bluuebunny/crossref_metadata_2025_split huggingface dataset:
Radiological tarsal bone morphology in adolescent age of congenital clubfeet treated with the Ponseti method
Authors: Hamel Johannes , Hörterer Hubert , Harrasser Norbert 
Published: April 2021

AbstractBackgroundMajor abnormalities of tarsal bone shape after surgical clubfoot treatment are well known from the literature. The Ponseti method has gained widespread acceptance in primary treatment of congenital clubfeet. Despite the longtime experience, data regarding the development of tarsal bones after this treatment are still rare. The aim of the study was therefore to evaluate radiographic parameters describing tarsal bone shape of clubfeet after Ponseti treatment and compare them to age-matched healthy feet.MethodsTwenty two consecutive severe clubfeet in 14 patients were investigated by repeated diagnostic ultrasound during the corrective process. Extent and temporal course of correction were documented with standardized X-rays after a mean follow-up of 12 years (between the ages of 10–14 years) and compared to a group of age-matched normal feet.ResultsReliability testing for all X-ray parameters showed good to excellent results. In comparison to the control group, all parameters except the radius of the trochlea (RT) were significantly altered in clubfeet with highest differences shown for the anterior talar motion segment (ATM), talonavicular coverage (TNC) and the talometatarsal index (TMT-Index). Differentiation between minor and major deformities showed significant differences only for the front tarsal index (FTI).ConclusionsTarsal bone shape of clubfeet treated by the Ponseti method differs significantly from normal feet. One of the most pronounced and clinically relevant difference of the clubfoot talus compared to the normal talus is the markedly reduced anterior talar motion segment.
COVID-19 outbreak and acute cholecystitis in a Hub Hospital in Milan: wider indications for percutaneous cholecystostomy
Authors: Barabino Matteo , Piccolo Gaetano , Trizzino Arianna , Fedele Veronica , Ferrari Carlo , Nicastro Vincenzo , Pisani Ceretti Andrea , De Nicola Enrico , Mariani Nicolò Maria , Giovenzana Marco , Scifo Giovanna , Mazza Massimiliano , Vercelli Ruggero , Santambrogio Roberto , Luigiano Carmelo , Opocher Enrico 
Published: April 2021

Abstract
Background
COVID-19 pandemic has impacted the Italian National Health Care system at many different levels, causing a complete reorganization of surgical wards. In this context, our study retrospectively analysed the management strategy for patients with acute cholecystitis.

Methods
We analysed all patients admitted to our Emergency Department for acute cholecystitis between February and April 2020 and we graded each case according to 2018 Tokyo Guidelines. All patients were tested for positivity to SARS-CoV-2 and received an initial conservative treatment. We focused on patients submitted to cholecystostomy during the acute phase of pandemic and their subsequent disease evolution.

Results
Thirty-seven patients were admitted for acute cholecystitis (13 grade I, 16 grade II, 8 grade III). According to Tokyo Guidelines (2018), patients were successfully treated with antibiotic only, bedside percutaneous transhepatic gallbladder drainage (PC) and laparoscopic cholecystectomy (LC) in 29.7%, 21.6% and 48.7% of cases respectively. Therapeutic strategy of three out of 8 cases, otherwise fit for surgery, submitted to bedside percutaneous transhepatic gallbladder drainage (37.5%), were directly modified by COVID-19 pandemic: one due to the SARS-CoV-2 positivity, while two others due to unavailability of operating room and intensive care unit for post-operative monitoring respectively. Overall success rate of percutaneous cholecystostomy was of 87.5%. The mean post-procedural hospitalization length was 9 days, and no related adverse events were observed apart from transient parietal bleeding, conservatively treated. Once discharged, two patients required readmission because of acute biliary symptoms. Median time of drainage removal was 43 days and only 50% patients thereafter underwent cholecystectomy.

Conclusions
Percutaneous cholecystostomy has shown to be an effective and safe treatment thus acquiring an increased relevance in the first phase of the pandemic. Nowadays, considering we are forced to live with the SARS-CoV-2 virus, PC should be considered as a virtuous, alternative tool for potentially all COVID-19 positive patients and selectively for negative cases unresponsive to conservative therapy and unfit for surgery.
A signature of 24 aging‑related gene pairs predict overall survival in gastric cancer
Authors: Zhang Yankai , Yan Yichao , Ning Ning , Shen Zhanlong , Ye Yingjiang 
Published: April 2021

AbstractBackgroundAging is the major risk factor for most human cancers. We aim to develop and validate a reliable aging-related gene pair signature (ARGPs) to predict the prognosis of gastric cancer (GC) patients.MethodsThe mRNA expression data and clinical information were obtained from two public databases, The Cancer Genome Atlas (TCGA) dataset, and Gene Expression Omnibus (GEO) dataset, respectively. The best prognostic signature was established using Cox regression analysis (univariate and least absolute shrinkage and selection operator). The optimal cut-off value to distinguish between high- and low-risk patients was found by time-dependent receiver operating characteristic (ROC). The prognostic ability of the ARGPS was evaluated by a log‐rank test and a Cox proportional hazards regression model.ResultsThe 24 ARGPs were constructed for GC prognosis. Using the optimal cut-off value − 0.270, all patients were stratified into high risk and low risk. In both TCGA and GEO cohorts, the results of Kaplan–Meier analysis showed that the high-risk group has a poor prognosis (P < 0.001,P = 0.002, respectively). Then, we conducted a subgroup analysis of age, gender, grade and stage, and reached the same conclusion. After adjusting for a variety of clinical and pathological factors, the results of multivariate COX regression analysis showed that the ARGPs is still an independent prognostic factor of OS (HR, 4.919; 95% CI 3.345–7.235;P < 0.001). In comparing with previous signature, the novel signature was superior, with an area under the receiver operating characteristic curve (AUC) value of 0.845 vs. 0.684 vs. 0.695. The results of immune infiltration analysis showed that the abundance of T cells follicular helper was significantly higher in the low-risk group, while the abundance of monocytes was the opposite. Finally, we identified and incorporated independent prognostic factors and developed a superior nomogram to predict the prognosis of GC patients.ConclusionOur study has developed a robust prognostic signature that can accurately predict the prognostic outcome of GC patients.
Burnout and depression among psychiatry residents during COVID-19 pandemic
Authors: Alkhamees Abdulmajeed A. , Assiri Hatem , Alharbi Hatim Yousef , Nasser Abdullah , Alkhamees Mohammad A. 
Published: April 2021

AbstractVery few studies have been concerned with assessing the prevalence of burnout and depressive symptoms, especially during an infectious outbreak on non-frontline health care workers, such as a psychiatrist. In such instances, the role of psychiatrists and other mental health providers as a source of psychological support to the public and frontline workers is indispensable and valuable. This study aims to assess the prevalence of burnout and depressive symptoms, and their correlation, during the COVID-19 pandemic among psychiatry residents in Saudi Arabia. A total of 121 out of 150 psychiatry residents in Saudi Arabia completed the Maslach Burnout Inventory and Patient’s Health Questionnaire for the assessment of burnout and depressive symptoms. Burnout symptoms were found in 27.3%, and another 27.3% reported having depression symptoms. In addition, 16.5% reported having both burnout and depressive symptoms, with a significant relationship between them. Participants in the first 2 years of training and having a history of receiving mental health treatment in the past 2 years were at higher risk. The need is urgent to increase investment in mental health services and to construct a plan to reduce this risk of burnout and depression among psychiatrists by developing preventative strategies to prevent burnout and promote wellness is more important than ever.
Competitive employer positioning through career path analysis: the case of the Swiss nursing sector
Authors: Aeschbacher Remo , Addor Véronique 
Published: April 2021

AbstractBackgroundThe global shortage of nurses has caused strategic employer positioning and strengthened employer branding to become progressively relevant addressing the increased competition in the recruitment of nurses. This study provides competition-oriented strengths-and-weaknesses profiles for nurse attraction and attrition for the major types of healthcare institutions to advise on competitive employer positioning.MethodsWe applied bivariate weighted logistic regressions with cluster-adjusted standard errors to evaluate 4844 employer changes of 3011 nurses participating in thenurses at workstudy, whereby the reasons to quit (RQs) acted as both predictors of the former and the follow-up type of employer. For each employer type, we introduce a coordination system allocating each workplace criterion along its push and implicit pull characteristics, given through the specific odds ratios, to derive different strategic implications for an organisation’s competitive nurse recruitment.ResultsDepending on the employer type, workplace criteria were variously acting as push or pull factors in nurses’ career decisions.ConclusionsNurses’ career choices are affected by experienced and presumed workplace characteristics associated with specific employer types. Becoming aware of these associations and experiences, employers should leverage workplace criteria with relatively strong pull or/and weak push characteristics by intensified communication measurements and criteria with relatively weak pull or/and strong push characteristics should be enhanced to a competitive level.
Implementation research training for learners in low- and middle-income countries: evaluating behaviour change after participating in a massive open online course
Authors: Launois Pascal , Maher Dermot , Certain Edith , Ross Bella , Penkunas Michael J. 
Published: April 2021

Abstract
Background
Implementation research (IR) can play a critical role in the delivery of disease control interventions, particularly in low- and middle-income countries (LMICs). The growing demand for IR training has led to the development of a range of training programmes and university courses, the majority of which can not be accessed by learners in LMICs. This article reports on the evaluation of the massive open online course (MOOC) developed by the Special Programme for Research and Training in Tropical Diseases hosted by WHO on the topic of IR with a focus on infectious diseases of poverty. This study followed the Kirkpatrick Model to evaluate training programmes with a specific focus on post-training changes in behaviour.

Methods
MOOC participants were invited to take part in an anonymous online survey examining their knowledge of IR and how they applied it in their professional practice approximately 1–1.5 years after completing their course. The survey contained 43 open-ended, multiple choice and Likert-type questions. Descriptive statistics were calculated for the quantitative data and responses to the open-ended questions were thematically coded.

Results
A total of 748 MOOC participants responded to the survey. The demographic profile of the survey respondents aligned with that of the MOOC participants, with nearly 70% of respondents originating from Africa. Responses to the quantitative and open-ended survey questions revealed that respondents’ knowledge of IR had improved to a large extent as a result of the MOOC, and that they used the knowledge and skills gained in their professional lives frequently and had consequently changed their professional behaviour. Respondents most often cited the problem-solving aspect of IR as a substantial area of behavioral change influenced by participating in the MOOC.

Conclusions
These findings indicate that the MOOC was successful in targeting learners from LMICs, in strengthening their IR knowledge and contributing to their ability to apply it in their professional practice. The utility of MOOCs for providing IR training to learners in LMICs, where implementation challenges are encountered often, makes this platform an ideal standalone learning tool or one that could be combined with other training formats.
Factors influencing physical activity participation among people living with or beyond cancer: a systematic scoping review
Authors: Elshahat Sarah , Treanor Charlene , Donnelly Michael 
Published: April 2021

Abstract
Background
It has been posited that physical activity (PA) has the potential to improve health outcomes and the health-related quality of life of people living with or beyond cancer. Despite the well-documented health benefits of PA, there is a low level of PA among cancer patients. A systematic scoping review was conducted to investigate attitudes, perceptions, preferences and barriers vs. facilitators to cancer patients’ PA participation.

Methods
A systematic search was performed across four automated databases (PubMed, Embase, PsycINFO and Medline) in keeping with the PRISMA guideline. All cancer types were included, and any age/gender groups were eligible. Both qualitative and quantitative studies were included. The Health Belief Model provided a conceptual framework for the conduct of the scoping review as well as guiding thinking to inform evidence-based interventions.

Results
Ninety-eight articles were included in this review. Nearly half of the studies focused on mixed cancer sites; breast cancer was the most commonly examined cancer type (19%). Post-treatment was the most commonly investigated stage (33%), followed by studies of mixed stages of the cancer trajectory (27%), the acute treatment stage (23%) and pre-treatment stage (1%). Patient treatment stage was not reported in 16% of studies. Cancer patients reported positive attitudes to PA and recognized its benefits for health and wellbeing. Cancer-related side effects (e.g. fatigue) were a leading physiological barrier to PA participation, whereas effective symptom management techniques/tools acted as a powerful facilitator. Psychosocial barriers included low motivation and kinesiophobia, and perceived health benefits and social support/guidance by healthcare providers were significant facilitators. Inaccessible fitness facilities hindered cancer patients’ PA engagement though the availability of tailored amenities appeared to be a strong facilitator. PA preferences varied in terms of type, place, time, company and source of information and pointed to the need for individualized PA programs.

Conclusions
There is a need for further research to identify barriers and facilitators to PA that are faced by patients with particular cancer types. Recommended PA promoting-strategies involve including exercise science professionals in healthcare teams and ensuring that fitness facilities are accessible.
A critical discourse analysis of adolescent fertility in Zambia: a postcolonial perspective
Authors: Munakampe Margarate N. , Michelo Charles , Zulu Joseph M. 
Published: April 2021

AbstractBackgroundDespite global and regional policies that promote the reduction of adolescent fertility through ending early marriages and reducing early child-bearing, adolescent fertility remains high in most sub-Saharan countries. This study aimed to explore the competing discourses that shape adolescent fertility control in Zambia.MethodsA qualitative case study design was adopted, involving 33 individual interviews and 9 focus group discussions with adolescents and other key-informants such as parents, teachers and policymakers. Thematic and critical discourse analysis were used to analyze the data.ResultsAdolescents’ age significantly reduced their access to Sexual and Reproductive Health, SRH services. Also, adolescent fertility discussions were influenced by marital norms and Christian beliefs, as well as health and rights values. While early marriage or child-bearing was discouraged, married adolescents and adolescents who had given birth before faced fewer challenges when accessing SRH information and services compared to their unmarried or nulliparous counterparts. Besides, the major influencers such as parents, teachers and health workers were also conflicted about how to package SRH information to young people, due to their varying roles in the community.ConclusionThe pluralistic view of adolescent fertility is fueled by “multiple consciousnesses”. This is evidenced by the divergent discourses that shape adolescent fertility control in Zambia, compounded by the disempowered position of adolescents in their communities. We assert that the competing moral worlds, correct in their own right, viewed within the historical and social context unearth significant barriers to the success of interventions targeted towards adolescents’ fertility control in Zambia, thereby propagating the growing problem of high adolescent fertility. This suggests proactive consideration of these discourses when designing and implementing adolescent fertility interventions.
Comparative efficacy and safety profile for the treatment of humeral bone cysts in children: curettage and mixed bone grafting either with or without elastic intramedullary nailing
Authors: Wang Xuan , Han Jiuhui , Li Yazhou , Liu Yuchang , Luo Junzhong 
Published: April 2021

AbstractPurposeThe primary aim of our study was to evaluate the comparative efficacy and safety profile of curettage and mixed bone grafting without instrument or with elastic intramedullary nailing in the treatment of humeral bone cyst in children.MethodsOur retrospective study included a total of 48 children harboring humeral bone cyst in our hospital from August 2012 to February 2019. The patients enrolled were divided into elastic nailing group with the application of elastic intramedullary nailing (n= 25) and control group without using instrument (n= 23) during the management of curettage and mixed bone grafting. The following medical outcomes of the two groups were monitored and recorded: the amount of intraoperative blood loss, operation time and postoperative full weight-bearing time, in addition to postoperative clinical effects after 1 year, the function and pain level of shoulder joint before and 1, 3, 6, 9, 12, and 16 months after operation. Follow-up radiographic outcomes were reviewed to observe bone healing, local recurrence and internal fixation loosening, and other postoperative complications.ResultsThe clinical curative effect of the elastic nailing group was higher than that of the control group 16 months after operation (96.00% > 73.91%,P< 0.05). The intraoperative blood loss and postoperative full weight-bearing time in the elastic nailing group were less than those in the control group (P< 0.05), but the operation time was statistically insignificant between the two groups (P> 0.05). Before operation, the shoulder joint function of the two groups was comparable (P> 0.05), while the function showed remarkably better outcome in the elastic nailing group than control group 1 to 16 months after operation (P< 0.05). Before operation, the pain level of the two groups was comparable (P> 0.05), while 1 to 16 months after operation, the pain level of the elastic nailing group was significantly lower than that of the control group (P< 0.05). Patients in both groups were followed up for 16 months. Mixed bone grafting fusion was indicated by imaging CT and X-ray during the follow-up period, with an average fusion time of 11.3 ± 1.2 months (range, 8–16 months). Three months after operation, there was 1 case of incomplete pathological fracture in the control group, while no related complications occurred in the elastic nailing group. Moreover, no tumor recurrence was observed in the two groups. The two groups were comparable in terms of the incidence of complications (P> 0.05).ConclusionChildren with humeral cyst treated with curettage and mixed bone grafting with the additional use of elastic intramedullary nailing exerted superior results to those without using instrument as there are beneficial outcomes and safety profile and no complications.
Conservative treatment of left ventricular pseudoaneurysm after mitral valve replacement due to early left ventricular rupture: a case report
Authors: Duan Qun-Jun , Duan Cui-Ting , Yang Wei-Jun , Dong Ai-Qiang 
Published: April 2021

Abstract
Background
Left ventricular pseudoaneurysm due to early left ventricle rupture is a serious complication after cardiac surgery. Urgent surgery is recommended in most cases with a high mortality rate. Conservative treatment of a left ventricular pseudoaneurysm due to early left ventricle rupture is very rare.

Case presentation
We present a 61-year-old woman with left ventricular pseudoaneurysm after mitral valve replacement due to early left ventricle rupture. This patient was treated in a conservative approach. This patient had an uneventful recovery. She was in good condition and remained asymptomatic 3.5 years after mitral valve surgery.

Conclusion
This case suggests that medical treatment left ventricular pseudoaneurysm patients has a limited but acceptable role in selected and unusual circumstances.
Palmitate reduces starvation-induced ER stress by inhibiting ER-phagy in hypothalamic cells
Authors: Lim Yun , Kim Seolsong , Kim Eun-Kyoung 
Published: April 2021

AbstractPalmitate is a saturated fatty acid that is well known to induce endoplasmic reticulum (ER) stress and autophagy. A high-fat diet increases the palmitate level in the hypothalamus, the main region of the brain regulating energy metabolism. Interestingly, hypothalamic palmitate level is also increased under starvation, urging the study to distinguish the effects of elevated hypothalamic palmitate level under different nutrient conditions. Herein, we show that ER-phagy (ER-targeted selective autophagy) is required for progress of ER stress and that palmitate decreases ER stress by inhibiting ER-phagy in hypothalamic cells under starvation. Palmitate inhibited starvation-induced ER-phagy by increasing the level of B-cell lymphoma 2 (Bcl-2) protein, which inhibits autophagy initiation. These findings suggest that, unlike the induction of ER stress under nutrient-rich conditions, palmitate protects hypothalamic cells from starvation-induced stress by inhibiting ER-phagy.