bluuebunny/crossref_metadata_2025_split huggingface dataset:
Promoting digital health equity through remote patient monitoring: A feasibility study.
Authors: Kessler Alaina J. , Besculides Melanie , Kisswany Carol , Liu Mark , Berkalieva Asem , Mazumdar Madhu , Smith Cardinale B. , Gorbenko Ksenia O. 
Published: September 2022

441 Background: Remote patient monitoring (RPM) is a form of telemedicine involving collection and transmission of health data from patients to providers using non-invasive digital technology. RPM may offer earlier recognition of clinical deterioration to help reduce acute care use and improve healthcare outcomes. Studies of digital interventions in oncology have demonstrated reduction in symptom distress and unplanned hospitalizations but lack focus on minority patients. Studies of telehealth aiming to address disparities have not focused on patients with cancer. In this pilot study, we evaluated the feasibility of RPM among patients with cancer at a large urban medical center serving a racially and socioeconomically diverse population. Methods: We partnered with Current Health to provide an FDA-approved RPM wearable device, which included a secure HIPAA-compliant platform, to collect heart rate, temperature, respiration, oxygen saturation, and blood pressure. The kit included broadband access and a tablet to provide telehealth services. Oncology coordinators determined clinical inclusion and exclusion criteria of RPM initiation for patients. A centralized team of Nurse Practitioners (NPs) monitored alarms. Clinical alarms indicated abnormal vital signs; technical alarms indicated no data transmission for a 12-hour period. We measured feasibility by recruitment and retention, and used descriptive statistics to describe the study population, time enrolled on RPM, and alarms. Results: To date, we enrolled 39 patients on the RPM platform over a 14-month period with a weekly census of 10 patients undergoing RPM monitoring. Of the 39 patients, 19 (49%) were white, 10 (26%) Black, and 5 (13%) Asian; 3 (8%) patients identified as Hispanic. Nine (23%) patients had either primary or secondary Medicaid insurance. The average age was 57.9 years. The majority of patients (95%) had hematologic malignancies, all of whom were enrolled on hospital discharge. The mean length of time per patient enrolled with the device was 21.7 days. Over 14 months, there were 607 technical and 118 clinical alarms with an average of 2 clinical alarms per week addressed by NPs by phone, indicating low clinician burden. Conclusions: This pilot study demonstrated the feasibility of RPM in patients with cancer at home. Future studies should focus on equity-driven implementation of RPM in patients with cancer, as well as patient-reported and healthcare utilization outcomes to identify best practices in telemedicine implementation. RPM has promise to deliver high quality and equitable cancer care.
Multiscale modeling intervention development and perspectives from early-stage breast cancer survivors on technology to improve long-term adherence to endocrine therapy.
Authors: Gonzales Manuel , Garcia-Alcaraz Cristian , Kaur Navreet , Gong Jiaqi , Zhu Xishi , Tolman Sarah , Barnes Laura E , Wells Kristen J 
Published: September 2022

442 Background: Despite the important role of endocrine therapy (ET) in preventing cancer recurrence, rates of long-term adherence are poor among certain breast cancer survivors (BCS). Traditional medication adherence (MA) interventions that have primarily incorporated medication-taking reminders mainly focused on a “one size fits all” approach, which may explain why many interventions have proven unsuccessful. However, when combined with other context, sensors (i.e., wearable sensors, smartphone sensors) can facilitate a better understanding of medication-taking behaviors leading to individualized interventions that are time and context appropriate. The project team is developing a multiscale modeling and intervention (MMI) system designed to improve adherence to ET among BCS. This study describes MMI development. Methods: MMI development has included: 1) usability testing; 2) review of research literature regarding factors associated with ET MA; and 3) a neural network analysis of previously collected ET MA data. In usability testing, 20 BCS were recruited via social media posts to participate in semi-structured usability interviews. Interviews were conducted via videoconferencing and assessed perceptions of and willingness to use an ecological momentary assessment (EMA) smartphone app, smartwatch, smart pill bottle, and smart pill box. The literature review examined multiple systematic reviews to identify constructs associated with ET MA. Randomized neural network analysis with 32 early stage BCS taking ET was used to determine important features of ET MA 4 weeks following completion of a 346-item survey. Four-week medication adherence was measured daily with a medication event monitoring system (MEMS). Results: Usability testing participants were accepting of each technology and willing to use each technology at various frequencies. Forty-two surveys were reviewed as predictors of MA in systematic reviews. Randomized neural network analysis found 104 survey items had absolute weights at the 70th percentile, indicating a strong influence on week 4 ET MA, and 11 surveys were determined theoretically relevant. Conclusions: BCS are willing to use 4 components of the MMI system. The MMI system will soon be deployed for 6 months of data collection. If shown to be effective, the MMI framework can be used by oncologists and researchers to develop personalized interventions focused on understanding and increasing ET MA.
Erec et Enideand the Concept of Consent
Authors: Samuelson Charlie 
Published: September 2022

AbstractChrétien de Troyes’s Erec et Enide is about a husband’s appalling and disturbing mistreatment of his wife. Yet, this article contends, it can also be understood as a (perhaps surprisingly) critical reflection on sexual consent, which overlaps with key concerns of both medieval canon law and modern consent theory. In dialogue with each of these domains, this essay studies, first, how particular episodes not only call attention to the importance of sexual consent but also to factors that mitigate it—as well as to the more general limitations of the concept. Second, the article explores how the larger adventure series, which makes up the core of the romance, is persistently engaging with some of the knottiest issues in both medieval and modern thinking on sexual consent, such as its relation to equality, silence, volition, and the active/passive binary. Finally, the article reflects on the implications of considering this courtly romance alongside modern consent theory. On the one hand, modern theory pushes the medievalist to confront what is at stake in deeming Enide unable meaningfully to consent to the terms of her union with Erec. On the other, this medieval romance responds with crucial insights on, in particular, the history of the relationship between patriarchy and the concept of sexual consent.
In silico comparison between the mutated and wild-type androgen receptors and their influence on the selection of optimum androgenic receptor blockers for the treatment of prostate cancer
Authors: Akeel Al-Hussaniy Hany , S. Al-tameemi Zahraa , AL-Zobaidy Mohammed J. 
Published: September 2022

Background: Prostate cancer is a disease that occurs in men aged more than 50 years. In Iraq, 8.89 men per 100,000 population suffer from prostate cancer, with the incidence being 14,016 cases and mortality being 6,367 cases. Despite advances in treatment against prostate cancer, it can become resistant to drugs. Therefore, the aim of the current study was to search and identify binding sites for the repositioning of drugs by computational methods (docking). Methods: Based on the protein structure of the wild androgen receptor, the analysis parameters (22x22x22 on the X, Y, and Z axes) were established. Results: The interactions of the natural ligands with androgen receptor were 10.0 (testosterone) and 10.8 (dihydrotestosterone) while mutated androgen receptor (T877A) had a low affinity with testosterone and dihydrotestosterone (-5.3 and -6.7, respectively). In the interactions of both receptors with the reported inhibitors (antagonists), a decrease with Bicalutamide (-8.3 and -4.3, respectively) and an increase in affinity with Flutamide and Nilutamide (-7.7 and 8.6, wild AR; -8.7 and -9.3 AR T877A) were observed. As for Enzalutamide and Apalutamide (second-generation antagonists), the change was minimal between wild androgen receptor and T877A (-7.6 and -7.7; -7.3 and -7.3, respectively). The change in the affinity of the ligands with the androgen receptor and androgen receptor T877A shows how a mutation alters the bonds between these molecules. Conclusion: The identification of key sites and potent inhibitors against abnormal androgen receptor functions will enrich prostate cancer treatments.
Structure of groups of eigenfrequencies in spectra of geomagnetic pulsations in the nightside magnetosphere
Authors: Polyakov Andrey 
Published: September 2022

Using a new method of correlation function for amplitude and phase fluctuations (APCF), records of geomagnetic field component fluctuations (observatories Mondy and Borok) have been processed for a number of hour zones of the nightside magnetosphere. This method is meant to detect groups of equidistant frequencies inside the spectrum of source signal and also to measure a difference between two neighbor frequencies in each of these groups.
The groups of equidistant frequencies in broadband spectra of these fluctuations are shown to depend on eigenfrequencies of the 2D Alfvén wave resonator, just as for dayside fluctuations [Polyakov, 2018]. An empirical relation has been found between a combination of parameters of this resonator and local time. The similarity between structural elements in the final products of processing of Alfvén fluctuation N-S and E-W components for almost all hour zones clearly indicates the reliability of the results of the APCF method in processing any broadband signals.
Factors associated with conversion to surgical release after a steroid injection in patients with a trigger finger
Authors: van den Berg Catherine , van der Zwaard Babette , Halperin Joni , van der Heijden Brigitte 
Published: September 2022

Aims The aim of this retrospective study was to evaluate the rate of conversion to surgical release after a steroid injection in patients with a trigger finger, and to analyze which patient- and trigger finger-related factors affect the outcome of an injection. Methods The medical records of 500 patients (754 fingers) treated for one or more trigger fingers with a steroid injection or with surgical release, between 1 January 2016 and 1 April 2020 with a follow-up of 12 months, were analyzed. Conversion to surgical release was recorded as an unsuccessful treatment after an injection. The effect of patient- and trigger finger-related characteristics on the outcome of an injection was assessed using stepwise manual backward multivariate logistic regression analysis. Results Treatment with an injection was unsuccessful in 230 fingers (37.9%). Female sex (odds ratio (OR) 1.87 (95% confidence interval (CI) 1.21 to 2.88)), Quinnell stage IV (OR 16.01 (95% CI 1.66 to 154.0)), heavy physical work (OR 1.60 (95% CI 0.96 to 2.67)), a third steroid injection (OR 2.02 (95% CI 1.06 to 3.88)), and having carpal tunnel syndrome (OR 1.59 (95% CI 0.98 to 2.59)) were associated with a higher risk of conversion to surgical release. In contrast, an older age (OR 0.98 (95% CI 0.96 to 0.99)), smoking (OR 0.39 (95% CI 0.24 to 0.64)), and polypharmacy (OR 0.39, CI 0.12 to 1.12) were associated with a lower risk of conversion. The regression model predicted 15.6% of the variance found for the outcome of the injection treatment (R2 > 0.25). Conclusion Factors associated with a worse outcome following a steroid injection were identified and should be considered when choosing the treatment of a trigger finger. In women with a trigger finger, the choice of treatment should take into account whether there are also one or more patient- or trigger-related factors that increase the risk of conversion to surgery. Cite this article: Bone Joint J 2022;104-B(10):1142–1147.
A randomized controlled trial comparing two modern total wrist arthroplasties
Authors: Holm-Glad Trygve , Røkkum Magne , Röhrl Stephan M. , Roness Siri , Godang Kristin , Reigstad Ole 
Published: September 2022

Aims To analyze the short-term outcome of two types of total wrist arthroplasty (TWA) in terms of wrist function, migration, and periprosthetic bone behaviour. Methods A total of 40 patients suffering from non-rheumatoid wrist arthritis were enrolled in a randomized controlled trial comparing the ReMotion and Motec TWAs. Patient-rated and functional outcomes, radiological changes, blood metal ion levels, migration measured by model-based radiostereometric analysis (RSA), bone mineral density (BMD) measured by dual-energy X-ray absorptiometry (DXA), complications, loosening, and revision rates at two years were compared. Results Patient-Rated Wrist and Hand Evaluation (PRWHE) scores, abbreviated version of the Disabilities of the Arm, Shoulder and Hand questionnaire (QuickDASH) scores, and pain improved similarly and significantly in both groups. Wrist motion improved significantly in the Motec group only, and forearm rotation in the ReMotion group only. Cobalt (Co) and chromium (Cr) blood ion levels were significantly higher in the metal-on-metal (MoM) Motec group than in the metal-on-polyethylene (MoP) ReMotion group. Mean total translation was 0.65 mm (95% confidence interval (CI) 0.26 to 1.12) and 0.27 mm (95% CI 0.14 to 0.47) for the ReMotion carpal and radial components, and 0.32 mm (95% CI 0.22 to 0.45) and 0.26 mm (95% CI 0.20 to 0.34) for the Motec metacarpal and radial components, respectively. Apart from dorsal and volar tilts, which were significantly higher for the radial ReMotion than for the Motec component, no significant differences in absolute migration occurred. BMD around the radial components never returned to baseline. Almost one-third of patients required reoperation due to complications. Two ReMotion implants were revised to Motec TWAs due to carpal component loosening, and three Motec MoM articulations were revised to metal-on-polyether ether ketone due to painful synovitis. Conclusion Both implants provided matched function and were stable at short-term follow-up, but with a high complication rate. This procedure should be restricted to specialist centres undertaking prospective analysis until its role is clarified. Cite this article: Bone Joint J 2022;104-B(10):1132–1141.
Elbow arthroplasty research methods, outcome domains, and instruments used in clinical outcome studies
Authors: Watts Adam C. , Hamoodi Zaid , McDaid Catriona , Hewitt Catherine 
Published: September 2022

Aims Arthroplasties of the elbow, including total elbow arthroplasty, radial head arthroplasty, distal humeral hemiarthroplasty, and radiocapitellar arthroplasty, are rarely undertaken. This scoping review aims to outline the current research in this area to inform the development of future research. Methods A scoping review was undertaken adhering to the Joanna Briggs Institute guidelines using Medline, Embase, CENTRAL, and trial registries, limited to studies published between 1 January 1990 and 7 February 2021. Endnote software was used for screening and selection, and included randomized trials, non-randomized controlled trials, prospective and retrospective cohort studies, case-control studies, analytical cross-sectional studies, and case series of ten or more patients reporting the clinical outcomes of elbow arthroplasty. The results are presented as the number of types of studies, sample size, length of follow-up, clinical outcome domains and instruments used, sources of funding, and a narrative review. Results A total of 362 studies met the inclusion criteria. Most were of total elbow arthroplasty (246; 68%), followed by radial head arthroplasty (100; 28%), distal humeral hemiarthroplasty (11; 3%), and radiocapitellar arthroplasty (5; 1%). Most were retrospective (326; 90%) and observational (315; 87%). The median sample size for all types of implant across all studies was 36 (interquartile range (IQR) 21 to 75). The median length of follow-up for all studies was 56 months (IQR 36 to 81). A total of 583 unique outcome descriptors were used and were categorized into 18 domains. A total of 105 instruments were used to measure 39 outcomes. Conclusion We found that most of the literature dealing with elbow arthroplasty consists of retrospective observational studies with small sample sizes and short follow-up. Many outcomes have been used with many different instruments for their measurement, indicating a need to define a core set of outcomes and instruments for future research in this area. Cite this article: Bone Joint J 2022;104-B(10):1148–1155.
Prognostic value of interview rank when hiring for health: staff and nonsense or significant metric?
Authors: Mellor K , Robinson DBT , Luton O , James OP , Powell AGMT , Hopkins L , Hemington-Gorse S , Lala A , Egan RJ , Lewis WG 
Published: September 2022

Introduction Core surgical training recruitment works via a centralised national selection process, during which each applicant is assigned an interview performance rank. The aim of this study was to evaluate the relative performance of core surgical trainees related to interview rank (CSTIR) in a single UK statutory education body. Methods Data for two cohorts of core surgical trainees (87 individuals) were analysed prospectively over two years (2018–2021). The primary outcome measures were Membership of the Royal College of Surgeons (MRCS) examination pass and specialty national training number (NTN) appointment. Results The overall MRCS pass rate was 67.8% and the NTN success rate was 43.7%. CSTIR <332 was associated with MRCS pass (88.0% vs 59.7%, odds ratio [OR]: 4.90, p = 0.017) and CSTIR <550 with NTN success (57.4% vs 42.6%, OR: 3.56, p = 0.006). Multivariate analysis revealed that NTN appointment was associated with audit completion (OR: 1.49, p = 0.045), scientific publication (OR: 2.08, p = 0.008), CSTIR (OR: 6.02, p = 0.014), universal annual review of competence progression Outcome 1 (OR: 25.10, p = 0.002) and Improving Surgical Training programme (OR: 108.96, p < 0.001). Conclusions CSTIR was independently associated with conversion to higher surgical specialty NTN, suggesting that the current recruitment process predicts likely success in training.
Ultrasound-guided dry needling versus traditional dry needling for patients with knee osteoarthritis: A double-blind randomized controlled trial
Authors: Pang Johnson C. Y. , Fu Amy S. N. , Lam Stanley K. H. , Peng B. , Fu Allan C. L. 
Published: September 2022

ObjectiveTo compare the effect of ultrasound (US)-guided dry needling (DN) with traditional DN in the treatment of pain and dysfunction for patients with knee osteoarthritis (KOA).DesignA double-blind, randomized controlled trial.MethodsPatients (25 male and 65 female), age 50–80 years diagnosed with KOA were recruited and randomly assigned to one of three groups in a 1:1:1 ratio for intervention: real US-guided DN with exercise therapy (G1), placebo US-guided DN with exercise therapy (G2), and exercise therapy solely (G3). G1 and G2 were blinded to the application of real or placebo US guidance by turning the monitor of US imaging out-of-view from participants’ vantage points. The effectiveness of blinding was evaluated by asking the participants whether they had received real-US guided DN. The responses were assessed by Chi-square test. Visual Analogue Scale (VAS), Knee injury, and Osteoarthritis Outcome Score (KOOS) subscales (KOOS-pain, KOOS-symptoms, KOOS-quality-of-life (QoL)) were collected at baseline, 4 weeks, and 8 weeks by a blinded assessor. Data were analyzed by mixed model analysis of variance (ANOVA) with Bonferroni correction.ResultsEighty-four participants (61.26±5.57 years) completed the study. G1 achieved significant improvement in VAS at 8 weeks compared to G2 and G3 (G1 vs. G2: MD = -15.61, 95% CI [-25.49, -5.51],p= 0.001; G1 vs. G3: MD = -19.90, 95% CI [-29.71, -10.08],p< 0.001). G1 achieved significant improvement in KOOS-pain at 8 weeks compared to G2 and G3 (G1 vs. G2: MD = 9.76, 95% CI [2.38, 17.14],p= 0.006; G1 vs. G3: MD = 9.48, 95% CI [2.31, 16.66],p= 0.010). KOOS-symptoms and KOOS-QoL were not statistically significant between groups. G2 had no significant difference of the perceptions as G1 with p = 0.128. G2 were successfully blinded to placebo US-guided DN.ConclusionUS-guided DN with exercise therapy may be more effective than traditional DN with exercise therapy or exercise therapy alone in reduce pain of KOA.
Influenza vaccine coverage and factors associated with non-vaccination among adults at high risk for severe outcomes: An analysis of the Canadian Longitudinal Study on Aging
Authors: Gravagna Katie , Wolfson Christina , Sulis Giorgia , Buchan Sarah A. , McNeil Shelly , Andrew Melissa K. , McMillan Jacqueline , Kirkland Susan , Basta Nicole E. 
Published: September 2022

Background
Influenza vaccination is recommended in Canada for older adults and those with underlying health conditions due to their increased risk of severe outcomes. Further research is needed to identify who within these groups is not receiving influenza vaccine to identify opportunities to increase coverage.

Objectives
We aimed to 1) estimate influenza non-vaccination prevalence and 2) assess factors associated with non-vaccination among Canadian adults aged ≥65 and adults aged 46–64 with ≥1 chronic medical condition (CMC) due to their high risk of severe influenza outcomes.

Methods
We conducted a secondary analysis of cross-sectional data collected from 2015–2018 among participants of the Canadian Longitudinal Study on Aging. For both groups of interest, we estimated non-vaccination prevalence and used logistic regression models to identify factors associated with non-vaccination. We report adjusted odds ratios and 95% confidence intervals for the investigated variables.

Results
Overall, 29.5% (95% CI: 28.9%, 30.1%) of the 23,226 participants aged ≥65 years and 50.4% (95% CI: 49.4%, 51.3%) of the 11,250 participants aged 46–64 years with ≥1 CMC reported not receiving an influenza vaccination in the past 12 months. For both groups, lack of recent contact with a family doctor and current smoking were independently associated with non-vaccination.

Discussion
Influenza vaccination helps prevent severe influenza outcomes. Yet, half of adults aged 46–64 years with ≥1 CMC and more than one-quarter of all adults aged ≥65 years did not receive a recommended influenza vaccine in the year prior to the survey. Innovation in vaccination campaigns for routinely recommended vaccines, especially among those without annual family doctor visits, may improve coverage.

Conclusion
Influenza vaccination coverage among Canadian adults aged 46–64 years with ≥1 CMC and adults aged ≥65 years remains suboptimal. Vaccination campaigns targeting those at high risk of severe outcomes without routine physician engagement should be evaluated to improve uptake.