bluuebunny/crossref_metadata_2025_split huggingface dataset:
The genomic landscape of blood groups in Indigenous Australians in remote communities
Authors: Jadhao Sudhir , Hoy Wendy , Lee Simon , Patel Hardip R. , McMorran Brendan J. , Flower Robert L. , Nagaraj Shivashankar H. 
Published: April 2022

AbstractBackgroundRed blood cell (RBC) membrane‐associated blood group systems are clinically significant. Alloimmunisation is a persistent risk associated with blood transfusion owing to the antigen polymorphisms among these RBC‐associated blood groups. Next‐generation sequencing (NGS) offers an opportunity to characterize the blood group variant profile of a given individual. Australia comprises a large multiethnic population where most blood donors are Caucasian and blood group variants remain poorly studied among Indigenous Australians. In this study, we focused on the Tiwi Islanders, who have lived in relative isolation for thousands of years.Methods and materialsWe predicted the blood group phenotype profiles in the Tiwi (457) and 1000 Genomes Phase 3 (1KGP3‐2504) cohort individuals using RBCeq (https://www.rbceq.org/). The predicted phenotype prevalence was compared with the previous literature report.ResultsWe report, for the first time, comprehensive blood group profiles corresponding to the 35 known blood group systems among the Indigenous Tiwi islander population and identify possible novel antigen variants therein. Our results demonstrate that the genetic makeup of the Tiwi participants is distinct from that of other populations, with a low prevalence of LU (Au[a−b+]) and ABO (A2) and D+C+c+E+e− phenotype, an absence of Diego blood group variants, and a unique RHD (DIII type4) variant.ConclusionOur results may contribute to the development of a database of predicted phenotype donors among the Tiwi population and aid in improving transfusion safety for the ~2800 Tiwi people and the ~800,000 other Indigenous Australians throughout the nation.
A Snake-Inspired Swallowing Robot Based on Hoberman’s Linkages
Authors: Zhang Yang , Qian Zeyu , Huang Hailin , Yang Xiaojun , Li Bing 
Published: April 2022

Abstract
To solve the problems of existing swallowing robots, such as low load capacity, small deploy/fold ratio, and small swallowing space, this article presents a new snake-inspired swallowing robot (SSR) that can synchronously deploy and fold both axially and radially. The SSR is composed of multiple modules, each of which includes two end disk mechanisms (EDMs) and three connecting backbone mechanisms (CBBMs). The EDM is designed based on Hoberman’s linkages to achieve a radial deployment and a folding motion, while the CBBM is designed to realize the axial deployment and the folding movement and connect the EDMs. In addition, the driving device is designed. Then, to achieve the maximum deploy/fold ratio of the SSR and meet the requirements of assembly, the length of the rods is optimized on the basis of the kinematics analysis of the SSR. The final deploy/fold ratio reached up to 2.2459. The ratio of the maximum to the minimum swallowing space is 28.2754. In the end, experiments are conducted to evaluate the ability to swallow and store one object and multiple objects.
Increasing Reliability of Self-Folding of the Origami Hypar
Authors: Liu Addison , Johnson Mykell , Sung Cynthia 
Published: April 2022

Abstract
Self-folding systems, which can transform autonomously from a flat sheet into a 3D machine, provide opportunities for rapidly fabricable robots that are deployable on-demand. Existing self-folding fabrication processes convert fold patterns into laminated structures that respond to external stimuli, most commonly heat. However, demonstrations of these approaches have been generally limited to simple fold patterns with little ambiguity in folding configuration, and the reliability of self-folding drops drastically with the fold pattern complexity. In this paper, we explore methods of biasing a symmetric fold pattern, the origami hyperbolic paraboloid (hypar), to fold into one of the two possible configurations. The biasing methods are simulated using a bar-and-hinge inspired self-folding model that defines a single fold as a bending beam and the hypar crease pattern as an elastic spring network. Simulation results are also verified on physical samples. Based on these results, three techniques to bias the hypar by manipulating the target fold angles are proposed and tested. The results show that biasing a self-folding pattern can increase folding accuracy from 50% (purely random) to 70% and provide insights for improving the reliability of future self-folding systems with complex fold patterns.
Data flow within global clinical trials: a scoping review
Authors: Kwok Kaitlyn , Sati Neha , Dron Louis , Murthy Srinivas 
Published: April 2022

ObjectiveTo document clinical trial data flow in global clinical trials published in major journals between 2013 and 2021 from Global South to Global North.DesignScoping analysisMethodsWe performed a search in Cochrane Central Register of Controlled Trials (CENTRAL) to retrieve randomised clinical trials published between 2013 and 2021 fromThe BMJ, BMJ Global Health, the Journal of the American Medical Association, the Lancet, Lancet Global Health and the New England Journal of Medicine. Studies were included if they involved recruitment and author affiliation across different country income groupings using World Bank definitions. The direction of data flow was extracted with a data collection tool using sites of trial recruitment as the starting point and the location of authors conducting statistical analysis as the ending point.ResultsOf 1993 records initially retrieved, 517 studies underwent abstract screening, 348 studies underwent full-text screening and 305 studies were included. Funders from high-income countries were the sole funders of the majority (82%) of clinical trials that recruited across income groupings. In 224 (73.4%) of all assessable studies, data flowed exclusively to authors affiliated with high-income countries or to a majority of authors affiliated with high-income countries for statistical analysis. Only six (3.2%) studies demonstrated data flow to lower middle-income countries and upper middle-income countries for analysis, with only one with data flow to a lower middle-income country.ConclusionsGlobal clinical trial data flow demonstrates a Global South to Global North trajectory. Policies should be re-examined to assess how data sharing across country income groupings can move towards a more equitable model.
Understanding factors affecting 30-day unplanned readmissions for patients undergoing total knee arthroplasty (TKA): the ACT Transition from Hospital to Home Orthopaedics Survey
Authors: Chhabra Madhur , Perriman Diana , Phillips Christine , Parkinson Anne , Glasgow Nicholas , Douglas Kirsty , Cox Darlene , Smith Paul , Desborough Jane 
Published: April 2022

ObjectivesThe aim of this study was to investigate factors associated with unplanned 30-day readmissions following a total knee arthroplasty (TKA), including association with post-hospital syndrome, patient enablement and transition from hospital to home.Design, setting and participantsA cross-sectional written survey of public and private patients attending a 6-week follow-up appointment after TKA at one of four clinical services in the Australian Capital Territory (ACT) between 1 February 2018 and 31 January 2019. Multiple logistic regression analyses were used to measure associations between patient, hospital and transitional care factors with unplanned 30-day readmissions, while controlling for known confounders.ResultsOf the 380 participants who completed the survey (n=380, 54% of TKAs undertaken over the study period), 3.4% (n=13; 95% CI: 1.8 to 5.8) were subsequently readmitted within 30 days of discharge after a primary hospitalisation. Public patients were significantly more likely to be readmitted within 30 days compared with private patients (adjusted OR=6.31, 95% CI: 1.59 to 25.14, p=0.009), and patients who attended rehabilitation were significantly less likely to be readmitted within 30 days of discharge than those who did not (adjusted OR=0.16, 95% CI: 0.04 to 0.57, p=0.005). There were no associations between post-hospital syndrome or patient enablement and 30-day readmissions in this study.ConclusionReasons underlying the difference in unplanned readmission rates for public versus private patients need to be explored, including differences in surgical waiting times and the consequences for impairment and disease complexity. Strategies to foster increased participation post-surgical rehabilitation programmes need to be developed as an avenue to mitigate the burden of unplanned 30-day readmissions on individuals and health systems.
A cross-sectional examination of conflict-of-interest disclosures of physician-authors publishing in high-impact US medical journals
Authors: Baraldi James H , Picozzo Steven A , Arnold Jacob C , Volarich Kathryn , Gionfriddo Michael R , Piper Brian J 
Published: April 2022

ObjectiveTo assess the accuracy of self-reported financial conflict-of-interest (COI) disclosures in the New England Journal of Medicine (NEJM) and the Journal of the American Medical Association (JAMA) within the requisite disclosure period prior to article submission.DesignCross-sectional investigation.Data sourcesOriginal clinical-trial research articles published in NEJM (n=206) or JAMA (n=188) from 1 January 2017 to 31 December 2017; self-reported COI disclosure forms submitted to NEJM or JAMA with the authors’ published articles; Open Payments website (from database inception; latest search: August 2019).Main outcome measuresFinancial data reported to Open Payments from 2014 to 2016 (a time period that included all subjects’ requisite disclosure windows) were compared with self-reported disclosure forms submitted to the journals. Payments selected for analysis were defined by Open Payments as ‘general payments.’ Payment types were categorised as ‘disclosed,’ ‘undisclosed,’ ‘indeterminate’ or ‘unrelated’.ResultsThirty-one articles from NEJM and 31 articles from JAMA met inclusion criteria. The physician-authors (n=118) received a combined total of US$7.48 million. Of the 106 authors (89.8%) who received payments, 86 (81.1%) received undisclosed payments. The top 23 most highly compensated received US$6.32 million, of which US$3.00 million (47.6%) was undisclosed.ConclusionsHigh payment amounts, as well as high proportions of undisclosed financial compensation, regardless of amount received, comprised potential COIs for two influential US medical journals. Further research is needed to explain why such high proportions of general payments were undisclosed and whether journals that rely on self-reported COI disclosure need to reconsider their policies.
Mindfulness-based programmes for mental health promotion in adults in non-clinical settings: protocol of an individual participant data meta-analysis of randomised controlled trials
Authors: Galante Julieta , Friedrich Claire , Dalgleish Tim , White Ian R , Jones Peter B 
Published: April 2022

IntroductionWith mental ill health listed as a top cause of global disease burden, there is an urgent need to prioritise mental health promotion programmes. Mindfulness-based programmes (MBPs) are being widely implemented to reduce stress in non-clinical settings. In a recent aggregate-level meta-analysis we found that, compared with no intervention, these MBPs reduce average psychological distress. However, heterogeneity between studies impedes generalisation of effects across every setting. Study-level effect modifiers were insufficient to reduce heterogeneity; studying individual-level effect modifiers is warranted. This requires individual participant data (IPD) and larger samples than those found in existing individual trials.Methods and analysisWe propose an IPD meta-analysis. Our primary aim is to see if, and how, baseline psychological distress, gender, age, education and dispositional mindfulness moderate the effect of MBPs on distress. We will search 13 databases for good-quality randomised controlled trials comparing in-person, expert-defined MBPs in non-clinical settings with passive controls. Two researchers will independently select, extract and appraise trials using the revised Cochrane risk-of-bias tool. Anonymised IPD of eligible trials will be sought from authors, who will be invited to collaborate.The primary outcome will be psychological distress measured using psychometrically validated questionnaires at 1–6 months after programme completion. Pairwise random-effects two-stage IPD meta-analyses will be conducted. Moderator analyses will follow a ‘deft’ approach. We will estimate subgroup-specific intervention effects. Secondary outcomes and sensitivity analyses are prespecified. Multiple imputation strategies will be applied to missing data.Ethics and disseminationThe findings will refine our knowledge on the effectiveness of MBPs and help improve the targeting of MBPs in non-clinical settings. They will be shared in accessible formats with a range of stakeholders. Public and professional stakeholders are being involved in the planning, conduct and dissemination of this project.PROSPERO registration numberCRD42020200117.
Management and outcomes over time of acute coronary syndrome patients at particularly high cardiovascular risk : the ACSIS registry-based retrospective study
Authors: Grinberg Tzlil , Hammer Yoav , Wiessman Maya , Perl Leor , Ovdat Tal , Tsafrir Or , Kogan Yoni , Beigel Roy , Orvin Katia , Kornowski Ran , Eisen Alon 
Published: April 2022

ObjectiveSome patients following acute coronary syndrome (ACS) are at particularly increased risk for recurrent cardiovascular events. We aimed to examine temporal trends in the management and outcomes across the spectrum of these particularly high-risk patients.Design and settingA retrospective study based on the ACS Israeli survey (ACSIS) registry, a multicentre prospective national registry, taking place biennially in 25 cardiology departments in Israel. Temporal trends were examined in the early (2002–2008) and late (2010–2018) time periods.ParticipantsConsecutive patients with ACS enrolled in the ACSIS registry were stratified according to the Thrombolysis in Myocardial Infarction Risk Score for secondary prevention (TRS2°P) to high (TRS2°p=3), very high (TRS2°p=4) or extremely high risk (TRS2°p=5–9). Patients with TRS2°p<3 were excluded. From the initial 15 196 patients enrolled, 5359 patients were eventually included.Clinical outcome measures included 30-day major adverse cardiovascular events (MACE) and 1-year mortality.ResultsAmong 5359 patients (50% high risk, 30% very high risk and 20% extremely high risk), those with a higher risk were older, had more comorbidities, presented more with non-ST elevation myocardial infarction, and were treated less often with guideline-recommended pharmacotherapy and percutaneous coronary intervention. Over time, treatment has improved in all risk strata, and the rate of 30-day MACE has significantly decreased in all risk groups (from 21% to 10%, from 22% to 15%, and from 26% to 16%, in high, very high and extremely high-risk groups, respectively, p<0.001 for each). However, 1-year mortality decreased only among high and very high-risk patients, and not among extremely high-risk patients in whom 1-year mortality rates remained very high (28.7% vs 28.9%, p=1).ConclusionWithin a particularly high-risk cohort of patients with ACS, treatment has significantly progressed over almost 2 decades. While short-term outcomes have improved in all risk groups, 1-year mortality has remained unchanged in extremely high-risk patients with ACS.
Turnover intention and related factors among resident physicians in China under the standardised residency training programme: a cross-sectional survey
Authors: Sun Xiaoting , Zhang Mengmeng , Lu Zhanghong , Zhang Zhaoyu , Zheng Jialin Charlie , Cheng Liming , Zeng Lianhua , Qian Yingli , Huang Lei 
Published: April 2022

ObjectivesThis study aimed at examining the extent of turnover intention among the Chinese resident physicians who entered the newly established national standardised residency training programme (SRTP), and exploring factors associated with their turnover intention.DesignCross-sectional survey.SettingTen institutions from five geographical areas in China.Methods1414 residents were surveyed using paper-based questionnaires and scales regarding their demographics, work situation, attitudes towards SRTP, job satisfaction, psychological resilience, burnout and turnover intention in 2017. The turnover intention was described and compared between categorical groups. Linear regressions were used to select the factors associated with turnover intention. The structural equation model was used to capture the potential mediating effects.ResultsThe mean turnover intention score was 12.45 (SD=4.47). Nearly half (47.87%) of the residents had a high and very high level of turnover intention. Psychological resilience (β=0.066), burnout (β=0.141) and job satisfaction (β=0.022) were positively associated with turnover intention, while specialty (β=−0.135), year of training (β=−0.687), career in medicine (β=−2.191), necessity of training (β=−0.695) and satisfaction with income (β=−1.215) had negative associations with turnover intention. Working hours and nightshift interval indirectly were associated with turnover intention through the mediating effects of burnout. Career in medicine, necessity of training, satisfaction with income, and psychological resilience showed direct effects and indirect effects on turnover intention through burnout and job satisfaction as mediators.ConclusionsThe turnover intention among Chinese residents was prevalent and unignorable. Burnout was the major contributing factor, while year of training and positive attitudes towards training were protective factors. Burnout and job satisfaction also served as mediators. Interventions targeting these factors should be incorporated in the training programmes to keep a prosperous physician workforce.
Buried bumper syndrome: improving patient outcomes using a structured multidisciplinary team (MDT) approach to management
Authors: Kitchin Angus , Matull Wolf-Rudiger , Pearl Daniel 
Published: April 2022

IntroductionBuried bumper syndrome (BBS) is a complication seen in 2.4% of percutaneous endoscopic gastrostomy (PEG) tubes. We present a case series of 30 patients with BBS managed at a regional referral centre over 13 years.MethodsThe original pioneering service (2007–2013) involved sporadic management by various endoscopists or surgeons (group A). More recently (2014–2020), patients with endoscopic or clinically suspected BBS were referred to a specialist multidisciplinary team (MDT) clinic, facilitating a best interest approach to decision making (group B). The objective of this MDT clinic is to plan for an interventional endoscopic procedure under general anaesthesia (GA) with balloon assisted PEG manipulation±needle-knife excision aiming for successful endoscopic feeding tube (FT) replacement through the established tract.ResultsResults are expressed as group B (n=19) vs group A (n=11). Statistical analysis used Fisher’s exact and unpaired t-tests. In group B, less patients required surgery to replace their FT (1 (5.3 %) vs 4 (36.4 %), p<0.05), more FTs were replaced in the pre-existing tract (18 (94.7 %) vs 2 (18.2 %), p<0.001), mean length of stay (LOS) was shorter (4.2 vs 10.5 days, p<0.05) and there were fewer complications (2 (10.5 %) vs 4 (36.4 %), p=0.16). Overall, endoscopic versus surgical management was associated with a shorter LOS (5.3 vs 12 days, p<0.05).ConclusionNuanced decision making as part of a dedicated BBS service, employing MDT decision making and a structured management approach, is associated with improved patient outcomes.
Outcomes at 3 Months of a Place and Active Hold Method of Flexor Tendon Rehabilitation Following Zone II Injury
Authors: FARZAD Maryam , ABDOLRAZAGHI Hosseinali , SMAEEL BEYGI Amirreza , SHAFIEE Erfan , MACDERMID Joy C , LAYEGHI Fereydoun 
Published: April 2022

Background: Previous studies have shown that outcomes following a place and active hold (PAH) are better than a passive flexion protocol after a two-strand core-suture repair of flexor tendons injuries in zone II. This study aims to determine the outcomes of a PAH protocol of flexor tendon rehabilitation following a four-strand core-suture plus an epitendinous suture repair of the flexor digitorum profundus (FDP) combined with a simple horizontal loop repair of the flexor digitorum superficialis (FDS). Methods: This is a prospective study of patients with complete injury to both flexor tendons in zone II. All tendons were repaired with a simple horizontal loop for FDS and four-strand core-suture plus epitendinous suture for FDP. The PAH protocol was used postoperatively for 6 weeks. The outcome was evaluated using flexion contracture and total active motion (TAM), interpreted using Strickland criteria and categorised as excellent, good, fair and poor at 6 weeks and 3 months. The linear regression model was used to determine predictors of outcomes. Results: The study included 32 patients with flexor tendon injury in 46 fingers. No repairs ruptured, and 24 (52%) digits achieved good or excellent motion 6 weeks after surgery using the Strickland criteria. According to the Strickland criteria, 41 (89%) digits ranked as excellent and good with no poor result at a 3-month follow-up. Four patients had 5–10° of flexion contracture. Age was the predictor of TAM at 6 weeks and accounted for 13% of its variation. Improvement of TAM from 6 weeks to 3 months was related to age and flexion contracture at 6 weeks. Conclusions: The PAH protocol can be considered a safe technique for flexor rehabilitation after four-strand core-suture repair of FDP in zone II. Level of Evidence: Level IV (Therapeutic)
Penlight versus Smartphone: Diagnostic Efficacy of Transillumination
Authors: AZAD Ali , DE TOLLA Jadie , AYALON Omri , HACQUEBORD Jacques H. , GLICKEL Steven Z. , CATALANO Louis W. 
Published: April 2022

Background: The purpose of this study was to compare the diagnostic accuracy of a smartphone flashlight to a conventional penlight with regards to transillumination of simulated soft tissue masses of the hand and wrist. Methods: Eight participants performed transillumination assessments in a fresh frozen cadaver upper extremity model. Spheres measuring 9.5 mm were used to simulate fluid-filled or solid soft tissue masses. Two spheres were placed on the volar aspect and two on the dorsal aspect of the wrist. These were then evaluated with either a smartphone flashlight or penlight. Participants noted whether each sphere did or did not transilluminate. Each participant performed two evaluations at an interval of 3 weeks. Results: The overall sensitivity, specificity and accuracy of the smartphone were 100%, 44% and 72%, respectively. The overall sensitivity, specificity and accuracy of the penlight were 100%, 75% and 88%, respectively. The difference in accuracy between the smartphone group and penlight group was statistically significant (p = 0.029). The kappa value, indicating intra-observer agreement, for the smartphone group and penlight group was 0.76 and 0.76, respectively. Conclusion: In conclusion, transillumination with a penlight is a viable adjunct to the examination of soft tissue masses of the hand and wrist. The use of a smartphone flashlight, while convenient, is less accurate than a penlight and can lead the examiners to misinterpret the composition of soft tissue masses. Level of Evidence: Level IV (Diagnostic)