bluuebunny/crossref_metadata_2025_split huggingface dataset:
Defining Return to Sport: A Systematic Review
Authors: Vopat Bryan G. , Doege Joshua , Ayres Jack M. , Mackay Matthew , Tarakemeh Armin , Brown Symone M. , Mulcahey Mary K. 
Published: January 2022

Category: Sports Introduction/Purpose: Return to sport (RTS) commonly serves as a measure for assessment of clinical outcomes in orthopaedic sports medicine surgery. Unfortunately, while RTS is commonly utilized in research for this purpose, currently, there is no widely accepted or standardized definition for when an athlete has officially returned to his or her sport. The purpose of this study was to conduct a systematic review to evaluate and report the differences in specific definitions of return to sport (RTS) utilized in the orthopaedic surgery literature. Methods: A systematic review was performed using PubMed, Embase and Cochrane databases per PRISMA guidelines. Search terms consisted of variations of 'RTS' combined with variations of 'orthopedic surgery' and 'define' to capture as many relevant articles as possible. The definition of return to sport was recorded and analyzed. Results: 718 articles were identified in the initial search, 29 of which met eligibility criteria, providing a clear definition of RTS. Of the 29 studies included, 20 (69.0%) defined RTS as an athlete competing in a game or other competitive play, and these definitions are further broken down in Table 1. Three (10.3%) defined this as the athlete competing in a game or other competitive play, but with an explicitly stated competition-level modifier of the athlete returning to their pre-injury level of competition. Two articles (6.9%) included returning to training or practice and the remaining four articles (13.8%) used terminology other than the standard RTS. Conclusion: There is variability in the definition of RTS used in the literature. Most studies refer to the athlete competing in a game or other competitive play. Other variants include returning to practice/training and explicitly defined competition levels and objectives. Future studies should aim to standardize the definition of RTS to facilitate more precise assessment of outcome following sports medicine surgery. Using terminology that describes components of the recovery and rehabilitation process, such as 'return to participation' and 'return to performance' in addition to RTS will allow us to better understand the athlete's recovery and associated level of competition or performance.
The Lateral Drawer Test: A Novel Clinical Test to Assess Mortise Instability in Weber B Fibula Fractures
Authors: Zhao John Z. , Williams Caroline , Broughton Kimberly K. , Miller Christopher P. , Kwon John Y. 
Published: January 2022

Category: Trauma; Ankle Introduction/Purpose: Assessment of mortise stability is paramount in determining appropriate management of ankle fractures. While instability is readily apparent in bimalleolar or trimalleolar ankle fractures, determination of instability in the apparent isolated Weber B fibula fracture often requires further investigations such as stress radiography. While several authors have previously demonstrated poor predictive value of physical examination findings such as tenderness, ecchymosis and swelling with instability, no previous investigation has examined the ability of a translational test to determine deltoid ligament injury. The goal of this study is to test the validity of a novel clinical test, the lateral drawer test, in determining mortise instability in a cohort of patients with Weber B fibula fractures. Methods: Patients presenting with isolated fibula fractures were prospectively identified by an orthopaedic nurse practitioner or resident. Three views of the ankle as well as gravity stress views (GSV) were obtained. Prior to examining radiographs, two foot & ankle fellowship-trained orthopaedic surgeons (JYK, CPM) performed and graded the lateral drawer test. (Grade 0: no instability/symmetric to contralateral ankle, Grade I: translation < 5mm, Grade II: translation >= 5mm) While the surgeons were made aware of the presence of a Weber B fibula fracture, radiographs were not visualized prior to conducting the drawer test. Medial clear space (MCS) was measured. VAS pain scores were obtained before and after testing. The results of the lateral drawer test results were compared with radiographic measurements of MCS. Results: The study enrolled 57 consecutive patients with Weber B ankle fractures. Twenty-nine (51%) patients demonstrated radiographic instability with widening of the medial clear space >= 5 mm on GSV. When correlated with MCS measurement, the lateral drawer test demonstrated a sensitivity of 83.3%, specificity of 96%, positive predictive value (PPV) of 96% and negative predictive value (NPV) of 84% for determining instability. There was a strong correlation between the lateral drawer test grade and amount of MCS widening (⍴=0.82, p<0.001). Patients tolerated the lateral drawer test well with an average increase of 0.8 points on the VAS pain scale after testing. Conclusion: The lateral drawer test demonstrates high sensitivity, specificity, PPV and NPV for detecting instability in patients presenting with Weber B fibula fractures. While further validation is required in a larger cohort of patients, the lateral drawer test may offer an adjunct tool via physical examination to predict mortise stability.
Erianthus germplasm collection in Thailand: genetic structure and phylogenetic aspects of tetraploid and hexaploid accessions
Authors: Tsuruta Shin-ichi , Srithawong Suparat , Sakuanrungsirikul Suchirat , Ebina Masumi , Kobayashi Makoto , Terajima Yoshifumi , Tippayawat Amarawan , Ponragdee Werapon 
Published: January 2022

Abstract
Background
The genus Erianthus, which belongs to the “Saccharum complex”, includes C4 warm-season grasses. Erianthus species are widely distributed throughout Southeast Asia, East Asia and South Asia. Erianthus arundinaceus (Retz.) Jeswiet is highly adaptable to the environment, has a high percentage of dry matter, and is highly productive. Recently, this species has attracted attention as a novel bioenergy crop and as a breeding material for sugarcane improvement. Such interest in E. arundinaceus has accelerated the collection and conservation of its genetic resources, mainly in Asian countries, and also evaluation of morphological, agricultural, and cytogenetic features in germplasm collections. In Thailand, genetic resources of E. arundinaceus have been collected over the past 20 years and their phenotypic traits have been evaluated. However, the genetic differences and relatedness of the germplasms are not fully understood.

Results
A set of 41 primer pairs for nuclear simple sequence repeats (SSRs) developed from E. arundinaceus were used to assess the genetic diversity of 121 Erianthus germplasms collected in Thailand; of these primer pairs, 28 detected a total of 316 alleles. A Bayesian clustering approach with these alleles classified the accessions into four main groups, generally corresponding to the previous classification based on phenotypic analysis. The results of principal coordinate analysis and phylogenetic analysis of the 121 accessions on the basis of the SSR markers showed the same trend as Bayesian clustering, whereas sequence variations of three non-coding regions of chloroplast DNA revealed eight haplotypes among the accessions. The analysis of genetic structure and phylogenetic relationships, however, found some accessions whose classification contradicted the results of previous phenotypic classification.

Conclusions
The molecular approach used in this study characterized the genetic diversity and relatedness of Erianthus germplasms collected across Thailand. This knowledge would allow efficient maintenance and conservation of the genetic resources of this grass and would help to use Erianthus species as breeding materials for development of novel bioenergy crops and sugarcane improvement.
Neuropsychiatric symptoms and subsyndromes in patients with different stages of dementia in primary care follow-up (NeDEM project): a cross-sectional study
Authors: García-Martín Victoria , de Hoyos-Alonso M. Canto , Ariza-Cardiel Gloria , Delgado-Puebla Rosalía , García-Domingo Paula , Hernández-Melo Erika , de Haro-de Torres Javier López , del Cura-González Isabel 
Published: January 2022

AbstractBackgroundThe objective was to describe the prevalence and intensity of neuropsychiatric symptoms (NPSs) isolated and grouped into subsyndromes in patients with dementia in primary care (PC) to analyse their distribution based on stages of dementia and the relationship between them and the intensity of symptoms.MethodsDesign: Cross-sectional study. Setting and population: Patients with dementia, not institutionalized, in a PC follow-up. Variables: Sociodemographic and clinical variables. Assessment instruments: The frequency and intensity of NPSs were measured with the Neuropsychiatric Inventory (NPI), and the stages of dementia with the Global Deterioration Scale (GDS). Statistical analysis: The number of NPSs per patient, the mean NPI value, and the prevalence and intensity of NPSs isolated and grouped into subsyndromes were calculated, as were their 95% confidence intervals (CIs). The analyses were performed on an overall basis and by GDS scores. To analyse the association between the NPI and GDS scores, multivariate analysis was performed with a generalized linear model.ResultsOverall, 98.4% (95% CI 94.5;99.8) of the patients presented some type of NPS, with an average of five symptoms per patient. The most frequent symptoms were apathy [69.8% (95% CI 61.1;77.5)], agitation [55.8% (95% CI 46.8;64.5)] and irritability [48.8% (95% CI 39.9;57.8)]. The more intense NPSs were apathy [NPI 3.2 (95% CI 2.5;3.8)] and agitation [NPI 3.2 (95% CI 2.5;4.0)]. For subsyndromes, hyperactivity predominated [86.0% (95% CI 78.8;91.5)], followed by apathy [77.5% (95% CI 69.3;84.4]). By phase of dementia, the most common isolated symptom was apathy (60.7–75.0%). Affective symptoms and irritability predominated in the initial stages, and psychotic symptoms predominated in advanced stages. The mean NPI score was 24.9 (95% CI 21.5;28.4) and increased from 15.6 (95% CI 8.2;23.1) for GDS 3 to 28.9 (95% CI 12.6;45.1) for GDS 7. Patients with in the most advanced stages of dementia presented an NPI score 7.6 (95% CI 6.8;8.3) points higher than the score for mild dementia with adjustment for the other variables.ConclusionsA high prevalence of NPSs was found among patients with dementia treated in PC. Symptoms change and increase in intensity as the disease progresses. Scales such as the NPI allow these symptoms to be identified, which may facilitate more stage-appropriate management.
Factors associated with the use of deworming drugs during pregnancy in Tanzania; an analysis from the 2015–16 Tanzanian HIV and malaria indicators survey
Authors: Bankanie Vicent , Moshi Fabiola Vincent 
Published: January 2022

Abstract
Background
The use of deworming drugs is one of the important antenatal strategies in preventing anaemia in pregnancy. Little is known about the factors associated with the use of deworming drugs, which accounts for the aim of this study.

Method
The study used data from the 2015–16 Tanzania HIV Demographic and Health Survey and Malaria Indicators Survey (2015–16 TDHS-MIS). A total of 6924 women of active reproductive age from 15 to 49 were included in the analysis. Both univariate and multiple logistic regression analyses were used.

Results
The majority of interviewed women 3864(60.1%) took deworming drugs. In a weighed multiple logistic regression, women residing in urban areas reported greater use of deworming drugs than women residing in rural areas [AOR = 1.73, p = 0.01, 95% CI (1.26–2.38)]. In the four areas of residence, compared to women residing in mainland rural areas, women residing in mainland urban areas and Pemba islands reported greater use of deworming drugs [mainland urban (AOR = 2.56 p < 0.001,95% CI(1.78–3.75), and Pemba Island (AOR = 1.18, p < 0.001, 95% CI(1.17–1.20)]. However, women residing in Zanzibar Island (Unguja) were less likely to use deworming drugs compared to women in mainland rural women (AOR = 0.5, p < 0.001, 95% CI (0.45–0.55).
Similarly, compared to women under 20 years of age, women between 20 to 34 years reported significantly greater use of deworming drugs [20 to 34 years (AOR = 1.30, p = 0.03, 95% CI(1.02–1.65).
Likewise, greater use of deworming drugs was reported in women with a higher level of education compared to no education [higher education level (AOR = 3.25, p = 0.01,95% CI(1.94–7.92)], rich women compared to poor [rich (AOR = 1.43, p = 0.003, 95% CI (1.13–1.80)] and in women who initiated antenatal care on their first trimester of pregnancy compared to those who initiated later [AOR = 1.37, p < 0.001, 95% CI (1.17–1.61)].

Conclusion
Women who were more likely to use the deworming drugs were those residing in urban compared to rural areas, aged between 20 and 34 years, those with a higher level of formal education, wealthier, and women who book the antenatal clinic (ANC) within their first trimester of pregnancy. Considering the outcomes of anaemia in pregnancy, a well-directed effort is needed to improve the use of deworming drugs.
Oral extrusion of a vertebral body replacement device after chordoma tumor growth and radiation: case report and review
Authors: Gutiérrez-González Raquel , Zamarrón Álvaro , Ortega Celia , Hamre Frank , Kalantari Teresa , Rodríguez-Boto Gregorio 
Published: January 2022

Abstract
Background
Screw migration following anterior cervical discectomy and fusion is a very rare complication and it is often related to device failure. Even more exceptional is the extrusion of an intervertebral graft.

Case presentation
We report the second case of migration and extrusion through the oral cavity of a cervical vertebral body replacement device (expandable cylinder) in a patient that had undergone cervical corpectomy due to a vertebral chordoma.

Conclusion
The antecedent of radiation therapy as well as progressive tumor re-growth may have favored the development of this complication. A literature review is added.
Women’s attitudes towards negotiating safe sexual practices in Nigeria: Do family structure and decision-making autonomy play a role?
Authors: Imo Chukwuechefulam Kingsley , Odimegwu Clifford O. , De Wet-Billings Nicole 
Published: January 2022

Abstract
Background
The risk of contracting sexually transmitted infections (STIs), including human immunodeficiency virus (HIV) is related to women’s sexual attitudes, beliefs, and power dynamics within marriages in developing countries. Despite the interventions towards improving women’s sexual health and well-being, women are disproportionately affected by the risk of STIs transmission compared with their male counterparts in most sub-Saharan African countries including Nigeria. This study examined the roles of family structure and decision-making autonomy on women’s attitudes towards negotiating safe sexual practices in Nigeria.

Methods
The study involved analyses of data from a nationally representative and weighted sample size of 28,219 ever-married/cohabiting women aged 15–49 years from the 2018 Nigeria Demographic and Health Survey. Descriptive and statistical analyses were carried out, including frequency tables, Pearson’s chi-square test, and multivariable binary logistic regression model.

Results
The overall prevalence of having positive attitudes towards negotiating safe sexual practices were 76.7% and 69.6% for a wife justified in asking the husband to use a condom if he has an STI and refusing to have sex with the husband if he had sex with other women, respectively. The results further showed that polygamous unions negatively influenced urban and rural women’s attitudes towards negotiating safe sexual practices, but women’s decision-making autonomy on how to spend their earnings was found to be a protective factor for having positive attitudes towards negotiating safe sexual practices with partners. Surprisingly, there were significant variations in attitudes towards negotiating safe sexual practices among urban and rural women who enjoyed decision-making autonomy on their healthcare (aOR 1.70; CI 1.32–2.18 and aOR 0.52; CI 0.44–0.62, respectively). Plausibly, such women might have constrained them to compromise their sexual relationships for fear of being neglected by partners.

Conclusion
The outcomes of this study have some policy implications for both maternal and child health. There is the need to intensify programmes aimed at improving women’s sexual health and rights towards achieving sustainable development goals of preventing deaths of newborns, ending STIs and creating gender in Nigeria.
Adaptation strategies in transnational education: a case study of an australian Master of Health Administration Course offered to chinese managers
Authors: Liu Chaojie , Wu Qunhong , Liang Zhanming , Karimi Leila , Ferrier J. Adamm , Sheats Jane , Khalil Hanan 
Published: January 2022

Abstract
Background
Management decisions in health influence patient care outcomes; however, health management development courses in China are rare. This study aims to document and evaluate a transnational Master of Health Administration (MHA) course launched in 2000 for the benefit of Chinese health managers.

Methods
A case study of the MHA program jointly run by an Australian university and a Chinese Medical University was conducted. We reviewed the development of the MHA course through a document analysis (key events recorded in achieves, minutes, and audits) followed by reflection (by two course coordinators), extracting key themes related to adaptative strategies. We then conducted a questionnaire survey of 139 graduates seeking their views on relevance, satisfaction and challenges associated with each subject within the course, the relevance of key management skills (as determined by the Australasian College of Health Service Management competency framework), and the impact of the course on their personal career trajectories. Chi-square tests identified differences in the responses by age, gender, pre-training position, and current workplace.

Results
The curriculum pedagogy followed the principles of practice-based reflective learning. Research findings and student feedback shaped the curriculum design and subject content, to enhance management practices of the students. Survey participants expressed high levels of satisfaction and confirmed the relevance of all study subjects. Two subjects, health economics and data management, were perceived as being the most challenging. Of the ten management skills we assessed, relatively low self-rated confidence was found in “strategic thinking” and “planning”. Younger and less experienced graduates were more likely to report learning challenges (p < 0.05). Frontline managers were least likely to obtain promotion by changing employers (χ2 = 6.02, p < 0.05) or being seconded to another position (χ2 = 9.41, p < 0.01).

Conclusions
This case study illustrates the suitability of cross-country partnerships in health management training, which offers opportunities for managers to systematically explore and acquire a comprehensive set of management skills applicable to their career needs. Opportunities for developing training aligned to career development opportunities are critical for attracting and developing a competent and well-prepared health service management workforce in China.
Quantitative analysis of the MRI features in the differentiation of benign, borderline, and malignant epithelial ovarian tumors
Authors: Xiao Fuxia , Zhang Lin , Yang Sihua , Peng Kun , Hua Ting , Tang Guangyu 
Published: January 2022

Abstract
Objective
This study aims to investigate the value of the quantitative indicators of MRI in the differential diagnoses of benign, borderline, and malignant epithelial ovarian tumors (EOTs).

Materials and methods
The study population comprised 477 women with 513 masses who underwent MRI and operation, including benign EOTs (BeEOTs), borderline EOTs (BEOTs), and malignant EOTs (MEOTs). The clinical information and MRI findings of the three groups were compared. Then, multivariate logistic regression analysis was performed to find the independent diagnostic factors. The receiver operating characteristic (ROC) curves were also used to evaluate the diagnostic performance of the quantitative indicators of MRI and clinical information in differentiating BeEOTs from BEOTs or differentiating BEOTs from MEOTs.

Results
The MEOTs likely involved postmenopausal women and showed higher CA-125, HE4 levels, ROMA indices, peritoneal carcinomatosis and bilateral involvement than BeEOTs and BEOTs. Compared with BEOTs, BeEOTs and MEOTs appeared to be more frequently oligocystic (P < 0.001). BeEOTs were more likely to show mild enhancement (P < 0.001) and less ascites (P = 0.003) than BEOTs and MEOTs. In the quantitative indicators of MRI, BeEOTs usually showed thin-walled cysts and no solid component. BEOTs displayed irregular thickened wall and less solid portion. MEOTs were more frequently characterized as solid or predominantly solid mass (P < 0.001) than BeEOTs and BEOTs. The multivariate logistic regression analysis showed that volume of the solid portion (P = 0.006), maximum diameter of the solid portion (P = 0.038), enhancement degrees (P < 0.001), and peritoneal carcinomatosis (P = 0.011) were significant indicators for the differential diagnosis of the three groups. The area under the curves (AUCs) of above indicators and combination of four image features except peritoneal carcinomatosis for the differential diagnosis of BeEOTs and BEOTs, BEOTs and MEOTs ranged from 0.74 to 0.85, 0.58 to 0.79, respectively.

Conclusion
In this study, the characteristics of MRI can provide objective quantitative indicators for the accurate imaging diagnosis of three categories of EOTs and are helpful for clinical decision-making. Among these MRI characteristics, the volume, diameter, and enhancement degrees of the solid portion showed good diagnostic performance.
Pancreatic intraepithelial neoplasia with carcinoma in situ with repeated distally localized pancreatitis: a case report
Authors: Tanji Yoshiaki , Furukawa Kenei , Shirai Yoshihiro , Haruki Koichiro , Onda Shinji , Gocho Takeshi , Ikegami Toru 
Published: January 2022

Abstract
Background
Acute pancreatitis could be an early symptom of pancreatic cancer. However, repeated pancreatitis caused by pancreatic cancer is very rare.

Case presentation
A 69-year-old man was referred to our hospital with severe abdominal pain, and serial imaging studies showed acute distally localized pancreatitis with a pseudocyst. Although he had successful conservative medical treatment followed by discharge from the hospital, he was re-admitted with severe abdominal pain for recurrent distal pancreatitis with splenic artery aneurysm followed by its rupture. No pancreas mass was detected by imaging studies including endoscopic ultrasound and cytologic studies of the pancreas juice did not show any malignant cells, although slight dilatation of distal pancreas duct was observed only in the initial computed tomography. Because of the episodes of repeated distally localized pancreatitis caused by possible pancreatic ductal neoplasm, we planned and performed laparoscopy-assisted distal pancreatectomy after full-informed consent. Pathological examination revealed pancreatic intraepithelial neoplasia (PanIN) with carcinoma in situ in the distal main pancreas duct. The post-surgical course of the patient was uneventful and he was discharged 10 days after surgery from recurrent disease for over a year.

Conclusions
We encountered a case of repeated episodes of acute distally localized pancreatitis, for which distal pancreatectomy was performed, resulting in pathological diagnosis of PanIN with carcinoma in situ.