bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Comparison of Perioperative Complications of Hand and Wrist Arthroplasty for Osteoarthrosis by Orthopedic Versus Plastic Surgeons
Authors: Pham Jason T. , Lem Melinda R. , Tang Cathy J. 
Published: August 2023

Background: Arthroplasty is commonly performed in the management of osteoarthrosis of the hand and wrist by orthopedic or plastic surgeons with a fellowship in hand. The differences between operative outcomes between the 2 groups have not been described. Therefore, we analyzed a national database to determine acute outcomes between orthopedic and plastic surgery when performing arthroplasty for osteoarthrosis of the hand and wrist. Methods: A retrospective cross-sectional analysis was performed by including patients with osteoarthrosis of the hand and wrist by International Classification of Diseases codes. Demographic, operative, and outcome variables were collected. Pearson χ2 and Fischer exact tests were used for categorical variables, while a Mann-Whitney U test was performed for continuous variables. Multivariate regression analysis was performed to determine strength of predictors. Results: There were 3721 patients who received arthroplasty for osteoarthrosis of the hand and wrist from 2007 to 2020. Most cases were performed by orthopedic surgeons (82.7%); however, there were an increasing number of surgeries performed by plastic surgeons. Most cases were performed on the intercarpal or carpometacarpal joints (81.7%). The incidence of acute complications was low (1.9%) with superficial surgical site infections (SSIs) being the most common complication. Univariate analysis found that plastic surgery may result in higher chances of superficial SSIs, but multivariate analysis indicated that there were no significant differences between the 2 groups. Conclusion: There were no significant differences on multivariate regression analysis between plastic and orthopedic surgeons, suggesting that both can perform arthroplasty of the hand and wrist without safety concerns.
A sex-based analysis of 5-year outcomes following stenting for the treatment of aorto-iliac occlusive disease
Authors: Mwipatayi Bibombe Patrice , Barry Ian Patrick , Hanna Joseph , Macarulay Reane , Wong Jackie , Thomas Shannon , Vijayan Vikram , Puttaswamy Vikram , Ward Natalie C. 
Published: August 2023

Objectives The aim of this study was to evaluate the impact of sex on mid-term outcomes following stenting for aorto-iliac occlusive disease (AIOD). Methods The Covered versus Balloon Expandable Stent Trial (COBEST) compared the safety and efficacy of the covered stent (CS) with those of the bare metal stent (BMS) in the treatment of hemodynamically significant AIOD. It was identified that CS provided a significant benefit. The primary endpoint of our analysis was the rate of primary patency 5 years following stenting for AIOD (inclusive of both CS and BMS) in both sexes. Results Of the 168 lesions treated, 103 (61%) were present in men and 65 (39%) were present in women. Of the concomitant comorbidities, diabetes mellitus was significantly more common in women (17.5% vs 41.5%, p = .006). Although chronic limb threatening ischemia (CLTI) at the time of intervention was more common in women, the difference was not significant (16.5% vs 24.6%, p = .395). Sex was not associated with the primary patency rate (male; 0.70, 95% confidence interval [CI]: 0.23–2.19, p = .543). When considering both male sex and the utilization of BMS, no significant impact was found on the primary patency rate (hazard ratio [HR]: 3.43, 95% CI: 0.69–17.10, p = .133). All-cause mortality at 60 months was 22.6% in men compared to 19.4% in women ( p = .695). Conclusions No significant difference was identified in the primary patency rate between the sexes. Further investigation is warranted to ascertain whether sex-specific interventional guidelines are required in this regard.
Effects of scutellarin on acute myocardial ischemia/reperfusion injury in isolated rat heart
Authors: Qu Daoxu , Feng Peiwen , Zhang Xinjie , Zhou Mingjie 
Published: August 2023

Objectives This study aimed to evaluate the cardioprotective effects and mechanism of scutellarin (Scu) on heart ischaemia/reperfusion (I/R) injury by using an isolated Langendorff rat heart model. Methods Myocardial function was evaluated via measurements of cardiac haemodynamic parameters. Myocardial infarct size was macroscopically estimated by using TTC staining. The release of creatine kinase (CK) and lactate dehydrogenase (LDH) was used to evaluate cardiac injury. GSH/GSSG, SOD, and MDA were determined as being indicators of oxidative stress. CRP, IL-6, and TNF-α were also analysed to assess inflammation in the heart tissues. Cardiomyocyte apoptosis was quantified by using a TUNEL kit. PPARγ, Nrf2, and NF-κB were assayed via Western blotting. Results The results indicated that I/R induced significant cardiac dysfunction, myocardial infarct, and apoptosis, as well as decreasing the GSH/GSSG ratio, SOD activity, Nrf2 protein expression, and PPARγ protein expression, but increased levels of TNF-α, MDA, CRP, IL-6, and NF-κB. Conclusion These data suggest that Scu attenuates cardiac I/R.
A SuperLearner-enforced approach for the estimation of treatment effect in pediatric trials
Authors: Azzolina Danila , Comoretto Rosanna , Da Dalt Liviana , Bressan Silvia , Gregori Dario 
Published: August 2023

Background Randomized Clinical Trials (RCT) represent the gold standard among scientific evidence. RCTs are tailored to control selection bias and the confounding effect of baseline characteristics on the effect of treatment. However, trial conduction and enrolment procedures could be challenging, especially for rare diseases and paediatric research. In these research frameworks, the treatment effect estimation could be compromised. A potential countermeasure is to develop predictive models on the probability of the baseline disease based on previously collected observational data. Machine learning (ML) algorithms have recently become attractive in clinical research because of their flexibility and improved performance compared to standard statistical methods in developing predictive models. Objective This manuscript proposes an ML-enforced treatment effect estimation procedure based on an ensemble SuperLearner (SL) approach, trained on historical observational data, to control the confounding effect. Methods The REnal SCarring Urinary infEction trial served as a motivating example. Historical observational study data have been simulated through 10,000 Monte Carlo (MC) runs. Hypothetical RCTs have been also simulated, for each MC run, assuming different treatment effects of antibiotics combined with steroids. For each MC simulation, the SL tool has been applied to the simulated observational data. Furthermore, the average treatment effect (ATE), has been estimated on the trial data and adjusted for the SL predicted probability of renal scar. Results The simulation results revealed an increased power in ATE estimation for the SL-enforced estimation compared to the unadjusted estimates for all the algorithms composing the ensemble SL.
Facilitation of Competency-Based Learning With a Practicum Administration Software: The User Experience
Authors: Arinze Chika A. , Lokker Cynthia , Slifierz Mackenzie , Apatu Emma 
Published: August 2023

Objective Technology is essential in the facilitation of many operations in higher educational institutions. The use of web-based platforms to deliver academic content, including practice-based training, has gained popularity. However, their use in practicum process administration is not well studied. In the 2020/2021 academic year, a graduate program in the Faculty of Health Science within a public university in Ontario incorporated the InPlace platform to streamline the administration of the practicum process, including goal setting. This study aimed to understand the user experience of the platform in facilitating competency-based learning. Methods Twelve students participated in two focus group sessions that lasted approximately 1.5 hr each. Two staff members participated in one-on-one semi-structured interviews. The System Usability Scale (SUS) was used as a measure of the platform’s usability. Other outcomes included staff and students’ user experience. Result Overall, the students and staff believe the platform is good for facilitating competency-based learning. The SUS score was 61.8 (95% confidence interval, [56.7, 66.9]). Eight students (66.7%) indicated that the platform was useful in helping them navigate their learning goals. Staff expressed appreciation of the program with respect to communication, practicum process, and overall program administration. Some suggestions for improving the platform were made. Conclusion The practicum placement platform has shown some initial benefits in communication and practicum process administration. In a future configuration of similar platforms, the implementation of the suggestions provided in this study may be necessary to improve usability and enhance the facilitation of competence-based learning.
Primary Brainstem Hemorrhage—An Institutional Series From a Stroke Register and Evaluation of Outcome Determinants
Authors: Gupta Namrata , Pradhan Aseem , Ibrahim Sufyan , S Benak , Hegde Ajay , Menon Girish 
Published: August 2023

Objective Primary brainstem hemorrhage (PBH) carries poor prognosis and the need for aggressive management is a matter of debate especially in developing countries with limited resources. The aim of this study was to analyze the prognostic factors in mortality prediction following PBH in a series of 59 consecutive patients. Methods A single institutional, retrospective, cohort study with a study period of 6 years (2016-2021). All patients with computerized tomography-proven intracerebral hematoma in the midbrain, pons, or medulla, alone or in combination were included in the study. Outcome was analyzed using a modified Rankin score (mRS) and was categorized into good (mRS 0, 1, 2, and 3), poor (mRS 4 and 5), and death. Statistical analysis was done using univariate regression analysis followed by multivariate regression analysis and a P value < .05 was considered significant. Results A total of 59 patients diagnosed with primary brainstem hematoma were included in the study. Of the 59 patients, 40 (67.79%) were males and 19 (32.2%) were females, with a mean age of 55.51 ± 13.46 (range of 29-93 years). The median admission GCS score on admission was 6. No definite history of hypertension could be elicited in 18 patients (30.50%). The most common site for a brain stem hematoma was the pons 47 (79.9%) followed by pons-midbrain combination (06 10.2%). The average clot volume was 7.78 ± 6.5 mL. Fourth ventricular extension was seen in 18 patients (28.8%%) of whom 15 (27.2%) developed hydrocephalus. All patients were managed conservatively. At 3 months, 34 patients (57.62%) succumbed to the illness while 25 survived (42.37%) of whom only 12 had a good outcome (mRS 0-3). In addition to GCS score < 8, ( P < .001) large clot volume (>10 mL) ( P < .001), high systolic blood pressure on admission, and intraventricular extension, a high admission neutrophil-to-lymphocyte ratio (NLR) ( P < .03) was found to have significant correlation with mortality. Conclusion Brainstem hemorrhage has a high mortality and few patients have good clinical outcome. Admission GCS, clot volume, hypertensive in etiology, and a high NLR are poor prognostic factors. Low GCS on admission is the most important and independent predictor of mortality and poor outcome.
Comparing the performance of Cyperus papyrus and Typha domingensis for the removal of heavy metals, roxithromycin, levofloxacin and pathogenic bacteria from wastewater
Authors: Hamad Mohammed Taha Moustafa Hussien 
Published: August 2023

AbstractContamination of heavy metals and antibiotics would threaten the water and soil resources. Phytoremediation can be potentially used to remediate metal and antibiotics contaminated sites. The current study was carried out over a period of 12 months to assess the efficiency of the macrophytes Typha domingensis and Cyperus papyrus with different substrate materials to remove heavy metals and two antibiotics, roxithromycin and levofloxacin, from wastewater for reuse in agriculture. The concentrations of seven heavy metals (copper, nickel, iron, cadmium, zinc, lead, and chromium) in water and plant tissues were determined. The results showed that C. papyrus had a greater capacity than T. domingensis to remove biochemical oxygen demand (BOD) (80.69%), chemical oxygen demand (COD) (69.87%), and ammonium (NH4+) (69.69%). Cyperus papyrus was more effective in retaining solid pollutants. The bioaccumulation factors (BCF) roots of C. papyrus were higher levels of most metals than those of T. domingensis. The highest root–rhizome translocation factor (TF) values of C. papyrus were higher than T. domingensis. The bacterial indicators (total and fecal coliforms, as well as Faecal streptococci) and the potential pathogens (Escherichia coli, Staphylococcus aureus, and Pseudomonas aeruginosa) showed removal efficiencies ranging between 96.9% and 99.8%. The results indicated that the two systems could significantly reduce the concentration of antibiotics in wastewater, with roxithromycin showing higher elimination rates than levofloxacin. The results showed maximum removal of the heavy metals in constructed wetlands CWs planted with T. domingensis. The presence of zeolite and C. papyrus in the effluent of CWs significantly improved treatment capacity and increased pollutant removal efficiency.
A novel SNP in NKX1-2 gene is associated with carcass traits in Dezhou donkey
Authors: Wang Xinrui , Wang Tianqi , Liang Huili , Wang Liyuan , Akhtar Faheem , Shi Xiaoyuan , Ren Wei , Huang Bingjian , Kou Xiyan , Chen Yinghui , Zhan Yandong , Wang Changfa 
Published: August 2023

Abstract
Background
At present, donkey meat in the market shows an imbalance between supply and demand, and there is an urgent need to cultivate a meat-type Dezhou donkey breed. On the one hand, it can improve the imbalance in the market, and on the other hand, it can promote the rapid development of the donkey industry. This study aimed to reveal significant genetic variation in the NK1 homeobox 2 gene (NKX1-2) of Dezhou donkeys and investigate the association between genotype and body size in Dezhou donkeys.

Results
In this study, a SNP (g.54704925 A > G) was identified at the exon4 by high-depth resequencing of the Dezhou donkey NKX1-2 gene. The AA genotype is the dominant genotype. The g.54704925 A > G site was significantly associated with body length, thoracic girth, and hide weight (P < 0.05), while it was highly significantly associated with body height and carcass weight (P < 0.01) in Dezhou donkeys.

Conclusion
Overall, the results of this study showed that the NKX1-2 gene could be a candidate gene for breeding meat-type Dezhou donkeys, and the g.54704925 A > G locus could be used as a marker locus for selection and breeding.
Prevalence of gastro-oesophageal reflux disease, and its associated risk factors among medical students: a nation-based cross-sectional study
Authors: Baklola Mohamed , Terra Mohamed , Badr Amr , Fahmy Fayrouz Mohamed , Elshabrawy Enas , Hawas Yousef , Abdel-Hady Doaa , El-Gilany Abdel-Hady 
Published: August 2023

Abstract
Background
Gastroesophageal reflux disease (GERD) is a common digestive problem in adults particularly medical students, who are one of the most vulnerable groups. Many variables, including lifestyle changes and psychological stress, increase the prevalence of GERD among undergraduate medical students. Therefore, this study aims to assess the prevalence, and risk factors of GERD, and its relationship with perceived stress among medical students in Egypt.

Methods
In November and December of 2022, a cross-sectional descriptive study with an analytical component was carried out among medical students from six different universities. An online self-reported questionnaire was used to collect data. The questionnaire included data on sociodemographic characteristics, risk factors, lifestyle, the Arabic version of GerdQ, and the Arabic version of Cohen’s Perceived Stress Scale (PSS).

Results
The questionnaire was filled out by 964 medical students, the majority of whom were female (64%). Overall, 17.1% of participants reported symptoms of GERD. Logistic regression showed that smoking, high perceived stress, and a family history of GERD were the independent predictors of having GERD symptoms, with odds ratios of 4.1, 3.9, and 2.2, respectively.

Conclusion
GERD is a frequent condition among Egyptian medical students, affecting around one-fifth of them. In the fight against GERD, university-based smoking cessation and stress management programs may be influential.
Facilitators and barriers to tuberculosis active case findings in low- and middle-income countries: a systematic review of qualitative research
Authors: Fenta Melkie Dagnaw , Ogundijo Oluwaseun Adeolu , Warsame Ahmed Abi Abdi , Belay Abebaw Getachew 
Published: August 2023

Abstract
Background
Tuberculosis (TB) is an ancient infection and a major public health problem in many low- and middle-income countries (LMICs). Active case finding (ACF) programs have been established to effectively reduce TB in endemic global communities. However, there is little information about the evidence-based benefits of active case finding at both the individual and community levels. Accurately identifying the facilitators and barriers to TB-ACF provides information that can be used in planning and design as the world aims to end the global TB epidemic by 2035. Therefore, this study aimed to identify the facilitators and barriers to tuberculosis ACF in LMICs.

Methods
A systematic search was performed using recognized databases such as PubMed, Google Scholar, SCOPUS, HINARI, and other reference databases. Relevant studies that assessed or reported the ACF of TB conducted in LMICs were included in this study. The Joanna Briggs Institute’s (JBI) Critical Appraisal Tool was used to assess the quality of the selected studies. The Statement of Enhancing Transparency in Reporting the Synthesis of Qualitative Research (ENTREQ) was used to strengthen the protocol for this systematic review. The Confidence of Evidence Review Quality (CERQual) approach was also used to assess the reliability of the review findings.

Results
From 228 search results, a total of 23 studies were included in the final review. Tuberculosis ACF results were generated under two main themes: barriers and facilitators in LMICs, and two sub-themes of the barriers (healthcare-related and non-healthcare-related barriers). Finally, barriers to active TB case finding were found to be related to (1) the healthcare workers’ experience, knowledge, and skills in detecting TB-ACF, (2) distance and time; (3) availability and workload of ACF healthcare workers; (4) barriers related to a lack of resources such as diagnostic equipment, reagents, and consumables at TB-ACF; (5) the stigma associated with TB-ACF detection; (6) the lack of training of existing and new healthcare professionals to detect TB-ACF; (7) communication strategies and language limitations associated with TB ACF; and (8) poor or no community awareness of tuberculosis. Stigma was the most patient-related obstacle to detecting active TB cases in LMICs.

Conclusion
This review found that surveillance, monitoring, health worker training, integration into health systems, and long-term funding of health facilities were key to the sustainability of ACF in LMICs. Understanding the elimination of the identified barriers is critical to ensuring a maximum tuberculosis control strategy through ACF.
Ultrasound scoring system for prenatal diagnosis of placenta accreta spectrum
Authors: Zhang Junling , Li Hezhou , Feng Demin , Wu Juan , Wang Zhaoyu , Feng Fan 
Published: August 2023

Abstract
Background
To develop an ultrasound scoring system for placenta accreta spectrum (PAS), evaluate its diagnostic value, and provide a practical approach to prenatal diagnosis of PAS.

Methods
A total of 532 pregnant women (n = 184 no PAS, n = 120 placenta accreta, n = 189 placenta increta, n = 39 placenta percreta) at high-risk for placenta accreta who delivered in the Third Affiliated Hospital of Zhengzhou University between January 2021 and December 2022 underwent prenatal ultrasound to evaluate placental invasion. An ultrasound scoring system that included placental and cervical morphology and history of cesarean section was created. Each feature was assigned a score of 0 ~ 2, according to severity. Thresholds for the total ultrasound score that discriminated between no PAS, placenta accreta, placenta increta, and placenta percreta were calculated.

Results
Univariate and multivariate regression analysis identified seven indicators of PAS that were included in the ultrasound scoring system, including placental location, placental thickness, presence/absence of the retroplacental space, thickness of the retroplacental myometrium, presence/absence of placental lacunae, retroplacental myometrial blood flow and history of cesarean section. Using the final ultrasound scoring system, no PAS is diagnosed at a total score < 5, placenta accreta or placenta increta is diagnosed at a total score 5–10, and placenta percreta is diagnosed at a total score ≥ 10.

Conclusions
This study identified seven indicators of PAS and included them in an ultrasound scoring system that has good diagnostic efficacy and clinical utility.

Trial registration
ChiCTR2300069261 (retrospectively registered on 10/03/2023).
Preliminary psychometric properties of the Chinese version of the structured interview of personality organization (STIPO-CH)
Authors: Wang Yang , Li Zirong , Zhong Jie 
Published: August 2023

Abstract
Background
Kernberg originally proposed the psychoanalytic concept of personality organization (PO), which measures personality pathology from a dimensional approach with multiple scales and can be evaluated using the Structured Interview of Personality Organization (STIPO) from six domains: identity, object relations, primitive defenses, coping vs. rigidity, aggression, and moral values. The present study translated the original version into the Chinese STIPO (STIPO-CH) version and evaluated its reliability and validity.

Methods
The STIPO-CH was administered to 49 non-clinical subjects. They also completed the Chinese version of the Inventory of Personality Organization and the Millon Clinical Multiaxial Inventory to evaluate criterion-related reliability. Interrater reliability was assessed with intraclass correlations. An item analysis was carried out to explore the structure and internal consistency.

Results
Interrater reliability (intraclass correlations) ranged from 0.98 to 0.99. Results suggested acceptable internal consistency for identity and moral values. The correlations between STIPO-CH domains and self-report questionnaires indicated that construct validity and criterion-related validity were acceptable to good.

Conclusions
Overall, this study presents preliminary psychometric properties of STIPO-CH. Limitations regarding the sample, interviewers, and cultural differences are discussed. Future research is highly recommended.