bluuebunny/crossref_metadata_2025_split huggingface dataset:
The safety and effectiveness comparison of Delta Medical's PEEK interface screw and Endobutton and that of Smith & Nephew's in arthroscopic anterior cruciate ligament reconstruction: A multicenter prospective double-blind randomized controlled clinical trial
Authors: Gao Peng , Yuan Minghao , Xu Yongsheng , Wu Yufeng , Lin Xiaohang , Li Yanlin , Li Shensong , Wang Jing 
Published: November 2022

BackgroundTo reduce the costs and financial burden in the ACLR treatment, we compare the early clinical outcomes and Magnetic Resonance Imaging (MRI) results of Delta Medical's PEEK (polyether ether ketone) interference screw and EndoButton with those of Smith &amp; Nephew's PEEK interference screw and EndoButton in patients with arthroscopic anterior cruciate ligament reconstruction.MethodsA total of 104 patients in five different medical centers were randomly allocated into two groups: 1: Delta Medical's PEEK interference screw and EndoButton (53 patients); 2: Smith &amp; Nephew's PEEK interference screw and EndoButton (51 patients). The modified Lysholm knee score, the laxity examination, and clinical and functional range of motion were evaluated at 3 and 6 months postoperatively. The clinical effective rate was calculated and classified as excellent and good at 6 months postoperatively. MRI examinations were performed at 3 and 6 months postoperatively to determine the healing process. Computerized tomography (CT) was performed at 2 weeks and 3 months postoperatively to evaluate the complications.ResultsSignificant improvements in knee function and functional scores were observed in both groups after surgery regardless of the fixation materials applied (P &lt; 0.05). No differences were observed in the functional scores and range of motion. The assessments of Lysholm knee scores at 3 and 6 months produced no statistical differences (both P &gt; 0.05). The clinical effective rate revealed no difference between the groups at 6 months postoperatively (non-inferiority analysis P = 0.0220). The differences of laxity examination between the groups were not statistically significant (Fisher's test, P = 0.6139, 0.2004, respectively). No significant differences in the functional range of motion were found at each follow-up time-point (P &gt; 0.05). No major intra- or postoperative complications, such as infection, and vessel or nerve injury were observed.ConclusionsKnee function and functional scores were improved after ACLR in both groups, regardless of the PEEK interference screw and EndoButton applied. The difference in functional scores and range of motion were not significant in groups 1 and 2. Delta Medical's PEEK interference screw and EndoButton had a non-inferiority effect compared to Smith &amp; Nephew's PEEK interference screw and EndoButton. Delta Medical's PEEK interference screw and EndoButton were suitable for arthroscopic ACLR.
Psychological and sleep disturbances among first-line, second-line, and at home medical staff during the COVID-19 pandemic in Shanghai, China
Authors: Wang Ping , Shen Xiaolei , Jiang Yuhan , Wu Li , Shen Jun , Nie Xin , Chen Wei , Liu Jianren 
Published: November 2022

ObjectivesMedical workers are prone to psychological and sleep disturbances during the coronavirus disease 2019 (COVID-19) pandemic. Little is known about the varying degrees of influence among vaccinated medical staff working in different positions. The current study is aimed to evaluate and compare depression, anxiety and sleep disturbances among first-line, second-line and at home vaccinated medical staff during the COVID-19 pandemic in Shanghai, China.MethodsA cross-sectional online survey was conducted in May 2022. In addition to demographic data, levels of depression, anxiety, sleep quality, and insomnia were measured using the Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), Pittsburgh Sleep Quality Index (PSQI), and Athens Insomnia Scale (AIS).ResultsA total of 236 vaccinated medical workers completed the questionnaires, including 85 first-line medical staff (FMS), 82 second-line medical staff (SMS) and 69 at home medical staff (HMS). The proportions of depressive symptoms, anxiety symptoms, poor sleep quality, and insomnia were 52.1, 44.1, 55.9, and 49.2%, respectively. Compared with HMS, medical staff at work (FMS and SMS) got significantly higher frequency of poor sleep quality (both p &lt; 0.001), insomnia (both p &lt; 0.001), depressive (p &lt; 0.001 and p = 0.003, respectively) and anxiety symptoms (p &lt; 0.001 and p = 0.002, respectively). Compared with SMS, FMS were more likely to have poor sleep quality (p = 0.020). Besides, nurses got significantly higher percentage of poor sleep quality (OR = 1.352, p = 0.016) and insomnia (OR = 1.243, p = 0.041) than doctors. Whereas, the proportion of anxiety symptoms was increased in females than in males (OR = 2.772, p = 0.008).ConclusionsPsychological and sleep disturbances are common among medical staff at work during the COVID-19 pandemic. More psychological intervention should be administrated for FMS, especially for nurses.
Investigation and analysis of carbapenem-resistant gram-negative bacterial infection rates across hospitals in Shandong Province in China
Authors: Liu Keke , Xu Hua , Sun Jian , Liu Yuqing , Li Weiguang 
Published: November 2022

BackgroundThe increasing incidence of carbapenem-resistant bacterial infections has become a serious public health threat. This study aimed to investigate and analyze the current regional differences in carbapenem-resistant gram-negative bacteria (CRGN) in a major Province of China, and provide suggestions for preventing hospital infections.MethodsA questionnaire survey was used to obtain the current data on CRGN from 36 hospitals in Shandong Province, China, from 2019 to 2020. The association between the detection rates and discovery rates of CRGN and the use of antibacterial drugs was analyzed using Spearman's correlation coefficient. In addition, we compared the detection rates of CRGN and antibacterial drugs using hospitals categorized according to different levels and economic areas using the Kruskal-Wallis test.ResultsThe average detection rates of CRGN across the 36 hospitals varied from 1.91% to 66.04%. The discovery rate of carbapenem-resistant Enterobacteriaceae (CRE) and carbapenem-resistant Acinetobacter baumannii (CRAB) remained below 5‰, and that of carbapenem-resistant Pseudomonas aeruginosa (CRPA) was below 10‰. Except for CRAB, the correlations between the detection rate and antimicrobial drug use intensity and carbapenem drug use percentage were 0.11–0.29 and 0.31–0.47, respectively. Carbapenem drug use was higher in the provincial hospital group than in the prefecture-level hospitals (P &lt; 0.05), and that in the high-economic regional hospital group was higher than in the low-economic regional hospital group (P &lt; 0.05).ConclusionsThe detection and discovery rates of CRE were low, and those of CRAB were high in Shandong Province. Larger hospitals have higher carbapenem drug use. These results can be used as a reference for preventing CRGN infections in developing countries and provide a basis for regional carbapenem resistance prevention and control strategies.
The effectiveness of artificial intelligence-based automated grading and training system in education of manual detection of diabetic retinopathy
Authors: Qian Xu , Jingying Han , Xian Song , Yuqing Zhao , Lili Wu , Baorui Chu , Wei Guo , Yefeng Zheng , Qiang Zhang , Chunyan Chu , Cheng Bian , Kai Ma , Yi Qu 
Published: November 2022

BackgroundThe purpose of this study is to develop an artificial intelligence (AI)-based automated diabetic retinopathy (DR) grading and training system from a real-world diabetic dataset of China, and in particular, to investigate its effectiveness as a learning tool of DR manual grading for medical students.MethodsWe developed an automated DR grading and training system equipped with an AI-driven diagnosis algorithm to highlight highly prognostic related regions in the input image. Less experienced prospective physicians received pre- and post-training tests by the AI diagnosis platform. Then, changes in the diagnostic accuracy of the participants were evaluated.ResultsWe randomly selected 8,063 cases diagnosed with DR and 7,925 with non-DR fundus images from type 2 diabetes patients. The automated DR grading system we developed achieved accuracy, sensitivity/specificity, and AUC values of 0.965, 0.965/0.966, and 0.980 for moderate or worse DR (95 percent CI: 0.976–0.984). When the graders received assistance from the output of the AI system, the metrics were enhanced in varying degrees. The automated DR grading system helped to improve the accuracy of human graders, i.e., junior residents and medical students, from 0.947 and 0.915 to 0.978 and 0.954, respectively.ConclusionThe AI-based systemdemonstrated high diagnostic accuracy for the detection of DR on fundus images from real-world diabetics, and could be utilized as a training aid system for trainees lacking formal instruction on DR management.
A systematic review of the efficacy, effectiveness and cost-effectiveness of workplace-based interventions for the prevention and treatment of problematic substance use
Authors: Morse Ashleigh K. , Askovic Mina , Sercombe Jayden , Dean Kate , Fisher Alana , Marel Christina , Chatterton Mary-Lou , Kay-Lambkin Frances , Barrett Emma , Sunderland Matthew , Harvey Logan , Peach Natalie , Teesson Maree , Mills Katherine L. 
Published: November 2022

Employee alcohol and other drug use can negatively impact the workplace, resulting in absenteeism, reduced productivity, high turnover, and worksite safety issues. As the workplace can influence employee substance use through environmental and cultural factors, it also presents a key opportunity to deliver interventions, particularly to employees who may not otherwise seek help. This is a systematic review of workplace-based interventions for the prevention and treatment of problematic substance use. Five databases were searched for efficacy, effectiveness and/or cost-effectiveness studies and reviews published since 2010 that measured use of psychoactive substances (i.e., alcohol, cannabis, hallucinogens, inhalants, opioids, sedatives, hypnotics, anxiolytics, and stimulants) as a primary or secondary outcome, in employees aged over 18. Thirty-nine articles were identified, 28 describing primary research and 11 reviews, most of which focused solely on alcohol use. Heterogeneity between studies with respect to intervention and evaluation design limited the degree to which findings could be synthesized, however, there is some promising evidence for workplace-based universal health promotion interventions, targeted brief interventions, and universal substance use screening. The few studies that examined implementation in the workplace revealed specific barriers including lack of engagement with e-health interventions, heavy use and reluctance to seek help amongst male employees, and confidentiality concerns. Tailoring interventions to each workplace, and ease of implementation and employee engagement emerged as facilitators. Further high-quality research is needed to examine the effectiveness of workplace substance use testing, Employee Assistance Programs, and strategies targeting the use of substances other than alcohol in the workplace.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?RecordID=227598, PROSPERO [CRD42021227598].
Transition patterns of weight status: A cohort study of Chinese school-age children
Authors: Hu Xin , Tan Linglin , Wang Zhaoxin , Zhang Jing 
Published: November 2022

BackgroundChildhood overweight and obesity are increasing public concerns. However, little is known about the transition patterns of childhood weight status, especially in developing countries. In this study, we aimed to evaluate patterns of change in weight status and the risk factors among Chinese school-age children.MethodsThis retrospective cohort study included 2,334 children aged 6 years with complete 5-year (2012–2017) physical examination data in Minhang District, Shanghai. A time-homogeneous three-state Markov model was fit to the longitudinal data with dynamic outcomes (normal weight, overweight, and obesity).ResultsAccording to the Markov model, 42.3% of school-age children who were initially overweight transitioned to another weight status within 1 year, with 24.8% (95% confidence interval [CI]: 23.1, 27.0) transitioning to normal weight and 17.5% (95% CI: 15.9, 19.3) becoming obese. In contrast, children who were initially normal weight (92.9% [95% CI: 92.3, 93.5]) or obese (83.1% [95% CI: 81.1, 84.8]) tended to maintain their initial weight status. Male sex, semi-urban area, absence of late adiposity rebound, lower annual height increments, higher annual weight increments, and higher initial body mass index were significantly associated with a higher risk of developing or maintaining overweight and obesity (p &lt; 0.05).ConclusionsThe weight status of Chinese school-age children is more likely to change among those who are initially overweight than in those who are initially obese. Interventions to promote healthy weight status may be more effective if key groups are targeted, such as overweight and pre-school-age children.
Age-specific transmission dynamic of mumps: A long-term large-scale modeling study in Jilin Province, China
Authors: Yang Tianlong , Wang Yao , Zhao Qinglong , Guo Xiaohao , Yu Shanshan , Zhao Zeyu , Deng Bin , Huang Jiefeng , Liu Weikang , Su Yanhua , Chen Tianmu 
Published: November 2022

ObjectivesDespite the adoption of a new childhood immunization program in China, the incidence of mumps remains high. This study aimed to describe the epidemiological characteristics of mumps in Jilin Province from 2005 to 2019 and to assess the transmissibility of mumps virus among the whole population and different subgroups by regions and age groups.MethodsThe Non-age-specific and age-specific Susceptible–Exposed–Pre-symptomatic–Infectious–Asymptomatic–Recovered (SEPIAR) models were fitted to actual mumps incidence data. The time-varying reproduction number (Rt) was used to evaluate and compare the transmissibility.ResultsFrom 2005 to 2019, a total of 57,424 cases of mumps were reported in Jilin Province. The incidence of mumps was the highest in people aged 5 to 9 years (77.37 per 100,000). The two SEPIAR models fitted the reported data well (P &lt; 0.01). The median transmissibility (Rt) calculated by the two SEPIAR models were 1.096 (range: 1.911 × 10−5–2.192) and 1.074 (range: 0.033–2.114) respectively. The age-specific SEPIAR model was more representative of the actual epidemic of mumps in Jilin Province from 2005–2019.ConclusionsFor mumps control, it is recommended that mumps-containing vaccines (MuCV) coverage be increased nationwide in the 5–9 years age group, either by a mumps vaccine alone or by a combination of vaccines such as measles-mumps-rubella (MMR) vaccine. The coverage of vaccines in Jilin Province should be continuously expanded to establish solid immunity in the population. China needs to redefine the optimal time interval for MuCV immunization.
Robotic versus open extended cholecystectomy for T1a–T3 gallbladder cancer: A matched comparison
Authors: Yang Jun , Li Enliang , Wang Cong , Luo Shuaiwu , Fu Zixuan , Peng Jiandong , Liao Wenjun , Wu Linquan 
Published: November 2022

BackgroundThe feasibility and safety of robotic extended cholecystectomy (REC) are still uncertain. This study was performed to compare the short- and long-term outcomes of REC with those of open extended cholecystectomy (OEC) for T1a–T3 gallbladder cancer.MethodsFrom January 2015 to April 2022, 28 patients underwent REC in our center. To minimize any confounding factors, a 1:2 propensity score-matching analysis was conducted based on the patients’ demographics, liver function indicators, T stage, and symptoms. The data regarding demographics, perioperative outcomes, and long-term oncologic outcomes were reviewed.ResultsThe visual analogue scale score was significantly lower in the REC than OEC group immediately postoperatively (3.68 ± 2.09 vs. 4.73 ± 1.85, P = 0.008), on postoperative day 1 (2.96 ± 1.75 vs. 3.69 ± 1.41, P = 0.023), and on postoperative day 2 (2.36 ± 1.55 vs. 2.92 ± 1.21, P = 0.031). In addition, the REC group exhibited a shorter time to first ambulation (P = 0.043), a shorter time to drainage tube removal (P = 0.038), and a shorter postoperative stay (P = 0.037), but hospital costs were significantly higher in the REC group (P &lt; 0.001). However, no statistically significant difference was found in the operation time (P = 0.134), intraoperative blood loss (P = 0.467), or incidence of postoperative morbidity (P = 0.227) or mortality (P = 0.289) between the REC and OEC groups. In regard to long-term outcomes, the 3-year disease-free survival rate was comparable between the OEC and REC groups (43.1% vs. 57.2%, P = 0.684), as was the 3-year overall survival rate (62.8% vs. 75.0%, P = 0.619).ConclusionREC can be an effective and safe alternative to OEC for selected patients with T1a–T3 gallbladder cancer with respect to short- and long-term outcomes.
Risk factor score for the prediction of central compartment lymph node metastasis in papillary thyroid carcinoma and its clinical significance
Authors: Pan Xiaojia , Li Qinghuai 
Published: November 2022

ObjectiveTo establish the criteria for a risk factor score (RFS) for predicting the probability of central compartment lymph node metastasis (LNM) in papillary thyroid carcinoma (PTC) and to explore the clinical significance of the RFS.MethodsThe data of 412 patients with PTC who underwent surgical resection between May 2013 and July 2016 were retrospectively analysed and divided into two groups: a central LNM group and a non-central LNM group. In each group, the frequency of six risk factors was documented: sex, age, tumour size, extracapsular spread (ECS), tumour multifocality, and tumour location. The maximum likelihood method of discriminant analysis was adopted to calculate patient scores for the six risk indicators. In addition, the data of 104 patients with PTC admitted between July 2016 and December 2016 were prospectively analysed using this method and these six risk factors. A higher score represented one certain possibility that was the more appropriate for one patient.ResultsIn the retrospective group, the result was as follows: 129 patients with positive (+) lymph nodes in the central compartment and 168 patients with negative (−) lymph nodes in the central compartment, which was in line with the actual results. In the prospective group, there were 28 patients with positive lymph nodes in the central compartment and 48 patients with negative lymph nodes in the central compartment. The coincidence rates using the RFS were 71.9% for the retrospective group and 73.1% for the prospective group.ConclusionBy simple and quantitative analyses of the presence of central LNM, the RFS is of great significance when choosing surgical approaches and postoperative individual-based treatment plans, as well as when determining the prognosis of central compartment LNM in patients with PTC.
Safety and efficacy of extracorporeal shock wave lithotripsy vs. flexible ureteroscopy in the treatment of urinary calculi: A systematic review and meta-analysis
Authors: Lv Guangda , Qi Wenqiang , Gao Han , Zhou Yongheng , Zhong Minglei , Wang Kai , Liu Yunxing , Zhang Qiang , Zhou Changkuo , Li Yan , Zhang Lingling , Zhang Dongqing 
Published: November 2022

ObjectiveThis study aims to compare the safety and efficacy of extracorporeal shock wave lithotripsy (SWL) and flexible ureteroscopy lithotripsy (f-URS) in treating urinary tract stones.MethodsWe systematically searched PubMed, Embase, and Cochrane for literature comparing SWL with f-URS. The primary outcomes we focused on were stone-free rate (SFR) and complications; the secondary outcomes were operation time, hospital stay, retreatment rate, number of sessions, and auxiliary procedures rate. We used ReviewManager version 5.4.1 and STATA version 14.2 for meta-analysis.ResultsSeventeen studies with a total of 2,265 patients were included in the meta-analysis, including 1,038 patients in the SWL group and 1,227 patients in the f-URS group. The meta-analysis indicated that patients in the f-URS group had higher SFR than those in the SWL group [odds ratio (OR): 2.00, 95% confidence interval (CI): 1.29–3.12, p = 0.002]. In addition, we found no significant difference in complications (OR: 1.08, 95% CI: 0.85–1.37) between the two treatments. Also, we found that the retreatment rate and the auxiliary procedure rate in the f-URS group were significantly lower than those in the SWL group (OR: 0.08, 95% CI: 0.02–0.24, p &lt; 0.00001; OR: 0.30, 95% CI: 0.11–0.83, p = 0.02). Moreover, the number of sessions in the f-URS group was significantly lower than that in the SWL group [mean difference (MD): −1.96, 95% CI: −1.55 to −0.33, p = 0.003]. However, the operation time and hospital stay in the f-URS group were significantly longer than those in the SWL group (MD: 11.24, 95% CI: 3.51–18.56, p = 0.004; MD: 1.14, 95% CI: 0.85–1.42, p &lt; 0.00001).ConclusionFor 1–2-cm urinary stones, f-URS can achieve a higher SFR than SWL while having a lower retreatment rate, number of sessions, and auxiliary procedure rate. For urinary stones &lt;1 cm, there was no significant difference in SFR between SWL and f-URS groups. The SWL group has a shorter operative time and hospital stay than the f-URS group.
Biomechanical effects of cement discoplasty on the lumbar spinal unit
Authors: Huang Jiajun , Zeng Weike , Li Ming , Cheng Ziying , Huang Junshen , Liang Changchun , Li Yuxi , Huang Lin 
Published: November 2022

BackgroundPercutaneous cement discoplasty (PCD) is used to treat patients with low back and leg pain due to the intervertebral disc vacuum phenomena. Whether PCD can restore lumbar spinal stability remains unknown.ObjectiveThe purpose of our in vitro study was to evaluate the biomechanical changes brought about by PCD.MethodsEight fresh pig lumbar spines were tested in the following order: intact, after nucleotomy, and after discoplasty. Flexion/extension, lateral bending, and axial rotation were induced by pure moments. The range of motion and neutral zone were recorded. A CT scan was performed to assess the injection volume of the bone cement and to observe whether the bone cement was fractured. After removing the facet joint, a compression failure test was conducted to observe the fracture of bone cement.ResultsCompared with nucleotomy, range of motion (ROM) after discoplasty was reduced only in lateral flexion (P &lt; 0.05). The results of the neutral zone showed that the neutral zones in flexion–extension and lateral bending were significantly reduced after discoplasty (P &lt; 0.05). The neutral zone was more sensitive to changes in lumbar stability than ROM. Bone cement slides were observed during the biomechanical test. The CT scan and compression failure test showed that bone cement fracture was more likely to occur at the puncture channel in the annulus fibrosus region.ConclusionIn all, the biomechanical study indicates that discoplasty helps enhance the stability of the lumbar spine in flexion–extension and lateral bending, which explains how PCD works for low back pain. Fractures and sliding of bone cement were observed after discoplasty, and this was more likely to occur at the puncture channel in the annulus fibrosus region. This suggests that bone cement displacement after PCD may cause nerve compression.