bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison of oral iron chelators in the management of transfusion-dependent β-thalassemia major based on serum ferritin and liver enzymes
Authors: Yusuf Sulaiman , Herdata Heru Noviat , Edward Eka Destianti , Khairunnisa Khairunnisa 
Published: February 2023

Background: Excess iron deriving from a chronic transfusion and dietary intake increases the risk for cardiac complications in β-thalassemia major patients. Deferiprone and deferasirox are commonly prescribed to thalassemic patients who are at risk of iron overload. This study aimed to compare the performance and toxicity of deferiprone and deferasirox in β-thalassemia major patients.Methods: A cross-sectional observation was performed on 102 patients with β-thalassemia major. Serum ferritin along with total, indirect, and direct bilirubin levels were measured. Levels of liver enzymes, transaminase (ALT), and aspartate transaminase (AST), were also determined. Ferritin correlations with serum ALT, AST, and total bilirubin were constructed based on Spearman’s rank correlation. Statistical differences based on the serum parameters were analyzed between deferiprone and deferasirox groups. The differences of iron chelators’ effects between those receiving short-term (≤7 years) and long-term (>7 years) blood transfusion were also analyzed.Results: The averaged levels of bilirubin, ALT, AST, and ferritin were found to be high. Ferritin was positively correlated with ALT (r=0.508 andp<0.001) and AST ((r=0.569; p<0.001). There was no statistical difference in ferritin levels between the deferiprone and deferasirox groups (p=0.776). However, higher total bilirubin and ALT were observed in the deferasirox group than in the deferiprone group (p=0.001 and 0.022, respectively). Total (p<0.001), indirect (p<0.001), and direct bilirubin levels (p=0.015) were significantly higher in patients with long-term transfusions than those receiving short-term transfusions. Higher ferritin was found with a statistical significance ofp=0.008 in the long-term transfusions group.Conclusions: Ferritin is high in people with transfusion-dependent β-thalassemia major and positively correlated with ALT and AST. Deferasirox might pose a higher risk of developing hepatic injury as compared with deferiprone. Yet, no significant change of deferasirox efficacy (based on ferritin level) was found between those receiving short-term and long-term transfusions.
Socio-demographic correlates and trends in the timing of the onset of parenthood among women of reproductive age in Ghana: evidence from three waves of the demographic and health surveys
Authors: Baruwa Ololade Julius , Amoateng Yaw Acheampong 
Published: February 2023

Background: Childbearing is one of the central events in a woman’s life and the age at which this event occurs has important health, socioeconomic and fertility implications for her. Methods: We used three waves of the Ghana Demographic and Health Surveys (GDHS) from the individual files of married women aged 15 to 49 years old to explore the trends in the timing of the onset of parenthood among women in Ghana. The Cox proportional hazard model was used to assess the effect of socio-demographic factors on the birth experience of women. Results: Results showed the median age of the women increases from 17 years in 1998 to 19 years in 2014. Further, results showed that women with secondary education had 0.67, 0.89- and 0.77-times lower hazard risk of early birth than women without any formal education in 1988, 1998, and 2014 respectively. The hazard risk of early childbirth consistently decreased as age increased in all the years of surveys except in the case of the age group 40-44 in 1988, 1998 and 2014. Conclusions: This study showed that the timing of first childbirth is changing in the direction of a late childbirth regime in Ghana and could facilitate improvement on individual health, job stability and higher level of education. Efforts should be channeled to sensitizing women on the importance of delaying childbearing.
What works to recruit general practices to trials? A rapid review
Authors: Buckley Daire , McHugh Sheena M. , Riordan Fiona 
Published: February 2023

Background: Recruitment challenges are a barrier to the conduct of trials in general practice, yet little is known about which recruitment strategies work best to recruit practices for randomised controlled trials (RCTs). We aimed to describe the types of strategies used to recruit general practices for trials and synthesize any available evidence of effectiveness. Methods: We conducted a rapid evidence review in line with guidance from Tricco et al. Eligible studies reported or evaluated any strategy to improve practice recruitment to participate in clinical or implementation RCTs. PubMed, Embase, and Cochrane Central Library were searched from inception to June 22nd, 2021. Reference lists of included studies were screened. Data were synthesized narratively. Results: Over 9,162 articles were identified, and 19 studies included. Most (n=13, 66.7%) used a single recruitment strategy. The most common strategies were: in-person practice meetings/visits by the research team (n=12, 63.2%); phone calls (n=10, 52.6%); financial incentives (n=9, 47.4%); personalised emails (n=7, 36.8%) or letters (n=6, 52.6%) (as opposed to email ‘blasts’ or generic letters); targeting practices that participated in previous studies or with which the team had existing links (n=6, 31.6%) or targeting of practices within an existing practice or research network (n=6, 31.6%). Three studies reporting recruitment rates >80%, used strategies such as invitation letters with a follow-up phone call to non-responders, presentations by the principal investigator and study coordinator, or in-person meetings with practices with an existing affiliation with the University or research team. Conclusions: Few studies directly compared recruitment approaches making it difficult to draw conclusions about their comparative effectiveness. However, the role of more personalised letter/email, in-person, or phone contact, and capitalising on existing relationships appears important. Further work is needed to standardise how recruitment methods are reported and to directly compare different recruitment strategies within one study. PROSPERO registration: CRD42021268140 (15/08/2021)
TWO-HOLE DYNAMIC HIP SCREW (DHS) FIXATION OF GARDEN I AND II NECK OF FEMUR FRACTURES: RADIOLOGICAL OUTCOMES AND PREDICTIVE FACTORS OF AVASCULAR NECROSIS
Authors: Badurudeen A.A. , Mathai N. , Altaf D. , Mohamed W. , Deglurkar M. 
Published: February 2023

The aim of this study is to analyse the radiological outcomes and predictors of avascular necrosis following 2-hole DHS in Garden I and II neck of femur fractures in patients more than 60 years with a minimum follow up of one year.We retrospectively reviewed 51 consecutive patients aged more than 60 years who underwent DHS fixation for Garden I and II fractures. Demographics, fracture classification, time to surgery, pre-operative AMTS, preoperative posterior tilt angle, quality of reduction, pre and post-operative haemoglobin(hb), creatinine and comorbidities were analysed for correlation with AVN using Chi-Square test, Independent Sample and paired t test.There were 40 (78.4%) females and the mean age of the cohort was 77 years. 28 and 23 were Garden I and II NOF fractures respectively. Union was observed in all our patients except one(kappa =1). 12/51(23.5%) developed AVN of the femoral head. Statistically significant higher incidence of AVN was noted in patients with a pre-op tilt angle > 200 (p = 0.006). The mean drop in Hb was higher in patients who developed AVN (21.5 g/L) versus the non-AVN group (15.9 g/L) (p = 0.001). There was no difference in AVN rates with respect to laterality, mean time to surgery, pre-op AMTS and Charlson comorbidity index. 4/52 (7.6%) had re-operations (one hardware prominence, two conversions to arthroplasty, one fixation failure during the immediate post-op period). The 30-day and one year mortality rates were 1.9 % and 11.7 % respectively.2-hole DHS fixation in undisplaced NOF fractures has excellent union rates. A pre-operative posterior tilt angle of >200 and a greater difference in pre and post operative haemoglobin were found to correlate positively with the progression to AVN . No correlation was observed between AVN and time to surgery, laterality, quality of reduction and comorbidities.
ACTIVATED PROTEIN C (APC) PROMOTES A HEALING PHENOTYPE IN CULTURED MURINE TENOCYTES VIA PROTEASE-ACTIVATED RECEPTOR (PAR)-2, BUT NOT PAR-1
Authors: Fryer C. , Jackson C. , Mckelvey K. , Lin H. , Xue. M. 
Published: February 2023

Tendinopathy is a tendon pathology often resulting from a failed healing response to tendon injury. Activated protein C (APC) is a natural anti-coagulant with anti-inflammatory and wound healing promoting functions, which are mainly mediated by its receptors, endothelial protein C receptor (EPCR) and protease activated receptors (PARs). This study aimed to determine whether APC stimulates tenocyte healing and if so, to assess the involvement of the receptors.Mouse-tail tenocytes were isolated from 3-week-old wild type (WT), PAR- 1 knockout (KO) and PAR-2 KO mice. The expression of EPCR, PAR-1 and −2 and the effect of APC on tenocytes tendon healing and the underlying mechanisms were investigated by Reverse transcription real time PCR, western blot, 3- (4,5-dimethylthiazol-2-yl)-2,5- diphenyltetrazolium bromide (MTT) assay, zymography, and scratch wound healing/ migration assay.When compared to WT cells, PAR-1 KO tenocytes showed increased cell proliferation (3.3-fold, p<0.0001), migration (2.7-fold, p<0.0001) and wound healing (3-fold, p<0.0001), whereas PAR-2 KO cells displayed decreased cell proliferation (0.6-fold, p<0.05) and no change in cell migration or wound healing. APC at 1 μg/ml stimulated WT and PAR-1 KO tenocyte proliferation (~1.3, respectively, p<0.05) and wound healing (~1.3-fold, respectively, p<0.05), and additionally promoted PAR1-KO cell migration (1.4-fold, p<0.0001). APC only increased the migration (2-fold, p<0.05) of PAR-2 KO tenocytes. The activation of AKT, extracellular signal-regulated kinase (ERK)-2, and glycogen synthase kinase (GSK)-β3, the intracellular molecules that are associated with cell survival/growth, and matrix metalloproteinase (MMP)-2 that is related to cell migration and wound healing, were increased in all three cell lines in response to APC treatment.These findings show that PAR-1 and PAR-2 act differentially in tenocyte proliferation/migration/wound healing. APC likely promotes tenocyte proliferation/ wound healing via PAR-2, not PAR-1.
EARLIER GAINS IN ACTIVE RANGE OF MOTION FOLLOWING ROBOTIC-ASSISTED TOTAL KNEE ARTHROPLASTY COMPARED WITH CONVENTIONAL INSTRUMENTATION
Authors: Fary C. , Tripuraneni K. , Klar B. , Ren A.N. , Abshagen S. , Verheul R. 
Published: February 2023

We sought to evaluate the early post-operative active range-of-motion (AROM) between robotic-assisted total knee arthroplasty (raTKA) and conventional TKA (cTKA). A secondary data analysis on a global prospective cohort study was performed. A propensity score method was used to select a matched control of cTKA from the same database using 1:1 ratio, based on age, sex, BMI, and comorbidity index. This resulted in 216 raTKA and cTKA matched cases. Multivariable longitudinal regression was used to evaluate difference in ROM over time and values are reported as least squares means (95% confidence interval). The longitudinal model tested the treatment effect (raTKA vs cTKA), time effect, and their interaction with control on covariance of patients ‘s age, sex, BMI, comorbidity and pre-operative flexion. Logistic regression was used to analyze the active flexion level at one month (cut by 90°) and three months (cut by 110°).At one-month postoperative the raTKA cases had more AROM for flexion by an average of 5.54 degrees (p<0.001). There was no difference at three months (p=0.228). The raTKA group had a greater improvement from pre-operative values at both one-month, with an average 7.07° (3.6°, 10.5°, p<0.001) more improvement, and at three-months with an average improvement of 4° more (1.61°, 7.24°, p=0.0115). AROM for extension was lower overall in the raTKA group by an average of 0.44° (p=0.029). The raTKA patients had higher odds of achieving ≥90° of flexion at one-month (OR 2.15, 95% CI 1.16, 3.99).raTKA resulted in greater AROM flexion gains in the early postoperative period than cTKA. Additional research is needed to understand if these earlier gains in AROM are associated with improved patient satisfaction and continued improvements with time.
TENDOACHILLES LENGTHENING IMPROVES BAROPODOMETRIC PRESSURES ONE YEAR AFTER SURGERY FOR IDIOPATHIC TOE WALKERS
Authors: Mortimer J. , Louis H. , Whiteman L. , Forouzandeh P. , Steiner A. , Gregg T. , De Ridder K. 
Published: February 2023

Idiopathic Toe-walking (ITW) is a condition where children persistently walk on their toes in the absence of neurological or orthopaedic structural abnormalities. ITW affects 2% of children at the age of 5.5yr. This may eventually result in fixed ankle equinus. There is a paucity of long-term natural history studies in untreated ITW however persisting equinus contractures are implicated in common adult foot conditions.The Aim of this study is to show if the percentage of contact pressure through the hindfoot during standing and walking improve following surgical tendoachilles lengthening one year after surgery in children with ITW when compared to a normative cohort23 patients (46 feet) diagnosed with ITW between 2017-2022; were treated with open zone III Achilles lengthening. We reported patient demographics, clinical resolution, or revision. Passive dorsiflexion range and hindfoot pressure percentage when standing and walking were measured on a baropodometric walkway and compared pre-operatively and at 12-18months postoperatively. We compared this to data from a previously studied normative cohort87% of children had compete resolution of toe-walking. 3 had recurrence with 1 patient having a revision surgery. Mean pre-operative static heel pressure percentage was 15.7%, this improved to 54.7% (p<0.001). This neared normative average of 70.6%. Mean pre-operative dynamic heel pressure percentage was 5.5%, this improved to 44.6% (p<0.001). This neared the normative mean of 52.0%. Mean Passive dorsiflexion in extension and 90˚ knee flexion was −5.8˚ and 0.5˚ respectively. This improved on average by 17.4˚ and 14.5˚ to a new mean of 11.6˚ and 15.0˚ (p<0.001).Open Zone III Achilles lengthening for ITW has high resolution rates. Hindfoot contact pressures and passive ankle dorsiflexion show improvement at 1 year post operatively.
INTRAOPERATIVE COOLED RADIOFREQUENCY NERVE ABLATION DOES NOT IMPROVE POSTOPERATIVE TOTAL KNEE ARTHROPLASTY PAIN MANAGEMENT
Authors: Liew J. , Salmon L. , Mittal R. , Pinczewski L. 
Published: February 2023

Total Knee Arthroplasty (TKA) is a successful treatment for end stage osteoarthritis of the knee joint. However, post-operative pain can lead to patient dissatisfaction and poorer outcomes. Cooled radiofrequency nerve ablation (CRNA) has reportedly been effective at treating pain osteoarthritic knee pain by targeting the periarticular nerves of the knee. We undertook a prospective, controlled pilot study to determine if CRNA provides effective post-operative analgesia when utilised intra-operatively during total knee arthroplasty.Participants were recruited from January 2019 to February 2020. Those meeting inclusion criteria underwent TKA with intraoperative CRNA to 6 target sites prior to the cementing of implants. The primary outcomes were pain scores and opiate usage in the first 4 days post-operatively, then weekly up to 6 weeks. A total of 62 patients were screened and allocated sequentially; 18 were recruited to the control group and 12 recruited to the study group. The two groups did not have any significant difference in demographics.There were no clinically significant differences between the two groups in terms of pain scores nor opiate usage. There were complications as a result of the intervention.This study demonstrated no benefit of using intraoperative CRNA for improving post-operative pain scores or reducing opiate use after TKA.
Validity and reliability of the left ventricular assist device self-care behaviour scale
Authors: Kato Naoko P. , Melnikov Semyon , Denfeld Quin E. , Casida Jesus , Strömberg Anna , Ben-Gal Tuvia , Lee Christopher S. , Jaarsma Tiny 
Published: February 2023

Background
Adequate self-care behaviour is essential for patients with a left ventricular assist device (LVAD) to prevent complications, prolong life, and optimise quality of life. However, there were no valid and reliable measurements available to assess self-care behaviour among patients with LVAD. We have previously developed the 33-item LVAD self-care behaviour scale.

Objectives
To evaluate psychometric properties of the 33-item LVAD self-care behaviour scale.

Methods and results
Data on 127 patients with a LVAD in Israel, Japan, and the USA were analysed (mean age 51±14.3, 81% male). Exploratory factor analysis extracted three factors, and 13 items were excluded from the scale. Internal consistency assessed by Cronbach’s alpha was acceptable for the total scale (α = 0.80) and the three subscales: Factor 1: Monitoring (α = 0.81), Factor 2: Heart failure self-care (α = 0.67), and Factor 3: LVAD self-care (α = 0.63). The 20-item version of the LVAD self-care behaviour scale had sufficient convergent validity with another scale that assessed self-care related to the driveline of LVAD (r = 0.47, p<0.001). Test–retest reliability was adequate (intraclass correlation coefficient = 0.58).

Conclusions
The 20-item version of the LVAD self-care behaviour scale showed adequate validity and reliability. The scale is ready for use in clinical practice and research. Additional testing might further optimise the scale.
Remote follow-up based on patient-reported outcomes in patients with chronic kidney disease: A qualitative study of patient perspectives
Authors: Grove Birgith Engelst , Valen Schougaard Liv Marit , Ivarsen Per , Hjollund Niels Henrik , de Thurah Annette , Mejdahl Caroline Trillingsgaard 
Published: February 2023

BackgroundPatient-reported outcomes (PROs) are increasingly used in outpatient follow-up. PRO-based remote follow-up offers a new healthcare delivery model, where PROs are used as the basis for outpatient follow-up in patients with chronic kidney disease. However, the patient’s perspective of this novel remote care delivery remains unknown.ObjectivesThis study aimed to explore the patients’ experiences using PROs in remote care and how this mode of follow-up may enhance patient engagement.DesignA qualitative approach was employed, guided by Focused Ethnography and Interpretive Description.ParticipantsPurposively, 15 patients with chronic kidney disease experienced with PRO-based remote follow-up in 3 renal outpatient clinics in the Central Denmark Region, were recruited.MeasuresField studies comprising participant observation in remote PRO consultations and individual, semi-structured interviews with the patients constituted the empirical data. Thematic analysis was performed according to Braun and Clarke’s six-phase process.ResultsPRO-based remote follow-up may enhance patient engagement by a) improving communication, b) increasing disease knowledge, c) inducing flexibility, d) ensuring clinician feedback on PRO data, and e) prompting clinical action. Barriers to enhanced patient engagement were identified as a) lack of feedback on PRO data, b) lower disease knowledge, c) PRO in competition with biomedical data, and d) loss of personal relation.ConclusionPRO-based follow-up in remote care holds several advantages for the patients. However, some barriers need clinical awareness before PROs may enhance the patients’ engagement in remote follow-up. Future studies should explore the impact of involving relatives in PRO-based follow-up.
A UVR-sensor wearable device intervention to reduce sun exposure in melanoma survivors: Results from a randomized controlled trial
Authors: Vogel Rachel Isaksson , Luo Xianghua , Brown Katherine , Jewett Patricia , Dona Allison C. , Nagler Rebekah H. , Ahmed Rehana L. , Martinson Brian C. , Lazovich DeAnn 
Published: February 2023

Background
Melanoma survivors are at increased risk of developing a second primary melanoma; however, some report sub-optimal sun behaviors and sunburns. We tested the effectiveness of a wearable device with ultraviolet radiation (UVR)-sensing technology to improve sun behaviors and reduce sunburns in cutaneous melanoma survivors.

Materials and methods
We conducted a randomized controlled trial using Shade 2, a commercially available wrist device that measures UVR. The intervention group received the device and mobile application notifications about their exposure and prompts to use sunscreen. The control group received the device and a separate research mobile application without information about their exposure or notifications. Participants wore the device for 12 weeks and self-reported sun behaviors before, during, and after the intervention. The primary outcome was a composite score of sun protection behaviors at week 12.

Results
386 participants were randomized (186 control, 182 intervention). Most were female and 5+ years past their first melanoma diagnosis. The average age was 56 years. Most (93%) completed the study, though 40% experienced device issues. No meaningful differences were observed in self-reported sun protection behaviors at week 12 (controls 3.0±0.5 vs. intervention 2.9±0.5, p = 0.06), any sunburn during the intervention period (controls 14.4% vs. intervention 12.7%, p = 0.75), or average daily objective UVR exposure (controls median 87 vs. intervention 83 J/m2, p = 0.43).

Conclusion
Wearing a device that measured and alerted melanoma survivors to UVR exposure did not result in different sun behaviors, exposure, or sunburns relative to controls. The technology needs refinement before further attempts to assess the effectiveness of self-monitoring UVR exposure.

Clinical trials registration
NCT03927742.
Hipoacusia neurosensorial bilateral infantil postCovid
Authors: Almeida-Ayerve Cristina Nicole , Marcos-Alonso Susana , Fernández-Nava María José , Peña-Navarro Paula , Monópoli-Roca Chiara , Calvo-Boizas Enrique 
Published: February 2023

Introducción: Durante la pandemia por SARS-CoV-2 y después de la fase aguda, se han descrito síntomas persistentes como secuela. En área ORL se han descrito principalmente odinofagia, disfonía y acúfenos. La hipoacusia no está actualmente en la lista de síntomas pre o post COVID-19. Sin embargo, se han descrito algunos casos alrededor del mundo de hipoacusia neurosensorial sobre todo semanas después de superar la infección.
Caso clínico: Paciente varón de 8 años sin antecedentes, quien en marzo del 2020 acudió a urgencias por broncoespasmo relacionado con infección de vías respiratorias altas. Varios meses después presentó sensación subjetiva de hipoacusia, ante sospecha de Otitis media serosa se pautó tratamiento con corticoide intranasal. En octubre del 2020 lo derivan a la consulta de ORL por persistencia de la hipoacusia con otoscopia normal bilateral. En Audiometría Tonal Liminal (ATL) presentó hipoacusia neurosensorial bilateral moderada con curvas A bilaterales en impedanciometria.
Evolución: Durante el seguimiento, se confirmó la hipoacusia bilateral descrita en Potenciales Evocados Auditivos de Estado Estable (PEAEE). En el estudio etiológico y debido a la fecha de inicio de los síntomas (inicio de la pandemia COVID-19), se añadió serología con anticuerpos para SARS COV 2 siendo estos positivos; el paciente no se encontraba vacunado y ninguno de los padres referían el antecedente dicha infección.
Conclusiones: La pérdida auditiva, total o parcial, no está actualmente en la lista de síntomas COVID-19 agudo ni en COVID persistente, además de que no hay suficiente evidencia para relacionar este síntoma como secuela de dicha infección. Se necesitan estudios de alta calidad para determinar los riesgos a largo plazo a nivel cócleo-vestibular.