bluuebunny/crossref_metadata_2025_split huggingface dataset:
Dental Arch Relationship Outcomes of 5-Year-Olds Born With Unilateral Cleft Lip and Palate Following the Centralization of Cleft Services
Authors: Alattar Batol K. , Ireland Anthony J. , Sandy Jonathan R. , Fowler Peter V. 
Published: February 2025

To investigate the interdental arch relationship outcomes of 5-year-old children with unilateral cleft lip and palate (UCLP) before and after centralization of cleft services in the United Kingdom (UK) using the modified Huddart-Bodenham index (MHBI) and to investigate any differences in MHBI by cleft laterality. Retrospective cross-sectional study. Evaluation of three-dimensional study models of children with a complete UCLP. All available 5-year-old orthodontic study models of participants with UCLP from the precentralization Clinical Standard Advisory Group (CSAG n = 107) and postcentralization cleft care UK (CCUK n = 195) studies. The models were also grouped by cleft laterality (left and right sided). Differences between the interdental arch relationship outcomes were assessed using the MHBI. This index scored the buccal/palatal or labial/palatal relationships of 8 maxillary deciduous teeth with the opposing mandibular dentition. The anterior segment, buccal cleft segment, and noncleft segment scores were calculated and combined to calculate the MBHI total arch scores. Inter and intraexaminer reliability demonstrated high levels of agreement. Statistically significant differences in the anterior segment, buccal noncleft segment, and total arch MHBI scores were found, with postcentralization CCUK performing better. Right-sided UCLP had statistically significantly better buccal cleft segments, but no differences were found for the other MBHI segments or total arch scores. There were improved interdental arch relationships postcentralization of cleft services in the United Kingdom. Cleft laterality differences were limited to the buccal cleft segment with right-sided UCLP having better MBHI scores.
Impact of Hypoalbuminemia on Clinical Outcomes in Patients Receiving Cefazolin for Methicillin-Susceptible Staphylococcus aureus Bacteremia
Authors: Whitenack Kaylee M. , Ilges Dan , Epps Kevin L. , McGary Alyssa , Robinson John C. 
Published: February 2025

Background: Cefazolin is a preferred treatment option for methicillin-susceptible Staphylococcus aureus (MSSA) bacteremia. Recent studies have suggested a potential impact on clinical outcomes in patients with hypoalbuminemia treated with highly protein-bound antimicrobials. Objective: The purpose of this study was to determine if there are any differences in clinical outcomes between normoalbuminemic and hypoalbuminemic patients treated with cefazolin for bacteremia. Methods: A retrospective, multicentered cohort study of patients hospitalized between 2019 and 2023 with MSSA bacteremia treated with cefazolin for at least 24 hours prior to culture clearance. Patients were divided into hypoalbuminemia (serum albumin ≤2.5 mg/dL) or normoalbuminemia groups. The primary outcome was time to culture clearance. Results: Of 69 patients included (50 in normoalbuminemia group and 19 in hypoalbuminemia group), the most common sources of bacteremia were line-related, osteoarticular, and infective endocarditis. Deep-seated infections were present in 24% of the normoalbuminemia group and 58% of the hypoalbuminemia group. Patients with hypoalbuminemia had a significantly longer mean hospital length of stay (12 vs 7 days, P = 0.016). After adjusting for deep-seated infection, hypoalbuminemia was associated with increased time to culture clearance by 1.2 days ( P = 0.039). In-hospital mortality was significantly higher in the hypoalbuminemia group (26% vs 4%, P = 0.015). Conclusion and Relevance: Limited research is available describing the relationship between serum albumin levels and clinical outcomes. Our study suggests patients with hypoalbuminemia treated with cefazolin for MSSA bacteremia have significantly longer time to culture clearance, increased mortality, and longer length of stay.
The Clinical Impact of Heart Failure on the Postoperative Outcomes for Lung Cancer Patients Undergoing Lobectomy and Sublobar Resection by Video-Assisted Thoracic Surgery: A Propensity Score-Matched Analysis of 2016-2020 HCUP-NIS Data
Authors: He Xiaoying , Wu Weibin , Wang Yan , Xiao Jingyi , Feng Juanjuan , Hong Hua , Chen Yue , Huang Rong , Guan Hongyu , Li Hai 
Published: February 2025

Background: The clinical impact of heart failure (HF) on postoperative outcomes following video-assisted thoracic surgery (VATS) for lung cancer resection remains controversial. This study aimed to assess patient and hospital characteristics related to the type of surgery, as well as the independent impact of HF on surgical outcomes. Methods: We conducted a retrospective analysis using data from the National Inpatient Sample database. A total of 20 693 patients aged 18 years or older, diagnosed with lung cancer, and undergoing lobectomy or sublobar resection via VATS between 2016 and 2020 were included. Patients were stratified based on the presence of HF. The HF-present cohorts were matched to HF-absent controls using a 1:2 nearest-neighbor propensity score-matching (PSM) analysis. The matched cohorts were then compared across several endpoints, including mortality, length of stay (LOS), hospitalization costs, and postoperative complications. Results: After PSM, the study included 1781 patients who underwent lobectomy and 1157 who underwent sublobar resection, with 594 and 386 patients, respectively, having concurrent HF. In both the lobectomy and sublobar resection groups, patients with HF demonstrated significantly higher in-hospital mortality rates ( P < .001), longer LOS ( P < .001), increased total hospital charges ( P < .001), and a greater risk for overall postoperative complications ( P < .001). Conclusions: Among patients with lung cancer undergoing VATS, the presence of HF is associated with an increased risk of postoperative complications. This finding underscores the necessity for enhanced monitoring and care for patients with HF should be treated during the postoperative recovery phase.
Extensor Tendon Rupture After Distal Ulna Resection: A Multicenter Case Series
Authors: Wong Megan N. , Brown Chelsea R. , Vaghani Parth , Goyal Kanu S. 
Published: February 2025

Background: The Darrach procedure, comprising distal ulna resection, has been used to treat numerous wrist and distal radioulnar joint pathologies. Extensor tendon rupture from the proximal ulnar stump is a recognized, but lesser known postoperative complication. We present this case series of extensor tendon ruptures following Darrach procedures and their subsequent reconstructions to share different surgeon experiences with this complication. Methods: Patients with extensor tendon rupture after Darrach procedure were identified from contributing hand surgeon case logs. The treating surgeons shared demographic data and surgical case details pertinent to this study. A single patient experience is presented as the representative case, with the remaining patient experiences summarized in a table. Results: Seven patients were included. Nearly all patients underwent intraoperative capsular closure following distal ulna resection, and their extensor tendon ruptures were treated with revision surgeries. Conclusion: While rarely reported in the literature, treating surgeons should be aware of extensor tendon rupture as a possible complication after Darrach procedure.
Genetic diversity analysis of some Vaccinium species in the Black Sea region of Türkiye using iPBS markers
Authors: Gleku Olivet Delasi , Sultana Nusrat , Serçe Sedat 
Published: February 2025

Background The genus Vaccinium is economically significant for its highly nutritious berries. Türkiye hosts wild genetic resources of Vaccinium, primarily distributed along the Black Sea region. These species are valuable for crop improvement, local food security, and require urgent conservation efforts. Objectives This study analyzed the genetic diversity, population structure, and gene flow among wild Vaccinium species in Türkiye using iPBS retrotransposon markers. Methods A total of 22 individuals from three wild Vaccinium species ( V. arctostaphylos, V. myrtillus, V. uliginosum) and two domesticated cultivars were analyzed using 10 iPBS markers. Genetic diversity was assessed based on polymorphic bands, Shannon's index, and gene flow. Cluster analysis (UPGMA), principal component analysis (PCoA), and STRUCTURE analysis were performed to evaluate population structure. Results Out of 312 bands, 177 (56%) were polymorphic, with the highest bands (32) produced by iPBS2391. Low genetic diversity (Shannon's index = 0.14–0.2) and moderate gene flow (0.3) were observed. AMOVA revealed 49% of variance within individuals and 51% among species. Distinct clusters were identified, though some individuals showed high admixture and heterozygosity, forming separate clusters. Conclusion These findings provide insights into the genetic diversity and population structure of Turkish wild Vaccinium species, offering valuable information for conservation strategies and berry cultivation efforts worldwide.
Effect of Taurine Combined With Creatine on Repeated Sprinting Ability After Exhaustive Exercise Under Hot and Humid Conditions
Authors: Yu Peiqi , Fan Yongzhao , Wang Xiangyu , Wu Hao 
Published: February 2025

Background: Taurine (TAU) and creatine (Cr) are common ergogenic aids used by athletes to enhance performance; however, the effect of their combined supplementation, and on recovery in high temperature and humidity environments, has not been studied. Hypothesis: Combined TUA and Cr will have greater effect on physiological indicators and repetitive sprint performance recovery after exhaustive exercise under hot and humid conditions than single supplementation or placebo. Study Design: Single-blind crossover randomized controlled study. Level of Evidence: Level 2. Methods: Participants (12 sports students) were assigned randomly to 1 of 4 supplementation intervention groups: placebo (P), taurine (T), creatine (C), or taurine + creatine (T+C). Exercise protocol included exhaustion tests and repeated sprinting exercises were conducted in a laboratory environment at 35 °C/65% relative humidity. Heartrate, blood lactate (BLa), tympanic temperature, thermal sensation, and rating of perceived exertion were monitored throughout. Heartrate variability, time to exhaustion (TTE), reaction time, and countermovement jump (CMJ) height were tracked before and after exhaustion exercise and before sprint exercise. Results: TTE was significantly higher in the T+C group than in the P group ( P = 0.04). BLa and tympanic temperature increased rapidly in all 4 conditions, then decreased gradually, and T group peak values were higher than those of P group ( P = 0.04; P < 0.01). CMJ decreased in the C and T+C groups ( P = 0.04; P = 0.04) after exhaustive exercise, unlike other groups ( P > 0.05). Indicators of repeated sprint exercise, peak power, mean power, and power decrement showed a decreasing trend within groups but no difference between groups ( P > 0.05). Conclusion: In this small student group, under hot and humid conditions, T+C supplementation significantly enhanced TTE. Clinical Relevance: TAU, Cr, and their combined supplementation do not significantly improve repeated sprint performance after exhaustive exercise under hot and humid conditions.
Understanding Older Adults’ Intention to Use Telehealth: A Qualitative Study Using the UTAUT Framework
Authors: Fleischer Anne , Lowman Joneen , Strader Kristen 
Published: February 2025

Introduction/Objectives: As healthcare embraces telehealth, a need exists to understand factors that promote older adults’ telehealth usage, including the influence of age-related sensory impairments. The objective of this study was to describe older adults’ perceptions of telehealth and factors they considered before using telehealth within the framework of The Unified Theory of Acceptance and Use of Technology (UTAUT). Methods: This descriptive qualitative study collected data through semi-structured interviews. Twenty-four older adults were randomly selected from a pool of 103 participants who completed the initial UTAUT survey study. Individual interviews were conducted by telephone. Reflective thematic analysis was used to identify themes within the UTAUT construct that influence older adults’ use of telehealth. Results: Older adults identified preparedness, receptiveness, and willingness to use telehealth as important overarching factors to consider when using telehealth. These are connected to the UTAUT constructs: facilitating conditions, social influence, effort expectancy, and performance expectancy. Conclusions: This study supports UTAUT as an appropriate framework for assessing telehealth readiness and predicting behavioral intention to use telehealth. Our findings provide limited evidence that sensory impairments do not impact telehealth readiness unless the individual lacks appropriate adaptations.
An Evaluation of the Decline in Primary Care Physician Visits, 2010 to 2021
Authors: Jetty Anuradha , Ezran Marie , Huffstetler Alison N. , Jabbarpour Yalda 
Published: February 2025

Introduction: Primary care is the backbone of the United States healthcare system, yet it continues to be underfunded and inaccessible to many. Previous studies explored primary care visit patterns until 2016, leaving gaps in our understanding of how recent factors like state Medicaid expansions, the Coronavirus Disease 2019 (COVID-19) pandemic, and population growth have influenced these patterns. Hence, the objective of the current study was to analyze the trends in primary care visits provided by outpatient clinicians over time and by visit type and contextualize study findings within the changing healthcare landscape. Methods: The Medical Expenditure Panel Survey data (2010-2021) were used to examine trends in the total number and share of ambulatory, preventive, acute, and chronic care visits and investigate sociodemographic factors associated with a given clinician visit. The outcome variable was the clinician type: Primary Care Physicians (PCPs), Internal Medicine (IM) subspecialists, and Nurse Practitioners or Physician Assistants or Registered Nurses (NP/PA/RNs). Explanatory variables included gender, age, race/ethnicity, education, region of respondent’s residence, income-to-poverty ratio, insurance coverage, number of chronic conditions, and survey year. Univariate, bivariate, and multinomial logistic regression analyses were performed. Results: The visits led by PCPs and IM subspecialists declined by 43% and 23% between 2010 and 2021, respectively. However, visits led by NP/PA/RNs increased by 98%. From 2010 to 2021, the proportion of preventive care visits provided by PCPs, IMs, and NP/PA/RNs increased by 25%, 7%, and 4%, respectively. PCPs provided fewer acute and chronic care visits in 2021 than in 2010. Regression analyses illustrated that relative to Non-Hispanic White patients, non-White patients had a higher likelihood of seeing PCPs. Patients reporting 1 chronic condition were more likely to obtain care from an IM or NP/PA/RN than a PCP. In contrast, those with 2 or more chronic conditions had a greater propensity to see PCP than NP/PA/RN. Conclusion: Despite a growing need for primary care services, the decrease in visits to PCPs is concerning and requires further examination. The declining trends in acute and chronic care visits raise questions as to whether primary care, in its current form, can continue to provide its essential attributes and services.
Improved Biomechanical Performance of Tibial Spine Fracture Repair With Suture and Anchor Fixation in Pediatric Cadaveric Knees
Authors: Johnstone Thomas M. , Hollyer Ian , McFarlane Kelly , Alayeh Amin , Tompkins Marc , Ganley Theodore , Yen Yi-Meng , Ellis Henry B. , Chan Calvin K. , Green Daniel W. , Sherman Seth L. , Shea Kevin G. 
Published: February 2025

Background: Prior studies in porcine and adult human bone suggest that suture fixation is superior to screw fixation of pediatric tibial spine fractures (TSFs). However, we have previously demonstrated that 2-suture repair was biomechanically comparable with 2-screw repair in human pediatric cadaveric knees. Purpose: To evaluate whether TSF fixation with sutures attached to anchors placed in stronger metadiaphyseal bone would produce biomechanically superior repair to 2-screw and 2-suture constructs. Study Design: Controlled laboratory study. Methods: Six pediatric cadaveric knees were acquired. We applied the same TSF creation protocol used in our previous study, then repaired the fractures by passing 2 No. 2 FiberWire sutures through the fracture fragment and the base of the anterior cruciate ligament, with sutures passed through bony tunnels and secured to two 2.8-mm anchors in the metadiaphyseal cortex. This construct of suture plus suture anchor (suture anchor group) underwent the same biomechanical loading protocol used in our prior study, in which pediatric knees were randomly assigned to either screw fixation (n = 6; fractures reduced with two 4.0-mm cannulated screws and washers) or suture fixation (n = 6; fractures repaired as in the suture anchor group except the sutures were tied across a metaphyseal bony bridge after their exit from the bony tunnels). All specimens were mounted in flexion and biomechanically tested with cyclic loading followed by a load-to-failure test. New data were statistically compared with the prior study’s results. Results: The suture anchor group had a median age of 9.00 years, while the screw and suture groups had identical median ages (8.50 years). All groups had an identical number of samples of each laterality. The ultimate failure load differed significantly across fixation methods ( P = .006), primarily driven by higher ultimate failure loads in the suture anchor group (225.50 ± 46.46 N) when compared with the screw group (143.52 ± 41.97 N; P = .01) and suture group (135.35 ± 47.94 N; P = .009). Conclusion: TSF fixation with sutures tied to metadiaphyseal suture anchors provided significantly stronger repair than 2-suture and 2-screw constructs. Clinical Relevance: The suture anchor fixation method for TSF may offer enhanced stability and durability to reduce the risk of postoperative complications while improving functional patient outcomes.
Systematising safety: Developing integrated safety management systems in healthcare
Authors: Macrae Carl 
Published: February 2025

Background After several decades of sustained effort, patient safety remains a difficult challenge. A range of policy interventions and organisational activities now focus on patient safety issues, but these are often developed as stand-alone interventions or are implemented in isolation. This contrasts to the approach taken in other safety-critical sectors, where safety is built on carefully organised and tightly integrated safety management systems (SMS) that bring together all the fundamental activities of understanding, implementing, monitoring and improving safety in organisations. Methods This article considers the organising principles that underpin SMS in a range of other sectors, and explores and describes the key functions and activities that are of particular relevance to healthcare. Strategies in other safety-critical sectors are reviewed, emerging thinking in healthcare is described and the relevance of policy and legislation are considered. Results SMS are the foundation of safety in sectors from aviation to food production, but healthcare does not yet have a well-specified and widely shared view on what constitute the fundamental principles, activities and functions necessary to support integrated systems of safety management. This critical issue is increasingly being recognised by national health agencies, and the journey towards developing integrated SMS in healthcare represents the next phase in the systemic improvement of patient safety. Conclusion The development of healthcare SMS can be informed by the experiences of safety-critical sectors that have travelled this path before; by emerging thinking and exploration in healthcare organisations; and by revisiting the legislative and policy context that shapes patient safety.
Characterization of a COPD-AssociatedNephronectinFunctional Splicing Genetic Variant in Human Lung TissueviaLong-Read Sequencing
Authors: Saferali Aabida , Wienecke Anastacia N. , Xu Zhonghui , Liu Tao , Sheynkman Gloria M. , Hersh Craig P. , Cho Michael H. , Silverman Edwin K. , Zhou Xiaobo , Wilson Carole L. , Schnapp Lynn M. , Randell Scott H. , Ramos Silvia B.V. , Laederach Alain , Vollmers Christopher , Castaldi Peter J. 
Published: February 2025

BackgroundIdentification of COPD disease-causing genes is an important tool for understanding why COPD develops, who is at highest COPD risk, and how new COPD treatments can be developed. Previous COPD genetic studies have identified a highly significant genetic association near nephronectin(NPNT), a gene involved in tissue repair, but the biological mechanisms underlying this association are unknown.MethodsSplicing quantitative trait locus analysis (sQTL) was performed to identify common genetic variants that alter RNA splicing in lung tissues. These lung sQTL signals were compared to COPD genetic association results near theNPNTgene using colocalization analysis to determine whether genetic risk for COPD in this region may act through altered splicing. Long read sequencing characterized COPD-associated splicing events at isoform-level resolution, and in silico protein structural analysis identified likely functional effects of this alternative splicing.ResultsAn established COPD genetic risk variant, rs34712979_A, creates a cryptic splice acceptor site that causes four separate splicing changes imNPNT. The only of these splicing changes that was associated with COPD phenotypes involved a cassette exon (exon 3). Long read RNA sequencing demonstrated that the COPD risk allele causes a shift in isoform usage away from the dominant NPNT Isoform B precursor, which excludes exon 3, to the Isoform A precursor which splices-in exon 3. Alpha-fold protein structural analysis reveals that inclusion of this exon disrupts an EGF-like functional domain in NPNT.ConclusionGenetic variants in the nephronectin (NPNT) gene increase COPD risk by changing RNA splicing ofNPNTin the lung.