bluuebunny/crossref_metadata_2025_split huggingface dataset:
De-Politicizing and Dis-Remembering the White Terror Through Gothic: The Grand Narrative and Embarrassed Politics of Collective Commemoration in the Movie Detention
Authors: Lin Min-tser 
Published: December 2024

Abstract
This article aims to read Taiwan’s 2019 cinematic horror sensation, Detention, as part of the nation’s effort to construct a grand narrative of collective commemoration, as it tries to streamline its multiple conflicting memories about the Nationalist government’s violent political suppressions of suspected dissidents during the mid-20th century, commonly called the White Terror. For this nationalist narrative to follow the Gothic scenario of progression from repression to liberation, embarrassing elements of the past, especially many White Terror victims’ sympathy with the Chinese Communist Party, must be de-politicized and dis-remembered. The movie adopts a ploy that can be called “isomorphic camouflage” in presenting its scenes and characters to evoke most viewers’ impressions about the White Terror while removing their actual political significances. This Gothic agenda, however, confronts its traumatizing point at the center of the movie, its female protagonist Fang Ray-shin, whose “ignorance and innocence” ironically expose the limitation of the nationalist collective commemoration.
Endoscopic Screening for Laryngotracheal Complications in Children Following Prolonged Mechanical Ventilation Maintained Through Endotracheal Intubation: A Cross-Sectional Pilot Project
Authors: Dutta Mainak , Jana Debjit , Mukherjee Diptanshu , Panja Tanaya , Shukla Amit Kumar , Daga Divya , Yadav Krishna Kumar , Mondal Swarnali , Bandyopadhyay Saumendra Nath 
Published: December 2024

Background: An endoscopic screening program following successful weaning from prolonged mechanical ventilation maintained through endotracheal tube (ET; prolonged intubation) may be justified to assess the upper (laryngotracheal) airway in children who may not always be symptomatic for intubation-related complications. Objectives: To evaluate effects of prolonged intubation in children through endoscopic screening of the laryngotracheal airway. Methods: In this cross-sectional pilot project, children (2 months-12 years) successfully extubated following prolonged intubation were selected, irrespective of having symptoms, for a 1-time flexible nasolaryngoscopy at third to sixth month post-extubation (follow-up window). Laryngotracheal airway changes, if present, were noted. Results: Out of 122 children, 42 developed symptoms of complications. Five of them attended within 3 months post-extubation, the rest were evaluated in the follow-up window. Eighty children aged ≤6 years and 4 children >6 years were intubated with uncuffed ET. Symptoms, when present, included respiratory distress (100%), noisy breathing (~36%), cough (~29%), and dysphagia (~12%). Screening revealed positive findings in 40 out of 42 symptomatic children, and in 8 out of 80 asymptomatic children (χ2 = 80.314; after Yate’s correction; significant at P < .0001). The commonest lesion was subglottic stenosis (~54%) and intubation granuloma (~48%). Relationship between the nature of ET (cuffed/uncuffed) and complications of prolonged intubation was statistically significant (χ246.553; significant at P < .0001). Conclusion: The present study proposes the potential utility of follow-up endoscopic screening of upper (laryngotracheal) airway in children successfully weaned from prolonged intubation. A statistically significant relationship existed between prolonged intubation and upper airway complications that were not always symptomatic.
Relationship between post-prostatectomy urinary incontinence, sexual functions, and dyadic adjustment: A cross-sectional study
Authors: Rossi Francesco , Marino Filippo , Gandi Carlo , Bizzarri Francesco Pio , Campetella Marco , Bientinesi Riccardo , Silvaggi Marco , Sacco Emilio 
Published: December 2024

Introduction: Robot-assisted radical prostatectomy (RARP) is the treatment option for localized prostate cancer. It can lead to side effects like erectile dysfunction (ED) and post-prostatectomy urinary incontinence (PPUI). This study aimed to evaluate association between dyadic adjustment, PPUI and ED. Material and Methods: Consecutive male patients who underwent RARP from January 2019 to December 2021, with at least 12 months of follow-up and preoperative International Index of Erectile Function (IIEF) 15 erectile domain questionnaire’s score ⩾17 were enrolled. Demographic and surgical data were collected at baseline. Validated questionnaires were self-administered at 12-month follow-up: IIEF-15, Dyadic Adjustment scale (DAS), and Los Angeles–Prostate Cancer Index Urinary Function Score (UCLA-PCI-UFS). Univariable and multivariable analyses were performed to examine degree of association between different variables. Results: Out of 96 enrolled patients, 37 (38.5%) were socially incontinent (>1 pad per day) at 12 months from surgery. Statistically significant association was found between incontinence and lower DAS total score ( p < 0.0001), DAS consensus domain ( p < 0.0001), and DAS affectional expression domain ( p = 0.002). DAS total score ( p = 0.002) and DAS consensus domain score ( p = 0.012) were lower in impotent group (IIEF-15 erectile domain score <17). On a multivariable analysis, PPUI (beta: −0.25; 95% CI: −4.42, −0.47; p = 0.016) and post-operative ED (beta: 0.19; 95% CI: 0.002, 0.57; p = 0.048) were independent predictors of low DAS score. Pelvic lymphadenectomy (PLND) (beta coefficient: 0.25; 95% CI: 0.1, 1.2; p = 0.022), bladder neck reconstruction (beta: 0.26; 95% CI: 0.19, 1.09; p = 0.006), and ED (beta coefficient: −0.3; 95% CI: −0.07, −0.018; p = 0.001) were independent predictors of continence status. Conclusion: PPUI following RARP is associated with lower dyadic adjustment, independently from other factors, indicating significant impact of PPUI on marital relationships. Further research should be conducted to understand better the cross-effective relationship between PPUI, potency, dyadic adjustment, and the effect of surgical treatments on incontinence and sexual function.
Levofloxacin-loaded silicone contact lenses materials for ocular drug delivery
Authors: Guo Xuefang , Sun Ying , Qiao Jing , Fan Ben , Zhang Xueqin 
Published: December 2024

Silicone contact lenses (SCL), as an emerging ocular drug delivery system, achieve controlled drug release. However, the existing drug loading methods have limitations such as low drug uptake, complicated operation process, poor welling rate and transmittance of the lens after drug loading. In this study, an effective microemulsion soaking method was proposed to increase the drug-loading capacity of silicone contact lenses. Levofloxacin (LVF) was encapsulated into the microemulsion by direct agitation, then the microemulsion was loaded into silicone contact lenses using the immersion method. The adsorption capacity of levofloxacin and its effect on drug release kinetics were explored. The results showed that the particle size of the microemulsion was approximately 160 nm. The levofloxacin microemulsion soaking method (LVF-ME-SCL) significantly enhanced the drug loading of levofloxacin in the silicone contact lenses, achieving a maximum drug loading of 216.32 ± 1.15 μg/lens ( p > 0.05). The total release rate of levofloxacin was 95.96% when the sustained release time was 10 h, and the drug leakage observed after 10 h was negligible. The survival rate of E. coli and S. aureus in LVF-ME-SCL-1 (LVF concentration was 4.8 mg/mL) group was 0 and 19.33 ± 0.02% ( p < 0.0001), with a significant difference, indicating that the drug-loaded silicone contact lenses exhibited effective bactericidal properties against E. coli and S. aureus. Following the addition of maximum levofloxacin, the surface contact angle of silicone contact lenses decreased significantly to 32.88 ± 1.19° ( p > 0.05), while the swelling, mechanical properties, and oxygen permeability remained relatively unchanged. There was no significant decrease in the transmittance of the contact lenses after the addition of levofloxacin, which remained above 95%. In conclusion, these results show that the microemulsion impregnation method effectively improves the drug loading and sustained release time of levofloxacin, and maintains lens performance stability before and after drug loading, so it is expected to be used in ophthalmic treatment.
Establishing the Research Priorities of ADHD Professionals: An International Delphi Study
Authors: Stephens Kate , Sciberras Emma , Bisset Matthew , Summerton Ainsley , Coghill David , Middeldorp Christel M , Payne Leanne , Bellgrove Mark A , Faraone Stephen V. , Banaschewski Tobias , Newcorn Jeffery H. , Espinet Stacey D. , Manor Iris , Alqahtani Mohammed M.J. , Varnham Jeremy , Silk Timothy J 
Published: December 2024

Objectives: To determine ADHD research priorities from the perspective of ADHD professionals internationally. Method: A two-stage modified Delphi design was used. In Stage 1 (qualitative), participants listed research questions relating to ADHD that they perceived to be most important ( N = 132). In Stage 2 (quantitative), participants were then asked to rate each research question that was deemed appropriate (able to be researched and not already addressed by research) in terms of perceived importance ( N = 180). Results: Stage 1 generated 382 research questions with 10 broad areas identified for example, co-occurring conditions and treatment, etc. The top 20 most important questions related to ADHD in women/girls, long-term medication use, non-pharmacological interventions, ADHD measurement/rating scales, and efficacy of emotional regulation interventions. Conclusion: These results can inform an ADHD research agenda which represents the views of the individuals from major ADHD professional groups internationally. Parallel work is needed focusing on research priorities from the perspective of ADHD consumers.
Effect of Time to Surgery on Surgical Site Infection in Open Distal Radius Fractures: A Review of the ACS Trauma Quality Improvement Program Database
Authors: Sobba Walter , Lin Lawrence J. , Sanchez-Navarro Gerardo E. , De Tolla Jadie , Ayalon Omri , Hacquebord Jacques H. 
Published: December 2024

Introduction: Managing open distal radius fractures (DRFs) poses challenges. While preventing surgical site infection (SSI) involves prompt antibiotic administration and thorough irrigation and debridement, the impact of urgent intervention on reducing postoperative infection rates is debated. We hypothesize that timing of surgery does not significantly affect the incidence of SSI in open DRF treated within or after 24 hours from time of injury. Methods: We retrospectively analyzed the American College of Surgeons Trauma Quality Improvement Program from 2011 to 2021. We focused on outcome variables, including superficial SSI and deep SSI or osteomyelitis. To evaluate the relationship between time to operative intervention and SSI rates, we employed least absolute shrinkage and selection operator and multivariate regression models, adjusting for patient-specific factors and injury severity. Results: A total of 14 486 patients were included. Regression modeling demonstrated a 23% increase in the odds of deep SSI with each 1-day delay in surgery ( P = .010). However, no association was found between time to surgery and superficial SSI (odds ratio [OR] = 0.96, P = .768). Injury severity score (ISS) was associated with increased odds of superficial SSI (OR = 1.06, P < .001) and deep SSI (OR = 1.06, P < .001) while diabetes (OR = 3.56, P = .013) was significantly associated with increased rates of superficial SSI. Conclusions: Extended time to surgery correlates with a modest rise in deep SSI incidence in open DRF. However, there was no heightened risk of superficial SSI in patients with delayed surgery. Polytrauma, alcohol use disorder, and diabetes were linked to elevated SSI rates in open DRF.
Improving diagnosis of primary aldosteronism through education: a modified Delphi study to identify key learning points
Authors: Widjaja Jocelyn , Yang Jun , Harrison Julia 
Published: December 2024

Background: Primary aldosteronism (PA) is the most common endocrine cause of secondary hypertension and can be effectively managed, or even cured, with targeted treatment. Despite this, it remains largely undiagnosed leaving a significant patient population with resistant hypertension and modifiable cardiovascular risk. Objective: To determine expert consensus on key information about PA that should ideally be taught to medical students as a step toward improving the detection of this common, underdiagnosed, and often easily treated condition. Design: The study employed a modified Delphi method which consisted of three rounds, the first of which contained an open-ended question about key areas that experts believe to be most important for inclusion in medical teaching resources and then progressing to assessment of individual versus group rankings of consensus items. Experts included both clinician-educator-researchers and patients with lived experience. Results: Nine critical knowledge areas in epidemiology, diagnostics, and pathophysiology were identified by the Delphi as consensus items, with the highest ranked being: “PA is common but often under-diagnosed – think about it with every hypertensive patient.” Conclusion: Experts reached a consensus, for the first time, on nine critical knowledge areas about PA that should be covered in medical education. Importantly, the consensus accounted for patients’ values and decisions. The results of this study could be used to assess medical student knowledge and their learning resources to facilitate curriculum development and medical resource updates to ensure the timely and accurate diagnosis of PA in hypertensive patients.
Hardware Removal after Lisfranc ORIF Results in Immediate Improvement in Physical Function
Authors: Sroka Oliver , Campbell Megan L. , Dong Willie , Thorne Tyler , Higgins Thomas , Rothberg David , Haller Justin , Marchand Lucas 
Published: December 2024

Category: Trauma; Midfoot/Forefoot Introduction/Purpose: Hardware removal (HWR) after Lisfranc open reduction internal fixation (ORIF) is often standard following successful treatment. The purpose of this study was to investigate whether HWR after Lisfranc ORIF resulted in immediate, measurable impact via PROMIS physical function (PF) and pain intensity (PI) scores. Methods: A retrospective review of all adult patients with surgically treated, isolated Lisfranc injuries at one tertiary level 1 trauma center between 2002-2023 was performed. Demographic data and patient reported outcomes (PROs) were recorded. Patients were excluded if they received index treatment other than ORIF, underwent secondary surgical intervention for their Lisfranc injury other than HWR, or if HWR did not occur in the standard 3-6 month interval following ORIF. Patients who underwent HWR and had PROMIS scores collected at their postoperative visit were compared to those with retained hardware by 6 months. The primary outcome was patient reported measures of PROMIS PF and PI. The Wilcoxon signed-rank test compared differences between PRO scores within the HWR removal group and the Wilcoxon ranked-sum test compared differences between HWR and no HWR groups. Distributive MCID was calculated using the 0.5 SD method. Results: We identified 482 patients (489 feet) with isolated Lisfranc injuries. Of these, seventy-seven feet underwent ORIF followed by HWR. Thirty feet had ORIF but did not have HWR. HWR occurred an average of 132 days (4.5 months) after ORIF. Patients who underwent HWR had a statistically significant increase in average PF scores in the immediate postoperative period, reaching the calculated MCID of 3.3 (40.2 to 45.6, p< 0.001). HWR patients also had a non-significant decrease in average PI scores (55.9 to 54.2, p=0.103). Compared to those who did not undergo HWR, the HWR group demonstrated a statistically significant net improvement in PF scores from surgery, with an average improvement of 4.7 postoperatively (P=0.003). Conclusion: Patients experienced immediate and significant improvement in PROMIS PF scores after HWR for Lisfranc ORIF. HWR patients also had a non-significant decrease in average PROMIS PI scores.
High-Stress Shifts Among Orthopaedic Trainees Alter Cognitive Abilities and Surgical Performance
Authors: Walley Kempland C. , Jandzinski Michal , Michaels Ross , Eichman Jack , Hake Mark , Ahn Jaimo , Holmes James 
Published: December 2024

Category: Other; Trauma Introduction/Purpose: The effect of sleep deprivation and environmental stresses for orthopaedic trainees can manifest as physical and mental impairment in addition to worsening psychomotor performances. Lack of sleep and rest may compromise both decision making and clinical judgement, though this area of study largely has been unstudied. The purpose of this study is to quantify the volume of clinical workload that precipitates a decline in psychomotor and cognitive performance among orthopaedic trainees. Methods: The study cohort was comprised of Orthopedic Surgery residents (PGYII-V) from an Level I Academic Medical System/Tertiary Care Center taking primary fracture/trauma call over 1 24 month span. Resident participants were evaluated prior to, and immediately after, 12 and 24-hour call shifts. Participants’ technical and spatial processing abilities were evaluated via targeted drilling exercises on sawbones. Cognitive performance and neuropsychology assessments were captured with a validated, cognitive testing platform. These performances were analyzed against matched-clinical workload stress-level assignments following each call shift. Results: Following exposure to call-shifts, residents that experienced a high-stress call shift displayed statistically significant impairments to their cognitive performances with declines in their mental flexibilities (P = 0.0079) and information processing (P = 0.0003) capabilities. High-stress call shift exposure was also associated with significantly worse performance on psychomotor testing, a proxy for surgical performances, as demonstrated by higher aiming errors (P = 0.028) and miss distances (P = 0.046) on drilling exercises. Linear regression demonstrated a protective effect of increased baseline attention on psychomotor performance following call shift exposure (P=0.0004). Conclusion: Following high-stress call shifts among orthopaedic trainees, one can expect declines in neurocognition and technical performance independent of length of call shift and sleep deprivation. This study demonstrates a statistically significant and potentially clinically important relationship between increased clinical workload and decline in psychomotor performance and cognitive function. Higher baseline attention may be protective against this decline.
Impact of Early Weightbearing after Autologous Osteochondral Transplantation for Osteochondral Lesion of the Talus– A Systematic Review and Meta-Analysis
Authors: Chiet Hong Choon , Pearce Christopher J. 
Published: December 2024

Category: Sports;n Arthroscopy Introduction/Purpose: The influence of early weightbearing after autologous osteochondral transplantation (AOT) for the treatment of osteochondral lesion of the talus (OLT) remains unclear. We aim to provide a comprehensive systematic review and meta-analysis to determine the impact of early weightbearing on the clinical outcomes of AOT for OLT with secondary aims to review the rate of return to sports and/or activities and complications. Methods: A systematic review of the PubMed, Embase, and The Cochrane Library databases was performed according to the PRISMA guidelines. Publications were divided into Group A where patients were allowed early weightbearing within the first 6 weeks while Group B consisted of patients who were only allowed weightbearing after 6 weeks. Unweighted estimates were calculated instead of quantitative random-effects meta-analysis due to the high heterogeneity and low level of evidence of the included studies. Results: A total of 35 studies with 1457 ankles were included. There were 20 studies in Group A and 15 studies in Group B. Both the AOFAS and VAS scores were not affected by early weightbearing after AOT for OLT. There were also no differences in rate of return to sports and/or activities found although late weightbearers were more likely to have complications compared to early weightbearers (19% vs 8.4%; RR=0.44, 95% CI:0.32-0.61, p< 0.01). Notably, late weightbearers were 1.79 times (RR=0.56, 95% CI:0.13-2.48, p=0.45) more likely to have postoperative ankle stiffness with/without pain. They were also twice more likely to require repeat surgery for the ankle (11.8% vs 5.4%; RR=0.46, 95% CI:0.28-0.73, p=0.001). The commonest cause for repeat surgery was ankle arthroscopy and debridement for postoperative impingement or pain. Conclusion: Early weightbearing after AOT for OLT yielded similarly good clinical outcomes and return to sports and/or daily activities when compared to late weightbearing. Late weightbearers were significantly more likely to suffer from complications and twice as likely to require repeat surgery.
Impact of Surgeon Specialty on Ankle Arthrodesis Readmission, Complication, and Infection Rates: A Medicare Analysis
Authors: Nixon Devon , Ko Hyunkyu , Martin Brook 
Published: December 2024

Category: Ankle Arthritis; Other Introduction/Purpose: Ankle arthrodesis (AA) remains a reliable treatment option to address end-stage ankle pathology in appropriately selected patients. When successful, AA surgeries can yield high patient satisfaction and marked improvements in patient-reported outcomes. AA can be performed by orthopedic surgeons (MD or DO) and non-orthopedic surgeons (DPM). However, no prior study has compared surgical safety indicators of AA based on surgeon specialty. Methods: Utilizing Medicare claims from 2016 to 2019, we retrospectively identified patients ≥65 years of age who underwent AA based on CPT coding. Patients on Medicare Health Maintenance Organization (HMO), End-Stage Renal Disease (ESRD), age under 65, and dual-eligible patients were excluded. Within this dataset, provider specialty was identified from Part B (provider claim), allowing for comparisons between orthopedic and non-orthopedic surgeons. We compared groups based on readmission, all-complication, and infection rates within 1-year of AA using logistic regressions controlling for age, sex, race, and Charlson Comorbidity Index (CCI). To help mitigate bias, we also performed a propensity matched model with the same variables. Data were reported as percentage point (PPT) differences (95% CI) between groups, with a positive number indicating higher rate of complications among patients treated by non-orthopedic surgeons. Results: During our timeframe, 3,274 AA procedures were performed by orthopedic surgeons and 614 by non-orthopedic surgeons. Non-orthopedic surgeons performed AA on patients with greater comorbidities (CCI scores: 0, 1, 2+: 34.7%, 20.4%, 44.8%) compared to orthopedic surgeons (CCI scores: 28.2%, 16.4%, 55.4%) (p< 0.001). AA performed by non-orthopedic surgeons, compared to orthopedic surgeons, had higher all-cause readmission rates (46.1% vs. 39.4%, p=0.008), all-complication rates (72.3% vs. 63.7%, p< 0.001) as well as complications with readmission (49.9% vs. 43.9%, p=0.019) and without readmission (55.0% vs. 43.1%, p< 0.001). All-cause infection risk within 1-year was higher in non-orthopedic surgeons (16.2% vs. 9.3%, p< 0.001), and persisted in our propensity-matched analyses (6.9 ppt higher (CI: 2.2, 11.7), p=0.004). Differences in the other safety measures were largely attenuated in the propensity-matched analysis. Conclusion: AA performed by non-orthopedic surgeons had greater all-complication, readmission, and infection rates as compared to AA done by orthopedic surgeons. Infection risk most notably persisted in analyses controlling for comorbidities. Infection following AA can lead to devastating outcomes for patients. The implication of findings like these will require further study to better understand how foot and ankle care is administered to patients at a policy-level.