bluuebunny/crossref_metadata_2025_split huggingface dataset:
Minimum 2-Year Outcomes and Return to Sports of Competitive Athletes Who Undergo Subspine Decompression During Primary Hip Arthroscopy for Femoroacetabular Impingement Syndrome and Subspine Impingement: A Propensity-Matched Controlled Study
Authors: Jimenez Andrew E. , Lee Michael S. , George Tom , Owens Jade S. , Harris W. Taylor , Maldonado David R. , Lall Ajay C. , Domb Benjamin G. 
Published: April 2022

Background: Patient-reported outcomes (PROs) and return to sports (RTS) have not been established in athletes undergoing primary hip arthroscopy and subspine decompression for femoroacetabular impingement syndrome (FAIS) and subspine impingement (SSI). Purpose: (1) To report minimum 2-year PROs and RTS in competitive athletes undergoing primary hip arthroscopy for treatment of FAIS with subspine decompression for treatment of SSI and (2) to compare clinical results with a matched control group of athletes without SSI. Study Design: Cohort study, Level of evidence, 3. Methods: Data were reviewed for professional, collegiate, and high school athletes undergoing primary hip arthroscopy for FAIS with arthroscopic subspine decompression for SSI between February 2011 and October 2018. Inclusion criteria included preoperative and minimum 2-year follow-up scores for the modified Harris Hip Score, Nonarthritic Hip Score, Hip Outcome Score–Sport Specific Subscale, and visual analog scale for pain. Rates of achieving the minimal clinically important difference (MCID) were also calculated. For comparison, athletes in the SSI group were propensity matched according to age at the time of surgery, sex, body mass index, lateral center-edge angle, alpha angle, sport level, acetabular labrum articular disruption grade, and sport type to a control group of athletes without SSI. Results: A total of 30 SSI athletes were included in the study, with a mean plus or minus standard deviation follow-up of 32.1 ± 7.1 months and age of 20.9 ± 5.7 years. The SSI cohort demonstrated significant improvement in all recorded PROs ( P < .001), returned to sports at high rates (88.5%), and achieved the MCID for the Hip Outcome Score–Sport Specific Subscale at a high rate (80.0%). Furthermore, these patients had a low rate of undergoing revision surgery (6.7%). When compared with a propensity-matched control group of 59 athletes, the SSI group demonstrated similar rates of RTS, revision, and achieving the MCID for all PROs. Conclusion: Competitive athletes with FAIS and SSI who underwent primary hip arthroscopy and subspine decompression had favorable outcomes and high RTS rates at minimum 2-year follow-up. These results were comparable with those of a control group of athletes without SSI undergoing primary hip arthroscopy.
Four-Year Effects of a 2-Year Nutrition and Gender Sensitive Agricultural Program on Women’s Nutritional Status, Knowledge, and Empowerment in Rural Burkina Faso
Authors: Bliznashka Lilia , Becquey Elodie , Ruel Marie T. , Olney Deanna K. 
Published: April 2022

Background: Little is known about the sustained effects of nutrition- and gender-sensitive agricultural programs (NSAPs) after they end. Objectives: To examine the 4-year effects (2010-2014) of a 2-year NSAP (2010-2012) on women’s outcomes in rural Burkina Faso. Methods: We used baseline (2010) and endline (2012) data from a cluster-randomized controlled trial of Helen Keller International’s Enhanced Homestead Food Production (EHFP) program and baseline (2014) data from a new program. We included 134 women: 82 who participated in the 2-year EHFP program (treatment) and 52 who did not (control). We examined program (2010-2012), post-program (2012-2014), and overall 4-year effects (2010-2014) using difference-in-difference analysis (DID). Results: We found significant positive program effects (2010-2012) on women’s underweight prevalence (DID: 16.44 percentage points [pp]; P = .09) and on women’s knowledge about appropriate age to introduce liquids (DID: 28.40 pp; P = .01). Although there were no significant postprogram effects (2012-2014), differences found in 2012 between the treatment and control group were sustained resulting in an overall 4-year (2010-2014) reduction in women’s underweight prevalence (DID: 18.26 pp; P = .02) and an improvement in women’s knowledge about appropriate age to introduce liquids (DID: 31.29 pp; P = .02). We observed no postprogram or overall 4-year effects on women’s knowledge of child feeding and handwashing practices or women’s empowerment. Conclusions: Nutrition- and gender-sensitive agricultural programs demonstrate potential for sustained improvements in women’s nutritional status and nutritional knowledge. Postprogram assessments of NSAPs should be embedded in program evaluations to help further understand the potential of NSAPs to generate sustainable impacts on women’s outcomes.
Modified Zipper Method, a Promising Treatment Option in Severe Pediatric Immune-Mediated Neurologic Disorders
Authors: Nikolaus Marc , Kühne Fabienne , Tietze Anna , Thumfart Julia , Kempf Caroline , Gratopp Alexander , Knierim Ellen , Bittigau Petra , Kaindl Angela M. 
Published: April 2022

Objective To introduce and evaluate a modified version of the “zipper method”—a treatment strategy alternating intravenous immunoglobulin (IVIG) and plasma exchange (PLEX) first reported for 9 pediatric cases of Guillain-Barré syndrome in 2018—for treatment of severe immune-mediated neurologic disorders in children. Methods The modified zipper method comprised longer intervals between PLEX-IVIG cycles (48 hours instead of 24 hours), more cycles (7-10 instead of 5), a consistent plasma volume exchange (instead of the original multistep approach), and variable infusion times for IVIGs (4-8 hours). The modified zipper method was applied as an individual treatment approach once standard therapy failed. The follow-up ranged from 6 months to 2 years. Cases were analyzed retrospectively. Disease severity was mainly quantified by the Guillain-Barré syndrome disability score. Results Four children (9-15 years) with (1) Miller-Fisher syndrome, (2) Bickerstaff brainstem encephalitis, (3) common Guillain-Barré syndrome, and (4) severe acute disseminated encephalomyelitis were treated by the modified zipper method. Results for duration of mechanical ventilation (median of 12 days, interquartile range [IQR] 8-16), hospital stay (median of 23 days, IQR 22-24), and time to unaided walking (median of 22 days, IQR 21-37) outperformed previous studies with IVIG/PLEX alone or IVIG + PLEX combinations unlike the zipper method. Conclusion The modified zipper method is associated with a low mortality, a short mechanical ventilation time, a short hospital stay, and an excellent outcome in children with severe Guillain-Barré syndrome or acute disseminated encephalomyelitis. Our regimen is streamlined for applicability. Results emphasize its robust effectiveness as an option for therapy escalation in severe neuroimmunologic diseases. Now, multicenter trials are needed to evaluate this novel treatment strategy.
Longitudinal Predictors of Informant-Rated Everyday Function in Mild Cognitive Impairment
Authors: Divers Ross M. , De Vito Alyssa N. , Pugh Erika A. , Robinson Anthony , Weitzner Daniel S. , Calamia Matthew R. 
Published: April 2022

Objective To examine predictors of informant-reported everyday functioning in mild cognitive impairment (MCI) and relations between everyday function and conversion to dementia. Methods Informants of participants (n = 2614) with mild cognitive impairment (MCI) were administered the Functional Activities Questionnaire (FAQ). Changes in dimensions of functional ability as determined by an exploratory factor analysis (EFA) were examined over 3 years and participant predictors of change were examined using multilevel modeling (MLM). Results The FAQ consisted of 3 factors, multistep, finance, and memory/orientation daily tasks. Impairment in memory/orientation tasks was significantly higher than impairment in multistep tasks. Worse functioning was associated with greater depression, worse memory, worse speed/EF, higher years of education and identifying as White. There was variability in some of these associations with different FAQ factors. Impairments in financial and memory/orientation daily tasks predicted follow-up conversion to dementia. Conclusions Depression, speed/EF, and memory are consistently associated with domains of everyday functioning. Race, education, and age may be more variability associated with everyday functioning. Specific attention should be paid to subtle declines in the financial and memory/orientation domains as they may uniquely predict future dementia development. Depression may be a modifiable risk factor associated with functional impairment over time.
Effect of orifice size on liquid breakup dynamics and spray characteristics in slinger atomizers
Authors: Chakraborty Arnab , Sahu Srikrishna , Maurya Dalton 
Published: April 2022

The ability of the rotary slingers to achieve fuel atomization by employing the rotational speed of the turbine shaft obviates the use of high-pressure fuel pump and makes those a popular choice for small gas turbine engines. Such atomizers contain arrays of orifices on their outer periphery for injection of the liquid into the combustion chambers. In the present work, we experimentally investigate the influence of the choice of orifice size on primary liquid breakup dynamics and spray characteristics in slinger atomizers. Three slinger discs with the same disc size and number of orifices but with different orifice size, d o (= 1 mm, 1.5 mm, and 2 mm) are examined in a high-speed slinger test rig for a range of rotational speed (2000–10,000 rpm) and liquid feed rate (0.2–1 lpm). The operating conditions are relevant to part-load and engine relighting conditions for which the selection of geometric parameters of the injector may play a crucial role in achieving the atomizer performance. In the current work, the liquid breakup process in the vicinity of the slinger orifices was visualized using front light illumination technique, whereas the pulse-shadowgraph technique was employed for droplet sizing. It is found that smaller orifice size promotes column mode of liquid breakup which results in larger primary liquid breakup length and subsequently results in larger Sauter mean diameter. The results highlight that the orifice size is an important design parameter as the liquid atomization in slinger atomizers is sensitive to the selection of orifice size especially for lower range of rotational speeds.
Acupuncture in addition to usual care for patients with irritable bowel syndrome: a component network meta-analysis
Authors: Gan Yu , Huang Shi-Le , Luo Meng-Qi , Chen Min , Zheng Hui 
Published: April 2022

Objective: The efficacy of acupuncture alone in the treatment of irritable bowel syndrome (IBS) is controversial, but the benefit of acupuncture added to usual care has rarely been studied. We aimed to examine the benefit of acupuncture added to usual care through network meta-analysis (NMA). Methods: PubMed, Embase, and the Cochrane Register of Controlled Trials (CENTRAL) were searched from their inception to 1 July 2021, without any language restriction. Randomized controlled trials (RCTs) testing the effect of acupuncture alone or acupuncture combined with usual care for IBS were included. The primary outcome was improvement of global IBS symptoms. Standard NMA was performed to compare differential combinations of acupuncture (including manual acupuncture (MA) and electroacupuncture (EA)), and component network meta-analysis (CNMA) was subsequently performed to determine whether acupuncture provided additional benefits to usual care. The effect size of an intervention was measured using relative ratio (RR). Results: We included 25 RCTs (n = 3041 participants) after screening 582 retrieved articles. Five RCTs were classified as low risk of bias. The results of standard NMA showed that MA combined with usual care ranked the most effective (sham acupuncture as common comparator; RR = 1.96 (95% confidence interval (CI) 1.23 to 3.12)). The results of CNMA showed that MA was the most effective component (RR = 1.38 (95% CI, 1.12 to 1.70)) when added to usual care. Conclusion: Acupuncture provided additional benefits to usual care, and it might be considered as adjunctive therapy for patients who respond inadequately to usual care.
A high acromion-greater tuberosity impingement index increases the risk of retear after arthroscopic rotator cuff repair
Authors: Xie Linghui , Xu Xinxian , Ma Baoxiang , Liu Haixiao 
Published: April 2022

Background No evaluation has been done on the relationship of the acromion–greater tuberosity impingement index (ATI) with retear after arthroscopic rotator cuff repair (ARCR). Our purpose was to evaluate whether a higher ATI is associated with retear after ARCR. Methods 132 patients received ARCR and underwent MRI scan at a one year follow-up to assess tendon healing, and the findings were graded no retear (NR), partial-thickness retear (PR) or full-thickness retear (FR). The ATI, the critical shoulder angle (CSA), acromion index (AI) and lateral acromial angle (LAA) were measured with postoperative radiographs. Functional scores were obtained preoperatively and at a one year follow-up. Results Postoperative Constant scores and ASES scores were significantly different between groups with inferior outcomes in the FR group ( p < 0.05 for all). The UCLA score was significantly better in the NR group compared with the PR and FR groups ( p < 0.05), and in the PR group compared with the FR group ( p < 0.05). For ATI and CSA, the values of the PR and FR groups were larger than the NR group ( p < 0.05 for all), but there were no significant differences between the PR and FR groups ( p > 0.05 for all). No significant differences were observed with regard to the AI and LAA ( p > 0.05, respectively). The repair integrity was positively related to the ATI (0.304, p < 0.05) and CSA (0.252, p < 0.05), but not related to the AI or LAA ( p > 0.05 for both). ATI was not related to any functional scores ( p > 0.05 for all). Conclusion This study revealed that the ATI was positively related to rotator cuff retear. Patients with retears had significantly greater ATIs after ARCR. Level of Evidence: III, case–control study.
The Relationship Between Sleep Disturbance and Apolipoprotein E ε4 in Adults With Mild Cognitive Impairment and Alzheimer’s Disease Dementia: An Integrative Review
Authors: Wei Wanrui , Wang Kairong , Shi Jiyuan , Li Zheng 
Published: April 2022

Background Apolipoprotein E ε4 (APOE ε4) was shown to be a risk factor for mild cognitive impairment (MCI) and Alzheimer’s disease (AD) dementia. When coupled with sleep disturbance, APOE ε4 posed additional risks to cognitive impairment. But the literature on the association between sleep disturbance and the APOE ε4 status of persons who are cognitively impaired has not yet been systematically examined. Objectives To explore and synthesize the relationship between sleep disturbance and APOE ε4 status of adults with MCI and AD. Methods An integrative review was guided by Whittemore and Knafl’s methodology. Systematic searches identified studies with multiple sources published before May 20, 2021. A matrix and narrative synthesis was employed to organize and synthesize the findings. Joanna Briggs Institute (JBI) Critical Appraisal tools (2020) were used to evaluate the quality of the selected studies. Results A total of 7 studies were included. APOE ε4 was associated with poor sleep quality in terms of the deterioration of nighttime total sleep time, 24-hour total sleep time, rapid eye movement, sleep efficiency, sleep latency, and wake after sleep onset in a population with MCI or AD. The interacted and adjusted relationship between sleep disturbance and APOE ε4 on the progression of cognitive decline was inconsistent. Conclusions There is evidence to support an association between sleep disturbance and APOE ε4 in individuals with cognitive impairment, but a further examination of the relationship between sleep parameters and APOE ε4 is warranted, especially as the causal or dose–response relationship remains unclear.
Effective Handwashing Practice in Dilla University Referral Hospital; Duration of Hand Rubbing and the Amount of Water as Key Enablers
Authors: Gebremeskel Kanno Girum , Diriba Kuma , Getaneh Birtukan , Melaku Abayneh , Eshete Soboksa Negasa , Agyemang-Badu Samuel Yaw , Negassa Belay , Alembo Awash , Tesfu Legesse Miheret , Cherenet Aneley , Genoro Abire Belayneh , Birhanie Aregu Mekonnen 
Published: April 2022

Background: Ineffective hand hygiene in healthcare settings is a global challenge that is associated with a high rate of nosocomial infections. The study aimed to measure the effectiveness of handwashing at Dilla University referral hospital. Method: This study consisted of 2 parts; the survey work and laboratory analysis. A total of 63 participants were selected to take surveys using an interviewer-administered questionnaire to collect the data regarding the socio-demographic and hand hygiene-related practices. A laboratory tests (swab test) was used to assess handwashing effectiveness from 63 participants by taking 126 swab test (63 before and after hand washing sessions). A swab test was collected from the palms of each participant before and after hand washing using a sterile technique. The cultures were then incubated aerobically overnight at 37°C, and examined for microbial growth. The bacterial load was reported as the number of colony-forming units (CFU). Result: The proportion of effective hand washing in Dilla University Referral Hospital was 82.5%. The mean colony-forming unit before and after handwashing were 55 and 2 CFU/ml, respectively with an average reduction of 94.6% in terms of CFU/ml. The mean amount of water used for effective handwashing was 336.03 (±219.46) ml. There was a significant mean difference in the amount of water used and duration of hand rubbing between effective and non-effective handwashing among the participants ( P < 0.01). The bacterial load before and after handwashing indicated that there was a significant (53.3 mean CFU) reduction in bacterial load after handwashing practice which indicated that the handwashing intervention in the Referral hospital was effective ( P < 0.01). Conclusion: The proportion of effective Hand washing in Dilla University referral Hospital was 82.5% with a 94.6% reduction in terms of (CFU/ml). The amount of water use and the duration of hand rubbing showed a significant difference in the reduction of the microbial load.
Labour market regulations and efficiency in tourism industry
Authors: Mamatzakis Emmanuel , Pegkas Panagiotis , Staikouras Christos 
Published: April 2022

This study examines the effect of the labour market regulations on Greek tourism industry performance. The tourism industry, the steam engine of the Greek economy, always drives to enhance efforts to reach further savings in operating costs. However, the labour regulations that influence the tourism sector’s ability to adjust costs have not been thoroughly investigated. We present a novel methodology that permits the evaluation of the effect of labour market regulations on technical and allocative efficiency in one step. The empirical results demonstrate the complexity of the relationship between labour regulations and efficiency. Labour market liberalization is associated with improvements in allocative efficiency but may have opposite effects on technical efficiency. Policymakers should pay attention to these complicated interactions when planning reforms on labour market. JEL codes: D24, D61, J30, J80, Z30
‘It’s my back…’; developing the coming to spinal clinic resource to improve the health literacy of young people with adolescent idiopathic scoliosis and their parents
Authors: Bray Lucy , Wilkinson Catherine , Bruce Colin , Davidson Neil , Satchwell Candice , Carter Bernie 
Published: April 2022

This study focussed on identifying the key concerns and information needs of young people with Adolescent Idiopathic Scoliosis (AIS) and their parents and examined what resources might help improve young people’s ‘participativeness’ and health literacy during clinic consultations. A qualitative participatory design underpinned the study. Workshops involving multiple methods were used to engage with young people with AIS and their parents, who were recruited through a regional children’s hospital. The study design was informed by patient and public consultation with eight young people and two parents. 10 young people (aged 14–16 years) and 11 of their parents participated in the study. Young people and their parents reported uncertainty and anxiety before coming to clinic and faced issues participating in the consultation, being involved in decision-making and understanding the information and language. These challenges resulted in unmet information needs. Young people’s health literacy relating to an AIS diagnosis and treatment is facilitated by them being prepared and informed before coming to clinic and be actively supported to be involved during the consultation. We collaboratively developed the ‘Coming to Spinal Clinic’ resource to help young people with AIS and parents prepare for and get the most out of their visit.
Non-attendance in cervical cancer screening among migrant women in Portugal: A cross-sectional study
Authors: Marques Patrícia , Geraldes Mariana , Gama Ana , Heleno Bruno , Dias Sónia 
Published: April 2022

Objectives: Cervical cancer has a high mortality rate among women worldwide. Although cervical cancer screening (CCS) is an effective strategy in reducing mortality of the disease, inequalities in accessing screening exist, particularly among migrant women. This study aims to characterize migrant women’s participation in CCS and determine factors associated with non-attendance to CCS. Methods: A cross-sectional study based on a web-based survey targeting adult migrant women living in Portugal was conducted. Prevalence of non-attendance to CCS was examined, and its associations with socioeconomic, migration-related, and health-related factors were determined using adjusted logistic regression models. Results: A total of 1100 migrant women were included in the study. Prevalence of CCS non-attendance was 24.5%. CCS non-attendance was associated with younger age, being born in Africa or Asia, being single/divorced/widowed, never having had a GP appointment in Portugal and not having regular gynecology appointments. Being born in South and Central America, shorter length of stay in Portugal, having had HPV vaccination, and not having children are associated with CCS attendance. Conclusion: These findings point out that an important percentage of migrant women do not attend CCS. Strategies to increase participation should be developed, considering the inequalities identified and designed to target the specific needs of migrant women to improve their CCS attendance and increase cervical cancer prevention.