bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison Between in Situ Fixation and Fixation After Closed Reduction in Valgus-Impacted Femoral Neck Fractures: A Multicenter Study
Authors: Jang Byung-Woong , Park Jung-Wee , Nho Jae-Hwi , Kim Jinjae , Kim Tae-Young , Lee Young-Kyun , Kim Jin-Woo 
Published: December 2024

OBJECTIVES:
The objective of this study was to compare clinical outcomes between in situ fixation and fixation after closed reduction (CR) in patients aged 50 years and older with valgus-impacted femoral neck fractures using data from multiple centers.

METHODS:

Design:
Retrospective multicenter cohort study.

Setting:
Five tertiary-care university hospitals.

Patient Selection Criteria:
Patients aged 50 years and older, treated with operative fixation of valgus-impacted femoral neck fractures using multiple cannulated screws from 2003 to 2019.

Outcome Measures and Comparisons:
Complications such as fixation failure, osteonecrosis of femoral head (ONFH), and reoperation were compared between the groups (in situ fixation group and fixation after CR group). Postoperative EuroQol-5 Dimension (EQ-5D), Harris Hip Score, and Koval grade were compared.

RESULTS:
The mean age of the 206 patients (161 in situ fixation group, 45 in fixation after CR group) who met the inclusion criteria was 68.9 ± 10.9 years (range, 50–95 years). There were 39 men and 167 women. Fixation failure occurred in 11.2% (6.8% of in situ fixation group vs. 26.7% of fixation after CR group, P = 0.002). Reoperation was required for 10.2% (7.5% of the in situ fixation group vs. 20% of the fixation after CR group, P = 0.023). Fixation failure and reoperation rates were significantly higher in the fixation after the CR group than in the in-situ fixation group (odds ratio = 4.757, P = 0.002 and odds ratio = 3.104, P = 0.023, respectively). At the 2-year follow-up, ONFH occurred in 5.8% (9 out of 161, in situ fixation group vs. 3 out of 45, fixation after CR group). There was no significant difference in the occurrence of ONFH between the 2 groups (P = 0.727). The Koval's grade at 6 and 12 months demonstrated better results in the in-situ group (P = 0.027, 0.044, respectively). Postoperative EQ-5D and Harris Hip Score scores showed no statistically significant differences between the 2 groups.

CONCLUSIONS:
In patients aged 50 years or older with valgus-impacted femoral neck fractures, when fixation was done after reduction, the reoperation rate was higher due to fixation failure compared with in-situ fixation. There was no significant difference in the incidence of ONFH in valgus-impacted femoral neck fractures regardless of whether reduction was performed.

LEVEL OF EVIDENCE:
Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
Nonunion of Adult Forearm Fractures: Evaluation of Intramedullary Nailing With Grafting as a Treatment Option
Authors: Onay Tolga , Akkaya Mesut , Dilek Mehmet , Tütüncü Mehmed Nuri , Akpınar Fuat 
Published: December 2024

OBJECTIVES:
To evaluate the effectiveness of intramedullary nailing combining with iliac or fibular autograft for the treatment of adult forearm nonunions.

METHODS:

Design:
Retrospective case series.

Setting:
Two academic trauma referral centers.

Patient Selection Criteria:
Adult patients who sustained surgical treatment for forearm fracture (OTA/AO 2R2-2U2) nonunion with intramedullary nailing and grafting from May 2005 to January 2023 were included.

Outcome Measures and Comparisons:
The primary outcome was to determine the bone union rates after nonunion surgery with intramedullary nail and grafting. Secondary outcomes were to assess functional scores including The Visual Analog Score; the shortened version of the Disabilities of the Arm, Shoulder, and Hand (QuickDASH) questionnaire; Grace–Eversmann evaluation criteria.

RESULTS:
The study included 24 patients comprising 19 men and 5 women (7 radius, 14 ulna, 3 both bones) with an average age at the time of surgery of 40.5 ± 11.2 years (range, 23–61 years) and union was achieved for 24 out of 27 bones (88.8%) in 22 out of 24 patients. The mean (average) preoperative and postoperative QuickDASH scores were found as 64.5 ± 18.2 and 15.3 ± 18.9, respectively. The functional improvement was found statistically significant (P < 0.001). The mean (average) preoperative and postoperative Visual Analog Score was found to be 7.2 ± 2.1 and 1.52 ± 1.5, respectively. The difference was found statistically significant (P < 0.001). Two cases of radius nonunion healed with 10 degrees and 15 degrees of angulation and shortening, while nonunion persisted in 2 patients. All remaining cases healed without deformity. Excellent to acceptable results were obtained for 83.3% of patients according to Grace–Eversmann criteria.

CONCLUSİONS:
Intramedullary nailing with autologous grafting is a viable option for the treatment of adult forearm nonunions.

LEVEL OF EVIDENCE:
Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
Diversifying the Nursing Workforce Through Holistic Admissions Review to Nursing School
Authors: Fangonil-Gagalang Evangeline 
Published: December 2024

ABSTRACT:
Although a diverse healthcare workforce has been linked to improved care quality and cost savings, the U.S. nursing workforce does not mirror the population of underrepresented minority (URM) groups in the country. Holistic admissions review (HAR) is an innovative process that can increase the number of URM students entering nursing education programs. In addition to using traditional grade point average and entrance test scores for admissions criteria, HAR considers non-academic attributes such as personal qualities and life experiences. Nursing schools that adopt HAR can help diversify the nursing workforce. Lebacqz's (1987) Six Theories of Justice can aid Christian nurse educators in evaluating and advocating for HAR.
Integrating Faith and Learning Using a Biblical Concept-Based Curriculum
Authors: Bell Ashley 
Published: December 2024

ABSTRACT:
The integration of faith and learning (IFL) in nursing has deep historical roots. However, barriers have developed to successful IFL in Christian higher education. A biblically based concept curriculum (BBCC) is proposed that emphasizes deep learning, critical thinking, and student-centered learning. Examples are provided of BBCC curricular integration, pedagogical methods, and assessments related to the IFL. Results of student evaluations before and after implementation of the BBCC identified an increase in students' perceptions of IFL in nursing courses.
Orgasmic Disorders
Authors: Giraldi Annamaria 
Published: December 2024

Aim:
To describe orgasm disorders in women.

Results:
Orgasmic problems are prevalent in women, and many experience distress related to the condition. The problem often co-exist with other sexual disorders and can be caused by many biopsychocial factors. A comprehensive assessment focusing on biopsychosocial factors contributing to the orgasmic problem is necessary. This includes a sexological, medical, and psychological history. Treatment should include cognitive and behavioral interventions, which may include the partner. No pharmacological treatment is approved to treat orgasmic disorders in women.
Residual silicone oil does appear after conventional removal and contributes to postoperative emulsification
Authors: Chen Ying , Wang Li Kenneth Kai , Steel David H , Chan Yau Kei 
Published: December 2024

Purpose:
To validate the presence of residual non-emulsified silicone oil (SO) following conventional surgical removal techniques used in vitreoretinal surgery and provide insights for optimizing surgical parameters and reducing subsequent emulsification-related complications.

Methods:
The two surgical steps of repeated fluid-air exchange (FAX), including aspiration and infusion, were simulated in vitro to investigate their effectiveness in removing residual non-emulsified SO under various clinical settings. Aspiration was performed at three different positions with respect to the SO interface (i.e., within the SO phase, at the SO/BSS interface, and within the BSS phase) with a 25-gauge probe. An infusion was positioned near the SO/BSS interface with an intraoperatively standardized flow rate (5mL/min). In a further ex vivo study, the volume of residual non-emulsified SO (collected by Dichloromethane) was quantified by Flourier-transform infrared spectroscopy (FTIR) in both repeated FAX and passive drainage (PD) groups.

Results:
In the in vitro model, regardless of which position a 25-gauge probe was located, residual non-emulsified SO could not be effectively removed even under high aspiration levels (p>0.05). Continuous BSS infusion led to small SO droplet formation. Residual SO in both non-emulsified and emulsified forms was observed in the ex-vivo model subjected to repeated FAX. The volume of residual non-emulsified SO was quantified, ranging from 2.75 to 24.71 μL, without significant difference among experimental groups (p>0.05).

Conclusions:
Complete residual non-emulsified SO removal was technically challenging by conventional surgical techniques. This residual non-emulsified SO could serve as a source of ongoing SO emulsification.
Social Determinants of Health in Age-Related Macular Degeneration: A Nationally Representative Survey Study
Authors: Huang Ryan S. , Patil Nikhil S. , Mihalache Andrew , Xie Jim , Popovic Marko M. , Kertes Peter J. , Muni Rajeev H. , Kohly Radha P. 
Published: December 2024

Purpose:
To investigate the relationship between social determinants of health (SDoH) and the prevalence of age-related macular degeneration (AMD).

Methods:
This analysis included adult respondents (>50 years old) from the 2017 National Health Interview Survey (NHIS). The primary outcomes were self-reported diagnosis of AMD and self-reported vision loss due to AMD. Univariable and multivariable logistic regression models were employed for analysis.

Results:
A total of 14,267 NHIS participants were included, of whom 668 (4.7%) reported an AMD diagnosis. In the multivariable analysis, respondents aged over 81 years had higher odds of AMD (OR=7.54, 95%CI=[4.76, 11.96], p<0.001) compared to those aged 51-60. Divorced, separated, or widowed participants (OR=1.27, 95%CI=[1.01, 1.61], p=0.042) were also associated with higher odds of AMD compared to married participants. Conversely, Black/African-American (OR=0.23, 95%CI=[0.14, 0.39], p<0.001), Asian (OR=0.38, 95%CI=[0.16, 0.88], p=0.023), and gay, lesbian, or bisexual respondents (OR=0.45, 95%CI=[0.22, 0.93], p=0.032) had lower odds of AMD compared to White and heterosexual respondents, respectively. Employment was also associated with lower odds of AMD (OR=0.71, 95%CI=[0.53, 0.96], p=0.026) compared to unemployment.

Conclusion:
Several SDoH were associated with self-reported AMD diagnosis. These factors should be considered by policymakers and clinicians to effectively orchestrate public health initiatives aimed at promoting equitable care.
Prevalence and associated factors of choroidal caverns in patients with type 2 diabetes mellitus.
Authors: Vidal-Oliver Lourdes , Spissinger Sabrina , Almeida Elisa Herzig-de , Garzone Davide , Chronopoulos Argyrios , Finger Robert P. 
Published: December 2024

Purpose:
To study the prevalence of choroidal caverns (CCs) in patients with type 2 diabetes (T2DM) and their association with demographic and clinical data.

Methods:
We included patients with T2DM and nondiabetic controls in a cross-sectional, monocenter study. The main outcome measure was the presence of CCs. Exploratory variables included age, sex, diabetic retinopathy (DR) status, duration of T2DM, visual acuity, arterial hypertension (aHT), hyperlipidemia, HbA1c, choroidal thickness (CT) and choroidal vascularity index (CVI). Group differences between eyes with and without CCs and associations with demographic and clinical variables were assessed.

Results:
After including a total of 205 eyes of 116 patients, the prevalence of CCs was 25% in the control, 28% in the T2DM without DR and 9.5% in the DR groups. The locations of the caverns were: choriocapillaris (N=2, 4.2%), Sattler's (N=29, 60.4%) and Haller's layer (N=17, 35.4%). 34.3% of patients had caverns in both eyes. We found no significant differences in systemic conditions (including aHT, hyperlipidemia, HbA1c or T2DM disease duration). CVI was the only parameter independently associated with the presence of choroidal caverns (OR 1.37).

Conclusions:
We found choroidal caverns in almost a quarter of patients with and without T2DM. CCs were mainly located in the Sattler’s layer. CVI was independently associated with the presence of CCs. These findings suggest that the presence of CCs may be a sign of a higher metabolic activity within the choroidal microenvironment, irrespective of T2DM status.
Prolonged time from cross-clamp until normothermic machine perfusion start is associated with an increased risk of early allograft dysfunction following DCD liver transplant
Authors: Lee Charles , Mathur Amit K. , Mao Shennen , Heimbach Julie K. , Taner C. Burcin , Aqel Bashar , Croome Kristopher P. 
Published: December 2024

There is a paucity of data on the impact of cold ischemia time before the initiation of normothermic machine perfusion (NMP), particularly in more susceptible organs such as livers from donation after circulatory death (DCD) donors. The present analysis aimed to investigate the impact of prolonged time from cross-clamp until NMP start on early allograft dysfunction and other peri–liver transplant (LT) outcomes. All DCD LT performed and placed on NMP at Mayo Clinic Arizona, Florida, and Rochester from January 2022 to March 2024 were included. The decision was made a priori to divide the population into 2 groups based on terciles: typical cross-clamp to on-pump time (lower 2 terciles) versus prolonged cross-clamp to on-pump time (upper tercile; >2 h 45.6 min). Three hundred eighty-four DCD LT undergoing NMP met the inclusion criteria. The rate of early allograft dysfunction was significantly higher in the prolonged cross-clamp to on-pump group (51.2%) compared to the typical cross-clamp to on-pump group (37.6%) (p = 0.01). The prolonged cross-clamp to on-pump group also had higher rates of acute kidney injury and the number of packed red blood cells transfused during LT. No significant difference in ischemic cholangiopathy (2.4% vs. 3.1%; p = 0.68) or graft survival at 12 months was seen between the prolonged cross-clamp to on-pump and typical cross-clamp to on-pump group, respectively. Following cross-clamp, DCD liver grafts should be placed on the NMP pump as quickly as is safely and logistically possible. In cases where delays are unavoidable, such as waiting for biopsy results or liver reallocation with another center, acceptable results can still be achieved, and therefore, livers with prolonged times should still be used.
A case of disseminated nocardia infection with initial symptoms manifesting as cognitive impairment: Case report and literature review
Authors: Li Xiayahu , Zhou Weiguo , Zhao Kai , Li Yaolin 
Published: December 2024

Rationale:

Nocardia infections, although rare, pose significant challenges in diagnosis and treatment, especially when involving the central nervous system (CNS). Mortality rates in such cases can be high, highlighting the need for early recognition and tailored antimicrobial therapy.

Patient concerns:
A 58-year-old male with a history of chronic obstructive pulmonary disease, antineutrophil cytoplasmic antibody–associated glomerulonephritis, and steroid-induced diabetes mellitus presented with disorganized speech, fever, cough, dyspnea, and psychiatric symptoms.

Diagnoses:
The patient was diagnosed with severe pneumonia, left pneumothorax, bilateral pulmonary bullae, and CNS involvement. Next-generation sequencing (NGS) identified Nocardia farcinica as the causative agent.

Interventions:
Initial treatment with ceftriaxone was ineffective. Upon identification of N. farcinica via NGS, the patient was started on a tailored antimicrobial regimen consisting of sulfamethoxazole, linezolid, and meropenem.

Outcomes:
Despite initial clinical improvement, the patient was discharged early due to financial constraints. Unfortunately, he later succumbed to the infection.

Lessons:
This case underscores the difficulty of diagnosing Nocardia infections, particularly when they involve the CNS. The use of advanced diagnostic tools such as NGS, along with early and appropriate antimicrobial therapy, is crucial for improving patient outcomes. Financial and healthcare access challenges may impact the success of treatment, emphasizing the importance of comprehensive follow-up and patient support.
Persistent and severe hypotension during radical transabdominal ovarian cancer surgery: A case report
Authors: He Xinyan , Liu Hui 
Published: December 2024

Rationale:
In radical surgery for ovarian cancer (OC), hypotension that is difficult to correct is usually rare unless there is significant blood loss. We recently encountered a patient who developed persistent and severe hypotension during radical transabdominal OC surgery.

Patient concerns:
A patient was 52 years old with a history of hypertension and well-controlled preoperative blood pressure (BP). A total of 2000 mL of ascites was drained and blood loss was 300 mL when the operation proceeded to 5.5 hours. The patient’s cardiopulmonary function and blood gas analysis showed no significant abnormalities.

Diagnoses:
persistent and uncorrectable hypotension.

Interventions:
There was no significant edema in the patient’s head or face, nor did the surgeon observe noticeable edema in her intestinal walls or other organs. No oozing was seen at the surgical site. Fluid resuscitation and vasopressor administration were continued. As BP control further deteriorated, blood counts, coagulation, and biochemical electrolyte analyses revealed severe hypoalbuminemia (13.5 g/L) and coagulation dysfunction.

Outcomes:
After intravenous human serum albumin (HSA) and fresh frozen plasma therapy, her hypoalbuminemia and coagulation were gradually corrected.

Lessons:
Based on this case, we suggest that in OC patients experiencing mild intraoperative bleeding and minimal heart rate variation but persistent refractory hypotension, hypoalbuminemia should be considered even if preoperative biochemical tests (including serum albumin levels) are normal. Confirming hypoalbuminemia warrants HSA administration to alleviate hypovolemic shock symptoms. Additionally, it is important to be cautious of potential coagulation issues with albumin use, possibly requiring plasma infusion to address coagulopathy.
A bibliometric analysis of hepatolenticular degeneration research in traditional Chinese medicine using CiteSpace and VOSviewer: A study protocol for systematic review
Authors: Tao Zhuang , Wang Fei , Jiang Zhenzhen , Wang Chi , Jiang Chao , Ye Sheng , Yang Wenming , Wang Meixia 
Published: December 2024

Background:
The purpose of this review was to analyze treatments for hepatolenticular degeneration (HLD) in traditional Chinese medicine (TCM), exploring the potential mechanisms and latest advances, as well as potential future directions.

Methods:
We searched articles from the China National Knowledge Infrastructure, the Wanfang database, the Chinese Medical Journal Database, PubMed, the Cochrane Library, and Embase. We used CiteSpace (version 5.8. R3) and VOSviewer (version 1.6.17) software for visual analysis of bibliometrics.

Results:
We selected a final total of 532 studies for visual analysis. In terms of authors, Yang Wenming was the most prolific author in this field, and there were 5 coauthor teams, namely Yang Renmin’s team, Bao Yuancheng’s team, Yang Wenming’s team, Chen Huaizhen’s team, and Han Hui’s team. The top 5 research topics focused on TCM syndrome (13.45%), clinical efficacy (9.45%), integrative medicine (6.91%), liver fibrosis (6.36%), and cognitive dysfunction (4.18%). The top 5 clusters were “#1 Gandouling tablet,” “#2 Gandou Fumu decoction,” “#4 Gandou decoction,” “#5 Clinical Efficacy,” and “#8 Theoretical research.” Research hotspots changed over the past decades, and current studies looked at damp-heat syndrome, phlegm stasis syndrome, and the efficacy of prescriptions.

Conclusion:
Currently, studies in TCM syndromes are relatively limited, and although the field of TCM in HLD is rapidly developing with established networks of teams and collaborations, large-scale collaboration is still in its infancy. Looking toward the future, despite the deficiencies in this field, it is crucial to further explore the advantages of integrative medicine for treating HLD.
Current Trends in Deep Plane Neck Lifting
Authors: Chinta Sachin R. , Brydges Hilliard T. , Laspro Matteo , Shah Alay R. , Cohen Joshua , Ceradini Daniel J. 
Published: December 2024

Introduction
The aging neck is a prevalent aesthetic concern, with over 160,000 neck procedures performed in 2020. It is characterized by increased soft tissue laxity and displacement of cervical structures. While nonsurgical interventions like cryoablation and laser resurfacing show promise, their variable responses highlight the necessity for surgical solutions. Traditional neck lifts address superficial structures but often neglect the subplatysmal plane. Recently, deep plane neck lifts have gained attention for addressing deeper anatomical structures. This paper systematically reviews the literature on subplatysmal modifications in cervicoplasty, aiming to clarify the risks and benefits of these evolving surgical techniques.

Methods
On February 20, 2024, a systematic review adhering to Preferred Reporting Items for Systematic Review and Meta-Analyses 2020 guidelines was performed. MEDLINE, PubMed, Cochrane, and Scopus databases were searched for terms related to neck rejuvenation. Independent reviewers screened titles, abstracts, and full texts, including all relevant studies. Data extracted included patient numbers, procedures, outcomes, and complications.

Results
From an initial 771 articles, 57 studies encompassing 8648 patients met inclusion criteria. The most commonly altered anatomical structures during “deep plane” neck lift (DPNL) were the submandibular gland (69.9%), digastric muscles (58.6%), and subplatysmal fat (48.6%). Postoperative complications were reported in 59.6% of studies, with nerve palsy (0.2%–12%) and hematoma (0.2%–4%) being most common. Aesthetic outcomes were less frequently reported (56% of studies); patient satisfaction ranged from 81.6% to 98.6%, while objective measures were reported in only 12% of studies.

Conclusions
Recent surveys indicate a growing concern over excess laxity under the chin, with patients increasingly seeking neck rejuvenation. Our review found that DPNL techniques vary widely, with the submandibular gland and digastric muscles being the most frequently altered structures. Despite a general lack of standardized outcome measures, patient satisfaction was high. However, DPNL showed a higher rate of postoperative nerve palsy compared to traditional neck lift. Overall, while DPNL demonstrates potential aesthetic benefits, the increased risk necessitates thorough patient counseling and further studies for standardization and comparison.