bluuebunny/crossref_metadata_2025_split huggingface dataset:
Trifecta versus Perimount Magna Ease aortic valves: Failure mechanisms
Authors: Suzuki Ryo , Ito Toshiro , Suzuki Masato , Ohori Shunsuke , Takayanagi Ryo , Miura Shiro 
Published: May 2022

Background There are increasing reports of early externally mounted pericardial Trifecta bioprosthesis failure. We compared the hemodynamic performance of Trifecta and Carpentier–Edwards Perimount Magna Ease valves to determine the failure mechanism. Methods We retrospectively included 270 consecutive patients (age: 73.4 ± 8.2 years; 57.5% male; mean follow-up: 48.0 ± 20.3 months) who underwent aortic valve replacement from 2014 to 2021 at a single center and compared the Trifecta ( N = 137) and Carpentier–Edwards Perimount Magna Ease valve ( N = 133) patients. Results The prosthetic valve major aortic regurgitation incidence was higher for the Trifecta than that for the Carpentier–Edwards Perimount Magna Ease valve (6.3% vs. 0%, P < 0.009). Among the Trifecta failures, 33% developed structural valve deterioration, but all requiring redo aortic valve replacement developed major prosthetic valve aortic regurgitation. Freedom at 5 years from redo aortic valve replacement due to structural valve deterioration was significantly lower for Trifecta (89.4% vs. 100%, P = 0.003). The reoperation hazards were determined for Trifecta (vs. Carpentier–Edwards Perimount Magna Ease): 11.6 (1.47–90.9; P = 0.02), prosthetic valve aortic regurgitation: 2.38 (1.70–3.32; P < 0.01), structural valve deterioration: 20.82 (4.08–106.2; P < 0.01), 5-year mean transprosthetic pressure gradient: 1.14 per 1-point increase (1.03–1.24; P = 0.007), and urgent surgery: 10.1 (2.59–39.0; P = 0.001). The Cox regression analysis identified that prosthetic valve aortic regurgitation solely contributed to redo aortic valve replacement (hazard ratio: 2.38; confidence intervals: 1.70–3.32). Conclusions Significantly, more early failures occurred with the Trifecta valve than the Carpentier–Edwards Perimount Magna Ease valve but the Trifecta showed reasonable mean transprosthetic pressure gradient over time. Prosthetic valve aortic regurgitation and calcific structural valve deterioration synergistically contributed to Trifecta valve failure alternatively.
Decreased Serum zinc, selenium, and vitamin E as possible risk factors of hepatic fibrosis in non-alcoholic fatty liver disease
Authors: Abdallah Ahmed Alamir Mahmoud , Abdelrahman Mona Mohammed , Attia Haitham Mohammad Al-Amir Shahat , Hafez Alshimaa , Anwar Rashed Shimaa , Amin Yasser Abdelkarim , Hemdan Shimaa Badawy 
Published: May 2022

Backgrounds The incidence of non-alcoholic fatty liver disease (NAFLD) has been significantly growing in recent years. Although the pathophysiology of fibrosis progression in NAFLD is not yet known, oxidative stress and inflammation have been known to have a major role in the development of NASH. Understanding the impact of micronutrients in NAFLD could potentially help us better understand NAFLD pathogenesis. Aims Assessing the serum levels of Zn, Se, and Vitamin E and their relation to the development of hepatic fibrosis in NAFLD patients. Methods This study included 80 NAFLD patients and 40 healthy controls. All of the patients were subjected to abdominal ultrasound and FibroScan examination (to estimate hepatic fibrosis and steatosis degree), and the serum levels of Zn, Se, and vitamin E were evaluated. Results A statistically significant difference in the serum levels of Zn and Se was observed between the NAFLD group and the control group (P-value = 0.04 and 0.05, respectively). The serum levels of Zn and Se were independently related to the presence of hepatic fibrosis in NAFLD. However, serum vitamin E was not related to the severity of NAFLD. Furthermore, no significant difference in the levels of Zn, Se, and vitamin E was observed between the different groups of NAFLD patients categorized according to the degree of steatosis and the control group. Conclusions Reduced serum levels of Zn and Se can be considered a possible risk factor for hepatic fibrosis in NAFLD. Deficiency in these micronutrients could play a role in the pathogenesis of NAFLD.
Evaluating Pelvis Rotation Style at Foot Contact: A Propensity Scored Biomechanical Analysis in High School and Professional Pitchers
Authors: Manzi Joseph E. , Zeitlin Jacob H. , Dowling Brittany , Roberts Nicholas , Ruzbarsky Joseph J. , Ciccotti Michael C. , Dines Joshua S. 
Published: May 2022

Background: Early pelvis rotation has been associated with decreased throwing arm kinetics and conventionally was considered a component of proper pitching form in baseball throwers. However, previous assessments of pelvis rotation style have not accounted for confounders such as playing level, anthropometric characteristics, or ball velocity and have not evaluated sufficient sample sizes. Purpose: To compare kinetic and kinematic parameters based on pelvis rotation style in high school and professional pitchers. Study Design: Descriptive laboratory study. Methods: High school and professional baseball pitchers threw 8 to 12 fastball pitches while being evaluated using 3-dimensional motion capture (480 Hz). These pitchers were 1:1 propensity score matched by age, height, weight, handedness, and ball velocity based on early (<60°) versus late (≥60°) pelvis rotation style at foot contact. A total of 26 kinematic and 10 kinetic parameters were compared between groups. The kinematic parameters were used to conduct a linear regression between early and late pelvis rotation at foot contact. Results: Pelvis rotation at foot contact was not significantly associated with ball velocity for either high school ( P = .243) or professional pitchers ( P = .075). No difference was found in elbow varus torque between high school early rotators (57.5 ± 14.9 N·m) and late rotators (51.3 ± 14.7 N·m; P = .036) and between professional early rotators (80.1 ± 11.8 N·m) and late rotators (79.0 ± 11.2 N·m; P = .663). At foot contact in high school pitchers, stride length increased by 2.1% of body height (B = −0.205; β = −0.470; P < .001), trunk rotation increased by 4.2° (B = −0.417; β = −0.488; P < .001), and trunk flexion at foot contact decreased by 4.4° (B = 0.442; β = 0.476; P < .001) with every 10° increase in pelvis rotation. At foot contact in professional pitchers, stride length increased by 2.3% of body height (B = –0.229; β = –0.478; P < .001), trunk rotation increased by 4.3° (B = –0.431; β = –0.515; P < .001), and trunk flexion decreased by 4.0° (B = 0.404; β = 0.373; P < .001) with every 10° increase in pelvis rotation. Conclusion: Pelvis rotation at foot contact was associated with several kinematic parameters in both groups and may influence mechanics further along the kinetic chain. Landing open or closed was not significantly associated with throwing arm kinetics or ball velocity for both high school and professional baseball pitchers, contrary to previous thought. Clinical Relevance: Coaches and players may better focus their efforts on refining other kinematic parameters for enhanced performance outcomes and safe pitching mechanics.
Disagreement in Pass Rates Between Strength and Performance Tests in Patients Recovering From Anterior Cruciate Ligament Reconstruction
Authors: Thompson Xavier D. , Bruce Amelia S. , Kaur Mandeep , Diduch David R. , Brockmeier Stephen F. , Miller Mark D. , Gwathmey F. Winston , Werner Brian C. , Hart Joe M. 
Published: May 2022

Background: Performance on strength and functional tests is often used to guide postoperative rehabilitation progress and return to activity decisions after anterior cruciate ligament reconstruction (ACLR). Clinicians may have difficulty in determining which criteria to follow if there is disagreement in performance outcomes among the tests. Purpose/Hypothesis: The purpose of this study was to compare pass rates between strength tests and single-leg hop (SLHOP) tests among men and women and between patients with lower and higher preinjury activity levels recovering from ACLR. We hypothesized that pass rates would be nonuniformly distributed among test types, sex, and activity level and that more participants would pass hop tests than strength tests. Design: Cross-sectional study; Level of evidence, 3. Methods: A total of 299 participants (146 men; 153 women)—at a mean of 6.8 ± 1.4 months after primary, unilateral, and uncomplicated ACLR (mean age, 23 ± 9.7 years; mean height, 172 ± 10.5 cm; mean mass, 75.8 ± 18.4 kg)—completed testing. Quadri.tif strength was evaluated using peak torque during isokinetic knee extension at 90 deg/s and 180 deg/s. Jump distance during the SLHOP and triple hop tests was measured (in cm). Strength and hop test measures were evaluated based on the limb symmetry index ((LSI) = (ACLR / contralateral side) × 100). We operationally defined “pass” as >90% on the LSI. Results: Pass rates were nonuniformly distributed between isokinetic knee extension at 90 deg/s and the SLHOP test ( χ2 = 18.64; P < .001). Disagreements between isokinetic testing at 90 deg/s and the SLHOP test occurred in 36.5% (109/299) of the participants. Among those who failed strength testing and passed hop testing, a greater portion reported higher activity levels before their injury ( χ2 = 6.90; P = .01); however, there was no difference in pass rates between men and women. Similar patterns of disagreement were observed between all strength test and hop test outcomes. Conclusion: ACLR patients with higher activity levels may be more likely to pass hop testing despite failing quadri.tif strength testing. This may be an indicator of movement compensations to achieve jump symmetry in the presence of quadri.tif weakness.
Testing an Extended Social Cognitive Model of Occupational Turnover Intentions
Authors: Salzmann Patrizia , Berweger Simone , Bührer Zippora 
Published: May 2022

Workforce shortages in the health and social care sectors are a relevant issue worldwide. One measure to mitigate workforce shortages is to improve working conditions and workers’ future prospects in order to encourage worker retention. Although studies have examined factors related to organizational turnover, less is known about the factors that lead to occupational turnover intentions. Drawing upon social cognitive career theory, this study examines the reasons behind health and social care workers’ occupational turnover intentions considering emotional exhaustion as an explanatory variable. The participants were 403 health and social care workers who responded to a questionnaire about 4 years after completing their vocational education and training at the upper-secondary level. Structural equation analyses revealed that affective occupational commitment showed the highest negative correlation with occupational turnover intentions. Furthermore, the results suggest that career-related outcome expectations, wellbeing, and supportive working conditions are crucial for designing effective interventions.
Ask depressed patients about brain fog to ensure melancholia is not mist
Authors: Parker Gordon 
Published: May 2022

Objective This study aims to highlight cognitive ‘brain fog’ as a key depression sub-typing symptom, being weighted to melancholic (as against non-melancholic) depression and note its common persistence after episode remission. Method This paper weights clinical observation but considers several salient overview papers and research findings. Results While ‘brain fog’ is intrinsically non-specific in that it has multiple causes, when assessed as a second-order depressive sub-typing symptom, it has seemingly distinctive specificity to the melancholic sub-type, with many patients with melancholia resonating with such a descriptor question. As it may persist (albeit attenuated) after episode remission, psychostimulant medication may be of benefit in some patients. Conclusion In the clinical assessment and differential diagnosis of those with a depressive disorder, inquiring into ‘brain fog’ can have distinct diagnostic benefit in differentiating melancholic and non-melancholic depression.
Clinical Efficacy of Soluble Thrombomodulin, Tissue Plasminogen Activator Inhibitor complex, Thrombin-Antithrombin complex,α2-Plasmininhibitor-Plasmin complex in Pediatric Sepsis
Authors: Li Juanzhen , Zhou Jingyi , Ren Hong , Teng Teng , Li Biru , Wang Ying , Xiang Long 
Published: May 2022

Objective To investigated the clinical efficacy of Soluble thrombomodulin (sTM), tissue plasminogen activator inhibitor complex (t-PAI·C),thrombin-antithrombin complex (TAT),α2-plasmininhibitor-plasmin complex (PIC) in pediatric sepsis and pediatrics sepsis-induced coagulopathy (pSIC). Methods We prospectively collected patient data with sepsis diagnosed in the PICU of Shanghai Children's Medical Center from June 2019 to June 2021. sTM,t-PAI·C, TAT,PIC and classical coagulation laboratory tests (CCTs) were evaluated on the day of sepsis diagnosis. Results Fifty-nine children were enrolled, There were significant differences in t-PAI·C (P = 0.001), Plt (P < 0.001), PT (P < 0.001), INR (P < 0.001), aPTT (P < 0.001), and TT (P = 0.048) between the pSIC and non-pSIC groups, logistic regression analysis showed that Plt (P = 0.032) was an independent risk factor for pSIC. Logistic regression analysis showed that sTM (P = 0.007) and Plt (P = 0.016) were independent risk factors for the outcome in pediatrics sepsis following discharge. The AUC of sTM combined with Plt on the mortality outcome of children with sepsis at discharge was 0.889 (95%CI: 0.781,0.956). which was better than that for PRISM III (AUC, 0.723), pSOFA (AUC, 0.764), and blood Lac (AUC, 0.717) when sepsis was diagnosed in the PICU. Conclusions The t-PAI·C increased in children with pSIC. The prediction of sepsis outcome using sTM combined with Plt was better than with PRISM III, pSOFA, or Lac.Further research is still needed in the future to explore the clinical value of sTM, TAT, PIC, and t-PAI·C in diagnosis and outcome of pediatrics sepsis and pSIC.
Platelet-Rich Plasma Versus Corticosteroid Injections for the Treatment of Mild-to-Moderate Carpal Tunnel Syndrome: A Markov Cost-Effectiveness Decision Analysis
Authors: Klifto Kevin M. , Klifto Christopher S. , Pidgeon Tyler S. , Richard Marc J. , Ruch David S. , Colbert Stephen H. 
Published: May 2022

Background: Platelet-rich plasma (PRP) or corticosteroid injections may be used to conservatively treat mild-to-moderate carpal tunnel syndrome (CTS). We evaluated the cost-effectiveness of PRP injections versus corticosteroid injections for the treatment of mild-to-moderate CTS. Methods: Markov modeling was used to analyze the base-case 45-year-old patient with mild-to-moderate CTS, unresponsive to conservative treatments, never previously treated with an injection or surgery, treated with a single injection of PRP, or methylprednisolone/triamcinolone 40 mg/mL. Transition probabilities were derived from level-I/II studies, utility values from the Tufts University Cost-Effectiveness Analysis Registry reported using visual analog scale (VAS), Boston Carpal Tunnel Questionnaire Symptom severity (BCTQ-S), and Boston Carpal Tunnel Questionnaire Functional status (BCTQ-F), and costs from Medicare, published studies, and industry. Analyses were performed from healthcare/societal perspectives. Outcomes were incremental cost-effectiveness ratios (ICER) and net monetary benefits (NMB). Willingness-to-pay thresholds were $50 000 and $100 000. Deterministic/probabilistic sensitivity analyses were performed. Results: From a healthcare perspective, compared to PRP injections, the ICER for corticosteroid injections measured by VAS: -$13.52/quality-adjusted-life-years (QALY), BCTQ-S: -$11.88/QALY, and BCTQ-F: -$16.04/QALY. PRP versus corticosteroid injections provided a NMB measured by VAS: $428 941.12 versus $375 788.21, BCTQ-S: $417 115.09 versus $356 614.18, and BCTQ-F: $421 706.44 versus $376 908.45. From a societal perspective, compared to PRP injections, the ICER for corticosteroid injections measured by VAS: -$1024.40/QALY, BCTQ-S: -$899.95/QALY, and BCTQ-F: -$1215.51/QALY. PRP versus corticosteroid injections provided a NMB measured by VAS: $428 171.63 versus $373 944.39, BCTQ-S: $416 345.61 versus $354 770.36, and BCTQ-F: $420 936.95 versus $375 064.63. Conclusions: PRP injections were more cost-effective than methylprednisolone/triamcinolone injections from healthcare and societal perspectives for mild-to-moderate CTS.
Impact of tobacco usage on readmission and complication rates following shoulder replacement surgery: A study of 164,527 patients
Authors: White Christopher A , Dominy Calista L , Tang Justin E , Pitaro Nicholas L , Patel Akshar V , Wang Kevin C , Kim Jun S , Cho Samuel K , Cagle Paul J 
Published: May 2022

Background Tobacco carcinogens have adverse effects on bone health and are associated with inferior outcomes following orthopedic procedures. The purpose of this study was to assess the impact tobacco use has on readmission and complication rates following shoulder arthroplasty. Methods The 2016–2018 National Readmissions Database was queried to identify patients who underwent anatomical, reverse, and hemi-shoulder arthroplasty. ICD-10 codes Z72.0 ×  (tobacco use disorder) and F17.2 ×  (nicotine dependence) were used to define “tobacco-users.” Demographic, 30-/90-day readmission, surgical complication, and medical complication data were collected. Inferential statistics were used to analyze complications for both the cohort as a whole and for each procedure separately (i.e. anatomical, reverse, and hemiarthroplasty). Results 164,527 patients were identified (92% nontobacco users). Tobacco users necessitated replacement seven years sooner than nonusers ( p < 0.01) and were more likely to be male (52% vs. 43%; p < 0.01). Univariate analysis showed that tobacco users had higher rates of readmission, revisions, shoulder complications, and medical complications overall. In the multivariate analysis for the entire cohort, readmission, revision, and complication rates did not differ based on tobacco usage; however, smokers who underwent reverse shoulder arthroplasty in particular were found to have higher 90-day readmission, dislocation, and prosthetic complication rates compared to nonsmokers. Conclusion Comparatively, tobacco users required surgical correction earlier in life and had higher rates of readmission, revision, and complications in the short term following their shoulder replacement. However, when controlling for tobacco usage as an independent predictor of adverse outcomes, these aforementioned findings were lost for the cohort as a whole. Overall, these findings indicate that shoulder replacement in general is a viable treatment option regardless of patient tobacco usage at short-term follow-up, but this conclusion may vary depending on the replacement type used.
Trend and correlates of under-5 mortality in Ethiopia: A multilevel model comparison of 2000–2016 EDHS data
Authors: Wolde Kibrealem Sisay , Bacha Reta Habtamu 
Published: May 2022

Objectives: The main objectives of this article were to answer (1) what is the trend of under-5 mortality from 2000 to 2016 Ethiopian Demographic and Health Survey? (2) What are the correlates that contribute to under-5 mortality in Ethiopia? Methods: The data used in this study were obtained from 2000, 2005, 2011, and 2016 Ethiopian Demographic and Health Survey data. We used multivariable three-level logistic regression model to predict under-5 mortality, with sex of a child, preceding birth interval, birth order, place of delivery, weight of child at birth, and plurality as first-level variables; mother’s education level, wealth index, mother’s age at first birth, and sex of household head as second-level variables; and residence and survey time as third-level variables. Results: The under-5 mortality declined from 166 deaths per 1000 live birth in 2000 to 67 deaths per 1000 live births in 2016. The odds of under-5 mortality among children with rural residence were 2.81 times greater than among children with urban residence. Moreover, the odds of under-5 mortality were higher among mothers who gave birth with preceding birth intervals of less than 24 months. A child whose preceding birth interval was less than 24 months had a 0.235, 0.174, 0.143, and 0.107 predicted probability of dying in the years 2000, 2005, 2011, and 2016, respectively. Conclusion: Child mortality varied across time in Ethiopia. Understanding both the time-varying nature of the correlates and changes in the type of their associations can help to explain some of the decreases in child mortality rates. Direction and/or presence of a relationship between these correlates and child mortality significantly interacted with time. Therefore, to mitigate the burden of under-5 mortality, the concerned body should provide awareness to the community.
“Who needs an app? Fertility patients’ use of a novel mobile health app”
Authors: Miner Skye A , Gelgoot Eden N , Lahuec Alix , Wunderlich Samantha , Safo Darryl , Brochu Felicia , Dawadi Shrinkhala , Robins Stephanie , Bernadette Siobhan , O’Connell Laura , Chan Peter , Ells Carolyn , Holzer Hananel , Lo Kirk , Mahutte Neal , Ouhilal Sophia , Rosberger Zeev , Tulandi Togas , Zelkowitz Phyllis 
Published: May 2022

Objective The number of couples experiencing infertility treatment has increased, as has the number of women and men experiencing infertility treatment-related stress and anxiety. Therefore, there is a need to provide information and support to both men and women facing fertility concerns. To achieve this goal, we designed a mhealth app, Infotility, that provided men and women with tailored medical, psychosocial, lifestyle, and legal information. Methods This study specifically examined how fertility factors (e.g. time in infertility treatment, parity), socio-demographic characteristics (e.g. gender, education, immigrant status), and mental health characteristics (e.g. stress, depression, anxiety, fertility-related quality of life) were related to male and female fertility patients’ patterns of use of the Infotility app. Results Overall, the lifestyle section of the app was the most highly used section by both men and women. In addition, women without children and highly educated women were more likely to use Infotility. No demographic, mental health or fertility characteristics were significantly associated with app use for men. Conclusion This study shows the feasibility of a mhealth app to address the psychosocial and informational needs of fertility patients.