bluuebunny/crossref_metadata_2025_split huggingface dataset:
Spine trabecular bone scores and bone mineral density of postmenopausal Taiwanese women
Authors: Huang Mei-Lan , Hsieh Tsyh-Jyi , Lin Song-Shei , Huang Wen-Chuan 
Published: September 2022

Abstract

Objectives
The aims of the study were to determine the mean trabecular bone score (TBS) of postmenopausal Taiwanese women and to analyze the value of TBS in predicting osteoporosis.

Methods
A total of 1,915 postmenopausal women with lumbar spine and hip bone mineral density (BMD) and spine TBS were enrolled from a single medical center into this study. The women's BMD and TBS were measured using dual x-ray absorptiometry (Discovery Wi; Hologic, Bedford, Mass) and iNsight software (Med-Imaps SASU, Merignac, France), respectively. The women's demographic characteristics; lumbar spine, total hip, and femoral neck BMD; and lumbar spine TBS were recorded, and correlations among the parameters were identified using a 2-tailed Pearson test, in which a P value less than 0.05 was considered statistically significant. We developed simple linear regression models to represent changes related to TBS and performed an analysis of variance on the selected variables.

Results
The average age of the women was 62.5 ± 9.1 years (range, 25.7–93.7 years). The mean TBS was 1.300 ± 0.086 (range, 1.015‐1.596). The TBS was weakly and negatively correlated with body mass index (r = −0.078) and moderately and positively correlated with the lumbar spine BMD (r = 0.619). The patients' lowest BMD values among those measured at multiple sites revealed a higher rate of osteoporosis (32.5%) than those measured at individual sites. Degraded TBS were noted in 21.2% of the participants, and a combination of BMD and TBS results predicted more individuals (7.8%) at a high risk of fracture than did the BMD result only. The rates of both osteoporosis and degraded TBS increased with age.

Conclusions
Bone mineral density and TBS can be used in combination to predict osteoporosis in a greater number of postmenopausal Taiwanese women. Because the incidence of osteoporosis is the highest among older women, clinicians should pay careful attention to TBS degradation among older patients without low BMD.
Weight strategy in older adults with obesity: calorie restriction or not?
Authors: Colleluori Georgia , Villareal Dennis T. 
Published: September 2022

Purpose of review
Along with the marked increase in the population of older adults with obesity is the need for effective strategies to treat aging- and obesity-related complications. This review highlights recent progress in obesity management in older adults.

Recent findings
Although calorie restriction is needed to significantly reduce fat mass, an exercise protocol is crucial to ameliorate functional outcomes. The addition of a resistance exercise protocol improves the response of muscle protein synthesis to anabolic stimuli, preventing the calorie restriction-induced reduction in muscle and bone mass. The addition of an aerobic exercise protocol improves cardiorespiratory fitness and cognitive function. However, the addition of both aerobic and resistance exercise protocols to calorie restriction provides the greatest improvements in myocellular quality, frailty, and cardiometabolic and cognitive outcomes, translating into the greatest improvement in quality of life. Such comprehensive lifestyle intervention effectively improves glucometabolic control and age-relevant outcomes in older adults with diabetes. When combined with testosterone therapy, such lifestyle intervention also preserves muscle and bone mass in older, men with obesity and hypogonadism.

Summary
We conclude that calorie restriction among older adults with obesity should be prescribed in combination with both aerobic and resistance exercise to maximize benefits on overall health.
Inclusion of Disability Content in Simulation
Authors: Ozkara San Eda , Marx Katherine A. , Robertiello Gina , Latimer Beth , Nahum Jennifer L. , Pasklinsky Natalya 
Published: September 2022

Background:
Despite recommendations to include disability content in nursing education, nursing students have little exposure to disability education, which would help to develop necessary knowledge, skills, and attitudes in learning to care for patients with disabilities.

Purpose:
This study evaluated learners' perceptions of the effectiveness of a tabletop simulation in meeting their learning needs related to nursing care for children with disabilities and their families.

Methods:
The research design was a descriptive educational intervention study. Nursing students (n = 234) enrolled in the pediatric nursing course attended the simulation as a required part of their coursework.

Results:
The majority of the students found the tabletop simulation with disability content to be an effective educational intervention.

Conclusions:
The results obtained from this study indicated that the tabletop simulation was an effective educational strategy for nursing students' learning to provide care for children with disabilities and their families.
Embolic Stroke Associated With a Pulmonary Arteriovenous Fistula
Authors: Chen Lizhang , Yang Yujia , Tang Li , Zhou Muke , He Li 
Published: September 2022

Introduction:
Here, we described a patient with ischemic stroke due to embolism, through an isolated pulmonary arteriovenous fistula (PAVF). Our case could be a paradigm of embolic stroke of undetermined source (ESUS) with an uncommon cause, providing an etiologic investigation process in addition to diagnostic pitfalls and pearls, eventually raising neurologists’ ability to treat ESUS.

Case Report:
A 37-year-old right-handed woman presented to our emergency department with sudden onset left upper limb and lower limb weakness. She denied a past medical history of hypertension, diabetes, heart diseases, and other cerebrovascular disease risk factors, and she is without a family history of stroke, previous trauma, toxic exposure, or drug use. On admission, her physical and neurological examinations were negative, except for left-sided hemiparesis. Her routine evaluations, serum autoantibody testing, and digital subtraction angiography were negative. Subsequent diffusion-weighted brain magnetic resonance imaging demonstrated acute infarction in the right frontoparietal lobe. To find the etiology of this case, more detailed examinations were performed. Finally, she was diagnosed with ESUS, which was caused by the PAVF.

Conclusions:
This case raises the awareness of a potential important emboligenic mechanism, the existence of an isolated PAVF as a right-to-left shunt in patients with a stroke of unknown origin should not be overlooked, even if a PAVF is not suggested by the initial physical findings or chest x-ray.
Evaluating the Effectiveness of State-Level Policies on Childhood Blood Lead Testing Rates
Authors: Ruckart Perri Zeitz , Bove Frank J. , Dallas Cham 
Published: September 2022

Context:
Lead exposure can harm nearly every organ in the human body. Millions of US children are exposed to lead hazards. Identifying lead-exposed children using blood lead testing is essential for connecting them to appropriate follow-up services. However, blood lead testing is not consistently conducted for at-risk children. Thus, determining which policies help improve blood lead testing rates is essential.

Objective:
This analysis provides critical evidence to better understand which state-level policies are more effective at increasing childhood blood lead testing rates. These include metrics, incentives, other managed care organization guidance, provider guidelines, mandatory reporting of results to state health departments, data sharing between Medicaid and other state agencies, and proof of testing for school enrollment.

Design:
This analysis included 33 states with complete data on the number of children tested for blood lead in 2017-2018 as reported to the Centers for Disease Control and Prevention. Linear regression modeling was conducted to examine associations between testing rates and the aforementioned policies. Fully adjusted models included percentages of the population living in pre-1980 housing, younger than 6 years with Medicaid coverage, and foreign-born.

Results:
Strongest unadjusted and adjusted regression coefficients were observed for requiring proof of testing for school enrollment (β = .12, P = .03) and metrics (β = .06, P = .01), respectively.

Conclusion:
Policies associated with higher childhood blood lead testing rates can be used by policy makers; local, state, and federal public health agencies; professional organizations; nonprofit organizations; and others to inform development and implementation of additional policies to increase childhood blood lead testing.
One Decade Later: The Generalizability, Diversity, and Inclusion of Community Health Needs Assessments
Authors: Summers-Gabr Nicole Marie , Cantrall Jessica 
Published: September 2022

Context:
The 2010 Patient Protection and Affordable Care Act aimed to reduce health disparities and change medicine to be more community-driven. To maintain tax-exempt status, hospitals must complete a Community Health Needs Assessment (CHNA) every 3 years. This assessment must (a) integrate input from individuals the community serves, (b) make the report publicly assessable, and (c) adopt an implementation strategy based on community health needs identified in the assessment. However, there is little information on how representative CHNAs are of the community.

Design:
A content analysis was performed on a random sample of CHNA reports.

Setting:
This investigation examined nonprofit hospitals across the United States.

Objectives:
This investigation analyzed the quality of CHNAs and described existing CHNA practices through 4 means: (1) identified the type of data included; (2) examined the frequency in the methods of data collection; (3) understood how representative those data are of the hospital's service region; and (4) explored to what extent the hospital addressed diversity and inclusion such as through recruitment.

Methods:
A stratified random sample was drawn of CHNAs published in the past 3 years (n = 450 reports). The sample was stratified by the US Department of Agriculture's Rural-Urban Continuum codes to balance hospital representation from metro and nonmetro areas.

Results:
A series of dependent t tests revealed that these hospitals' reports represented a significantly more female, White, college-educated, and older population than the service area. In addition, only 3.12% of hospitals collected primary youth data. Finally, results also found that survey recruitment was not inclusive of individuals who did not have Internet access, could not read, or did not speak English fluently.
Long-Term Outcomes of Arthroscopic-Assisted Bone-Ligament-Bone Reconstruction for non-static Scapholunate Ligament Injury.
Authors: Della Rosa Norman , Bertozzi Nicolò , Annoscia Paolo , Adani Roberto 
Published: September 2022

Purpose:
Scapho-lunate (SL) ligament injury is the most common cause of carpal instability. This retrospective case-series study aimed to assess the effectiveness and the maintenance of the results obtained by reconstructing the SL ligament with a bone–ligament–bone autograft through an arthroscopic-assisted minimally invasive approach.

Methods:
Thirty-six patients were initially enrolled but only 31 constituted the final population study (23 male, 8 females; median age was 38 years; range, 18-55). Radiographic (postero-anterior and true lateral radiographs to assess the SL gap, radio-lunate, capito-lunate angles; CT scan and MR images) functional (grip strength: Jamar test and Pinch test; active range of motion), and subjective (patient-rated wrist evaluation test) outcome measurements were collected. Minimum follow-up was 50 months.

Results:
Grip strength and wrist mobility were significantly improved from the preoperative values and improved in time. No SL synostosis, nor any carpal bone necrosis was observed. No wrist showed any sign of arthrosis or progression towards wrist instability. Only four patients had SL gap > 3 mm.

Conclusions:
Providing a biologic reconstruction of both volar and dorsal portion of the SL ligament, while avoiding extensive capsulotomy, the proposed technique for SL reconstruction obtained significant functional outcomes improvement which were maintained over time, while preventing degenerative changes to the articular surfaces.
Sirenomelia: Review of a rare syndrome with case report, review of anatomy, and thoughts on management
Authors: Pederson William C , Phillips William A. , Jalalabadi Faryan , White Lindsey , Reece Edward , Pederson William C 
Published: September 2022

Background:
Sirenomelia is a very rare syndrome in which the infant is born with the legs fused from the pelvis down to the feet. It is often fatal in the neonatal period due to multiple other anomalies. The feet, if present, are often splayed outward or face backwards, and may be absent. There are no case reports of any patient with this syndrome who have successfully ambulated after separation of the legs.

Methods:
We report here on a patient we treated with sirenomelia who was born with the feet facing backwards, but otherwise normal-appearing hips and thighs. She had no other anomalies which would lead to fatality in the near future. After preop tissue expansion, we performed separation of the legs with through-knee amputations, utilizing a vascularized flap from the lower part of the legs based on the sciatic vessels for coverage of the perineum. There was no need for skin grafts or dermal matrices, and she healed primarily. She was referred to physical therapy in an attempt to allow her to ambulate.

Results:
She began to ambulate on her stumps early on, and is now walking with stubby prostheses. Her other medical issues have remained stable and non-problematic.

Conclusions:
Selected patients with sirenomelia may be able to ambulate after separation of the legs. This will depend on the status of other congenital differences as well as the status of the legs when separated. Careful workup with multidisciplinary planning of overall care as well as surgical care is essential.
Does Presurgical Taping Change Nose and Lip Esthetics in Infants with Unilateral Cleft Lip and Palate After Surgical Lip Repair? A Randomized Controlled Trial
Authors: Abd El-Ghafour Mohamed , Aboulhassan Mamdouh A. , El-Beialy Amr Ragab , Fayed Mona M. Salah , Eid Faten Hussein Kamel , Emara Dawlat , El-Gendi Mahmoud 
Published: September 2022

Background:
The aim of the current randomized controlled trial (RCT) was to assess the effectiveness of taping alone in changing nose and lip (N&L) esthetics in infants with unilateral complete cleft lip and palate (UCLP) before and after surgical lip repair.

Methods:
The followed study design was prospective, balanced, randomized, parallel-groups, single-blinded, controlled-trial. All the steps were carried out in the Department of Orthodontics, Cairo university in Egypt. Thirty-one, non-syndromic UCLP infants were randomly assigned to either no-treatment (control) or taping groups. In taping group, all infants received horizontal tape between the 2 labial segments aiming to decrease the cleft gap. No other interventions were performed to infants included in this group. Standardized photographs and videos were captured to the included infants in both groups at the beginning of the treatment (T1), directly before surgical lip repair (T2) and 2 weeks after surgical lip repair (T3). Photos and shots from videos were calibrated and used for outcome assessment. Blinded-assessors carried out all the measurements digitally on the standardized photos at T1, T2 and T3 using Adobe Systems, Photoshop CS3 software.

Results:
Significant changes in all the measurements were recorded in the taping group at T2 before surgical lip repair in comparison to control group. At T3, no differences were found between the 2 groups.

Conclusions:
Taping is a successful intervention in changing nose and lip esthetics before surgical lip repair. After surgical lip repair, both groups had matching esthetics.
Real-World Experience of Tixagevimab and Cilgavimab (Evusheld) in Rheumatologic Patients on Rituximab
Authors: Ocon Anthony J. , Mustafa S. Shahzad 
Published: September 2022

Abstract

Background/Objective
Although vaccination is the primary strategy against severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), rheumatologic patients on B-cell depleting agent rituximab may have a suboptimal response. Tixagevimab and cilgavimab (Evusheld) could be administered under Food and Drug Administration emergency use authorization as pre-exposure prophylaxis.

Methods
A cohort study of rheumatologic patients on rituximab therapy who received Evusheld was followed longitudinally. Adverse events were monitored.

Results
Forty-three patients received Evusheld, with diagnoses including rheumatoid arthritis, ANCA vasculitis, immune-mediated myositis, Sjögren disease, and systemic lupus erythematosus. Average time to follow-up was 100 ± 33 days. One patient experienced symptomatic infection with SARS-CoV-2 confirmed by home antigen test twice. A total of 97.8% of patients during follow-up did not contract acute SARS-CoV-2 infection. At the same time, 32,074 new local cases were reported with a local cumulative SARS-CoV-2 incidence rate of 4.32%. Adverse events included myalgia, flu-like symptoms, fevers, injection site pain, or headache. No serious adverse events, anaphylaxis, or cardiac events occurred.

Conclusions
Evusheld demonstrated effectiveness in preventing symptomatic SARS-CoV-2 infection in a real-world cohort of rheumatologic patients on rituximab therapy. Administration of Evusheld may be considered as part of a multilayered approach to risk mitigation in this high-risk population as pre-exposure prophylaxis.
Clinical Analysis of Primary Malignant Lacrimal Sac Tumors: A Case Series Study With a Comparison to the Previously Published Literature
Authors: Zhao Hong-shu , Shi Ji-tong , Wei Wen-bin 
Published: September 2022

Purpose:
To report management of a series of patients with primary malignant lacrimal sac tumors and to compare these results to the previously published literature.

Materials and Methods:
A total of 27 patients with pathologically confirmed primary malignant lacrimal sac lesions were enrolled into this study. Pathological classifications, clinical characteristics, various treatment modalities and follow-up time, including tumor recurrence, were documented. The outcome measures included overall survival, progression-free survival, and median survival time.

Results:
Among 27 eligible cases, 33.33% (9/27) of the tumor was non-Hodgkin B-cell lymphoma, and 33.33% (9/27) was squamous cell carcinoma; both were the most common tumor in this series, followed by adenocarcinoma 18.52% (5/27), then melanoma 7.41% (2/27). Treatment modalities included surgery, radiotherapy, and/or chemotherapy, the overall survival rate of 27 patients was 70.37%, with a median follow-up of 45 months (range: 7 mo–16 y), 8 patients had died from metastatic disease, but 13 patients remained without evidence of recurrent tumor. The 5-year overall survival and progression-free survival for all cases were 73.33% and 66.67%, respectively. The median survival time for 5 deceased patients with interstitial brachytherapy was 98 months, and 5-year survival rate was 60%.

Conclusions:
In this series, among primary malignant lacrimal sac tumors, the proportion of lymphoma had increased when compared with the previously published literature, and multidisciplinary therapy may lead to a good prognosis in the majority of patients with the tumors and patients may benefit more from interstitial brachytherapy than external beam radiotherapy.
A 29-MRNA HOST RESPONSE WHOLE-BLOOD SIGNATURE IMPROVES PREDICTION OF 28-DAY MORTALITY AND 7-DAY INTENSIVE CARE UNIT CARE IN ADULTS PRESENTING TO THE EMERGENCY DEPARTMENT WITH SUSPECTED ACUTE INFECTION AND/OR SEPSIS
Authors: Kostaki Antigone , Wacker James W. , Safarika Asimina , Solomonidi Nicky , Katsaros Konstantinos , Giannikopoulos George , Koutelidakis Ioannis M. , Hogan Catherine A. , Uhle Florian , Liesenfeld Oliver , Sweeney Timothy E. , Giamarellos-Bourboulis Evangelos J. 
Published: September 2022

ABSTRACT

Background: Risk stratification of emergency department patients with suspected acute infections and/or suspected sepsis remains challenging. We prospectively validated a 29–messenger RNA host response classifier for predicting severity in these patients. Methods: We enrolled adults presenting with suspected acute infections and at least one vital sign abnormality to six emergency departments in Greece. Twenty-nine target host RNAs were quantified on NanoString nCounter and analyzed with the Inflammatix Severity 2 (IMX-SEV-2) classifier to determine risk scores as low, moderate, and high severity. Performance of IMX-SEV-2 for prediction of 28-day mortality was compared with that of lactate, procalcitonin, and quick sequential organ failure assessment (qSOFA). Results: A total of 397 individuals were enrolled; 38 individuals (9.6%) died within 28 days. Inflammatix Severity 2 classifier predicted 28-day mortality with an area under the receiver operator characteristics curve of 0.82 (95% confidence interval [CI], 0.74–0.90) compared with lactate, 0.66 (95% CI, 0.54–0.77); procalcitonin, 0.67 (95% CI, 0.57–0.78); and qSOFA, 0.81 (95% CI, 0.72–0.89). Combining qSOFA with IMX-SEV-2 improved prognostic accuracy from 0.81 to 0.89 (95% CI, 0.82–0.96). The high-severity (rule-in) interpretation band of IMX-SEV-2 demonstrated 96.9% specificity for predicting 28-day mortality, whereas the low-severity (rule-out) band had a sensitivity of 78.9%. Similarly, IMX-SEV-2 alone accurately predicted the need for day-7 intensive care unit care and further boosted overall accuracy when combined with qSOFA. Conclusions: Inflammatix Severity 2 classifier predicted 28-day mortality and 7-day intensive care unit care with high accuracy and boosted the accuracy of clinical scores when used in combination.
Making the Financial Case for Surgical Resident Well-being: A Scoping Review
Authors: Greenberg Anya L. , Doherty Devon V. , Cevallos Jenny R. , Tahir Peggy , Lebares Carter C. 
Published: September 2022

Objective:
To conduct a scoping review of literature on financial implications of surgical resident well-being.

Background:
Surgeon well-being affects clinical outcomes, patient experience, and health care economics. However, our understanding of the relationship between surgical resident well-being and organizational finances is limited.

Methods:
Authors searched PubMed, Web of Science, and Embase with no date or language restrictions. Searches of the gray literature included hand references of articles selected for data extraction and reviewing conference abstracts from Embase. Two reviewers screened articles for eligibility based on title and abstract then reviewed eligible articles in their entirety. Data were extracted and analyzed using conventional content analysis.

Results:
Twenty-five articles were included, 5 (20%) published between 2003 and 2010, 12 (48%) between 2011 and 2018, and 8 (32%) between 2019 and 2021. One (4%) had an aim directly related to the research question, but financial implications were not considered from the institutional perspective. All others explored factors impacting well-being or workplace sequelae of well-being, but the economics of these elements were not the primary focus. Analysis of content surrounding financial considerations of resident well-being revealed 5 categories; however, no articles provided a comprehensive business case for investing in resident well-being from the institutional perspective.

Conclusions:
Although the number of publications identified through the present scoping review is relatively small, the emergence of publications referencing economic issues associated with surgical resident well-being may suggest a growing recognition of this area’s importance. This scoping review highlights a gap in the literature, which should be addressed to drive the system-level change needed to improve surgical resident well-being.