bluuebunny/crossref_metadata_2025_split huggingface dataset:
Postoperative Opioid Reduction Using a Multimodal Pain Protocol for Outpatient Orthopaedic Sports Medicine Surgery
Authors: Bernstein Ethan M. , Van Buren J. Preston , Wolf Kieran S.M. , Cantor Addison G. , Wei Wu Wei , Bailey James R. , Smith Jennifer L. 
Published: November 2024

Background: Orthopaedic surgery regularly employs opioids for postoperative pain management. Multimodal pain protocols have been shown to reduce opioid prescriptions in orthopaedic surgery. Purpose: To analyze the impact of a division-level multimodal pain protocol for orthopaedic sports medicine surgery on opioid prescription reduction and pain level postoperatively. Study Design: Cohort study; Level of evidence, 3. Methods: All orthopaedic sports medicine procedures at a military treatment facility were categorized into 1 of 3 pain tiers. A pain protocol emphasizing multimodal pain control was implemented for each tier. A retrospective cohort study compared pre- and postprotocol pain groups for each respective tier (n = 40 in each) for visual analog scale (VAS) for pain scores 2 weeks postoperatively, postoperative opioid prescription, and time to discontinuation of postoperative opioids. Results: The mean number of opioid pills prescribed for all tiers decreased by 43.6% (preprotocol 35.7 ± 3.1; postprotocol 20.1 ± 1.5; P < .0001) after pain protocol implementation. Of the total opioids prescribed in the postprotocol cohort, a mean of 64.1% were consumed. There was no significant difference in overall visual analog scale for pain scores at 2 weeks postoperatively (preprotocol 2.72 ± 0.41; postprotocol 2.99 ± 0.43; P = .40). At 2 weeks postoperatively, only 1 patient continued opioids in the postprotocol group compared with 20 patients with continued opioid use in the preprotocol group ( P < .001). Conclusion: A division-level multimodal pain protocol applied to orthopaedic sports medicine procedures led to decreased opioid prescription postoperatively with no significant difference in 2-week postoperative pain scores compared with more opioid reliant and variable protocols in a cohort of military service members. Despite the reduced prescription, patients consumed a mean of 64.1% of pills, indicating continued overprescription.
Delivery of Oral Health Services at Medical Visits through 3 Medical Dental Integration Models
Authors: Braun P.A. , Flowerday C. , Bienstock A. , Callaghan T. , Freeman K. , Gable M. , Ramirez L. , Dickinson L.M. 
Published: November 2024

Introduction: The Rocky Mountain Network of Oral Health is 1 of 3 regional projects funded by the Health Resources and Services Administration (2019 to 2024) focusing on caries prevention through medical-dental integration (MDI) in community health centers (CHCs). MDI models included provision of preventive oral health services (POHS) at medical visits by the medical team (model 1), by integrated dental hygienists (DHs; model 2), or a hybrid of these models (model 3). The overarching aim is to evaluate the effectiveness of these models on 3 objectives: (1) ≥50% receive POHS, (2) ≥75% with high caries risk receives dental referral, and (3) ≥30% of parents/caregivers set an oral health goal for the child. Methods: Primary care association practice facilitators (PFs) recruited 22 CHCs to participate from Arizona, Colorado, Montana, and Wyoming. CHCs completed oral health needs assessments prior to participating. PFs coached CHCs using an MDI change package. CHCs submitted monthly and 6-mo, aggregated, deidentified population metrics for children aged 0 to 40 mo receiving well-child care visits. Monthly CHC-specific reports were used by PFs with teams in continuous quality improvement activities. POHS delivery trends over time were assessed using a linear mixed model, adjusting for number of eligible patients during each 6-mo reporting period. Results: Participating CHCs were urban (55%), rural (36%), and frontier (8%). Twelve (55%) had co-located dental clinics. Ten CHCs implemented model 1, 5 implemented model 2, and 7 implemented model 3. From September 2020 to August 2023, CHCs reported providing 91,604 POHS to eligible children. After adjustment, there was significant improvement over time for all objectives: objective 1: F(5, 90) = 4.66, P = 0.0008; objective 2: F(5, 90) = 2.99, P = 0.0151; objective 3: F(5, 90) = 4.56, P = 0.0009. Conclusions: The implementation of 3 MDI models across 22 CHCs in 4 states resulted in a meaningful increase in POHS delivery. POHS delivery by both medical and embedded DHs was associated with the most substantial increase in POHS delivery. Knowledge Transfer Statement: The results of this study can be used by medical and dental providers when deciding which approach they wish to use when planning the delivery of preventive oral health services at medical visits.
Medical-Dental-Behavioral Integration: Embracing Whole-Person Health in Research and Practice
Authors: Heaton L.J. , Tiwari T. , Tranby E.P. 
Published: November 2024

This editorial describes the 9 articles in this supplement that emphasize and support establishing and maintaining integrated health care systems that address all aspects of a person’s health, given the complex links between oral, behavioral, and systemic health. The 9 articles in this supplement represent original data collection from clinical and big data studies, a theoretical discussion of the implementation of medical-dental-behavioral integration models, and a scoping review of the links between oral health and one health. These articles involve providers representing oral health care, primary care, nursing, behavioral health, and other health care providers in the delivery of integrated, whole-person care. This editorial discusses barriers and opportunities that emerge when we understand overall health as a complex interplay of factors, including individual, emotional, social, and environmental. The articles described briefly in this editorial provide strong evidence for the importance, feasibility, and necessity of integrated health care and concept of overall health. Knowledge Transfer Statement: The goal of this editorial and following supplement articles is to present different perspectives on the implementation of medical-dental-behavioral integration to provide comprehensive, whole-person care. Through a discussion of barriers to and opportunities that emerge from this type of integrated care, this editorial and supplement provide strong evidence for the importance, feasibility, and necessity of integrated health care and concept of overall health.
Periodontitis and Metabolic Control of Adults with Type 1 Diabetes
Authors: Jeftha A. , Suliman A. , Conradie-Smit M. , Kimmie-Dhansay F. 
Published: November 2024

Introduction: Periodontitis has been reported with increased incidence and prevalence in patients with diabetes mellitus (DM). Noncommunicable diseases burden the South African public health system, and there are no data reporting on this relationship in this population. This is required to inform management protocols in type 1 diabetes mellitus (T1DM), which currently exclude the importance of periodontal treatment. Objectives: The aim of this study was to determine whether there was an association between periodontitis and the glycemic control of adult patients with T1DM at a tertiary institution in South Africa. Methods: A cross-sectional study was conducted on adults diagnosed with T1DM. Bleeding on probing, periodontal pocket depth, and radiographical bone loss were assessed and the periodontal status of the patient was compared to their glycemic control, measured by HbA1c. An HbA1c level of ≤7% was considered to indicate adequate glycemic control. Results: There were 120 adult participants, of whom 61.7% (74) were female and 38.3% (46) were male. The majority were nonsmokers and younger than 44 y. There were 78 (65%) participants with uncontrolled blood glucose and 42 (35%) with good control (HbA1c ≤ 7%). The median HbA1c level was 8.75 (range, 6.1 to 12.2). Most participants (94%) had periodontitis, and 97% of them had uncontrolled blood glucose. Conclusion: There was an association between percentage bleeding score (P < 0.001) and metabolic control in adults with T1DM treated at a tertiary hospital in Cape Town, South Africa. Periodontitis severity as described by staging was not associated with T1DM in this sample. The high prevalence of periodontitis in this sample (94%) highlights the need for periodontal management to form a part of holistic patient care in patients with T1DM in this setting. Knowledge Transfer Statement: The study results highlight the role of periodontitis severity and gingival bleeding scores on the metabolic control of adults with T1DM and thus emphasizes the importance of periodontal care in whole-person health in this patient population.
Role of molecular alterations in transplantation decisions for patients with primary myelofibrosis
Authors: Luque Paz Damien , Gagelmann Nico , Benajiba Lina , Riou Jérémie , Salit Rachel , Orvain Corentin , Schroeder Thomas , Bories Claire , Gurnari Carmelo , Badbaran Anita , Boyer Françoise , Pagliuca Simona , Rautenberg Christina , Tavitian Suzanne , Pangiota Victoria , Ianotto Jean-Christophe , Thol Felicitas , Cayssials Emilie , Heuser Michael , Rubio Marie-Thérèse , Cassinat Bruno , Daltro de Oliveira Rafael , Sauter Craig , Maciejewski Jaroslaw P. , Reinhardt Hans Christian , Scott Bart L. , Ugo Valérie , Kröger Nicolaus , Kiladjian Jean-Jacques , Robin Marie 
Published: November 2024

Abstract
The aim of our study was to analyze the potential survival benefit associated with hematopoietic stem cell transplantation (HSCT) according to clinicobiological scores, which incorporate mutation-enhanced international prognostic score system (MIPSS) to facilitate decision-making in this context. One transplant (n = 241) and 1 nontransplant cohort (n = 239) were used to test the hypothesis that patients with primary myelofibrosis with higher risk molecular score benefit from HSCT. A weighted propensity score was applied to balance confounding factors with the transplanted cohort as reference. Weighted Cox proportional hazard models and logistic regression analyses were performed. Overall, 105 patients who did not receive transplant could be matched to the 239 patients who did receive transplants. HSCT was associated with a higher 6-year overall survival rate in intermediate-2 (60.1% vs 41.5%) and high-risk DIPSS patients (44.4% vs 6.55%), high-risk MIPSS70 (46.5% vs 23.9%), high-risk (73.2% vs 39.7%) or very high-risk MIPSS70+V2 (51.8% vs 24%). Patients with intermediate MIPSS70 scores have an advantage of survival with HSCT only when their myelofibrosis transplant scoring system (MTSS) were low or intermediate. Patients who received transplant had an increased mortality risk the first year, but a significant benefit with HSCT after the 1-year landmark was observed in higher risk patients. This study confirms that, similar to DIPSS, MIPSS70 and MIPSS70+V2 risk score in addition to MTSS can be used to determine which patients with primary myelofibrosis have survival benefit from HSCT over non-HSCT strategies.
BMSC-derived exosomes promote osteoporosis alleviation via M2 macrophage polarization
Authors: Zhang Yanbin , Bai Jing , Xiao Bin , Li Chunyan 
Published: November 2024

AbstractOsteoporosis is characterized by reduced bone mass due to imbalanced bone metabolism. Exosomes derived from bone mesenchymal stem cells (BMSCs) have been shown to play roles in various diseases. This study aimed to clarify the regulatory function and molecular mechanism of BMSCs-derived exosomes in osteogenic differentiation and their potential therapeutic effects on osteoporosis. Exosomes were extracted from BMSCs. Bone marrow-derived macrophages (BMDMs) were cultured and internalized with BMSCs-derived exosomes. Real-time quantitative PCR was used to detect the expression of macrophage surface markers and tripartite motif (TRIM) family genes. BMDMs were co-cultured with human osteoblasts to assess osteogenic differentiation. Western blot was performed to analyze the ubiquitination of triggering receptor expressed on myeloid cell 1 (TREM1) mediated by TRIM25. An ovariectomized mice model was established to evaluate the role of TRIM25 and exosomes in osteoporosis. Exosomes were successfully isolated from BMSCs. BMSCs-derived exosomes upregulated TRIM25 expression, promoting M2 macrophage polarization and osteogenic differentiation. TRIM25 facilitated the ubiquitination and degradation of TREM1. Overexpression of TREM1 reversed the enhanced M2 macrophage polarization and osteogenic differentiation caused by TRIM25 overexpression. TRIM25 enhanced the protective effect of BMSCs-derived exosomes against bone loss in mice. These findings suggested that BMSCs-derived exosomes promoted osteogenic differentiation by regulating M2 macrophage polarization through TRIM25-mediated ubiquitination and degradation of TREM1. This mechanism might provide a novel approach for treating osteoporosis.
Genetically predicted circulating linoleic acid levels and risk of osteoarthritis: a two-sample mendelian randomization study
Authors: Yang Wen , Xiao Wenwu , Liu Hailong 
Published: November 2024

Abstract
Objectives
This study aimed to provide insight into the effect of genetically predicted linoleic acid (LA) levels on osteoarthritis (OA).

Methods
The LA dataset was obtained from the UK Biobank (UKBB) consortium and contained 114,999 samples. The OA discovery dataset was derived from MRC-IEU consortium and included 38,472 cases and 424,461 controls. The OA validation set was derived from a summary-level genome-wide association study (GWAS) and included 39,427 cases and 378,169 controls. Genetic variants strongly associated with LA (p < 5 × 10− 8) were extracted as instrumental variables (IVs). The inverse variance weighted (IVW) approach was adopted as the primary analysis method in this study. In addition, multiple sensitivity analysis methods were used to assess the reliability of our results.

Results
The IVW approach showed that circulating LA levels were negatively associated with OA risk in the discovery set (odds ratio (OR) = 0.993, 95% confidence interval (95% CI): 0.988–0.998, p = 0.011). A consistent result was obtained in the validation set (OR = 0.904, 95%CI: 0.845–0.967, p = 0.003). These results were validated by sensitivity analysis.

Conclusion
This study provides new evidence for the causal relationship between LA and OA, which provides new insights for the treatment of OA.
Early clinical efficacy of 3D-printed artificial vertebral body in spinal reconstruction after total en bloc spondylectomy for spinal tumors
Authors: Wang Xiaodong , Sun Shaosong , Jiang Yuanyuan , Ren Bao , Zhang Xiong , Miao Jun , Ji Jingtao , Han Ye 
Published: November 2024

Abstract
Background
Total en bloc spondylectomy (TES) is a recognized surgical approach for managing spinal tumors. With advancements in three-dimensional (3D) printing technology, the use of 3D-printed prosthetics for vertebral reconstruction post-tumor resection has gained traction. However, research on the clinical implications of these prosthetics remains limited.

Methods
This retrospective study evaluated patients who underwent TES for primary and metastatic thoracolumbar tumors at the Department of Spinal Surgery, Tianjin Hospital, between October 2017 and September 2020. These patients received anterior reconstruction with 3D-printed artificial vertebral bodies.

Results
14 patients completed the surgery, with intraoperative blood loss ranging from 1,400 to 4,200 ml (mean 2,767 ± 790 ml) and operative duration between 240 and 520 min (mean 382 ± 75.9 min). The follow-up period extended from 7 to 43 months, with an average of 19.9 ± 9.5 months. Standardized prefabricated prosthetics were utilized in nine patients, while five received customized prosthetics. Throughout the follow-up, there were no reports of posterior connecting rod, 3D-printed prosthetic, or pedicle screw failures. Notably, one patient presented with significant prosthetic subsidence resulting in screw loosening, and three cases of prosthetic subsidence were observed.

Conclusion
The incorporation of 3D-printed prosthetics in TES procedures yielded favorable clinical outcomes. Further research is warranted to optimize these prosthetics for enhanced postoperative stability and patient-specific applications.
Factors influencing job performance of nurses in COVID-19 care: a study in Egypt
Authors: Senosy Ayman Muhammad Kamel 
Published: November 2024

AbstractCoronavirus disease (COVID-19) is an illness that has critical effects on public health and overall circumstances across the world. The performance of nurses represents the vital actions in providing care for COVID-19 patients. The aim of this study was to assess job performance and associated nurses, patients, and environmental-related factors among nurses providing care to COVID-19 patients in Egypt through the following: assessing the nurses’ knowledge regarding care of COVID-19 patients; assessing the nurses’ practice regarding care of COVID-19 patients; assessing different factors that affect different types of nurses' job performance; and assessing the factors associated with the job performance of nurses providing care to COVID-19 patients.Design A descriptive exploratory study was used to meet the aim of the study.Setting The study was conducted at Ain Shams University COVID-19 Hospital.Study subjects A convenient sample of all 52 available nurses working at Ain Shams University COVID-19 Hospital. Data collection tools: The data was collected using a self-administered questionnaire. It consisted of the following: A. Self-administered nurses’ questionnaire: Part I: Demographic characteristics of nurses. Part II: Nurses knowledge assessment. Part III: Factors associated with nurses' job performance. B. Narses’s practice observational checklist. Results: The mean age (mean ± SD) of the study population was 40.59 ± 6.90. As regards their years of experience working as nurses, only 32.7% of them have more than ten years of experience. In relation to the total satisfactory level of knowledge about coronavirus, the study reveals that 55.8% of the nurses have unsatisfactory knowledge regarding coronavirus, There is a highly significant relationship between level of practice and years of experience (p-value < 0.001**), while there is a significant relationship between level of practice and educational level and attending the training courses about caring for COVID-19 patients (P-value 0.033*, P-value 0.025*), respectively.Conclusion The study concluded that most of the studied nurses had unsatisfactory knowledge, and more than half had incompetent practice scores about nursing care practices for patients with COVID-19. There was a positive linear correlation between the nurses' knowledge and practice. The factors affecting their performance in caring for patients with COVID-19, lack of cooperation between nurses and patients, lack of supplies and equipment during care were the most frequently reported factors, as were an unequal nurse-patient ratio, many nursing tasks, and a lack of patients' knowledge.Recommendation The study recommends the importance of promoting the nursing care guidelines as a standard procedure in ICUs, and the nursing care guideline educational program for patients with COVID-19 should be scheduled regularly for nurses. Providing the hospitals with supplies to avoid the shortage's effect on nurses’ performance.
Regulation, modification, and evolution of remote sign language interpreting in Sweden – a service in progress
Authors: Warnicke Camilla , Matérne Marie 
Published: November 2024

Abstract
Background
The sign language interpreting service has undergone a tremendous change due to COVID-19 and remote interpreting has become a more frequent alternative to the face-to-face format. The aim of the study is to investigate how the interpreters perceive the organisation of remote interpreting in Sweden and how it has evolved since the COVID-19 pandemic.

Method
Interviews with 26 experienced remote interpreters, representing 19 of Sweden’s 21 counties, were analysed with qualitative content analysis.

Results
Three themes were revealed in the analysis. The first theme was regulation. It was stated that directives and regulatory decisions concerning provision of remote interpreting services were varied and unclear. Several different platforms were used when interpreting remotely. Some of the services had conducted risk analyses, whereas others had not. The second theme was modification, including adjusting interactions to suit the preferences and capabilities of the users (both signing and speaking parties), as well as adjustments to work environments and workplaces. The third theme, evolution of remote interpreting, showed that support and training were rare and varied. Although the processes and organisation of remote interpreting are not yet fully established in Sweden, remote interpreting is here to stay.

Conclusions
In Sweden, remote interpreting is a service that varies according to regulations and the type of assignments. The service would benefit from being more uniform and streamlined across Sweden, although consideration must be given to those involved with the service.
Clinician attitudes towards adoption of evidence-based practice: a nationwide multiprofessional cross-sectional study of child and adolescent mental health services in Sweden
Authors: Santesson Anna Helena Elisabeth , Holmberg Robert , Bäckström Martin , Gustafsson Peik , Jarbin Håkan , Perrin Sean 
Published: November 2024

Abstract
Background
Implementation of evidence-based practice (EBP) in child and adolescent mental health services (CAMHS) is a priority to improve service delivery and outcomes. Clinicians’ EBP attitudes are likely to play a crucial role in implementation but are poorly understood. This study aimed to assess variation in EBP attitudes in a large national sample of CAMHS clinicians in Sweden, and to compare these findings to findings from the United States of America (USA).

Methods
CAMHS clinicians (n = 799; 60% response rate) completed the Evidence-Based Practice Attitude Scale (EBPAS) and items from the Organizational Readiness for Change Scale (ORC) ahead of an EBP for depression implementation effort across Sweden. EBPAS scores were compared with the USA study. Predictors of global and specific attitudes (gender, age, working years, education, profession, perceived benefit of diagnosis and organizational readiness and type of service) were examined using simple and multiple linear regressions.

Results
Clinicians had positive attitudes towards EBP on the four-dimensional subscales of the EBPAS, somewhat more so than their American counterparts. Clinician and organizational characteristics were related to at least one attitudinal dimension in both models, with perceived utility of diagnosis being the strongest and most consistent predictor across dimensions and models.

Conclusions
Results from this large-scale national study underscore the need to consider cultural, contextual, and individual variations in attitudes towards EBP when planning implementation efforts. Such efforts may need to be tailored to the working contexts, needs, and values of CAMHS clinicians, particularly their views on the utility of diagnosis.