bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Use of NovoSorb BTM for Trauma Reconstruction: Illustrative Cases and a Proposed Decision-making Tool
Authors: Hendrickson Susan A. , Flod Sara , Misky Adam T. , Senarath-Yapa Kshemendra , Hettiaratchy Shehan 
Published: October 2024

Summary:
Achieving a functional and aesthetic reconstruction following complex trauma is a challenge. Skin substitutes, including acellular dermal matrices, and newer, synthetic options such as NovoSorb biodegradable temporizing membrane (BTM) have given the reconstructive surgeon a useful tool where autologous options have been exhausted, are inappropriate, or would present a suboptimal reconstruction. This case series describes 6 patients admitted to an urban level I major trauma center between July and December 2022. All patients underwent complex reconstructive lower limb surgery using BTM as either a primary or salvage option. In each case, this approach was chosen on a case-by-case basis where it was felt BTM would offer a reconstructive advantage, or where primary reconstructive options had been exhausted. Data were collected retrospectively from case notes. Three patients received BTM as a primary reconstructive option. BTM integrated successfully in all 3. Three patients received BTM as a salvage option. In 1, the exposed fracture site was successfully bridged, and in another, BTM was successfully reapplied over exposed fracture site where BTM had previously failed to incorporate. Although BTM is a relatively new tool in the reconstructive surgeon’s armamentarium, requiring further research into long-term outcomes, cost-effectiveness, and patient satisfaction, it can be a useful and versatile tool.
Hypertension and its determinants in Abu Dhabi population: a retrospective cohort study
Authors: Alketbi Latifa Baynouna , Al Hashaikeh Basil , Fahmawee Toqa , Sahalu Yusra , Alkuwaiti Mouza Hamad Helal , Nagelkerke Nico , Almansouri Mohammad , Humaid Ahmad , Alshamsi Noura , Alketbi Rudina , Aldobaee Muna , Alahbabi Nayla , Alnuaimi Jawaher , Mahmoud Esraa , Alazeezi AlYazia , Shuaib Fatima , Alkalbani Sanaa , Saeed Ekram , Alalawi Noura , Alketbi Fatima , Sahyouni Mohammad 
Published: October 2024

Background:
Preventing high blood pressure and its complications requires identifying its risk factors. This study assessed predictors of hypertension and its associated complications among Emirati adults in Abu Dhabi, United Arab Emirates (UAE).

Methods:
This retrospective cohort study was conducted by retrieving data from the Electronic Medical Records (EMR) of Emiratis who participated in a national cardiovascular screening program between 2011 and 2013. The study cohort comprised 8456 Emirati adults (18 years and above): 4095 women and 4361 men. The average follow-up period was 9.2 years, with a maximum of 12 years.

Results:
The age-adjusted hypertension prevalence in Abu Dhabi increased from 24.5% at baseline to 35.2% in 2023. At baseline, 61.8% of hypertensive patients had controlled blood pressure, which increased to 74.3% in 2023. Among those free from hypertension at screening, 835 patients (12.3%) were newly diagnosed during the follow-up period. Using Cox regression, the hypertension prediction model developed included age [P value <0.001, hazard ratio 1.051, 95% confidence interval (CI) 1.046–1.056], SBP (P value <0.001, hazard ratio 1.017, 95% CI 1.011–1.023) and DBP (P value <0.001, hazard ratio 1.029, 95% CI 1.02–1.037), glycated hemoglobin (P < 0.001, hazard ratio 1.132, 95% CI 1.077–1.191), and high-density lipoprotein cholesterol (HDL-C) (P value <0.001, hazard ratio 0.662, 95% CI 0.526–0.832). This prediction model had a c-statistic of 0.803 (95% CI 0.786–0.819). Using survival analysis (Kaplan–Meier), higher blood pressure was associated with more cardiovascular events and mortality during follow-up.

Conclusion:
Targeting population-specific predictors of hypertension can prevent its progression and inform healthcare professionals and policymakers to decrease the incidence, complications, and mortality related to hypertension.
Improving joy at work and reducing burnout in health care workers in Victoria, Australia using the Institute for Healthcare Improvement joy in work framework: A mixed-methods study
Authors: Jordan Joanne E. , Garner Kerryn , Bones Kate , McKenzie Lisa , Linzer Mark , Rathert Cheryl , Goelz Elizabeth , McCall Jesse , Sawyer Eleanor , Baass Briana , Herco Fiona 
Published: October 2024

Background
Burnout in health care workers (HCWs) has serious ramifications for individual well-being, patients, organizations, and health systems. Global evidence demonstrates the COVID-19 pandemic has amplified the risk of burnout. Scalable interventions to address burnout are critical to protect HCW well-being.

Purpose
Underpinned by the Conservation of Resources theory, this study examines the impacts of a statewide improvement initiative (the Initiative), using the Institute for Healthcare Improvement Joy in Work (JiW) Framework, to reduce burnout and increase joy at work across participating health care organizations in Victoria, Australia.

Methodology/Approach
An impact evaluation was undertaken utilizing a mixed-methods design. Quantitative outcomes included burnout and joy at work measured using an adapted Mini Z tool. In-depth interviews with implementation teams sought insights into the effectiveness of interventions.

Results
Overall, 20 teams from 17 organizations across diverse health care settings and geographical locations participated. At a statewide level, outcomes in burnout and joy at work were inconclusive due to limited data. However, five out of eight teams reporting sufficient data achieved measurable improvements in one or more outcomes. Qualitative data revealed the Initiative increased workplace resources and supports such as providing “permission” for HCWs to prioritize well-being at work, improved communications between management and HCWs, and increased HCWs' teamwork and camaraderie, resulting in safer and more positive workplaces.

Conclusion and Practice Implications
The JiW Framework, implemented across diverse settings, provided organizations with a structured process to develop multifaceted improvements that resulted in enhanced resources that appeared to improve HCW well-being. Compared to individual well-being support, this approach offers organization-level change and scalability potential.
TikTok as a Source of Education and Misinformation in Lichen Sclerosus
Authors: Foster Jennifer , Sarlashkar Priya , Abraham Olivia , Negris Olivia , Lanthier Jaclyn , Krapf Jill , Mauskar Melissa M. 
Published: October 2024

Objectives
The purpose of this study is to evaluate the content, delivery, and quality of medical information for vulvar lichen sclerosus on the social media platform TikTok.

Materials and Methods
This is a descriptive, cross-sectional study. Using the third-party data scraping tool Apify, TikTok videos tagged with #lichensclerosus or “lichen sclerosus” were identified and sorted by view count. A sample of 100 videos was reviewed by 2 independent reviewers, excluding those not discussing lichen sclerosus. Videos were assessed using a coding document, the Patient Educational Materials Assessment Tool, and the DISCERN instrument. Interrater reliability was measured, and statistical analyses included Fleiss' kappa, intraclass correlation coefficient, t tests, and Wilcoxon rank sum test with Holm-Bonferroni correction.

Results
Content creators included patients (46%), health care professionals (30%), and others. Topics focused on clinical disease (52%) and treatment (48%). Evidence-based medicine was discussed in 71.7% of treatment-related videos, while 51.7% included nonevidence-based approaches, with a neutral or positive sentiment. Videos discussing topical steroids often had negative sentiments. Quality assessment revealed 61% of videos were understandable, 27% actionable, and 46% contained misinformation. Videos by health care professionals had less misinformation and higher quality scores compared to patient-generated content. Commercially biased videos were more understandable but contained more misinformation.

Conclusions
TikTok serves as a significant platform for sharing information on lichen sclerosus, but nearly half of the content contains misinformation. Health care professionals need to engage in social media to provide accurate information and counteract misinformation. Enhanced collaboration with patient advocates and careful resource sharing can improve the quality and reliability of medical information available online.
Efficacy and safety of different oral anticoagulants for stroke prevention in older patients with atrial fibrillation: A network meta-analysis
Authors: Zhang Han , Liu Feng , Lu Xueli 
Published: October 2024

Background:
Various oral anticoagulants have been used for stroke prevention in older patients with atrial fibrillation (AF). However, the optimal anticoagulants for stroke prevention has not yet been developed. We performed a systematic review and network meta-analysis to determine the optimal instructions.

Methods:
We searched for randomized controlled trials (RCTs) from PubMed, Embase, and the Cochrane Library without restriction for publication date or language at January 2024. Any RCTs that compared the effectiveness of a direct oral anticoagulant and a vitamin K antagonist (VKA) for stroke prevention in older patients with AF were included in this network meta-analysis. The Bayesian network meta-analysis used a random effects model and surface under the cumulative ranking curve analysis to rank results. All analyses were done using R software with gemtc package, with statistical significance set at P < .05.

Results:
We included 7 RCTs (79,003 patients) comparing 8 different instructions including Apixaban 5 mg, Dabigatran 110 mg, Dabigatran 150 mg, Edoxaban 30 mg, Edoxaban 60 mg, Rivaroxaban 15 mg, Rivaroxaban 20 mg, and VKA. Apixaban 5 mg, Dabigatran 110 mg, and Dabigatran 150 mg was more effective than the VKA for reducing stroke or systemic embolism risks, and the difference was statistically significant (P < .05). Apixaban 5 mg, Dabigatran 110 mg, Dabigatran 150 mg, Edoxaban 30 mg, and Edoxaban 60 mg was associated with a reduction of the intracranial hemorrhage rate than the VKA (P < .05). The surface under the cumulative ranking curve shows that Dabigatran 110 mg ranked first for reducing stroke or systemic embolism risks. Edoxaban 60 mg ranked first for major bleeding. Dabigatran 110 mg ranked first for intracranial hemorrhage. Apixaban 5 mg ranked first for all bleeding events.

Conclusions:
Direct oral anticoagulants were found to have lower rates of thromboembolic events compared to VKAs in older patients with AF. Apixaban 5 mg, Dabigatran 110 mg, Dabigatran 150 mg, Edoxaban 30 mg, and Edoxaban 60 mg were also associated with a reduction of intracranial hemorrhage than VKA.
Effect of small dose esketamine on perioperative neurocognitive disorder and postoperative depressive symptoms in elderly patients undergoing major elective noncardiac surgery for malignant tumors: A randomized clinical trial
Authors: Huang Cuifang , Yang Ruimin , Xie Xianlong , Dai Huijun , Pan Linghui 
Published: October 2024

Background:
Perioperative neurocognitive disorder and postoperative depressive symptoms are significant complications after surgery. Studies have indicated that esketamine possesses neuroprotective and antidepressant qualities.

Methods:
This trial included 209 patients aged 60 to 86 years undergoing tumor resection who received esketamine (Group E) or not (Group C) during and after surgery. In group E, patients were given an intravenous dose of 0.5 mg/kg of esketamine 10 minutes after induction of general anaesthesia. In addition, esketamine (2 mg/kg) in combination with sufentanil was used for PCIA during 48 hours postoperatively. On the other hand, saline was used as a substitute for esketamine in group C. Cognitive function was evaluated using neuropsychological tests and telephone interview for cognitive status-modified, and symptoms of depression were assessed using Hamilton Depression Rating Scale 17.

Results:
Compared to Group C, patients in Group E exhibited lower rates of depressive symptoms at 3, 7, and 90 days post-surgery (53.9% vs 67.7%, 26.3% vs 47.9%, and 13.3% vs 28.4%). Group E also showed decreased time for Trail Making Test on days 7 and 90. However, there were no significant differences in the incidence of delirium 1 to 5 days post-surgery or cognitive impairment 90 days post-surgery between the 2 groups (12.1% vs 10.9% and 8.4% vs 9.7%).

Conclusions:
Intraoperative low-dose esketamine and postoperative low-dose esketamine combined with sufentanil for patient-controlled intravenous analgesia has been shown to improve postoperative analgesia, alleviate postoperative depressive symptoms, and aid in the recovery of social executive ability. However, this approach did not reduce the incidence of postoperative delirium or postoperative cognitive dysfunction.
Reversible elevation of creatine kinase and creatinine caused by sintilimab-induced hypothyroidism: A case report
Authors: Liu Shu-Rong , Zhao Zhen-Guang , Zhai Rui-Ren , Wang Li-Juan , Yang Chen , Ma Quan-Bin , Wang Li 
Published: October 2024

Rationale:
Programmed cell death (PD) -1 inhibitors has significantly improved the prognosis of cancer patients by enhancing antitumor immune responses. However, PD-1 inhibitors are associated with immune-related adverse events, some of which are rare and potentially life-threatening. Thus far, elevated creatine kinase (CK) and creatinine caused by a novel PD-1 inhibitor (sintilimab)-induced hypothyroidism has not yet been reported.

Patient concerns:
A 63-year-old male patient with esophageal cancer who developed hypothyroidism accompanied by unexplained increases in CK and creatinine after sintilimab treatment.

Diagnosis:
Since the increases in CK and creatinine paralleled the decrease in thyroxine, after excluding other potential conditions, we speculated that the muscular and renal dysfunction might be caused by sintilimab-induced hypothyroidism.

Interventions and outcomes:
As the patient’s thyroid function improved with levothyroxine replacement therapy, the levels of CK and creatinine concomitantly returned to normal.

Conclusion and lessons:
The elevated CK and creatinine levels in this patient were caused by sintilimab-induced hypothyroidism. Our case highlights the importance of keeping PD-1 induced hypothyroidism in mind when patients present with unexplained increased levels of CK and creatinine. Hypothyroidism-related muscular and renal dysfunctions, which can be restored with thyroid hormone replacement, need to be identified early and treated promptly so that unnecessary examinations and treatments can be avoided in these patients.
Cervical angiofibroma of soft tissue: A rare case report with literature review
Authors: Shi Yaoqi , Xu Yuhong , Li Minhua , Zheng Weiping , Shan Jiangjing 
Published: October 2024

Rationale:
Angiofibroma of soft tissue (AFST) is a rare benign fibrous tumor recently included in the 2020 WHO classification of soft tissue and bone tumors. Currently, there are limited reports on AFST, and pathologists lack sufficient understanding of its clinical and pathological characteristics. There is scarce literature available on AFST in the cervical region.

Patient concerns:
We presented a case of a 49-year-old woman who was admitted to our hospital for emergency treatment due to vaginal bleeding and fatigue. Ultrasound revealed a 63 × 27 mm hypoechoic mass extending from the cervical opening to the external opening, with a hemoglobin level of 58.0 g/L on blood routine.

Diagnoses:
The tissue exhibited a pale-yellow mucinous appearance with distinct tissue boundaries and a fibrous capsule under a microscope. HE staining revealed spindle-shaped fibroblast-like cells with a consistent morphology, thin-walled branching small blood vessels, and dilated blood vessels. Regions with abundant cells and areas with sparse cells were alternately distributed and migrated gradually. Immunohistochemical analysis indicated positive expression of P53, desmin, progesterone receptor, estrogen receptor, epithelial membrane antigen, vimentin, CD68, CD163 in the tumor, but negative expression of P16, S-100, smooth muscle actin, CD117, CD10, STAT-6. CD34 was negative in the tumor cells but positive in the vascular endothelium. The Ki-67 index value was 5%. Pathological examination confirmed a soft tissue angiofibroma of the cervix.

Interventions:
Emergency hysteroscopic surgery was performed following infusion of 3 units of packed red blood cells. A local excision of the cervical mass was performed.

Outcomes:
A 1-month follow-up ultrasound showed no abnormal mass in the cervical canal, and there have been no signs of recurrence to date.

Lessons:
Cervical angiofibroma of soft tissue is a rare tumor with a benign clinical manifestation, minimal local recurrence, and no significant metastatic potential. Treatment primarily involves local resection with a focus on achieving negative surgical margins. By presenting this case, we aim to enhance the diagnostic and differential diagnostic capabilities of pathologists in identifying uterine tumors and preventing misdiagnosis.
Validation of Artificial Intelligence-Based POTTER Calculator in Emergency General Surgery Patients Undergoing Laparotomy: Prospective, Bi-Institutional Study
Authors: Panossian Vahe S , Argandykov Dias , Arnold Suzanne C , Gebran Anthony , Paranjape Charudutt N , Hwabejire John O , DeWane Michael P , Velmahos George C , Kaafarani Haytham MA ,   for the POTTER Validation Group
Published: October 2024

BACKGROUND:
The Predictive Optimal Trees in Emergency Surgery Risk (POTTER) calculator, a widely used interpretable artificial intelligence risk calculator, has been validated in population-based studies and shown to predict outcomes in patients who underwent emergency general surgery better than surgeons. We sought to prospectively validate POTTER.

STUDY DESIGN:
Patients undergoing an emergency exploratory laparotomy for nontrauma indications at 2 academic medical centers between June 2020 and March 2022 were included. POTTER preoperative risk calculations and postoperative outcomes were systematically recorded. POTTER’s performance in predicting 30-day postoperative mortality, septic shock, respiratory failure, bleeding, and pneumonia was assessed using the c-statistic methodology.

RESULTS:
A total of 361 patients were included. The median age was 63 years (interquartile range 51 to 72 years), 45.4% were women, and the overall mortality and morbidity were 24.1% and 51.4%, respectively. POTTER predicted mortality accurately with a c-statistic of 0.90. POTTER also accurately predicted the occurrence of individual postoperative complications, with c-statistics ranging between 0.80 and 0.89.

CONCLUSIONS:
This is the first prospective validation of the artificial intelligence-enabled POTTER calculator. The superior accuracy, user-friendliness, and interpretability of POTTER make it a useful bedside tool for preoperative patient and family counseling.
Age-dependent shaping of the social environment in a long-lived seabird: a quantitative genetic approach
Authors: Moiron Maria , Bouwhuis Sandra 
Published: October 2024

Individual differences in social behaviour can result in fine-scale variation in spatial distribution and, hence, in the social environment experienced. Given the expected fitness consequences associated with differences in social environments, it is imperative to understand the factors that shape them. One potential such factor is age. Age-specific social behaviour—often referred to as ‘social ageing’—has only recently attracted attention, requiring more empirical work across taxa. Here, we use 29 years of longitudinal data collected in a pedigreed population of long-lived, colonially breeding common terns (Sterna hirundo) to investigate sources of variation in, and quantitative genetic underpinnings of, an aspect of social ageing: the shaping of the social environment experienced, using the number of neighbours during breeding as a proxy. Our analyses reveal age-specific declines in the number of neighbours during breeding, as well as selective disappearance of individuals with a high number of neighbours. Moreover, we find this social trait, as well as individual variation in the slope of its age-specific decline, to be heritable. These results suggest that social ageing might underpin part of the variation in the overall multicausal ageing phenotype, as well as undergo microevolution, highlighting the potential role of social ageing as a facilitator for, or constraint of, the evolutionary potential of natural populations.This article is part of the discussion meeting issue ‘Understanding age and society using natural populations’.
Agents seeking long-term access to the wisdom of the crowd reduce immediate decision-making accuracy
Authors: Mann Richard P. 
Published: October 2024

Living in groups offers social animals the significant advantage of accessing collective wisdom and enhanced information processing, enabling more accurate decisions related to foraging, navigation and habitat selection. Preserving group membership is crucial for sustaining access to collective wisdom, incentivizing animals to prioritize group cohesion. However, when individuals encounter divergent information about the quality of various options, this can create a conflict between pursuing immediate rewards and the maintenance of group membership to improve access to future pay-offs. In this study, I show that rational agents who seek to maximize long-term rewards will be more inclined to follow the decisions of their peers than those with short-term horizons. In doing so, they necessarily make less-rewarding decisions in the short-term, which manifests in a lower individual accuracy when choosing the better of two options. Furthermore, I demonstrate that intuitions about collective wisdom can be misleading in groups of agents who prioritize long-term rewards, with disagreement being a better signal for the accuracy of collective choices than consensus. These results demonstrate that observed patterns of sociality should be interpreted in the context of the life history of an individual and its peers, rather than through the lens of an isolated decision.
This article is part of the discussion meeting issue ‘Understanding age and society using natural populations’.
Understanding age and society using natural populations
Authors: Firth Josh A. , Albery Gregory F. , Bouwhuis Sandra , Brent Lauren J. N. , Salguero-Gómez Roberto 
Published: October 2024

Ageing affects almost all aspects of life and therefore is an important process across societies, human and non-human animal alike. This article introduces new research exploring the complex interplay between individual-level ageing and demography, and the consequences this interplay holds for the structure and functioning of societies across various natural populations. We discuss how this Special Issue provides a foundation for integrating perspectives from evolutionary biology, behavioural ecology and demography to provide new insights into how ageing shapes individuals’ social behaviour and social associations, and how this in turn impacts social networks, social processes (such as disease or information transfer) and fitness. Through examining these topics across taxa, from invertebrates to birds and mammals, we outline how contemporary studies are using natural populations to advance our understanding of the relationship between age and society in innovative ways. We highlight key emerging research themes from this Special Issue, such as how sociality affects lifespan and health, the genetic and ecological underpinnings of social ageing and the adaptive strategies employed by different species. We conclude that this Special Issue underscores the importance of studying social ageing using diverse systems and interdisciplinary approaches for advancing evolutionary and ecological insights into both ageing and sociality more generally.This article is part of the discussion meeting issue ‘Understanding age and society using natural populations ’.