bluuebunny/crossref_metadata_2025_split huggingface dataset:
Two Stages Management for Dislocation of Knee – A Case Report
Authors: Dibyosubroto A. Adityo , Achmad J Jachja , Wurarah Julia 
Published: October 2024

Introduction: Knee dislocation were defined as complete loss of tibiofibular articulation confirmed by radiography. The mean age at injury was 37.8 ± 15.3 years. Of the 303 patients included, 65% were male and 35% were female. We report a case of 37 years old women who comes to our ER. She complained pain at her right knee since 30 minutes after hit by motorcycle. Internal rotation of tibia could be seen in this patient. There were no damaged found on vascular and additional injuries. Knee radiography were carried out to confirm diagnosis. Discussion: According the Good and Johnson, they defined knee dislocation to include the grossly unstable knee, with a minimum of 2 of the 4 major knee ligaments injured. In this patient we performed operative immediately by closed reduction and cast fixation on knee with guidance of fluoroscopy. During the intraoperative we got the valgus test, varus test, Lachman’s test and anterior drawer test were positive. Every week, we follow up by radiography to check is there any shifting or loss reduction on the cast. After three weeks, we open the cast and found the negative result on valgus and varus test, but the anterior/posterior drawer test and Lachman’s test still positive. It confirmed by MRI with total tear on ACL, partial tear on PCL and partial tear on lateral meniscus. Then we planned to do two arthroscopy, first is ACL, second is PCL. During first arthroscopy we found many hematoma, then we performed harvest from the hamstring: semimembranosus and gracilis tendon as graft for ACL reconstruction. Result: Three weeks after the external fixation was removed, the result of valgus and varus test were negative. The outcome of ACL reconstruction is a stable ACL, it confirmed with the negative result of anterior drawer test. Conclusion: Delayed reconstruction may resulted resolution of swelling, less stiffness, better ROM of knee and some structures healed by itself, but more hematoma. This also support other studies about delay reconstruction could potentially yield equivalent stability outcomes compared with acute surgery.
Reconstruction of a Chronic Patellar Tendon Rupture: A Case Report
Authors: Fachri Dliyauddin , Utoyo Ghuna Arioharjo 
Published: October 2024

Introduction: A chronic patellar tendon rupture in adolescent is very rare but can happen in sport-related injury. Presentation at more than 6 weeks after injury might cause a significant disability. Prompt diagnosis and treatment are key factors to a good prognosis. In this case, we use an autologous semitendinosus tendon graft to repair the patellar tendon rupture. Case Report: A 17-year-old male presented with pain at left knee since 6 months ago. The pain started after he landed on his left knee, having jumped while playing volleyball. On physical examination of the left knee, edema and high patella were found. There was also a palpable gap at the inferior pole of the patella. The patient was unable to do active extension of the left lower leg. MRI evaluation of the left knee revealed a patellar tendon rupture, myositis ossificans and a partial ACL rupture. The patient was scheduled for an elective surgery, consisting of patellar tendon reconstruction using an autologous semitendinosus graft along with ossificans removal and debridement. Discussion: Risk factors of tendon rupture should be assessed with extensive evaluation to construct the appropriate surgical repair method. The decision on which method to use depends greatly on the patient's profile and nature of injury. Immobilization period and routine rehabilitation exercises are vital to an enhanced recovery and fully functional knee. Conclusion: An autologous semitendinosus graft provides a good result without the need of a steel wire, as demonstrated in our case. Immobilization period and routine rehabilitation exercises are vital to an enhanced recovery and fully functional knee.
Managing ACL Injuries: A Comprehensive Systematic Review and Meta-Analysis of Conservative vs. Operative Treatment Approaches
Authors: Wiksa Astrayana Gusti Agung , Wien Aryana Gusti Ngurah 
Published: October 2024

Introduction: ACL injuries from sports activities lead to substantial functional impairments and debates over optimal treatment (conservative vs. operative). We conducted a systematic review and meta-analysis focusing on IKDC score-based functional outcomes. Objectives: The aim of study is to review the management of ACL injuries. Methods: We identified relevant studies comparing ACL treatments, assessing IKDC-scored functional outcomes. Two reviewers independently performed data extraction and quality assessment. Random-effects models pooled effect sizes, generating forest plots. Heterogeneity and publication bias were assessed. Results: Five studies met inclusion criteria. Meta-analysis showed no significant correlation between non-operative and operative approaches regarding IKDC-scored functional outcomes. Forest plots revealed no significant differences. Conclusion: This systematic review/meta-analysis indicates no significant difference in IKDC-scored functional outcomes between non-operative and operative ACL treatments. IKDC scores were found to be higher in the operative treatment group when the follow-up period extended beyond 10 years. Individualized decisions, considering patient preferences and risks, are crucial. Further research is needed to explore additional outcome influencers and refine treatment guidelines.
The Association between Socio-demographics and Post-Reconditioning Physical Fitness of Athletes Undergoing ACL Reconstruction
Authors: Suriadiredja Siti S. , Lubis Andri M.T. , Kurniarobbi Jull , Reyhan Taufan F. 
Published: October 2024

Introduction: Meniscus and anterior cruciate ligament (ACL) are the most common knee sports injuries. During the injury and its management, there may be a decrease in the level of physical fitness. Athletes need good physical fitness to be able to return to sports optimally. Objective. The aim of this study is to determine the association between socio-demographics and post-reconditioning physical fitness of athletes undergoing ACL reconstruction in Indonesia. Materials & Methods: This is a cross-sectional study with analytic descriptive approach using secondary data from one hospital for two years. This study include athletes with ACL injury who underwent ACL reconstruction followed by reconditioning three times a week in six months. At the end of the reconditioning, they were tested for their level of physical fitness. Results: Forty-six athletes were obtained. Socio-demographics show that most of the subjects were male (87%) aged over 25 years (58.7%), have basic-middle level of education (65.2%), amateur athletes (54.3%) who play contact sports (73.9%), got injured during training (73.9%) with a non-contact mechanism (89.1%), had a single knee injury (60.9%), and good exercise compliance (73.9%). Most of the subjects achieved good post-reconditioning physical fitness, including cardiorespiratory endurance (65.2%), muscle strength (73.9%), muscle endurance (80.4%), and flexibility (87%). Multivariate analysis shows that exercise compliance was significantly associated with muscle strength (AOR=25.1; 95% CI:1.812-348.761) and muscle endurance (AOR=12.8; 95% CI:1.695-97.193). Conclusion: The reconditioning program following ACL reconstruction in athletes provide a good level of physical fitness and the most contributing factor is the good exercise compliance.
Predicting pathological complete response following neoadjuvant chemoradiotherapy (nCRT) in patients with locally advanced rectal cancer using merged model integrating MRI-based radiomics and deep learning data
Authors: Lu Haidi , Yuan Yuan , Liu Minglu , Li Zhihui , Ma Xiaolu , Xia Yuwei , Shi Feng , Lu Yong , Lu Jianping , Shen Fu 
Published: October 2024

Abstract
Background
To construct and compare merged models integrating clinical factors, MRI-based radiomics features and deep learning (DL) models for predicting pathological complete response (pCR) to neoadjuvant chemoradiotherapy (nCRT) in patients with locally advanced rectal cancer (LARC).

Methods
Totally 197 patients with LARC administered surgical resection after nCRT were assigned to cohort 1 (training and test sets); meanwhile, 52 cases were assigned to cohort 2 as a validation set. Radscore and DL models were established for predicting pCR applying pre- and post-nCRT MRI data, respectively. Different merged models integrating clinical factors, Radscore and DL model were constituted. Their predictive performances were validated and compared by receiver operating characteristic (ROC) and decision curve analyses (DCA).

Results
Merged models were established integrating selected clinical factors, Radscore and DL model for pCR prediction. The areas under the ROC curves (AUCs) of the pre-nCRT merged model were 0.834 (95% CI: 0.737–0.931) and 0.742 (95% CI: 0.650–0.834) in test and validation sets, respectively. The AUCs of the post-nCRT merged model were 0.746 (95% CI: 0.636–0.856) and 0.737 (95% CI: 0.646–0.828) in test and validation sets, respectively. DCA showed that the pretreatment algorithm could yield enhanced clinically benefit than the post-nCRT approach.

Conclusions
The pre-nCRT merged model including clinical factors, Radscore and DL model constitutes an effective non-invasive tool for pCR prediction in LARC.
Clinical outcomes and outcome predictors of two-year assertive community treatment in Norway: an explorative prospective pre–post study
Authors: Ruud Torleif , Selle Maria Lie , Clausen Hanne K. , Heiervang Kristin S. , Odden Sigrun , Stuen Hanne Kilen , Landheim Anne 
Published: October 2024

Abstract
Background
Assertive Community Treatment (ACT) teams have become a part of mental health services for people with severe mental illness in many high-income countries. Studies in several countries have investigated the outcomes of ACT, and knowledge is also needed about outcomes of ACT teams in Norway. Our aims were to study clinical outcomes of ACT, how the outcomes were associated with characteristics of patients and treatment, and whether they differed across ACT teams.

Methods
Our explorative, prospective, pre–post multicenter study involved 142 patients who received ACT for two years from the first 12 ACT teams established in urban and rural areas of Norway. There was no control group. The primary outcome was change in clinician-rated psychiatric symptoms. Secondary outcomes were clinician-rated change in functioning and engagement and change in community tenure compared with 2 years prior to ACT. We measured fidelity to the ACT model using the Tool for Measurement of Assertive Community Treatment. We performed linear mixed-effects modeling to analyze outcomes and their associations with characteristics of patients and treatment.

Results
After two years, psychiatric symptoms were significantly reduced with a small effect size. Negative symptoms, anxiety and depression, and agitation and mania had significant reductions, while positive symptoms had nonsignificant changes. Functioning, engagement, and community tenure all significantly increased with small effect sizes. Age, difficulty to engage, problematic use of alcohol, frequent previous use of inpatient services, total number of sessions, and team’s fidelity to the ACT model were associated with different groups of symptoms. Less improvement in functioning was associated with team fidelity and number of sessions. Change in engagement was not associated with any predictors. Increased community tenure was greater for younger patients and patients who were on community treatment orders at treatment start.

Conclusions
ACT for two years led to significant positive outcomes with small effect sizes for psychiatric symptoms, functioning, engagement, and community tenure. The outcomes were associated with some potential predictors, and some team-level variance emerged. Positive significant outcomes after two years indicate that larger improvements may be achieved from longer-term treatments by ACT teams.
Patterns and predictors of help-seeking intentions for suicidal ideation compared to other health conditions among rural Chinese adults
Authors: Wu Yang , Chen Zhenzhen , Guo Yaoguang , Han Jin 
Published: October 2024

AbstractPsychological help-seeking for suicidal ideation is a critical aspect of effective suicide prevention. Past research has documented low help-seeking amongst rural residents in China. This study investigates the patterns and predictors of help-seeking intentions for suicidal ideation versus mental (depression) and physical (heart disease) health conditions among Chinese rural residents using General Help-Seeking Questionnaire Vignette version. A total of 143 rural participants from sixteen villages in Hubei province of China completed the survey via home-visiting interviews. Results revealed a general trend that the help-seeking intentions decreased as the helping sources shifted from close others (spouses, family, etc.) to professional helpers and online sources. Additionally, rural residents with higher educational levels, high self-efficacy, and more severe suicide ideations were more willing to seek help; and suicide literacy was found to be negatively associated with help-seeking intentions. The implications of the research findings are discussed.
A qualitative focus group study on legal experts’ views regarding euthanasia requests based on an advance euthanasia directive
Authors: Coers D. O. , Scholten S. H. , de Boer M. E. , Sizoo E. M. , Buijsen M. A. J. M. , Frederiks B. J. M. , Leget C. J. W. , Hertogh C. M. P. M. 
Published: October 2024

Abstract
Background
The Dutch Euthanasia law permits euthanasia in patients with advanced dementia lacking decisional capacity based on advance euthanasia directives. Nevertheless, physicians encounter difficulties assessing the criteria for due care in such cases. This study explores the perspectives of legal experts on the fulfillment of these criteria and the potential for additional legal guidance to support physicians’ decision-making processes.

Methods
A qualitative study was conducted with legal experts. Two focus group sessions were conducted. The data analysis was conducted iteratively, with the data being interpreted using thematic content analysis and the framework method.

Results
Participants emphasize the importance of considering the patient’s current wishes and informing them about the limitations of advance euthanasia directives. While representatives and healthcare professionals can assist in interpreting wishes, the final decision regarding euthanasia rests with the physician. The participants also discuss the challenges posed by pre-recorded wishes due to changing preferences. Furthermore, they present different views on the value of life wishes of patients with advanced dementia. While some participants prioritize life wishes over advance euthanasia directives, others question whether such expressions still reflect their will. Participants find it essential to assess unbearable suffering in the context of the current situation. Participants acknowledge the necessity to interpret advance euthanasia directives but also current expressions and they entrust this interpretation to physicians, viewing them as the primary authority, despite consulting multiple sources.

Conclusions
The Dutch Euthanasia law’s due care criteria are open norms –which are open in substance and require further elaboration, mostly determined on a case-by-case basis to the field standards of the profession–, placing the responsibility on physicians to interpret advance euthanasia directives and patient expressions. Despite potential support from various sources of information, there is limited additional legal guidance available to assist physicians in making decisions.
Trends in non-daily cigarette smoking in England, 2006–2024
Authors: Jackson Sarah E. , Brown Jamie , Shahab Lion , Cox Sharon 
Published: October 2024

Abstract
Background
Cigarette smoking is incredibly harmful, even for people who do not smoke every day. This study aimed to estimate trends in non-daily smoking in England between 2006 and 2024, how these differed across population subgroups, and to explore changes in the profile of non-daily smokers in terms of their sociodemographic and smoking characteristics and vaping and alcohol consumption.

Methods
Data were collected monthly between November 2006 and April 2024 as part of a nationally representative, repeat cross-sectional survey of adults (≥ 18 years; n = 353,711). We used logistic regression to estimate associations between survey wave and non-daily smoking and used descriptive statistics to characterise the profile of non-daily smokers across 3-year periods.

Results
The proportion who smoked non-daily was relatively stable between November 2006 and November 2013, at an average of 10.5% [10.1–10.9%] of cigarette smokers, then increased to 27.2% [26.0–28.4%] of cigarette smokers (4.0% [3.7–4.2%] of adults) by April 2024. This increase was particularly pronounced among younger adults (e.g. reaching 52.8%, 20.4%, and 14.4% of 18-, 45-, and 65-year-old cigarette smokers by April 2024) and those who vape (reaching 34.2% among vapers vs. 23.1% among non-vapers). Over time, there were reductions in non-daily smokers’ mean weekly cigarette consumption (from 34.3 in 2006–2009 to 21.1 in 2021–2024), urges to smoke (e.g. the proportion reporting no urges increased from 29.2 to 38.0%), and motivation to stop smoking (e.g. the proportion highly motivated to quit within the next 3 months decreased from 30.8 to 21.0%).

Conclusions
An increasing proportion of adults in England who smoke cigarettes do not smoke every day, particularly younger adults. Although non-daily smokers report smoking fewer cigarettes and weaker urges to smoke than they used to, which may make it easier for them to stop smoking, they appear to be decreasingly motivated to quit.
Human in vitro models for Fabry disease: new paths for unravelling disease mechanisms and therapies
Authors: Borisch Carla , Thum Thomas , Bär Christian , Hoepfner Jeannine 
Published: October 2024

AbstractFabry disease is a multi-organ disease, caused by mutations in the GLA gene and leading to a progressive accumulation of glycosphingolipids due to enzymatic absence or malfunction of the encoded alpha-galactosidase A. Since pathomechanisms are not yet fully understood and available treatments are not efficient for all mutation types and tissues, further research is highly needed. This research involves many different model types, with significant effort towards the establishment of an in vivo model. However, these models did not replicate the variety of symptoms observed in patients. As an alternative strategy, patient-derived somatic cells as well as patient-independent cell lines were used to model specific aspects of the disease in vitro. Fabry disease patients present different phenotypes according to the mutation and the level of residual enzyme activity, pointing to the necessity of personalized disease modeling. With the advent of induced pluripotent stem cells, the derivation of a multitude of disease-affected cell types became possible, even in a patient-specific and mutation-specific manner. Only recently, three-dimensional Fabry disease models were established that even more closely resemble the native tissue of investigated organs and will bring research closer to the in vivo situation. This review provides an overview of human in vitro models and their achievements in unravelling the Fabry disease pathomechanism as well as in elucidating current and future treatment strategies.
Sedation and general anaesthesia of crocodilians: a systematic review
Authors: Kruuse Asbjørn Onsberg , Markusen Louise Damholt , Grøndahl Carsten , Olsen Lisbeth Høier 
Published: October 2024

AbstractSedation and general anaesthesia of crocodilians pose unique challenges due to their aggressive nature, poikilothermic physiology, and specific anatomical and physiological characteristics, all factors that complicate crocodilian anaesthesia. This review aimed to systematically review the literature regarding sedation and general anaesthesia of crocodilians with focus on efficacy and impact on vital parameters. A systematic literature search was performed according to PRISMA guidelines on May 2, 2023 in the databases Embase, PubMed, Scopus and Web of Science. Publications were excluded based on predefined exclusion criteria, which encompassed non-standard publications and publications unrelated to crocodilians, with fewer than five animals and/or with insufficient data on sedation and general anaesthesia. Five key factors were used to evaluate the strength of evidence: number of included animals, study design, definition of recovery time, blinded assessment of recovery and conflict of interest. Ten publications were included in this systematic review. Drugs used included alpha-2-adrenoceptor agonists, dissociative anaesthetics, benzodiazepines, neuromuscular blocking agents, propofol, alfaxalone, and inhalant gasses. The studies included in total 55 Alligator mississippiensis, 110 Crocodylus porosus, 15 Crocodylus johnstoni, and 15 Crocodylus niloticus. Factors such as temperature, administration route, dose, species, and age influenced protocols for sedation and general anaesthesia of crocodilians. The studies included used five different study designs. Only one study included a control group, done on retrospectively collected data. Blinded recovery assessments and declarations of no conflict of interest were noted in some studies. The use of four distinct recovery definitions posed challenges to comparability in this systematic review. The studies reported that medetomidine provided stable and reversible sedation, although it depressed heart rate. Alfaxalone was less stable outside the optimal temperature range. Intubation and inhalation anaesthesia were effective, and adrenaline reduced the length of the recovery period. Overall, the review provides valuable insights for veterinarians, researchers, and wildlife professionals involved in sedation and general anaesthesia of the crocodilian species, however, the literature is limited, and further research is needed to improve evidence-based medical management.