bluuebunny/crossref_metadata_2025_split huggingface dataset:
Surgical Demographics of Acute Hand Compartment Syndrome
Authors: Williams Derrick W. , Dyer George S. M. , von Keudell Arvind , Zhang Dafang 
Published: March 2022

Background: We aimed to describe the demographic, injury-related, and treatment-related characteristics of patients who undergo fasciotomies for acute hand compartment syndrome. Methods: A cohort of 53 adult patients with acute hand compartment syndrome treated with fasciotomy at 2 tertiary care referral centers over a 10-year time period from January 1, 2006, to June 30, 2015, were retrospectively identified. We reviewed the electronic medical record for patient-related variables (eg, age, sex, smoking status, diabetes mellitus), injury-related variables (eg, mechanism of injury, presence of fractures), and treatment-related variables (eg, compartments released, number of operations, use of split-thickness skin grafts, and time from injury to surgery). Results: The mean age of our cohort was 45 years, and 33 patients (62%) were men. The mechanism of injury varied widely, but the most common causative mechanisms were crush injury (25%), prolonged decubitus (17%), and infection (11%). Associated hand fractures were present in 15 (28%) patients. The surgically released compartments varied; the dorsal interosseous compartments (83%), thenar compartment (75%), and hypothenar compartment (74%) were most frequently released, while the adductor pollicis compartment (43%) and Guyon canal (28%) were least frequently released. Conclusions: The demographics of acute hand compartment syndrome have evolved in the last 25 years compared with the prior literature, partly as a result of the opioid epidemic leading to a rise in “found down” compartment syndrome. Treating providers should recognize crush injury, prolonged decubitus, and infection as the most common causes of acute hand compartment syndrome.
A single institution pre-/post-comparison after introduction of an external urinary collection device for female medical patients
Authors: Jasperse Nathan , Hernandez-Dominguez Oscar , Deyell Jacob S , Prasad Janani P , Yuan Charlene , Tomy Meril , Kuza Catherine M , Grigorian Areg , Nahmias Jeffry 
Published: March 2022

Background External urinary collection devices (EUCDs) may serve as an alternative to indwelling urinary catheters (IUCs) and decrease the rate of catheter associated urinary tract infections (CAUTIs). PureWick® is a novel female EUCD; however, no study has definitively proven benefit regarding reduction of CAUTIs. Aim We sought to compare the CAUTI rate and IUC days before and after availability of the PureWick® EUCD at a single institution. We provide a descriptive analysis of female medical patients receiving an EUCD. Methods A retrospective review of adult female patients admitted to a single institution on a medical service who received an IUC and/or an EUCD was performed. Patients who received an IUC in the 3 months before EUCD availability (PRE) were compared to patients who received an IUC and/or EUCD in the 12 months after (POST). Results Out of 848 female patients, 292 received an EUCD in the POST cohort and overall, 656 received an IUC (259 (100%) PRE vs. 397 (67.4%) POST). Compared to the PRE cohort, the POST cohort had a higher number of IUC days (median, 3 vs 2 days, p = 0.001) and a higher rate of CAUTI (infections per 1000 catheter days, 9.3 vs 2.3, p = 0.001). The rate of UTI associated with EUCD use was 9.8 infections per 1000 device days. Discussion While EUCDs might appear to be a promising alternative to IUCs for female patients, this single center pre-/post-analysis found that both the number of IUC days and the CAUTI rate increased after introduction of a female EUCD.
Outcomes of elbow fracture-dislocations treated with and without an Internal Joint Stabilizer of the Elbow (IJS-E): A retrospective cohort study
Authors: Sheth Mihir , Price Matthew Bent , Taylor Tristen , Mitchell Scott 
Published: March 2022

Background The internal joint stabilizer of the elbow (IJS-E) adds to techniques for maintaining reduction of elbow fracture-dislocations while allowing early motion. Literature on this device is limited to small case series. Methods Retrospective comparison of function, motion and complications in patients who sustained elbow fracture-dislocations reconstructed with (30 patients) and without (34 patients) an IJS-E by a single surgeon. The minimum follow up was 10 weeks. Results The mean follow up was 16 ± 17 months. The mean final flexion arc did not differ between the two groups, however patients without an IJS achieved greater pronation. There were no differences in mean Mayo Elbow Performance, Quick-DASH and pain scores. Five patients (17%) underwent IJS-E removal. The rates of capsular releases for stiffness after 12 weeks and recurrent instability were similar. Conclusions The use of an IJS-E to supplement traditional repair of elbow fracture-dislocations does not appear to affect final function or motion, and appears to be effective in reducing the risk of recurrent instability in a group of patients deemed high risk. However, its use is weighed against a 17% rate of removal at early follow up and possibly inferior forearm rotation. Level of Evidence Retrospective Cohort study, Level 3
Radiocapitellar Contact Characteristics After Osteochondral Defect Repair Using a Novel Hybrid Reconstructive Procedure
Authors: Dee Derek T. , Hung Victor T. , Schamblin Connor J. , Lupica Gregory M. , Hitchens Hunter R. , McGarry Michelle H. , Lee Thay Q. 
Published: March 2022

Background: Many procedures to reconstruct osteochondral defects of the elbow radiocapitellar (RC) joint lack versatility or durability or do not directly address the subchondral bone structure and function. Purpose/Hypothesis: To biomechanically characterize the RC joint contact area, force, pressure, and peak pressure before and after reconstruction of osteochondral defects using a novel hybrid reconstructive procedure. It was hypothesized that the procedure would restore the contact characteristics to the intact condition. Study Design: Controlled laboratory study. Methods: A total of 10 cadaveric elbows (mean age 67 ± 2.7 years) were dissected to isolate the humerus and radial head. RC contact area, contact force, mean contact pressure, and peak contact pressure were measured with the elbow at 45° of flexion and neutral forearm rotation at compressive loads of 25, 50, and 75 N. Osteochondral defects 8 and 11 mm in diameter were created at the center of the capitellum; the defects were then reconstructed with a titanium fenestrated threaded implant, countersunk in the subchondral bone, with an acellular dermal matrix allograft sutured in place on top of the implant. Five conditions (intact, 8-mm defect, 8-mm repair, 11-mm defect, and 11-mm repair) were tested and results were compared using repeated-measures analysis of variance. Results: Both 8- and 11-mm defects significantly increased RC mean contact pressure at all compressive loads ( P ≤ .008) and significantly increased peak contact pressure at compressive loads of 50 and 75 N ( P < .002) compared with the intact condition. Repair of the 8-mm defect significantly decreased RC mean contact pressure at 25- and 50-N loads ( P ≤ .009) and significantly decreased peak contact pressure at 50- and 75-N loads ( P ≤ .035) compared with the defect condition. Repair of the 11-mm defect decreased mean contact pressure significantly at all compressive loads ( P ≤ .001) and peak contact pressure at 50- and 75-N loads ( P < .044) compared with the defect condition. Conclusion: RC joint contact pressure was restored to intact conditions while avoiding increased peak contact pressure or edge loading after repairing osteochondral defects related to osteochondrosis with a novel hybrid reconstruction technique. Clinical Relevance: This hybrid procedure that addresses the entire osteochondral unit may provide a new treatment option for osteochondral defects.
The “Chiang Mai Lean Forward” Radiographic View for Acromioclavicular Joint Injuries: A Cadaveric Study
Authors: Phornphutkul Chanakarn , Rajchawiang Korakod 
Published: March 2022

Background: Operative treatment is suggested for unstable type 3 acromioclavicular (AC) joint injuries; however, there is no clear consensus regarding the definition of an unstable type 3 injury. We propose a new radiographic method, the “Chiang Mai lean forward” view, to verify horizontal displacement in an unstable AC joint injury. Hypothesis: A radiograph taken with the torso leaning forward would allow the detection of a higher proportion of AC joint injuries. Study Design: Descriptive laboratory study. Methods: A total of 20 shoulders from 10 fresh whole-body cadaveric specimens (mean age, 68.8 years) were tested at 3 different torso leaning angles (30°, 45°, and 60°) to determine the best position for projecting the x-ray beam. The shoulders were dissected sequentially starting with the AC ligament (stage 1), then additional sectioning of the partial coracoclavicular (CC) ligament with either the trapezoid ligament cut first (stage 2A) or the conoid ligament cut first (stage 2B), and finally complete sectioning of the CC ligament (stage 3). Radiography was performed after each stage to evaluate the degree of displacement of the anterior border of the acromion relative to the anterior border of the clavicle. Paired t tests were used to compare the degree of displacement at each stage to that of the shoulder before cutting. Results: Leaning at an angle of 30° provided better visualization of the AC joint in the “Chiang Mai lean forward” view. Compared with the intact condition, complete isolated cutting of the AC ligament produced 5.21 mm of horizontal displacement of the AC joint ( P < .0001), complete tearing of the AC ligament and partial cutting of the CC ligament resulted in a displacement of <12 mm (7.91 mm at stage 2A [ P = .0003] and 8.10 mm at stage 2B [ P = .0013]), and complete tearing of both the AC and the CC ligaments resulted in a displacement of 26.37 mm ( P < .0001). Conclusion: The “Chiang Mai lean forward” radiographic view is a potentially useful tool for determining the degree of the injury and the stability of the AC joint.
Methodological Approaches to Cost-Effectiveness Analysis in Saudi Arabia: What Can We Learn? A Systematic Review
Authors: Maraiki Fatma , Bazarbashi Shouki , Scuffham Paul , Tuffaha Haitham 
Published: March 2022

Objective The recent establishment of the health technology assessment (HTA) entity in the Kingdom of Saudi Arabia (KSA) has resulted in increased interest in economic evaluation. The aim of this study is to evaluate the technical approaches used in published economic evaluations and the limitations reported by the authors of the respective studies that could affect the ability to perform economic evaluations in the KSA. Methods We conducted a systematic literature review of published economic evaluations performed for the KSA over the past 10 years. An electronic literature search of the PubMed, EMBASE, and Cochrane databases was performed. A CHEERS checklist was used to assess the quality of reporting. Reported limitations were classified into domains including the definition of perspectives, identification of comparators, estimation of costs and resources, and use of the incremental cost-effectiveness ratio threshold. Results Twelve evaluations were identified; most involved cost-effectiveness analysis (92%). Missing and unclear data were found within the CHEERS criteria. Regardless of the perspective used, most described the perspective as an “institutional” perspective (70%) and almost half were reclassified by the current reviewer (42%). Most did not clearly state the comparator (83%), and published model comparators were commonly used (50%). Resource estimation was mostly performed by the authors of the respective studies (67%), and costs were mostly obtained from hospital institutional data (75%). The lack of an established threshold for the country-specific willingness to pay was observed in 50% of the analyses. Conclusions Economic evaluations from the KSA are limited. Capacity building and country-specific HTA guidelines could improve the quality of evaluations to better inform decision making. Highlights Economic analysis of health technology should follow standard guidelines. Unfortunately, these guides are often underutilized, and our findings identify considerable missing, not clearly stated, or incomplete data within the analyses, which can weaken the impact of the recommendations. The limitations reported by the authors of the respective studies emphasize the suboptimal quality of the reporting. A lack of data was frequently identified and resulted in using “institutional” practice as a major source of data input for the analyses. In light of the call for the establishment of an HTA entity in the KSA, framing a standard analytic approach when conducting economic evaluations will support HTA in informing resource allocation decisions. We hope that our findings highlight the need for country-specific guidance to improve practice and enhance future research.
Integration of GWAS and transcriptome analyses to identify SNPs and candidate genes for aluminum tolerance in rapeseed (Brassica napus L.)
Authors: Zhou Huiwen , Xiao Xiaojun , Asjad Ali , Han Depeng , Zheng Wei , Xiao Guobin , Huang Yingjin , Zhou Qinghong 
Published: March 2022

Abstract
Background
The exchangeable aluminum (Al), released from the acid soils, is another addition to the environmental stress factors in the form of Al toxicity stress. Al stress affects the normal crop development and reduces the overall yield of rapeseed (Brassica napus L.). The response mechanism of plants to Al toxicity is complicated and difficult to understand with few QTL related studies in rapeseed under Al toxicity stress.

Result
Using 200,510 SNPs developed by SLAF-seq (specific-locus amplified fragment sequencing) technology, we carried out the genome-wide association analysis (GWAS) in a population of 254 inbred lines of B. napus with large genetic variation and Al-tolerance differences. There were 43 SNPs significantly associated with eight Al-tolerance traits in the seedling stage were detected on 14 chromosomes, and 777 candidate genes were screened at the flanking 100 kb region of these SNPs. Moreover, RNA-seq detected 8291 and 5341 DEGs (the differentially expressed gene) in the Al -tolerant line (ATL) and -sensitive line (ASL), respectively. Based on integration of GWAS and RNA-seq analysis, 64 candidate genes from GWAS analysis differentially expressed at least once in 6 h vs 0 h or 24 h vs 0 h conditions in ATL or ASL. Moreover, four out of sixty-four candidate genes (BnaA03g30320D, BnaA10g11500D, BnaC03g38360D and BnaC06g30030D) were differentially expressed in both 6 h and 24 h compared to 0 h (control) conditions in both lines. The proposed model based on the candidate genes excavated in this study highlighted that Al stress disturb the oxidation-redox balance, causing abnormal synthesis and repair of cell wall and ABA signal transduction, ultimately resulting in inhibition of root elongation.

Conclusions
The integration of GWAS and transcriptome analysis provide an effective strategy to explore the SNPs and candidate genes, which has a potential to develop molecular markers for breeding Al tolerant rapeseed varieties along with theoretical basis of molecular mechanisms for Al toxicity response of Brassica napus plants.
Time to complete hepatitis C cascade of care among patients identified during mass screening campaigns in rural Rwanda: a retrospective cohort study
Authors: Kamali Innocent , Shumbusho Fabienne , Barnhart Dale A. , Nyirahabihirwe Françoise , Gakuru Jean de la Paix , Dusingizimana Wellars , Nizeyumuremyi Esdras , Habinshuti Placide , Walker Stephen , Makuza Jean Damascene , Serumondo Janvier , Nshogoza Rwibasira Gallican , Ndahimana Jean d’Amour 
Published: March 2022

Abstract
Background
Since the discovery of direct-acting antivirals, treatment for hepatitis C virus (HCV) is increasingly accessible in low-resource settings, but quality of care in these settings is not known. We described progression through the cascade of care among individuals who screened positive for HCV antibodies during a mass screening campaign in Kirehe and Kayonza, two rural Rwandan districts, in September 2019.

Methods
This retrospective cohort study used routine clinical data to assess proportions of participants completing each stage of the cascade of care, including: (a) screening positive on rapid diagnostic test; (b) return of initial viral load results; (c) detectable viral load; (d) treatment assessment; (e) treatment initiation; (f) return of sustained virological response (SVR12) results; and (g) achieving SVR12. We proposed three indicators to assess timely care provision and used medians and interquartile ranges (IQR) to describe the time to complete the cascade of care.

Results
Overall, 666 participants screened HCV positive, among them, 452 (68.1%) were female and median age was 61 years (IQR: 47, 70). Viral load results were returned for 537 (80.6%) participants of whom 448 (83.4%) had detectable viral loads. Of these, 398 (88.8%) were assessed for treatment, 394 (99%) were initiated, but only 222 (56.3%) had results returned for SVR12. Among those with SVR12 results, 208 (93.7%) achieved SVR12. When assessing timely care provision, we found 65.9% (95% CI: 62.0, 69.7) of initial viral load results were returned ≤ 30 days of screening; 45% (95% CI: 40.1, 49.8) of people with detectable viral load completed treatment assessment ≤ 90 days of initial viral load results; and 12.5% (95% CI: 9.2, 16.3) of SVR12 results were returned ≤ 210 days of treatment initiation among those who initiated treatment. The overall median time from screening to SVR12 assessment was 437 days.

Conclusion
Despite high rates of SVR12 among those who completed all stages of the cascade of care, we identified gaps and delays in the treatment cascade. Improving communication between viral load testing hubs and health facilities could reduce the turn-around time for viral load testing, and actively monitor timeliness of care provision could improve quality of HCV care.
Decreased acylated and total ghrelin levels in bipolar disorder patients recovering from a manic episode
Authors: Abdel Aziz Karim , Al-Mugaddam Fadwa , Sugathan Subi , Saseedharan Prashanth , Jouini Tarek , Elamin Mohamed Elhassan , Moselhy Hamdy , Aly El-Gabry Dina , Arnone Danilo , Karam Sherif M. 
Published: March 2022

Abstract
Background
To date, only few studies have investigated ghrelin levels in bipolar disorders, and all have exclusively measured acylated ghrelin, with none investigating total ghrelin (acylated and des-acylated). We aimed to investigate peripheral levels of acylated and total ghrelin in subjects experiencing a manic episode of bipolar disorder.

Methods
Peripheral levels of acylated and total ghrelin were measured in hospitalised medicated individuals recovering from a manic episode. Enzyme-linked immunosorbent assays (ELISA) were used to measure ghrelin levels in patients and compared with healthy controls. The relationship between ghrelin levels in bipolar disorder, self-reported hunger measures, demographic and clinical parameters was investigated with correlational analyses.

Results
Twenty-four subjects (15 males, 9 females) recovering from mania and 27 matched healthy controls (13 males, 14 females) were recruited for the study. Mean values of both acylated (187 vs.520 pg/mL) and total ghrelin (396 vs. 648 pg/mL) were significantly reduced in bipolar disorder (p = 0.001). Ghrelin levels correlated positively with markers of illness severity and negatively with prescribed mood stabilizers, second-generation antipsychotics, weight and body mass index.

Conclusion
Peripheral measurements of acylated and total ghrelin were both reduced in bipolar disorder patients compared to healthy controls. Whilst illness severity promotes higher ghrelin levels, pharmacological treatment and weight gain exercise the opposite effect.
Facilitators and barriers for lifestyle change in people with prediabetes: a meta-synthesis of qualitative studies
Authors: Skoglund Gyri , Nilsson Birgitta Blakstad , Olsen Cecilie Fromholt , Bergland Astrid , Hilde Gunvor 
Published: March 2022

Abstract
Background
The increasing prevalence of type 2 diabetes worldwide is a major global public health concern. Prediabetes is a reversible condition and is seen as the critical phase for the prevention of type 2 diabetes. The aim of this study is to identify and synthesize current evidence on the perceived barriers and facilitators of lifestyle change among people with prediabetes in terms of both initial change and lifestyle change maintenance.

Methods
A systematic literature search in six bibliographic databases was conducted in April 2021. Potential studies were assessed for eligibility based on pre-set criteria. Quality appraisal was done on the included studies, and the thematic synthesis approach was applied to synthesize and analyse the data from the included studies.

Results
Twenty primary studies were included, containing the experiences of 552 individuals. Thirteen studies reported participants perceived facilitators and barriers of lifestyle change when taking part in community-based lifestyle intervention programs, while seven studies reported on perceived facilitators and barriers of lifestyle change through consultations with health care professionals (no intervention involved).
Three analytical themes illuminating perceived barriers and facilitators for lifestyle change were identified: 1) the individual’s evaluation of the importance of initiating lifestyle change, 2) the second theme was strategies and coping mechanisms for maintaining lifestyle changes and 3) the last theme was the significance of supportive relations and environments in initiating and maintaining lifestyle change.

Conclusion
Awareness of prediabetes and the perception of its related risks affects the motivation for lifestyle change in people at risk of type 2 diabetes; but this does not necessarily lead to lifestyle changes. Facilitators and barriers of lifestyle change are found to be in a complex interplay within multiple ecological levels, including the interpersonal, intrapersonal, environmental and policy level. An integrated understanding and analysis of the perceived barriers and facilitators of lifestyle change might inform people with prediabetes, healthcare professionals, and policy makers in terms of the need for psychological, social, and environmental support for this population.