bluuebunny/crossref_metadata_2025_split huggingface dataset:
Rami Comminution Is Associated With Displacement of Minimally Displaced Lateral Compression Type 1 Injuries on Lateral Stress Radiographs
Authors: Hadeed Michael M. , Tucker Nicholas J. , Heare Austin , Mauffrey Cyril , Parry Joshua A. 
Published: May 2022

Objectives:
To determine whether displacement on lateral stress radiographs (LSRs) in patients with minimally displaced lateral compression type 1 pelvic ring injuries is associated with any demographic and/or injury characteristics.

Design:
Retrospective comparative cohort.

Setting:
Urban level 1 trauma center.

Patients/Participants:
Ninety-three consecutive patients with minimally displaced lateral compression type 1 injuries.

Intervention:
Displacement of pelvic ring injury on LSR (≥10 mm vs. <10 mm).

Main Outcome Measurements:
Demographic and injury characteristics (mechanism of injury, Nakatani rami classification, rami comminution, Denis zone, complete/incomplete sacral fracture, sacral comminution).

Results:
65.6% of patients (n = 61) had ≥10 mm of displacement on LSR. On univariate analysis, displacement was associated with increased age [median difference 11: confidence interval (CI), 2–23], female sex [proportional difference (PD): 25.1%, CI, 3.9%–44.4%], Nakatani classification (type I PD: 27.9%, type II PD: −19.5%), and rami comminution (PD: 55.6%, CI, 35.4%–71.3%). On multivariate analysis, displacement was only associated with rami comminution (odds ratio: 16.48, CI, 4.67–58.17). Displacement was not associated with energy of injury mechanism, sacral fracture Denis zone, complete sacral fracture, sacral comminution, or bilateral rami fractures.

Conclusions:
Although rami comminution was the only variable found to be independently associated with displacement ≥10 mm on LSR, no single variable perfectly predicted displacement. Future studies are needed to determine whether displacement on stress radiographs should change the management of these injuries.

Level of Evidence:
Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
Rare Presentation of Pediatric Multiple Enchondromatosis Limited to Single Ray or Single Nerve Distribution in the Hand: A Multicenter Case Series
Authors: Muffly Brian T. , O’Shaughnessy Maureen A. , Fazal Faris Z. , Riley Scott A. , Shah Apurva S. , Cornwall Roger , Burke Charity S. 
Published: May 2022

Background:
Multiple enchondromas in the pediatric hand is a relatively rare occurrence and the literature regarding its incidence and treatment is sparse. Within this rare subset of patients, we identified a unique cohort in which lesions are confined to multiple bones in a single ray or adjacent rays within a single nerve distribution. We review the clinical and pathologic characteristics and describe the indications for and outcomes of treatment in this unique subset of patients as well as offer conjectures about its occurrence.

Methods:
Institutional review board (IRB)-approved retrospective multicenter study between 2010 and 2018 identified subjects with isolated multiple enchondromas and minimum 2-year follow-up. Data analyzed included demographics, lesion quantification and localization, symptoms and/or fracture(s), treatment of lesion(s), complications, recurrence, and presence of malignant transformation.

Results
Ten patients were evaluated with average age at presentation of 9 years (range: 4 to 16) and mean clinical follow-up of 6 years (range: 2.8 to 8.6). Five subjects had multiple ray involvement in a single nerve distribution and 5 had single ray involvement with an average of 4 lesions noted per subject (range: 2 to 8). All children in the study had histopathologic-proven enchondromas and underwent operative curettage±bone grafting. Indications for surgical intervention included persistent pain, multiple prior pathologic fractures, impending fracture and deformity. During the study period three subjects experienced pathologic fracture treated successfully with immobilization. Recurrence was noted in 40% at an average of 105 weeks postoperatively (range: 24 to 260) and appears higher than that reported in the literature. No case of malignant transformation was observed during the study period.

Conclusions:
A rare subset of pediatric patients with multiple enchondromas of the hand is described with lesions limited to a single ray or single nerve distribution. Further awareness of this unique subset of patients may increase our understanding of the disease and improve patient outcomes.

Level of Evidence:
Level IV—therapeutic (case series).
Single-cell analysis of transcription factor regulatory networks reveals molecular basis for subtype-specific dysregulation in acute myeloid leukemia
Authors: Sun Ruixia , Sun Lina , Xie Xiaowei , Li Xuan , Wu Peng , Wang Lu , Zhu Ping 
Published: May 2022

Abstract
Highly heterogeneous acute myeloid leukemia (AML) exhibits dysregulated transcriptional programs. Transcription factor (TF) regulatory networks underlying AML subtypes have not been elucidated at single-cell resolution. Here, we comprehensively mapped malignancy-related TFs activated in different AML subtypes by analyzing single-cell RNA sequencing data from AMLs and healthy donors. We first identified six modules of regulatory networks which were prevalently dysregulated in all AML patients. AML subtypes featured with different malignant cellular composition possessed subtype-specific regulatory TFs associated with differentiation suppression or immune modulation. At last, we validated that ERF was crucial for the development of hematopoietic stem/progenitor cells by performing loss- and gain-of-function experiments in zebrafish embryos. Collectively, our work thoroughly documents an abnormal spectrum of transcriptional regulatory networks in AML and reveals subtype-specific dysregulation basis, which provides a prospective view to AML pathogenesis and potential targets for both diagnosis and therapy.
Bullous Impetigo Following an Abrasion in a 17-Year-Old Female
Authors: Medepalli Vidya M. , Srikakolapu Siddharth , Preda-Naumescu Ana , Brodell Robert T. , Nahar Vinayak K. 
Published: May 2022

ABSTRACT
Teledermatology is a term to describe the provision of dermatologic medical services through telecommunication technology. This is a teledermatology case of bullous impetigo.
Experiences of Participating in an Academic–Hospital Partnership Nursing Program: A Qualitative Study
Authors: LEE Li-Hung , CHEN Shu-Ling , TSAY Shiow-Luan , YANG Cheng-I 
Published: May 2022

ABSTRACT

Background
Although 5-year colleges account for 41.7% of all nursing graduates in Taiwan, most of these graduates go on to university and earn a bachelor's degree. In 2015, four universities received approval from the Ministry of Education of Taiwan and started to enroll students in the academic–hospital partnership nursing program to guide nursing graduates from 5-year colleges into the nursing workplace. The effects of this program have never been examined, especially from the perspective of the students.

Purpose
The aim of this study was to explore the experiences of students currently participating in the academic–hospital partnership nursing program.

Methods
A qualitative approach was used in this study. Twelve students were invited to participate in a focus group that met for five sessions over 3 years to understand the motivations for and experiences of participating in the academic–hospital partnership nursing program. Data were analyzed using thematic analysis.

Results
Six themes were identified: (a) incentives for participating in the academic–hospital partnership nursing program, (b) worries about making the wrong decision, (c) worries about future adaptation, (d) facing the real workplace, (e) confusion about role perception and benefits, and (f) administrator support.

Conclusions/Implications for Practice
The findings of this study enhance the general understanding of nursing student experiences and the changes over time in the academic–hospital partnership nursing programs. Moreover, the findings may be used to help teachers and nursing administrators at healthcare institutes better support the needs of students at each program stage. In addition, the findings may serve as a reference for the government in refining the design of these programs in the future.
Development of Burnout in Physical Therapist Students and Associated Factors: A Study During COVID-19
Authors: Smith Allison , Ellison Jennifer , Bogardus Jennifer , Gleeson Peggy 
Published: May 2022

Introduction.Burnout is a negative response to work-related stress and follows a developmental process that might begin during students' academic studies.Review of Literature.Numerous factors affect burnout in graduate students, and few published studies have assessed burnout in physical therapist students.Subjects.Participants included 1,340 Doctor of Physical Therapy (DPT) students from DPT programs across the United States.Method.Students completed a Psychdata survey in fall 2020 that assessed burnout using the Oldenburg Burnout Inventory for Students (OLBI-S), resilience using the Connor-Davidson Resilience Scale (CD-RISC), perceived stress using the Perceived Stress Scale (PSS), and additional questions regarding levels of support and the learning environment. Burnout levels for each year in a DPT program were determined using 2 one-way independent analysis of variances, 1 for each OLBI-S subscale. Cutoff scores to group students into the burnout and nonburnout groups were determined using quartiles. Logistic regression was used to identify factors that may have an influence on the development of burnout.Results.No significant difference was found in burnout scores among students in different years in a DPT program. Using cutoff scores, 35.4% of DPT students were in the burnout group. Factors found to be statistically significant in predicting burnout were satisfaction with the level of support from faculty, satisfaction with overall learning environment, CD-RISC score, and PSS score (χ2(4) = 266.827,P< .001). The final model explained 24.8% of the variance and correctly classified 72.1% of cases.Discussion and Conclusion.Students who have higher levels of perceived stress, lower levels of satisfaction with the level of support from faculty, and lower levels of satisfaction with their overall learning environment at DPT school may be more likely to develop burnout, while students who have higher levels of resilience may be less likely to develop burnout. This study was conducted during the COVID-19 pandemic and may not be generalizable to nonpandemic times.
Machine Learning for the Prevalence and Severity of Coronary Artery Calcification in Nondialysis Chronic Kidney Disease Patients
Authors: Zhu Haitao , Yin Changqing , Schoepf U. Joseph , Wang Dongqing , Zhou Changsheng , Lu Guang Ming , Zhang Long Jiang 
Published: May 2022

Purpose:
This study sought to determine whether machine learning (ML) can be used to better identify the risk factors and establish the prediction models for the prevalence and severity of coronary artery calcification (CAC) in nondialysis chronic kidney disease (CKD) patients and compare the performance of distinctive ML models with conventional logistic regression (LR) model.

Materials and Methods:
In all, 3701 Chinese nondialysis CKD patients undergoing noncontrast cardiac computed tomography (CT) scanning were enrolled from November 2013 to December 2017. CAC score derived from the cardiac CT was calculated with the calcium scoring software and was used to assess and stratify the prevalence and severity of CAC. Four ML models (LR, random forest, support vector machine, and k-nearest neighbor) and the corresponding feature ranks were conducted. The model that incorporated the independent predictors was shown as the receiver-operating characteristic (ROC) curve. Area under the curve (AUC) was used to present the prediction value. ML model performance was compared with the traditional LR model using pairwise comparisons of AUCs.

Results:
Of the 3701 patients, 943 (25.5%) patients had CAC. Of the 943 patients with CAC, 764 patients (20.6%) and 179 patients (4.8%) had an Agatston CAC score of 1 to 300 and ≥300, respectively. The primary cohort and the independent validation cohort comprised 2957 patients and 744 patients, respectively. For the prevalence of CAC, the AUCs of ML models were from 0.78 to 0.82 in the training data set and the internal validation cohort. For the severity of CAC, the AUCs of the 4 ML models were from 0.67 to 0.70 in the training data set and from 0.53 to 0.70 in the internal validation cohort. For the prevalence of CAC, the AUC was 0.80 (95% confidence interval [CI]: 0.77-0.83) for ML (LR) versus 0.80 (95% CI: 0.77-0.83) for the traditional LR model (P=0.2533). For the severity of CAC, the AUC was 0.70 (95% CI: 0.63-0.77) for ML (LR) versus 0.70 (95% CI: 0.63-0.77) for traditional LR model (P=0.982).

Conclusions:
This study constructed prediction models for the presence and severity of CAC based on Agatston scores derived from noncontrast cardiac CT scanning in nondialysis CKD patients using ML, and showed ML LR had the best performance.
What Is the Medication Iatrogenic Risk in Elderly Outpatients for Chronic Pain?
Authors: Jambon Julie , Choukroun Chloé , Roux-Marson Clarisse , Viel Éric , Leguelinel-Blache Géraldine 
Published: May 2022

Purpose
Medication iatrogeny is a major public health problem that increases as the population ages. Therapeutic escalation to control pain and associated disorders could increase polypharmacy and iatrogeny. This study aimed to characterize the medication iatrogenic risk of elderly outpatients with chronic pain.

Methods
This was a prospective cohort study recruiting patients 65 years or older with chronic pain. A medication iatrogenic assessment was performed based on the best possible medication history to record risk of adverse drug events (Trivalle score), STOPP (Screening Tool of Older Person's Prescriptions)/START (Screening Tool to Alert doctors to Right Treatment) criteria, and potentially inappropriate medications.

Results
We recruited 100 patients with an average age of 71 years. The median number of medications before pain consultation was 8 (interquartile range = [7;11]). Trivalle score showed that 43% of patients were at moderate or high medication iatrogenic risk. Before consultation, 79% and 75% of patients had at least 1 STOPP or START criterion on their orders, respectively. One-third of orders mentioned benzodiazepine prescribed for more than 4 weeks. At least 1 potentially inappropriate medication was prescribed for 54% of the patients, with a median of 1 per patient (interquartile range = [0;1]). A combination of several anticholinergics was prescribed in 23% of patients.

Conclusion
Elderly patients with chronic pain are at risk of medication iatrogeny. Preventive measures as multidisciplinary medication review could reduce the iatrogenic risk in these outpatients.
This study is registered at clinicaltrials.gov as NCT04006444 on July 3, 2019.
A global and regional view of the opportunity for climate-smart mariculture
Authors: Alleway Heidi K. , Jones Alice R. , Theuerkauf Seth J. , Jones Robert C. 
Published: May 2022

Food systems and the communities they support are increasingly challenged by climate change and the need to arrest escalating threats through mitigation and adaptation. To ensure climate change mitigation strategies can be implemented effectively and to support substantial gains in greenhouse gas emissions reduction, it is, therefore, valuable to understand where climate-smart strategies might be used for best effect. We assessed mariculture in 171 coastal countries for vulnerabilities to climate change (12 indicators) and opportunities to deliver climate mitigation outcomes (nine indicators). We identified Northern America and Europe as having comparatively lower regional vulnerability and higher opportunity for impact on climate mitigation. Australia, Canada, France, Italy, Japan, Republic of Korea, New Zealand, Norway and the United States of America were identified as well-positioned to advance strategies linked to mariculture. However, the nature of vulnerabilities and opportunities within and between all regions and countries varied, due to the formation of existing mariculture, human development factors and governance capacity. Our analysis demonstrates that global discussion will be valuable to motivating climate-smart approaches associated with mariculture, but to ensure these solutions contribute to a resilient future, for industry, ecosystems and communities, local adaptation will be needed to address constraints and to leverage local prospects.
This article is part of the theme issue ‘Nurturing resilient marine ecosystems’.
Marine protected areas in the context of climate change: key challenges for coastal social-ecological systems
Authors: Schmidt Daniela N. , Pieraccini M. , Evans L. 
Published: May 2022

Climate and ecological emergencies play out acutely in coastal systems with devastating impacts on biodiversity, and the livelihoods of communities and their cultural values. Marine Protected Areas (MPAs) are one of the key management and regulatory tools against biodiversity loss, playing a role in strengthening bio-cultural diversity and sustainability of coastal social-ecological systems. What is unclear though is the effectiveness of static protections under climate change as species move. Next to ecological uncertainty, regulatory uncertainty may play a role in weakening marine conservation. We asked whether MPAs are ecologically effective now and can sustain or improve to be so in the future while facing key climate and regulatory uncertainties. MPAs can support the protection of cultural values and have an impact on activities of sea-users and the sustainability of social-ecological systems. As such, questions surrounding their legitimacy under a changing climate and increased uncertainty are pertinent. We argue that MPA governance must be cognisant of the interdependency between natural and human systems and their joint reaction to climate change impacts based on an integrated, co-developed, and interdisciplinary approach. Focusing on the UK as a case study, we highlight some of the challenges to achieve effective, adaptive and legitimate governance of MPAs.
This article is part of the theme issue ‘Nurturing resilient marine ecosystems’.
Climate change and cetacean health: impacts and future directions
Authors: Kebke Anna , Samarra Filipa , Derous Davina 
Published: May 2022

Climate change directly impacts the foraging opportunities of cetaceans (e.g. lower prey availability), leads to habitat loss, and forces cetaceans to move to other feeding grounds. The rise in ocean temperature, low prey availability and loss of habitat can have severe consequences for cetacean survival, particularly those species that are already threatened or those with a limited habitat range. In addition, it is predicted that the concentration of contaminants in aquatic environments will increase owing to Arctic meltwater and increased rainfall events leading to higher rates of land-based runoff in downstream coastal areas. These persistent and mobile contaminants can bioaccumulate in the ecosystem, and lead to ecotoxicity with potentially severe consequences on the reproductive organs, immune system and metabolism of marine mammals. There is a need to measure and assess the cumulative impact of multiple stressors, given that climate change, habitat alteration, low prey availability and contaminants do not act in isolation. Human-caused perturbations to cetacean foraging abilities are becoming a pervasive and prevalent threat to many cetacean species on top of climate change-associated stressors. We need to move to a greater understanding of how multiple stressors impact the metabolism of cetaceans and ultimately their population trajectory.This article is part of the theme issue ‘Nurturing resilient marine ecosystems’.
Building bridges between natural and social science disciplines: a standardized methodology to combine data on ecosystem quality trends
Authors: Richter I. , Roberts B. R. , Sailley S. F. , Sullivan E. , Cheung V. V. , Eales J. , Fortnam M. , Jontila J. B. , Maharja C. , Nguyen T. Ha. , Pahl S. , Praptiwi R. A. , Sugardjito J. , Sumeldan J. D. C. , Syazwan W. M. , Then A. Y. , Austen M. C. 
Published: May 2022

Despite a growing interest in interdisciplinary research, systematic ways of how to integrate data from different disciplines are still scarce. We argue that successful resource management relies on two key data sources: natural science data, which represents ecosystem structure and processes, and social science data, which describes people's perceptions and understanding. Both are vital, mutually complementing information sources that can underpin the development of feasible and effective policies and management interventions. To harvest the added value of combined knowledge, a uniform scaling system is needed. In this paper, we propose a standardized methodology to connect and explore different types of quantitative data from the natural and social sciences reflecting temporal trends in ecosystem quality. We demonstrate this methodology with different types of data such as fisheries stocks and mangrove cover on the one hand and community's perceptions on the other. The example data are collected from three United Nations Educational Scientific and Cultural Organization (UNESCO) Biosphere reserves and one marine park in Southeast Asia. To easily identify patterns of convergence or divergence among the datasets, we propose heat maps using colour codes and icons for language- and education-independent understandability. Finally, we discuss the limitations as well as potential implications for resource management and the accompanying communication strategies.This article is part of the theme issue ‘Nurturing resilient marine ecosystems’.