bluuebunny/crossref_metadata_2025_split huggingface dataset:
Parallelogram flap versus homodigital island flap in the treatment of fingertip defects with bone exposure: a prospective controlled study
Authors: Zhang Yingkai , Wang Yao , He Xianwei , Zhou Jiaqi , Cai Guoping , Wu Rongbo 
Published: June 2022

Abstract
Purpose
A modified local transposition flap (we call it “parallelogram flap”) surgery was performed for fingertip injuries. This study aimed to compare the clinical effects of parallelogram flap and homodigital island flaps in fingertip reconstruction.

Methods
The study collected patients who underwent parallelogram transposition flaps and homodigital island flaps to repair fingertip defects from 2019 to 2021. 150 cases (150 fingers) were included in our study. All operations were performed by one surgical team. Record the operation time, two-point discrimination (2PD), Total Active Movement (TAM) and the MHQ (Michigan Hand Questionnaire) of the injured fingers to evaluate the therapeutic effect.

Results
All parallelogram (Group A) and homodigital island flap (Group B) had survived postoperatively. The operative duration of Group A (31.2 ± 3.3 min) is shorter than Group B (97.8 ± 6.1 min) (P < 0.05). At the 6-month follow-up, there was no difference with the two-point discrimination (2PD) of the palmar part of the flaps and the Total Active Movement (TAM) of injured figures in Group A and Group B. The MHQ summary scores in Group A (94.29 ± 3.14) were much higher than in Group B (91.73 ± 3.41) (P < 0.05). Evaluation of the MHQ subscale performance showed that the overall hand function, activities of daily living, work performance and pain score had no differences(P > 0.05), but aesthetics (92.15 ± 7.16) and satisfaction (92.45 ± 5.61) score in Group A was higher than aesthetics (86.56 ± 5.60) and satisfaction (86.72 ± 8.21) score in Group B (P < 0.05 for both).

Conclusions
The reconstruction using parallelogram flaps is a easier and more versatile treatment with better functions, less morbidity and better aesthetics. This method is a better choice for reconstruction of fingertip injury.
A height-weight formula to measure body fat in childhood obesity
Authors: Licenziati Maria Rosaria , Ballarin Giada , Iannuzzo Gabriella , Lonardo Maria Serena , Di Vincenzo Olivia , Iannuzzi Arcangelo , Valerio Giuliana 
Published: June 2022

Abstract
Background
The assessment of body composition is central in diagnosis and treatment of paediatric obesity, but a criterion method is not feasible in clinical practice. Even the use of bioelectrical impedance analysis (BIA) is limited in children. Body mass index (BMI) Z-score is frequently used as a proxy index of body composition, but it does not discriminate between fat mass and fat-free mass. We aimed to assess the extent to which fat mass and percentage of body fat estimated by a height-weight equation agreed with a BIA equation in youths with obesity from South Italy. Furthermore, we investigated the correlation between BMI Z-score and fat mass or percentage of body mass estimated by these two models.

Methods
One-hundred-seventy-four youths with obesity (52.3% males, mean age 10.8 ± 1.9) were enrolled in this cross-sectional study. Fat mass and percentage of body fat were calculated according to a height-weight based prediction model and to a BIA prediction model.

Results
According to Bland–Altman statistics, mean differences were relatively small for both fat mass (+ 0.65 kg) and percentage of body fat (+ 1.27%) with an overestimation at lower mean values; the majority of values fell within the limits of agreement. BMI Z-score was significantly associated with both fat mass and percentage of body fat, regardless of the method, but the strength of correlation was higher when the height-weight equation was considered (r = 0.82; p < 0.001).

Conclusions
This formula may serve as surrogate for body fat estimation when instrumental tools are not available. Dealing with changes of body fat instead of BMI Z-score may help children and parents to focus on diet for health.
Successful pregnancy with restorative reproductive medicine after 16 years of infertility, three recurrent miscarriages, and eight unsuccessful embryo transfers with in vitro fertilization/intracytoplasmic sperm injection: a case report
Authors: Boyle Phil C. , Stanford Joseph B. , Zecevic Ivana 
Published: June 2022

Abstract
Background
Restorative reproductive medicine represents a comprehensive approach to subfertility (infertility and miscarriage) with investigations, diagnoses, and treatments combined with fertility charting to restore optimal reproductive function. Restorative reproductive medicine assumes that multiple factors need to be identified and treated (cycle optimization) for up to 12 cycles to achieve a successful pregnancy. Conception can occur during normal intercourse without intrauterine insemination or in vitro fertilization.

Case presentation
A 35-year-old Croatian female presented for fertility treatment in May 2019 with a previous diagnosis of polycystic ovaries, infertility of 16 years duration, and 8 unsuccessful embryo transfers with in vitro fertilization and intracytoplasmic sperm injection. She was gravida 3 para 0, with 2 miscarriages after spontaneous conception at 5–6 weeks gestation in 2002 and 2004, followed by a miscarriage after in vitro fertilization at 12 weeks gestation in 2011. We initially found poor follicle function and suboptimal progesterone levels. Restorative reproductive medicine treatment resulted in conception after two cycles of treatment. This pregnancy ended in miscarriage at 7 weeks 4 days. Additional investigations found a balanced Robertsonian translocation (13, 14) and a uterine septum. We achieved repeat fertilization with restorative reproductive medicine after three cycles of treatment following resection of the uterine septum and ovulation induction with letrozole and human chorionic gonadotrophin. She had a full-term healthy pregnancy and live birth in 2021.

Conclusion
We propose that a full evaluation of underlying factors, and up to 12 cycles of cycle optimization, should be offered to subfertile patients before considering in vitro fertilization treatment.
Assessing the prevalence of young children living in households prepared for COVID-19 in 56 low- and middle-income countries
Authors: Lu Chunling , Luan Yiqun , Naicker Sara N. , Subramanian S. V. , Behrman Jere R. , Heymann Jody , Stein Alan , Richter Linda M. 
Published: June 2022

Abstract
Background
The COVID-19 pandemic and governments’ attempts to contain it are negatively affecting young children’s health and development in ways we are only beginning to understand and measure. Responses to the pandemic are driven largely by confining children and families to their homes. This study aims to assess the levels of and associated socioeconomic disparities in household preparedness for protecting young children under the age of five from being exposed to communicable diseases, such as COVID-19, in low- and middle-income countries (LMICs).

Methods
Using data from nationally representative household surveys in 56 LMICs since 2016, we estimated the percentages of young children under the age of five living in households prepared for communicable diseases (e.g., COVID-19) and associated residential and wealth disparities at the country- and aggregate-level. Preparedness was defined on the basis of space for quarantine, adequacy of toilet facilities and hand hygiene, mass media exposure at least once a week, and phone ownership. Disparities within countries were measured as the absolute gap in two domains—household wealth and residential area - and compared across regions and country income groups.

Results
The final data set included 766,313 children under age five. On average, 19.4% of young children in the 56 countries lived in households prepared for COVID-19, ranging from 0.6% in Ethiopia in 2016 to 70.9% in Tunisia in 2018. In close to 90% of countries (50), fewer than 50% of young children lived in prepared households. Young children in rural areas or in the poorest households were less likely to live in prepared households than their counterparts.

Conclusions
A large portion of young children under the age of five in LMICs were living in households that did not meet all preparedness guidelines for preventing COVID-19 and caring for patients at home. This study highlights the need to ensure all families in LMICs have the means to prevent the spread of the pandemic or other communicable illnesses to young children during pandemics.
Delirium detection in hospitalized adults: the performance of the 4 'A's Test and the modified Confusion Assessment Method for the Emergency Department. A comparison study
Authors: Muser Olga , Seiler Kevin , Bachnick Stefanie , Gehri Beatrice , Zúñiga Franziska , Hasemann Wolfgang 
Published: June 2022

Abstract
Background
Early detection of delirium through systematic screening is essential to mitigate and prevent possible consequences. The 4 'A's Test (4AT) is a new tool that can be used for delirium detection easily and without special training. The modified Confusion Assessment Method for Emergency Department (mCAM-ED) is an operationalized version of the Confusion Assessment Method, a worldwide used tool for delirium screening in clinical practice and research. This is the first comparison of both delirium screening tools. This study aimed to investigate performance accuracy of the 4AT compared to the mCAM-ED in detecting delirium in hospitalized patients.

Methods
In this prospective single-centre cross-sectional pilot study, patients from six wards were selected consecutively. All patients underwent a delirium screening with the gold standard, the mCAM-ED. To rate the algorithm of the 4AT, corresponding items of the mCAM-ED were derived and used.

Results
A total of 116 patients with a median age of 73 years could be included. Dementia was present in 11 (9.5%) patients, and 42.2% were women. Delirium was present in 8/116 (6.9%) and 16/116 (13.8%) patients according to the mCAM-ED and the 4AT, respectively. In comparison, the 4AT showed 100% (95% CI 0.63, 1.00) sensitivity, 93% (95% CI 0.86, 0.97) specificity, 13.50 (95% CI 6.93, 26.30) positive likelihood ratio and 0.00 (95% CI 0.00, NaN) negative likelihood ratio.

Conclusions
In this first comparison, the 4AT showed a high rate of false-positive scores, which may result in an increased need for further in-depth assessments.
Imaging of COVID-19 vasculopathy from head to toe: Egyptian collective experience after 2 years of the pandemic
Authors: Fathy Ahmed , Rizk Adel , Elnekeidy Abdelaziz , Gharraf Heba Said , Abdelgawad Mohamed Saied , Samir Ahmed 
Published: June 2022

Abstract
Background
COVID-19 vasculopathy is a critical condition that impacts the disease prognosis including vasculitis and thromboembolic complications. This study aimed to provide the Egyptian experience about the COVID-19 vasculopathy during the past two years of the pandemic and to collectively include the different modalities and imaging techniques for the diagnosis of cerebrovascular, pulmonary, gastrointestinal, and peripheral arterial vascular complications.

Results
This is a multi-center retrospective analysis of 3500 PCR-proved COVID-19 infection between March 2020 and December 2021. A cohort of 282 consecutive patients with COVID-19 vasculopathy was considered for inclusion. They included 204 males and 78 females (72:28%). The mean age was 68 years, and age ranged from 48 to 90 years. Five radiologists evaluated the different imaging examinations in consensus including computed tomography (CT), CT-angiography (CTA), CT-perfusion (CTP), magnetic resonance imaging (MRI), MR-arteriography (MRA), and MR-venography (MRV). 244/282 (86.5%) patients suffered from non-hemorrhagic cerebral ischemic infarctions. 13/282 (4.6%) patients suffered from hemorrhagic cerebral infarctions. 5/282 (1.8%) patients suffered from cerebral vasculitis. Pulmonary vascular angiopathy was detected in 10/282 (3.5%) patients, including pulmonary embolism in 10/10 patients, pulmonary infarctions in 8/10 patients, pulmonary vascular enlargement in 5/10 patients, and vascular "tree-in-bud" sign in 2/10 patients. Intestinal ischemia and small bowel obstruction were detected in 3/282 patients (1%) while GIT bleeding was encountered in 4/282 patients (1.4%). Lower limb arterial ischemia was found in 3/282 patients (1%). Additionally; 39/282 (13.8%) patients developed peripheral deep venous thrombosis (DVT) due to prolonged ICU recumbence while 28/282 (10%) patients developed jugular vein thrombosis sequel to prolonged catheterization. A p value (0.002) and (r) = 0.8 statistically proved strong significant relation between COVID-19 vasculopathy and D-dimer levels.

Conclusions
Multi-system vasculopathy was a serious complication of COVID-19 which impacted the patients' morbidity and mortality. An Egyptian experience about the COVID-19 vasculopathy during the past two years of the pandemic was provided. It encountered the different modalities and imaging techniques for the diagnosis of cerebrovascular, pulmonary, gastrointestinal, and peripheral arterial COVID-19 vascular complications.
Articulating fertilizer subsidy effects on women’s diet quality by food supply source in Mali
Authors: Assima Amidou , Zanello Giacomo , Smale Melinda 
Published: June 2022

AbstractBackgroundMali’s fertilizer subsidy program aims to reduce food insecurity among the nation’s predominantly rural people by jump-starting productivity gains of major crops. This paper contributes to sparse evidence regarding its effects.MethodsTheory predicts that agricultural productivity can affect diet quality directly through two channels. The production channel influences the availability of food for household consumption or sale. The income pathway, resulting from sales, leads to household food expenditure. We test this hypothesis by applying propensity score matching methods to farm household survey data collected from 2400 households in Mali in 2018.ResultsWe find that the overall effect of the fertilizer subsidy on women’s dietary diversity is positive in the Niger Delta and negative on the Koutiala Plateau. Further examination by food supply source reveals no subsidy effects on the dietary diversity provided by on-farm production in either zone. The subsidy negatively influences dietary diversity of foods sourced as gifts in the Niger Delta. Subsidy effects on dietary diversity accessed through food purchases are strong and positive in the Niger Delta, but negative on the Koutiala Plateau. The Koutiala Plateau is found in the region of Sikasso, where rising incomes from cotton production, which is the major export crop of the region and of the nation, have been shown not to alleviate poverty and malnutrition (a dilemma known as the “Sikasso Paradox”).ConclusionsOur approach reveals that additional income from increased yields stimulated by subsidized fertilizer can enable off-farm purchases of more nutritious food and thereby improve nutritional outcomes for women.
Improvements in pig agriculture through gene editing
Authors: Whitworth Kristin M. , Green Jonathan A. , Redel Bethany K. , Geisert Rodney D. , Lee Kiho , Telugu Bhanu P. , Wells Kevin D. , Prather Randall S. 
Published: June 2022

AbstractGenetic modification of animals via selective breeding is the basis for modern agriculture. The current breeding paradigm however has limitations, chief among them is the requirement for the beneficial trait to exist within the population. Desirable alleles in geographically isolated breeds, or breeds selected for a different conformation and commercial application, and more importantly animals from different genera or species cannot be introgressed into the population via selective breeding. Additionally, linkage disequilibrium results in low heritability and necessitates breeding over successive generations to fix a beneficial trait within a population. Given the need to sustainably improve animal production to feed an anticipated 9 billion global population by 2030 against a backdrop of infectious diseases and a looming threat from climate change, there is a pressing need for responsive, precise, and agile breeding strategies. The availability of genome editing tools that allow for the introduction of precise genetic modification at a single nucleotide resolution, while also facilitating large transgene integration in the target population, offers a solution. Concordant with the developments in genomic sequencing approaches, progress among germline editing efforts is expected to reach feverish pace. The current manuscript reviews past and current developments in germline engineering in pigs, and the many advantages they confer for advancing animal agriculture.
Prevalence and related factors of child posttraumatic stress disorder during COVID-19 pandemic: A systematic review and meta-analysis
Authors: Yang Fan , Wen Jiaxing , Huang Ning , Riem Madelon M. E. , Lodder Paul , Guo Jing 
Published: June 2022

AbstractBackgroundThe COVID-19 pandemic has drastically impacted many aspects of society and has indirectly produced various psychological consequences. This systematic review aimed to estimate the worldwide prevalence of posttraumatic stress disorder (PTSD) in children due to the COVID-19 pandemic, as well as to identify protective or risk factors contributing to child PTSD.MethodsWe conducted a systematic literature search in the PubMed, ProQuest, PsycINFO, Embase, Web of Science, WanFang, CNKI, and VIP databases. We searched for studies published between January 1, 2020 and May 26, 2021, that reported the prevalence of child PTSD due to the COVID-19 pandemic, as well as factors contributing to child PTSD. Eighteen studies were included in our systematic review, of which 10 studies were included in the meta-analysis.ResultsThe estimated prevalence of child PTSD after the COVID-19 outbreak was 28.15% (95% CI: 19.46–36.84%, I2 = 99.7%). In subgroup analyses for specific regions the estimated prevalence of post-pandemic child PTSD was 19.61% (95% CI: 11.23–27.98%) in China, 50.8% (95% CI: 34.12–67.49%) in the USA, and 50.08% in Italy (95% CI: 47.32–52.84%).ConclusionsFactors contributing to child PTSD were categorized into four aspects: personal factors, family factors, social factors and infectious diseases related factors. Based on this, we presented a new framework summarizing the occurrence and influence of the COVID-19 related child PTSD, which may contribute to a better understanding, prevention and development of interventions for child PTSD in forthcoming pandemics.
Pinning forces of sliding drops at defects
Authors: Saal Alexander , Straub Benedikt B. , Butt Hans-Jürgen , Berger Rüdiger 
Published: June 2022

Abstract
Wetting of surfaces depends critically on defects which alter the shape of the drop. However, no experimental verification of forces owing to the three phase contact line deformation at single defects is available. We imaged the contact line of sliding drops on hydrophobic surfaces by video microscopy. From the deformation of the contact line, we calculate the force acting on a sliding drop using an equation going back to Joanny and de Gennes (J. Chem. Phys., 81 (1984) 554). The calculated forces quantitatively agree with directly measured forces acting between model defects and water drops. In addition, both forces quantitatively match with the force calculated by contact angle differences between the defect and the surface. The quantitative agreement even holds for defects reaching a size of

of the drop diameter. Our validation for drop’s pinning forces at single defects is an important step towards a general understanding of contact line motion on heterogeneous surfaces.
Artificial Neural Network Approach to Competency-Based Training Using a Virtual Reality Neurosurgical Simulation
Authors: Reich Aiden , Mirchi Nykan , Yilmaz Recai , Ledwos Nicole , Bissonnette Vincent , Tran Dan Huy , Winkler-Schwartz Alexander , Karlik Bekir , Del Maestro Rolando F. 
Published: June 2022

BACKGROUND:
The methodology of assessment and training of surgical skills is evolving to deal with the emergence of competency-based training. Artificial neural networks (ANNs), a branch of artificial intelligence, can use newly generated metrics not only for assessment performance but also to quantitate individual metric importance and provide new insights into surgical expertise.

OBJECTIVE:
To outline the educational utility of using an ANN in the assessment and quantitation of surgical expertise. A virtual reality vertebral osteophyte removal during a simulated surgical spine procedure is used as a model to outline this methodology.

METHODS:
Twenty-one participants performed a simulated anterior cervical diskectomy and fusion on the Sim-Ortho virtual reality simulator. Participants were divided into 3 groups, including 9 postresidents, 5 senior residents, and 7 junior residents. Data were retrieved from the osteophyte removal component of the scenario, which involved using a simulated burr. The data were manipulated to initially generate 83 performance metrics spanning 3 categories (safety, efficiency, and motion) of which only the most relevant metrics were used to train and test the ANN.

RESULTS:
The ANN model was trained on 6 safety metrics to a testing accuracy of 83.3%. The contributions of these performance metrics to expertise were revealed through connection weight products and outlined 2 identifiable learning patterns of technical skills.

CONCLUSION:
This study outlines the potential utility of ANNs which allows a deeper understanding of the composites of surgical expertise and may contribute to the paradigm shift toward competency-based surgical training.
Sacroiliac Joint Fusion Using Robotic Navigation: Technical Note and Case Series
Authors: Wang Timothy Y. , Bergin Stephen M. , Murphy Kelly R. , Abd-El-Barr Muhammad M. , Grossi Peter , Shaffrey Christopher I. , Crutcher Clifford , Than Khoi D. 
Published: June 2022

BACKGROUND:
Patients undergoing sacroiliac (SI) fusion can oftentimes experience significant improvements in pain and quality of life.

OBJECTIVE:
To describe a novel application of robotic navigation to assist with minimally invasive SI joint fusion.

METHODS:
Patients undergoing stand-alone SI joint fusion with ExcelsiusGPS robotic navigation from July 2020 through June 2021 were retrospectively enrolled. Baseline demographic and perioperative variables including radiation exposure, postoperative pain scores, and narcotic requirements in the postanesthesia care unit (PACU) were recorded. Length of stay and any postoperative complications were also noted.

RESULTS:
A total of 10 patients (64.4 ± 8.2 years, body mass index 28.7 ± 4.8 kg/m2) met inclusion criteria. Seven patients (70.0%) were female, and there was a 6:4 split between left-sided and right-sided SI joint fusion. The total operative time was 54 ± 9 minutes, and the estimated blood loss was 21.0 ± 16.7 mL. The intraoperative radiation exposure was 13.7 ± 6.2 mGy, and there were no complications. The average pain score in PACU was 5.2 ± 1.0, and the average opioid administration in PACU was 27.6 ± 10.3 morphine equivalents. Length of stay was 0.4 ± 0.7 days, with 7 of 10 patients discharged on the same day as surgery. There were no readmissions. The average length of follow-up was 4.3 ± 2.5 months. At the last follow-up, patients reported an average of 73.1% ± 30.1% improvement in their preoperative pain.

CONCLUSION:
Robot-navigated SI joint fusion is a feasible and reproducible method for addressing refractory SI joint disease. Further investigation on clinical outcomes and long-term fusion rates is needed, as are studies comparing robot-navigated SI joint fusion with more traditional techniques.