bluuebunny/crossref_metadata_2025_split huggingface dataset:
Treating Knee Osteoarthritis With Platelet-Rich Plasma and Hyaluronic Acid Combination Therapy: A Systematic Review
Authors: Baria Michael R. , Vasileff W. Kelton , Borchers James , DiBartola Alex , Flanigan David C. , Plunkett Evan , Magnussen Robert A. 
Published: April 2021

Background: Platelet-rich plasma (PRP) and hyaluronic acid (HA) are injectable treatments for knee osteoarthritis. The focus of previous studies has compared their efficacy against each other as monotherapy. However, a new trend of combining these 2 injections has emerged in an attempt to have a synergistic effect. Purpose: To systematically review the clinical literature examining the combined use of PRP + HA. Design: Systematic review. Methods: A systematic review was performed according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines using PubMed and Embase. The following search terms were used: knee osteoarthritis AND platelet rich plasma AND hyaluronic acid. The review was performed by 2 independent reviewers who applied the inclusion/exclusion criteria and independently extracted data, including methodologic scoring, PRP preparation technique, HA composition, and patient-reported outcomes (PROs). Results: A total of 431 articles were screened, 12 reviewed in full, and 8 included in the final analysis: 2 case series, 3 comparative, and 3 randomized studies. Average follow-up was 9 months. The modified Coleman Methodology Score was 38.13 ± 13.1 (mean ± SD). Combination therapy resulted in improved PROs in all studies. Of the comparative and randomized studies, 2 demonstrated that combination therapy was superior to HA alone. However, when PRP alone was used as the control arm (4 studies), combination therapy was not superior to PRP alone. Conclusion: Combination therapy with PRP + HA improves PROs and is superior to HA alone but is not superior to PRP alone.
Effect of Tibial Tunnel Placement Using the Lateral Meniscus as a Landmark on Clinical Outcomes of Anatomic Single-Bundle Anterior Cruciate Ligament Reconstruction
Authors: Büyükdoğan Kadir , Laidlaw Michael S. , Fox Michael A. , Kew Michelle E. , Miller Mark D. 
Published: April 2021

Background: It remains unclear if use of the lateral meniscus anterior horn (LMAH) as a landmark will produce consistent tunnel positions in the anteroposterior (AP) distance across the tibial plateau. Purpose: To evaluate the AP location of anterior cruciate ligament (ACL) reconstruction tibial tunnels utilizing the LMAH as an intra-articular landmark and to examine how tunnel placement affects knee stability and clinical outcomes. Study Design: Cohort study; Level of evidence, 3. Methods: A retrospective review was conducted of 98 patients who underwent primary ACL reconstruction with quadrupled hamstring tendon autografts between March 2013 and June 2017. Patients with unilateral ACL injuries and a minimum follow-up of 2 years were included in the study. All guide pins for the tibial tunnel were placed using the posterior border of the LMAH as an intra-articular landmark. Guide pins were evaluated with the Bernard-Hertel grid in the femur and the Stäubli-Rauschning method in the tibia. Patients were divided by the radiographic location of the articular entry point of the guide pin with relation to the anterior 40% of the tibial plateau. Outcomes were evaluated by the Marx Activity Scale and International Knee Documentation Committee (IKDC) form. Anterior knee laxity was evaluated using a KT-1000 arthrometer and graded with the objective portion of the IKDC form. Rotational stability was evaluated using the pivot-shift test. Results: A total of 60 patients were available for follow-up at a mean 28.6 months. The overall percentage of AP placement of the tibial tunnel was 39.3% ± 3.8% (mean ± SD; range, 31%-47%). Side-to-side difference of anterior knee laxity was significantly lower in the anterior group than the posterior group (1.2 ± 1.1 mm vs 2.5 ± 1.3 mm; P < .001; r = 0.51). The percentage of AP placement of the tibial tunnel demonstrated a positive medium correlation with side-to-side difference of anterior knee laxity as measured by a KT-1000 arthrometer ( r = 0.430; P < .001). The anterior group reported significantly better distribution of IKDC grading as compared with the posterior group (26 grade A and 6 grade B vs 15 grade A and 13 grade B; P = .043; V = 0.297). The pivot-shift test results and outcome scores showed no significant differences between the groups. Conclusion: Using the posterior border of the LMAH as an intraoperative landmark yields a wide range of tibial tunnel locations along the tibial plateau, with anterior placement of the tibial tunnel leading toward improved anterior knee stability.
Violence Against Prostitutes and Non-prostitutes: An Analysis of Frequency, Variety and Severity
Authors: Zara Georgia , Theobald Delphine , Veggi Sara , Freilone Franco , Biondi Eleonora , Mattutino Grazia , Gino Sarah 
Published: April 2021

Violence against women is a form of gender violence, and the lethal aspect of it, defined as femicide, is a global health and human rights problem. This study looked at 330 cases of femicide that occurred in North West Italy, between 1970 and 2020, committed by 303 male perpetrators. The victims included women who were prostitutes and those who were not. Findings show that only a small proportion of femicide occurs within an anonymous setting: Victims were mostly killed by a man they knew. The type and intensity of the relationship was likely to affect how the violence occurred. In those cases in which victims and perpetrators had an intimate relationship, the risk of overkill, that is, an excessive use of violence that goes further than what is necessary to cause death, was four times higher in comparison with the murder of unknown victims. As with non-prostitutes, the risk of overkill was almost fourfold for those prostitutes who knew their perpetrators. Furthermore, when comparing prostitutes with any unknown victims, the risk of being overkilled was almost five times higher for the former, suggesting that prostitutes are more at risk of being murdered with excessive violence. In addition, prostitutes were more likely to be victims of sexual murder, postmortem mutilation, and being killed by men who had previous criminal records. Women who are victims of violence are not a homogeneous group, although some of the psychosocial correlates are the same and relevance should be given to the features behind the type, intensity, and nature of the relationship between prostitutes and non-prostitutes and their perpetrators. These variables are what make violence against women a preventable problem.
Improved Smoking Cessation Rates in a Pharmacist-Led Program Embedded in an Inflammatory Bowel Disease Specialty Medical Home
Authors: Tse Stacy Saithy , Sands Bruce E. , Keefer Laurie , Cohen Benjamin L. , Maser Elana , Ungaro Ryan C. , Marion James F. , Colombel Jean-Frédéric , Itzkowitz Steven H. , Gelman Jessica , Dubinsky Marla C. 
Published: April 2021

Background: Cigarette smoking is associated with disease progression, poor outcomes, and increased biologic use in Crohn’s Disease (CD). In this prospective study, we describe the structure and results of a pharmacist-driven smoking cessation program in an Inflammatory Bowel Disease (IBD) Specialty Medical Home. Methods: One pharmacist designed and implemented a collaborative drug therapy management (CDTM) program, which allowed the pharmacist to initiate and modify smoking cessation aids, monitor medication safety and efficacy, and provide behavioral counseling. Crohn’s Disease patients who were current smokers and referred to the program were analyzed. Clinical and demographic data, disease activity, and smoking history were collected. The primary outcome was the proportion of patients in the enrolled group and the declined group who quit smoking at least once during the follow-up period. Secondary outcomes include demographic and clinical differences between enrolled and declined patients, and enrolled quitters and non-quitters. Results: Thirty-two patients were referred to the program and 19 participated. Over a median follow-up period of 305 [264-499] days, 42% (8/19) of enrolled patients quit smoking at least once. Fifteen percent (2/13) of declined patients quit smoking. Patients who continued to smoke had more instances of loss of response to a biologic, need to start a new biologic, or escalation of biologic therapy. The CDTM pharmacist was able to provide all necessary clinical services for smokers enrolled in the program. Conclusions: A pharmacist-led smoking cessation program in a specialty medical home is feasible. It may result in successful quit attempts and may optimize IBD medication use.
Ethics simulation in nursing education: Nursing students' experiences
Authors: Honkavuo Leena 
Published: April 2021

Background: Ethics stimulation in nursing education focuses on human, non-technical factors in a clinical reality. Simulation as a teaching method began in the 1930s with flight simulators. In the beginning of the 1990s, simulations developed further in tandem with other technological and digital inventions, including touchscreen and three-dimensional anatomical models. Medical science first used simulation as a pedagogical teaching tool. In nursing education, simulation has been used for approximately a hundred years. Teaching has mainly focused on medical-technical, patient-specific interventions and their management. Objective: The objective of this study was, from a caring science didactic perspective, to deepen the understanding of ethics simulation in nursing education. Design: Qualitative design and explorative, descriptive and hermeneutic approach of an inductive character. Methods: Semi-structured face-to-face interviews in 2016–2017 with six Norwegian nursing students who were encouraged to narrate about their experiences of ethics simulation in nursing education. Ethical considerations: Informed consent was obtained from the participants. Anonymity and confidentiality regarding data material were guaranteed. Results: Interpretation of the nursing students’ narratives resulted in the following meaning units: ethical being and ethos, nursing students’ formation process, bridge-building between theory and clinical practice, and teacher and ethics simulation. Conclusion: Through ethics simulation, nursing students can obtain an increased knowledge and a sense of being able to handle difficult ethical situations. Nursing students’ values, moral actions and ethical value base offer a positive point of departure, for both theoretical and practical ethics teaching, and an awareness of the unique human being, the patient, in clinical reality. The implementation of ethics simulation needs more attention in nursing education.
Ethical dilemmas embedded in performing fieldwork with nurses in the ICU
Authors: Kvande Monica Evelyn , Delmar Charlotte , Lauritzen Jette , Damsgaard Janne Brammer 
Published: April 2021

Background: Background: In general, qualitative research design often involves merging together various data collection strategies, and researcher’s may need to be prepared to spend longer periods in the field to pursue data collection opportunities that were not foreseen. Furthermore, nurse researchers performing qualitative research among patients and their relatives often experience unforeseen ethical dilemmas. Aim: This paper aimed to explore aspects of ethical dilemmas related to qualitative nursing research among patients and their relatives in the intensive care unit (ICU). Research design: This paper is based on a qualitative researcher’s personal experience during a hermeneutic phenomenological study involving close observation and in-depth interviews with 11 intensive care nurses. Data were collected at two ICUs in two Norwegian university hospitals. Ethical considerations: The study was approved by the Norwegian Social Science Data Services (NSD). The Regional Committee for Medical and Health Research Ethics (REK) granted dispensation to the project regarding health personnels confidentiality of the patients who were present during the observation (2012/622-4). Findings: Close observation with nurses in the ICU requires the researcher to balance being a qualitative researcher, an ICU nurse and a sensitive fellow human being open to the suffering of the other—that is, being embodied, engaged and affected by sensitive situations and simultaneously constantly stepping back and reflecting on the meaning of those situations. Conclusions: The qualitative researcher’s ethical awareness also entails knowing and acknowledging his or her own vulnerability, which becomes apparent in the researcher-participant relationship and settings in which being a fellow human always overrules the researcher’s role in ethical dilemmas.
Right to health, autonomy, and access to prenatal services
Authors: Both Tatianne dos Santos Perez , de Souza Laís Alves , Teston Elen Ferraz , Júnior Antonio Rodrigues Ferreira , Ajalla Maria Elizabeth Araújo , Batiston Adriane Pires 
Published: April 2021

Background: The concept of the right to health includes decent conditions of work, housing, and leisure. It can be assessed through the evaluation of access to health services and programs. The creation of the Brazilian Unified Health System expanded access to healthcare for the entire Brazilian population. Aim: This study aimed to understand the use of the Brazilian Unified Health System by pregnant women who live on the Brazil–Paraguay border, whose residents are known as Braziguayans. Methods: We conducted 16 semi-structured interviews with users of prenatal services at Unified Health System units located at the border of the municipalities of Ponta Porã and Pedro Juan Caballero. Ethical considerations: The Research Ethics Committee of the Federal University of Mato Grosso do Sul approved of this research. All participants were provided with project information and signed an informed consent form. Findings: Through content analysis of the interviews, “right to health” and “autonomy, pathways, and access” were two recurrent themes that have arisen. These suggested that Braziguayan women live in conditions of social vulnerability. They do not fully experience the right to healthcare, despite sufficient knowledge about the Brazilian and Paraguayan healthcare systems from which to choose prenatal care. The interviewees acknowledged that Unified Health System use is a right of Brazilian citizens and considered its units to be safe environments. These women also understand the structuring of Unified Health System and the mechanisms of accessing healthcare programs. Conclusion: We can conclude that, despite widely known difficulties, Unified Health System represents, for Braziguayan women, potential access to reliable health services for adequate prenatal and childbirth assistance.
Adverse prognostic factors for rescuing patients with acute myocardial infarction–induced cardiac arrest receiving percutaneous coronary intervention under extracorporeal membrane oxygenation
Authors: Ye Jianxi 
Published: April 2021

Background:Acute myocardial infarction–induced cardiac arrest has high mortality rate.Objective:To investigate the risk factors of extracorporeal membrane oxygenation combined with percutaneous coronary intervention in rescuing acute myocardial infarction–induced cardiac arrest.Methods:Forty‐three eligible patients were assigned into death and survival groups. Their general clinical data, treatment outcomes, and various indicators 24, 48, and 72 h after extracorporeal membrane oxygenation implantation were compared. The factors affecting clinical outcomes were determined by multivariate logistic regression analysis. A nomogram prediction model was constructed and validated.Results:After removing extracorporeal membrane oxygenation device, 19 patients recovered and 24 died (mortality rate: 55.81%). The two groups had different conventional cardiopulmonary resuscitation duration, number of diseased vessels, distribution of culprit vessel, time from cardiac arrest to extracorporeal membrane oxygenation implantation, length of stay in critical care unit, and mean arterial pressure 24 and 48 h after extracorporeal membrane oxygenation implantation (p < 0.05). Left anterior descending as the culprit vessel, number of diseased vessels, conventional cardiopulmonary resuscitation duration, time from cardiac arrest to extracorporeal membrane oxygenation implantation, and mean arterial pressure 48 h after extracorporeal membrane oxygenation resuscitation were independent risk factors for death. The predicted mortality rate was 72.6%, and the actual concordance index (C‐index) was 0.869. Such indices after internal and external validations were 0.861 and 0.848, respectively, suggesting a good concordance.Conclusion:Left anterior descending as the culprit vessel, number of diseased vessels, conventional cardiopulmonary resuscitation duration, time from cardiac arrest to extracorporeal membrane oxygenation implantation, and mean arterial pressure 48 h after extracorporeal membrane oxygenation resuscitation are independent risk factors for patients with acute myocardial infarction–induced cardiac arrest undergoing extracorporeal membrane oxygenation combined with percutaneous coronary intervention.
Suffering and Symptoms At the End of Life in ICU Patients Undergoing Renal Replacement Therapy
Authors: Ramer Sarah J. , Viola Martin , Maciejewski Paul K. , Reid M. Carrington , Prigerson Holly G. 
Published: April 2021

Background: We know little about the end-of-life suffering and symptoms of intensive care unit (ICU) decedents in general and those who undergo renal replacement therapy (RRT) in particular. Objectives: To examine differences in end-of-life suffering and various symptoms’ contribution to suffering between ICU decedents who did not undergo RRT, those who underwent RRT for end-stage kidney disease (ESKD), and those who underwent RRT for acute kidney injury (AKI). Methods: This is a cross-sectional study conducted at a quaternary-level referral hospital September 2015-March 2017. Nurses completed interviews about ICU patients’ suffering and symptoms in their final week. We dichotomized overall suffering into elevated and non-elevated and each symptom as contributing or not to a patient’s suffering. Results: Sixty-four nurses completed interviews on 165 patients. Median patient age was 67 years (interquartile range 57, 78); 41% were female. In a multivariable model, undergoing RRT for AKI (odds ratio [OR] 2.95, 95% confidence interval [CI] 1.34-6.49) was significantly associated with elevated suffering compared to no RRT; undergoing RRT for ESKD was not. Adjusting for length of stay, AKI-RRT patients were more likely than non-RRT patients to have fecal incontinence (OR 2.21, 95% CI 1.00-4.93), painful broken skin (OR 2.41, 95% CI 1.14-5.12), and rashes (OR 3.61, 95% CI 1.35-9.67) contributing to their suffering. Conclusions: Undergoing RRT for AKI was associated with elevated suffering in the last week of life in ICU decedents. Painful broken skin, rashes, and fecal incontinence were more likely to contribute to suffering in AKI-RRT patients than in non-RRT patients. How to reduce suffering associated with AKI-RRT in ICU patients merits further study.
Skeletal Maturation in Patients With Cleft Lip and/or Palate: A Systematic Review
Authors: Wu Xiaoyi , Kuang Wenying , Zheng Jie , Yang Zhengkun , Ren Meiqing , Yang Ruicong , Yuan Wenjun 
Published: April 2021

Objective: The objective of this systematic review was to evaluate the evidence regarding skeletal maturation in patients with cleft lip and/or palate (CL/P) and to investigate whether the skeletal maturation is delayed in these patients. Design: Systematic review. Methods: Electronic and manual searches of scientific literature were conducted in 4 databases (MEDLINE, Embase, Cochrane Library, and Web of Science). Cohort studies that compared the skeletal maturation of patients with CL/P with that of children without CL/P were eligible for inclusion. The quality of included cohort studies was assessed using the Newcastle-Ottawa Scale. Patients and Participants: Patients of any sex and ethnicity with CL/P and children without CL/P were included in this systematic review. Main Outcome Measures: Difference in skeletal maturation between patients with CL/P and patients without CL/P. Results: Thirteen retrospective cohort studies were included in this systematic review. Ten studies were considered of high quality and 3 were considered of general quality. The results of the included studies comparing skeletal maturation of patients with CL/P and children without CL/P were heterogeneous. Conclusion: Heterogeneity of skeletal maturation assessment methods, chronological age, sex, cleft type, and race may influence the final results of clinical studies on skeletal maturation in patients with CL/P. Overall, there is limited evidence to determine whether the skeletal maturation level of patients with CL/P is delayed compared to that of normal children. Further studies are needed to determine the skeletal maturation patterns in patients with CL/P.
Nd:YAG laser vitreolysis and health-related quality of life in patients with symptomatic vitreous floaters
Authors: García Begoña Gacimartin , Orduna Magán Carlos , Alvarez-Peregrina Cristina , Villa-Collar César , Sánchez-Tena Miguel Ángel 
Published: April 2021

Background: The treatment of floaters has consisted primarily of monitoring. The therapeutic approach is based on surgical removal or Nd:YAG laser treatment. The objective of this study was the assessment of the quality of life in patients treated with Nd:YAG laser for floaters. Methods: Single-center pretest-posttest design in a cohort of subjects treated with Nd-YAG laser with Ultra Q-Reflex technology. Health-related quality of life of the patients was measured before and after the intervention with the Visual Function Questionnaires VFQ-25 and VFQ-39. Anxiety level was measured with the State-Trait Anxiety Inventory. Visual acuity, contrast sensitivity, and safety parameters were also considered. Results: Thirty-four patients were included in the study. For the VFQ-25 baseline, the median was 73.05, interquartile range (19.25) versus a final median value of 93.76 (8.73) with p < 0.01. The baseline median for the extended version VFQ-39 was 74.60 (19.01) versus the final median of 95.01 (6.50) with p < 0.001. Regarding the anxiety, according to the STAI questionnaire, there were statistically significant differences between the baseline and the final conditions, with a baseline median of 38 (11) versus a final median of 18 (19); p < 0.001. When the analyses differentiated between patients with and without myopia, there were statistically significant differences for VFQ-25 and VFQ-39. Conclusions: This study shows an improvement in the health-related quality of life and a significant decrease in anxiety for patients that have undergone Nd: YAG Ultra-Q Reflex laser vitreolysis for floaters vaporization. The effect found is higher in myopic patients.