bluuebunny/crossref_metadata_2025_split huggingface dataset:
Beyond Frankenstein: the Politics of the Gothic in Iraqi Fiction
Authors: Courtney Molly 
Published: October 2024

Abstract
This article examines works of post-2003 Iraqi fiction that draw on the aesthetic and thematic conventions of the postcolonial gothic genre by centering the grotesque figure of the animated corpse. Through these figures, the texts bring the disposable victims of necropolitical violence back into view, resisting their erasure while also resurrecting the buried histories that contributed to the outbreak of ongoing conflict. As these texts foreground the victims of violence both past and present, they issue powerful critiques of neocolonial and sectarian violence, particularly through their inversion of the gothic trope of the terrifying Other. In these texts, initially frightening animated corpses are revealed to be the sympathetic victims of violence, rendering necropolitical violence, rather than the corpses, the true source of horror in the texts and issuing a call to the reader to sympathize and even empathize with the frightening Other.
A Cross-sectional Study to Assess the Self-esteem Among Adolescents in an Urban Poor Locality of Bengaluru City
Authors: Niveditha CS  , Srikanth Jayanthi , Kulkarni Sridevi 
Published: October 2024

Self-esteem refers to the individual’s perception or subjective appraisal of one’s own self-worth, self-confidence and self-respect. Self-esteem plays an important role in determining and preventing mental health disorders. There is a dearth in the knowledge of understanding self-esteem among Indian urban slum adolescents; therefore, this study was taken to assess self-esteem among adolescents of an urban poor locality using ‘The Rosenberg Self-esteem scale’. A cross-sectional survey among adolescents aged 15 to 19 years was conducted from April to June 2023 in the urban poor locality of Bangalore. Taking prevalence of low self-esteem among adolescents as 15.3%, the sample size was calculated as 200. Out of 200 subjects, 52.7% were females and 47.5% were male. We found that 28.0% were school dropouts. The study showed a majority of the subjects had normal or high self-esteem and 10.5% had low self-esteem. Increasing age of the adolescents was found to be significantly associated with self-esteem scores ( p < .05). This study identified that 10.5% had poor self-esteem and they need support from family, school and Sneha Clinic at Urban Primary Health Centre to improve their life skills and prevent mental health issues in adolescence and adulthood.
The Impact of Prophylaxis on the Quality of Life of Boys with Haemophilia—A Twin-centre Study from South India
Authors: Anurekha V. , Danishraja M. , Sujitha K. , Shylaja S. , Rathinavel C. , Rameshbabu B. , Kumaravel K.S. , Sampathkumar D. 
Published: October 2024

Background and Aims: Quality of life (QOL) of boys with haemophilia was severely affected due to many reasons like frequent hospital visits and joint stiffness. This study aims to analyse the impact of the prophylaxis programme on the QOL of haemophiliac boys. Methods: This is a twin-centre cross-sectional study that included all boys with haemophilia aged between 4 and 18 years and receiving prophylaxis. The Canadian Haemophilia Outcome – Kids Life Assessment Tool (CHO-KLAT) Version 3 was used to compare pre-prophylaxis scores with post-prophylaxis scores obtained after four months of prophylaxis. Results: The mean (standard deviation [SD]) age of the study participants was 10.66 (1.28) years. About 88% had haemophilia A and 66.66% had good adherence to prophylaxis. The mean pre-prophylaxis total score was 45.6 (4.9) and the mean post-prophylaxis total score was 64.3 (5.4). Significant improvement in total scores and domain scores was observed in the post-prophylaxis group.
Biomechanical Changes to the Hindfoot After Zadek Osteotomy
Authors: Bellas Nicholas , Nayak Raghunandan , Pasha Mehreen , Wolf Megan , McDonald Thomas , Obopilwe Elifho , Geaney Lauren E. 
Published: October 2024

Background: Insertional Achilles tendinopathy (IAT) is a common source of heel pain in active adults and athletes. The Zadek osteotomy (ZO) is a calcaneal dorsal closing wedge osteotomy that has demonstrated clinical success as a treatment for IAT, purported to favorably improve tendon mechanics, decrease impingement, and decrease pressure within the retrocalcaneal bursa. The present study aims to evaluate the biomechanical effects of ZO on Achilles strain, position of the Haglund prominence relative to the Achilles insertion, and retrocalcaneal pressure. Methods: The ZO was performed on 10 fresh-frozen foot and ankle mid tibia-fibula cadaveric specimens. An osteotomy was performed using a 1-cm dorsal closing wedge procedure secured with a 7.0 mm cannulated screw. Point pressure sensor catheters and differential variable reluctance transducers were used to measure the retrocalcaneal pressure and Achilles strain, respectively, pre- and postosteotomy. Paired t-tests were utilized to detect statistical differences ( P < .05). Results: After the ZO, the Haglund prominence was translated 9.9 mm anteriorly with respect to the insertion of the Achilles ( P < .05) and the Achilles tendon insertion was translated 3.4 mm proximally ( P < .05). The ratio of calcaneal length to greater tuberosity length, the X/Y ratio, increased from 2.56 to 3.52 with the osteotomy ( P < .05). At maximum dorsiflexion, retrocalcaneal pressure decreased from 117 to 66 mm Hg (44%, P = .018). The Achilles strain changed from 0.00362 to 0.00436 in the anterior fibers ( P = .484) and changed from 0.00467 to 0.00283 in the posterior fibers ( P = .088). Conclusion: Biomechanical testing in a cadaveric model demonstrates that the ZO decreased retrocalcaneal pressure, shifted the Achilles tendon insertion proximally, increased the X/Y ratio of the calcaneus, and did not significantly change the strain of the Achilles tendon. Clinical Relevance Despite the clinical success demonstrated in recent literature, there are no biomechanical studies describing the effect of the ZO on the biomechanics of the hindfoot, and the mechanism of symptom relief of the ZO for IAT is not well understood. The present study measures two potential ZO effects relative to Haglund prominence by measuring retrocalcaneal pressure and displacement of the Achilles tendon with respect to the Haglund prominence, and measures one ZO effect relative to calcification of the tendon by measuring the Achilles tendon strain.
Early-onset rectal cancer: Experience of a single-center, high-volume unit
Authors: Lehtonen Taru M. , Koskenvuo Laura E. , Lepistö Anna H. 
Published: October 2024

Background and objective: The incidence of early-onset colorectal cancer among the young (<50 years) has been reported to have risen in last decades. This retrospective study aimed to investigate the characteristics of early-onset rectal cancers (EO-RCs) and potential changes in proportion of EO-RCs, and further to report the mortality and recurrence rates of EO-RCs. Methods: In the years 2007–2021, 2557 rectal cancer (RC) patients were operated in Helsinki University Hospital and of them 147 were 18–49 years old. Cumulative overall survival (OS), disease-specific survival, and disease-free survival were calculated using the Kaplan–Meier analysis. Results: The percentual amount of the EO-RCs varied between 2.5% and 11.3% annually and there was no perceivable trend. Majority were adenocarcinomas (98.7%), of which 8.8% were mucinous. Predisposing factors such as Lynch syndrome, polyposis, or ulcerative colitis were seen in 26 patients (17.7%) and in 10 of 22 patients (45.5%) under 35 years. The cumulative 5-year OS was 91.9% in stage I, 93.3% in stage II, 86.7% in stage III, and 50.0% in stage IV disease. Metastatic recurrence was found in 22 cases (18.4%) and local recurrence in 8 patients (5.4%) and 6 patients had both. Conclusions: In our cohort of 147 EO-RC patients, OS was good and the clinical course did not seem to differ much from the course of RC in general population.
Evaluating Predictive Factors for Lymphocele Formation Following Kidney Transplantation
Authors: Boiko Oleksandr , Garcia-Alonso Ignacio , Navarro Adela , Maldonado Asier , Prieto Sergio , Llorente Ana , Iliuta Florina , Sanz Joel , Olano Ivan , Martinez Beatriz , Estrade Oskar , Padilla Jesus 
Published: October 2024

Introduction Lymphocele is a common complication post-kidney transplantation, influenced by various factors including surgical technique, graft vessel count, operator experience, body mass index, ischemia time, and immunotherapy regimens. Project Aims The purpose of this study was to evaluate lymphocele risk factors, particularly focusing on the role of end-stage kidney disease. Design A retrospective study was conducted on renal transplant recipients from a single center (March 2020 to December 2022). Patients were categorized into those developing lymphocele and those without during the postoperative period. Data, including sociodemographic, personal history, graft-related variables, intervention, and postoperative outcomes, were collected from electronic medical records. Results Out of 291 renal transplant recipients, 57 (19.6%) developed postoperative lymphocele, with 15 (5.1%) being symptomatic. Patients with body mass index <24.9 kg/m2 have lower risk of developing lymphocele with an Odds Ratio of 0.538 (P=0.046). Higher lymphocele prevalence was noted in patients with chronic tubulointerstitial nephritis (46.2%; OR 3.815; P=0.024). Focal segmental glomerulosclerosis patients showed no lymphocele (0.0%; OR 0.123; P=0.048). Other factors, including autosomal dominant polycystic kidney disease, did not exhibit significant differences in lymphocele prevalence. Conclusion The etiology of end-stage kidney disease can serve as a significant predictor of lymphocele development during the postoperative period following renal transplantation. Further larger prospective studies are required to comprehensively assess risk factors and explore end-stage kidney disease potential role in predicting lymphocele formation.
Nurses’ attitudes towards patient safety and their relationship to adverse patient events in Oman
Authors: Almanhali Raeda , Al Sabei Sulaiman Dawood , Matua Amandu Gerald 
Published: October 2024

Background: Adverse events (AEs) are major causes of mortality. Identification of nurses’ attitudes towards patient safety and their impact on AEs is critical in enhancing safe practices. Aim: To assess the relationship between attitudes towards patient safety and AEs as perceived by nurses working in Sultanate of Oman. Methods: A descriptive, cross-sectional study was conducted. Data to evaluate nurses’ attitudes towards patient safety was collected using the Safety Attitude Questionnaire. The relationship between attitudes towards patient safety and the perceived incidence of adverse patient events was examined using logistic regression analysis. Results: A total of 184 questionnaires were administered from February to April 2022, with a response rate of 96.8%. The results revealed that nurses had a negative attitude towards patient safety. The highest reported adverse event was patient and family complaints. Findings showed a significant relationship between working conditions and patient and family verbal abuse (OR = 0.505, CI (0.283–0.901), p = 0.021). Job satisfaction was a significant predictor of patient fall (OR = 0.57, CI (0.353–0.932), p = 0.025) and medication error (OR = 0.58, CI (0.354–0.949), p = 0.030). Conclusion: Nurses’ attitudes towards patient safety are a significant predictor contributing to the occurrence of AEs. This finding provides key insights about patient safety status that key stakeholders could use to improve safety culture, including raising patient safety awareness.
Comparison of clinical and endoscopic efficacy between vedolizumab and infliximab in bio-naïve patients with ulcerative colitis: a multicenter, real-world study
Authors: Huang Zhaopeng , Tang Jian , Wu Ruibin , Long Shunhua , Chen Wenke , Lu Tingna , Xia Qiuyue , Wu Yanhui , Yang Hongsheng , Yang Qingfan , Huang Zicheng , Guo Qin , Li Miao , Gao Xiang , Chao Kang 
Published: October 2024

Background: No head-to-head trial directly compares the effectiveness of vedolizumab (VDZ) and infliximab (IFX) in patients with ulcerative colitis (UC) who were naïve to biologic therapy. Objectives: We aimed to compare the clinical and endoscopic effectiveness of VDZ and IFX in biologic-naïve patients with UC in real-world settings. Design: It was a multicenter, observational, real-world cohort study conducted at five centers. Methods: Patients diagnosed with UC and treated with either IFX or VDZ as their first-line biologic therapy were retrospectively enrolled. Steroid-free remission, clinical response, clinical remission, and endoscopic healing at week 14 and week 52 were compared between the two groups after propensity score weighting. Results: A total of 199 patients (117 VDZ and 82 IFX) were included in the study. There were no significant differences in steroid-free remission (64.6% vs 56.1%, p = 0.224), clinical response (83.4% vs 73.4%, p = 0.086), or clinical remission (69.4% vs 60.1%, p = 0.174) at week 14. However, VDZ showed better results in steroid-free remission (67.5% vs 44.4%, p = 0.004), clinical response (69.7% vs 47.1%, p = 0.005), and clinical remission (67.5% vs 44.4%, p = 0.004) at week 52. In terms of endoscopic healing, VDZ was similar to IFX at week 14 (25.7% vs 17.4%, p = 0.185), but VDZ had a significantly higher rate at week 52 (29.5% vs 11.8%, p = 0.027). VDZ was found to be superior to IFX in therapeutic continuation (hazard ratio = 0.339, 95% CI: 0.187–0.614, p < 0.001). The rate of adverse events was similar between the two groups (6.8% vs 8.5%, p = 0.655). Conclusion: VDZ demonstrated similar clinical and endoscopic effectiveness to IFX at week 14 in biologic-naïve patients with UC, but appeared to be superior at week 52. The safety outcomes were comparable between the groups.
Prescribed cumulative dosage of corticosteroids to patients with inflammatory bowel disease diagnosed between 2006 and 2020: a retrospective observational study
Authors: Iiristo Johannes , Karling Pontus 
Published: October 2024

Background: Treatments and strategies for inflammatory bowel disease (IBD) have gradually evolved in the 2000s. Objectives: We investigated whether the prescription of corticosteroids (prednisolone and budesonide) in patients with IBD in the first 5 years after diagnosis changed in patients diagnosed between 2006 and 2018. Design: Retrospective observational study. Methods: The cumulative prescribed dosage of corticosteroids for the first 5 years after diagnosis was registered in all patients with IBD ( n = 386) at our clinic for those diagnosed between 2006 and 2018. Results: The proportion of patients with IBD who were prescribed at least one prescription of corticosteroids in year 1–5 after diagnosis was 55.3%, 27.9%, 22.7%, 14.1%, and 14.6%, respectively. The proportion of patients who had a cumulative dose of prednisolone >1 g in the first 5 years after diagnosis was 40.1% for ulcerative colitis and 34.9% for Crohn’s disease (CD). The cumulative prescribed dosage (within 3 years after diagnosis) of prednisolone had declined (rs = −0.164, p = 001), but had increased for budesonide (rs = 0.202, p < 0.001) between 2006 and 2020. The prescription of any immunomodulator for IBD in the first 5 years from diagnosis was stable between 2006 and 2018 (rs = 0.056, p = 0.257), but there was a minor increase in the prescription of Tumor Necrosis Factor (TNF)-inhibitors (rs = 0.119, p = 0.020). The use of five-acetyl salicylic acid (5-ASA) decreased in patients with CD (rs = −201, p = 0.012). Conclusion: There was a decrease in the prescription of prednisolone and an increase in the prescription of budesonide treatment from 2006 to 2023; however, the cumulative exposure to corticosteroids in patients with IBD remains at a relatively high level.
Encapsulated donor faeces for faecal microbiota transplantation: the Glyprotect protocol
Authors: Hansen Mette Mejlby , Rågård Nina , Andreasen Pia Winther , Paaske Sara Ellegaard , Dahlerup Jens Frederik , Mikkelsen Susan , Erikstrup Christian , Baunwall Simon Mark Dahl , Hvas Christian Lodberg 
Published: October 2024

Background: Faecal microbiota transplantation (FMT) is a highly effective treatment for Clostridioides difficile infection. Its use is backed by solid evidence, but application methods differ. Encapsulated FMT is a non-invasive, patient-friendly and scalable application method that may be preferred over colonoscopy or nasoduodenal tube application. Objectives: We describe a detailed protocol, the Glyprotect protocol, for producing glycerol-based capsules to increase FMT accessibility. Design: Using iterative quality improvement methods, we developed and validated the Glyprotect protocol as a reproducible protocol for cryopreserving minimally processed donor faeces in a standard hospital laboratory setting. Methods: We describe detailed standard operating procedures for producing glycerol-based capsules, including all necessary materials and troubleshooting guidelines. Capsule integrity was tested at various temperatures and pH levels. Flow cytometry was used to measure microbiota counts and dose accuracy. Results: The Glyprotect protocol has been used for more than 2500 capsule-based FMT treatments and complies with European tissue and cell standards. The protocol is optimised to preserve microbes and minimise modulation of the donated microbiota by removing debris and water, which also reduces the number of capsules needed per FMT treatment. The intestinal microbiota is preserved in glycerol for cryoprotection and to prevent capsule leakage. Each capsule contains 650 µL microbe–glycerol mass, estimated to contain an average of 2.5 × 108 non-specified bacteria. Conclusion: The Glyprotect protocol enables hospitals and tissue establishments to set up capsule production in a standard laboratory, improving patients’ access to FMT. The protocol facilitates the scalability of FMT services because capsule FMT is less time-consuming and less expensive than liquid-suspension FMT applied by colonoscopy or nasojejunal tube. Trial registration: Not applicable.
Biomechanical Performance of 4-Leg Sustained Dynamic Compression Staples in First Tarsometatarsal Arthrodesis
Authors: Wang Tian , Pelletier Matthew , Johnson James , Kline Courtney , Walsh William , Lareau Craig , Safranski David 
Published: October 2024

Background This study investigates the biomechanical efficacy of new 4-leg Sustained Dynamic Compression (SDC) NiTiNOL staples, hypothesized to offer superior stability and resilience to loading before fusion completion, compared with conventional hardware. Methods Twenty sawbones left full foot models were divided into 4 treatment groups: (1) 4-leg Inline Staple, (2) 4-leg Inline Staple + 2-leg Staple, (3) 4-leg Inline Staple + Screw, and (4) Plate + Screw. An osteotomy was performed to simulate a Lapidus procedure, and the respective fixation methods were applied. Mechanical testing was conducted using a servo-hydraulic testing machine to evaluate constructs’ load, contact force, contact area, and plantar gap. Results The 4-leg Inline Staple + Screw group demonstrated significantly increased joint contact force, joint contact area, and decreased plantar gap compared with the Plate + Screw group, both before and after cyclic testing. All SDC-containing constructs exhibited post-cyclic joint contact areas that were 2.36×, 3.87×, and 5.49× greater than the post-cyclic plate + screw group. Most notably, the 4-leg Inline Staple + Screw group maintained a plantar gap of less than 3 mm throughout the testing, unlike other groups. Conclusions The 4-leg Inline SDC Staple, particularly when combined with a static screw, demonstrated biomechanical superiority over traditional plate and screw constructs in Lapidus procedures. These findings suggest a promising avenue for enhanced post-operative stability, which could translate into quicker patient recovery, improved fusion rates, and potentially lower non-union rates. Further clinical trials are warranted to validate these biomechanical advantages in patient outcomes. Level of Evidence: Therapeutic, Level V: Bench Testing
Venous Thromboembolism in Outpatient Elective Foot and Ankle Procedure Patients Who Is at Risk?
Authors: Heo Kevin Y. , Karzon Anthony , Manz Wesley , Kadakia Rishin J. , Bariteau Jason T. , Coleman Michelle M. 
Published: October 2024

Background Venous thromboembolism (VTE) is a rare but potentially serious complication following elective foot and ankle (F&A) procedures. The absence of guidelines for thromboprophylaxis in elective procedures underscores the importance of identifying patients at risk. This study aimed to identify key risk factors of VTE in patients who underwent elective foot and ankle (F&A) operations. Methods Data was collected from the IBM MarketScan Database (2009-2019) for patients >18 years old without prior VTE who underwent elective F&A procedures. Patients were divided into 3 groups based on region of operation (forefoot, mid/hindfoot, lower leg/ankle). VTE incidence (including deep vein thrombosis and/or pulmonary embolism) was recorded 30 and 90 days postprocedure. Risk factors for VTE were identified through multivariate logistic regression. Results Among the 301 256 patients who underwent elective F&A procedures, the overall 90-day incidence of VTE was 0.95%. The findings revealed that 31.9% of VTE incidents occurred within the first 2 weeks after operation, and 29.2% still occurred after 6 weeks. Analysis of the anatomical region of operation demonstrated that the lowest rate of 90-day VTE was amongst patients undergoing forefoot procedures (0.70%). There was a higher risk for VTE in patients undergoing midfoot/hindfoot procedures (1.22%, OR = 1.81) and lower leg/ankle procedures (1.76%, OR = 2.31). Additional risk factors for VTE included thrombophilia (4.02%, OR = 3.37), male sex (1.30%, OR = 1.47), increasing age (1.02% age 65+, OR = 1.41), and a high Charlson Comorbidity Index (1.12%, OR < 0.82 for scores <5). Conclusion This study identifies the incidence and timing for VTE after elective F&A procedures. Furthermore, this study defines the risk factors associated with increased odds of VTE after elective F&A procedures. These findings are helpful in educating patients about a continued risk for VTE throughout the 90-day postoperative period and beyond. These results can also be utilized to stratify patients who need thromboprophylaxis based on the individual risk level. Level of Evidence: Level III: Retrospective cohort study