bluuebunny/crossref_metadata_2025_split huggingface dataset:
Adapting the Australian Environmental Assessment Tool—High Care (EAT-HC): Experiences and Practical Implications From Germany, Japan, and Singapore
Authors: Fahsold Anne , Brennan Sumiyo , Doan Therese , Sun Joanna , Palm Rebecca , Verbeek Hilde , Holle Bernhard 
Published: September 2022

Background: Assessing the built environment in nursing homes is part of several established instruments. Measurements are primarily published in English, so there is a need for cross-cultural adaptation to be able to use them in other countries. This procedure should be carried out alongside translation guidelines to ensure successful adaptation not only for assessments that capture complex constructs, such as the built environment, but also for assessments to be applied in healthcare in general. Objective: This article presents different approaches to adopt the Australian Environmental Assessment Tool—High Care (EAT-HC) based on the World Health Organization (WHO) guidelines for instrument translation. The comparison of these processes should provide implications for further adaptations of the instrument. Methods: The adaptation processes carried out in Germany, Japan, and Singapore were compared using thematic analysis. Steps taken to achieve linguistic validation and to adopt the tool were analyzed qualitatively in the context of overarching needs for adjustment. Results: Every perspective adapted the WHO guidelines for their respective purposes of applying the EAT-HC. The order of steps varied, but elements to validate the results with the instruments’ creators and to ensure validity were included in all three countries. For items that might be challenging, we detected possible reasons that might help future adaptors manage this process more efficiently. Conclusion: The EAT-HC benefits from adaptation alongside the WHO guidelines in terms of enhancing the quality of translation and feasibility of application. Individual supplementary adaptation steps allow the identification of culture-specific needs for application in other countries.
A real-time algorithm for the detection of compensatory movements during reaching
Authors: Averell Edward , Knox Don , van Wijck Frederike 
Published: September 2022

Introduction: Interactive game systems can motivate stroke survivors to engage with their rehabilitation exercises. However, it is crucial that systems are in place to detect if exercises are performed correctly as stroke survivors often perform compensatory movements which can be detrimental to recovery. Very few game systems integrate motion tracking algorithms to monitor performance and detect such movements. This paper describes the development of algorithms which monitor for compensatory movements during upper limb reaching movements in real-time and provides quantitative metrics for health professionals to monitor performance and progress over time. Methods: A real-time algorithm was developed to analyse reaching motions in real-time through a low-cost depth camera. The algorithm segments cyclical reaching motions into component parts, including compensatory movement, and provides a graphical representation of task performance. Healthy participants ( n = 10) performed reaching motions facing the camera. The real-time accuracy of the algorithm was assessed by comparing offline analysis to real-time collection of data. Results: The algorithm’s ability to segment cyclical reaching motions and detect the component parts in real-time was assessed. Results show that movement types can be detected in real time with accuracy, showing a maximum error of 1.71%. Conclusions: Using the methods outlined, the real-time detection and quantification of compensatory movements is feasible for integration within home-based, repetitive task practice game systems for people with stroke.
Is the future scarless? – Fibroblasts as targets for scarless wound healing: a narrative review
Authors: Parry Dylan , Allison Keith 
Published: September 2022

Introduction: Scarless healing is the ideal outcome of wound healing and is exhibited in some species. This narrative review assembles the current understanding of fibroblast heterogenicity along with the latest fibroblast-related targets for scar reduction therapies. Human regenerative wound healing is deemed possible due to the wound regeneration already seen in the early gestation foetus. Methods: This literature narrative review was undertaken by searching PubMed and Web of Science databases and Google Scholar to find articles concerning the fibroblast involvement in wound healing. We evaluated and collated these articles to form a consensus of the current understanding of the field. Discussion: This article describes current understanding of fibroblast heterogenicity and involvement in wound healing, focusing on the role of fibroblasts during physiological scarring. We also present the current most promising targets involving fibroblasts in the reduction of scarring and how we can manipulate the behaviour of fibroblasts to mimic the wound regeneration models in the human foetus. These targets include the pro-fibrotic EN1 positive fibroblast lineage, TGFβ1 inhibition, and genetic therapies utilising miRNAs and siRNAs. Conclusion: No therapies are currently available to eradicate scarring; however, treatment options are available to reduce the appearance of scarring. Further research into the heterogenicity and interactions of fibroblasts in both the foetus and adult is needed, and this may lead to the development of novel treatments against scarring. Lay Summary Scarless healing refers to the repair of a wound with minimal residual scarring. The main cell responsible for the repair process is the fibroblast. It is now understood that there are different types of fibroblasts. Simply, some of these fibroblasts lead to scarring and some lead to regeneration. The early human foetus has mainly regenerative fibroblasts, but during aging the number of scarring fibroblasts increase to become the majority in the adult . Understanding how we can modify this process may ultimately result in the reduction in scarring. Currently, scar reduction therapies are aimed at optimal wound healing, surgical removal of abnormal scars, and using steroids and other drugs to encourage better wound repair by limiting the effect of scarring fibroblasts. Future therapies aim to target specific groups of fibroblasts to encourage regenerative wound healing. This narrative review aims to cover the current understanding of the different groups of fibroblasts and their effect on wound healing. We also cover the current and potential therapies that can be used to reduce scarring and suggest further areas for research in this field.
Biomechanical Comparisons of Trochanteric Hip Fracture Fixation Using Short-, Mid-, and Long-Length Proximal Femoral Nails
Authors: Matsumura Tomohiro , Takahashi Tsuneari , Ae Ryusuke , Takeshita Katsushi 
Published: September 2022

Introduction For trochanteric hip fractures, proximal femoral nails (PFNs) have been frequently used for surgical treatment. No study has clarified whether length of the nail affected the wiper motion; the repetitive motion of the distal nail inside canal after surgery. Methods Thirty synthetic femora were used to biomechanically evaluate construct lateral angular movement of 3 different lengths of PFN [TFN-ADVANCED Proximal Femoral Nailing System (TFNA) 170 (short-length), 235 (mid-length), and 300 (long-length) mm] constructs for the fixation of stable pertrochanteric fractures. Cyclic testing and radiological evaluation were performed to investigate the loosening patterns in 3 different fixation constructs. Migration along the mechanical axis during the cyclic testing from 1-100th, 100-500th, 500-1000th, 1000-1500th, and 1500-2000th cycles was compared between TFNA lengths. Also, before and after cycling changes in tip to apex distance, angulation of fracture line, and lateral angular movement of the distal stem inside the canal were compared between TFNA lengths. Results Migration along the mechanical axis during cyclic loading, plus changes after cycling in tip to apex distance, and fracture line angulation did not differ between TFNA lengths for the fixation of stable intertrochanteric fracture model using synthetic femora. Conversely, one-way analysis of variance revealed a significant difference in lateral angular movement of the distal stem inside the canal after cyclic testing between groups (1.4 ± 1.6°, .21 ± .35°, and .26 ± .57° in 170-mm short nail, 235-mm middle nail, and 300-mm long nail, respectively; P = .026), and post-hoc analysis also revealed that middle nail yielded significantly less lateral angular movement compared with short nail ( P = .047) but did not significantly differ from the long nail. Conclusions Mid-length TFNA for the fixation of stable trochanteric hip fracture model using synthetic femora resulted in significantly smaller lateral angular movement of the distal stem after cyclic loading.
Multi-Level Posterior Cervical Foraminotomy Associated With Increased Post-operative Infection Rates and Overall Re-Operation Relative to Anterior Cervical Discectomy With Fusion or Cervical Disc Arthroplasty
Authors: Ng Mitchell K. , Kobryn Andriy , Baidya Joydeep , Nian Patrick , Emara Ahmed K. , Ahn Nicholas U. , Houten John K. , Saleh Ahmed , Razi Afshin E. 
Published: September 2022

Study Design Retrospective Cohort Study Objective Cervical radiculopathy meeting operative criteria has traditionally been managed using anterior cervical discectomy and fusion (ACDF). However, cervical disc arthroplasty (CDA) and posterior cervical foraminotomy (PCF) are also reasonable options. This study aimed to assess differences in postoperative outcomes among patients undergoing multi-level ACDF, CDA, or PCF comparing medical/surgical complications and healthcare utilization parameters. Methods Patients who underwent multi-level ACDF, CDA, or PCF between 2012 and 2019 were identified from the American College of Surgeons National Surgical Quality Improvement Project (ACS-NSQIP) database. Patients were stratified based on procedure type and propensity score matched to resolve baseline differences. ANOVA was performed to identify differences in medical complications, surgical complications, and healthcare utilization metrics. Results A total of 31 344 patients who underwent an eligible procedure were identified (ACDF: n = 28 089, CDA: n = 1748, PCF: n = 1507), and 684 patients remained in each group following propensity score matching. Patients undergoing multi-level PCF were found to experience longer lengths of hospital stay (PCF: 1.67 ± 1.61 days, ACDF: 1.50 ± 1.32 days, CDA: 1.27 ± 1.05 days, P < .001), higher rates of reoperation (PCF: 3.2%, ACDF: 1.0%, CDA: .4%, P = .020), superficial infection (PCF: 1.3%, ACDF: .3%, CDA: .1%, P = .008) and deep infection (PCF: 1.2%, ACDF: 0%, CDA: 0%, P < .001). There were no outcome differences between multi-level ACDF and CDA. Conclusions Patients undergoing multi-level PCF were at increased risk for longer hospital stay, re-operation, and infection relative to those undergoing ACDF and CDA. Future research should aim to uncover the precise mechanisms underlying these complications, as well as analyze long term outcomes. Level of Evidence III
Effect of Different Adhesive Strategies on the Microshear Bond Strength of Calcium-Silicate-Based Materials
Authors: Gürcan Aliye Tuğçe , Şişmanoğlu Soner , Sengez Görkem 
Published: September 2022

Aim: To evaluate the microshear bond strength (µSBS) of mineral trioxide aggregate and Biodentine to various resin-based materials using different adhesive strategies. Materials and Methods: Three resin-based materials—a self-adhering resin composite with or without acid etching (Vertise flow; Kerr, Orange, CA, USA), a conventional flowable composite with a total-etch adhesive (Filtek Ultimate Flowable; 3M ESPE, St. Paul, MN, USA), and a flowable resin-modified glass ionomer cement (RMGIC) without any surface modification (Ionoseal; VOCO GmbH, Cuxhaven, Germany)—and two calcium-silicate-based materials—Biodentine and BIOfactor mineral trioxide aggregate (MTA)—were tested. A total of 100 cylindrical acrylic molds were prepared. Biodentine and BIOfactor MTA were prepared and placed into the central holes on the molds. Specimens were divided into two main groups according to materials and into five subgroups ( n = 10). µSBS were evaluated using a µSBS testing device. The failure modes were examined under a stereomicroscope with magnification. They were categorized as adhesive, cohesive, or mixed. Data were analyzed using two-way analysis of variance (ANOVA) and Tukey test. The significance level was taken as α = 0.05. Results: It was observed that both calcium-silicate-based material type and resin-based material type influenced the µSBS significantly according to two-way ANOVA. Biodentine exhibited higher bond strength values than MTA. However, no statistically significant interaction was demonstrated between these factors ( P = .396). The µSBS values of intermediate materials to Biodentine and MTA were listed from the lowest to the highest as follows: RMGIC < Acid Etch + RMGIC < SARC (self-adhering resin composite) < FC (flowable composite) < Acid Etch + SARC. Conclusion: Self-adhering composites can be used on calcium-silicate-based materials in vital pulp treatments because of their mechanical properties. Acid-etching ensures high µSBS values. Although the µSBS of Biodentine were higher than MTA according to this study’s results, there was no statistically significant difference in µSBS of FC and acid-etched SARC to MTA.
Correlation of Delayed Gadolinium-Enhanced MRI of Cartilage (dGEMRIC) Value With Hip Arthroscopy Intraoperative Findings and Midterm Periacetabular Osteotomy Outcomes
Authors: Lee Jessica H. , Houck Darby A. , Gruizinga Brandt A. , Garabekyan Tigran , Jesse Mary K. , Kraeutler Matthew J. , Mei-Dan Omer 
Published: September 2022

Background: Delayed gadolinium-enhanced magnetic resonance imaging of cartilage (dGEMRIC) is an advanced imaging technique that is purported to quantify cartilage damage in acute and chronic joint disease and predict periacetabular osteotomy (PAO) outcomes. There is a paucity of literature relating dGEMRIC values to arthroscopic findings before PAO and postoperative outcomes after PAO. Purpose: To assess the utility and validity of dGEMRIC as a preoperative and prognostic assessment tool of cartilage status and integrity as it relates to intraoperative findings and midterm postoperative outcomes after PAO. Study Design: Case series; Level of evidence, 4. Methods: We analyzed a cohort of 58 patients (70 hips) with a median age of 30.1 years (range, 15-50) with hip dysplasia who underwent hip arthroscopy, followed by a PAO with preoperative dGEMRIC. The primary outcome measures were intraoperative assessment and correlation with cartilage damage (presence of cartilage flap, Outerbridge grade of the acetabulum and femoral head). Secondary outcome measures were postoperative patient-reported outcome (PRO) scores, including the International Hip Outcome Tool and Non-arthritic Hip Score. Correlation analyses were performed to determine the relationship between dGEMRIC values and (1) PROs and (2) intraoperative assessment of cartilage damage. Results: There were significant negative linear relationships between dGEMRIC values and the primary outcome measures: presence of a cartilage flap (coronal, P = .004; sagittal, P < .001), Outerbridge grade of acetabular articular cartilage lesion (coronal, P = .002; sagittal, P = .003), and Outerbridge grade of femoral head articular cartilage lesion (coronal, P = .001; sagittal, P < .001). Despite significant overall improvement in all patients, there was no significant correlation between preoperative dGEMRIC values and improvement in PROs from presurgery to latest postoperative follow-up (median, 2.2 years; range, 1.0-5.0 years). Conclusion: Although dGEMRIC values (sagittal and coronal) were significant predictors of the intraoperative presence of cartilage flaps and overall cartilage integrity, they were not associated with midterm outcomes after PAO.
Effect of a Condensed NBA Season on Injury Risk: An Analysis of the 2020 Season and Player Safety
Authors: Morikawa Landon H. , Tummala Sailesh V. , Brinkman Joseph C. , Buckner Petty Skye A. , Chhabra Anikar 
Published: September 2022

Background: Health and safety concerns surrounding the coronavirus 2019 (COVID-19) pandemic led the National Basketball Association (NBA) to condense and accelerate the 2020 season. Although prior literature has suggested that inadequate rest may lead to an increased injury risk, the unique circumstances surrounding this season offer a unique opportunity to evaluate player safety in the setting of reduced interval rest. Hypothesis: We hypothesized that the condensed 2020 NBA season resulted in an increased overall injury risk as compared with the 2015 to 2018 seasons. Study Design: Descriptive epidemiology study. Methods: A publicly available database, Pro Sports Transactions, was queried for injuries that forced players to miss ≥1 game between the 2015 and 2020 seasons. Data from the 2019 season were omitted given the abrupt suspension of the league year. All injury incidences were calculated per 1000 game-exposures (GEs). The primary outcome was the overall injury proportion ratio (IPR) between the 2020 season and previous seasons. Secondary measures included injury incidences stratified by type, severity, age, position, and minutes per game. Results: A total of 4346 injuries occurred over a 5-season span among 2572 unique player-seasons. The overall incidence of injury during the 2020 season was 48.20 per 1000 GEs but decreased to 39.97 per 1000 GEs when excluding COVID-19. Despite this exclusion, the overall injury rate in 2020 remained significantly greater (IPR, 1.42 [95% CI, 1.32-1.52]) than that of the 2015 to 2018 seasons (28.20 per 1000 GEs). On closer evaluation, the most notable increases seen in the 2020 season occurred within minor injuries requiring only a 1-game absence (IPR, 1.53 [95% CI, 1.37-1.70]) and in players who were aged 25 to 29 years (IPR, 1.57 [95% CI, 1.40-2.63]), averaging ≥30.0 minutes per game (IPR, 1.67 [95% CI, 1.47-1.90]), and playing the point guard position (IPR, 1.67 [95% 1.44-1.95]). Conclusion: Players in the condensed 2020 NBA season had a significantly higher incidence of injuries when compared with the prior 4 seasons, even when excluding COVID-19–related absences. This rise is consistent with the other congested NBA seasons of 1998 and 2011. These findings suggest that condensing the NBA schedule is associated with an increased risk to player health and safety.
The Relationship Between Nursing Care Delivery Models, Emotional Exhaustion, and Quality of Nursing Care Among Jordanian Registered Nurses
Authors: Abusamra Ammar , Rayan Ahmad Hussien , Obeidat Rana F. , Hamaideh Shaher H. , Baqeas Manal Hassan , ALBashtawy Mohammed 
Published: September 2022

Background Inappropriately selected models of nursing care delivery and emotional exhaustion of nurses at work not only affect the nurses’ health, but also the health of their patients. Purpose To examine the relationship between nursing care delivery models, nurses’ emotional exhaustion, and quality of nursing care. Methods A cross-sectional survey that used a convenience sampling technique was employed. A total of 160 participants completed the study. Participants provided information about nursing care delivery models, nurses, emotional exhaustion, and quality of nursing care. Results Participants had a moderate level of emotional exhaustion. No statistically significant difference in the scores of quality of nursing care and emotional exhaustion were found according to the type of care delivery model ( P > .05). Emotional exhaustion was significantly and negatively correlated with the (nursing staff characteristics) subscale of quality of nursing care ( r = −.183, P = .021). There was a significant difference in emotional exhaustion in regard to shift duty, marital status, education level, years of experience, salary, and working area). Only marital status significantly predicted emotional exhaustion ( t = 2.57, B = −8.98, P = .011). Conclusions Quality of nursing care was associated with nurses’ emotional exhaustion rather than models of nursing care delivery. As nurses’ emotional exhaustion could negatively affect the quality of nursing care, addressing the emotional exhaustion of nurses is important to improve patient outcomes.
Multimorbidity of communicable and non-communicable diseases in low- and middle-income countries: A systematic review
Authors: Kaluvu Lucy , Asogwa Ogechukwu Augustina , Marzà-Florensa Anna , Kyobutungi Catherine , Levitt Naomi S , Boateng Daniel , Klipstein-Grobusch Kerstin 
Published: September 2022

Objective The aim of this systematic review is to analyse existing evidence on prevalence, patterns, determinants, and healthcare challenges of communicable and non-communicable disease multimorbidity in low- and middle-income countries (LMICs). Methods PubMed, Cochrane, and Embase databases were searched from 1st January 2000 to 31st July 2020. The National Institute of Health (NIH) quality assessment tool was used to critically appraise studies. Findings were summarized in a narrative synthesis. The review was registered with PROSPERO (CRD42019133453). Results Of 3718 articles screened, 79 articles underwent a full text review of which 11 were included for narrative synthesis. Studies reported on 4 to 20 chronic communicable and non-communicable diseases; prevalence of multimorbidity ranged from 13% in a study conducted among 242,952 participants from 48 LMICS to 87% in a study conducted among 491 participants in South Africa. Multimorbidity was positively associated with older age, female sex, unemployment, and physical inactivity. Significantly higher odds of multimorbidity were noted among obese participants (OR 2.33; 95% CI: 2.19–2.48) and those who consumed alcohol (OR 1.44; 95% CI: 1.25–1.66). The most frequently occurring dyads and triads were HIV and hypertension (23.3%) and HIV, hypertension, and diabetes (63%), respectively. Women and participants from low wealth quintiles reported higher utilization of public healthcare facilities. Conclusion The identification and prevention of risk factors and addressing evidence gaps in multimorbidity clustering is crucial to address the increasing communicable and non-communicable disease multimorbidity in LMICs. To identify communicable and non-communicable diseases trends over time and identify causal relationships, longitudinal studies are warranted.