bluuebunny/crossref_metadata_2025_split huggingface dataset:
Proximal humeral fractures in Finland
Authors: Leino Oskari K. , Lehtimäki Kaisa K. , Mäkelä Keijo , Äärimaa Ville , Ekman Elina 
Published: December 2021

Aims Proximal humeral fractures (PHFs) are common. There is increasing evidence that most of these fractures should be treated conservatively. However, recent studies have shown an increase in use of operative treatment. The aim of this study was to identify the trends in the incidence and methods of treatment of PHFs in Finland. Methods The study included all Finnish inhabitants aged ≥ 16 years between 1997 and 2019. All records, including diagnostic codes for PHFs and all surgical procedure codes for these fractures, were identified from two national registers. Data exclusion criteria were implemented in order to identify only acute PHFs, and the operations performed to treat them. Results During the 23-year study period, 79,676 PHFs were identified, and 14,941 operations were performed to treat them. The incidence of PHFs steadily increased. In 2019, the overall incidence was 105 per 100,000 person-years (105). The sex-adjusted incidence for females was 147.1 per 105, and the age-adjusted incidence for patients aged ≥ 80 years was 407.1 per 105. The incidence of operative treatment for PHFs rose during the first half of the study period and decreased during the second half. The use of plate osteosynthesis in particular decreased. In 2019, the incidence of operative treatment for PHFs was 13.2 per 105, with 604 operations. Conclusion Although the incidence of PHFs is steadily increasing, particularly in elderly females, the incidence of operative treatment is now decreasing, which is in line with current literature regarding their treatment. Cite this article: Bone Joint J 2022;104-B(1):150–156.
How does the community COVID-19 level of risk impact on that of a care home?
Authors: Nightingale Glenna , Laxton Megan , Illian Janine B. 
Published: December 2021

Objectives
To model the risk of COVID-19 mortality in British care homes conditional on the community level risk.

Methods
A two stage modeling process (“doubly latent”) which includes a Besag York Mollie model (BYM) and a Log Gaussian Cox Process. The BYM is adopted so as to estimate the community level risks. These are incorporated in the Log Gaussian Cox Process to estimate the impact of these risks on that in care homes.

Results
For an increase in the risk at the community level, the number of COVID-19 related deaths in the associated care home would be increased by exp (0.833), 2. This is based on a simulated dataset. In the context of COVID-19 related deaths, this study has illustrated the estimation of the risk to care homes in the presence of background community risk. This approach will be useful in facilitating the identification of the most vulnerable care homes and in predicting risk to new care homes.

Conclusions
The modeling of two latent processes have been shown to be successfully facilitated by the use of the BYM and Log Gaussian Cox Process Models. Community COVID-19 risks impact on that of the care homes embedded in these communities.
Shifting gender norms to improve HIV service uptake: Qualitative findings from a large-scale community mobilization intervention in rural South Africa
Authors: Leddy Anna M. , Gottert Ann , Haberland Nicole , Hove Jennifer , West Rebecca L. , Pettifor Audrey , Lippman Sheri A. , Kahn Kathleen , Mathebula Rhandzekile , Rebombo Dumisani , Gómez-Olivé Xavier , Twine Rhian , Peacock Dean , Pulerwitz Julie 
Published: December 2021

Background
Interventions to improve HIV service uptake are increasingly addressing inequitable and restrictive gender norms. Yet comparatively little is known about which gender norms are most salient for HIV testing and treatment and how changing these specific norms translates into HIV service uptake. To explore these questions, we implemented a qualitative study during a community mobilization trial targeting social barriers to HIV service uptake in South Africa.

Methods
We conducted 55 in-depth interviews in 2018, during the final months of a three-year intervention in rural Mpumalanga province. Participants included 25 intervention community members (48% women) and 30 intervention staff/community-opinion-leaders (70% women). Data were analyzed using an inductive-deductive approach.

Results
We identified three avenues for gender norms change which, when coupled with other strategies, were described to support HIV service uptake: (1) Challenging norms around male toughness/avoidance of help-seeking, combined with information on the health and preventive benefits of early antiretroviral therapy (ART), eased men’s fears of a positive diagnosis and facilitated HIV service uptake. (2) Challenging norms about men’s expected control over women, combined with communication and conflict resolution skill-building, encouraged couple support around HIV service uptake. (3) Challenging norms around women being solely responsible for the family’s health, combined with information about sero-discordance and why both members of the couple should be tested, encouraged men to test for HIV rather than relying on their partner’s results. Facility-level barriers such as long wait times continued to prevent some men from accessing care.

Conclusions
Despite continued facility-level barriers, we found that promoting critical reflection around several specific gender norms, coupled with information (e.g., benefits of ART) and skill-building (e.g., communication), were perceived to support men’s and women’s engagement in HIV services. There is a need to identify and tailor programming around specific gender norms that hinder HIV service uptake.
The effect of hearing aids on cognitive function: A systematic review
Authors: Sanders Maxime E. , Kant Ellen , Smit Adriana L. , Stegeman Inge 
Published: December 2021

Rationale
Dementia currently affects 50 million people globally with this expected to triple by 2050. Even though hearing loss is associated with cognitive decline, the underlying mechanisms are not fully understood. Considering hearing loss is the largest modifiable risk factor for developing dementia, it is essential to study the effect of hearing aids on cognitive function.

Objective
To systematically review the existing literature to examine the evidence for using hearing aids intervention as a treatment for deteriorating cognitive function.

Design
A search of PubMed, Cochrane Library, Embase and grey literature was conducted revealing 3060 unique records between 1990–2020. Two reviewers independently selected longitudinal studies observing the effects of hearing aids on cognitive function in persons without dementia at onset of the study. Due to the heterogeneity of the data, a meta-analysis could not be performed. Outcomes are described in a summary of findings table and portrayed diagrammatically.

Results
We identified 17 unique studies, spanning 30 years of research and 3526 participants. The included studies made use of 50 different cognitive function tests. These tests were grouped into separate cognitive domains according to the DSM-V classification for further analysis. The most beneficial impact of hearing aids seems to be in the cognitive domain of executive function, with six studies showing improvement, two studies being inconclusive and three studies not demonstrating a significant effect. Three of five studies demonstrated significant improvement when screening for brief mental status. The least beneficial impact is seen in domain of complex attention, with eight studies showing no significant effects, compared with one demonstrating improvement with intervention.

Conclusions
Based on this systematic review, we conclude that there is controversy about the effects of hearing aids on cognition. Additional research through randomized clinical trials with standardized cognitive assessment and longer follow-up is warranted to further elucidate this relationship.
Comparison of urine proteome among rat models by intraperitoneal injection with single bacteria and co-injection with two bacteria
Authors: Meng Wenshu , Zhao Chenyang , Gao Youhe 
Published: December 2021

PurposeTo explore and compare urine proteome changes among rat models by intraperitoneal injection with single bacteria and co-injection with two bacteria.MethodEscherichia coliandStaphylococcus aureusare two common human pathogens. Three rat models were established: (i) the intraperitoneal co-injection ofE.coliandS.aureusmodel (ES model), (ii) intraperitoneal injection ofE.colimodel (E model), and (iii) intraperitoneal injection ofS.aureusmodel (S model). Urinary proteomes on days 0, 1 and 2 of the three models were analyzed by liquid chromatography coupled with tandem mass spectrometry (LC-MS/MS).ResultsA total of 111, 34 and 94 differential proteins were identified in the ES model, E model and S model, respectively. Among them, some differential proteins were reported to be associated with bacterial infection. Approximately 47% differential proteins in the E model overlapped with ES model, and 37% differential proteins in the S model overlapped with ES model. Compared with the E model and S model, a total of 71 unique differential proteins were identified in the ES model.ConclusionOur results indicated that (1) the urine proteome could distinguish different bacterial intraperitoneal injections models and (2) the effects of co-injection with two bacteria on the urine proteome were not simple superposition of single injection.
Response to self-care practice messages among patients with diabetes mellitus visiting Jimma University medical center facility based cross sectional design application of extended parallel process model
Authors: Abawari Mohammed Jemal , Amdisa Demuma , Birhanu Zewdie , Kebede Yohannes 
Published: December 2021

ObjectiveTo determine response to self-care practice message among patients with diabetes in Jimma University Medical center based on the Extended Parallel Process Model.DesignA facility-based cross-sectional study was conducted.SettingJimma University Medical Center is found in Jimma town.ParticipantsA total of 343 patients with diabetes participated in the study; making a response rate of 93.9%. All patients with diabetes who were 18 years and above and who were on follow up and registered were included in the study and those with Gestational DM were excluded.Data analysisMultivariable logistic regression analysis.ResultResponsive respondents scored high in self-care practice score as compared to other respondents. educational status, information sources, knowledge, and preferred message appeals were independent predictors of controlling the danger of diabetes.ConclusionThere is a significant gap in controlling the danger of diabetes. Variables like the level of education, knowledge of diabetes mellitus, information sources, and message appeals were independent predictors of controlling the danger of diabetes. Designing message having higher efficacy while maintaining the level of threat is the best that fits the existing audience’s message processing to bring about desired diabetic self-care Practice.
Mild anemia and 11- to 15-year mortality risk in young-old and old-old: Results from two population-based cohort studies
Authors: Galbussera Alessia A. , Mandelli Sara , Rosso Stefano , Zanetti Roberto , Rossi Marianna , Giacomin Adriano , Detoma Paolo , Riva Emma , Tettamanti Mauro , Porta Matteo G. Della , Lucca Ugo 
Published: December 2021

Background
Mild anemia is a frequent although often overlooked finding in old age. Nevertheless, in recent years anemia has been linked to several adverse outcomes in the elderly population. Objective of the study was to investigate the association of mild anemia (hemoglobin concentrations: 10.0–11.9/12.9 g/dL in women/men) with all-cause mortality over 11–15 years and the effect of change in anemia status on mortality in young-old (65–84 years) and old-old (80+ years).

Methods
The Health and Anemia and Monzino 80-plus are two door-to-door, prospective population-based studies that included residents aged 65-plus years in Biella municipality and 80-plus years in Varese province, Italy. No exclusion criteria were used.

Results
Among 4,494 young-old and 1,842 old-old, mortality risk over 15/11 years was significantly higher in individuals with mild anemia compared with those without (young-old: fully-adjusted HR: 1.35, 95%CI, 1.15–1.58; old-old: fully-adjusted HR: 1.28, 95%CI, 1.14–1.44). Results were similar in the disease-free subpopulation (age, sex, education, smoking history, and alcohol consumption adjusted HR: 1.54, 95%CI, 1.02–2.34). Both age groups showed a dose-response relationship between anemia severity and mortality (P for trend <0.0001). Mortality risk was significantly associated with chronic disease and chronic kidney disease mild anemia in both age groups, and with vitamin B12/folate deficiency and unexplained mild anemia in young-old. In participants with two hemoglobin determinations, seven-year mortality risk was significantly higher in incident and persistent anemic cases compared to constant non-anemic individuals in both age groups. In participants without anemia at baseline also hemoglobin decline was significantly associated with an increased mortality risk over seven years in both young-old and old-old. Limited to the Monzino 80-plus study, the association remained significant also when the risk was further adjusted also for time-varying covariates and time-varying anemia status over time.

Conclusions
Findings from these two large prospective population-based studies consistently suggest an independent, long-term impact of mild anemia on survival at older ages.
How are trial outcomes prioritised by stakeholders from different regions? Analysis of an international Delphi survey to develop a core outcome set in gastric cancer surgery
Authors: Alkhaffaf Bilal , Metryka Aleksandra , Blazeby Jane M. , Glenny Anne-Marie , Williamson Paula R. , Bruce Iain A. ,   on behalf of the GASTROS International Working Group
Published: December 2021

Background
International stakeholder participation is important in the development of core outcome sets (COS). Stakeholders from varying regions may value health outcomes differently. Here, we explore how region, health income and participant characteristics influence prioritisation of outcomes during development of a COS for gastric cancer surgery trials (the GASTROS study).

Methods
952 participants from 55 countries participating in a Delphi survey during COS development were eligible for inclusion. Recruits were grouped according to region (East or West), country income classification (high and low-to-middle income) and other characteristics (e.g. patients; age, sex, time since surgery, mode of treatment, surgical approach and healthcare professionals; clinical experience). Groups were compared with respect to how they categorised 56 outcomes identified as potentially important to include in the final COS (‘consensus in’, ‘consensus out’, ‘no consensus’). Outcomes categorised as ‘consensus in’ or ‘consensus out’ by all 3 stakeholder groups would be automatically included in or excluded from the COS respectively.

Results
In total, 13 outcomes were categorised ‘consensus in’ (disease-free survival, disease-specific survival, surgery-related death, recurrence of cancer, completeness of tumour removal, overall quality of life, nutritional effects, all-cause complications, intraoperative complications, anaesthetic complications, anastomotic complications, multiple organ failure, and bleeding), 13 ‘consensus out’ and 31 ‘no consensus’. There was little variation in prioritisation of outcomes by stakeholders from Eastern or Western countries and high or low-to-middle income countries. There was little variation in outcome prioritisation within either health professional or patient groups.

Conclusion
Our study suggests that there is little variation in opinion within stakeholder groups when participant region and other characteristics are considered. This finding may help COS developers when designing their Delphi surveys and recruitment strategies. Further work across other clinical fields is needed before broad recommendations can be made.
Patient and retina specialists’ preferences in neovascular age-related macular degeneration treatment. A discrete choice experiment
Authors: Gallego-Pinazo Roberto , Pina-Marin Begoña , Comellas Marta , Aceituno Susana , Gómez-Baldó Laia , Blanch Carles ,   on behalf of the AMD-Manage investigators
Published: December 2021

Introduction and objective
Neovascular age-related macular degeneration (nAMD) leads to severe and permanent visual impairment, significantly impacting patients’ quality of life and functional independence. Although treatment with anti- vascular endothelial growth factor (VEGF) prevents and, in some cases, reverses visual damage, the need for frequent monitoring visits and intravitreal injections represents a significant burden on patients, caregivers and retina specialists.

Objective
To elicit preferences for nAMD treatment characteristics from the perspectives of patients and retina specialists.

Method
A discrete choice experiment was conducted. Participants (patients > 50 years with nAMD receiving anti-VEGF drugs for at least 2 years and without previous experience with anti-VEGF and retina specialists working in the Spanish National Healthcare System) were asked to select one of two hypothetical treatments resulting from the combination of five attributes (effects on visual function, effects on retinal fluid, treatment regimen, monitoring frequency, and cost); their levels were identified by reviewing the literature and two focus groups. The relative importance (RI) given to each attribute was estimated using a mixed logit model. The marginal rates of substitution (MRS) were calculated taking cost as the risk attribute.

Results
A total of 110 patients (P) [aged 79.0 (SD:7.4) years; 57.3% women; 2.3 (SD:0.7) years with nAMD; 2.1 years (SD:0.1) in treatment] and 66 retina specialists (RS) participated in the study. Participants gave greater RI to improvements in their visual function [60.0% (P); 52.7% (RS)], lower monitoring frequency [20.2% (P); 27.1% (RS)] and reduction in retinal fluid [9.8% (P); 13.0%(RS)]. Patients and retina specialists would agree to an increase in cost by 65.0% and 56.5%, respectively, in exchange for improvements of visual function; and 25.5% and 43.3% on delaying monitoring frequency by one month.

Conclusions
Efficacy of treatment, in terms of visual function improvements, is the main driver for treatment election for both patients and retina specialists. Treatment monitoring requirements are also considered, mainly from the retina specialist’s perspective. These results suggest that the use of more efficacious anti-VEGF agents with a longer duration of action may contribute to aligning treatment characteristics with patients/specialists’ preferences. A better alignment would facilitate better disease management, fulfilling the unmet needs of patients and retina specialists.
COVID-positive ankle fracture patients are at increased odds of perioperative surgical complications following open reduction internal fixation surgery
Authors: Mercier Michael R. , Galivanche Anoop R. , Brand Jordan P. , Pathak Neil , Medvecky Michael J. , Varthi Arya G. , Rubin Lee E. , Grauer Jonathan N. 
Published: December 2021

Introduction
Ankle fractures have continued to occur through the COVID pandemic and, regardless of patient COVID status, often need operative intervention for optimizing long-term outcomes. For healthcare optimization, patient counseling, and care planning, understanding if COVID-positive patients undergoing ankle fracture surgery are at increased risk for perioperative adverse outcomes is of interest.

Methods
The COVID-19 Research Database contains recent United States aggregated insurance claims. Patients who underwent ankle fracture surgery from April 1st, 2020 to June 15th, 2020 were identified. COVID status was identified by ICD coding. Demographics, comorbidities, and postoperative complications were extracted based on administrative data. COVID-positive versus negative patients were compared with univariate analyses. Propensity-score matching was done on the basis of age, sex, and comorbidities. Multivariate regression was then performed to identify risk factors independently associated with the occurrence of 30-day postoperative adverse events.

Results
In total, 9,835 patients undergoing ankle fracture surgery were identified, of which 57 (0.58%) were COVID-positive. COVID-positive ankle fracture patients demonstrated a higher prevalence of comorbidities, including: chronic kidney disease, diabetes, hypertension, and obesity (p<0.05 for each). After propensity matching and controlling for all preoperative variables, multivariate analysis found that COVID-positive patients were at increased risk of any adverse event (odds ratio [OR] = 3.89, p = 0.002), a serious adverse event (OR = 5.48, p = 0.002), and a minor adverse event (OR = 3.10, p = 0.021).

Discussion
COVID-positive patients will continue to present with ankle fractures requiring operative intervention. Even after propensity matching and controlling for patient factors, COVID-positive patients were found to be at increased risk of 30-day perioperative adverse events. Not only do treatment teams need to be protected from the transmission of COVID in such situations, but the increased incidence of perioperative adverse events needs to be considered.
Practical Methods of GIS for Archaeologists: Viewshed Analysis – The Kingdom of Pylos example
Authors: Malaperdas George D. 
Published: December 2021

Visibility (or Viewshed) Analysis in archeology is a function given through GIS, in purpose to contribute in the field of archaeology and especially in landscape archeology, by reconstituting the visual panorama of a study area of the past. The concept of landscape archeology is a multidimensional research process that is not limited to archaeologists but places a special emphasis on a multidisciplinary approach. Mycenaean Messenia was the area of study and analysis of the visual panorama for two important reasons. First of all, it is a large area, which presents territories of varying heterogeneity in terms of morphology, while having a large sea front and an open observation horizon. Secondly, it is one of the continental regions of the Mycenaean period, which has evoked the largest number of residential facilities, structures and tombs, and also has been extensively studied by archaeologists since the 1920s. The main aim of this paper is to make an effort to identify archaeological information, through the bibliographic references of the archaeologists who studied the area, with the GIS visibility analysis. For that reason, the author tries for those residential locations that have been assigned a role or function of the site by archaeologists, such as an observation station, to be controlled in parallel and on the basis of new technologies (GIS and Viewshed Analysis) if this view is verified.