bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of Symptoms on Quality of Life in Patients with Chronic Wounds
Authors: Lin Chen , Ailing Hu , Caifei Li , Yuan Liu 
Published: November 2024

ABSTRACT

OBJECTIVE
To analyze the occurrence of symptoms and quality of life (QoL) among patients with chronic wounds and the impact of chronic wounds on QoL.

METHODS
Researchers evaluated 200 patients with chronic wounds using a general information questionnaire, a modified version of the Memorial Symptom Assessment Scale, and the Chinese version of the Cardiff Wound Impact Questionnaire. They performed correlation and linear regression analyses to explore the impact of symptoms on QoL.

RESULTS
Mean symptoms scores were all moderately severe and ranged as follows: 0 to 7.06 ± 3.85 for mean total symptom, 0 to 2.69 ± 1.33 for mean frequency, 0 to 2.27 ± 1.02 for mean severity, and 0 to 2.29 ± 1.29 for mean distress. Scores on the three dimensions of QoL (daily life, social life, and well-being) were 51.61 ± 14.73, 48.63 ± 17.20, and 47.45 ± 8.65, respectively. Patients’ symptoms on each subscale were negatively correlated with the dimensions of QoL (r = −0.383 to −0.559, P < .01). Multiple linear regression analyses showed that 9 symptoms collectively explained 66.1% of the total variance of daily life (P < .01); 7 symptoms explained 59.0% of the total variance of social life (P < .01); and 10 symptoms explained 59.6% of the total variance of well-being (P < .01).

CONCLUSIONS
Patients with chronic wounds had high levels of psychological symptoms and moderate QoL, scoring lowest on well-being. Sleep disruption, limitations in activity, and scarring were the main symptoms affecting their QoL. Nurses should prioritize managing these symptoms to improve patients’ QoL.
Evaluation of Clinical Outcomes and Quality of Life following the Karydakis Flap Procedure for Pilonidal Sinus Treatment
Authors: Breidung David , Billner Moritz , Buben Philipp , Grieb Gerrit , Sievers Reiner , Reichert Bert , Megas Ioannis-Fivos , Barth André A. 
Published: November 2024

ABSTRACT

OBJECTIVE
To evaluate the clinical outcome of the Karydakis flap procedure performed by a single surgeon for the treatment of pilonidal sinus, focusing on postoperative complications, recurrence rate, wound healing time, and return to daily life.

METHODS
Authors performed a retrospective data analysis of patients who underwent reconstruction of pilonidal sinus using the Karydakis technique at the Department of Plastic, Reconstructive and Hand Surgery, Center for Severe Burn Injuries of Paracelsus Medical University, Klinikum Nürnberg, Germany, between 2014 and 2021. All cases were performed by a single surgeon. Patients were requested to attend a follow-up appointment in person or, if this was not possible, by telephone.

RESULTS
A total of 103 patients were enrolled in the study. The postoperative complication rate was 11.7%. Revision surgery was required in 4.9% of patients because of a complication. Wound healing time was on average 21.4 days postoperatively. A total of seven patients (6.8%) had a recurrence within 59 months postoperatively.

CONCLUSIONS
The Karydakis flap is a robust reconstructive off-midline procedure for the treatment of pilonidal sinus. Relatively few postoperative complications and a low recurrence rate are advantages of the surgical procedure. Based on the results of quality-of-life factors, patients experience early functional return to daily life after the Karydakis flap procedure.
Bagging an Extremity for Negative-Pressure Wound Therapy: A Case Report
Authors: Bulić Krešimir , Gatin Lucija 
Published: November 2024

ABSTRACT
Negative-pressure wound therapy (NPWT) is used to promote wound closure or to prepare a wound for definite coverage. However, the anatomy of the hand makes it difficult to apply dressings that require an airtight seal. In this report, the authors describe the case of a patient with an extensive defect of his right hand and forearm who was treated with a free fibula osteocutaneous flap transfer. The remaining defect was covered with a split-thickness skin graft following NPWT. An airtight seal was achieved by placing the whole extremity in a sterile bag and sealing it proximal to the defect. The authors present a simple and innovative way of treating defects on upper extremities with NPWT with excellent results.
Hidradenitis Suppurativa: Radical Surgical Excisions with Staged Reconstructions: A Single-Surgeon Retrospective Review of 71 Patients
Authors: Judge Abigail C. , Tahernia Amir H. 
Published: November 2024

ABSTRACT

BACKGROUND
Hidradenitis suppurativa is a chronic, inflammatory disease involving the pilosebaceous unit of apocrine gland-bearing skin. Wide surgical excision, wherein margins extend beyond active lesions, is considered curative.

OBJECTIVE
To evaluate the safety and efficacy of wide surgical excision in the treatment of hidradenitis suppurativa.

METHODS
This single-surgeon, single-site analysis included all patients undergoing radical surgical excision of hidradenitis suppurativa between 2015 and 2019. Using paper case notes and electronic health records, researchers identified a total of 71 patients who underwent 262 surgeries.

RESULTS
The mean number of surgeries per patient was 3.7, and the total number of sites addressed was 309. Wound dehiscence, infection, and flap necrosis were the most common complications. Disease recurrence in surgically treated areas was noted in two patients (3%).

CONCLUSIONS
For patients with failed medical management of hidradenitis suppurativa or who have otherwise developed severe disease, wide surgical excision remains a safe, effective treatment with comparatively low recurrence rates. Surgeons should consider staging surgeries, rather than performing a single-stage reconstruction, and anticipate complications.
Redefining Calciphylaxis as a Uniquely Bone Forming Subcutaneous C5b-9–Mediated Microvascular Injury Syndrome Associated With Localized Subcutaneous and Systemic Complement Pathway Activation
Authors: Wolner Zachary , Tello Luna , Kalomeris Taylor , Swerlick Robert , Magro Cynthia M. 
Published: November 2024

Background:
Microvascular thrombosis is key to the pathogenesis of calciphylaxis. C5b-9–mediated microvascular injury reflective of complement pathway activation could be a key pathophysiologic event.

Methods:
We conducted a retrospective multicenter study of 24 patients who have had biopsy-supported calciphylaxis from the 2010–2022 data base from Emory where C5b-9 immunohistochemistry (IHC) had not been conducted and the 2019–2023 data base from Cornell where C5b-9 IHC was done as part of the routine calciphylaxis work up. IHC for C5b-9 on lesional biopsy specimens was assessed and correlated with routine light microscopic findings and clinical features.

Results:
Most of the patients in our study had uremic calciphylaxis associated with obesity, diabetes, dialysis, hypertension, hyperparathyroidism and elevated serum phosphorus. Most patients did not have defined procoagulant and/or hyperviscosity states. The vascular pathology was predominantly limited to the subcutaneous fat and ranged from a calcific intimal arteriopathy to microvascular thrombosis with endothelial injury with or without endothelial calcification. In most cases (ie, in excess of 80%), there was prominent deposition of C5b-9 within the vasculature including the microvasculature and arteries of the fat at least localized to injured vessels suggesting a causal association. In about 40% of cases, there was evidence of systemic complement pathway activation revealed by concurrent dermal microvascular C5b-9 deposition.

Conclusions:
Calciphylaxis is characterized by subcuticular vascular changes that reflect an interplay between complement triggered endothelial cell injury, resultant vascular thrombosis, and subsequent abluminal calcification. Complement inhibition therapy defines a potential intervention that should be explored.
Metoidioplasty in Norway: A 13-year Experience from a National Center
Authors: Sundhagen Henriette Pisani , Wæhre Anne , Tønseth Kim Alexander 
Published: November 2024

Background:
Genital surgery is often considered the final step in surgical gender-affirming treatment. Metoidioplasty is a variant where the enlarged clitoris is lengthened and straightened. The technique has several advantages but is not without complications. We evaluated the surgical outcomes after metoidioplasty from our national center from 2007 to 2020.

Methods:
All patients who had undergone the metoidioplasty procedure at Oslo University Hospital from January 1, 2007, to December 31, 2020, were identified by the Local Quality Register of Gender Incongruence. Demographic, clinical, and surgical variables were recorded. Statistical analysis was carried out with SPSS.

Results:
A total of 84 patients were identified. The median age at the time of surgery was 27.5 years. Of 84 patients, 48 (57.1%) experienced some kind of complication after the surgery, with an average of 1.7 complications. Complications related to the urethroplasty were the most common, with strictures occurring in 19 (22.6%) patients and urethral fistulas occurring in 11 (13.1%) patients. Forty-one patients (48.8%) needed 1 or more secondary procedures. After the management of strictures and fistulas, a secondary testis implant correction was the most frequent revision procedure performed in 38.1% (32) of patients. With increasing body mass index, the risk of complications and of undergoing secondary procedures also increased significantly (P = 0.045 and 0.019, respectively).

Conclusions:
Metoidioplasty is an operation with a relatively high complication rate, mainly related to urethroplasty. There is an urgent need for future research with a focus on quality of life and long-term follow-up.
OPTICAL COHERENCE TOMOGRAPHY–BASED EPIRETINAL MEMBRANE STAGE CORRELATES WITH TANGENTIAL RETINAL DISPLACEMENT AND METAMORPHOPSIA
Authors: Takano Shun-ichiro , Ishida Masahiro , Ichikawa Yoshikazu , Watanabe Amaka , Shoji Takuhei , Shinoda Kei , Takeyama Asuka , Imamura Yutaka 
Published: November 2024

Purpose:
To investigate correlations of the optical coherence tomography–based epiretinal membrane (ERM) classification with metamorphopsia and tangential retinal displacement after ERM surgery.

Methods:
ERM stage (stage 1–4) was defined as originally described. Metamorphopsia scores at baseline, 1 month, 3 months, and 6 months after ERM surgery were measured with M-CHARTS (Inami, Co, Tokyo). Tangential retinal displacement was measured as described previously. Eyes with retinal cysts, lamellar hole with epiretinal proliferation, or retinoschisis were excluded.

Results:
One hundred thirty-five eyes of 135 consecutive patients who underwent ERM surgery at a single academic hospital were enrolled. There were 20 eyes of stage 1, 57 eyes of stage 2, 54 eyes of stage 3, and 4 eyes of stage 4. Epiretinal membrane stage correlated with tangential retinal displacement at 1 month, 3 months, and 6 months postoperatively (Spearman rank correlation coefficient, P < 0.001), which also correlated with both horizontal and vertical preoperative M-CHARTS scores (P < 0.001) and horizontal scores at 1 month (P = 0.001) and 3 months (P = 0.016). Visual acuities did not show any correlations with the stage.

Conclusion:
Optical coherence tomography–based ERM classification correlates strongly with tangential retinal displacement after ERM surgery. This classification is particularly useful to predict pre- and postoperative metamorphopsia, but not for visual acuity.
Contact Lens Regulation: Where Have We Been, Where are We Going?
Authors: Risser Kayleigh M. , Zhou Melody Y. , Koster Karl G. , Tejawinata Felicia I. , Gu Xinyu , Steinemann Thomas L. 
Published: November 2024

Abstract:
The Food and Drug Administration and the Federal Trade Commission influence the contact lens (CL) market, with the Food and Drug Administration regulating CLs as medical devices and the Federal Trade Commission dictating how they are prescribed and sold. Legislative oversight came to the forefront in 2004, when the Contact Lens Rule was introduced, drastically changing how CLs are prescribed and distributed. This article examines the evolution of CL regulations over the past two decades and discusses how regulation, such as allowing passive verification, has shaped the current and evolving CL market. We also explore how related products (decorative CLs, artificial tears) are regulated and compare US regulations with those abroad. Finally, we discuss how future technological advancements, including artificial intelligence, promise to change the CL industry and its regulation worldwide.
Effectiveness of Ankle-Foot Orthoses for Patients with Weakness of the Plantarflexors and Dorsiflexors: Biomechanical Comparison of Different Orthotic Concepts
Authors: Burkhardt Meike , Schmalz Thomas , Drewitz Heiko , Kannenberg Andreas , Bellmann Malte 
Published: November 2024

Abstract

Introduction
Weakness of plantarflexor and dorsiflexor muscles is a complex individual condition and can result in pathological gait, such as crouch gait or knee hyperextension. Affected patients can be supported with ankle-foot orthoses (AFOs) to improve gait and safety.

Objective
This study aims to compare three orthotic ankle joint designs in AFOs for patients with muscle weakness in the plantarflexors and/or dorsiflexors: a conventional hinged ankle joint with rigid stops (CAJ), a jointless orthosis (JLO), and a reactive-dynamic ankle joint with adjustable spring modules (RDA).

Study Design
Seven patients with plantarflexor and/or dorsiflexor muscle weakness tested three orthosis configurations in randomized order during a single session.

Methods
Biomechanical gait analysis was performed during standing and walking on level ground and up and down 10° slopes. The main outcomes were ground reaction forces, joint angles, moments, and power at the ankle, knee, and hip joints. Mean values of outcome measures for patients and values of an able-bodied control group were compared with nonparametric analyses of variance and pairwise post hoc tests.

Results
Throughout all motion tasks, statistically significant differences (P < 0.05) were predominantly found in ankle and knee joint kinematics between RDA and CAJ, as well as between JLO and CAJ, whereas only few differences were found between RDA and JLO.

Conclusions
For this patient group, RDA enabled the most physiological gait, with outcomes measure values closest to those of the able-bodied control group, and the best perception of support for an active lifestyle and physically demanding activities. In less physically demanding situations, such as short walking distances and even surfaces, JLO also showed sufficient support for physiological gait and may be an adequate orthosis for patients living with supportive infrastructure or a more sedentary lifestyle. CAJ restricted physiological movements, showed the highest deviations from the values of the able-bodied controls in most activities, and provides the least comfort for patients in the tested situations.

Clinical Relevance Statement
Determining the best possible orthotic care and support for different patient groups is essential to enable independence, safety, and comfort during activities of daily living based on individual requirements.
3.0-Tesla MRI Observation at Return to Play After Hamstring Injuries
Authors: Zein Muhammad Ikhwan , Reurink Gustaaf , Suskens Jozef J. M. , Monte Jithsa R. C. , Smithuis Frank F. , Buckens Stan , Maas Mario , Tol Johannes L. 
Published: November 2024

Objective:
To describe 3.0-Tesla (T) magnetic resonance imaging (MRI) findings of hamstring muscles in clinically recovered athletes who were cleared for return to play (RTP).

Design:
Prospective observational study.

Setting:
Hospital.

Participants:
Athletes (amateur and professional) who were cleared for RTP after hamstring injury. Fifty-eight participants were included in the analysis.

Independent Variables:
3-T MRI at baseline (within 7 days from initial injury) and MRI at RTP (within 10 days of RTP).

Main Outcome Measures:
Injury location, grade of injury (modified Peetrons and British Athletics Muscle Injury Classification/BAMIC), presence and the extent of intramuscular signal abnormality, intramuscular tendon disruption, and thickness. Reinjuries within 1 year of RTP were recorded.

Results:
Magnetic resonance images at RTP showed that 55 (95%) participants had intramuscular increased signal intensity (edema) and 44 (76%) participants had intramuscular abnormal low-signal intensity (suggesting fibrosis) on MRI. There was an overall reduction of injury grades according to the modified Peetrons and BAMIC classification at initial injury to RTP. Three (5%) participants had no abnormal signal intensities (grade 0 or grade 0A) on MRI at RTP. Intramuscular tendon disruption, waviness, and tendon thickening were present at RTP in, respectively, 22 (38%), 15 (26%), and 36 (62%). We recorded 3 (5%) reinjuries.

Conclusions:
At RTP, 3.0-T MRI shows high percentages of MRI abnormalities (edema, fibrosis, and intramuscular tendon disruption and thickening). We conclude that complete normalization of 3.0-T MRI is not expected for RTP decision after a hamstring injury. Its possible association with reinjury risk has to be determined in larger cohorts.
Musculoskeletal Soreness Location and Intensity in Soccer Athletes Across Multiple Seasons
Authors: Pexa Brett S. , Blue Malia N. M. , Barczak-Scarboro Nikki E. , Taylor Jeffrey B. , Johnston Christopher D. , Ford Kevin R. 
Published: November 2024

Objective:
To compare soreness location and intensity between male and female soccer athletes across 2 competitive seasons.

Design:
Descriptive Cohort Study.

Setting:
Collegiate Sports Medicine Facility.

Participants:
Forty male and 42 female collegiate soccer athletes.

Intervention:
Season-long soccer trainings and games.

Main Outcome Measures:
Athletes reported perceived soreness location and intensity daily. χ2 analysis and linear mixed effect models were used to compare soreness locations and intensities by sex.

Results:
Male and female soccer athletes reported similar number of soreness instances, but male soccer athletes reported soreness more frequently at the ankle, foot, hip, pelvis, and posterior thigh. Female soccer athletes reported soreness more frequently at the anterior leg, anterior thigh, and knee. There was no significant difference in soreness intensity between sexes at any body location (P = 0.86). When collapsed across sex, the frequency of anterior thigh soreness was higher at preseason (7.49%, CI: 5.46-9.52) than at midseason (4.55%, CI: 2.52–6.57; t = −2.94, P = 0.023) and at postseason (3.00%, CI: 0.76-5.23; t = −3.74, P < 0.001). There was also a significant difference in hip soreness frequency between the preseason (2.35%, CI: 1.32-3.33) and the postseason time points (0.52%, CI: −0.73% to 1.67%; t = −2.68, P = 0.023).

Conclusions:
Male and female athletes differ in the locations of their lower extremity soreness. However, lower extremity soreness intensity does not differ between sexes. Soccer athletes report soreness more frequently during the preseason and midseason than during the postseason. With tools to measure daily soreness location and intensity, clinicians could create targeted interventions to reduce soreness and limit its negative affect.
Nurse-Led Mobile App Effect on Quality of Life in Breast Cancer Patients After Surgery: Nonrandomized Controlled Prospective Cohort Study (Step 3)
Authors: Aydin Aydanur , Gürsoy Ayla 
Published: November 2024

Background
Following surgery, women with breast cancer (BC) frequently experience emotional and physiological negative consequences.

Objective
To evaluate the effect of a nurse-led mobile app (NL-Mapp) intervention on quality of life (QoL) in patients after surgery for BC.

Methods
This single-center, 12-month, nonrandomized controlled trial, with 2 parallel groups, represents the final stage of 3-step research. In this study, women were assigned to either the intervention (n = 45) or control (n = 45) group. The intervention group participated in the NL-Mapp, whereas participants in the control group received standard care. The main outcomes were measured using the Functional Assessment of Cancer Therapy—Breast at 3 time points (baseline and 1 and 12 months after the intervention). Clinical Trial number: NCT06505538

Results
The intervention participants reported significant improvement in physical well-being, emotional well-being, and the BC-specific subscale compared with the control group at the 1-month postsurgery mark. Equally noteworthy, at the 1-year follow-up, consistent improvements were observed across all QoL subscale scores for the intervention group, except for the BC-specific subscale for additional concerns.

Conclusion
Our study revealed a notable enhancement in the QoL among postoperative women with BC who utilized the NL-Mapp. This program emerges as an effective intervention for providing short-term and longer-term supportive care to women affected by BC, leading to tangible improvements in their QoL.

Implication for Nursing
The study’s findings offer valuable evidence supporting the integration of mobile health services into clinical and transitional nursing care.
Intraoperative Surgical Guidance for DIEP Flap Harvest using Augmented Reality
Authors: Edgcumbe Philip , Jiang Tony , Ho Joshua F. , Martin Michael L. , Stein Michael J. , Isaac Kathryn V. 
Published: November 2024

SUMMARY:
Augmented reality (AR) systems for surgical navigation provides the capability to project preoperative CT scans and segmented anatomical structures directly into the surgeon’s field of view, along with virtual displays akin to traditional monitors. Utilizing the Meta Quest 3 consumer AR headset, we found that it can achieve clinically acceptable accuracy in surgical navigation for deep inferior epigastric perforator (DIEP) surgeries. Notably, the Quest 3 can operate independently thanks to a novel registration technique employing hand tracking, suitable for use in sterile environments.
The DIEP flap is a widely favored option for autologous breast reconstructions. Intraoperatively, the perforator arteries are selected to maximize tissue perfusion and minimize donor site morbidity. Conventionally, preoperative CT angiograms are used to locate perforators and visualize vessel courses, thus reducing DIEP flap harvest time and complication rates. Though, there are currently very limited means to reliably translate information found on preoperative imaging for use in the operating theater.
The Meta Quest 3 was trialed in three DIEP flap surgeries by displaying segmented deep inferior epigastric arteries and DIEP arteries during preoperative and intraoperative phases of surgery. The AR projections facilitated the visualization of the DIEP arteries and efficient pedicle dissection by guiding the placement and length of the fascial incision. Furthermore, this work supports the hypothesis that AR will improve flap design, reduce harvest time, and improve safety during DIEP flap harvesting.