bluuebunny/crossref_metadata_2025_split huggingface dataset:
Velocity-Based Resistance Training Monitoring: Influence of Lifting Straps, Reference Repetitions, and Variable Selection in Resistance-Trained Men
Authors: Jukic Ivan , García-Ramos Amador , Tufano James J. 
Published: May 2022

Background: Using lifting straps during pulling exercises (such as deadlift) may increase absolute velocity performance. However, it remains unclear whether lifting straps could also reduce the degree of relative fatigue measured by velocity decline and maintenance in a training set. Hypothesis: There will be less mean velocity decline (MVD) and greater mean velocity maintenance (MVM) for deadlifts performed with (DLw) compared with without (DLn) lifting straps, and an underestimation of MVD and MVM when using the first compared with the fastest repetition as a reference repetition. Study Design: Randomized cross over design. Level of Evidence: Level 3. Methods: A total of 16 resistance-trained men performed a familiarization session, 2 1-repetition maximum [1RM] sessions (1 with and 1 without lifting straps), and 3 randomly applied experimental sessions consisting of 4 sets of 4 repetitions: (1) DLw against the 80% of DLn 1RM (DLwn), (2) DLn against the 80% of the DLn 1RM (DLnn), and (3) DLw against the 80% of the DLw 1RM (DLww). MVD and MVM were calculated using the first and the fastest repetition as the reference repetition. Results: MVD was significantly lower during DLwn and DLnn compared with DLww ( P < 0.01), whereas MVM was greater during DLwn and DLnn compared with DLwn ( P < 0.01) with no differences between DLwn and DLnn for both MVD and MVM ( P > 0.05). The second repetition of the set was generally the fastest (54.1%) and lower MVD and higher MVM were observed when the first repetition was used as the reference repetition ( P < 0.05). Conclusion: Lifting straps were not effective at reducing MVD and increasing MVM when the same absolute loads were lifted. Furthermore, using the first repetition as the reference repetition underestimated MVD, and overestimated MVM. Clinical relevance: The fastest repetition should be used as the reference repetition to avoid inducing excessive fatigue when the first repetition is not the fastest.
Infrapedicular approach to CT-guided thermal ablation in the thoracic spine
Authors: Burkett Brian , Kim Dong Kun , Benson John , Carr Carrie , Morris Jonathan M 
Published: May 2022

Objectives The aim of this study is to introduce the infrapedicular approach to CT-guided spine interventions, a specialized technique that can safely expand the scope of spine lesions amenable to treatment, and to document the feasibility in a variety of procedural scenarios to the extent possible with a retrospective case series. Methods Data from 24 cases performed at a single institution over a 10-year period were retrospectively reviewed to assess the technical feasibility and safety profile of the technique. Results The infrapedicular approach enabled a technically satisfactory procedural result in 24 cases (mean age 63.9 years, range 35–83 years). Two peri-procedural complications occurred, including a small pneumothorax and a cerebrospinal fluid leak, both of which resolved with conservative treatment. No lasting injurious effects or additional complications were identified. The infrapedicular approach was found to be particularly useful in multiple technically challenging scenarios: it facilitates access to lesions in the inferior vertebral body, allows biopsy, cement augmentation, or ablation of high thoracic lesions difficult to treat due to limitations of steep angulation of fluoroscopy and CT scanners, and enables treatment of large lesions by using multiple overlapping probes.
Nonalcoholic fatty liver disease and health outcomes: An umbrella review of systematic reviews and meta-analyses
Authors: Zhong Lixian , Wu Chutian , Li Yuting , Zeng Qiuting , Lai Leizhen , Chen Sisi , Tang Shaohui 
Published: May 2022

Purpose: A large number of systemic reviews and meta-analyses have explored the relationship between nonalcoholic fatty liver disease (NAFLD) and multiple health outcomes. The aim of this study is to conduct an umbrella review to assess the strength and evidence for the association between NAFLD and health outcomes. Methods: We systematically identified the present meta-analyses of observational studies reporting an association between NAFLD and health outcomes. For each meta-analysis, we assessed the quality with AMSTAR2 and graded the epidemiologic evidence. Results: Fifty-four articles comprising 111 unique meta-analyses were included in this study. Eighty-five unique outcomes showed significant associations ( P ← 0.05), whereas 26 unique outcomes showed insignificant associations, and we cannot assess the epidemiologic evidence. For 85 significant health outcomes, four outcomes (carotid intima-media thickness (C-IMT), peak A velocity, left ventricle end-diastolic diameter, incident chronic kidney disease (CKD) in adult patients) was graded as high quality of evidence, 23 outcomes were graded as the moderate quality of evidence, and the remaining 58 outcomes were graded as weak quality of evidence. Fourty-seven (87.03%) studies showed critically low methodological quality. Conclusion: In this umbrella review, only four statistically significant health outcomes showed high epidemiologic evidence. NAFLD seems to relate to an increased risk of C-IMT, peak A velocity, left ventricle end-diastolic diameter, and incident CKD in adult patients.
Exploring the risk factors and prognosis of transverse myelitis in systemic lupus erythematosus
Authors: Wang Minhui , Wang Ziqian , Zhang Li , Zhao Jiuliang , Wu Di , Li Jing , Wang Qian , Su Jinmei , Xu Dong , Zhang Shangzhu , Li Mengtao , Zeng Xiaofeng 
Published: May 2022

Purpose: We aimed to describe the clinical characteristics and outcomes of patients with transverse myelitis (TM) as a rare manifestation in systemic lupus erythematosus (SLE) and explore the risk factors and prognosis of SLE-related TM (SLE-TM). Methods: We conducted a retrospective case–control and cohort analysis. All patients with SLE-TM (58 patients) and 232 with SLE without TM, as a control group, were admitted to Peking Union Medical College Hospital between January 1993 and May 2021. Factors associated with the presence of SLE-TM and its prognosis were assessed using logistic regression and Cox proportional hazard models. Results: Multivariate analysis revealed that positive anti-Ro/Sjogren’s syndrome A (anti-Ro/ SSA) (<0.01) and increased erythrocyte sedimentation rate (ESR) ( p < 0.01) were associated with SLE-TM. Regarding prognosis, methylprednisolone (MP) pulse therapy within 2 weeks of onset (adjusted hazard ratio (AHR), 2.12; 95% confidence interval (CI), 1.06–4.23; p = 0.03) was associated with short-term neurological improvement. An American Spinal Injury Association Impairment Scale (AIS) grades of A, B, or C at onset (AHR, 0.12; 95% CI 0.05–0.28; p < 0.001) and hypoglycorrhachia (AHR, 0.29; 95% CI, 0.13–0.65; p < 0.01) were associated with a short-term non-improved outcome. Conclusions: The positive anti-Ro/SSA antibodies and increased ESR may be associated with the presence of SLE-TM. An initial presentation with severe myelitis and hypoglycorrhachia appear to be predictors of a poor neurological outcome. Early steroid pulse therapy may improve the prognosis.
Association of continuous glucose monitoring-derived time in range with major amputation risk in diabetic foot osteomyelitis patients undergoing amputation
Authors: Yin Xueyao , Zhu WeiFen , Liu Chao , Yao Huilan , You Jiaxing , Chen Yixin , Ying Xiaofang , Li Lin 
Published: May 2022

Objective: The metrics generated from continuous glucose monitoring (CGM), such as time in range (TIR), are strongly correlated with diabetes complications. This study explored the association of perioperative CGM-derived metrics with major amputation risk in patients with diabetic foot osteomyelitis (DFO). Methods: This study recruited 55 DFO patients with grade 3–4 wounds according to the Wagner Diabetic Foot Ulcer Classification System, all of whom underwent CGM for 5 days during the perioperative period. The CGM-derived metrics were defined in accordance with the most recent international consensus recommendations. Results: Patients with major amputation had significantly less TIR and higher time below range (TBR) (all p < 0.05). In binary logistic regression analyses, a lower TIR was associated with the risk of major amputation (odds ratio: 0.83 (95% confidence interval: 0.71–0.99), p = 0.039). This association remained statistically significant after adjustments for age, sex, body mass index, type of diabetes, smoking, drinking, durations of diabetes and DFU, ankle-brachial index, albumin, estimated-glomerular filtration rate, Society for Vascular Surgery wound, ischemia, and foot infection (WIfi) stage, multidrug-resistant organisms, and hemoglobin A1c. Further adjustment for the mean amplitude of glycemic excursion (MAGE) reduced this association. TBR was also independently associated with the risk of major amputation (odds ratio: 1.60 (95% confidence interval: 1.17–2.18), p = 0.003); this association persisted after adjustment for MAGE. Conclusion: Perioperative TIR (3.9–10.0 mmol/L) and TBR (<3.9 mmol/L) were significantly associated with major amputation in hospitalized patients with DFO.
Perioperative glycemic status is linked to postoperative complications in non-intensive care unit patients with type-2 diabetes: a retrospective study
Authors: Oba Takeshi , Nagao Mototsugu , Kobayashi Shunsuke , Yamaguchi Yuji , Nagamine Tomoko , Tanimura-Inagaki Kyoko , Fukuda Izumi , Sugihara Hitoshi 
Published: May 2022

Background: Perioperative hyperglycemia is a risk factor for postoperative complications in the general population. However, it has not been clarified whether perioperative hyperglycemia increases postoperative complications in patients with type-2 diabetes mellitus (T2D). Therefore, we aimed to analyze the relationship between perioperative glycemic status and postoperative complications in non-intensive care unit (non-ICU) hospitalized patients with T2D. Materials and Methods: Medical records of 1217 patients with T2D who were admitted to the non-ICU in our hospital were analyzed retrospectively. Relationships between clinical characteristics including perioperative glycemic status and postoperative complications were assessed using univariate and multivariate analyses. Perioperative glycemic status was evaluated by calculating the mean, standard deviation (SD), and coefficient of variation (CV) of blood glucose (BG) measurements in preoperative and postoperative periods for three contiguous days before and after surgery, respectively. Postoperative complications were defined as infections, delayed wound healing, postoperative bleeding, and/or thrombosis. Results: Postoperative complications occurred in 139 patients (11.4%). These patients showed a lower BG immediately before surgery ( P = 0.04) and a higher mean postoperative BG ( P = 0.009) than those without postoperative complications. There were no differences in the other perioperative BG parameters including BG variability and the frequency of hypoglycemia. The multivariate analysis showed that BG immediately before surgery (adjusted odds ratio (95% confidence interval [CI]), 0.91 (0.85–0.98), P = 0.01) and mean postoperative BG (1.11 (1.05–1.18), P < 0.001) were independently associated with postoperative complications. Conclusion: Perioperative glycemic status, that is, a low BG immediately before surgery and a high mean postoperative BG, are associated with the increased incidence of postoperative complications in non-ICU patients with T2D.
Female healthcare providers’ knowledge, attitude, and practice towards cervical cancer screening and associated factors in public hospitals of Northwest Ethiopia
Authors: Abebaw Eden , Tesfa Mulugeta , Gezimu Wubishet , Bekele Firomsa , Duguma Abdissa 
Published: May 2022

Objective: Cervical cancer is the fourth most common gynaecological cancer in the world. Its incidence and burden are high in developing regions, especially in sub-Saharan Africa. The World Health Organization plans to increase vaccination, screening, and treatment of cases to 90%, 70%, and 90%, respectively, in developing countries by 2030. Therefore, the aim of this study was to assess knowledge, attitudes, and practices of cervical cancer screening and predictors among female healthcare providers. Methods: Institution-based cross-sectional survey was done from 4 March to 20 April 2019. The data were collected using a structured questionnaire. The data were entered into EpiData version 3.1 and analysed with SPSS version 25. Logistic regression analysis was used to identify associations. After controlling for confounders, an independent association was declared at a p-value of 0.05 with a 95% confidence interval. Results: Of a total of 404 participants, half were nurses. One hundred seventy-seven (43.8%) had adequate knowledge, 124 (30.7%) had a favourable attitude, and 35 (8.7%) had regular screening practice. The availability of trained personnel in the health facility and regular screening were variables associated with knowledge. Participants’ attitude was shown association with profession, level of education, and knowledge. Moreover, knowledge of the causes of cervical cancer and knowledge of screening were variables significantly associated with screening practice. Conclusion and recommendations: Unfortunately, there is low adequate knowledge, low favourable attitude, and irregular screening practice of cervical cancer in the study area. Despite their own effects, their knowledge and attitude may affect the vast majority of their clients. Therefore, this finding calls for prompt action, such as training for participants to increase awareness, to shape their attitudes, and to increase the uptake of screening services.
‘I got to understand what it means to be a cancer patient’: Qualitative evidence from health professional cancer patients and survivors
Authors: Natuhwera Germans , Ellis Peter , Acuda Stanley Wilson , Namukwaya Elizabeth 
Published: May 2022

Objective: The study sought to (1) examine healthcare professionals’ (HCPs) lived experiences of cancer and (2) generate evidence to inform policy and clinical practice for cancer care. Methods: This was a qualitative study conducted between January and December 2020 on HCPs who were ill with, or who had survived cancer in Uganda. Purposive sampling was used. A demographic form and an open-ended topic guide were used to collect data. Face-to-face and telephone interviews were conducted in English; audio-recorded data was collected until saturation was reached. Colaizzi’s framework of thematic analysis was used. Results: Eight HCP cancer patients and survivors from medical, allied health, and nursing backgrounds participated in the study. Their mean age was 56 years (29–85). Five were female. Four broad themes emerged from the interviews: (1) experience of pre-diagnosis and receiving bad news, (2) impact on self and role identity, (3) healthcare system and treatment experiences, and (4) the gaps and what should be done. Conclusion: Cancer patient-hood introduces vulnerability and remarkable disruptions and suffering in nearly all domains of quality-of-life, that is, in professional identity and work, social, emotional, physical, and economic facets of life. Participants identified how they experienced a healthcare system which was costly and staffed by unmotivated staff with limited access to resources, which resulted in many unmet needs and an overall poor experience. Participants identified how, in their view, the healthcare system in Uganda needed to be better resourced, protected by policy and legislation and how cancer awareness among the population needed to be improved.
Mutations in CLDN2 Are Not a Common Cause of Pediatric Idiopathic Hypercalciuria in Canada
Authors: Ulrich Emma H. , Harvey Elizabeth , Morgan Catherine J. , Pinsk Maury , Erickson Robin , Robinson Lisa A. , Alexander R. Todd 
Published: May 2022

Background: Hypercalciuria is the most common risk factor for kidney stone formation, including in pediatric patients. However, the etiology is often unknown and children are frequently diagnosed with idiopathic hypercalciuria. Nearly 50% of children with hypercalciuria have a first-degree relative with kidney stones, suggesting a strong genetic basis for this disease. A failure of calcium reabsorption from the proximal nephron is implicated in the pathogenesis of hypercalciuria. Claudin-2 is a tight junction protein abundantly expressed in the proximal tubule. It confers paracellular permeability to calcium that is essential for transport across the proximal tubule where the majority of filtered calcium is reabsorbed. Objective: Our objective was to examine the frequency of coding variations in CLDN2 in a cohort of children with idiopathic hypercalciuria. Design: Mixed method including retrospective chart review and patient interview, followed by genetic sequencing. Setting: Three tertiary care centers in Canada. Patients: Children (age 1-18 years) with idiopathic hypercalciuria. Patients with other causes of hypercalciuria were excluded. Methods: Data were collected from 40 patients with idiopathic hypercalciuria. Informed consent to collect DNA was obtained from 13 patients, and the final and only coding exon of CLDN2 was sequenced. Results: The majority of patients were male, white, and had a positive family history of kidney stones. Parathyroid hormone levels were significantly lower than the reference range ( P < .001). The levels of 1,25-dihydroxyvitamin D were also significantly higher in our patient cohort, relative to the reference range ( P < .001). Sequence analysis of CLDN2 did not identify any coding variations. Limitations: Sequencing analysis was limited to the final coding exon and small sample size. Conclusions: CLDN2 coding variations are not a common cause of idiopathic hypercalciuria in Canadian children. Further study is needed to determine the causes of hypercalciuria in pediatric patients and develop targeted therapies.
Silver Linings Around the Increased Use of Telehealth After the Emergence of COVID-19: Perspectives From Primary Care Physicians
Authors: McAlearney Ann Scheck , Gaughan Alice A. , Shiu-Yee Karen , DePuccio Matthew J. 
Published: May 2022

Introduction/Objectives: With the emergence of COVID-19, the transition from in-person care to widespread use of telehealth raised many well-described challenges for primary care providers (PCP). The purpose of this study was to improve understanding of how this increased use of telehealth impacted PCPs in positive ways, and specifically focus on any “silver linings” of using telehealth. Methods: We interviewed PCPs working at a large Midwestern academic medical center between June and July 2020 and asked for perspectives about the use of telehealth during the pandemic. Verbatim transcripts were coded and analyzed using deductive dominant thematic analysis that allowed for categorization of data and identification of emergent themes. Results: PCPs noted 3 main benefits of using telehealth: (1) demonstrated remote care was feasible, (2) patients expressed gratitude; and (3) payers fully reimbursed for telehealth visits. PCPs also described “silver linings” they perceived for patients: (1) easier access to care, (2) more convenient follow-up care, and (3) ability to get quick specialty referrals. Conclusions: Study participants offered encouraging feedback regarding the potential for telehealth to offer a convenient and patient-centric alternative to in-person care. As a healthcare delivery mode, telehealth can remove personal and social barriers to care for many patients, but reimbursement parity and more evidence is needed to inform best practices for ongoing telehealth use in primary care. With the continuing use of telehealth, it will be important to monitor health outcomes as well as consider how these modalities may need to be adapted to mitigate potential care disparities.
Quadriceps Tendon Autograft in Pediatric Anterior Cruciate Ligament Reconstruction: Graft Dimensions and Prediction of Size on Preoperative Mri
Authors: Baghdadi Soroush , Williams Brendan A , Lawrence J Todd R , Maguire Kathleen J , Wells Lawrence , Ganley Theodore J 
Published: May 2022

Background: There has been a growth of interest in quadriceps autograft anterior cruciate ligament (ACL) reconstruction in the pediatric population. Hypothesis/Purpose: The goal of this study was to evaluate children and adolescents who underwent ACL reconstruction using a quadriceps autograft to determine the properties of the harvested graft and to assess the value of demographic, anthropometric, and MRI measurements in predicting the graft size preoperatively. Methods: A retrospective IRB-approved database search was performed from January 2018 through October 2020 for patients undergoing ACL reconstruction. Patients <18 years old at the time of surgery in whom a quadriceps tendon autograft was used were selected. Demographic data and anthropometric measurements were recorded and graft measurements were abstracted from the operative note. Knee magnetic resonance images (MRI) were reviewed to measure the quadriceps tendon thickness on sagittal cuts (Figure 1). Graft length and diameter were then correlated with anthropometric and radiographic data. Results: A total of 169 patients (98 male) were included in the final analysis, with a median age of 15 years (range, 9-17). A tendon length of 65mm or more was harvested in 159 (94%) patients. The mean final graft diameter was 8.4 ± 0.7mm (range, 7 – 11mm) (Table 1). All patients had a graft diameter of 7mm or more, and 139 (82%) had a diameter of 8mm or larger. Preconditioning decreased the graft diameter by a mean of 0.68 ± 0.23mm. Age (P=0.04) and quadriceps thickness on MRI (P<0.001) were significant predictors of the final graft diameter. An MRI sagittal thickness of >6.7mm was 97.4% sensitive for obtaining a graft of ≥8mm in diameter. Conclusion: Our findings suggest that tendon-only quadriceps autograft is a reliable graft source in the pediatric ACL reconstruction, yielding a graft of ≥8mm in diameter in 82% of pediatric patients. Furthermore, preoperative MRI measurements can be reliably used to predict a graft of adequate diameter in children and adolescents undergoing ACL reconstruction, with a sagittal thickness of >6.7mm being highly predictive of a final graft size ≥8mm. [Table: see text][Figure: see text]