHg (high) CAP conditions, and the joint angles, dynamic stability index, EMG, and plantar pressure were measured.

Result
While the low CAP condition did not affect the ankle range of motion (ROM), The high CAP condition restricted both the ankle sagittal and frontal ROM, whereas the medium CAP condition limited only the ankle frontal ROM. The knee and hip ROM did not differ between conditions. The dynamic stability for the high and medium CAP cases was comparable but significantly higher than that of the low CAP condition. The ankle muscle activity and corresponding co-contraction increased with increasing CAP for gastrocnemius medialis (GM), soleus (SOL), peroneus longus (PL), tibialis anterior (TA) muscles in the weight acceptance and push-off phases but not in the single limb support. Knee muscle activity, including vastus lateralis (VL) and semitendinosus (SEMI) was similar between all conditions. A higher relative pressure was observed under the lateral aspect of the heel when walking in the high CAP condition.

Conclusion
The results suggest that a high-collar shoe with a high CAP may not be an appropriate choice for walking owing to the injury risk factors and limited walking efficiency. A medium CAP is associated with certain advantages and, thus, a superior choice for high-collar shoe design.
Congenital diaphragmatic hernia in a middle-income country: Persistent high lethality during a 12-year period
Authors: Scavacini Marinonio Ana Sílvia , Harumi Miyoshi Milton , Testoni Costa-Nobre Daniela , Sanudo Adriana , Nema Areco Kelsy Catherina , Daripa Kawakami Mandira , Xavier Balda Rita de Cassia , Konstantyner Tulio , Bandiera-Paiva Paulo , Vieira de Freitas Rosa Maria , Correia Morais Lilian Cristina , La Porte Teixeira Mônica , Cunha Waldvogel Bernadette , Veiga Kiffer Carlos Roberto , Branco de Almeida Maria Fernanda , Guinsburg Ruth 
Published: February 2023

BackgroundIn high- and middle-income countries, mortality associated to congenital diaphragmatic hernia (CDH) is high and variable. In Brazil, data is scarce regarding the prevalence, mortality, and lethality of CDH. This study aimed to analyze, in São Paulo state of Brazil, the temporal trends of prevalence, neonatal mortality and lethality of CDH and identify the time to CDH-associated neonatal death.MethodsPopulation-based study of all live births with gestational age ≥ 22 weeks, birthweight ≥400g, from mothers residing in São Paulo State, Brazil, during 2004–2015. CDH definition and its subgroups classification were based on ICD-10 codes reported in the death and/or live birth certificates. CDH-associated neonatal death was defined as death up to 27 days after birth of infants with CDH. CDH prevalence, neonatal mortality and lethality were calculated and their annual percent change (APC) with 95% confidence intervals (95%CI) was analyzed by Prais-Winsten. Kaplan-Meier estimator identified the time after birth that CDH-associated neonatal death occurred.ResultsCDH prevalence was 1.67 per 10,000 live births, with a significant increase throughout the period (APC 2.55; 95%CI 1.30 to 3.83). CDH neonatal mortality also increased over the time (APC 2.09; 95%CI 0.27 to 3.94), while the lethality was 78.78% and remained stationary. For isolated CDH, CDH associated to non-chromosomal anomalies and CDH associated to chromosomal anomalies the lethality was, respectively, 72.25%, 91.06% and 97.96%, during the study period. For CDH as a whole and for all subgroups, 50% of deaths occurred within the first day after birth.ConclusionsDuring a 12-year period in São Paulo State, Brazil, CDH prevalence and neonatal mortality showed a significant increase, while lethality remained stable, yet very high, compared to rates reported in high income countries.