bluuebunny/crossref_metadata_2025_split huggingface dataset:
A qualitative investigation to identify return to sports criteria after shoulder stabilization surgery used by professional team physicians
Authors: Szlufcik Mike , Pasurka Mario , Theodoropoulos John , Betsch Marcel 
Published: December 2024

Purpose: Purpose of this study is to explore currently utilized readiness to return to sports (RTS) criteria after shoulder stabilization surgery used in elite athletes to gain novel insights into the RTS decision making process of professional team physicians. Methods: 19 qualitative semi-structured interviews with professional team physicians were conducted by a single trained interviewer. The interviews were used to identify team physician concepts and themes regarding the criteria used to determine RTS after shoulder stabilization surgery. General inductive analysis and a coding process were used to identify themes and sub-themes arising from the data. A hierarchical approach in coding helped to link themes. Results: We were able to identify five key themes that participating physicians focused on to determine RTS decision making: external influence, objective and subjective criteria, time elapsed since surgery and type of sport. The most important RTS criteria included: range of motion and muscle strength followed by clinical joint stability, time since surgery, ability of sporting movement, psychological readiness, functional testing, absence of pain and allied team support. Conclusion: This study identified several main themes and subordinate minor themes as having the most influence on RTS decision after shoulder surgery. We showed that even among specialized professional team physicians, the main criteria to RTS in these categories were inconsistent necessitating the future development of specific RTS guidelines.
The effect of ergonomic interventions on fatigue and musculoskeletal symptoms of university students during combined information and communication technologies tasks
Authors: Depreli Özde , Topcu Zehra Güçhan , Angın Ender , Değer Ünal , Karaman Ayşen 
Published: December 2024

Background As part of developments in educational systems, university students use combined information and communication technologies (ICT) tasks that may impact musculoskeletal (MSK) symptoms. Objective This study aims to investigate the acute effect of ergonomic interventions applied during combined ICT tasks, which include reading electronic documents on a laptop and creating handwritten summaries after prolonged sitting in the lecture, on fatigue, discomfort, and musculoskeletal pain in university students. Methods Fatigue severity was measured with the Modified Borg Scale, and pain, discomfort, and satisfaction with an ergonomic intervention were measured with the Visual Analogue Scale. Postural awareness was measured with the Postural Habits and Awareness Scale. The ergonomic intervention consisted of ergonomics education and in-class exercises. The Wilcoxon signed-rank test and T-Test were used to compare the posttest–pretest changes within the group. Results A total of 44 university students, whose mean age was 22 ± 2 years, were included in this study. The ergonomic intervention was found to have a moderate effect on discomfort (r = .376) and a large effect on musculoskeletal pain (r = .570) and postural awareness (r = .608). Additionally, this intervention changed MSK pain by 32.5%, discomfort by 14.1%, and postural awareness by 60.8%. Conclusions Ergonomic approaches positively affected musculoskeletal pain, discomfort, and postural awareness of students exposed to an intensive lecture with combined ICT tasks, whereas no effect was seen in the levels of fatigue and headache. Further research with a control group is needed.
“Man vs. Machine: 3D Milling of Auricular Frameworks”
Authors: Yom Jina , Palacios Jose F. , Neuwirth Allison , Atamian Elisa K. , Goldstein Todd , Bastidas Nicholas 
Published: December 2024

Objective Autologous rib harvest with manual framework production is the current gold standard for microtia reconstruction. Recent clinical success with implantation of cadaveric costal cartilage grafts opens the possibility of point of care auricular framework production. This paper assesses the feasibility and efficiency of 3D milling of cadaveric costal cartilage for auricular framework production. Design A Nagata/Firmin style auricular framework was manually carved en bloc out of soap and 3D scanned to design a milling toolpath on a desktop 3-axis computer numerical control (CNC) machine. An en bloc framework was then milled from cadaveric costal cartilage. Time to mill a complete framework was recorded. The dimensional/volumetric analyses were performed. Main Outcome Measure(s) The main outcome measures were total time to mill a complete auricular framework out of cadaveric cartilage and dimensional/volumetric comparisons to the model ear. Results Total milling time for the cartilage framework was approximately 7 min. Finalizing steps took an extra 20 min. Total time to produce a final framework ready for implantation was approximately 27 min, compared to the traditional 1-2 h by manual carving. All dimensional comparisons were within 2 mm to the manually carved model. Volumetric analysis showed 71% similarity. Conclusions En bloc cadaveric costal cartilage framework milling is both feasible and efficient. 3D milling significantly reduces framework production time and allows for accurate reconstruction of the complex ear geometry, which can translate to cost savings, optimized patient safety, and potential for patient-specific reconstruction. The next step toward achieving clinical application is ensuring framework sterility.
Real world comparison of immune-related adverse events with nivolumab-relatlimab versus ipilimumab-nivolumab in patients with advanced cutaneous melanoma
Authors: Kielkowski Brooke , Mansour Diana , Ebbert Brooke , Seago Kelsea , Wen Sijin , Li Hang , Barrett Christine 
Published: December 2024

Introduction Frontline therapy for patients with advanced cutaneous melanoma often includes immune checkpoint inhibitors (ICIs). Although these agents have increased response rates, many patients will experience immune-related adverse events (irAEs). The difference in safety profiles of the current combinations available are not well established. Therefore, this study aimed to compare the incidence of severe irAEs of patients receiving ipilimumab-nivolumab versus nivolumab-relatlimab in a real-world setting. Methods A retrospective chart review was conducted on all patients who underwent treatment with either combination ICI for advanced cutaneous melanoma. Results A total of 47 patients who received either one or more doses of either combination ICI were included for analysis. Of these patients, 37 (78.2%) had at least one irAE of any grade. The baseline characteristics among the patients who received nivolumab-relatlimab and those who received ipilimumab-nivolumab were not significantly different. The severity of the 73 irAEs that occurred ranged from grade 1 to grade 3, with 16 (21.9%) irAEs occurring in the nivolumab-relatlimab, 3 (18.8%) of which were grade 3–4. Meanwhile, those receiving ipilimumab-nivolumab developed 57 (78.1%) irAEs, with 14 (24.6%) being grade 3–4. This study's findings show that nivolumab-relatlimab had a lower incidence of developing severe irAEs in comparison to ipilimumab-nivolumab. Conclusions Treatment with nivolumab-relatlimab could be preferred as a combination ICI given the lower incidence of severe irAEs, delayed onset of irAEs, and lower rate of treatment discontinuation.
Productivity and aseptic process evaluation during batch production simulation of intravenous medications using a semi-automated compounding device
Authors: Riestra Ana C , Grisaleña Jaione , Telleria Naiara , Cajaraville Gerardo 
Published: December 2024

Introduction Intravenous (IV) medications can be prepared using compounding devices to increase productivity, and reduce risks associated with aseptic compounding. This study evaluated the productivity and quality outcomes of the aseptic process for simulated batches of IV medications used in clinical practice produced using a semi-automated compounding device (Gri-fill; Grifols). Methods Simulated batches from 50 to 600 preparations were completed representing hazardous and non-hazardous drugs, including one-step single component (atropine sulfate, cisplatin) and multistep, multiple component (mitomycin C, piperacillin/tazobactam, trastuzumab, 5-fluorouracil and gemcitabine). Productivity, device autonomy, quality of the aseptic process (media-fill test) and sterility of the preparations were evaluated. Results A total of 2024 final preparations and 460 intermediate products were compounded during 78 working hours. For low and high complexity level preparations, median (minimum-maximum) production speed was 1.3 (0.6–1.7) and 3.7 (2.6–4.3) min per preparation, respectively. The longest process (36.2 min/bag) was the preparation of a simulated gemcitabine 3 L bulk solution bag, which included reconstitution of vials and filling the bulk bag. All operational errors (0.6%) were resolved autonomously by the user. None of the 883 media fill preparations showed microbiological growth and all 114 analyzed preparations passed the sterility test. Conclusions Using a semi-automated compounding device, preparation efficiency of IV medications ranged from 14 preparations/h for multicomponent preparations from vials requiring reconstitution, to 100 preparations/h for low complexity preparations using a bulk solution bag. The aseptic processes demonstrated the absence of microbial growth in all tested preparations.
Helicobacter pylori Seroprevalence in Rheumatoid Arthritis Patients with Interstitial Lung Disease
Authors: Oka Shomi , Higuchi Takashi , Furukawa Hiroshi , Shimada Kota , Okamoto Akira , Fujimori Misuzu , Hashimoto Atsushi , Komiya Akiko , Saisho Koichiro , Yoshikawa Norie , Katayama Masao , Matsui Toshihiro , Fukui Naoshi , Migita Kiyoshi , Tohma Shigeto 
Published: December 2024

Background: Rheumatoid arthritis (RA) is complicated with interstitial lung disease (ILD). Gastroesophageal reflux disease is prevented by Helicobacter pylori infection and is a predisposing factor for idiopathic pulmonary fibrosis. However, the prevalence of H. pylori infection in RA patients with ILD has not been sufficiently investigated. Objective: In this study, we analyzed anti- H. pylori antibodies in RA patients with ILD. Design: Case-control observational study Methods: Anti- H. pylori antibodies were analyzed in the sera of RA patients using a commercially available enzyme-linked immunosorbent assay kit. Results: The positivity of anti- H. pylori antibodies in RA with ILD ( n = 30 [18.0%], P = .0227), usual interstitial pneumonia ( n = 10 [14.3%], P = .0212), and airway disease ( n = 30 [18.0%], P = .0227) was significantly lower than that of RA without chronic lung disease ( n = 78 [27.5%]). The positivity of anti- H. pylori antibodies was also lower in RA with chronic lung disease ( n = 68 [18.2%], P = .0059). Multiple logistic regression analyses showed that the presence of anti- H. pylori antibodies was independently and protectively associated with chronic lung disease in RA. Conclusion: The seroprevalence of H. pylori was lower in RA with ILD. H. pylori infection prevented ILD in patients with RA by protecting them from gastroesophageal reflux disease.
Fidelity of a home-based pulmonary rehabilitation program in people with COPD referred from primary care
Authors: Dal Corso Simone , Holland Anne E , George Johnson , Abramson Michael J , Russell Grant , Zwar Nick , Bonevski Billie , Perryman Jaycie , Cox Narelle S 
Published: December 2024

Purpose: Pulmonary rehabilitation (PR) is highly effective but underutilised. Pathways to home-based PR (HBPR) from general practice could improve utilisation, but program fidelity in this setting is unknown. This study aimed to explore the fidelity of HBPR in people referred from general practice. Methods: Secondary analysis of intervention-group data from two-arm cluster RCT (RADICALS-interdisciplinary intervention for people with COPD including smoking cessation support, home medicine reviews and 8-weeks HBPR). HBPR fidelity assessed by the extent to which exercise training was prescribed according to protocol. Completion of HBPR and contributing factors were determined. Results: 107 participants (68% of intervention group) were referred to HBPR, with n = 75 (70%) commencing the program (mean age 68 years, FEV1 65% predicted, median mMRC 1). Aerobic training was prescribed according to protocol for 74% of participants in week one, and on average 89% of participants in weeks 2–8. Resistance training was prescribed according to protocol for 98% and 88% of participants (Week 1 and Weeks 2–8, respectively). Rehabilitation completers ( n = 57, 76%) were 26 times more likely to have attended the Week 2 phone call (95% CI 2–352). Clinically meaningful improvements were achieved in health-related quality of life (SGRQ) and health status (CAT) following rehabilitation. Conclusion: PR program fidelity can be maintained when delivering HBPR to people with COPD referred directly from general practice. Early engagement with PR may be key to supporting rehabilitation completion.
Impact of Moringa oleifera Hydro-Alcoholic Bark Extract on Diabetic Wound Healing: A Topical Approach
Authors: Manhas Diksha , Malairaman Udayabanu 
Published: December 2024

Purpose The current study was aimed to evaluate the potential of Moringa oleifera against diabetic foot ulcer, where the wound healing is impaired and susceptible to infection. Methods The effects of M. oleifera hydroalcoholic bark extract (MOHE) on different parameters influencing diabetic wound healing were comprehensively investigated including: anti-inflammatory effects, antibacterial properties, antioxidant activity, anti-diabetic properties, and fibroblast proliferation and migration. Furthermore, in vivo studies were conducted in diabetic rats and Zebrafish to investigate the topical effects of MOHE on wound healing. Results The findings of this study demonstrated that MOHE has strong anti-diabetic effect, including a significant inhibition of α-amylase activity (IC50 = 0.043 mg/mL) and 2.92-fold increase in 2-NBDG uptake in McCoy cells. MOHE demonstrated considerable antioxidant activity, inhibiting DPPH (IC50: 0.046 mg/mL) and ABTS (IC50: 0.04 mg/mL) free radicals. In in vitro wound healing studies employing MOHE revealed a significant increase in McCoy fibroblast proliferation (148.83%) and improved migration, resulting in a wound closure rate of 46.3%. MOHE exhibited significant antibacterial activity against pathogenic bacteria species. It efficiently reduced heat-induced RBC hemolysis, with anti-inflammatory effect of 73% at 0.2 mg/mL. Furthermore, MOHE demonstrated better results in the treatment of diabetic wounds in Wistar rats and fin regeneration in Zebra fish compared to Calendula cream. Conclusion This evidence based pharmacological study highlights the promising potential of MOHE in facilitating the healing of diabetic wounds, offering a topical approach to address this challenging healthcare issue.
Evaluation of Veress Needle as a Liver Retraction Technique in Laparoscopic Sleeve Gastrectomy
Authors: Ertekin Suleyman Caglar , Akbulut Gökhan , Turgut Emre , Akyol Hüseyin , Ergenç Muhammer , Yeğen Cumhur 
Published: December 2024

Background Liver retraction management in laparoscopic sleeve gastrectomy (LSG) is challenging for surgeons, especially in patients with enlarged livers. Traditional methods, such as the Nathanson retractor (NR), often necessitate additional incisions, potentially increasing liver enzymes and increasing the risk of complications. The aim of this study was to evaluate the efficacy of the use of a Veress needle (VN), an alternative liver retraction technique, in LSG surgery compared with NR. Materials and Methods This study was conducted at a university-affiliated hospital between May 2022 and December 2022. Patients who underwent LSG were divided into two groups: one utilizing the NR and the other employing the VN for liver retraction. Parameters such as operation duration, retraction time, liver laceration, trocar-induced hemorrhage, subxiphoid trocar site infections, pain scores measured via the visual analog scale (VAS) at various time points, pre- and postoperative liver enzyme levels (AST, ALT, GGT, ALP) and CRP levels were analyzed. Results Data from 151 patients were analyzed. The AST/ALT elevations ( P < 0.001) were significantly lower in the VN group (73 patients) than in the NR group (78 patients), while there was no significant difference in GGT/ALP levels. Retraction-related bleeding was significantly greater in the NR group than in the VN group (6.4% vs 0%, P = 0.035). Postoperative infection rate was lower in the VN group but not statistically significant (0% vs 3.8%, P = 0.135). CRP differences were significant on the first postoperative day ( P < 0.001). Postoperative VAS scores were significantly lower in the VN group at all measured time points except at the 48th hour and 10th day. Conclusions The VN technique in LSG significantly reduces liver enzyme elevation and the need for an extra trocar and incision, potentially lowering complication risk and enhancing patient outcomes.
Compliance with care standards and professional knowledge of operating theatre personnel before, during and after laparoscopic bariatric surgery: A study in public hospitals in Iran
Authors: Kouhestani Zahra , Aboutalebi Mohammad Sadegh , Izadan Mahshad , Aarabi Akram , Mosleh Sorour 
Published: December 2024

Introduction: By adhering to care standards, many adverse outcomes for patients, such as pressure injuries, tissue necrosis and patient falls, can be prevented. The aim of this study was to investigate the level of compliance with care standards before, during and after various types of bariatric surgeries. Materials and methods: This study was a cross-sectional descriptive study conducted in the operating theatres of selected teaching hospitals in Isfahan (Iran). The study sample consisted of all operating theatre personnel in the selected teaching hospitals who met the inclusion criteria. Compliance with care standards was measured using a researcher-developed checklist. A researcher-developed questionnaire with 43 true/false questions was used to evaluate the operating theatre personnel’s professional knowledge. The data were analysed using SPSS version 20 and descriptive and inferential statistics. Results: The mean score of adherence to care standards and the mean score of professional knowledge of operating theatre personnel regarding care of laparoscopic bariatric surgery were 78.35 ± 9.49 and 29.45 ± 6.17, respectively. There is no significant relationship between these two variables, with a two-tailed significance (Sig.) of 0.056 and a correlation coefficient (r) of 0.199. Discussion and conclusion: In general, it can be concluded that the specific knowledge of the local operating theatre personnel regarding minimally invasive laparoscopic surgery care is at an intermediate level. Requirements for training in this area were therefore successfully identified. In addition, not all operating theatre personnel adhere to the standards of care for patients undergoing laparoscopic bariatric surgery. This non-adherence could be due to insufficient training or the absence of established standards in hospitals.
Efficacy of Shipixiaoji Granules, Lenvatinib, and Tislelizumab in Patients with Unresectable Hepatocellular Carcinoma: Protocol for a Prospective, Single-Arm, Phase Ⅱ Trial
Authors: Zhang Zhen , Liang Zicheng , Tan Xiaoning , Jian Huiying , Gao Wenhui , Zeng Puhua 
Published: December 2024

Background and Aim Shipixiaoji granules (SPXJ) is traditional Chinese medicine that treats hepatocellular carcinoma (HCC). However, its efficacy in HCC is still unknown. This prospective study assessed the outcomes of using SPXJ combined with tyrosine kinase inhibitors (TKIs) and immune checkpoint inhibitors (ICIs) in the management of patients with unresectable HCC. Methods This study was conducted as a single-arm phase II clinical trial. We recruited patients diagnosed with CNLC stage Ⅱ to Ⅲ HCC. The treatment regimen included oral lenvatinib (12 mg for patients weighing ≥60 kg; 8 mg for those weighing <60 kg) once daily, intravenous tislelizumab (200 mg) every 3 weeks, and SPXJ twice daily. The primary endpoint was defined as progression-free survival (PFS) in accordance with RECIST 1.1 criteria. Results Fifty-four patients were enrolled in this study. The primary endpoint was achieved, with a median PFS of 12.7 months. The objective response rate (ORR) was recorded at 55.6%. The disease control rate (DCR) was observed at 98.1%. Additionally, we compared PFS based on the participants’ sleep behavior. The results indicated that patients with a morning chronotype had a median PFS of 14.1 months, while those with a night chronotype had a median PFS of 9.85 months (95% CI: 1.366-6.853, P < .05). Treatment-related adverse events were reported in 96.3% (n = 52) of patients. Conclusions The combination of SPXJ, lenvatinib, and tislelizumab demonstrated substantial safety and anti-tumor efficacy as first-line treatment for unresectable HCC. Moreover, patients’ sleep behavior significantly influences treatment efficacy.
Measuring the impact of digitisation on NHS nurses’ time and morale: A time and motion study
Authors: Hicks Joshua , McAleer Claire , Mutowo Mutsa 
Published: December 2024

Objective Despite the benefits of digital transformation, many healthcare organisations still rely on manual, traditional processes to transfer clinical images and videos to electronic patient records (EPRs), consuming valuable nurse–patient-facing time. Our study aimed to outline tasks performed by nurses to traditionally transfer clinical images and videos to EPRs, assess the impact on nurses’ time and efficiency cost, and report on nurse experiences when transitioning to a digitised process. Methods Observations spanned two one-week periods in the ENT outpatient department of Royal Devon University Healthcare NHS Foundation Trust, using direct observational time and predetermined motion time system analysis to map nurses’ tasks pre-and post-implementation of a Medical Video Recorder and Centralised Medical Content Management. Two staff experience surveys were conducted, and data was aggregated to evaluate the impact of digitisation. Results Nurses traditionally followed two processes to transfer clinical images and video to EPRs. Digitisation saved 43 seconds per endoscopy (a 10% efficiency gain) compared to Process 1, in which nurses print, attach, scan, and digitise images off-site to EPRs, and 3 minutes and 8 seconds (a 33% efficiency gain) compared to Process 2, where urgent content is recorded on an iPad and transferred to EPRs. Digitising could save nurses 26 working days annually by reducing non-patient-facing tasks in the ENT department, leading to an annual time efficiency cost-saving of £6780. Furthermore, 75% of nurses reported significantly improved morale, 63% strongly agreed that digitisation improved confidence in the accuracy of patient details, and all paper processes were eliminated. Conclusion Our findings highlight the inefficiency of traditional methods in transferring images and videos to EPRs. Digital transformation could enhance nursing efficiency and morale, improving care quality. Future studies should evaluate the effectiveness of Medical Video Recorders and Centralised Medical Content Management in other departments.