bluuebunny/crossref_metadata_2025 huggingface dataset:
Health advocacy and moral distress among nurses in organ transplant units
Authors: Victorino João Paulo , de Brito Emanuele Seicenti , Westin Ursula Marcondes , Vargas Mara Ambrosina de Oliveira , Mendes Karina Dal Sasso , Ventura Carla Aparecida Arena
Published: October 2024

Background

Health advocacy is crucial for both patients and healthcare professionals. However, nurses who recognize the importance of health advocacy may experience heightened moral distress, particularly in complex donation and transplantation cases where patient autonomy, respect, and advocacy are paramount.

Aim

To identify the factors contributing to moral distress among nurses working in solid organ transplant units at a university hospital in São Paulo, with a focus on health advocacy.

Research Design

This descriptive, cross-sectional study employs both quantitative and qualitative methods. For this, the quantitative phase of the study was conducted utilizing the Moral Distress Scale, while the qualitative phase was executed through focus group discussions.

Participants and Research Context

The quantitative phase involved 15 nurses using the Moral Distress Scale. The qualitative phase consisted of a focus group with 5 nurse managers/coordinators from the transplant units. Quantitative data were analyzed using R® software, while qualitative data were analyzed using Bardin’s Content Analysis.

Ethical Considerations

The study was approved by the Research Ethics Committee of the Ribeirão Preto College of Nursing, University of São Paulo. Participation was voluntary and confidentiality was ensured.

Results

A significant correlation was found between moral distress and the factors of “disregard for patient autonomy” ( p = .0100) and “therapeutic obstinacy” ( p = .0492).

Conclusion

The primary determinants associated with moral distress in the context of health advocacy were identified as “disregard for patient autonomy” and “therapeutic obstinacy.”
Influencer Marketing: A Review and Research Agenda Using VOSviewer
Authors: Kumar Rajeev , Prabha Vineet , Kumar Manoj , Rehal Poonam , Samanta Prasenjeet , Singh Priyank Kumar
Published: October 2024

Influencer marketing has emerged as a powerful strategy within the digital marketing landscape, leveraging the reach and engagement of social media influencers to promote brands and products. This study conducts a comprehensive systematic review of influencer marketing research using VOSviewer and RStudio, two robust tools for visualising and analysing scientific literature. The study uses academic sources, and a total of 74 papers indexed in Scopus, including journal articles, conference papers and review articles, providing a detailed overview of the evolution and current state of influencer marketing research. This study underscores the significance of authenticity and trust, privacy issues and engagement as important themes in influencer marketing research as a critical component of contemporary marketing strategies for driving consumer engagement. The study offers a detailed examination of the existing body of research on the phenomenon of influencer marketing.
Efficacy and Safety of Mifepristone and Misoprostol Compared to Misoprostol Alone for the Resolution of Miscarriage and Intrauterine Fetal Death: A Systematic Review and Meta-Analysis
Authors: Pirrami Rachael G. , Reinert Justin P.
Published: October 2024

Objective:

To determine the efficacy and safety of mifepristone and misoprostol together (intervention) compared to misoprostol alone (comparator) for the resolution of miscarriage and intrauterine fetal death.

Data Sources:

A systematic review and meta-analysis were conducted following the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) methodology through July 2024 that evaluated the efficacy and safety of mifepristone and misoprostol together compared to misoprostol alone for the resolution of miscarriage and intrauterine fetal death through July 2024.

Study Selection and Data Extraction:

Primary endpoints were overall delivery success, 24-hour delivery success, and incidence of safety outcomes. A P-value of <0.05 was considered statistically significant, and heterogeneity was reported as the I2 value.

Data Synthesis:

Twelve randomized controlled trials (RCTs) were included. Overall delivery success was higher in the intervention group (0.73 [CI 0.64-0.82], P < 0.01). Twenty-four-hour delivery rate was higher (1.54 [CI 1.32-1.77], P = 0.06), and a shorter time to delivery interval (9.22-18.78 vs 15.47-37.1 hours) was observed in the intervention group. Gastrointestinal adverse effects were more frequent in the intervention group (0.04 [CI –0.03 to 0.12], P < 0.01).

Relevance to Patient Care and Clinical Practice:

Mifepristone and misoprostol together demonstrated higher delivery success rates and comparable safety outcomes to misoprostol alone, demonstrating the potential of improving patient care and positively impacting the time to successful delivery for patients at the bedside.

Conclusions:

The use of mifepristone and misoprostol together for the resolution of miscarriage and intrauterine fetal death is warranted over the use of misoprostol alone.
Transformative Routes to Sustainable Development: The Nexus Between Fiscal Decentralization and Sustainable Environment in Developing Countries
Authors: Ali Sajjad , Gill Abid Rashid , Ali Minhaj
Published: October 2024

The debate on fiscal decentralization (FD)’s potential impact on environmental sustainability is expanding, but actual evidence is few. A balanced dataset of 21 developing nations from 2000 to 2020 is used to explore how FD impacts environmental sustainability. We employ second-generation unit root tests, Westerlund cointegration, and cross-section autoregressive distributed lag (CS-ARDL) models for empirical assessment. In addition, a novel Environmental Sustainable Development Index (ESDI) is used. The results demonstrate FD enhances ESDI. Economic growth, total natural resource rent, and population growth impair sustainability, while institutional quality enhances it. Eco-friendly natural resource exploitation helps countries become more sustainable. These goals require modern sustainable development methods. Analysis of FD and institutional quality policies reveals how nations combat environmental pollution, providing policymakers with empirical evidence for global climate change initiatives. According to the findings, local governments should be empowered to reduce emissions, mitigate environmental harm, and establish sustainable industrial practices.
A Qualitative Exploration of the Impact of Increasing Criminalization on Domestic Violence Support Workers: Nonfatal Strangulation as a Case Study
Authors: Sharman Leah S. , Douglas Heather , Fitzgerald Robin
Published: October 2024

Specialized nongovernmental domestic violence (DV) services provide critical support to victim/survivors. This research draws on 14 semistructured focus groups with 27 DV support workers to examine how expanded criminalization impacts support workers’ roles using a case study of a 2016 nonfatal strangulation offense legislated in Queensland, Australia. Our results describe a lack of governmental support intersecting with increased complexity and higher workload burden resulting from expanded criminalization. Expansions to criminal law need to account for and critically assess the full system impact of new DV legislation and the added burdens placed on the pivotal third sector of DV services.
Heavy Metal Contamination in Omo River, Ethiopia: Environmental and Human Health Risks
Authors: Abiy Andemo Kotacho , Tilahun Yimer Girma , Sorsa Sota Solomon , Seifu Berego Yohannes
Published: October 2024

The Omo River flows through the town of Omorate, where domestic, municipal, and industrial wastes from the town and its surroundings, including agrochemicals, are discharged into the river. The present study was conducted to determine the levels of heavy metals and associated environmental and human health impacts from the Lower Omo River freshwater ecosystem (water and sediment) of the Lower Omo River. The mean concentrations of heavy metals detected in the river water were 0.439 mg/l for (Mn), 0.1 (Zn), 0.168 (Cu), 0.393 (Cr), 0.318 (Pb), 0.007 (Ni), 8.926 (Fe), and 0.06 (Co).The order for the mean concentrations of the heavy metals in the water was Fe > Mn > Cr > Pb > Cu > Zn > Cu > Co > Ni. The HPI value indicates that all water sampling sites were highly contaminated. Oral and dermal HQs for both children and adults were in the order of Cr > Pb > Mn > Fe > Cu > Co > Ni > Zn. The HQ value greater than 1 was investigated for Cr, Pb, and Mn in both children and adults by ingestion and dermal routes from the river water. The CRs for both children and adults by ingestion of the river water followed the order Cr > Pb. According to the CRI value, the river water could be classified as a very high environmental risk. The EI results for the heavy metals detected in the sediments also followed the order: Fe > Cr > Cu > Pb > Mn > Co > Zn > Ni.
How is observed (de)motivating teaching associated with student motivation and device-based physical activity during physical education?
Authors: Van Doren Nele , Compernolle Sofie , Bouten Arne , Haerens Leen , Hesters Laura , Sanders Taren , Slembrouck Maarten , De Cocker Katrien
Published: October 2024

Previous Self-Determination Theory (SDT) research has highlighted the impact of physical education (PE) teachers’ (de)motivating styles on students’ motivation, in-class moderate-to-vigorous physical activity (MVPA), and sedentary behaviour. However, most studies relied on questionnaires to assess PE teachers’ (de)motivating styles, and the few that used observations focused primarily on one specific (de)motivating style in relation to motivational outcomes, overlooking behavioural outcomes. This study advances SDT-based research by examining associations between PE teachers’ observed (de)motivating styles (i.e. four styles, eight approaches, and 43 behaviours), students’ motivation (i.e. intrinsic motivation, identified regulation, introjected regulation, external regulation, and amotivation), and students’ device-based in-class MVPA and sedentary behaviour. A total of 79 secondary school PE teachers and 885 students participated. One PE lesson per teacher was recorded and (de)motivating styles were rated using the Situation-in-School Physical Education-Coder (SIS-PE-Coder). Students completed an online questionnaire to assess their motivation and wore Actigraph accelerometers to measure in-class MVPA and sedentary behaviour. Linear mixed-effects models, controlling for the lesson topic, and students’ sex and age, revealed that PE teachers’ observed attuning approach related positively and demanding and abandoning approaches related negatively to students’ intrinsic motivation. The demanding approach also related positively to students’ introjected regulation. Notably, the demanding approach showed a dual pathway, negatively relating to intrinsic motivation but positively relating to in-class MVPA. In turn, intrinsic motivation was positively related to in-class MVPA. By relying on observations, the findings suggest that PE teachers can optimize student motivation by being more attuning and less demanding and abandoning.
An Unforgetting Cradling: A Performative Witnessing of a Mother’s Return to a Children’s Orphanage
Authors: Deegan James G.
Published: October 2024

Once I walked as an accidental autoethnographer through the entrance door of a repurposed children’s orphanage. There on the doorstep, I witnessed a former resident in the final moments of a secular pilgrimage of unforgetting and cradling. Unforgetting is understood, in this article, as a metaphor for the thousands of women and children robbed of their truth, agency, and sometimes their future in state and religious-run orphanages. Cradling is understood as a metaphor for a desiring, sensual, performative, and singular/universal reparation. Influenced by phenomenological writings on the buildings we inhabit and those that inhabit us, and embodied, rhythmic, sensory, and experimental qualitative inquiry writing, I challenge the erasure of violence-toleration in official discourses of church and state-run institutions through a performative aesthetic of witnessing, evoking, and inscribing the lost sensations of a denied, difficult, and violent past into the grand narratives of mothers, children, and childhood.
Discharge Communication and the Achievement of Lifestyle and Behavioral Changes Post-Stroke in the Transitions of Care Stroke Disparities Study
Authors: Johnson Karlon H. , Gardener Hannah , Gutierrez Carolina M. , Marulanda Erika , Campo-Bustillo Iszet , Gordon-Perue Gillian , Brown Scott C. , Ying Hao , Zhou Lili , Bishop Lauri , Veledar Emir , Fakoori Farya , Asdaghi Negar , Koru-Sengul Tulay , Hlaing WayWay M. , Romano Jose G. , Rundek Tatjana ,   on behalf of the Transitions of Care Stroke Disparities Study (TCSD-S) Investigators
Published: October 2024

Objectives: This study identifies the association between patient perception of discharge education/resources and adequate transitions of care (ATOC) (i.e., patient achievement of at least 75% of recommended positive behaviors and activities within 30 days post-stroke hospitalization). Methods: The analysis measured the association between sufficient discharge communication (SDC) (i.e., patient receipt of sufficient diet education, sufficient toxic habit cessation education, if applicable, and scheduled medical follow-up appointment) and ATOC within 30 days post-discharge overall and by race/ethnicity [non-Hispanic White (NHW), non-Hispanic Black (NHB), and Hispanic] in the Transitions of Care Stroke Disparities Study (TCSD-S) (2018-2023). Results: In our sample (N = 1151, Average Age 64+/−14 years, 57% Men, 54% NHW, 24% NHB, 23% Hispanic), 31% overall, as well as 22% of NHW, 43% of NHB, and 41% of Hispanics reported SDC. After covariate adjustment, patients reporting SDC had increased likelihood of accomplishing ATOC when compared to patients not reporting SDC overall (OR = 1.97; 95% CI: 1.42-2.74) and among NHW (OR = 2.76; 95% CI: 1.64-4.64) and NHB (OR = 2.29; 95% CI: 1.16-4.53). The association among Hispanic participants was not statistically significant. Conclusion: Our findings reinforce the importance of providing quality communication to patients to ensure a successful transition of care from hospital to home or rehabilitation facility.
A fault identification method for Fuel cell engine air supply subsystem pressure sensor based on Random forest
Authors: Bin Guo , Haoyi Yu , Zhangu Wang , Ziliang Zhao , Ji Pu
Published: October 2024

To detect possible failures of the pressure sensor in the fuel cell engine air supply subsystem, this study proposes a fault identification method based on Random forest. To simulate faults in the sensor, we injected deliberate faults and constructed a fault dataset based on it. This dataset includes gradual fixed deviation and gradual complete deviation. The peRandom forestormance of training accuracy is observed on different fault datasets, aiming to identify fault types based on the deviation in accuracy caused by the presence of polluted or corrupted samples in the dataset. The results indicate that machine learning can effectively distinguish the data collected within 9 min. The validity of the residual law established by the root mean square error (RMSE) can be demonstrated through an example, wherein successful identification of intermittent faults 1.2/1.5 can be achieved a difference of 33%, which can effectively distinguish fault categories. In addition, this method does not rely on high-precision models and effectively utilizes abundant sensor data and the uneven distribution of data sets under faults, including sensors other than the target fault sensor, for machine learning to identify different types of sensor faults.
Wireless power transfer for deep cycle lithium-ion batteries in electric vehicles using inductive coupling
Authors: Mubarak Ansa , Amin Arslan Ahmed , Ahmad Muhammad , Shafique Muhammad Furqan , Zafar Muhammad Shaheer
Published: October 2024

This study presents designing and evaluating a reliable wireless power transfer (WPT) mechanism to charge electric vehicle (EV) batteries using resonant coupling. The EV wireless system was created applying the principles of mutual inductance whereby the receiving and transmitting coils were interlinked and connected to their circuits. Significant mathematical work was also done to obtain the equations for the impedance, the power input, and output power. Proteus software was employed to draw a Printed Circuit Board (PCB) for the reception of the receiver and the transmitter circuits. The simulations were conducted using ANSYS Maxwell and MATLAB softwares, utilizing the key parameters of the transmitter and the receiver coils. The experimental setup included an EV installed with transmitter and receiver circuits, copper coils, a compensation network of capacitors, and a 12 V battery voltage monitor. The study showed that the efficiency of wireless power transfer was 78% with the enhanced power density for the gap ranging between 6 and 20 cm. The innovations presented in this paper are a new lower operating frequency of 70 kHz, coil optimization, and a dynamic study on coil misalignment all of which enhance the efficiency and reduce cost of the proposed system.
A randomised comparison of transverse abdominal plane block versus thoracic epidural analgesia on postoperative opioid consumption for colorectal enhanced recovery after surgery programme (OPIATE study)
Authors: Ambulkar Reshma , Solanki Sohan Lal , Salunke Bindiya , PS Pavithra , Gholap Supriya , Desouza Ashwin L , Bakshi Sumitra G , Agarwal Vandana
Published: October 2024

Background:

The transverse abdominis plane block is increasingly being used as a less-invasive alternative to thoracic epidural analgesia for effective pain management. This study aimed to compare transverse abdominis plane block with opioid-based thoracic epidural analgesia in terms of postoperative opioid consumption.

Methods:

Patients in the thoracic epidural analgesia group received a continuous infusion of 0.1% levobupivacaine with 2mcg/ml of fentanyl, while those in the transverse abdominis plane group received 6-hourly boluses of 0.4ml/kg of 0.25% levobupivacaine. The primary objective was to compare the average fentanyl consumption, measured as intravenous fentanyl equivalents, over 72 hours.

Results:

Data of 35 patients were analysed. Fentanyl consumption at the end of 72 hours was significantly lower in the transverse abdominis plane group (median [interquartile range] 495 mcg (255, 750), and mean (95% confidence interval) 717.35mcg (403.54–1031.16)) compared to the thoracic epidural analgesia group (median [interquartile range] 760mcg (750, 760), and mean (95% confidence interval) 787mcg (746.81–827.19)) with a p value of 0.010. Pain scores at rest and during movement were comparable between the groups ( p > 0.05). However, the median pain scores during movement were significantly lower in the thoracic epidural analgesia group at 60 and 72 hours ( p ⩽ 0.05).

Conclusion:

Multimodal analgesia with transverse abdominis plane resulted in lower opioid consumption over 72 hours compared to thoracic epidural analgesia.
Outcomes at mean follow-up of four years following AO type-C distal humerus fractures managed with fixation or arthroplasty
Authors: Allen James , Budworth Luke , Cowling Paul , Tunstall Charlotte , Limb David , Vollans Sam
Published: October 2024

Aim

To compare outcomes between open reduction internal fixation (ORIF), total elbow replacement (TER) and distal humerus hemiarthroplasty (DHH) for AO type-C (AOC) fractures of the distal humerus in patients aged 50 years or older.

Methods

A retrospective analysis of acute AOC distal humerus fractures in patients aged 50 years or older between 2016 and 2022. Outcomes measured: Oxford Elbow Score (OES), Mayo Elbow Performance Score (MEPS), complication rate, re-operation rate and range of movement (ROM).

Results

Sixty-five patients met the inclusion criteria (20 males, 45 females). Mean age was 64.4, 77.1 and 61.3 years old for ORIF, TER and DHH respectively. Logistic model analysis revealed a statistically significant increased complication rate in the ORIF group compared to the TER and DHH groups (ORIF vs TER p = 0.01; ORIF vs DHH p = 0.048). There was a higher re-operation rate in the ORIF group compared to the DHH group ( p = 0.03). There were no differences in OES, MEPS or ROM between groups.

Discussion

This supports the use of TER in elderly patients with AOC distal humerus fractures. In the younger patient, DHH may have lower rates of complications and re-operations compared to ORIF, but function remains similar. We propose a prospective randomised control trial.
Sport-Related Injury and Performance Enhancing Substance Use by Young Athletes
Authors: McNaughton Michael , Hunt Danielle , Parmeter Becky , O’Brien Michael , Cook Danielle , Meehan William , Stracciolini Andrea
Published: October 2024

Background:

Legal performance enhancing substance (PES) use is increasing in young athletes and may lead to banned PES use. This study examines legal PES use and consideration of banned PES use in young athletes with a season-ending injury (SEI) compared to young athletes with non-SEI/no previous injury.

Hypothesis:

Young athletes sustaining SEI or concussions have increased odds of reporting legal PES use and consideration of banned PES use compared with non-SEI or no injury.

Study Design:

Cross-sectional study.

Level of Evidence:

Level 4.

Methods:

Cross-sectional study from 2013 to 2020 of athletes aged 6 to 25 years.

Results:

No association was found between reporting legal PES use or consideration of banned PES use and young athletes with SEI or concussion compared with no injury/non-SEI. 14% of athletes reported legal PES use and 3% reported consideration of banned PES use. In adjusted analysis, athletes who were male (odds ratio [OR], 1.38; 95% CI, 1.16-1.73; P = 0.03), have history of depression (OR, 3.01; 95% CI, 1.26-7.18; P = 0.01), weight train (OR, 1.66; 95% CI, 1.04-2.65; P = 0.03), and believe that athletic ability is influenced by weight (OR, 1.75; 95% CI, 1.08-2.83; P = 0.02) had increased odds of reporting legal PES use. Older (OR, 1.18; 95% CI, 1.03-1.36; P = 0.02) and male (OR, 1.57; 95% CI, 1.02-1.81; P < 0.04) athletes had increased odds of consideration of banned PES use.

Conclusion:

This study found no increased odds of reported PES use in young athletes with sports-related injury or concussion regardless of injury type or severity. Factors associated with PES use were male sex, age, history of depression, weight training, and belief that weight affects athletic performance.

Clinical Relevance:

Risk factors associated with PES use in young athletes are essentially unknown. This study can inform pertinent clinical care, education, and policy implementation.
Developing and validation of a smartphone app for post-discharge early follow-up after colorectal cancer surgeries
Authors: Kupper Bruna Elisa Catin , Bernardon Elaine Cordeiro , Antunes Camila Forni , Martos Natalia Martinez , Sacomani Carlos Alberto Ricetto , Azevedo Mauricio , Adolfi Junior Mario Sergio , Bezerra Tiago Santoro , Marques Tomas Mansur Duarte de Miranda , Stevanato Filho Paulo Roberto , Takahashi Renata Mayumi , Nakagawa Wilson Toshihiko , Lopes Ademar , Aguiar Samuel
Published: October 2024

Background

Colorectal surgeries are complex procedures associated with high rates of complications and hospital readmission.

Objective

This study aimed to develop an electronic post-discharge follow-up plan to remotely monitor patients’ symptoms in the postoperative period of colorectal surgeries and evaluate the outcomes of emergency department visits and the rate of severe complications within 15 days after hospital discharge.

Design

We developed a digital tool capable of remotely assessing symptoms that could indicate complications related to colorectal surgical procedures and directing early management. This project was divided into two stages. The first was platform development with an algorithm for identifying symptoms and directing conduct, and the second was clinical validation of the program and evaluation of patient's experience. Patients who underwent elective oncological colorectal surgery were invited to participate in this study. We used commercial software (CleverCare) that was adjusted according to the clinical algorithm developed in this study, predicting complications and directing conduct with minimal human intervention using a Chatbot with Natural Language Processing (NPL) and artificial intelligence.

Results

We planned three Interim Analyses to evaluate the outcomes of complications, referrals to the Emergency Department (ED), ED visits, adherence, and patient satisfaction. After each analysis, specialists validated the changes before implementation. A total of 92 eligible participants agreed to participate in the study. The ability to detect complications increased with each adjustment phase, and after the third and last phase, the digital solution identified 3(4.8%) real complications, with a sensitivity of 75%, specificity of 83%, accuracy of 82%, positive predictive value of 27%, and negative predictive value of 97%. Complete adherence to the monitoring program was 83.7% with an NPS score of 94 in the last evaluation phase.

Conclusion

The digital platform is safe with high adherence rates and good patient acceptance.
Paradoxical Tuberculosis Immune Reconstitution Inflammatory Syndrome Complicated by Large Bilateral Psoas Abscess: A Case Report
Authors: Castilla-Encinas Adriam M. , Soto Salas Valeria Rocio , Alvarez-Delgado Hugo , Bocanegra-Becerra Jhon E. , Rondan Paola L.
Published: October 2024

Immune reconstitution inflammatory syndrome is a common manifestation in human immunodeficiency virus (HIV)-positive patients infected with tuberculosis (TB). One of the unusual complications of this condition is the development of psoas abscess. We describe a case of immune reconstitution inflammatory syndrome (IRIS) in a patient with disseminated TB under treatment, HIV-positive with a low CD4 cell count, complicated by bilateral psoas abscess. Our patient presented with fever, abdominal pain, and lymphadenopathy, typical symptoms of TB-IRIS. Diagnosis was confirmed by surgical drainage of the abscess of the right iliac psoas muscle with detection of acid-fast bacteria on Ziehl-Neelsen staining and negative culture of purulent discharge. Treatment with prednisone was started in addition to continuation of antituberculosis therapy and antiretroviral therapy.
Controversies of the Plantar Fasciitis
Authors: Desnantyo Andre Triadi
Published: October 2024

Plantar fasciitis commonly reflects a repetitive strain injury of foot’s plantar fascia structure cause by overuse standing or weight bearing activities. Plantar fascia not really a tendon ; it’s sheet of connective tissue (fascia) from bone at back foot to bone at in front, and more like a ligament. This tissue spanning the arch of the foot and stretch from the heel to toes. The pain is caused by chronic irritation of the arch of the foot due to excessive strain of the plantar fascia as the bow’s string and location of the pain is closely to the heel. Pain hits when get up after a period of sitting or rest. Morning pain is a signature symptom of plantar fasciitis.

In fact, the plantar fasciitis found so little inflammation and shows collagen degeneration-disorganization, so better to use a more generic suffix – like ‘opathy’ (diseased) or osis (condition) become fasciosis. And degeneration in plantar fascia is similar to the chronic necrosis of tendinosis (dying tissue). Inflammation and necrosis are not the same medical situation, and understanding the differences is essensial for adequate treatment.

Bone spurs on the heel or calcaneal spurs get the blame often for plantar fasciitis because it seems so obvious and simple known after x-ray examination. Heel spurs merely a modest calcification of the plantar fascia. The spurs is brittle and thin so that are not as much of painful mechanical problem. Statistically about 10-20% of the population has this spurs and thats lots of people have painless spurs. But the spurs are probably more painful at plantar fasciitis symptoms when other factors are present. In the other hand, examining the foot with ultrasound might turn up some other obvious cause of plantar foot pain, for example thickening of fascia. The evidence shows a connection between fascia thickening, flat feet and plantar fasciitis, but cannot confirmed that thickened plantar fascia is the caused.

Treating plantar fasciitis with all available modalities is more rationale consideration because plantar fasciitis has more variable origin and condition, so that is why respond after treatment might be different in each other cases, especially in a chronic plantar fasciitis or stubborn overuse injury.
Bucket-Handle Meniscus Tear Management with Meniscectomy Versus Repair
Authors: Sakti Muhammad
Published: October 2024

A torn meniscus is one of the most common knee injuries. Bucket handle tears make up about 10% of all meniscus tears. A bucket handle meniscus tear can happen to anyone, but it's more likely to occur if you play sports or exercise frequently. Twisting your knee while running or pivoting may cause a bucket handle meniscus tear. After a bucket-handle meniscus tear, a partial meniscectomy by arthroscopy is recommended, when a meniscal suture is impossible. Short-term results of meniscectomy after bucket-handle meniscus tear, without cartilage or ligament additional injury, are mostly excellent: pain and blocking disappear, return to sports activities is possible.

But the clinical and radiological long-term outcomes are worse after meniscectomy than after meniscus preservation. The consensus clearly states that numerous meniscus tears that were considered irreparable should be repaired, e.g., older tears, tears in obese patients, long tears, etc.

Bucket-handle meniscus tears are common knee injuries that are often treated surgically with meniscectomy or meniscal repair. the current data revealed that only 24.0% of surgically treated bucket-handle meniscus tears were treated using repair. Identification of patient, socioeconomic, and hospital factors differentially associated with meniscal repair suggest that other factors may systematically influence surgical decision-making for this patient population.

However, repair of a displaced bucket handle tear of the meniscus can be technically challenging. When repair is required, surgery should be performed as early as possible. Evidence that biological enhancement such as needling or the application of platelet-rich plasma would improve healing was not identified. Preservation of the meniscus should be considered as the first line of treatment because of an inferior clinical and radiological long-term outcome after partial meniscectomy compared to meniscus repair.

We use an all-inside suture device on the middle and posterior part of the tear The anterior part of the tear is repaired with an outside-in method. Postoperatively, patients will be nonweight-bearing on the operated limb, and range of motion restricted from 0 to 90° for 6 weeks, with the aim of resuming running by 6 months.
Arthroscopic Management of Stiff Elbow
Authors: Kholinne Erica
Published: October 2024

Restoration of motion in a stiff elbow is complex, time-consuming, and costly. Traditionally, a stiff elbow has been defined as having less than 100 degrees of motion arc in the pronosupination and flexion-extension plane. However, this definition may not be sufficient and accurate anymore. Stiff elbow is often underestimated because the traditional belief is that the elbow is not a weight-bearing joint. However, recent studies have shown that the elbow bears loads created by gravity and muscle contraction, and stiffness of the elbow increases load-bearing during resting and arm swing motion.

Stiffness of the elbow can be caused by intrinsic and extrinsic components, which can later be mixed. If degeneration is the background of the disease, then the bony component is more dominant. At the same time, if post-traumatic is the background of the disease, then the soft tissue component is more dominant. Limitations of flexion are usually caused by a bony block in the anterior compartment and soft tissue contracture in the posterior part. On the other hand, a limitation in extension is usually caused by a bony block in the posterior compartment and soft tissue contracture in the anterior part.

Treatment of the stiff elbow ranges from debridement surgery to reconstruction surgery. Arthroscopic osteocapsular arthroplasty is one of the options for treating a stiff elbow. However, it has its challenges, such as a steep learning curve, limited working space, and limited indication in a stiff elbow with advanced-stage elbow osteoarthritis. It benefits patients because of less pain and less intra-articular bleeding, with the premise for early exercise and rapid return of function. During an arthroscopic osteocapsular release, release to the medial collateral ligament can improve flexion. However, good visualization during MCL release is mandatory to avoid ulnar nerve injury and perform adequate release. Prophylactic ulnar nerve release prior to arthroscopic osteocapsular release is recommended for patients with less than 90 degrees of preoperative elbow flexion. Arthroscopic osteocapsular release provides the same functional score compared to open osteocapsular release in primary elbow OA with a stiff elbow. However, the open group can expect a greater flexion arc due to better visibility during the MCL procedure. Arthroscopic osteocapsular release for post-traumatic stiff elbow showed better range of motion gain in extra-articular fracture cases compared to intra-articular fracture cases.

Stiff elbow is challenging, and arthroscopic limitations are especially significant for severely limited flexion motion cases or advanced cases. Arthroscopic management should be avoided if the anatomy is distorted.
Outcome of the Nirschl Technique for Treating Tennis Elbow: A Systematic Review
Authors: Sihotang Airlangga B P , Harvy M Marsheila
Published: October 2024

Introduction & Objectives:

In the modern era, marked by remarkable advancements in medical science and technology, open surgery often referred to as conventional or traditional surgery including in the managmenet of lateral epicondylitis or tennis elbow. Despite being introduced approximately 40 years ago, there are scarce information regarding the outcome of the Nirscl technique. To date, there are no reviews regarding the outcome of such technique in lateral epincodylitis. We aim to investigate the clinical results of surgical treatment of lateral epicondylitis using the Nirschl technique.

Materials & Methods:

A systematic literature search was performed in PubMed, Google Scholar, Sciencedirect, and Cochrane in August 11, 2023. The studies were critically appraised using the Rayyan. We included studies involving adult patients (>16 years) diagnosed with lateral epicondylitis that had undergone the Nirschl surgical procedure. There was no language and date restriction. Outcomes that were recorded were pain scale, scorings, rate of returning to sports or work, number of revision surgeries required, and patient satisfaction.

Results:

From a total 614 studies, 9 studies involving 561 elbows were included in this review. The mean duration of follow-up ranged from 6 months to 12.6 years. The available data suggested the patient who underwent the surgery were mostly ended up with an excellent condition. The mean pain of the patients were decreased. Almost all patients reported with no complication and returned to work or sport.

Conclusion:

The Nirschl technique offers satisfactory outcome for those with lateral epincodylitis, with majority of the patients return to sports or work. However, as this review was limited by level of evidence of the studies, more prospective studies are required to investigate the outcome of such technique.
Single bundle vs double bundle for anterior cruciate ligament reconstruction evaluated with T2 mapping: A case series
Authors: Nelwan Bobby N. , Lubis Andri M.T. , Dilogo Ismail H. , Hanitya Alberto L.
Published: October 2024

Introduction:

ACL reconstruction is needed to restore the stability and biomechanics properties of the injured knee joints in order to reproduce the function of the native ACL. The single-bundle (SB) and double-bundle (DB) techniques are most commonly used to reconstruct the injured ACL. However, its superiority upon each other is still controversial. The goal of this case series is to determine the superiority of either methods of ACL repair in terms of postoperative joint stability.

Materials and methods:

This study presented a case series of six patients underwent ACL reconstruction, consisted of three patients with SB ACL reconstruction and three patients with DB ACL reconstruction with further T2 mapping for joint instability evaluation. Only two DB patients showed consistent decreased value in every follow-up.

Results:

ACL tear can generate joint instability. Joint instability is resulted from two mechanisms of relative cartilage overloading. First, there is an abnormal load distribution due to shifting of the center of pressure of the tibiofemoral force, resulting in increased stresses on the articular cartilage of the knee joint. There is also an increase of translation between articular surfaces, resulting in increased shear stresses on the articular cartilage. A trauma of knee joint causes cartilage damage and increased oxidative and metabolic stress of chondrocytes, resulting in chondrocyte senescence acceleration.

Conclusion:

This case series showed inconsistent results to determine either SB or DB has a better outcome in joint instability, thus further larger studies are needed.
Risk Factors for Graft Rupture following ACL Reconstruction Surgery: A Systematic Review
Authors: Dewantara Armansyah Nur , Wien Aryana I Gusti Ngurah , Febyan
Published: October 2024

Introduction & Objectives:

Anterior Cruciate Ligament (ACL) injuries are common in sports-related activities and often require reconstruction surgery to restore knee stability. Graft rupture, the failure of the reconstructed ACL graft, remains a significant concern post-surgery. This systematic review and meta-analysis aim to identify risk factors associated with graft rupture, including age, graft type, and meniscal injuries, to enhance clinical decision-making and patient outcomes.

Materials & Methods:

A comprehensive literature search was conducted in multiple electronic databases. Studies meeting inclusion criteria were analyzed for age distribution, graft type impact, and the association between meniscal injuries and graft rupture. Data were extracted, and the risk of bias was assessed using standardized criteria.

Results:

Five studies met the inclusion criteria, providing insights into risk factors for graft rupture. Younger age consistently emerged as a significant risk factor for graft failure due to increased activity levels, biomechanical demands, and physiological factors. Graft type, specifically hamstring tendon grafts, showed a slightly elevated risk of failure compared to quadriceps tendon grafts. Meniscal injuries were associated with increased graft failure risk, potentially due to altered biomechanics and impaired graft integration. These risk factors interact and contribute to the overall outcome of ACL reconstruction.

Conclusion:

The interplay of age, graft type, and meniscal injuries significantly influences graft rupture risk in ACL reconstruction. Addressing each risk factor within the context of the patient's profile is essential for successful treatment. Individualized treatment plans should be developed, accounting for patient demographics, lifestyle, and injury characteristics. Further research into the underlying mechanisms connecting these risk factors could lead to targeted preventive strategies and improved patient outcomes.
Future Potential of Stem Cells Conditioned Medium (Secretome) in Knee Cartilage Healing: A Systematic Review
Authors: Adisthanaya Surya , Febyan  , Astawa Putu , Wien Aryana Gusti Ngurah
Published: October 2024

Introduction and Objectives:

Articular cartilage injuries, caused by trauma, genetic predisposition, and degenerative changes, are characterized by limited self-repair abilities due to the absence of blood vessels and restricted progenitor cell entry. Osteoarthritis (OA) is a common condition, progressively eroding articular cartilage and impacting all joint tissues. Mesenchymal Stem Cells (MSCs) offer promising stem cell-based therapies for cartilage regeneration, with their secretome playing a vital role in tissue repair. MSC-derived exosomes have demonstrated beneficial effects in promoting cartilage regeneration and preventing degeneration. This review highlights the potential of MSCs in cell therapy for repairing articular cartilage defects and related issues.

Materials and Methods:

In this systematic review PubMed, MEDLINE, the Cochrane Library, Scopus, Web of Science, and Science Direct were searched up to 27 July 2023. The ARRIVE criteria were used to assess the risk of bias.

Results:

Of the 63 screened studies, based on the inclusion and exlusion criteria, 6 studies met the eligibility criteria to systematically reviewed. Theres a significance of synovial membrane-derived MSCs (SMMSCs) in cartilage repair due to their close relation to chondrocytes and enhanced chondrogenic potential. We also found specific microRNAs to enhance the effectiveness. To enhance the impact of MSC exosomes, we have explored methods for effectively retaining them at the cartilage defect site.

Conclusion:

It was demonstrate strong support for the promising potential of Stem Cells Conditioned Medium (Secretome) in facilitating knee cartilage healing.
Single Bundle vs. Double Bundle ACL Reconstruction: Is there any difference in Joint Stability and Subjectivity?
Authors: Manalu Vinalola , Marsetio Aldo Fransiskus , Nelwan Bobby
Published: October 2024

Introduction:

Anterior cruciate ligament rupture (ACL) is one of the most frequent orthopedic sport injuries. Total rupture of ACL can be managed either with single bundle (SBACL) or double bundle (DBACL) reconstruction techniques. The aim of the study was to compare surgical outcomes with joint stability and subjectivity outcomes to analyze whether DBACL reconstruction is superior than SBACL.

Methods:

A cohort study was conducted in total ACL rupture patients between 2019-2022 at Gatot Soebroto Central Army Hospital. Fourty three male patients were included in this study, with 22 patients in SBACL group and 21 patients in DBACL group. The International Knee Documentation Committee (IKDC) and Lysholm scores were used to subjectively evaluate the function of the knee joint before the surgery and the postoperative follow-up at three and six months. Both groups were measured by Lachman test, Pivot test, and rolimeter for joint stability.

Results:

The results of patient reported outcomes using IKDC and Lysholm scores showed no significant difference in both groups before surgery and after three-month and six-month follow-ups (p=0.401; p=0.054; p=0.066 and p=0.345; p=0.217; p=0.082), although the mean value from each group had improved. Joint stability was measured using Lachman test (p=0.849; p=0.126; p=0.466), Pivot test (p=0.877; p=0.678; p=0.904), and rolimeter (p=0.395; p=0.566; p=0.455) also showed no significant differences.

Conclusion:

The study showed non superiority between single bundle ACL reconstruction and double bundle ACL reconstruction in joint stability and subjectivity.
Household Inefficient Electricity Consumption and Its Determinants in Rural Areas
Authors: Basumatary Sijousa , Devi Mridula , Basumatary Konita , Basumatary Iragdao Raja
Published: October 2024

Using stochastic frontier analysis (SFA) technique on the main data obtained by stratified random sampling, we have examined the inefficiency of families’ energy use in rural areas in this work. The households’ average efficiency is 77.25%, which suggests that there is a 22.75% underlying inefficiency. The stochastic demand frontier shows that minimum wattage requirements and government subsidies have a considerable beneficial influence on residential power usage. Unexpectedly, the number of living rooms does not cause an increase in electricity usage in rural areas. Overall, we discovered that rural regions’ inefficient electricity use is more a result of supply-side limitations than of demand-side ones.
Experiential Pedagogies for Cultivating Entrepreneurial Mindsets: Action Design Learning as Tailored Framework
Authors: Nzembayie Kisito F. , Buckley Anthony Paul , Talay Isilay
Published: October 2024

Despite the recent recognition of experiential learning as an effective pedagogy for cultivating entrepreneurial mindsets, it still lacks a robust and tailored conceptual foundation primed for adoption in entrepreneurship education (EE). Addressing this deficit, this research integrates action learning and design learning to propose Action Design Learning (ADL) as a bespoke and adaptable framework for experiential learning in EE. ADL fosters entrepreneurial mindsets by placing first- and second-person learning at the core of pedagogy, using emergent entrepreneurial artifacts as focusing devices. Through longitudinal insider action research, the framework is abductively evaluated across two cases in Irish universities, culminating in a functional adaptation primed for adoption. The study reveals that ADL provides a robust conceptual foundation that educators can readily apply in designing and delivering high-impact curricula that foster metacognitive abilities deemed foundational to an entrepreneurial mindset. Consequently, this study contributes to the experiential learning discourse by offering a theoretically grounded pedagogy that overcomes skepticism about the efficacy of this approach in promoting high-impact EE.
An extraordinary case of Buschke–Lowenstein tumor: multiple localization, malignant transformation, and clinical insights—a case presentation and literature review
Authors: Müdüroğlu Mustafa , Güllüoğlu Yaşar Barış , Taşlıpınar Melike , Uymaz Derya Salim , Büyükbabani Nesimi , Ağaoğlu Galip , Kordan Yakup , Özkan Arif
Published: October 2024

Background

Buschke–Lowenstein (B–L) tumors are rare, aggressive warty lesions that can grow to enormous sizes and have a risk of malignant transformation despite their benign histology. These tumors are primarily caused by HPV types 6 and 11, with additional risk factors, including immunodeficiency, multiple sexual partners, poor hygiene, and a history of other genital infections. The typical treatments include topical medications, cryotherapy, chemotherapy, radiotherapy, and surgery. Surgery is considered the gold standard, particularly for extensive and infiltrative lesions, as demonstrated in our case.

Case presentation

We report a case of a male patient with perianal and penopubic B–L tumors, who had multiple sexual partners and no history of homosexual relationships, presenting with refractory classic condyloma. The perianal tumor exhibited malignant transformation, while the penopubic tumor remained histopathologically benign. Upon admission, the patient showed unusual biochemical blood results, including hypercalcemia and anemia of chronic illness. The operation and postoperative period were managed by a multidisciplinary team. The patient was satisfied with both the cosmetic and functional outcomes. Histopathological examination confirmed the suprapubic lesion as a B–L tumor, whereas the perianal specimen revealed a small focus of squamous cell carcinoma arising from a B–L tumor.

Conclusions

With an experienced multidisciplinary team, excision of the tumor is still the standard treatment for BL tumor. Achieving a negative surgical margin for any SCC foci is of utmost importance to prevent recurrence. Close and careful follow-up is essential due to the high recurrence rate associated with these tumors. Further research is needed to clarify existing controversies and to enrich the literature on this rare phenomenon.