bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical and Radiological Outcomes of Autologous Osteochondral Transplantation with and without Micronized Allograft Cartilage Matrix Augmentation for Osteochondral Lesions of the Talus
Authors: Mercer Nathaniel P. , Samsonov Alan , Dankert John , Kennedy John G. 
Published: January 2022

Category: Ankle; Basic Sciences/Biologics; Trauma Introduction/Purpose: Autologous osteochondral transplantation (AOT) using a cylindrical graft, in the treatment of osteochondral lesions of the talus (OLT) is typically indicated for patients with larger lesions. However, with lesions that are irregular in shape, the AOT graft may not completely replace the lesion. For these lesions, we utilize Extracellular Matrix Cartilage Allograft (EMCA) augmentation in AOT to act as a physiologic grout between the host and graft interface. The purpose of this study was to evaluate the clinical and radiological outcomes of AOT with concentrated bone marrow aspirate (CBMA) and EMCA augmentation in the treatment of OLT. Methods: A retrospective analysis comparing patients treated with AOT/CBMA alone and AOT with CBMA/EMCA was performed. Clinical outcomes were evaluated with the use of the Foot and Ankle Outcome Score (FAOS). Magnetic resonance imaging (MRI) was evaluated with the use of the Magnetic Resonance Observation of Cartilage Repair Tissue (MOCART) score. Cyst formation was also evaluated on postoperative MRI. Results: Twenty-six patients were included in the AOT + CBMA/EMCA group, with 10 males and 16 females. Thirty-four patients were included in the AOT/CBMA group, with 17 males and 17 females. The mean symptoms, pain, ADL, sports activities, and QOL scores in FAOS significantly improved in both groups (p<0.001), but there was no significant difference between groups at final follow-up. There was no significant difference between the mean MOCART scores between groups (p=0.118). In the AOT/CBMA group, 2 patients (7.7%) complained of knee pain and 5 patients (19.2%) required additional surgery (2 hardware removals and 3 arthroscopic debridements of scar tissue in the ankle). In the AOT + CBMA/EMCA group, 3 patients (8.8%) complained of knee pain, and one patient (2.9%) required hardware removal. Conclusion: The current study demonstrated that AOT combined with CBMA and EMCA was an effective surgical treatment for OLT, providing good clinical and radiological outcomes. However, the benefit of combining ECMA with CBMA in small chondral defects at the host graft interface may be marginal as the biologic effect is induced by the CBMA and the mechanical scaffold effect of ECMA may not be required in such small defects.
Effects of sand burial depth on Xanthium spinosum seed germination and seedling growth
Authors: Tao Yuan-yuan , Shang Tian-cui , Yan Jun-jie , Hu Yun-xia , Zhao Yu , Liu Ying 
Published: January 2022

AbstractIn desert habitats, sand burial is an important factor affecting germination of plant seeds and seedling growth.Xanthium spinosumhas strong adaptability in arid desert areas, and is a common malignant invasive plant in Xinjiang, China. The effects of different sand burial depths on seed germination, seedling emergence, growth and biomass allocation were studied to provide a scientific basis for further control ofX. spinosum. Six sand burial depths (1, 2, 3, 5, 7 and 9 cm) were established to explore the response ofX. spinosumseed germination and seedling growth to sand burial. The first emergence time, peak emergence time, emergence rate, seedling growth height, biomass and biomass distribution ofX. spinosumseeds was significantly different at sand burial depths (P< 0.05). TheX. spinosumseeds had the highest emergence rate (71.5%) at 1 cm sand burial and the maximum seedling height (7.1 cm). As sand burial depth increased, the emergence rate and seedling height gradually decreased. Emergence rate (12.25%) and seedling height (2.9 cm) were lowest at 9 cm sand burial. The root length at 9 cm depth (13.6 cm) was significantly higher than that at other sand depths (P< 0.05). The sand burial depth affected the biomass accumulation and distribution ofX. spinosum. As sand burial depth increased, the root biomass and rhizome ratio increased, and the most deeply buried seedlings allocated more biomass for root growth. The optimal sand burial depth for seed germination and seedling growth ofX. spinosumwas 1–3 cm, and high burial depth (5–9 cm) was not conducive to the germination and growth ofX. spinosumseedlings. For prevention and control ofX. spinosum, we suggest deeply ploughing crops before sowing to ensureX. spinosumseeds are ploughed into a deep soil layer.
Assessing the quality of patient handovers between ambulance services and emergency department – development and validation of the emergency department human factors in handover tool
Authors: Golling Marina , Behringer Wilhelm , Schwarzkopf Daniel 
Published: January 2022

Abstract
Background
Patient handover between prehospital care and the emergency department plays a key role in patient safety. Therefore, we aimed to create a validated tool for measuring quality of communication and interprofessional relations during handover in this specific setting.

Methods
Based on a theoretical framework a comprehensive item pool on information transfer and human factors in emergency department handovers was created and refined in a modified Delphi survey involving clinical experts. Based on a pre-test, items were again revised. The resulting Emergency Department Human Factors in Handover tool (ED-HFH) was validated in a field test at the emergency department of a German university hospital from July to December 2017. The ED-HFH was completed by emergency department and ambulance service staff participating in handovers and by an external observer. Description of item characteristics, exploratory factor analysis, analyses on internal consistency and interrater reliability by intraclass-correlation. Construct validity was analysed by correlation with an overall rating on quality of the handover.

Results
The draft of the ED-HFH contained 24 items, 90 of 102 eligible staff members participated in the field test completing 133 questionnaires on 38 observed handovers. Four items were deleted after analysis of item characteristics. Factor analysis supported a single factor explaining 39% of variance in the items. Therefore, a sum-score was calculated with a possible range between 14 and 70. The median value of the sum-score in the sample was 61.5, Cronbach’s α was 0.83, intraclass-correlation was 0.52, the correlation with the overall rating of hand-over quality was ρ = 0.83 (p ≤ 0.001).

Conclusions
The ED-HFH showed its feasibility, reliability and validity as a measure of quality of information transfer and human factors in handovers between ambulance services and the emergency department. It promises to be a useful tool for quality assurance and staff training.
Serum creatinine/cystatin C ratio as a surrogate marker for sarcopenia in patients with gastric cancer
Authors: Sun Jing , Yang Hui , Cai Wentao , Zheng Jingwei , Shen Ningzhe , Yang Xinxin , Pan Bujian , Zhang Weiteng , Chen Xiaodong , Shen Xian 
Published: January 2022

Abstract
Background
Sarcopenia is an age-related syndrome that may have negative impact on surgical outcomes and long-term survival of patients with gastric cancer. Serum creatinine/cystatin C (Cr/CysC) ratio has attracted attention as a surrogate marker for sarcopenia but has not been adequately studied in patients with gastric cancer. The purpose of this study was to investigate the validity of serum Cr/CysC ratio as a predictor of sarcopenia, evaluate a statistical cut-off value, and assess the relationship between Cr/CysC ratio and prognosis of patients with gastric cancer.

Methods
We retrospectively studied 327 patients who underwent surgery for gastric cancer from June 2009 to October 2021. The skeletal muscle mass index was calculated using computed tomography (CT). We determined the relevance of serum Cr/CysC ratio as a surrogate maker for sarcopenia by comparing it with various biomarkers. The Concordance index (C-index) was calculted to measure whether the Cr/CysC ratio can prognosis of patients with gastric cancer.

Results
Serum Cr/CysC was significantly correlated with with Skeletal Muscle Index (SMI) (r = 0.221, p < 0.001) and Skeletal Muscle Area (SMA) (r = 0.258, p < 0.001). The area under the curve for sarcopenia was significantly larger for serum Cr/CysC ratio than for other biomarkers (Cr/CysC: 0.644, CysC: 0.535, Cr: 0.556). Patients in the high-Cr/CysC group have longer survival time than that in low-Cr/CysC group, defined by the cutoff value 0.67. The C-index of both Cr/CysC ratio and SMI with OS was 0.63.

Conclusions
Serum Cr/CysC ratio can be used accurately, inexpensively, and easily to evaluate sarcopenia in male patients with gastric cancer. Our study shows that patients with Cr/CysC below 0.67 had possibility of sarcopenia and would be poor prognosis.
Effects of an oral mucosa protective formulation on chemotherapy- and/or radiotherapy-induced oral mucositis: a prospective study
Authors: Ueno Takao , Yatsuoka Wakako , Ishiki Hiroto , Miyano Kanako , Uezono Yasuhito 
Published: January 2022

Abstract
Background
Oral mucositis (OM) associated with cancer treatment not only impairs patients’ quality of life but also causes treatment delays or changes. This prospective exploratory study was conducted to evaluate the efficacy of Episil® oral liquid, which is an approved protective formulation for the oral mucosa in patients with OM. The extent of the pain-relieving effect, feeling during use, and adverse events or problems were evaluated.

Methods
In total, 10 Japanese cancer patients with OM receiving chemotherapy, pretreatment therapy for hematopoietic stem cell transplantation, or radiation therapy for head and neck cancer were enrolled.

Results
A numerical rating scale (NRS) was used to assess oral pain intensity due to OM. Compared to baseline, the mean NRS began to decrease at 5 min after using Episil® (7.1 ± 1.4 to 4.6 ± 2.87; p = 0.264). A significant decrease was observed in the pain score after using Episil® compared with that before using Episil®, and this effect lasted up to 120 min. The protective effects of Episil® were observed 3–5 min after application. Some patients felt slight soreness or discomfort when applying Episil®. However, this discomfort due to Episil®’s stimulation was within the allowable range and transient. No adverse events were observed in any of the cases.

Conclusions
The results of this prospective study showed that Episil® could be an effective treatment to relieve oral pain in Japanese patients with moderate to severe OM, and this newly approved product might adequately support patients’ oral intake.

Trial registration
University Hospital Medical Information Network Clinical Trials Registry (UMIN-CTR) (UMIN000031921).
Metabolic phenotypes and risk of colorectal cancer: a systematic review and meta-analysis of cohort studies
Authors: Goodarzi Golnoosh , Mozaffari Hadis , Raeisi Tahereh , Mehravar Fatemeh , Razi Bahman , Ghazi Maryam Lafzi , Garousi Nazila , Alizadeh Shahab , Janmohammadi Parisa 
Published: January 2022

Abstract
Background
The association of obesity with colorectal cancer (CRC) may vary depending on metabolic status.

Objective
This meta-analysis aimed to investigate the combined impacts of obesity and metabolic status on CRC risk.

Methods
The Scopus, PubMed, and web of sciences databases were systematically searched up to Jun 2021 to find all eligible publications examining CRC risk in individuals with metabolically unhealthy normal-weight (MUHNW), metabolically healthy obesity (MHO), and metabolically unhealthy obesity (MUHO) phenotypes.

Results
A total of 7 cohort studies with a total of 759,066 participants were included in this meta-analysis. Compared with healthy normal-weight people, MUHNW, MHO, and MUHO individuals indicated an increased risk for CRC with a pooled odds ratio of 1.19 (95% CI = 1.09–1.31) in MUHNW, 1.14 (95% CI = 1.06–1.22) in MHO, and 1.24 (95% CI = 1.19–1.29) in MUHO subjects. When analyses were stratified based on gender, associations remained significant for males. However, the elevated risk of CRC associated with MHO and MUHO was not significant in female participants.

Conclusions
The individuals with metabolic abnormality, although at a normal weight, have an increased risk for CRC. Moreover, obesity is associated with CRC irrespective of metabolic status.
Diet and nutritional status among hospitalised children in Hawassa, Southern Ethiopia
Authors: Hjellbakk Vilde K. , Hailemariam Hailu , Reta Fikadu , Engebretsen Ingunn M. S. 
Published: January 2022

Abstract
Background
Undernutrition constitutes a major problem among children in Hawassa, Ethiopia, and the literature on nutritional status in hospitalised children is scarce. The aim of this study was to investigate dietary diversity, nutritional practices, and the frequencies of undernutrition and the factors associated with severe acute malnutrition (SAM) in a hospitalised paediatric population in Hawassa, Southern Ethiopia.

Methods
A hospital-based cross-sectional study was carried out among hospitalised children in Hawassa, Southern Ethiopia. Children aged 6 to 59 months and their caregivers admitted for >24 hours from two public hospitals in Hawassa between November 2019 and January 2020 were included. Dietary diversity was assessed using World Health Organization (WHO) guidelines. Weight and height/length of the children were measured, and z-scores were calculated using the WHO growth standards. The definition of SAM was a weight-for-height z-score (WHZ) less than –3 or a clinically confirmed SAM diagnosis with higher WHZ.

Results
A total of 188 caregiver-child pairs were assessed in the two public hospitals. The majority of the patients were admitted with SAM (N = 70/188, 37%) or respiratory tract infections (N = 44/188, 23%). There was a similar number of boys and girls with SAM. Of all the children, 59% reported to have consumed foods from fewer than four food groups, while 40% reported eating foods from four or more food groups. The rate of malnutrition was high, and 35.8% of the children were classified as wasted (WHZ < –2) and 41% were stunted (height-for-age z-score < –2). Nearly 30% of the SAM patients were also stunted.

Conclusion
This study revealed that hospitalised children in this setting had poor dietary diversity and nutritional status, a high degree of morbidity, and extreme poverty. There is thus a need to focus on nutrition patterns in clinical settings.
Barriers and facilitators to program directors’ use of the medical education literature: a qualitative study
Authors: Doja Asif , Lavin Venegas Carolina , Cowley Lindsay , Wiesenfeld Lorne , Writer Hilary , Clarkin Chantalle 
Published: January 2022

Abstract
Background
It is unclear how often frontline clinical teachers are using this literature and its evidence base in teaching and assessment. Our study purpose was to examine postgraduate program director perspectives on the utilization and integration of evidence-based medical education literature in their teaching and assessment practices.

Methods
The authors conducted semi-structured telephone interviews with a convenience sample of current and former program directors from across Canada. Interviews were transcribed and analyzed inductively to distil pertinent themes.

Results
In 2017, 11 former and current program directors participated in interviews. Major themes uncovered included the desire for time-efficient and easily adaptable teaching and assessment tools. Participants reported insufficient time to examine the medical education literature, and preferred that it be ‘synthesized for them’. (i.e., Best evidence guidelines). Participants recognised continuing professional development and peer to peer sharing as useful means of education about evidence-based tools. Barriers to the integration of the literature in practice included inadequate time, lack of financial compensation for teaching and assessment, and the perception that teaching and assessment of trainees was not valued in academic promotion.

Discussion
Faculty development offices should consider the time constraints of clinical teachers when planning programming on teaching and assessment. To enhance uptake, medical education publications need to consider approaches that best meet the needs of a targeted audiences, including frontline clinical teachers. This may involve novel methods and formats that render evidence and findings from their studies more easily ‘digestible’ by clinical teachers to narrow the knowledge to practice gap.
The effect of the online flipped classroom on self-directed learning readiness and metacognitive awareness in nursing students during the COVID-19 pandemic
Authors: Khodaei Safoura , Hasanvand Shirin , Gholami Mohammad , Mokhayeri Yaser , Amini Mitra 
Published: January 2022

Abstract
Background
The COVID-19 pandemic has initiated digital developments in higher education while closing in-person university classes. As this crisis continues, the need to revive virtual learning opportunities was seriously felt. The present study was conducted to determine the online flipped classroom’s effect on nursing students’ self-directed learning readiness and metacognitive awareness.

Methods
This quasi-experimental single-group study with pretest-posttest design recruited 34 sophomore students of a nursing school in Lorestan province, Western Iran selected by census according to the inclusion criteria. Online asynchronous learning and online flipped classrooms were used during the semester’s first and second eight weeks, respectively. Students filled out self-directed learning readiness scale and metacognitive awareness inventory online before, in the middle of, and at the end of the semester. Data were analyzed using paired t-test in Stata-14 software.

Results
There was no significant difference between the mean score of metacognitive awareness before and after Online asynchronous learning (P=0.15), but the mean score of self-directed learning readiness increased significantly after OA (P=0.0004). After applying online flipped classrooms, students’ mean (SD) scores of metacognitive awareness and self-directed learning readiness were 272.03 (53.03) and 162.03 (21.77), respectively, which confirmed their significant improvement compared to before the intervention. A comparison of the mean score changes of both methods indicated that their implementation did not lead to significant differences between the mean total score of metacognitive awareness (P=0.15) and the mean total score of self-directed learning readiness (P=0.07).

Discussion
Online flipped classroom approach can be used as an effective method in nursing education by improving self-directed learning and metacognitive awareness, which are essential in online education for nursing students.
Regenerating zebrafish scales express a subset of evolutionary conserved genes involved in human skeletal disease
Authors: Bergen Dylan J. M. , Tong Qiao , Shukla Ankit , Newham Elis , Zethof Jan , Lundberg Mischa , Ryan Rebecca , Youlten Scott E. , Frysz Monika , Croucher Peter I. , Flik Gert , Richardson Rebecca J. , Kemp John P. , Hammond Chrissy L. , Metz Juriaan R. 
Published: January 2022

AbstractBackgroundScales are mineralised exoskeletal structures that are part of the dermal skeleton. Scales have been mostly lost during evolution of terrestrial vertebrates whilst bony fish have retained a mineralised dermal skeleton in the form of fin rays and scales. Each scale is a mineralised collagen plate that is decorated with both matrix-building and resorbing cells. When removed, an ontogenetic scale is quickly replaced following differentiation of the scale pocket-lining cells that regenerate a scale. Processes promotingde novomatrix formation and mineralisation initiated during scale regeneration are poorly understood. Therefore, we performed transcriptomic analysis to determine gene networks and their pathways involved in dermal scale regeneration.ResultsWe defined the transcriptomic profiles of ontogenetic and regenerating scales of zebrafish and identified 604 differentially expressed genes (DEGs). These were enriched for extracellular matrix, ossification, and cell adhesion pathways, but not in enamel or dentin formation processes indicating that scales are reminiscent to bone. Hypergeometric tests involving monogenetic skeletal disorders showed that DEGs were strongly enriched for human orthologues that are mutated in low bone mass and abnormal bone mineralisation diseases (P< 2× 10−3). The DEGs were also enriched for human orthologues associated with polygenetic skeletal traits, including height (P< 6× 10−4), and estimated bone mineral density (eBMD,P< 2× 10−5). Zebrafish mutants of two human orthologues that were robustly associated with height (COL11A2,P=6× 10−24) or eBMD (SPP1,P=6× 10−20) showed both exo- and endo- skeletal abnormalities as predicted by our genetic association analyses;col11a2Y228X/Y228Xmutants showed exoskeletal and endoskeletal features consistent with abnormal growth, whereasspp1P160X/P160Xmutants predominantly showed mineralisation defects.ConclusionWe show that scales have a strong osteogenic expression profile comparable to other elements of the dermal skeleton, enriched in genes that favour collagen matrix growth. Despite the many differences between scale and endoskeletal developmental processes, we also show that zebrafish scales express an evolutionarily conserved sub-population of genes that are relevant to human skeletal disease.
Effects of different artificial diets on commercial honey bee colony performance, health biomarkers, and gut microbiota
Authors: Ricigliano Vincent A. , Williams Steven T. , Oliver Randy 
Published: January 2022

Abstract
Background
Honey bee colonies managed for agricultural pollination are highly dependent on human inputs, especially for disease control and supplemental nutrition. Hives are routinely fed artificial “pollen substitute” diets to compensate for insufficient nutritional forage in the environment. The aim of this study was to investigate the effects of different artificial diets in a northern California, US commercial beekeeping operation from August through February. This time period represents an extended forage dearth when supplemental nutrition is used to stimulate late winter colony growth prior to almond pollination in the early spring. A total of 144 honey bee colonies were divided into 8 feeding groups that were replicated at three apiary sites. Feeding groups received commercial diets (Global, Ultra Bee, Bulk Soft, MegaBee, AP23, Healthy Bees), a beekeeper-formulated diet (Homebrew), or a sugar negative control. Diets were analyzed for macronutrient and amino acid content then evaluated with respect to honey bee colony population size, average bee weight, nutrition-related gene expression, gut microbiota abundance, and pathogen levels.

Results
Replicated at three apiary sites, two pollen-containing diets (Global and Homebrew) produced the largest colonies and the heaviest bees per colony. Two diets (Bulk Soft and AP23) that did not contain pollen led to significantly larger colonies than a sugar negative control diet. Diet macronutrient content was not correlated with colony size or health biomarkers. The sum of dietary essential amino acid deficiencies relative to leucine content were correlated with average bee weight in November and colony size used for almond pollination in February. Nutrition-related gene expression, gut microbiota, and pathogen levels were influenced by apiary site, which overrode some diet effects. Regarding microbiota, diet had a significant impact on the abundance of Bifidobacterium and Gilliamella and trended towards effects on other prominent bee gut taxa.

Conclusions
Multiple colony and individual bee measures are necessary to test diet efficacy since honey bee nutritional responses are complex to evaluate. Balancing essential amino acid content relative to leucine instead of tryptophan may improve diet protein efficiency ratios. Optimization of bee diets could improve feed sustainability and agricultural pollination efficiency by supporting larger, healthier honey bee colonies.