bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Relationship Between Ethical Attitudes and Compassion Fatigue in Nurses Working in Surgical Intensive Care Units
Authors: Üçüncüoğlu Melek , Güner Yasemin , Çilingir Dilek , Taşdemir Erdem , Akturan Selçuk 
Published: October 2024

Aim
This study aimed to explore the relationship between ethical attitudes and compassion fatigue experienced by nurses in surgical intensive care units.

Methods
It is mixed-design research. The study was conducted with 38 nurses working in the surgical intensive care units of a university hospital who agreed to participate in the study. Quantitative data were collected using the Nurse Information Form, the Ethical Attitude Scale for Nursing Care, and the Compassion Fatigue–Short Scale. Qualitative data were collected using a semistructured questionnaire, through individual interviews with 9 volunteer nurses in surgical intensive care units.

Results
The study revealed that nurses exhibited high levels of ethical attitudes in nursing care along with high levels of compassion fatigue. During the qualitative data analysis, 4 key themes emerged: ethical approaches in surgical intensive care units, professional quality of life in nurses, the reflections of compassion fatigue on ethical behavior, and nurses’ well-being.

Conclusions
It was concluded that when compassion fatigue increased in nurses in surgical intensive care units, ethical attitudes in nursing care decreased. Therefore, compassion fatigue can be addressed by programs that support nurses’ well-being, such as meditation, deep breathing, self-compassion exercises, and so on. It can be reduced.
Sleep Hygiene for the Prevention of Hospital Delirium in Neurocritical Care Patients
Authors: Chadwell Sarah P. , Williams Ishan C. , Hundt Elizabeth 
Published: October 2024

Background
Delirium is a state of altered level of consciousness often leading to confusion, inattention, and changes to levels of cognition. Delirium increases average length of stay in the hospital and costs the US health care system approximately $148 billion each year in associated medical costs. Sleep hygiene is an important factor in delirium prevention for all hospitalized patients.

Objectives
This quality improvement project was designed to increase implementation of an evidence-based sleep hygiene bundle in the neurocritical care population in order to decrease rates of hospital-acquired delirium.

Methods
This project followed the Plan, Do, Study, Act (PDSA) framework to facilitate a continuous quality improvement intervention at a mid-Atlantic academic medical center in the neurocritical care population. The continuous quality improvement included the incorporation of “sleep” as a topic into the daily rounding checklist, thus optimizing the ability to improve adherence to a multicomponent sleep hygiene bundle. The intervention includes the preintervention-postintervention occurrences of delirium and use of the daily rounding checklist.

Results
Nursing adherence to documentation of delirium assessments was high at approximately 99%. Following the intervention, there was a 41% decrease in the number of patients who screened positive for hospital-acquired delirium.

Discussion
The improvement in cases of hospital-acquired delirium may be attributed to the project intervention. Recommendations for future interventions include analysis of training on sleep plans, focus on nursing education regarding delirium assessment tools, or a measure of staff and/or patient satisfaction related to the intervention.
ZIP Code and ZIP Code Tabulation Area Linkage: Implications for Bias in Epidemiologic Research
Authors: Chen Futu , MacDonald Beau , Xu Yan , Franco Wilma , Campos Alberto , Palinkas Lawrence A. , Johnston Jill , Eckel Sandrah P. , Garcia Erika 
Published: October 2024

Background:
To our knowledge, no agreed-upon best practices exist for joining U.S. Census ZIP Code Tabulation Areas (ZCTAs) and U.S. Postal Service ZIP Codes (ZIPs). One-to-one linkage using 5-digit ZCTA identifiers excludes ZIPs without direct matches. “Crosswalk” linkage may match a ZCTA to multiple ZIPs, avoiding losses.

Methods:
We compared noncrosswalk and crosswalk linkages nationally and for mortality and health insurance in California. To elucidate selection implications, generalized additive models related sociodemographics to whether ZCTAs contained nonmatching ZIPs.

Results:
Nationwide, 15% of ZCTAs had nonmatching ZIPs, i.e., ZIPs dropped under noncrosswalk linkage. ZCTAs with nonmatching ZIPs were positively associated with metropolitan core location, lower socioeconomics, and non-White population. In California, 34% of ZIPs in the mortality and 25% in the health insurance data had ZCTAs with nonmatching ZIPs; however, these ZIPs constitute only 0.03% of total mortality and 0.44% of total insurance enrollees.

Conclusions:
Our study findings support the use of crosswalk linkages and ZCTAs as a unit of analysis. One-to-one linkage may cause bias by differentially excluding ZIPs with more disadvantaged populations, although affected population sizes seem small.
Target Trial Emulation Using Cohort Studies: Estimating the Effect of Antihypertensive Medication Initiation on Incident Dementia
Authors: Bennett Erin E. , Liu Chelsea , Stapp Emma K. , Gianattasio Kan Z. , Zimmerman Scott C. , Wei Jingkai , Griswold Michael E. , Fitzpatrick Annette L. , Gottesman Rebecca F. , Launer Lenore J. , Windham B. Gwen , Levine Deborah A. , Fohner Alison E. , Glymour M. Maria , Power Melinda C. 
Published: October 2024

Background:
Observational studies link high midlife systolic blood pressure to increased dementia risk. However, the synthesis of evidence from randomized controlled trials has not definitively demonstrated that antihypertensive medication use reduces dementia risk. Here, we emulate target trials of antihypertensive medication initiation on incident dementia using three cohort studies, with attention to potential violations of necessary assumptions.

Methods:
We emulated trials of antihypertensive medication initiation on incident dementia using data from the Atherosclerosis Risk in Communities study, Cardiovascular Health Study, and Health and Retirement Study. We used data-driven methods to restrict participants to initiators and noninitiators with overlap in propensity scores and positive control outcomes to look for violations of positivity and exchangeability assumptions.

Results:
Analyses were limited by the small number of cohort participants who met eligibility criteria. Associations between antihypertensive medication initiation and incident dementia were inconsistent and imprecise (Atherosclerosis Risk in Communities: HR = 0.30 [0.05, 1.93]; Cardiovascular Health Study: HR = 0.66 [0.27, 1.64]; Health and Retirement Study: HR = 1.09 [0.75, 1.59]). More stringent propensity score restrictions had little effect on findings. Sensitivity analyses using a positive control outcome unexpectedly suggested antihypertensive medication initiation increased the risk of coronary heart disease in all three samples.

Conclusions:
Positive control outcome analyses suggested substantial residual confounding in effect estimates from our target trials, precluding conclusions about the impact of antihypertensive medication initiation on dementia risk through target trial emulation. Formalized processes for identifying violations of necessary assumptions will strengthen confidence in target trial emulation and avoid inappropriate confidence in emulated trial results.
Public Awareness of Blindness Caused by Hyaluronic Acid Injection in China: A Questionnaire Survey
Authors: Liao Zhi-Feng , Zhang Guo-Yi , Li Fang-Wei , Wang Shi-Wei , Liu Fang-Cen , Wang Hai-Bin , Luo Sheng-Kang 
Published: October 2024

Background:
The occurrence of blindness resulting from facial injection is a catastrophic complication that remains a significant safety concern for patients. The aim was to assess public awareness of blindness caused by hyaluronic acid injection.

Methods:
The Tencent questionnaire platform was used to gather self-reported demographic data, information about injection experience, and factors influencing the understanding of blindness. Additionally, we included an educational section on blindness caused by hyaluronic acid injection and evaluated the respondents’ intention to undergo injections.

Results:
A total of 1000 respondents completed the questionnaire, 15.4% had received filler injections, and 53.7% expressed their consideration of facial filler injections. The majority of respondents (68.3%) reported being aware of the risk of blindness associated with filler injections, with professional health blogs, social media, and news serving as the primary sources of information. Furthermore, 93.4% of the respondents believed that plastic surgeons should discuss the risk of blindness with patients before injection.

Conclusions:
The majority of the respondents in this study were aware of the possibility of blindness resulting from filler injections. Health blogs, news outlets, and social media platforms are likely the primary channels through which the public obtains information on this topic.
Outcomes of Trabeculectomy and Predictors of Success in Patients of African Ancestry With Primary Open Angle Glaucoma
Authors: Mamidipaka Anusha , Shi Amy , Addis Victoria , He Jocelyn , Lee Roy , Di Rosa Isabel , Salowe Rebecca , Ying Gui-Shuang , O’Brien Joan 
Published: October 2024

Précis:
Trabeculectomy in African ancestry individuals with primary open angle glaucoma (POAG) shows a 46% success rate and frequent complications, indicating that younger age and family history are significant predictors of surgical failure in this high-risk population.

Objective:
To investigate outcomes of trabeculectomy ab externo in African ancestry POAG patients and to analyze the impact of demographic and phenotypic factors on surgical success and complication rates.

Patients and Methods:
A retrospective case-control study enrolled 63 eyes of 55 POAG cases who underwent trabeculectomy ab externo. Data on demographics, family glaucoma history, surgical specifics, and pre/postoperative measures (intraocular pressure, visual acuity, visual field, medication usage, complications within 1 year) were collected. The analysis included linear/logistic regression models adjusting for inter-eye correlation.

Results:
Trabeculectomy yielded success without additional medication in 46%, qualified success with medication in 22%, and surgical failure necessitating further intervention in 32% within 1 year. Subjects experienced a reduction in intraocular pressure (IOP) (46%), daily glaucoma medication (73%), and eye drop usage (67%) 1-year post-trabeculectomy (all P<0.001). However, there was a postoperative decline of 56% in visual acuity (VA) (P<0.001) and a significant worsening of visual field parameters, including a 14% decrease in mean deviation (P=0.02) and a 19% decrease in visual field index (P=0.004). Fifty-nine percent of patient eyes experienced complications within 1 year of surgery. Univariate analysis of predictive factors for surgical outcomes revealed that younger age at surgery (P=0.01) and family history of glaucoma (P=0.046) were predictive of lower rates of surgical success. Multivariable analysis revealed worse preoperative VA (OR: 0.79 per 0.1 LogMAR increases, P=0.02) was associated with a lower likelihood of surgical success.

Conclusion:
This study underscores the low rates of trabeculectomy success and high rates of complications in an African ancestry population with POAG. While the procedure exhibited positive effects on IOP control and medication reduction, our analysis found that multiple factors, particularly age, family history, and worse preoperative VA play crucial roles in influencing surgical success.
Safety and efficacy of stem cell therapy for Crohn’s disease: an umbrella review of systematic reviews
Authors: Thangavelu Lakshmi , Mohan Syam , Alfaifi Hassan A. , Farasani Abdullah , Menon Soumya V. , Bansal Pooja , Choudhary Chhavi , Kumar M Ravi , Vashishth Raghav , Al- Rihaymee Afrah M.A. , Rustagi Sarvesh , Malhotra Anil K. , Shabil Muhammed , Khatib Mahalaqua N. , Zahiruddin Quazi S. , Abdelwahab Siddig I. , Bushi Ganesh , Almasabi Saleh H.A. , Alrasheed Hayam A. , Rabaan Ali A. 
Published: October 2024

Background:
Crohn’s disease is a chronic, relapsing form of inflammatory bowel disease marked by severe gastrointestinal inflammation and a broad range of debilitating symptoms. Despite advances in medical treatments, achieving sustained remission remains challenging for many patients. This umbrella review aims to consolidate evidence from various systematic reviews to evaluate the efficacy and safety of stem cell therapies in treating Crohn’s disease.

Methods:
This review followed the Joanna Briggs Institute methodology and adhered to PRISMA guidelines. A literature search of PubMed, Web of Science, Embase, and the Cochrane Library covered records up to 20 April 2024. Only systematic reviews and meta-analyses on stem cell therapy for Crohn’s disease were considered. Data were extracted and analyzed for clinical efficacy indicators like remission induction and safety metrics, including adverse events and mortality rates.

Results:
Sixteen systematic reviews were included, spanning studies conducted between 2009 and 2023. Stem cell therapy showed a pooled risk ratio (RR) of 1.299 (95% CI: 1.192–1.420) for clinical remission, indicating a 29.9% increased likelihood of remission compared to controls. The pooled RR for healing perianal Crohn’s disease was 1.358 (95% CI: 1.13–1.631), suggesting a 35.8% increased likelihood of healing. A pooled RR of 1.481 (95% CI: 1.036–2.116) shows a 48.1% higher immediate fistula closure rate with stem cell therapy. For long-term outcomes, a RR of 1.422 (95% CI: 1.091–1.854) indicates a 42.2% increased likelihood of maintaining closure. However, stem cell therapy did not significantly impact Crohn’s Disease Activity Index (CDAI) (RR: 1.154, 95% CI: 0.193–6.883) and Perianal Disease Activity Index (PDAI) scores (mean difference at 12 weeks: −0.505, 95% CI: −2.481 to 1.471; mean difference at 24 weeks: −0.338, 95% CI: −1.638 to 0.963). The safety profile was comparable to conventional therapies, with a pooled RR of 0.972 (95% CI: 0.739–1.278) for adverse events and 1.136 (95% CI: 0.821–1.572) for serious adverse events.

Conclusion:
Stem cell therapy offers significant progress in treating Crohn’s disease, particularly in complex cases, by improving fistula closure rates and suggesting potential as a supplementary therapy. Its safety profile aligns with conventional treatments, yet ongoing clinical trials are crucial to optimize its use. Continual research will enable healthcare providers to tailor more effective treatment strategies for this challenging condition.
Advancing Value-Based Academic–Clinical Partnership Evaluation in Physical Therapy Education: Multiattribute Utility Analysis as a Contextual Methodological Approach
Authors: North Sara 
Published: October 2024

Introduction.
There is a need to investigate the application of systematic, scholarly methods to develop and implement a sustainable, flexible process for evaluating academic–clinical partnership effectiveness. The purpose of this study was to explore the potential for multiattribute utility analysis (MAUA) methodology to be applied in the context of academic–clinical partnership evaluation.

Review of the Literature.
Persistent systemic challenges related to academic–clinical partnership volume and quality require intentional strategies addressing the inherent complexities of the clinical learning environment and contextual differences between academic institutions. Multiattribute utility analysis appears to be a viable existing methodological framework based on its successful application in a wide variety of fields.

Subjects.
Directors and Co-Directors of Clinical Education in accredited Doctor of Physical Therapy programs.

Methods.
The MAUA methodological framework was used to identify and quantify weighted priorities in factors contributing to partnership effectiveness as perceived by academic–clinical education programs across the United States. Survey participants were invited to share their perspectives regarding priority characteristics and assessment approaches to advance value-based partnership evaluation in physical therapy education.

Results.
The products resulting from this contemporary analysis, coupled with the previous applied MAUA simulation, offer a methodology and flexible framework that may be utilized by academic–clinical education faculty to perform a value-based partnership evaluation and make decisions within the context of their institution. Clinical educator survey results also provide a new depth of insight regarding trends in the collective degree of attribute prioritization and the complexity and intersectionality across partnership priorities.

Discussion and Conclusion.
The proposed processes may allow academic programs to narrow the large number of possible partnership criteria to a manageable subset, offering a way forward for those interested in pursuing a quantitative method for practical decision making. The ability to assess partnership quality using an evidence-based framework such as MAUA may allow partners to maintain, enhance, or discontinue partnerships based on a shared understanding of attribute alignment, rather than reactively coming together in practice to address challenges needing resolution.
Indolent systemic mastocytosis (ISM) without skin lesions as a recurrent anaphylaxis: a case report study
Authors: Ghelichi-Ghojogh Mousa , Ebrahimi Mohsen , Ghezeljeh Edris , Delavari Sahar , Aghapour Seyed Ali 
Published: October 2024

Introduction and importance:
Mastocytosis encompasses a diverse range of disorders characterized by the clonal accumulation of mast cells in various tissues, including the skin, bone marrow, and gastrointestinal tract.

Case presentation:
This case report describes a 32-year-old male patient who presented with a history of recurrent anaphylactic attacks and elevated serum tryptase levels without apparent skin involvement. The diagnostic process and clinical implications of non-cutaneous mastocytosis are discussed in the context of existing WHO criteria.

Clinical discussion:
Mastocytosis, although a rare disease, carries the potential for severe complications and can present with atypical symptoms, thereby complicating its diagnosis and management. Consequently, the development of a reliable diagnostic and therapeutic strategy is of paramount importance.

Conclusion:
There is a pressing need to delve deeper into the investigation of the potential impacts and manifestations of mastocytosis to further our understanding and enhance patient care.
Domestic single-port robot-assisted laparoscopic surgery for pyelotomy combined with shockwave lithotripsy: the first case report
Authors: Li Ruixiao , Ni Jianxin , Li Xuelian , Wu Bin , Li Bo , Su Rui-Ping , Xue Song , Wu Guojun 
Published: October 2024

Introduction and Importance:
Kidney stones are a common condition treated in urology departments and rank first among hospitalized patients. Staghorn kidney stones are a particular type of kidney stone that fill or occupy most of the renal collecting system. They have a large stone load and are often associated with recurrent urinary tract infections and chronic renal insufficiency.

Case presentation:
The authors report a case of single-port robot-assisted laparoscopic pyelotomy combined with EMS (Electromagnetic Shockwave Lithotripsy) for surgical stone removal, and discuss and analyze it based on published literature. A 75-year-old woman visited our hospital in January 2024 due to right waist pain and hematuria. Computed Tomography (CT) indicated a stone ~6.1×5.8×3.5 cm in the right renal pelvis and calyces. Staghorn kidney stones are challenging to remove surgically, have a low stone clearance rate, and are prone to recurrence, making them one of the most difficult issues in urological surgery. Combined treatment effectively reduces the number of skin-renal passages, decreases the occurrence of injuries and complications, and improves the success rate of lithotripsy and the stone-free rate. Therefore, the patient underwent single-port robot-assisted laparoscopic pyelotomy combined with EMS surgical lithotomy and was discharged 7 days after the operation. There were no complications postoperation, and follow-up showed that the stones were completely cleared without any residue.

Clinical discussion:
The treatment of staghorn kidney stones requires a comprehensive approach to reduce the number of skin-renal passages and the occurrence of complications. Single-port robot-assisted pyelotomy combined with EMS lithotripsy can ensure the effectiveness of the surgery while reducing risks and enhancing patient recovery.

Conclusion:
For staghorn kidney stones, single-port robot-assisted pyelotomy combined with EMS stone removal is a safe and effective procedure with a beautiful incision, fewer complications, and excellent patient outcomes.
Three-dimensional Analysis of Skeletal Stability in Cleft Lip and Palate Patients Undergoing Bimaxillary Surgery With Le Fort I Osteotomy and Intraoral Vertical Ramus Osteotomy
Authors: Nguyen Loi Phuoc , Kim Jun-Young , Ha Tae-Wook , Ho Nguyen Chon Thanh , Park Jin Hoo , Jung Young-Soo 
Published: October 2024

Orthognathic surgery in patients with lip and palate clefts is challenging owing to scar tissue from primary repairs and severe deformities. In this study, we evaluated the stability of Le Fort I osteotomy with intraoral vertical ramus osteotomy (IVRO) in patients with cleft lip and palate using 3-dimensional (3D) analysis. This retrospective study comprised 14 cleft lip and palate patients (3 females, 11 males; the average age at surgery: 23.8 y) who underwent bimaxillary orthognathic surgery involving Lefort I osteotomy and IVRO. Cone-beam computed tomography (CBCT) images were obtained at preoperative (T0), 1-month postoperative (T1), and 1-year follow-up (T2) periods. The 3D analysis assessed the transitions and rotations of the maxilla and mandible using a virtual triangle. The maxilla showed stability in all directions at the 1-year follow-up with minimal relapse. The distal segment of the mandible exhibited clinically acceptable anterior (1.15 mm relapse) movements and pitch rotation (2.88° counterclockwise relapse) during the first year postoperatively. The proximal mandibular segment underwent anterior-inferior transition (1.21 and 2.01 mm, respectively) and lateral-outward rotation (4.90° and 7.51°, respectively) postsurgery, remaining unchanged 1 year postoperation. Le Fort I osteotomy with IVRO provides skeletal stability in patients with cleft lips and palates. This study demonstrated a minimal maxillary relapse and clinically acceptable movements in the distal mandibular segment during the first postoperative year. The proximal mandibular segment moved anteriorly and inferiorly, rotated laterally and outward after surgery, and remained unchanged at the 1-year follow-up.