bluuebunny/crossref_metadata_2025_split huggingface dataset:
Outcomes After Repair of Quadriceps Tendon Rupture in Patients Aged 40 Years and Younger
Authors: Rao Somnath , Johnson Emma E. , D’Amore Taylor , Szeto Stanley , Otlans Peters , Cohen Steven B. 
Published: May 2022

Background: Injury to the quadriceps tendon is rare and most commonly occurs in middle-aged men. Few reports are available regarding outcomes after quadriceps tendon rupture in younger patients. Purpose/Hypothesis: To review the clinical outcomes of patients who underwent quadriceps tendon repair at age ≤40 years. We hypothesized that this cohort would experience better clinical outcomes in comparison to historical older controls. Study Design: Case series; Level of evidence, 4. Methods: Using an institutional database, we retrospectively identified patients who underwent quadriceps tendon repair between January 2009 and December 2017. Patients were included in the study if they were aged ≤40 years at the time of surgery and had sustained an isolated, complete tendon rupture. Patient and injury characteristics were recorded. Patients were contacted to complete a custom survey, the 2000 International Knee Documentation Committee (IKDC) form, the Lysholm scale, and the Tegner scale. Results: Included were 38 patients (86.8% male; mean age, 32.0 ± 6.9 years; age range, 15-40 years), with a mean follow-up of 5.9 ± 2.3 years (range, 2.4-11.3 years). At final follow-up, the mean IKDC score was 74.1 ± 22.6 (range, 26.4-100.0), and the mean Lysholm score was 85.4 ± 20.0 (range, 30-100), which were similar if not inferior to historical controls of patients >40 years. Only 16 patients (42.1%) had unchanged or higher Tegner scores after surgery, whereas 22 patients (57.9%) reported lower postoperative activity level. Overall, 91.2% (31/34) of workers returned at a mean 3.9 months after surgery, whereas 63% (12/19) of athletes were able to return to play at 8.8 months. At final follow-up, 12 patients (31.6%) reported persistent pain and stiffness in their knees. Additionally, 3 patients (7.9%) reported pain without stiffness, and 4 (10.5%) reported stiffness without pain. Patients reporting pain or stiffness had significantly lower IKDC scores, Lysholm scores, postoperative Tegner scores, and change in their Tegner score at final follow-up in comparison to those who did not report pain or stiffness. Conclusion: Although patients aged ≤40 years had satisfactory outcomes after quadriceps tendon repair, this injury resulted in significant long-term sequelae in a substantial percentage of patients, despite their youth. Further, this group did not have better outcomes compared with historical controls aged > 40 years.
Barriers to Research Utilization in Nursing: A Systematic Review (2002–2021)
Authors: Jabonete Fritz Gerald V. , Roxas Rachel Edita O. 
Published: May 2022

Introduction There is an existing gap between what people learned from theory and what they clinically practiced, as revealed in research studies in nursing. This gap is primarily due to identified barriers in utilizing the research findings in actual nursing practice. Objective To present a scientific mapping of the Scopus-indexed literature published from 2002 to 2021, which studied barriers to research utilization in nursing using the BARRIER scale. Methods This systematic review utilized bibliometric analysis. One hundred seventy-nine extracted literature from Scopus was manually reviewed, and the study included 53 documents for further analysis. Results Remarkably, almost three-fourths of the documents identified setting-related factors as the most common barrier to research utilization in nursing (n = 39, 73.58%). This is followed by presentation-related factors (n = 16.98%) and nurse-related factors (n = 5, 9.43%), respectively. Findings revealed that insufficient time at work in implementing new ideas was perceived as the top barrier in research utilization in nursing. Conclusion It is crucial to determine the hindrances to the utilization of research findings. The results of this study establish the connection between research and evidence-based practice which stimulates in meeting the gap in the current nursing practice. Future studies must include research utilization studies that apply tools other than the BARRIER scale.
Planning decentralized urban renewable energy systems using algal cultivation for closed-loop and resilient communities
Authors: Quan Steven Jige , Chang Soowon , Castro-Lacouture Daniel , Igou Thomas K , Dutt Florina , Ding Jiaqi , Chen Yongsheng , Pei-Ju Yang Perry 
Published: May 2022

To tackle climate challenges, communities need to harvest renewable energy and resources on site locally to close the loops for enhancing the resilience of communities facing unpredictable and uncertain future changes. A decentralization planning of urban renewable energy systems is proposed by treating urban waste streams and producing biomass through applying algal biotechnology. When applying algal technology as a renewable and decentralized energy source in urban systems, the overall performance can vary by levels of urban nutrients, solar and CO2 resources, and the transportation cost when considering its application to different urban densities, urban form, and the spatial scale of urban settings. This research explores three potential impacts on the algal system’s energy performance: (1) urban density, (2) urban form in different contexts, and (3) spatial scale. The research examines the impacts by testing urban settings given in actual contexts in Atlanta, Georgia, USA. Four neighborhoods representing the high-density urban, mid-density urban, mixed suburban, and typical suburban areas are investigated. The density-scale–performance relationships are explored through testing different urban forms of neighborhoods in both hypothetical and actual neighborhood settings. A GIS-based model is developed to estimate the overall energy performance of the decentralized renewable energy system in urban environments. Results show that the energy performance is positive mainly for high-density urban neighborhoods with small-to-medium scales, up to 0.36 MJ per ton of municipal solid wastes for actual settings and 0.37 MJ for hypothetical cases. Neighborhoods with higher density have higher energy performance while up scaling has negative effects on the energy performance with a low degree of significance. Optimal scales are found as a 1-km radius in real test beds and 1.3 km in hypothetical settings, in which the results show trade-offs between scaling effects in the system efficiency gain and the transportation cost increase.
Optical Coherence Tomography Angiography: Clinical Utility and Future Directions
Authors: Foulsham William , Chien Jason , Lenis Tamara Lee , Papakostas Thanos D. 
Published: May 2022

Purpose: This work aims to review the principles of optical coherence tomography angiography (OCTA), to survey its clinical utility, and to highlight the strengths of this technology as well as barriers to adoption. Methods: A literature review with editorial discussion of the current applications for OCTA is presented. Results: There have been recent advances in multiple domains in OCTA imaging, including devices, algorithms, and new observations pertaining to a range of pathologies. New devices have improved the scanning speed, signal-to-noise ratio, and spatial resolution and offer an increased field of view. New algorithms have been proposed to optimize image processing and reduce artifacts. Numerous studies employing OCTA have been published describing changes to the microvasculature in diabetic retinopathy, age-related macular degeneration, central serous chorioretinopathy, retinal vein occlusion, and uveitis. Conclusions: OCTA provides noninvasive, high-resolution volumetric scans of the retinal and choroidal vasculature. OCTA can provide valuable data to augment traditional dye-based angiography in a range of chorioretinal diseases.
Stakeholder perspectives on ‘Swiss quality’ healthcare in the context of inbound medical tourism to Switzerland: An exploratory qualitative study
Authors: Couceiro João , Elger Bernice S. , Satalkar Priya 
Published: May 2022

Background Global literature on medical travel focuses on patients from high-income countries traveling to middle-income countries reputed for providing high quality care at significantly lower costs. However, little is known about the movement of wealthy foreign patients to high-income countries such as the USA, the UK or Switzerland. Objective In this paper, we focus on Swiss medical tourism stakeholders and their strategies to attract a niche of self-paying foreign patients to undergo medical treatment in Switzerland. We describes how they harness the label of ‘Swiss quality’ healthcare to promote Switzerland in global medical travel industry. Methods We conducted semi-structured, in-depth interviews with 30 medical tourism stakeholders including 15 healthcare professionals (HCPs) treating self-paying foreign patients in publicly funded and privately owned hospitals in French- and German-speaking regions of Switzerland. The data were inductively coded using thematic analysis. Results We present their views on ‘Swiss quality’ healthcare under three themes: health-related human resources, Swiss medical infrastructure, and foreign patients’ perceived trust in the ‘Swiss quality’ label. Participants equated Switzerland's global image and ‘Swiss quality’ as a ‘brand’ and believed that foreign patients’ trust in ‘Swiss quality’ is a unique selling point of Swiss healthcare system. Conclusion By problematizing the use of ‘Swiss quality’ label to attract wealthy patients to Switzerland, we highlight a few ethical questions that deserve further scrutiny.
Evaluation of patient relatives’ opinions on physical restraint
Authors: Özdemir Ömer Fahri , Keçeci Ayla 
Published: May 2022

Background Most of the research on physical restraint is focused on determining patients’ experiences of restraint, the consequences of restraint, and healthcare professionals’ perceptions and attitudes. The aim of this study was to determine the opinions of the relatives of patients, who are a critical component of care, about physical restraint. The study used the mixed methods research approach, which combines quantitative and qualitative data collection methods. Method The study population consisted of 984 relatives of patients hospitalized in units where physical restraint was commonly applied between January 2018 and December 2018, and the sample consisted of 277 relatives of patients. The qualitative sample of the study consisted of 22 patient's relatives who were interviewed using the maximum diversity sampling method, a purposive sampling method. The quantitative data were analyzed using frequency, percentage, Chi Square (X2-Chi Square) test, and the qualitative data were analyzed using content analysis. Results The results showed that consent for physical restraint was generally obtained from spouses, physical restraint was applied to prevent self-harm, but relatives of the patients were insufficiently informed and worried about complications. It was also found that the most frequent reasons for physical restraint were self-harm and facilitation of treatment and care for the male patients and the feeling of helplessness for the female patients. Conclusion It was determined that the relatives of patients regarded physical restraint for treatment positively, but they were worried about complications, and they were mostly insufficiently informed before the intervention.
Adenosquamous Carcinoma of the Distal Common Bile Duct: A Case of a Rare Type of Cholangiocarcinoma
Authors: Kanagasabapathy Samalai , Subasinghe Duminda , Sivaganesh Sivasuriya , Wijesinghe Harshima 
Published: May 2022

Introduction: Adenosquamous carcinoma (ASC) is a rare subtype of the conventional adenocarcinoma of the bile duct. The clinico-pathological characteristics of this entity are poorly understood partly due to its rarity. Case Summary: A 67-year-old ASA II male presented with obstructive jaundice subsequently complicated by cholangitis. CT abdomen showed dilatation of the intra and extrahepatic biliary tree. Endoscopic retrograde cholangiopancreatography revealed a stricture with a mucosal growth at the ampulla of Vater. He had a pancreaticoduodenectomy and the distal common bile duct tumour identified in the specimen was on histology an adenosquamous carcinoma (ASC) of the extrahepatic bile duct. Discussion: ASCs are considered to have more aggressive tumour biology compared to adenocarcinomas. The presence of a squamous component at the invasive front relates to its poor prognosis. Surgery is the curative option, but with a high propensity for early recurrence and distant metastases. The scarcity of reports on the clinicopathological course of ASC have resulted in a lack of standardised care pathways. Conclusion: A better understanding of the clinicopathological characteristics, biological behaviour and disease progression of ASC will aid therapeutic options and prognostication.
Scaling out a palliative compassionate community innovation: Nav-CARE
Authors: Pesut Barbara , Duggleby Wendy , Warner Grace , Ghosh Sunita , Bruce Paxton , Dunlop Rowena , Puurveen Gloria 
Published: May 2022

Background: There is an urgent need for community-based interventions that can be scaled up to meet the growing demand for palliative care. The purpose of this study was to scale out a volunteer navigation intervention called Nav-CARE by replicating the program in multiple contexts and evaluating feasibility, acceptability, sustainability, and impact. Methods: This was a scale-out implementation and mixed-method evaluation study. Nav-CARE was implemented in 12 hospice and 3 nonhospice community-based organizations spanning five provinces in Canada. Volunteers visited clients in the home approximately every 2 weeks for 1 year with some modifications required by the COVID-19 public health restrictions. Qualitative evaluation data were collected from key informants ( n = 26), clients/family caregivers ( n = 57), and volunteers ( n = 86) using semistructured interviews. Quantitative evaluation data included volunteer self-efficacy, satisfaction, and quality of life, and client engagement and quality of life. Findings: Successful implementation was influenced by organizational capacity, stable and engaged leadership, a targeted client population, and skillful messaging. Recruitment of clients was the most significant barrier to implementation. Clients reported statistically significant improvements in feeling they had someone to turn to, knowing the services available to help them in their community, being involved in things that were important to them, and having confidence in taking care of their illness. Improvements in clients’ quality of life were reported in the qualitative data, although no statistically significant gains were reported on the quality of life measure. Volunteers reported good self-efficacy and satisfaction in their role. Conclusion: The feasibility, acceptability, and sustainability of the program were largely dependent on strong intraorganizational leadership. Volunteers reported that their involvement in Nav-CARE enabled them to engage in ongoing learning and have a meaningful and relational role with clients. Clients and families described the positive impact of a volunteer on their engagement and quality of life.
The magnitude of prescribing medicines by brand names in a tertiary hospital, Mwanza, Tanzania
Authors: Mwita Stanley , Mchau Brigitte , Minja Winfrida , Katabalo Deogratias , Hamasaki Kayo , Marwa Karol 
Published: May 2022

Background: Globally, one of the most common causes of irrational use of medicines is brand-name prescribing. The consequence of prescribing medicines using brand names is an economic burden on patients and society. Thus, this study aimed to investigate the magnitude of prescribing medicines by brand names in a tertiary hospital in Mwanza, Tanzania. Methods: A retrospective cross-sectional study was conducted between April 2020 and March 2021 at the Bugando Medical Centre. Data were collected from electronic prescriptions (outpatients) and medical files (inpatients). The data were analyzed using STATA version 14. A Chi-square test was conducted to examine the relationship between different categorical variables. p-Values of less than 0.05 were considered statistically significant. Results: Of 851 prescriptions analyzed, 416 (48.9%) contained medicines prescribed using brand names. Compared to outpatient units, the proportion of prescriptions with medicines prescribed by brand names in inpatient units was significantly higher (58.5% vs 39.1%), p < 0.001. The most frequently prescribed medicines by brand names were Ampiclox (ampicillin + cloxacillin), 35.2%, Buscopan (hyoscine butylbromide), 8.7%, and Amoxyclav (amoxicillin + clavulanic acid), 7.7%. Conclusion: Prescriptions written with brand names were found to be common, especially among fixed-dose combinations (FDCs), according to the current study. Governments, institutions, and other stakeholders should support and encourage the use of generic names in prescription writing because it saves money for patients and health care systems. This calls for Tanzania’s government to prioritize the development and implementation of generic prescribing policies.
Long-term patient-reported neurocognitive outcomes in adult survivors of hematopoietic cell transplant
Authors: Wu Natalie L. , Phipps Amanda I. , Krull Kevin R. , Syrjala Karen L. , Carpenter Paul A. , Connelly-Smith Laura S. , Flowers Mary E. , Krakow Elizabeth F. , Ueda Oshima Masumi , Lee Stephanie J. , Chow Eric J. 
Published: May 2022

Abstract
Survivors of hematopoietic cell transplant (HCT) are at risk for neurocognitive impairments, which can negatively affect quality of life. Given limited studies, we aimed to describe the neurocognitive outcomes in a cohort of long-term adult HCT survivors. Eligible survivors (age ≥21 years at HCT and alive ≥2 years following HCT) completed a 60-question survey of neurocognitive function and quality of life, which included the Neuro-Quality of Life Cognitive Function Short Form (Neuro-QoL) and the Childhood Cancer Survivor Study Neurocognitive Questionnaire (NCQ). Analyses of risk factors included univariate comparisons and multivariable logistic regression. Survivors (n = 1861, 47.7% female, 65.6% allogeneic HCT) were surveyed at a median age of 64.2 years (interquartile range [IQR], 56.8-70.5) and a median 12.0 years (IQR, 6.0-21.0) from HCT. Survivors reported average Neuro-QoL scores (50.0 allogeneic; 49.2 autologous survivors) compared with an expected mean of 50 in the general population. On the NCQ, 17.4% to 31.2% of survivors reported impairments (Z-score &gt;1.28) in task efficiency, memory, emotional regulation, or organization, compared with an expected 10% in the general population (all P &lt; .01). In multivariable regression analyses, impaired Neuro-QoL (T-score &lt;40) was independently associated with hearing issues (odds ratio [OR], 2.13; 95% confidence interval [CI], 1.46-3.10) and sleep impairment (OR, 4.41; 95% CI, 2.80-6.94) among allogeneic survivors, with comparable associations in autologous survivors. Overall, long-term adult HCT survivors reported average cognitive quality of life compared with the general population. Subsets of survivors with hearing issues and sleep impairments were more likely to report lower quality of life and impaired neurocognitive function, which may facilitate targeted monitoring or interventions following HCT.
Sperm DNA methylation patterns at discrete CpGs and genes involved in embryonic development are related to bull fertility
Authors: Štiavnická Miriama , Chaulot-Talmon Aurélie , Perrier Jean-Philippe , Hošek Petr , Kenny David A. , Lonergan Patrick , Kiefer Hélène , Fair Sean 
Published: May 2022

Abstract
Background
Despite a multifactorial approach being taken for the evaluation of bull semen quality in many animal breeding centres worldwide, reliable prediction of bull fertility is still a challenge. Recently, attention has turned to molecular mechanisms, which could uncover potential biomarkers of fertility. One of these mechanisms is DNA methylation, which together with other epigenetic mechanisms is essential for the fertilising sperm to drive normal embryo development and establish a viable pregnancy. In this study, we hypothesised that bull sperm DNA methylation patterns are related to bull fertility. We therefore investigated DNA methylation patterns from bulls used in artificial insemination with contrasting fertility scores.

Results
The DNA methylation patterns were obtained by reduced representative bisulphite sequencing from 10 high-fertility bulls and 10 low-fertility bulls, having average fertility scores of − 6.6 and + 6.5%, respectively (mean of the population was zero). Hierarchical clustering analysis did not distinguish bulls based on fertility but did highlight individual differences. Despite this, using stringent criteria (DNA methylation difference ≥ 35% and a q-value < 0.001), we identified 661 differently methylated cytosines (DMCs). DMCs were preferentially located in intergenic regions, introns, gene downstream regions, repetitive elements, open sea, shores and shelves of CpG islands. We also identified 10 differently methylated regions, covered by 7 unique genes (SFRP1, STXBP4, BCR, PSMG4, ARSG, ATP11A, RXRA), which are involved in spermatogenesis and early embryonic development.

Conclusion
This study demonstrated that at specific CpG sites, sperm DNA methylation status is related to bull fertility, and identified seven differently methylated genes in sperm of subfertile bulls that may lead to altered gene expression and potentially influence embryo development.