bluuebunny/crossref_metadata_2025_split huggingface dataset:
Reduced cervical extensor muscle mass negatively influences the postoperative outcomes of single-door laminoplasty in elderly patients with cervical spondylotic myelopathy
Authors: sun Kai , zhang Bo , Wan Haiwu , yin Jinjian , Huang Bo , sun Guodong 
Published: November 2024

Abstract

Purpose
To investigate the relationship between the preoperative grading of paraspinal extensor muscle fat infiltration on cervical MR and the surgical outcomes of posterior single-door laminoplasty in elderly patients with cervical spondylotic myelopathy(CSM).
Methods
This study retrospectively reviewed 116 elderly patients who underwent posterior single-door laminoplasty for CSM between January 2015 and December 2020. The degree of fatty infiltration in the cervical extensor muscles was assessed via MR and classified into mild, moderate, and severe groups according to the Goutalier grading system. Baseline clinical data, surgical-related data, and clinical outcomes were collected and analyzed. Pre-and postoperative changes in the cervical sagittal alignment parameters were recorded for comparison.
Results
The baseline clinical data of the three patient groups showed no statistically significant differences.Significant statistical differences were found in the surgical parameters of postoperative drainage and hospital stay duration. At follow-up, the NDI scores, neck pain VAS scores, and JOA scores, along with their minimal clinically important difference (MCID), showed significant variations. Furthermore, the cervical sagittal alignment parameters during follow-up were significantly different across the three groups.
Conclusion
Elderly patients with CSM and severe fatty infiltration of the cervical extensor muscles experience poorer clinical outcomes following single-door laminoplasty, with a more pronounced loss of cervical sagittal balance observed during follow-up.
Systemic inflammatory markers are not optimal for the predicting of disease activity in Crohn's disease patients
Authors: Huang Jing-Wen , Zhan Min , Li Qian-kun , Zou Shu-fang , Cao Hui , WU Dong-sheng , Zhao Da , Yu Lian , Tian Gui-Xiang , Bin Bong-hua 
Published: November 2024

Abstract

Background and aims: Determining the disease activity is crucial for the management of Crohn's disease (CD). The value of serum systemic inflammatory markers for the evaluating the disease activity of CD.
Methods: The neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), platelet to albumin ratio (PAR), neutrophil to platelet ratio (NPR), lymphocyte to monocyte ratio (LMR), and C-reactive protein/albumin ratio (CAR) were measured. The values of these markers to predict disease activity of CD based on Simple Endoscopic Score for Crohn's (SES-CD) and Crohn disease activity index (CDAI) were measured.
Results: In total, 121 CD patients were included, and 40 (33.1%) were at the remission stage according to CDAI. Except WBC and NPR, other markers were all significantly lower in the remission group. ESR (r = 0.291) and PAR (r = 0.216) were weakly linked with the SES-CD activity. Moreover, ESR (r = 0.372), CRP (r = 0.293), NP (r = 0.185), NLR (r = 0.204), PAR (r = 0.199), a CAR (r = 0.262), and LMR (r = -0.189) were weakly correlated with the CDAI activity. Additionally, young age and higher ESR were identified to be the independent risk factors associated with SES-CD active, and low BMI was the sole independent risk factor for CDAI active.
Conclusion:Systemic inflammatory markers are not optimal for the predicting of disease activity in CD patients.
Association of weight change after smoking cessation on the risk of cancer in patients with allergic diseases: a nationally representative cohort study
Authors: Cho Hahyeon , Ha Soonho , Jeong Seogsong , Lee Hwamin 
Published: November 2024

Abstract

Relationships between allergies and cancer are complex and depend on various factors. However, little is known regarding the effects of weight change after smoking cessation on the risk of cancer in patients with allergic diseases. This study investigated 26,614 patients with asthma, allergic rhinitis, and atopic dermatitis from the NHIS-HEALS cohort, who had biennial health screenings between 2005 and 2008. All patients were followed up from 2009 until the date of cancer diagnosis, death, or 2013, whichever earliest. Allergic diseases patients who quit smoking and gained weight have a significantly higher cancer risk than non-smokers with stable weight (adjusted hazard ratio [aHR], 1.59; 95% confidence interval [CI], 1.11–2.27). This risk is particularly elevated in older adults (≥ 65 years, aHR, 2.06; 95% CI, 1.29–3.29), men (aHR, 1.53; 95% CI, 1.05–2.22), and those with multiple comorbidities (aHR, 1.77; 95% CI, 1.24–2.52). Moreover, varying effects of weight gain on lung cancer (aHR, 2.28; 95% CI, 1.21–4.28). These findings highlight the importance of personalized weight management strategies to maximize the benefits of smoking cessation in patients with allergic diseases. Comprehensive public health strategies that address both smoking cessation and weight control may be essential to reduce cancer risk among patients with allergic diseases.
Supply-side Readiness of Primary Health Care for COVID-19 Pandemic Response in Indonesia: A Survey in 34 Provinces
Authors: Fitrianingrum Nisaatul Maharanita , Kamilah Fariza Zahra , Larasanti Ayudina , Saputra Muhammad Anugrah , Espressivo Aufia , Herlinda Olivia 
Published: November 2024

Abstract

Background: During the COVID-19 pandemic, primary healthcare centres (Puskesmas) in Indonesia encountered multiple challenges due to the limited capacity of human resources, logistics, health facilities, and infrastructures. This situation compromised their ability to deliver essential health services. This study aims to portray the supply-side capacity of Puskesmas during the COVID-19 pandemic, focusing on health service delivery, pandemic response, and community engagement. It also identifies crucial components to enhance primary-level pandemic prevention, preparedness, and response (PPR).
Methods: An explanatory sequential mixed-method design was employed, gathering quantitative data through phone interviews and qualitative data from in-depth interviews and focus group discussions with Puskesmas’ staff and district health officials. A total of 385 Puskesmas across 34 provinces were selected using proportional multistage stratified random sampling.
Results: Findings indicate that during the pandemic’s early and peak phases in 2020 and 2021, Puskesmas struggled to deliver their tasks. Due to social restrictions, over 80% of Puskesmas adjusted their operations, including reduced working hours (35.97%), limited service types (33.94%), and restricted patient visits (18.55%). These adjustments adversely affected essential health services, like tuberculosis detection and treatment and childhood immunisation programs, with COVID-19 budget reallocations affecting essential service funding. Around 40% of Puskesmas failed to meet the personal protective equipment (PPE) standard, and over 80% experienced PCR test delays for over 24 hours. Furthermore, half of the Puskesmas in Indonesia had inadequate capacity to conduct COVID-19 vaccination programs. Despite these challenges, community health workers (CHWs) played a crucial role in contact tracing, monitoring self-isolated COVID-19 patients, and improving vaccine coverage.
Conclusion: The study highlights the importance for prioritising resource allocation and investment to strengthen primary healthcare in Indonesia for future pandemics, including enhancing the role of CHWs as critical partners of Puskesmas.
Hematocrit is an independent risk factor of recurrent Guillain-Barré syndrome
Authors: Wang Lijuan , Liu Yuelin , Ding Yaowei , Li Siwen , Jiang Wencan , Li Xiang , Chen Yuxin , Chen Kelin , Zhang Guojun 
Published: November 2024

Abstract

Guillain-Barré Syndrome (GBS) is an autoimmune disorder affecting the peripheral nervous system, characterized by progressive weakness and diminished or absent myotatic reflexes. While GBS typically exhibits a monophasic course, recurrent episodes can occur in certain patients. This study aimed to explore potential risk factors associated with recurrent GBS. We conducted a retrospective analysis involving GBS patients admitted to Beijing Tiantan Hospital between January 2012 and January 2022. Patients were categorized into recurrent and non-recurrent groups based on follow-up outcomes, meanwhile, clinical and laboratory data were compared between the two cohorts. Then, we integrated statistically significant indicators to identify independent risk factors for recurrent GBS using multifactorial logistic regression. Univariate analysis revealed that hematocrit (HCT) and mean platelet volume (MPV) were significantly elevated, whereas free triiodothyronine (FT3) and the percentage of vaccination was lower in patients with recurrent GBS compared to non-recurrent groups. Multifactorial logistic regression analysis revealed HCT (OR:1.015;95%CI: 1.001–1.028༛P = 0.032) is an independent risk factor for recurrent GBS. Elevated serum HCT levels correlate with an increased risk of recurrent GBS. Crucially, the incidence of recurrent GBS patients rises in tandem with rising serum HCT levels.
Arthroscopically Assisted Internal Brace Augmentation of the Medial Patellofemoral Ligament for Treating Patellar Dislocation
Authors: He Yeteng , Li Xiang , Yin Weilong , Jiang Rendong , Peng Xianbo , Liu Ying , Wei Hanyu 
Published: November 2024

Abstract

Objective
To describe the early clinical outcomes of arthroscopically assisted Internal Brace augmentation of the medial patellofemoral ligament (MPFL) in treating patellar dislocation.
Methods
A retrospective analysis was conducted on 19 patients with patellar dislocation (Dejour A and B trochlear dysplasia, TT-TG <20 mm, Insall-Salvati index 0.8–1.2) treated with arthroscopically assisted Internal Brace MPFL augmentation, with at least 24 months of follow-up. The cohort included 12 females and 7 males (mean age: 18.32 years). Outcomes assessed included radiological evaluations (patellar congruence angle, tilt angle, and lateralization distance via CT) and clinical scores (Lysholm, Kujala, VAS, Tegner, and Crosby-Insall). Patient satisfaction and complications were also recorded.
Results
All 19 surgeries were completed successfully without complications. Six patients underwent concurrent cartilage debridement. No patients were lost to follow-up (mean: 28.95 months). At the final follow-up, Kujala, Lysholm, VAS, and Tegner scores improved significantly (p < 0.001). Patellar positioning was good, with no redislocation or subluxation. Radiological assessments showed significant improvements in congruence angle, tilt angle, and lateralization distance (p < 0.001). No postoperative complications were reported. Most patients (90%) were satisfied and returned to pre-injury activity levels.
Conclusion
Arthroscopically assisted Internal Brace MPFL augmentation effectively improves knee stability in patellar dislocation, with favorable early outcomes and low complication rates.
The exploration of the subclavian vessels in an emergency situation by orthopedic trauma surgeons
Authors: Grechenig Peter , Gänsslen Axel , Dauwe Jan , Wittig Ulrike , Sagmeister Maximilian , Koutp Amir , Puchwein Paul , Hohenberger Gloria 
Published: November 2024

Abstract

Purpose:
The aim of the present study was to evaluate the time and the safety of the procedure to perform an infraclavicular approach to the subclavian vessels for damage control of major vascular injuries of the upper extremity in the shoulder region using a cadaver model for non-thoracic surgeons.
Methods:
A sample of 100 orthopaedic trauma residents, specialists, and attendings was recruited from an AO cadaveric dissection course in Graz, Austria, on extremity access. Emergency infraclavicular access to the subclavian vessels was performed on 50 cadavers on 2 consecutive days. Attention was paid to time, successful clamping of the vessels, self-assessment and learning curve.
Results:
First day: Only 9 (27%) participants felt safe among the 33 participants who performed correct emergency access including clamping of the correct vessels on the first day.
Second day: 55 (71%) of the 77 participants who correctly clamped the subclavian vessels on the second day reported feeling safe.
Comparing day 1 to day 2 we found an improvement of 35% (subclavian artery) and 37% (subclavian vein) in the correct identification of subclavian vessels in our sample. The evaluations of this study show that there is no correlation between surgical experience and successful emergency access.
Conclusion:
The value of anatomic dissections is therefore of major importance to teach unusual techniques This study shows the importance and effectiveness of anatomical dissection courses and anatomical learning. To sum up, it can be said that correct self-assessment can be improved through practice.
Knowledge, Attitude, and Practice on Water, Sanitation and Hygiene among Internal Displaced Persons in Somalia
Authors: Tahlil Abdullahi Ahmed , Dahir Mohamed Abdisalan , Hassan Yahye Sheikh Abdulle , Osman Marian Muse , Dahir Gallad , Jimale Liban Hassan , Mohamed Mohamed Abdelrahman , Fiidow Osman Abubakar 
Published: November 2024

Abstract

Introduction
Access to clean water, adequate sanitation, and hygiene services is a basic human right. In spite of this, it remains one of the major challenges that internally displaced persons face in Somalia. This study assesses the knowledge, attitudes, and practices of IDPs regarding Water, sanitation and hygiene.
Methods
A cross-sectional study was conducted among IDPs in eight high-density IDP camps in Mogadishu and Baidoa. A sample size of 728 participants was recruited through multistage and systematic random sampling techniques. A structured questionnaire was used for data collection. Data analysis was done using SPSS version 26. The KAP scores were categorized based on predefined cut-off points. Associations of demographic variables with KAP levels was tested using chi-square and Fisher's exact tests; the level of significance was set as p < 0.05.
Result
The study revealed that the majority of participants had 71.2% poor knowledge, 70.3% negative attitudes, and 80.2% demonstrating poor practices towards WASH. The analysis showed that there are strong associations between the levels of knowledge and the following sociodemographic factors: age (p < 0.001), marital status (p = 0.001), level of education (p = 0.048), employment status (p < 0.001), family size (p < 0.001), duration of stay in IDP camp (p < 0.001), and utilization of healthcare services (p < 0.001). Negative attitude towards WASH was also significantly associated with younger age groups (p < 0.001), marital status (p = 0.004), educational attainment (p < 0.001), employment (p < 0.001), household size (p < 0.001), duration of camp residency (p < 0.001), and healthcare access (p < 0.001). Furthermore, the level of education, employment status, household size, and duration of stay in camp were significantly associated with WASH practices at p < 0.001.
Conclusion
The study found that there are gaps in the knowledge, negative attitude, and poor practices concerning WASH among IDPs in Somalia. It is, therefore, important that addressing these disparities will be a guarantee for better health and well-being among IDPs in Somalia.
The Effect of 𝛃-Human Chorionic Gonadotropin on Vasculogenic Mimicry in Bladder Cancer
Authors: Eid Hanya Elsayed , Sattar Anas , Gobena Edessa Negera , Weerasinghe Nirusha 
Published: November 2024

Abstract

Background – Bladder cancer is the 7th and 9th most prevalent cancer in the world and in the United Kingdom, respectively. The primary cause of death in affected patients is invasion and metastasis. Despite the presence of various anti-angiogenic drugs, their therapeutic effects are short-lived due to development of resistance, hence the need for research into novel biomarkers for therapeutic targeting. Vasculogenic mimicry (VM) is a neovascularization model in aggressive tumours whereby the malignant cells acquire the phenotype of endothelial cells to develop vessel-like networks to provide sufficient nutrients for tumour growth. It has been observed in several malignant tumours. β-human chorionic gonadotropin (β-hCG) is a hormone normally produced at detectable levels during pregnancy but can also be produced ectopically in several cancers, including of the bladder. Therefore, due to its angiogenic growth factor properties, β-hCG has been proposed to be central to cancer progression. This study thus aims to investigate the effect of various β-hCG concentrations on VM in vitro.
Methods – 3D cell cultures were prepared using T24 and SCaBER cell line suspensions, recombinant β-hCG solutions with varying concentrations of 500 mg/mL, 1000 mg/mL, and 2000 mg/mL, and rat tail I collagen. Upon incubation and fixation, immunocytochemical staining was performed targeting the endothelial cell markers CD31/34 and basement membrane laminin.
Results – Results demonstrated a two-fold increase in VM channel development when incubated with β-hCG compared to without. In SCaBER 3D cell cultures, VM channels’ development increased in a dose-dependent pattern, unlike in the T24 cultures, with the most VM channels developing in 2000mg/mL.
Conclusions – These findings suggest the possible association between β-hCG and VM in bladder cancer and the potential use of β-hCG as a less invasive screening biomarker for bladder cancer.
Learning Curve on Prostate Fusion Biopsies: Key Insights
Authors: Lepretre Mélanie , Chaoui Iyad , Bruyere Franck , Bourgi Ali 
Published: November 2024

Abstract

Purpose
MRI-guided prostate biopsies offering improved accuracy in detecting clinically significant cancer. Image fusion (IF) techniques have shown promise, but their adoption requires overcoming a learning curve. This study evaluates the impact of operator experience on prostate biopsy outcomes using the HITACHI ultrasound system.
Methods
This prospective study was conducted from September 2016 to March 2020, including 148 patients undergoing mpMRI and targeted biopsies. The patients were grouped into Early (first 50 cases), Intermediate (cases 51–100), and Late (cases 101–148) phases, based on operator experience. Biopsy outcomes, including cancer detection rates, procedure times, and false-negative rates, were analyzed across these phases.
Results
A significant learning curve was observed. In the Early phase, the detection rate for clinically significant cancers was 12%, increasing to 18% in the Intermediate phase and 25% in the Late phase. The overall positivity rate rose from 30–45%, while procedure times decreased from 45 to 30 minutes. Sensitivity for detecting clinically significant cancer improved from 60–85%, showing enhanced accuracy with operator experience.
Conclusion
Operator experience plays a crucial role in improving prostate biopsy outcomes using IF techniques. As proficiency increased, both cancer detection rates and procedural efficiency improved. These findings emphasize the need for adequate training and experience to optimize results and ensure the full benefits of fusion biopsy technologies in prostate cancer diagnosis.
The role of urinary Dickkopf-3/creatinine ratio in diagnosis of acute kidney injury before creatinine elevation in pediatric intensive care unit
Authors: Gökçeli Sefa Armağan , Günay Neslihan , Güntürk İnayet , Dündar Mehmet Akif , Akyıldız Başak Nur , Yazıcı Cevat , Yel Sibel , Poyrazoğlu Muammer Hakan , Dursun İsmail 
Published: November 2024

Abstract

Background
Early identification of AKI is crucial to lowering morbidity and mortality in pediatric intensive care units (PICU). Dickkopf-3(DKK3) is a glycoprotein produced by stressed tubular epithelium, plays role in Wnt/β-catenin pathway and demonstrates tubulointerstitial damage. The aim of this study to investigate the possible role of urinary DKK3 in detecting AKI before creatinine elevation in PICU and whether elevated urinary DKK3 is associated with worse outcomes.
Methods
117 patients were included in the study. Urine DKK3 levels were measured on PICU admission. Patients who developed AKI and those who did not during the 10-days follow-up were compared in terms of urine DKK3 levels, clinical and laboratory variables. Univariate and multiple binary logistic regression analyses were performed to examine risk factors for the development of AKI and mortality.
Results
Forty-two (35.8%) patients experienced AKI and 39(33%) patients died. Median urine DKK3 level was statistically significantly higher in patients developing AKI (p < 0.001). In multivariate logistic regression model, only LogDKK3/Cr (AOR:3.619; 95%CI:1.478–8.876) was independently associated with AKI. The predictors of mortality by logistic regression model, PELOD (AOR:1.115; 95% CI:1.026–1.212) and LogDKK3/Cr (AOR:3.914; 95%CI:1.397–10.961) were independently associated with mortality. Urine DKK3/Cr more than 63311 pg/ml increases the risk of AKI 5.547 times (95% CI:1.618–19.022, p = 0.006) and more than 86963 pg/ml increases the risk of mortality 5.569 times (95% CI:1.329–22.499, p = 0.019).
Conclusions
Urine DKK3 is a useful biomarker in predicting the development of AKI according to KDIGO SCr for patients in PICU and high levels are a risk factor for AKI and mortality.
Does intraoperative forced-air warming increase the risk of surgical site infections after spine surgery?: A propensity score-matched analysis
Authors: Handa Kyoichi , Kanno Haruo , Matsuya Shigetsune , Onoda Satsuki , Murotani Motoki , Ozawa Hiroshi 
Published: November 2024

Abstract

Purpose: To compare the incidence of surgical site infection (SSI) between spine surgeries with and without intraoperative use of forced-air warming (FAW).
Methods: This study analyzed 245 patients who underwent spine surgery. Baseline characteristics such as age, gender, body mass index, the American Society of Anesthesiologists Physical Status (ASA-PS), diagnosis of diabetes mellitus, and current smoking habits were investigated. Surgical data such as operative site, previous spine surgery at the same site, operative time, intraoperative blood loss, and use of spinal instrumentation were evaluated. Patients were divided into two groups based on the use of FAW. The baseline characteristics, surgical data, and incidence of SSI were compared between the two groups. To estimate the incidence of SSI without biases due to various confounding factors, a propensity score pairwise matching was performed.
Results: The FAW was used in 45 patients, while 200 patients underwent surgery without the use of the FAW. The incidence of SSI was not significantly higher in patients with FAW (8.9%) compared to those without FAW (3.0%) (P = 0.07). Patients with FAW exhibited significantly higher ASA-PS, longer operative times, greater intraoperative blood loss, and a higher rate of instrumentation use compared to those without FAW (P < 0.01). After propensity score matching, which yielded 39 pairs of patients, the incidence of SSI was no significant difference between patients with (10.3%) and without FAW (7.7%) (P = 0.69).
Conclusion: The present study using propensity score-matched analysis demonstrated FAW did not increase the incidence of SSI in spine surgery.