bluuebunny/crossref_metadata_2025_split huggingface dataset:
Predicting the individualized risk of nonadherence to zoledronic acid among osteoporosis patients receiving the first infusion of zoledronic acid: development and validation of new predictive nomograms
Authors: Li Chong , Lu Ke , Shi Qin , Gong Ya-qin 
Published: July 2022

Introduction: Achieving optimal adherence to zoledronic acid (ZOL) among osteoporosis (OP) patients is a challenging task. Here, we aimed to develop and validate a precise and efficient prediction tool for ZOL nonadherence risk in OP patients. Methods: We prospectively collected and analyzed survey data from a clinical registry. A total of 1010 OP patients treated for the first time with ZOL in two separate hospitals were selected for nonadherence analysis. The evaluation included a 16-item ZOL Nonadherence Questionnaire and potential risk factors for ZOL nonadherence were assessed via univariate and multivariate analyses. We next developed and validated two distinct-stage nomograms. Discrimination, calibration, and clinical usefulness of the predicting models were assessed using the area under the curve (AUC), calibration curves, and decision curve analysis (DCA). Results: The total nonadherence rate was 20.30% after the first ZOL infusion. To generate a model predicting ZOL nonadherence risk, six predictors of 16 items were retained. Model 2 (AUC, 0.8486; 95% confidence interval [CI], 0.8171–0.8801) exhibited considerably more discrimination in desirable functional outcomes, relative to Model 1 (AUC, 0.7644; 95% CI, 0.7265–0.8024). The calibration curves displayed good calibration. DCA revealed that a cutoff probability of 5–54% (Model 1) and 1–85% (Model 2) indicated that the models were clinically useful. External validation also exhibited good discrimination and calibration. Conclusions: This study developed and validated two novel, distinct-stage prediction nomograms that precisely estimate nonadherence risk among OP patients receiving the first infusion of ZOL. However, additional evaluation and external validation are necessary prior to widespread implementation.
The top 100 most impactful articles on the anterior cruciate ligament: An altmetric analysis of online media
Authors: Civilette Matthew D , Rate William R , Haislup Brett D , Cohen Andrew S , Camire Lyn , Bodendorfer Blake M , Gould Heath P 
Published: July 2022

Objectives: To identify the top 100 most impactful anterior cruciate ligament articles in online media as measured by the Altmetric Attention Score and compare their characteristics to the most-cited anterior cruciate ligament articles in the scientific literature. Methods: The Altmetric database was queried to identify all published articles pertaining to the anterior cruciate ligament. The search yielded 9445 articles, which were stratified by highest to lowest Altmetric Attention Score. The top 100 articles were included. Collected data included article type, article topic, journal name, and online mentions in news, blogs, Twitter, Facebook, Wikipedia, and other sources. The geographic origin of each article was also determined based on the institutional affiliation of the first author. Results: Altmetric Attention Score of the top 100 anterior cruciate ligament articles ranged from 109 to 2193 (median 172.0, interquartile range 137.5–271.5). Of the 100 articles, 65 were published in three journals: American Journal of Sports Medicine, British Journal of Sports Medicine, and Journal of Orthopaedic & Sports Physical Therapy. The most prevalent article type was original research (60%), followed by systematic review/meta-analysis (18%). The most prevalent article topic was rehabilitation and return to play after anterior cruciate ligament reconstruction (22%), followed by epidemiology/risk factors (16%), injury prevention (14%), and biomechanics of anterior cruciate ligament injuries (14%). Of the top 100 articles, 54% were American, 31% were European, and 15% were published in other countries outside of the United States and Europe. Conclusion: This study used Altmetric Attention Score to identify the 100 most engaged anterior cruciate ligament articles in online media. The characteristics of these articles differed substantially from the most-cited anterior cruciate ligament articles in the literature with regard to article type, article topic, geographic origin, and publication journal. These findings suggest that alternative metrics measure distinct components of anterior cruciate ligament article engagement and add an important dimension to understanding the overall impact of published research on the anterior cruciate ligament.
Older adults’ exposure to anticholinergic medications: Implications for pharmaceutical care for Nigerian older adults
Authors: Okoro Roland Nnaemeka , Idris Algoni Idris 
Published: July 2022

Introduction: Anticholinergic medications which are commonly prescribed to older adults can produce more pronounced adverse effects compared to the younger population. Objectives: To investigate the prevalence of polypharmacy, describe the prescription patterns of anticholinergic medications, determine the prevalence of exposure to high-risk anticholinergic cognitive burden (ACB) medications, and identify the potential predictors of exposure to high-risk ACB medications in older adults in a Nigerian secondary hospital. Methods: This cross-sectional study that included older adults prescribed at least one anticholinergic medication was conducted at a secondary care hospital in Nigeria. The study data were initially summarized using descriptive statistics, whereas multivariable logistic regression analysis was used to identify the potential predictors of exposure to high-risk ACB medications. In this study, the cumulative ACB scores were dichotomized into low risk (score 1–2) and high risk (score ⩾ 3). A p value less than 0.05 was considered to be statistically significant. Results: A total of 256 older adults were included in this study; 113 (44.1%) had polypharmacy, whereas 26.6% (188/256) were exposed to high-risk ACB medications. Of a total of 391 anticholinergic medications used by the population, furosemide (36.57%) was the most commonly prescribed. The adjusted multivariable logistic regression analysis indicated that patients who had acute diseases were 2.5 times (adjusted odds ratio (AOR) = 2.49, 95% confidence interval (CI): 1.40–4.45) more likely to be exposed to high-risk ACB medications than those with chronic diseases. Conclusion: The study demonstrates a high prevalence of polypharmacy and exposure to high-risk ACB medications suggesting the need for pharmaceutical care in this high-risk population. Older adults’ exposure to high-risk ACB medications was significantly associated with prescriptions for acute diseases.
Development and Analysis of a New Cylindrical Lithium-Ion Battery Thermal Management System
Authors: Sun Yasong , Bai Ruihuai , Ma Jing 
Published: July 2022

AbstractWith the development of modern technology and economy, environmental protection and sustainable development have become the focus of global attention. The promotion and development of electric vehicles (EVs) have bright prospects. However, many challenges need to be faced seriously. Under different operating conditions, various safety problems of electric vehicles emerge one after another, especially the hidden danger of battery overheating which threatens the performance of electric vehicles. This paper aims to design and optimize a new indirect liquid cooling system for cylindrical lithium-ion batteries. Various design schemes for different cooling channel structures and cooling liquid inlet directions are proposed, and the corresponding solid-fluid coupling model is established. COMSOL Multiphysics simulation software is adopted to simulate and analyze the cooling systems. An approximate model is constructed using the Kriging method, which is considered to optimize the battery cooling system and improve the optimization results. Sensitivity parameter analysis and the optimization design of system structure are performed through a set of influencing factors in the battery thermal management. The results indicate that the method used in this paper can effectively reduce the maximum core temperature and balance the temperature differences of the battery pack. Compared with the original design, the optimized design, which is based on the non-dominated sorting genetic algorithm (NSGA-II), has an excellent ability in the optimized thermal management system to dissipate thermal energy and keep the overall cooling uniformity of the battery and thermal management system. Furthermore, the optimized system can also prevent thermal runaway propagation under thermal abuse conditions. In summary, this research can provide some practical suggestions and ideas for the engineering and production applications and structural optimization design carried by electric vehicles.
Ultrasound-assisted modified paramedian technique for spinal anesthesia in elderly
Authors: Zeng Wei , Shi Yisa , Zheng Qihui , Du Shengfang 
Published: July 2022

Abstract
Background
At present, there are two techniques which are widely applied clinically; the midline and the paramedian. Both methods are difficult for clinicians when treating the elderly. The aim of this work is to explore the feasibility of an ultrasound-assisted modified paramedian technique for spinal anesthesia in the elderly. This would provide clinicians with a new and easy-to-operate technique.

Methods
A total of 150 elderly patients who were scheduled for urology surgery under spinal anesthesia in our hospital were randomly divided into three groups (n = 50): (i) midline technique group (group M), (ii) paramedian technique group (group P), and (iii) modified paramedian technique group (group PM). All spinal anesthesia were performed by the same second-year resident.

Results
Compared with groups M and P, group PM had significantly higher first-attempt success rate (P < 0.05, especially in patients aged 65-74 years), fewer attempts (P < 0.05), and higher patient satisfaction score (P < 0.05). Compared with group M, the time taken to perform spinal anesthesia and the number of needle redirections were significantly reduced in group PM (P < 0.05). There was no statistically significant difference between groups PM and P. There were also no statistically significant differences in the cases of inconsistency between ultrasound-assisted and landmark-guided location of intervertebral space, the time taken to ultrasound-assisted location, the onset time to pain block at T10, the incidence of hypotension, anesthesia effect and the incidence of headache, lower back pain, or nausea and vomiting, within 24 h after surgery.

Conclusions
The modified paramedian technique in spinal anesthesia for elderly patients can significantly improve the first-attempt success rate, reduce both the number of attempts and procedure time, and minimize tissue damage during the operation. Compared with the traditional techniques, the modified paramedian technique combines the advantages of both the midline and the paramedian methods, and is easy to learn. It is worthy of further research and application.

Trial registration
Prospectively registered at the China Clinical Trial Registry, registration number ChiCTR2100047635, date of registration: 21/06/2021.
Kinetics of 2 different high-sensitive troponins during targeted temperature management in out-of-hospital cardiac arrest patients with acute myocardial infarction: a post hoc sub-study of a randomised clinical trial
Authors: Larsen Alf Inge , Grejs Anders Morten , Vistisen Simon Tilma , Strand Kristian , Skadberg Øyvind , Jeppesen Anni Nørgaard , Duez Christophe H. V. , Kirkegaard Hans , Søreide Eldar 
Published: July 2022

Abstract
Introduction
Short term hypothermia has been suggested to have cardio protective properties in acute myocardial infarction (AMI) by reducing infarct size as assessed by troponins. There are limited data on the kinetics of these biomarkers in comatose out-of-hospital cardiac arrest (OHCA) patients, with and without AMI, undergoing targeted temperature management (TTM) in the ICU.

Purpose
The aim of this post hoc analyses was to evaluate and compare the kinetics of two high-sensitivity cardiac troponins in OHCA survivors, with and without acute myocardial infarction (AMI), during TTM of different durations [24 h (standard) vs. 48 h (prolonged)].

Methods
In a sub-cohort (n = 114) of the international, multicentre, randomized controlled study “TTH48” we measured high-sensitive troponin T (hs-cTnT), high-sensitive troponin I (hs-cTnI) and CK-MB at the following time points: Arrival, 24 h, 48 h and 72 h from reaching the target temperature range of 33 ± 1 °C. All patients diagnosed with an AMI at the immediate coronary angiogram (CAG)—18 in the 24-h group and 25 in the 48-h group—underwent PCI with stent implantation. There were no stent thromboses.

Results
Both the hs-cTnT and hs-cTnI changes over time were highly influenced by the cause of OHCA (AMI vs. non-AMI). In contrast to non-AMI patients, both troponins remained elevated at 72 h in AMI patients. There was no difference between the two time-differentiated TTM groups in the kinetics for the two troponins.

Conclusion
In comatose OHCA survivors with an aetiology of AMI levels of both hs-cTnI and hs-cTnT remained elevated for 72 h, which is in contrast to the well-described kinetic profile of troponins in normotherm AMI patients. There was no difference in kinetic profile between the two high sensitive assays. Different duration of TTM did not influence the kinetics of the troponins.
Trial registration: Clinicaltrials.gov Identifier: NCT01689077, 20/09/2012.
Prevalence of cardiovascular diseases and risk factors in adult patients with haemophilia: a cross-sectional study in a tertiary care hospital clinic in Sri Lanka
Authors: Vithanage Thamudika , Ratnamalala Visaka , Wickramaratne Chandana , Katulanda Gaya , Rodrigo Chithramali Hasanthika 
Published: July 2022

Abstract
Background
Management of cardiovascular disease (CVD) in patients with haemophilia is extremely challenging. Therefore, knowing the prevalence of CVD and risk factors in this population is imperative.

Methods
All consented patients ≥ 18 years of age attending the haemophilia clinic at a tertiary care centre were recruited to the study. Data were collected using a pretested, investigator administered questionnaire. Seated blood pressure, anthropometric measurements and blood samples were obtained using standard techniques. Lipid profile and fasting plasma glucose were estimated. Prevalence of risk factors for CVD was compared with those of age matched males in the general population. P values < 0.05 were considered significant.

Results
Of the total 109 participants, 92 (84.4%) had haemophilia A. The median age of the study group was 36 years. Three (2.8%) had at least one cardiovascular disease. There were 10 (9.2%), 30 (27.5%), 13 (11.9%) and 4 (3.7%) participants with diabetes, hypertension, current smoking and obesity (Body Mass Index (BMI) ≥ 30 kg/m2) respectively. 32 (29.4%) and 37 (33.9%) participants had waist circumference ≥ 90 cm and waist hip ratio ≥ 0.9 respectively. 38 (34.9%) had total cholesterol ≥ 200 mg/dl, 43 (39.5%) had low density lipoprotein (LDL) cholesterol ≥ 130 mg/dl, 25 (22.9%) had triglycerides (TG) ≥ 150 mg/dl and 58 (53.2%) had High density lipoprotein (HDL) cholesterol < 40 mg/dl. Diabetes was significantly associated with factor levels below 5% (p = 0.038). BMI, waist circumference and dyslipidaemia in the study were significantly higher compared to the general population.

Conclusion
The study signifies an increased prevalence of risk factors for CVD among patients with haemophilia and the need for preventive measures.
Sample size calculation for prevalence studies using Scalex and ScalaR calculators
Authors: Naing Lin , Nordin Rusli Bin , Abdul Rahman Hanif , Naing Yuwadi Thein 
Published: July 2022

Abstract
Background
Although books and articles guiding the methods of sample size calculation for prevalence studies are available, we aim to guide, assist and report sample size calculation using the present calculators.

Results
We present and discuss four parameters (namely level of confidence, precision, variability of the data, and anticipated loss) required for sample size calculation for prevalence studies. Choosing correct parameters with proper understanding, and reporting issues are mainly discussed. We demonstrate the use of a purposely-designed calculators that assist users to make proper informed-decision and prepare appropriate report.

Conclusion
Two calculators can be used with free software (Spreadsheet and RStudio) that benefit researchers with limited resources. It will, hopefully, minimize the errors in parameter selection, calculation, and reporting. The calculators are available at: (https://sites.google.com/view/sr-ln/ssc).
Patient-reported outcomes after initial conservative fracture treatment in primary healthcare – a survey study
Authors: Vabo Stein , Steen Knut , Brudvik Christina , Hunskaar Steinar , Morken Tone 
Published: July 2022

AbstractBackgroundPrimary healthcare in Norway has first-line responsibility for medical emergencies, including traumas and fractures. Normally, patients with suspected fractures are referred to specialist care. However, some municipalities have X-ray facilities and handle minor fractures locally. We investigated patient-reported outcome measures after initial treatment of radiologically diagnosed fractures of the wrist, collarbone, and ankle at a primary healthcare centre in a rural municipality with a large ski resort. The patients’ general satisfaction with the treatment was also investigated.MethodsValidated questionnaires were sent to patients with fractures of the wrist or collarbone (Quick DASH—Disability of Arm, Shoulder and Hand) or the ankle (FAOS -The Foot and Ankle Outcome Score). Patients with wrist and collarbone fractures also answered the Quality-of-life questions that are a subscale of the FAOS questionnaire for ankle fractures. Patient satisfaction was measured for all fracture groups. The Quick DASH scale ranges from 0 (no disability at all) to 100 (great disability), while for FAOS a score of 100 indicates no symptoms and 0 indicates extreme disabilities.ResultsA total of 148 of 238 patients answered the questionnaire (62% response rate). Patients with distal radius fractures had a mean Quick DASH score of 5.1 (median 0, range 0–77), and scores were significantly lower for males (p = 0.013) and increased with age (p = 0.024). Patients with collarbone fractures had a mean Quick DASH score of 2.1 (median 0, range 0–32) with no significant age or gender differences. Patients with ankle fractures had the following mean subscale-scores: Pain, 93.8; Symptoms, 71.4; Activities of daily living, 97.4; Sport, 90.0; and Quality of life, 92.1. The scores did not differ significantly by specialization of the physician. A total of 88% of the patients were highly or very highly satisfied with the handling of their fracture.ConclusionsThe patients reported low rates of functional disability and high rates of satisfaction after initial radiological diagnosis and treatment of their fracture at the primary healthcare centre. Specialisation of the treating physician was not associated with the outcome in any of the fracture types.
Nonsteroidal anti-inflammatory drug exposure and the risk of microscopic colitis
Authors: Yen Eugene F. , Amusin Daniel B. , Yoo Janet , Ture Asantewaa , Gentile Nicole M. , Goldberg Michael J. , Goldstein Jay L. 
Published: July 2022

AbstractBackgroundMedication consumption has been suggested as a risk factor for microscopic colitis (MC), but studies of varying design have yielded inconsistent results. Our aim was to evaluate the association between medications and MC.MethodsA hybrid cohort of prospectively identified patients undergoing colonoscopy with biopsies for suspicion of MC (N = 144) and patients with MC enrolled within three months of diagnosis into an MC registry (N = 59) were surveyed on medication use. Medication use was compared between patients with and without diagnosis of MC by chi-squared test and binomial logistic regression adjusted for known risk factors of MC: age and gender.ResultsIn total, 80 patients with MC (21 new, 59 registry) were enrolled. Patients with MC were more likely to be older (p = 0.03) and female (p = 0.01) compared to those without MC. Aspirin and other non-steroidal anti-inflammatory drugs were more commonly used among patients who developed MC (p < 0.01). After controlling for age and gender, these medications remained independent predictors of MC with odds ratio for any non-steroidal anti-inflammatory drug use of 3.04 (95% CI: 1.65–5.69). No association between MC and other previously implicated medications including proton pump inhibitors and selective serotonin reuptake inhibitors was found.ConclusionsIn this cohort of patients with chronic diarrhea, we found use of aspirin and non-steroidal anti-inflammatory drugs, but not other implicated medications to be associated with the development of MC. Whether these drugs trigger colonic inflammation in predisposed hosts or worsen diarrhea in undiagnosed patients is unclear. However, we feel that these findings are sufficient to discuss potential non-steroidal anti-inflammatory drug cessation in patients newly diagnosed with MC.
Subcutaneous administration, higher age and lower renal function are associated with erythrocyte methotrexate accumulation in Crohn’s disease: a cross-sectional study
Authors: van de Meeberg M. M. , Seinen M. L. , Fidder H. H. , Lin M. , Oldenburg B. , de Boer N. K. , Bouma G. , de Jonge R. , Bulatović Ćalasan M. ,   the Dutch Initiative on Crohn and Colitis (ICC)
Published: July 2022

Abstract
Background
Methotrexate is an immunomodulatory drug for patients with Crohn’s disease. Erythrocyte MTX-polyglutamates (MTX-PG1-5) may be used for therapeutic drug monitoring (TDM) as MTX-PG is thought to mediate MTX’s efficacy. Information on determinants of the concentration of MTX-PG in patients with Crohn’s disease is lacking. We aim to identify clinical and biochemical determinants of the erythrocyte MTX-PG1-5 and MTX-PGtotal concentration in patients with Crohn’s disease.

Methods
Adults with Crohn’s disease on methotrexate treatment who visited the outpatient clinic of Amsterdam UMC were included. Erythrocyte MTX-PGs were measured by tandem mass spectrometry.

Results
Nineteen patients were included, with a median duration of MTX use of 77 months (range 7–202). Twelve patients received MTX monotherapy, whereas 7 patients were on concomitant TNF-α inhibitors. The mean dose of MTX was 15.5 mg (SD ± 2.8) and 12 (63%) patients used subcutaneous MTX. MTX-PG1-5 were successfully measured in 18 patients, showing substantial variability in concentrations of MTX-PGtotal and individual species. The median MTX-PGtotal was 117.1 nmol/L (range 46.4–258.7) with preferential accumulation of MTX-PG3 (43.1 nmol/L, range 15.3–96.1). Patients on subcutaneous compared to oral MTX had higher median MTX-PG(4,5) levels (55 versus 9 nmol/L, p = 0.01). Higher age (β = 0.71) and lower estimated glomerular filtration rate (β = − 0.52) were associated with a significantly higher MTX-PGtotal concentration (R2 = 0.60, p = 0.001).

Conclusion
MTX-PG concentrations display a considerable inter-individual variability. Higher MTX-PG accumulation is associated with subcutaneous administration, higher age, and lower renal function in Crohn’s disease patients.