bluuebunny/crossref_metadata_2025_split huggingface dataset:
Early Tensile Loading in Nonsurgically Treated Achilles Tendon Ruptures Leads to a Larger Tendon Callus and a Lower Elastic Modulus: A Randomized Controlled Trial
Authors: Rendek Zlatica , Bon Beckman Leo , Schepull Thorsten , Dånmark Ida , Aspenberg Per , Schilcher Jörg , Eliasson Pernilla 
Published: August 2022

Background: Early tensile loading improves material properties of healing Achilles tendon ruptures in animal models and in surgically treated human ruptures. However, the effect of such rehabilitation in patients who are nonsurgically treated remains unknown. Hypothesis: In nonsurgically treated Achilles tendon ruptures, early tensile loading would lead to higher elastic modulus 19 weeks after the injury compared with controls. Study Design: Randomized controlled trial; Level of evidence, 2. Methods: Between October 2015 and November 2018, a total of 40 nonsurgically treated patients with acute Achilles tendon rupture were randomized to an early tensile loading (loaded group) or control group. Tantalum bead markers were inserted percutaneously into the tendon stumps 2 weeks after the injury to allow high-precision measurements of callus deformation under mechanical testing. The loaded group used a training pedal twice daily to produce a gradual increase in tensile load during the following 5 weeks. Both groups were allowed full weightbearing in an ankle orthosis and unloaded range of motion exercises. Patients were followed clinically and via roentgen stereophotogrammetric analysis and computed tomography at 7, 19, and 52 weeks after the injury. Results: The mean ± standard deviation elastic modulus at 19 weeks was 95.6 ± 38.2 MPa in the loaded group and 108 ± 45.2 MPa in controls ( P = .37). The elastic modulus increased in both groups, although it was lower in the loaded group at all time points. Tendon cross-sectional area increased from 7 weeks to 19 weeks, from 231 ± 99.5 to 388 ± 142 mm2 in the loaded group and from 188 ± 65.4 to 335 ± 87.2 mm2 in controls ( P < .001 for the effect of time). Cross-sectional area for the loaded group versus controls at 52 weeks was 302 ± 62.4 mm2 versus 252 ± 49.2 mm2, respectively ( P = .03). Gap elongation was 7.35 ± 13.9 mm in the loaded group versus 2.86 ± 5.52 mm in controls ( P = .27). Conclusion: Early tensile loading in nonsurgically treated Achilles tendon ruptures did not lead to higher elastic modulus in the healing tendon but altered the structural properties of the tendon via an increased tendon thickness. Registration: NCT0280575 (ClinicalTrials.gov identifier).
The Impact of Sustained Ownership of a Pet on Cognitive Health: A Population-Based Study
Authors: Applebaum Jennifer W. , Shieu Monica M. , McDonald Shelby E. , Dunietz Galit Levi , Braley Tiffany J. 
Published: August 2022

Objectives: To examine associations between sustained ownership of a pet and cognitive outcomes among a national sample of U.S. adults. Methods: Weighted linear mixed models were estimated using the Health and Retirement Study (2010–2016, n = 1369) to compare repeated measures of cognitive function between respondents who endorsed owning a pet in a sustained manner (>5 years), versus those who owned a pet ≤5 years, and non-pet owners. Results: Respondents aged 65+ who owned a pet >5 years demonstrated higher composite cognitive scores, compared to non-pet owners (β = .76, p = .03). Sustained pet ownership was associated with higher immediate (β = .3, p = .02) and delayed (β = .4, p = .007) word recall scores. There were no significant differences in cognitive scores between pet owners and non-owners aged < 65. Discussion: Sustained ownership of a pet could mitigate cognitive disparities in older adults. Further studies are needed to examine potential causal pathways, including physical activity and stress buffering, versus selection effects.
Reproductive Management in Catteries: Optimising health and wellbeing through veterinarian-breeder collaboration
Authors: Goericke-Pesch Sandra , Packeiser Eva-Maria 
Published: August 2022

Practical relevance: Many veterinarians – even those engaged in small animal reproduction – are uncomfortable with taking care of cat breeders or being in charge of catteries. Likely reasons for this are that feline reproduction is largely under-represented in undergraduate and graduate reproduction teaching, as well as in postgraduate education and science, whereas cat breeders themselves are often well informed and actively share knowledge with other cat breeders via the internet and social media. Clinical challenges: A variety of problems can exist within a cattery, and collaboration between veterinarian and breeder to solve these is ultimately beneficial for the breeder, for the veterinarian, and for the health and wellbeing of the individual cats and of the cattery as a whole. Aim: This review presents a comprehensive overview of aspects of cattery management that might negatively impact reproduction, including sanitation, hygiene and infectious disease control. It also discusses monitoring of reproductive performance, breeding recommendations, and the diagnostic and therapeutic approach to some common and specific problems. Equipment and technical skills: Reproductive management in the cattery requires no specialised equipment, as such. What it does need is an open mind, in terms of seeing how things are done, an open ear, for listening to the breeder, and the veterinarian’s clinical skills in palpation, auscultation and, where required, further examination of the animals. Keeping abreast of the latest information on infectious diseases, disinfection and genetics ensures proper advice is provided. Evidence base: Current knowledge of reproductive management in catteries is summarised in order to apply an evidence-based approach, whenever possible. Notwithstanding, much of the information remains empirical.
Use of Cannulated Screws for Primary Latarjet Procedures
Authors: Rattier Simon , Druel Thibaut , Hirakawa Yoshihiro , Gröger Falk , van Rooij Floris , Neyton Lionel 
Published: August 2022

Background: Rapid consolidation of the bone block is paramount for the success of the Latarjet procedure. Noncannulated screws have shown satisfactory long-term bone block fusion, while cannulated screws are challenged with inferior mechanical properties and fusion rates. Purpose: To report outcomes of the Latarjet procedure using cannulated screws, notably bone block fusion and complication rates at 3 months, as well as clinical scores and return to sports at minimum 2 years postoperatively. Study Design: Case series; Level of evidence, 4. Methods: We reviewed the records of 124 consecutive patients (124 shoulders) who underwent primary Latarjet procedures using cannulated screws between 2015 and 2018. All patients underwent clinical examination at 3 months postoperatively, including range of motion and radiographs to assess graft fusion. The Walch-Duplay score, Rowe score, Subjective Shoulder Value, and visual analog scale for pain were collected at a minimum follow-up of 2 years. Results: Overall, 9 patients (7%) required reoperation: 7 (6%) had screw removal for unexplained residual pain, 1 (0.8%) had lavage for deep infection, and 1 (0.8%) had evacuation to treat a hematoma. Furthermore, 3 patients (2.4%) had recurrent instability, none of whom underwent reoperation. At 3-month follow-up, all 124 shoulders showed complete radiographic graft fusion, and at 40 ± 11 months (mean ± SD; range, 24-64 months), 88% of patients had returned to sport (109/124), the Walch-Duplay score was 86 ± 14, Rowe was 84 ± 15, Subjective Shoulder Value was 88 ± 11, and visual analog scale for pain was 1 ± 1. Conclusion: The clinical relevance of these findings is that 4.5-mm cannulated screws are safe and effective for primary Latarjet procedures and grant adequate graft healing, with low recurrence of instability and a high rate of return to sports.
Reliability of the Tibial Tubercle–Roman Arch Distance for Evaluating Tibial Tubercle Malposition and Predicting Patellar Dislocation via Magnetic Resonance Imaging
Authors: Xu Zijie , Zhao Pei , Song Yifan , Wang Haijun , Zhou Aiguo , Yu Jia-Kuo 
Published: August 2022

Background: The tibial tubercle (TT)–trochlear groove (TT-TG) distance has low reproducibility in patients with a dysplastic trochlea, whereas the clinical value of the TT–posterior cruciate ligament (TT-PCL) distance remains controversial. Purposes: To establish a method to assess the position of the TT on magnetic resonance imaging (MRI) scans using the TT–Roman arch (TT-RA) distance, compare this method with the TT-TG and TT-PCL distance, and provide the pathological threshold value of the TT-RA distance in patients with patellar dislocation. Study Design: Cross-sectional study; Level of evidence, 3. Methods: The TT-RA distance, TT-TG distance, and TT-PCL distance were measured on MRI scans in 70 patients with a history of patellar dislocation and 70 healthy individuals. Inter- and intraobserver reliability of each measurement parameter were evaluated. The discriminatory capacity and the interrelationship of the 3 measurement parameters were investigated using Pearson correlation and the receiver operating characteristic curve. The pathological threshold values of these measurements were calculated according to the data of healthy individuals. Finally, logistic regression analysis was performed using these values. Results: Patients with patellar dislocation had a greater TT-RA distance compared with healthy individuals (18.05 ± 4.16 vs 13.86 ± 2.90 mm; P < .001). The TT-RA distance had a stronger diagnostic capacity, with an area under the curve of 0.802 compared with 0.625 for TT-PCL distance. Excellent reproducibility was seen for TT-RA distance measurement at any degree of trochlear dysplasia (all intraclass correlation coefficients [ICCs] >0.90). The inter- and intraobserver ICCs of the TT-TG distance measurements were extremely low for Dejour type D dysplasia (ICC, 0.509 and 0.616, respectively). The pathological TT-RA distance threshold was calculated as 19.5 mm. Logistic regression showed that patients with a TT-RA distance >19.5 mm were 11.7 times more likely to sustain patellar dislocation than were those with TT-RA distance less than this value. Conclusion: The TT-RA distance was a more reliable parameter with which to evaluate TT position than was TT-TG distance in patients with trochlear dysplasia. The TT-PCL distance was the least reliable among the 3 parameters studied.
Anticoagulation in pediatric cancer–associated venous thromboembolism: a subgroup analysis of EINSTEIN-Jr
Authors: Palumbo Joseph S. , Lensing Anthonie W. A. , Brandão Leonardo R. , Hooimeijer Hélène L. , Kenet Gili , van Ommen Heleen , Pap Akos F. , Majumder Madhurima , Kubitza Dagmar , Thelen Kirstin , Willmann Stefan , Prins Martin H. , Monagle Paul , Male Christoph 
Published: August 2022

Abstract
Anticoagulant treatment of pediatric cancer–associated venous thromboembolism (VTE) has not been prospectively evaluated. Management of anticoagulation for cancer-associated VTE is often challenged by drug interactions and treatment interruptions. A total of 56 of the 500 children (11.2%) with VTE who participated in the recent EINSTEIN-Jr randomized study had cancer (hematologic malignancy, 64.3%, solid malignant tumor, 35.7%). Children were allocated to either therapeutic-dose bodyweight-adjusted oral rivaroxaban (n=40) or standard anticoagulation with heparins, with or without vitamin K antagonists (n=16) and received a median of 30 concomitant medications. Based on sparse blood sampling at steady-state, pharmacokinetic (PK) parameters of rivaroxaban were derived using population PK modeling. During the 3 months of treatment, no recurrent VTE or major bleeding occurred (95% confidence interval, 0.0%-6.4%), and 3-month repeat imaging showed complete or partial vein recanalization in 20 and 24 of 52 evaluable children (38.5% and 46.2%, respectively). Anticoagulant treatment was interrupted 70 times in 26 (46.4%) children because of thrombocytopenia, invasive procedures, or adverse events, for a mean individual period of 5.8 days. Anticoagulant therapy was resumed in therapeutic doses and was not associated with thrombotic or bleeding complications. Rivaroxaban exposures were within the adult exposure range and similar to those observed in children with VTE who did not have cancer-associated VTE. Rivaroxaban and standard anticoagulants appeared safe and efficacious and were associated with reduced clot burden in most children with cancer-associated VTE, including those who had anticoagulant treatment interruptions. Rivaroxaban exposures were within the adult exposure range despite significant polypharmacy use. This trial was registered at www.clinicaltrials.gov as #NCT02234843.
Symptoms persisting after hospitalisation for COVID-19: 12 months interim results of the CO-FLOW study
Authors: Bek L. Martine , Berentschot Julia C. , Heijenbrok-Kal Majanka H. , Huijts Susanne , van Genderen Michel E. , Vlake J. Hans , van Bommel Jasper , Aerts Joachim G.J.V. , Ribbers Gerard M. , van den Berg-Emons Rita J.G. , Hellemons Merel E. 
Published: August 2022

IntroductionA large proportion of patients experience a wide range of sequelae after acute COVID-19, especially after severe illness. The long-term health sequelae need to be assessed. Our objective was to longitudinally assess persistence of symptoms and clusters of symptoms up to 12 months after hospitalisation for COVID-19 and to assess determinants of the main persistent symptoms.MethodsIn this multicenter prospective cohort study patients with COVID-19 are followed up for 2 years with measurements at 3, 6, 12 and 24 months after hospital discharge. Here, we present interim results regarding persistent symptoms up to 12 months.ResultsWe included 492 patients; mean±sdage was 60.2±10.7 years, 335 (68.1%) were males, median length of hospital stay was 11 (6.0–27.0) days. At 3 months after discharge 97.0% of the patients had at least one persisting symptom, this declined to 95.5% and 92.0% at 6 and 12 months, respectively (p=0.010). Muscle weakness, exertional dyspnoea, fatigue, and memory and concentration problems were the most prevalent symptoms with rates over 50% during follow-up. Over time, muscle weakness, hair loss and exertional dyspnoea decreased significantly (p<0.001), while other symptoms such as fatigue, concentration and memory problems, anosmia and ageusia persisted. Symptoms from the physical and respiratory cluster declined significantly over time, in contrast to the fatigue and cognitive symptom clusters.ConclusionThe majority of patients experienced COVID-19 sequelae up to 12 months after severe infection. Whereas physical and respiratory symptoms showed slow gradual decline, fatigue and cognitive symptoms did not evidently resolve over time.
Relatives’ perspectives on encounters and communication in nursing homes during the Covid-19 pandemic: a qualitative interview study
Authors: Eriksson Elisabet , Hjelm Katarina 
Published: August 2022

Abstract
Background
Relatives of nursing home (NH) residents have experienced national or local restrictions on visiting their elderly family member during the Covid-19 pandemic. Today, many NHs have a multicultural environment, as staff, residents and their relatives speak different languages. Thus far, studies of remote communication with staff with limited language skills during the Covid-19 pandemic are lacking.

Aim
The aim of the present study was to explore relatives’ experiences of encounters and communication with staff and residents in NHs during the Covid-19 pandemic.

Method
An explorative qualitative study using semi-structured telephone interviews with 17 relatives of NH residents (12 women and 5 men). Data were analyzed using qualitative content analysis to identify four main categories and nine sub-categories.

Results
Communicating during visiting restrictions was challenging, and relatives experienced ups and downs when trying to stay in contact with NH residents and staff. Relatives received general information, but desired information about residents’ everyday life without having to ask for it. Moreover, remote communication was difficult for residents with hearing impairment or dementia. Even relatives who understood different languages had to develop strategies to communicate with staff with limited language skills in Swedish and English. Relatives did not mention using translating applications to facilitate communication.

Conclusion
During visiting restrictions, relatives lacked information about residents’ everyday life and found communication with staff with limited language skills challenging. For this reason, and to enable communication with staff with limited language skills, there is a need to find practical and technical solutions for facilitating remote communication between relatives, residents and staff at NHs.
Endocapillary hypercellularity levels are associated with early complete remission in children with class IV lupus nephritis as the initial presentation of SLE
Authors: Li Chunzhen , Han Yanan , Zhang Lili , Chen Zhiguo , Jin Mei , Sun Suzhen 
Published: August 2022

Abstract
Background
Endocapillary hypercellularity (ECHC) is commonly seen in class IV lupus nephritis (LN), the most common and severe LN in children. Factors influencing early complete remission (CR) in pediatric class IV LN have been poorly described. We investigated the relationship between ECHC levels and early CR in pediatric class IV LN.

Methods
Patients with newly, simultaneously diagnosed systemic lupus erythematosus (SLE) and class IV LN by renal biopsy from 2012 to 2021 were studied. In this retrospective study, two pathologists who were blind to clinical information reviewed all pathological data retrospectively and classified glomerular lesions according to the revised criteria of the International Society of Nephrology and the Renal Pathology Society (ISN/RPS). The demographics, baseline clinical characteristics, laboratory parameters, renal histopathological findings, treatment regimen and CR at 6 months after immunosuppressive therapy were analyzed. ECHC was categorized as: > 50% (group A), 25–50% (group B) and < 25% (group C). CR was defined as absence of clinical symptoms, 24-hour urinary protein < 0.15 g, and normal levels of serum creatinine and albumin.

Results
Sixty-four patients were identified: 23, 15 and 26 in groups A, B and C, respectively. Group A had significantly higher levels of D-dimer, urine protein, and SLE disease activity index (SLEDAI) than groups B and C. Group C had a markedly higher estimated glomerular filtration rate (eGFR) than groups A and B. A substantially greater proportion of patients in group A had glomerular microthrombi and basement membrane thickening than in groups B and C. At 6 months post treatment, CR was achieved in 19 (82.6%), 5 (33.3%) and 11 (42.3%) in groups A, B and C, respectively (p < 0.05, group A vs groups B and C). Multiple logistic regression analysis revealed that ECHC and urine protein levels were significantly associated with CR.

Conclusion
ECHC and urine protein levels may be valuable biomarkers for predicting early CR in pediatric class IV LN.
Influence of different base materials and thicknesses on the fracture resistance of endocrown: A three-dimensional finite element analysis
Authors: Cheng Xia , Zhang Xiu-yin , Qian Wen-hao 
Published: August 2022

Abstract
Introduction
To analyze the stress distribution of the all-ceramic endocrown with different base materials and thicknesses using three-dimensional finite element analysis.

Methods
A endodontically treated maxillary premolar was scanned by micro-CT, a three-dimensional finite element model of the endocrown with fluid resin as the base material was divided into control (0 mm), 1 mm, 2 mm, and 3 mm groups according to base thickness. Three kinds of conventional base materials were used and divided into glass ion group (A), fluid resin group (B), and nanocomposite resin group (C), and a three-dimensional finite element model of the endocrown with 1.0 mm thickness of base was established. A static loading with axial and 45° direction was applied to each model, the stress distribution of each part of the endocrown was analyzed under different base materials and thicknesses.

Results
The different thickness of the base layer has an influence on the components of the restoration and the tooth. The stress in the control group was the largest. The stress was the lowest when the thickness of the base layer was 1 mm; The maximum of the equivalent stress, the first, second, and third principal stress in the endocrown, abutment, and alveolar bone, are basically the same with the different base materials. The stress on the base layer increases with the elastic modulus of base materials increases.

Conclusions
The base layer played a force buffering effect on the dental body restored with endocrowns, and the effect was the best at 1 mm; The selection of base material has little influence on the whole, but in order to protect the weak tissues of the cavity bottom, the base material with lower elastic modulus can be used.
General practitioners’ perceptions of distributed leadership in providing integrated care for elderly chronic multi-morbid patients: a qualitative study
Authors: Braut Harald , Øygarden Olaug , Storm Marianne , Mikkelsen Aslaug 
Published: August 2022

Abstract
Background
Distributed Leadership (DL) has been suggested as being helpful when different health care professionals and patients need to work together across professional and organizational boundaries to provide integrated care (IC). This study explores whether General Practitioners (GPs) adopt leadership actions that transcend organizational boundaries to provide IC for patients and discusses whether the GPs’ leadership actions in collaboration with patients and health care professionals contribute to DL.

Methods
We interviewed GPs (n = 20) of elderly multimorbid patients in a municipality in Norway. A qualitative interpretive case design and Gioia methodology was applied to the collection and analysis of data from semi-structured interviews.

Results
GPs are involved in three processes when contributing to IC for elderly multimorbidity patients; the process of creating an integrated patient experience, the workflow process and the process of maneuvering organizational structures and medical culture. GPs take part in processes comparable to configurations of DL described in the literature. Patient micro-context and health care macro-context are related to observed configurations of DL.

Conclusion
Initiating or moving between different configurations of DL in IC requires awareness of patient context and the health care macro-context, of ways of working, capacity of digital tools and use of health care personnel.