bluuebunny/crossref_metadata_2025_split huggingface dataset:
Incidental Triangular Fibrocartilage Complex Changes on Wrist MRI
Authors: Fones Lilah , Kasper Alexis , Milano Molly , Ilyas Asif M. 
Published: September 2024

Background: Triangular fibrocartilage complex (TFCC) changes on wrist magnetic resonance imaging (MRI) may occur in patients without corresponding symptoms and examination consistent with TFCC pathology. This study aims to define the rate of asymptomatic TFCC changes in patients undergoing wrist MRI for indications other than ulnar-sided wrist pain and to compare this with the rate in ulnar-sided wrist pain patients. Methods: Patients who underwent wrist MRI at a single large orthopedic practice over a 2-year period were identified by Current Procedural Terminology (CPT) code 73221. Patients with an associated diagnosis, including “hand,” “wrist,” “radius,” “radial,” “scaphoid,” “navicular,” or “De Quervain,” were retrospectively reviewed for demographics, symptoms, examination, trauma, and MRI findings. Patients with ulnar-sided wrist pain were used as the comparison group. Results: Wrist MRIs were available for 132 patients, with 92 in the primary cohort and 40 forming the comparison group. The MRI indications included wrist pain (other than ulnar-sided; 64%), hand/thumb pain (21%), mass (12%), and numbness/tingling (2%). The TFCC MRI changes were seen in 44% of the patients and abnormal TFCC was positively associated with age. In contrast, 80% of the 40 patients with ulnar-sided wrist pain had abnormal TFCC on MRI. Conclusions: There is a high rate of abnormal TFCC identified on MRI in patients without corresponding ulnar-sided wrist symptoms. This highlights the importance of not treating MRI imaging in isolation without correlating with the patient’s symptoms while also preparing patients for a high likelihood of asymptomatic TFCC changes on routine wrist MRI. Level of Evidence: Retrospective case series; Level IV
Assessing the Impact of Nicotine Dependence on 90-Day Major Complications and 2-Year Hardware Outcomes in Open Reduction and Internal Fixation of the Distal Radius Fracture
Authors: Lawand Jad J. , Obias Isabel B. , Tansey Patrick J. , Faillace John J. 
Published: September 2024

Background: This study aims to assess the impact of nicotine dependence on both 90-day major postoperative outcomes and 2-year implant-related outcomes in patients undergoing open reduction internal fixation (ORIF) for distal radius fractures. Methods: We queried TriNetX, a national research database that provides real-time access to deidentified medical records, for patients of all ages who underwent an ORIF of the distal radius (Current Procedural Technology codes 25607, 25608, 25609) between 2001 and 2021. Patients were categorized by nicotine dependence history (International Classification of Diseases, Tenth Revision code: F17), with groups 1:1 propensity matched for age, sex, race, ethnicity, body mass index, type 2 diabetes, hypertension, cerebrovascular disease, and chronic obstructive pulmonary disease. The primary analysis examined major postoperative complications within 90 days, while the secondary analysis assessed hardware-related issues within 2 years. Risk ratios and 95% confidence intervals were generated for each outcome. Results: Of 62 137 patients treated with distal radius ORIF, 7764 had nicotine dependence, and 54 373 did not. Each group comprised 7591 patients after 1:1 matching. Nicotine dependence was associated with increased risk of skin infections, sepsis, and wound disruption in the 90-day postoperative period ( P < .001). Within the 2-year postoperative period, nicotine dependence was associated with increased risk of mechanical complication of internal fixation device ( P < .001), nonunion ( P < .01), and surgical intervention for nonunion ( P = .009). Conclusions: Nicotine dependence is associated with increased risk of infection, sepsis, wound disruption within 90 days, and hardware complication, nonunion, and nonunion repair at 2 years. These data emphasize the importance of nicotine counseling by treating surgeons.
Advancing readiness for change in substance use for people with substance use disorders using the Kawa model based intervention program: A quasi-experimental study
Authors: Hsiao Han-Yi , Wang Tsui-Ying , Lee Chun-Hung , Lu Young-Chin , Huang Yu-Chen , Chien Ying-Chun , Potenza Marc N. , Lin Chung-Ying 
Published: September 2024

Background Substance use disorders (SUDs) may cause severe social and health problems. Therefore, providing adequate treatments for people with SUDs to change their drug use behaviors is important. This study examined the effectiveness of Kawa Model based therapy among people with SUDs in Taiwan. Methods Participants were recruited from people with SUDs who violated the Controlled Drugs Act in Taiwan were mandated to abstinence services by law from January 2016 through October 2021 in Southern Taiwan. Each participant selected a 2-hour for 4 times or 8-hour for one day compulsory treatments and received either the Kawa model based treatment ( n = 55; 9 women; mean ± SD age = 36.73 ± 10.42 years) or psychoeducation courses ( n = 42; 8 women; mean ± SD age = 27.57 ± 5.78 years), respectively. Stages of change was assessed using the University of Rhode Island Change Assessment before and after treatments. Results There were no significant differences in the stages of change scores at baselines between the 2 groups ( p = .06–0.20). After treatments, participants who received the Kawa Model based treatment had higher scores in specific stages of change than did those who received the psychoeducation course in the domains of ‘contemplation’ ( p = .001), ‘action’ ( p = .001), and ‘readiness’ ( p = .002). Conclusion The present study demonstrated initial and preliminary findings that the Kawa Model based therapy may improve readiness for changing drug use behaviors in people with SUDs.
Characteristics of middle cerebral artery aneurysms treated endovascularly in a clip-favored institution
Authors: Kiyofuji Satoshi , Koizumi Satoshi , Kin Taichi , Miyawaki Satoru , Hongo Hiroki , Umekawa Motoyuki , Saito Nobuhito 
Published: September 2024

Background The emergence of flow disruptors has brought a dynamic transition in the selection of treatment for middle cerebral artery (MCA) aneurysms, and the number of MCA aneurysms clipped is acceleratingly decreasing. Still, retreatment after endovascular treatment is still a dilemma, which may necessitate surgical clipping. It is all the more important to elucidate characteristics of MCA aneurysms that make clipping unfavorable. Thus, the practical characteristics of MCA aneurysms treated endovascularly in a clip-favored institution before the usage of flow disruption devices were investigated. Methods This is a retrospective, single-center observational study. The clinical and imaging characteristics of treated MCA aneurysms from January 2012 to May 2022 were analyzed. Results A total of 83 aneurysms were included; 70 aneurysms (84%) were clipped, and 13 (16%) were treated endovascularly. Eighteen aneurysms (22%) were ruptured (clipping, 12; endovascular, 6). The reasons for an endovascular treatment were as follows: distal (3); subacutely ruptured with burdens of spasm (2); multiple aneurysms (6: another clipped in 3, coiled in 1, and conservatively managed in 2); no access to the operating room due to COVID-19 (1); and retreatment after coiling (1). Endovascular group aneurysms were smaller (maximum diameter 5.2 vs 7.3 mm, p < 0.01, as well as dome, neck, and height) without differences in the dome/neck and aspect (height/neck) ratios. In a subgroup analysis of 78 MCA bifurcation aneurysms, the endovascular group was still smaller (dome 4.4 vs 5.8 mm, p = 0.025; neck 2.8 vs 3.9, p = 0.03). Conclusion In a limited series from a clip-favored institution before the flow disruption era, factors guided to endovascular treatments on MCA aneurysms were rather anatomical and clinical factors such as distal location, subacutely ruptured, multiple, or retreatment after coiling, than morphological factors such as dome/neck and aspect ratios albeit smaller size.
Utilizing a portable magnetic resonance imaging (MRI) in the setting of an acute ischemic stroke in a patient with a cardiac implantable electronic device
Authors: Patel Mayur S. , Mannix Nicholas , Carfora Arianna , Nimjee Shahid M. 
Published: September 2024

Background Cardiac implantable electronic device (CIED) generally excludes patients from undergoing fixed, high-field magnetic resonance imaging (MRI). Acute ischemic stroke patients undergo MRI as a standard part of an assessment of infarct burden. The use of a portable MRI scanner may be useful in patients who have contraindications to high-field MRI. We present the first case of a patient with a CIED who required an endovascular thrombectomy (EVT) for large vessel occlusion. She underwent a low-field MRI in the operating room with the Hyperfine portable system. Case The patient is an 80-year-old female status post-CIED, on Eliquis who presented with an acute ischemic stroke. Her National Institutes of Health Stroke Scale (NIHSS) of 8. Imaging demonstrated a left M2 occlusion on computed tomography angiogram (CTA) of the head and neck. No lytics were used due to concomitant gastrointestinal bleed. While, admitted, her NIHSS increased to 15. A subsequent CTA demonstrated a left internal carotid artery terminus and M1 occlusion. She underwent EVT with thrombolysis in cerebral infarction (TICI) 3 revascularization. An MRI was performed intraoperatively using a Hyperfine system, which is a low-field, portable MRI, to assess infarct volume. Conclusion Hyperfine Swoop brain MRI may be safe for use in patients with contraindications to high-field MRI scans. Continued technological refinement will improve the quality of diffusion-weighted imaging. Larger studies will be required to generalize Hyperfine MRI-based imaging for patients with devices that exclude them from high-field imaging.
Exploring the moderating role of health-promoting behaviours and self-compassion on the relationship between clinical decision-making and nurses’ well-being
Authors: Miley Molly , Mantzios Michail , Egan Helen , Connabeer Kathrina 
Published: September 2024

Background: Clinical decision-making is an essential part of the nursing role and has implications for both patient care and nurses’ well-being. Aim: This study aimed to explore the relationship between nurses’ perceptions of clinical decision-making ability and moral distress across a nursing population, and the potential link to self-compassion and health-promoting behaviours. Methods: A self-report questionnaire was distributed to a sample of nurses ( N = 152) from April to September 2022. The survey explored nurses’ perceptions of clinical decision-making ability, moral distress, physical activity, grazing, stress-eating, burnout and self-compassion. Results: Perceived clinical decision-making ability was associated with moral distress experience, and both self-compassion and grazing moderated this relationship, independently. Conclusion: Findings highlight the link between nurses’ perceptions of clinical decision-making ability and moral distress experience. Both eating behaviours and self-compassion influence the relationship between these two factors and identify potential areas that may support (and hinder) nurses’ well-being through clinical decision-making. These findings reinforce the importance of healthy eating habits and being self-compassionate to prevent moral distress arising as a result of clinical decision-making.
Lymph node ratio as an indicator of nodal status in the assessment of survival and recurrence in vulvar cancer: A cohort study
Authors: Mansouri Houyem , Zemni Ines , Sakhri Saida , Ayadi Mohamed Ali , Boujelbene Nadia , Ben Dhiab Tarek 
Published: September 2024

Background: Inguinal lymph node (LN) metastasis and particularly the number of metastatic lymph nodes (NMLN) represent a determinant prognostic factor in vulvar squamous cell carcinoma (VSCC). However, the NMLN may be related to the number of removed LNs. Therefore, the lymph node ratio (LNR) reflects not only the burden of LN involvement but also the quality and extent of lymphadenectomy. Objectives: To investigate the value of the LNR and the count of LN on overall survival (OS) and recurrence-free survival (RFS). Design: This study is a retrospective, longitudinal, institution-based study. Methods: This study included 192 patients treated for VSCC at the Salah Azaiez Institute between 1994 and 2022. Clinical, pathological, and evolutionary data were reported. Survival curves were generated by the Kaplan–Meier method, and predictive factors of outcome were analyzed using Cox proportional hazards models. Results: Surgery consisted of a radical vulvectomy, hemivulvectomy, and pelvic exenteration in, respectively, 96.4%, 2.1%, and 1.6% of cases followed by adjuvant radiotherapy in 38.5% of cases. LN dissection was bilateral in 88.5% of cases. LNR = 0, LNR = 0–0.2, and LNR ⩾0.2 were recorded in, respectively, 64.7%, 22.1%, and 13.2% of cases. With a mean follow-up time of 35 ± 42.06 months, the 5-year OS was 52.5% and the 5-year RFS was 55.8%. On multivariate analysis, the independent prognostic factors of OS were the LNR (hazard ratio (HR) = 5.702; 95% confidence interval (CI) = 2.282–14.245; p < 0.0001), Federation of Gynecology and Obstetrics (FIGO) stage (HR = 2.089; 95% CI = 1.028–4.277; p = 0.042), and free margins (HR = 2.247; 95% CI = 1.215–4.155; p = 0.01). Recurrences were recorded in 37.5% of cases. Independent prognostic factors of RFS were the LNR (HR = 2.911; 95% CI = 1.468–5.779; p = 0.002), FIGO stage (HR = 1.835; 95% CI = 1.071–3.141; p = 0.027), and free margins (HR = 2.091; 95% CI = 1.286–3.999; p = 0.003). Conclusion: Surgical margin, FIGO stage, and LNR represent the independent prognostic factors of survival and LNR showed superior prognostic predictive accuracy compared with the revised 2021 FIGO staging system for predicting OS and RFS in VSCC.
Expected outcome for reconstructive hand surgery after spinal cord injuries related to level of injury and sex
Authors: Ramström Therese , Bunketorp Käll Lina , Dunn Jennifer , Reinholdt Carina , Wangdell Johanna 
Published: September 2024

This retrospective, multicentre study maps grip strength and grasp ability after tendon transfer surgery in patients with tetraplegia. Data were analysed in the whole group and in subgroups stratified into the International Classification for Surgery of the Hand in Tetraplegia (ICSHT) and sex. In total, 200 arms (143 patients) had tendon transfer surgery to restore grip and pinch function, 74% were men, 42% were ICSHT group ≤3 and 58% ICSHT were group ≥4. The one-year outcome across all participants for grip strength was 5.2 kg, pinch strength 2.1 kg and a score of 108 for the Grasp and Release test. Men had significantly higher grip and pinch strength compared to women, while there was no significant difference with respect to grasp ability. ICSHT group ≥4 had significantly higher grip strength and grasp ability compared to ICSHT group ≤3, whereas no significant difference in pinch strength between ICSHT groups was seen. Level of evidence: III
Radiography versus computed tomography for osseous staging of Kienböck’s disease
Authors: Hesse Nina , Kalb Karl-Heinz , Stohldreier Yannick , Gildein Hannah , van Schoonhoven Jörg , Schmitt Rainer 
Published: September 2024

This retrospective study compared the diagnostic accuracy of conventional radiography (CR) and computed tomography (CT) in classifying Kienböck’s disease (KD) according to Lichtman staging. Besides age, cartilage condition and vascularity, bone morphology is important in choosing the most appropriate treatment in KD. In 278 patients, two musculoskeletal radiologists performed a consensus reading of 281 lunate necroses according to the Lichtman classification, based on CR and CT. Stage IIIc was most common in CR (43%) and CT (61%), followed by stage IIIa for CR (25%) and stage IV for CT (15%). In 67%, KD was classified as the same in both modalities. The KD stage had to be upgraded in CT in 34% of cases, notably with stage IIIa progressing to IIIc in 24 out of 69 patients and stage IIIb to IIIc in 23 out of 38 cases. Overall, the Lichtman score was significantly higher on CT. The findings suggest that CT is better than CR in accurately determining the stage of KD stage, indicating a potential shift towards more surgical salvage procedures. Level of evidence: III
Quantifying the ‘distance to LDC-goal’ in patients at very high cardiovascular risk with hyperlipidaemia in Germany: a retrospective claims database analysis
Authors: Stach Ksenija , Richter Hartmut , Fraass Uwe , Stein Alexandra 
Published: September 2024

Background and objectives: This study quantified the ‘distance to LDL-C goal’ in patients at very high cardiovascular risk with uncontrolled hyperlipidaemia. ‘Distance to LDL-C goal’ was defined as the percentage by which low-density lipoprotein cholesterol (LDL-C) levels needed to be reduced to achieve the LDL-C goals specified in the 2016 or 2019 European Society of Cardiology/European Atherosclerosis Society guidelines. Design and methods: This retrospective analysis using data from the IQVIA Disease Analyzer database included patients who were predominantly treated by a primary care physician, diabetologist or cardiologist between 2014 and 2018, with a diagnosis of hyperlipidaemia and an initial LDL-C measurement (index event) and one or more cardiovascular risk factors. The primary outcome was to assess the proportion of patients with uncontrolled hyperlipidaemia and to classify the ‘distance to LDL-C goal’ in these patients. Results: Data from 32,963 patients were analysed ( n = 27,159, n = 3873 and n = 1931 patients in the primary care physician, diabetology and cardiology cohorts, respectively). Most patients had uncontrolled LDL-C levels (⩾70 mg/dL; ⩾1.8 mmol/L) at index (91.0%, 86.4% and 94.0% of patients in the primary care physician, diabetology and cardiology cohorts, respectively). Analysis of the ‘distance to LDL-C goal’ indicated that approximately one-third of patients in each cohort required an LDL-C level reduction of up to 50% relative to index to achieve their LDL-C goal (35.8%, 43.7% and 28.4% of patients in the primary care physician, diabetology and cardiology cohorts, respectively). LDL-C control was not achieved at 36 months post-index in most patients with uncontrolled LDL-C levels (86.8%, 81.7% and 90.2% of patients in the primary care physician, diabetology and cardiology cohorts, respectively). Conclusion: LDL-C levels were uncontrolled in most patients with hyperlipidaemia. Analysis of the ‘distance to LDL-C goal’ showed that most patients required a substantial LDL-C level reduction to achieve their LDL-C goal.
Treatment trajectories and outcomes in inflammatory bowel disease: a tertiary single-centre experience
Authors: Wagner Kim , Müller Tanja M. , Vitali Francesco , Fischer Sarah , Haberkamp Sophie , Rouse-Merkel Rachel , Atreya Raja , Neurath Markus F. , Zundler Sebastian 
Published: September 2024

Background: There is an increasing diversification in the treatment landscape for inflammatory bowel diseases (IBD) leading to therapeutic challenges that can only incompletely be covered by prospective randomized double-blind trials. Real-world observations are therefore an important tool to provide insights into therapeutic strategies. Objectives: To describe the real-world treatment algorithms in an IBD referral centre. Design: Single-centre retrospective cohort study. Methods: We retrospectively analysed prospectively collected data on treatment sequences and outcomes from 502 patients with Crohn’s disease (CD) and ulcerative colitis (UC) treated with infliximab, adalimumab, vedolizumab or ustekinumab at a large German tertiary referral centre. Results: Treatment decisions correlated to baseline patient characteristics. Over time, infliximab continued to be the preferred first-line option in CD and UC, although ustekinumab and vedolizumab, respectively, became increasingly important choices. Remission rates decreased with the advancement of therapy lines. Conclusion: We provide insights into the evolution of tertiary centre real-world treatment sequences that might – together with other observations – help to guide the selection of therapies in IBD. Our data also strongly underscore the unmet need for biomarkers supporting treatment decisions. Trial registration: None.
One-bone forearm for the treatment of supination contractures secondary to neonatal brachial plexus injury
Authors: Rojas-Neira Juliana , Chaves Camilo , Díaz-Gallardo Paula , Nguyen Trong-Quynh , Dominguez-Amador Juan J , Soldado Francisco 
Published: September 2024

Background: The one-bone forearm procedure has been considered as a potential treatment for severe forearm deformities. However, its primary limitation lies in the elevated risks of nonunion and infection. In order to enhance union rates, a technical modification was introduced, aiming not only to establish end-to-end radio-ulnar fixation but also to incorporate an additional overlay and fixation between the proximal and distal radius osteotomy stumps. This technique, initially applied in a heterogeneous patient population including individuals with neurological, tumoral, and congenital conditions, yielded promising results, achieving a consolidation rate of 100% and enabling supination corrections of up to 120°. Methods: In this study, we present a retrospective cohort of 28 patients, with an average age of 9 years, all afflicted by forearm supination contracture exceeding 90° secondary to neonatal brachial plexus injury. These patients underwent treatment with the modified technique. Results: The mean correction achieved in forearm rotation was 116°, and the average follow-up period extended to 43 months. Remarkably, all patients exhibited bone union within an average period of 6.6 weeks, without any complications. Conclusion: Our findings underscore the efficacy of this modified technique, which enables substantial rotational corrections, boasts a high union rate, and maintains a low incidence of complications. This approach is particularly valuable for young patients suffering from neonatal brachial plexus injury with severe fixed supination deformities. Case series, Level of evidence: IV
Analytical Evaluation and Antioxidant Activity of Selected Vegetable Oils to Support Evidence-Based use in Dermal Products
Authors: Poljšak Nina , Kočevar Glavač Nina 
Published: September 2024

Objective This study presents an analytical and biological evaluation of selected vegetable oils and their unsaponifiable compounds, which are of crucial importance for the cosmetic and pharmaceutical industries, with the aim of ensuring their targeted use in dermal products. Methods Vegetable oils were selected based on their dominant fatty acid composition: pomegranate seed oil (punicic acid), linseed oil (α-linolenic acid), coconut oil (lauric acid), olive oil (oleic acid), poppy seed oil (linoleic acid), linden seed oil (linoleic acid), and marigold seed oil (α-calendic acid). Pharmacopoeial chemical values, fatty acid profiles, and unsaponifiable compounds were analysed. Antioxidant activity was measured using DPPH assay. Results Chemical values indicated good oxidative status and minimal hydrolysis. Fatty acid analysis revealed expected compositions, with rare linden and marigold seed oils exhibiting distinctive fatty acid composition, featuring sterculic and α-calendic acids. Marigold seed oil showed the richest profile of unsaponifiable compounds. Antioxidant activity was highest in olive oil and lowest in coconut oil. No significant correlation was found between the fatty acid composition, unsaponifiable matter, and antioxidant activity suggesting the synergistic or antagonistic interactions of oil components. Conclusion The study highlights the complex interactions among oil components that influence antioxidant activity. These findings deepen the understanding of the complex mechanisms determining the antioxidant properties of vegetable oils, crucial for informed decisions in dermal product formulation as demand for natural, effective cosmetic and pharmaceutical ingredients rises.