bluuebunny/crossref_metadata_2025_split huggingface dataset:
Thumb fingertip injuries reconstruction using a dorsoulnar flap of the thumb combined with relay V–Y flaps for donor site repair
Authors: Wang Jin , Zhou Xiao , Qiang Li , Xue Mingyu 
Published: July 2022

Purpose: To assess the clinical value and feasibility of the dorsoulnar flap of the thumb combined with relay V–Y flaps for reconstruction of the thumb fingertip injuries. Methods: In this retrospective study, we retrospectively reviewed 20 patients (13 men, 7 women; June 2014–June 2016) with thumb fingertip defects who underwent reconstructive procedures with transfer of the dorsoulnar flap of the thumb. The average size of the defects ranged from 1.8 cm × 2.0 cm to 2.0 cm × 3.0 cm, whereas the reconstructed dorsoulnar flap of the thumb ranged in size from 2.0 cm × 2.2 cm to 2.2 cm × 3.0 cm. A V-Y flap was used to repair the donor site at the same time. Sensation within the reconstructed thumb, the aesthetic appearance of both the donor and recipient sites, functional recovery, and return-to-work (RTW) time were measured. Results: All 40 flaps survived without necrosis. The follow-up period ranged from 6 to 24 months. There were no complications reported. The mean static two-point discrimination values at the reconstructed thumb fingertip and donor site were 8.5 mm (range 8–10 mm) and 12.5 mm (range 12–14 mm), respectively. The average visual analog scores for the aesthetic appearance of the recipient and donor sites were 8.4 (range 8–9.5) and 9.6 (range 9–10), respectively. The average Michigan Hand Outcome Questionnaire score for the reconstructed hand was 9.4 (range 6–16). The average RTW time was 9.8 weeks (range 6–13 weeks). All patients were satisfied with the aesthetic outcome. Conclusion: The dorsoulnar flap of the thumb is an ideal alternative for reconstruction of the thumb fingertip injuries, and a V-Y flap was suitable for repairing the donor site with a reduced incidence of complications.
English Language Usage and Academic Achievement Among Nursing Students: A Cross-Sectional Study
Authors: Alqahtani Naji 
Published: July 2022

Introduction Nursing students who speak English as a second language (ESL) face academic challenges such as academic and clinical underperformance and slower course progression. English language usage and its effect on Saudi undergraduate nursing students’ academic achievement is limited in the literature. Objectives To identify the level of and the effect of English language usage on academic achievement among Saudi undergraduate nursing students. Methods A cross-sectional, correlational descriptive design was employed. Data were collected from a convenience sample of nursing students (N = 90) attending a public nursing program in Saudi Arabia using English Language Usage Scale (ELUS-11). Data were analyzed using univariate, bivariate, and multivariate statistics. Results Saudi nursing students’ academic achievement was high. However, their English language usage was low. Yet, the student’s highest average score was related to listening, followed by reading, general, writing, and speaking. The general linear model revealed that English language usage influenced academic achievement (B = .026, p <.001) after controlling the sample gender and academic level. Conclusions The findings showed English language usage was associated with academic achievement. Saudi nursing students were willing to succeed in their studies despite their low levels of English skills. Providing English resources such as courses through extracurricular activities and workshops for the students might enhance their use of English, which might improve their academic achievement.
Real-world study of children and young adults with myeloproliferative neoplasms: identifying risks and unmet needs
Authors: Sobas Marta , Kiladjian Jean-Jacques , Beauverd Yan , Curto-Garcia Natalia , Sadjadian Parvis , Shih Lee Yung , Devos Timothy , Krochmalczyk Dorota , Galli Serena , Bieniaszewska Maria , Seferynska Ilona , McMullin Mary Frances , Armatys Anna , Spalek Adrianna , Waclaw Joanna , Zdrenghea Mihnea , Legros Laurence , Girodon François , Lewandowski Krzysztof , Angona Figueras Anna , Samuelsson Jan , Abuin Blanco Aitor , Cony-Makhoul Pascale , Collins Angela , James Chloé , Kusec Rajko , Lauermannova Marie , Noya Maria Sol , Skowronek Malgorzata , Szukalski Lukasz , Szmigielska-Kaplon Anna , Wondergem Marielle , Dudchenko Iryna , Gora Tybor Joanna , Laribi Kamel , Kulikowska de Nalecz Anna , Demory Jean-Loup , Le Du Katell , Zweegman Sonja , Besses Raebel Carlos , Skoda Radek , Giraudier Stéphane , Griesshammer Martin , Harrison Claire N. , Ianotto Jean-Christophe 
Published: July 2022

AbstractMyeloproliferative neoplasms (MPNs) are uncommon in children/young adults. Here, we present data on unselected patients diagnosed before 25 years of age included from 38 centers in 15 countries. Sequential patients were included. We identified 444 patients, with median follow-up 9.7 years (0-47.8). Forty-nine (11.1%) had a history of thrombosis at diagnosis, 49 new thrombotic events were recorded (1.16% patient per year [pt/y]), perihepatic vein thromboses were most frequent (47.6% venous events), and logistic regression identified JAK2V617F mutation (P = .016) and hyperviscosity symptoms (visual disturbances, dizziness, vertigo, headache) as risk factors (P = .040). New hemorrhagic events occurred in 44 patients (9.9%, 1.04% pt/y). Disease transformation occurred in 48 patients (10.9%, 1.13% pt/y), usually to myelofibrosis (7.5%) with splenomegaly as a novel risk factor for transformation in essential thrombocythemia (ET) (P= .000) in logistical regression. Eight deaths (1.8%) were recorded, 3 after allogeneic stem cell transplantation. Concerning conventional risk scores: International Prognostic Score for Essential Thrombocythemia-Thrombosis and new International Prognostic Score for Essential Thrombocythemia-Thrombosis differentiated ET patients in terms of thrombotic risk. Both scores identified high-risk patients with the same median thrombosis-free survival of 28.5 years. No contemporary scores were able to predict survival for young ET or polycythemia vera patients. Our data represents the largest real-world study of MPN patients age &lt; 25 years at diagnosis. Rates of thrombotic events and transformation were higher than expected compared with the previous literature. Our study provides new and reliable information as a basis for prospective studies, trials, and development of harmonized international guidelines for the specific management of young patients with MPN.
Linkage mapping combined with GWAS revealed the genetic structural relationship and candidate genes of maize flowering time-related traits
Authors: Shi Jian , Wang Yunhe , Wang Chuanhong , Wang Lei , Zeng Wei , Han Guomin , Qiu Chunhong , Wang Tengyue , Tao Zhen , Wang Kaiji , Huang Shijie , Yu Shuaishuai , Wang Wanyi , Chen Hongyi , Chen Chen , He Chen , Wang Hui , Zhu Peiling , Hu Yuanyuan , Zhang Xin , Xie Chuanxiao , Lu Xiaoduo , Li Peijin 
Published: July 2022

Abstract
Background
Flowering time is an important agronomic trait of crops and significantly affects plant adaptation and seed production. Flowering time varies greatly among maize (Zea mays) inbred lines, but the genetic basis of this variation is not well understood. Here, we report the comprehensive genetic architecture of six flowering time-related traits using a recombinant inbred line (RIL) population obtained from a cross between two maize genotypes, B73 and Abe2, and combined with genome-wide association studies to identify candidate genes that affect flowering time.

Results
Our results indicate that these six traits showed extensive phenotypic variation and high heritability in the RIL population. The flowering time of this RIL population showed little correlation with the leaf number under different environmental conditions. A genetic linkage map was constructed by 10,114 polymorphic markers covering the whole maize genome, which was applied to QTL mapping for these traits, and identified a total of 82 QTLs that contain 13 flowering genes. Furthermore, a combined genome-wide association study and linkage mapping analysis revealed 17 new candidate genes associated with flowering time.

Conclusions
In the present study, by using genetic mapping and GWAS approaches with the RIL population, we revealed a list of genomic regions and candidate genes that were significantly associated with flowering time. This work provides an important resource for the breeding of flowering time traits in maize.
The association between Roussouly sagittal alignment type and risk for adjacent segment degeneration following short-segment lumbar interbody fusion: a retrospective cohort study
Authors: Qu Zhe , Deng Bin , Gao Xiao , Pan Bin , Sun Wei , Feng Hu 
Published: July 2022

Abstract
Background
To date, the influence of Roussouly type on development of adjacent segment degeneration (ASD) after lumber fusion is still not fully explored, and the current study is aimed to evaluate the effect of Roussouly type on development of radiological ASD after single-level lumber fusion, and to compare the Roussouly types and spinopelvic parameters among those with different degenerative patterns of ASDs on sagittal plane.

Methods
A retrospective review of 288 patients underwent L4/5 or L5/S1 single-level posterior interbody fusions between January 2016 and December 2018 with a minimum 2-year follow up was performed. Radiological ASDs were identified and divided into 3 groups according to different degenerative patterns of the cephalad adjacent level on sagittal plane, including the types of retrolisthesis (Group A), anterolisthesis (Group B), and axial disc space narrowing (Group C). Roussouly types and radiological measurements were compared among three groups and potential risk factors for ASD were evaluated.

Results
Radiological ASD was found in 59 (20.5%) cases, in which patients with Roussouly type-2 was the most common. While, on subgroup analysis among three ASD groups, Roussouly type-1 occupied the highest proportion in Group A, differ in Group B and Group C, both with Type-2 as the most common. Moreover, Group A had significantly lower pelvic tilt (PT), larger sacral slope (SS), and larger segmental angle (SA) than Group B and Group C, which showed a more anteverted pelvic in Group A. Multivariate regression analysis noted Roussouly type, preoperative PT, and ∆PI-LL as the independent risk factors for radiological ASD.

Conclusion
Roussouly type was significantly associated with the development of radiological ASD; however, the Roussouly types and spinal pelvic parameters were varied among different sagittal degenerative patterns of ASD, which was important in restoring optimal lumbar sagittal alignments in initial surgery.
Prevalence and factors associated with latent autoimmune diabetes in adults (LADA): a cross-sectional study
Authors: Manisha Anselmo M. , Shangali Aminiel R. , Mfinanga Sayoki G. , Mbugi Erasto V. 
Published: July 2022

Abstract
Background
The Latent Autoimmune Diabetes in Adults (LADA) is a slowly progressive Type 1 diabetes subgroup with onset during middle age. Studies report that about 10% of adults initially diagnosed with clinical Type 2 diabetes (T2D) have LADA. Inappropriate diagnosis and mismanagement of the LADA can increase the risk of diabetic complications, which affect the quality of life and is the cause of increased mortality. In low-income countries setting, data regarding the magnitude of LADA is limited. We carried out this study to estimate the burden of misdiagnosed LADA among T2D patients in selected health facilities in Dar es Salaam and to bring awareness to the use of Glutamic Acid Decarboxylase (GAD) autoantibody in screening for LADA.

Methodology
We enrolled 186 phenotypically T2D patients in this cross-sectional study, through a standardized data collection tool we obtained participants’ demographic and clinical information. For testing GAD levels, we used a double-antibody Enzyme-Linked Immunosorbent Assay (ELISA). The Fisher’s Exact and student t-tests were used to test the significance of the statistical associations of the glycaemic control and diabetes complications between T2D and LADA.

Results
Out of 186 patients, 156 gave conclusive GAD Ab ELISA reading with LADA accounting for 5.1% (95% CI: 2.5 - 10.0). The mean age of subjects was 54.3 years (Range: 33-85 years). The parameters such as mean age, family history of diabetes mellitus status, Fasting Blood Glucose, clinical characteristics, and complications did not show significant statistical differences between patients with LADA and Type 2 diabetes. However, all LADA- Human Immunodeficiency Virus (HIV) comorbid patients had retinopathy, which was statistically insignificant in 20 (87%) T2D-HIV comorbid patients (p = 0.669). Neither neuropathy, nephropathy, nor Diabetic Mellitus (D.M.) foot syndrome was observed among LADA-HIV comorbid patients. Nevertheless, 22 (95.7%), 3 (13%), and 2 (8.7%) of T2D-HIV comorbidity had neuropathy, nephropathy, or D.M. foot syndrome, respectively.

Conclusions
The study established a LADA prevalence of 5.1% among T2D patients and has shown the role of GAD autoantibody in the screening for LADA. The study calls for a well- designed larger longitudinal study to generate strong evidence on the association of risk factors and complications associated with the LADA. This will develop robust evidence on the association of risk factors and complications associated with the LADA and T2D.
Teaching and learning lifestyle medicine during COVID-19: how has living during a pandemic influenced students’ understanding and attitudes to self-care and population health? A qualitative analysis
Authors: Harvey Christopher-James , Maile Edward J. , Baptista Ana , Pinder Richard J. 
Published: July 2022

Abstract
Background
In 2019 a new Lifestyle Medicine (LM) module was introduced to the undergraduate medical curriculum at Imperial College London. Lifestyle Medicine is an emergent discipline which aims to tackle the increasing burden of non-communicable disease. Previous work has suggested that students value clinical teaching over traditional Public Health topics. Taking a constructivist view of learning, this paper assesses changes in medical students’ attitudes towards Public Health and LM in response to living through a pandemic. We then make suggestions as to how this lived experience might be useful in teaching LM, and discuss the interaction between teaching, behaviour, and experience with consideration of self-determination theories in learning.

Methods
First-year medical students were surveyed at the end of their first year of teaching and asked if living during the COVID-19 pandemic had changed the value they place on LM and if so, how. Thematic analysis was conducted on responses representing 71% (n = 216) of the year group.

Results
Four themes were defined in the data: acknowledging importance; impact on behaviour; health inequalities and the wider determinants; and promoting Public Health and prevention. These themes highlight the distinct levels through which the pandemic has had an impact: from personal behaviour to population health.

Conclusions
This is the first study to look at the impact of living through a pandemic on attitudes to LM. Our results suggest that the pandemic has led to increased reflection on health behaviours. The lived-experience of COVID-19 may facilitate a better understanding of health inequalities and their impact, alongside the opportunities presented by effective LM interventions.
Palliative and end of life care in undergraduate medical education: a survey of New Zealand medical schools
Authors: Heath Lis , Egan Richard , Iosua Ella , Walker Robert , Ross Jean , MacLeod Rod 
Published: July 2022

Abstract
Background
In New Zealand, 34% of deaths occur in the hospital setting where junior doctors are at the frontline of patient care. The death rate in New Zealand is expected to double by 2068 due to the aging population, but many studies report that graduates feel unprepared to care for people near the end of life and find this to be one of the most stressful parts of their work. International guidelines recommend that palliative and end of life care should be a mandatory component of undergraduate medical education, yet teaching varies widely and remains optional in many countries. Little is known about how medical students in New Zealand learn about this important area of clinical practice. The purpose of this study was to investigate the organisation, structure and provision of formal teaching, assessment and clinical learning opportunities in palliative and end of life care for undergraduate medical students in New Zealand.

Methods
Quantitative descriptive, cross-sectional survey of module conveners in New Zealand medical schools.

Results
Palliative and end of life care is included in undergraduate teaching in all medical schools. However, there are gaps in content, minimal formal assessment and limited contact with specialist palliative care services. Lack of teaching staff and pressure on curriculum time are the main barriers to further curriculum development.

Conclusions
This article reports the findings of the first national survey of formal teaching, assessment and clinical learning opportunities in palliative and end of life care in undergraduate medical education in New Zealand. There has been significant progress towards integrating this content into the curriculum, although further development is needed to address barriers and maximise learning opportunities to ensure graduates are as well prepared as possible.
Use of digital technologies to combat loneliness and social isolation: a cross-sectional study in Swiss outpatient care during COVID-19 pandemic
Authors: Stängle Sabrina , Benedetti Franzisca Domeisen , Hediger Hannele , Bonmarin Mathias , Loeser Martin , Fringer André 
Published: July 2022

Abstract
Background
There is limited data on the use of digital technologies in outpatient care in Switzerland. Our objectives were therefore to determine which digital technologies are used and whether they had an impact on loneliness and social isolation in the wake of the COVID-19 pandemic.

Methods
A cross-sectional survey design was used with a convenience sample of 1272 outpatient care providers in Switzerland. The questionnaire used is based on an unsystematic literature review and a previous qualitative study with six outpatient caregivers and two caring relatives, based on which the 30 items for this questionnaire were developed. Data were analyzed descriptively, and group comparisons were made using the Kruskal Wallis test. Changes over time were measured using Friedman test with Bonferroni post hoc tests and Wilcoxon test for paired samples.

Results
The impact of the COVID-19 pandemic was evident both on the part of the health care system, e.g., inadequate protective equipment; on the part of health care providers, e.g., increasing fatigue in keeping abreast of the virus as the pandemic progressed; and on the part of clients, who reduced services of care, e.g., out of fear of infection. According to the assessment of the outpatient caregivers, loneliness and social isolation of the clients was high in spring 2020 and increased strongly in the following winter. Alternative solutions, such as digital technologies, were hardly used or not used at all by the clients.

Conclusions
The results suggest that the pandemic is dramatically impacting clients. This highlights the urgent need to invest in the development of appropriate digital technologies reducing the impact of social isolation and loneliness and the associated long-term costs to the healthcare system.
Implementing ethical aspects in the development of a robotic system for nursing care: a qualitative approach
Authors: Nielsen Svenja , Langensiepen Sina , Madi Murielle , Elissen Maurice , Stephan Astrid , Meyer Gabriele 
Published: July 2022

AbstractBackgroundAs robotics in nursing care is still in an early explorative research phase, it is not clear which changes robotic systems will ultimately bring about in the long term. According to the approach of “Responsible Research and Innovation”, the research project “PfleKoRo” aims to anticipate and mitigate ethical risks that might be expected when starting to develop a robot. The robot under investigation is intended to be a hands-on support in nursing care in due course. Therefore, the question is which ethical risks and requirements must be considered when developing the robot.MethodsGuided by the British Standard for the design of robotic systems, ethical risks related to the robot’s use were identified at the outset (Step 1). This was followed by the definition of the requirements needed to mitigate ethical risks (Step 2). Professional nurses, patients and relatives were involved in focus groups and interviews in Step 1. The transcribed interviews and focus groups were then analysed using content analysis. The available literature and expert guidance were taken into account in both steps. Finally, validation and verification methods were defined (Step 3).ResultsSixteen professional nurses participated in three focus groups. Individual interviews were held with a total of eight patients and relatives. Ethical risks and requirements could be defined in the context of dignity, autonomy, privacy, human relationships and safety in the project. Professional nurses feared most issues relating to safety and that the robot would lead to more workload instead of relief, whereas patients and relatives frequently raised the issue of the staffing ratio. Despite the focus on possible negative consequences, participants also made uncritical or optimistic comments regarding the robot’s use in the future.ConclusionFocus groups, individual interviews and existing literature revealed to some extent different ethical issues. Along with identified risks, the results suggest a general open-mindedness of nurses, patients and relatives towards the introduced robot. When investigating the ethical implications of robots for nursing care, one should include multiple perspectives and, in particular, potentially affected individuals.
You are exactly my type! The traits of a good doctor: a factor analysis study on public's perspectives
Authors: Grundnig Julia S. , Steiner-Hofbauer Verena , Drexler Viktoria , Holzinger Anita 
Published: July 2022

AbstractBackgroundA multiplicity of qualities and behaviours are considered essential in a good doctor and are identified in various medical profession frameworks. However, there is no consensus as to their meaning or even agreement on fundamental qualities. The authors wanted to examine the importance placed by the Austrian public on the professional and personal traits of ideal physicians. Competencies were used to create different types of ‘good doctor’ and then examined to discover how these can be integrated into existing medical professionalism frameworks.MethodsA 69-item Likert scale-based questionnaire was developed and administered via telephone interview to 1,000 subjects. Computer-assisted telephone interviews (CATI) were carried out by the Austrian GALLUP-Institute. An explorative factor analysis with promax rotation was undertaken to summarise the interrelationships among variables.ResultsFactor analysis identified six interpretable factors which we define as six different types of doctors: the dutiful doctor, the online health-celebrity, the medical expert, the service physician, the medical altruist, and the ethical agent. The items perceived as most important were ‘takes time’, ‘listens’, and ‘makes correct diagnoses’. Outcome measures of internal consistency and reliability estimates (Cronbach´s alpha, 0.69–0.86) for each element.ConclusionsThe six types of physicians may be a step toward recognizing the professional behaviour of all physicians, their actions as healers, and their commitment to moral concepts, values, and needs of their patients, and society. According to our results, the public has expectations of good doctors that go beyond the scope within the medical professionalism frameworks. Therefore, these guidelines should be adapted in light of the changing expectations and needs of the general population.