bluuebunny/crossref_metadata_2025_split huggingface dataset:
Mortality in COVID-19 patients after proximal femur fracture surgery: a systematic review and meta-analysis
Authors: Freitas Tânia , Ibrahim Abdulrazak , Lourenço António , Chen-Xu José 
Published: August 2022

Background: COVID-19 infection first emerged in December 2019 in China and has since rapidly spread to become a worldwide pandemic. Orthopaedic surgery suffered a significant decline in the volume of surgical cases, while the orthopaedic trauma services maintained or increased the activity. Emergency operations for proximal femur fractures (PFF) in the elderly population assumed levels comparable to before the pandemic, with the 1-year mortality rate ranging from 14% to 36%. Aims: To determine whether patients with PFF affected by COVID-19 have a higher risk of postoperative mortality through a systematic review and meta-analysis. Methods: PubMed, Web of Science, Scopus and BMC were searched from January 2020 to January 2021 to identify original studies reporting the mortality in COVID-19 patients after PFF surgery. Study and participants’ characteristics, mortality rate and odds ratio (OR) were extracted. Risk of bias assessment was carried, and visual inspection of the funnel plot was used to assess publication bias. A random-effects model for meta-analysis was adopted. Results: Among 656 articles that came from the search query and hand-search, 10 articles were eligible after applying inclusion and exclusion criteria. Overall, the sum of the study participants was 1882, with 351 COVID-19 positive patients (18.7%) and a total number of 117 deaths, with an overall mortality rate of 33.3%. The mortality rate of COVID-19 positive patients varied from 14.8% to 60% and was higher than of those without COVID-19, with OR ranging from 2.424 to 72.00. The inverse variance method showed an OR = 3.652. All studies showed a statistically significant p-value. Conclusions: The postoperative mortality in hip fracture patients with concomitant COVID-19 was 3.65 times higher than the mortality in non-COVID patients. The currently available literature demonstrates that COVID-19 infection represents a substantial risk factor for postoperative mortality in the already susceptible hip fracture population.
Protection of the innervation of the tensor fasciae latae in hip direct anterior and anterolateral approaches: a cadaver study
Authors: Korkmaz Ali Can , Gungor Yigit , Tuncay İbrahim , Bozkurt Murat , Acar Halil İbrahim 
Published: August 2022

Purpose: This study aims to reveal the exact course of the superior gluteal nerve (SGN) branch innervating the tensor fascia lata (TFL) and show how it can be protected in the direct anterior approach (DAA) and anterolateral approach (ALA). Methods: The anterolateral regions of 22 thighs from formalin-fixed cadavers were dissected. 3 anatomical points were determined. Point A, B, C indicates where the SGN enters the gluteus minimus (GMin) fibres, the SGN leaves the gluteal muscles, the SGN enters the TFL, respectively. Measurements were made on 3 separate lines. Results: On the anterior superior iliac spine (ASIS) and the head of the fibula line (Line 1), the horizontal–vertical distances from point B and C to the ASIS were 7.99 ± 3.65 mm–40.40 ± 11.50 mm and 11.74 ± 6.61 mm–70.35 ± 14.11 mm respectively. The horizontal-vertical distances from point A, B, C to the greater trochanter (GT) were 32.41 ± 9.97 mm–55.28 ± 12.25 mm; 67.70 ± 8.54 mm–17.76 ± 13.57 mm; 63.92 ± 9.96 mm–13.00 ± 7.92 mm on the GT and the head of the fibula line (Line 2), respectively. The horizontal-vertical distances from point A, B, C to the GT were 24.58 ± 9.83 mm–42.54 ± 12.86 mm; 9.45 ± 7.92 mm–36.25 ± 9.06 mm; 26.18 ± 11.12 mm–64.05 ± 11.67 mm on the ASIS and the GT line (Line 3). Conclusions: In the DAA, the increased risk of damaging the branch of the SGN that innervates the TFL must be kept in mind. The protection of this branch can be ensured with easy and applicable rules.
Impact of COVID-19 pandemic on hemodialysis access thrombosis
Authors: Cho Min S , Javed Zain , Patel Ravi , Karim Muhammad S , Chan Micah R , Astor Brad C , Gardezi Ali I 
Published: August 2022

Background: Delay in care of suspected stenosis or thrombosis can increase the chance of losing a functioning hemodialysis access. Access to care and resources were restricted during the COVID-19 pandemic. To evaluate the impact of the pandemic on arteriovenous fistula (AVF) and arteriovenous graft (AVG) procedures we have assessed the number and success of thrombectomies done before and during the COVID-19 pandemic. Methods: We examined all AVF and AVG angiograms with and without interventions, including thrombectomies, performed at a single center during April 2017–March 2021 (pre-COVID-19 era) and April 2020–March 2021 (COVID-19 era). Results: The proportion of procedures that were thrombectomies was higher during the COVID-19 era compared to the pre-COVID-19 era (13.3% vs 8.7%, p = 0.009). The proportion of thrombectomy procedures was higher during COVID-19 for AVF (8.2% vs 3.0%, p < 0.001) but there was no difference for AVG (26.5% vs 27%, p = 0.99). There was a trend toward a higher likelihood of unsuccessful thrombectomy during COVID-19 (33.3% vs 20.4%, p = 0.08). Conclusions: More dialysis access thromboses and unsuccessful thrombectomies were noted during the COVID-19 pandemic. This difference could be due to a delay in patients getting procedures to maintain their dialysis accesses.
Autistics working in academia: What are the barriers and facilitators?
Authors: Jones Sandra C 
Published: August 2022

Autistic people are under-represented in university student populations, but their numbers are growing, and the barriers to their inclusion are being recognised. Outside of the student body, autistic people in academia are often overlooked, although this is starting to change with the growth in inclusive autism research. However, they remain absent from the academic literature, despite the evident synergies between autistic strengths and academic careers. This study explored the perceptions of 37 autistic academics from various disciplines: what are the positives of working in academia for autistic people, and what are the negatives? Participants reported many positive aspects of an academic career, including the fit with the strengths, characteristics and motivations of autistic people. However, they also noted barriers and challenges – social, environmental and structural – many of which could be addressed by greater awareness and acceptance of autism. Given the considerable benefits that autistic teachers and researchers bring to higher education, there is a clear need for universities and colleges to implement changes to the physical and social environment to make academia more inclusive. Lay Abstract Academia appears to provide an ideal career option for autistic people: the opportunity to lock ourselves away in an ivory tower and utilise our extensive knowledge of a very specific topic. We know autistic people are underrepresented in postsecondary education, and there is a growing body of research on how to make universities more inclusive. What is missing from the literature is the voices of autistic people who have survived the university experience and gone on to become university teachers and researchers. Increasing the visibility of autistics in academia, and exploring the barriers and facilitators they experience in an academic career, is important to raise the aspirations of future university students and graduates. This study included 37 autistic academics from various disciplines and countries, exploring their perceptions of the positive and negative aspects of being an autistic in academia.
Participating in Research: Experiences of People Presenting to the Emergency Department With Self-Harm or Suicidality
Authors: Xanthopoulou Penny , Ryan Mary , McCabe Rose 
Published: August 2022

Research on sensitive topics with vulnerable populations is challenging in terms of ensuring safety and obtaining ethical approval. We explored the experiences of people with self-harm/suicidality who had taken part in research that included being video-recorded. Twenty-two semi-structured interviews took place within 2 weeks of attending the Emergency Department and were thematically analysed. Participating in research when in distress and in a challenging environment was found to be overwhelmingly positive. Participants valued contributing their time and insight, particularly when research was conducted in a skilled and kind manner. They identified personal (e.g., talking as part of the healing process) and wider benefits (e.g., helping to improve services) of participation, which for most, negated the difficulty of discussing highly sensitive topics when in crisis. Despite the potential ‘intrusiveness’ of video-recording, it was found to be acceptable by those who participated in the follow up interviews, a better method for learning and capturing interactions than e.g., questionnaires, and did not impede communication and the disclosure of distress.
Risk of Bias in Cluster Randomised Controlled Trials of Individual-Level Interventions: Protocol for a Semi-Structured Interview Study
Authors: Easter Christina , Kristunas Caroline , Hemming Karla , Greenfield Sheila 
Published: August 2022

Background Many cluster randomised trials of individual-level interventions are at risk of bias, mostly due to identification and recruitment biases, which would not feature under individual randomisation. This bias arises when participants are recruited into the trial with knowledge of the treatment arm they’ve been allocated to. These trials are also at risk of other biases including lack of clear documentation of primary outcome and apparent unconcealed randomisation. Many of these other risks are easily surmountable, and might reflect poor reporting rather than poor practice, or signal lack of knowledge. Objectives To determine whether investigators are aware of the common sources of risks of bias in cluster trials, and methods to mitigate these risks. We will explore why these biases occur in light of what is known about preventing them and what enables these risks to be mitigated. We will also explore the reasons for adopting cluster randomisation. Setting Principal investigators, statisticians and trialists with experience in conducting cluster randomised trials identified via an existing sampling frame of 104 contemporary cluster trials of individual-level interventions. Methods A realist approach will be used to underpin this study. We will conduct semi-structured interviews over Zoom to identify the rationale behind using a cluster trial when the intervention is at the level of the individual, and knowledge of the importance of blinding for those identifying and recruiting participants. Data collected from the interviews will be analysed using thematic analysis. Themes within the data will be mainly captured with the research question in mind but will remain flexible. Anticipated results We aim to understand the reasons why cluster trials are being conducted when they are at risk of bias. It is hoped that understanding these reasons will provide useful information so future cluster trialists are aware of these risks, and provided with practical solutions.
Effectiveness of chronic disease self-management education (CDSME) programs to reduce loneliness
Authors: Smith Matthew Lee , Chen Eunice , Lau Christy Ann , Davis Dianne , Simmons June W. , Merianos Ashley L. 
Published: August 2022

Objectives With about half of older adults reporting feelings of loneliness, interventions are needed to improve connectedness among our aging population. The health benefits of Chronic Disease Self-Management Education (CDSME) programs are well documented, but workshops’ ability to reduce loneliness remains unknown. Methods Using the Campaign to End Loneliness Measurement Tool, we examined 295 CDSME participants’ loneliness changes before and after the 6-week face-to-face workshops. Statistical analyzes used generalized estimating equations (GEE). Results On average, participants were age 74.3(±8.9) years and self-reported 3.3(±2.2) chronic conditions. The majority of participants were female (83%) and attended workshops in English (77%). Significant reductions in loneliness scores were observed from baseline to post-workshop ( p < 0.001). Discussion Findings expand our understanding about the benefits of small-group CDSME workshops to reduce loneliness among participants. CDSME workshops may reduce loneliness because of their highly interactive and process-driven format and ability to create bonds between participants with chronic conditions and shared experiences.
Prevalence and determinants of home delivery in urban and rural Philippines: Evidence from the 2017 National Demographic and Health Survey
Authors: Amit Arianna Maever L. , Pepito Veincent Christian F. , De los Reyes Sarah J. , Tang Clinton S. , Aliazas Neil Andrew Kiamco , Sumpaico-Tanchanco Lourdes 
Published: August 2022

Background: Women’s choice of place of delivery has implications on maternal and child mortality. This study aims to provide an updated and detailed comparison of prevalence and determinants of home delivery in the Philippines, and in urban and rural communities. Methods: Based on data from the 2017 Philippine National Demographic and Health Survey (NDHS), we estimated the prevalence of home delivery and determined factors influencing women’s decision to deliver at home. Analyses were restricted to data from 7229 women who were cohabiting or married, and their last-born child using logistic regression methods for survey data. Results: There remain a considerable proportion of women aged 15–49 years old who delivered at home (17.92% (95% confidence interval (CI): 15.77, 20.30)). More women in rural areas delivered at home (23.53% (95% CI: 20.38, 26.99)) than their counterparts in urban areas (10.72% (95% CI: 8.23, 13.85)), reflecting a significant difference in the home delivery prevalence of women relative to their place of residence. Our regression analyses showed that there is a relatively greater effect observed for the rural population in most of the proximal factors considered including birth order, women’s decision-making power, and emergency preparedness during pregnancy. Wealth index has the most pronounced effect with a significant increase in odds of home delivery among urban and rural women of the lowest wealth categories. Conclusion: The use of institutional childbirth services remains suboptimal in the Philippines with significant disparities between urban and rural communities. Current strategies therefore need to adopt a multi-sectoral approach to address the complex factors influencing women’s decision on place of delivery. Targeted efforts specific to population groups should also be made to contextualize and co-create health care services and solutions that will motivate them to deliver in health facilities.
Biomechanical assessment of the central band of the interosseous membrane using shear wave elastography: reliability and reproducibility
Authors: Rougereau Grégoire , Marty-Diloy Thibault , Vigan Marie , Vialle Raphaël , Soubeyrand Marc , Langlais Tristan 
Published: August 2022

The interosseous membrane of the forearm is an essential structure for the stability of the forearm skeleton, the most important part being the central band. The purpose of this study was to determine if shear wave elastography, a non-invasive ultrasound technique, can be used to measure shear wave speed in the central band and quantify stiffness. Fifteen healthy adult subjects were included (30 forearms). The participants forearms were positioned on an articulated plate, with their hand in neutral, pronated and then supinated positions of 30°, 60° and 90°. The shear wave speed was highest in 90° pronation (4.4 m/s (SD 0.3)) and 90° supination (4.4 m/s (SD 0.27)) indicating maximum stiffness in these positions. Its minimum value was in the neutral position, and either in 30° pronation or supination (3.5 m/s (SD 0.3)). Intra- and interobserver agreement was excellent, regardless of probe positioning or forearm mobilization. This study presents a reliable shear wave elastography measurement protocol to describe the physiological function of the central band of the interosseous membrane in healthy adults. Level of evidence: IV
Perinatal intimate partner violence during COVID-19 and its associated factors among postpartum mothers attending newborn immunization in southern Ethiopia, 2021: A cross-sectional study
Authors: Belay Alemayehu Sayih , Kassie Gidafie Aychew , Abera Gudeta Tesfaye 
Published: August 2022

Objective: This study aimed to assess the prevalence of perinatal intimate partner violence during COVID-19 and its associated factors among postpartum mothers attending newborn immunization in southern Ethiopia, 2021. Method: A facility-based cross-sectional study was conducted among 657 postpartum mothers from 1 to 30 March 2021 in southern Ethiopia. All postpartum mothers who visited the selected hospitals or health centers for newborn immunization and met the inclusion criteria were included in this study. Data were cleaned, coded, entered into Epidata manager version 4.2 and then exported into SPSS version 26 for analysis. Binary and multivariate logistic regression analysis was used. Results: The prevalence of perinatal intimate partner violence was 62.4%. In this study, income loss due to COVID-19 (adjusted odds ratio: 12.00, 95% confidence interval: 5.60, 25.71, p < 0.001) was the strongest factor associated with perinatal intimate partner violence. Young age women (adjusted odds ratio: 5.82, 95% confidence interval: 2.72, 12.46, p < 0.001), partner alcohol use (adjusted odds ratio: 2.21, 95% confidence interval: 1.37, 3.56, p = 0.001), partner substance use (adjusted odds ratio: 2.07, 95% confidence interval: 1.12, 3.83, p = 0.021), and partner relationships (cohabited) (adjusted odds ratio: 1.88, 95% confidence interval: 1.06, 3.34, p = 0.032) were also strongly associated with perinatal intimate partner violence. Conclusion: The prevalence of perinatal intimate partner violence was relatively high. The health of the women should be maintained through empowerment of women and provision of health education in order to minimize prevalence of perinatal intimate partner violence associated with low income, young age, substance use, and cohabited marital status. Future qualitative studies are required to identify the underlying multifactorial reasons for intimate partner violence.
Opioid Use Increases the Rate of Pseudarthrosis and Revision Surgery in Patients Undergoing Anterior Cervical Discectomy and Fusion
Authors: Lambrechts Mark J. , D’Antonio Nicholas D. , Heard Jeremy C. , Toci Gregory R. , Karamian Brian A. , Sherman Matthew , Canseco Jose A. , Kepler Christopher K. , Vaccaro Alexander R. , Hilibrand Alan S. , Schroeder Gregory D. 
Published: August 2022

Study Design Retrospective Cohort Objectives To (1) quantify the risk opioids impart on pseudarthrosis development, (2) analyze the effect of pseudarthrosis on clinical outcomes, and (3) identify if the amount of opioids prescribed are predictive of pseudarthrosis revision. Methods Patients who underwent ACDF at a single institution between 2017-2019 were retrospectively identified. Postoperative dynamic cervical spine radiographs were reviewed to assess fusion status. Logistic regression models measured the effect of morphine milligram equivalents (MME) prescribed on the likelihood of pseudarthrosis development. Receiver operating characteristic (ROC) curves were generated to predict the probability of surgical revision based on MME prescribed. Results Of 298 included patients, an average of 2.01 ± 0.82 levels were included in the construct and 121 (40.9%) patients were diagnosed with a pseudarthrosis. However, only 14 (4.7%) required a pseudarthrosis revision. Patients requiring pseudarthrosis revision had worse one-year postoperative Δ PCS-12 (−1.70 vs. 7.58, P = 0.004), Δ NDI (3.33 vs. −15.26, P = 0.002), and Δ VAS Arm (2.33 vs. −2.48, P = .047). Multivariate logistic regression analyses found the three-month postoperative (OR=1.00, P = .010), one-year postoperative (OR=1.001, P = 0.025), and combined pre- and postoperative MME (OR=1.000, P = .035) increased the risk of pseudarthrosis. ROC analysis identified cutoff values to predict pseudarthrosis revision at 90.00 (area under the curve (AUC): 0.693, confidence interval (CI): 0.554-0.832), 132.86 (0.710, CI: 0.589-0.840), 224.76 (0.687, CI: 0.558-0.817) and 285.00 (0.711, CI: 0.585-0.837) MME in the preoperative, three-month postoperative, one-year postoperative, and combined pre-and postoperative period. Conclusion Increased prescription of opioid medications following ACDF procedures may increase the risk of pseudarthrosis development and revision surgery. Level of Evidence Therapeutic Level III
Involvement of Bacteria in the Pathological Changes Before Achilles Tendon Rupture: A Case Series Investigating 16S rDNA in 20 Consecutive Ruptures
Authors: Cramer Allan , Moser Claus , Fritz Blaine Gabriel , Hölmich Per , Barfod Kristoffer Weisskirchner 
Published: August 2022

Background: The source of the pathological changes that occur before an acute Achilles tendon rupture (ATR) is not fully understood. Bacterial DNA has previously been detected in samples from ruptured Achilles tendons, suggesting a pathogenic role of bacteria in ATR. Purpose/Hypothesis: The purpose of this study was to investigate if DNA from bacteria was present in acutely ruptured Achilles tendons. We hypothesized that 20% to 30% of the samples from the rupture site and no samples from healthy tissue would be positive for bacterial DNA. Study Design: Case series; Level of evidence, 4. Methods: This study included 20 consecutive patients scheduled for surgical repair of an acute ATR. Tendon biopsy specimens were taken from the rupture site and from the healthy tendon tissue proximal to the rupture to act as a control. Samples were blinded to the technician and analyzed using polymerase chain reaction targeted to the bacterial 16S rDNA gene and Sanger sequencing to identify the bacterial species present. McNemar test for paired proportions was performed to test for statistically significant differences in the number of samples positive for bacterial DNA between the ruptured and control regions of the Achilles tendon. Results: Of the 20 patients, 1 (5%) had a positive sample with bacterial DNA from the ruptured part of the Achilles tendon. The same patient also had a positive control sample, although with different bacterial DNA. An additional patient had a positive control sample. There was no statistically significant difference in the number of bacterial DNA–positive samples between the ruptured and control regions of the Achilles tendon. The bacteria found ( Staphylococcus sp, Micrococcus sp, and Staphylococcus epidermidis) were normal commensal organisms on the human skin. Conclusion: Bacterial DNA was infrequent in tissue from ruptured Achilles tendons and, if identified, likely was a result of contamination. This suggests that bacteria are not involved in the pathological changes occurring before rupture of the Achilles tendon.