bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Meta-Analysis of Surgical Outcomes in 25727 Patients Undergoing Anterior Cervical Discectomy and Fusion or Anterior Cervical Corpectomy and Fusion for Cervical Deformity
Authors: Barot Karma , Ruiz-Cardozo Miguel A. , Singh Som , Trevino Gabriel , Kann Michael R. , Brehm Samuel , Bui Tim , Joseph Karan , Patel Rujvee , Hardi Angela , Yahanda Alexander T. , Jauregui Julio J. , Cadieux Magalie , Pennicooke Brenton , Molina Camilo A. 
Published: August 2024

Study Design Systematic Review. Objectives To evaluate which cervical deformity correction technique between anterior cervical discectomy and fusion (ACDF) and anterior cervical corpectomy and fusion (ACCF) produces better clinical, radiographic, and operative outcomes. Methods We conducted a meta-analysis comparing studies involving ACDF and ACCF. Adult patients with either original or previously treated cervical spine deformities were included. Two independent reviewers categorized extracted data into clinical, radiographic, and operative outcomes, including complications. Clinical assessments included patient-reported outcomes; radiographic evaluations examined C2-C7 Cobb angle, T1 slope, T1-CL, C2-7 SVA, and graft stability. Surgical measures included surgery duration, blood loss, hospital stay, and complications. Results 26 studies (25727 patients) met inclusion criteria and were extracted. Of these, 14 studies (19077 patients) with low risk of bias were included in meta-analysis. ACDF and ACCF similarly improve clinical outcomes in terms of JOA and NDI, but ACDF is significantly better at achieving lower VAS neck scores. ACDF is also more advantageous for improving cervical lordosis and minimizing the incidence of graft complications. While there is no significant difference between approaches for most surgical complications, ACDF is favorable for reducing operative time, intraoperative blood loss, and length of hospital stay. Conclusions While both techniques benefit cervical deformity patients, when both techniques are feasible, ACDF may be superior with respect to VAS neck scores, cervical lordosis, graft complications and certain perioperative outcomes. Further studies are recommended to address outcome variability and refine surgical approach selection.
From Modic to Disc Endplate Bone Marrow Complex - The Natural Course and Clinical Implication of Vertebral Endplate Changes
Authors: Rajasekaran Shanmuganathan , Ramachandran Karthik , K S Sri Vijay Anand , Kanna Rishi M. , Shetty Ajoy P. 
Published: August 2024

Study Design Review article. Objectives A review of literature on the epidemiology, natural course, pathobiology and clinical implications of vertebral endplate changes. Methods A literature search was performed using the Cochrane Database of Systematic Reviews, EMBASE, and PubMed. Studies published over the last 10 years were analysed. The searches were performed using Medical Subject Headings terms, and the subheadings used were “Vertebral endplate changes”, “Modic changes”, “Disc Endplate Bone Marrow complex”. Results The disc, endplate (EP), and bone marrow region of the spine constitute a unified morphological and functional unit, with isolated degeneration of any one structure being uncommon. Disc degeneration causes endplate defects, which result in direct communication and a constant cross-talk between the disc and the vertebral body. This may result in a persistent inflammatory state of the vertebral bone marrow, serving as a major pain generator. This review article focuses on vertebral endplate changes and how the current understanding has progressed from the Modic classification to the Disc Endplate Bone Marrow complex classification. It provides a clear portrayal of the natural course of these alterations and their clinical implications in low back pain. Conclusions In light of the heightened interest and current prominence of vertebral endplate changes within the spine community, we must progress beyond the Modic changes to achieve a comprehensive understanding. The DEBM complex classification will play a major part in disc degeneration research and clinical care, representing a considerable advancement in our understanding of the vertebral endplate changes over the classical Modic changes.
Nursing Code of Ethics Practice and Associated Factors Among Nurses Working in Ethiopia: A Cross-Sectional Study
Authors: Tolosa Mulugeta Hailu , Bekele Daniel Mengistu , Wake Addisu Dabi 
Published: August 2024

Background Codes of ethics provide essential guidance for nursing like those of other professions. This is because nurses are increasingly challenged by complex concerns in their practice. Ethical practice is the foundation for nurses because they deal with ethical issues on daily basis. Objectives This study was aimed to determine the nursing codes of ethics practice and associated factors among nurses working in selected public hospitals in Addis Ababa, Ethiopia. Methods Institution-based cross-sectional study was conducted in selected public hospitals in Addis Ababa between mid-March and June 2022. Study participants were selected using a simple random sampling technique. Result Of the 367 nurses, 334(91%) were aged ≤35 years. The majority 221(60.2%) of nurses were married. The level of a good “nursing code of ethics” practice among nurses was 48.8%. Having training on nursing ethics/code of ethics after school [AOR = 2.41, 95%CI: 1.24, 4.68, p-value = 0.009], good job satisfaction [AOR = 1.58, 95%CI: 1.25, 7.35, p-value = 0.022], good knowledge towards “nursing code of ethics” [AOR = 3.11, 95%CI: 1.59, 6.05, p-value = 0.001], and positive attitude towards “nursing code of ethics” [AOR = 8.56, 3.81, 18.25, p-value = 0.000] were factors significantly associated with “nursing code of ethics” practice. Conclusion The level of good “nursing code of ethics” practice among nurses was relatively low. Training in nursing ethics/code of ethics after school, job satisfaction, knowledge about “nursing code of ethics”, and attitude towards “nursing code of ethics” were factors significantly associated with “nursing code of ethics” practice. Health education and training on “nursing codes of ethics” need to be provided to improve nursing codes of ethics practice among nurses.
Estimating Utility Values for Health States of Nigerian Individuals with Stroke or Epilepsy Using the SF-36: A Brief Report on the Results of a Cross-Sectional Survey
Authors: Gebrye T. , Akosile C. O. , Okoye E. C. , Okoli U. V. , Fatoye F. 
Published: August 2024

Background. Stroke and epilepsy are the most common neurologic conditions affecting individuals. The Short Form Six-Dimension Health Index (SF-6D) is a preference-based measure of health developed to estimate utility values from the SF-36. This study estimated utility values for health states of Nigerian individuals with stroke or epilepsy using the SF-36. Methods. SF-36 responses from 125 and 69 individuals with stroke and persons with epilepsy, respectively, were transformed into health state utility values using the SF-6D algorithm. The Excel program developed by Brazier and colleagues was used to generate the SF-6D utility score estimated using a set of parametric preference weights. The health state utility values were determined using ordinal health state and standard gamble valuation techniques. Results. Mean ( s) ages of the stroke and epilepsy participants were 63.1 (11) and 39.6 (16) y, respectively. The mean ( s) utility scores for stroke and epilepsy were 0.52 (0.10) and 0.65 (0.1) for standard gamble and 0.48 (0.13) and 0.68 (0.11), respectively, using the ordinal health state paradigm. The mean ( s) utility of stroke (female = 0.46 [0.15]; male = 0.50 [0.12]) and epilepsy (female = 0.65 [0.13], male = 0.69 [0.11]) participants were reported. The mean ( s) annual episodes of seizure was 18.7 (39). Conclusions. To our knowledge, this is the first study to suggest that females with stroke and those with epilepsy considered their health to be poorer than that of their male counterparts. The significance of our findings is that they may be helpful for researchers, policy makers, and clinicians by providing input into economic evaluations to facilitate resource allocation for stroke survivors and people living with epilepsy to improve their health outcomes and reduce the huge burden associated with the conditions. Highlight We estimated a health state utility value for stroke and epilepsy to aid researchers and public health policy makers in conducting health economic analysis and outcomes research.
Generative AI in Undergraduate Medical Education: A Rapid Review
Authors: Hale Joshua , Alexander Seth , Wright Sarah Towner , Gilliland Kurt 
Published: August 2024

OBJECTIVES Generative artificial intelligence (AI) models such as OpenAI's ChatGPT and Google's Bard have forced educators to consider how these tools will be efficiently utilized to improve medical education. This article investigates current literature on how generative AI is and could be used and implemented in undergraduate medical education (UME). METHODS A rapid review of the literature was performed utilizing a librarian-generated search strategy to identify articles published before June 30, 2023, in 6 databases (Pubmed, EMBASE.com, Scopus, ERIC via EBSCO, Computer Science Database via EBSCO, and CINAHL via EBSCO). Inclusion criteria were (1) a focus on osteopathic and/or allopathic UME and (2) a defined use or implementation strategy for generative AI. Two reviewers screened all articles, and data extraction was performed by 1 reviewer and confirmed by the other reviewer. RESULTS A total of 521 relevant articles were screened during this review. Forty-one articles underwent full-text review and data extraction. The majority of the articles were opinion pieces (9), case reports (8), letters to the editor (5), editorials (5), and commentaries (3) about the use of generative AI while 7 articles used qualitative and/or quantitative methods. The literature is best divided into 5 categories of uses for generative AI in UME: nonclinical learning assistant, content developer, virtual patient interaction, clinical decision-making tutor, and medical writing. The literature indicates generative AI tools’ greatest potential is for use as a virtual patient and clinical decision-making tutor. CONCLUSIONS While the possibilities proliferate for generative AI in UME, there remains a dearth of quantitative evidence of its use for improving learner outcomes. The majority of the literature opines the potential for utilization, but only 7 studies formally evaluated the results of using generative AI. Future research should focus on the effectiveness of incorporating generative AI into preclinical and clinical curricula in UME.
Corticosteroid Infiltration to Treat Shoulder Stiffness After Rotator Cuff Repair
Authors: Saade François , Liotard Jean-Pierre , ReSurg  , Agu Chinyelum , Van Rooij Floris , Saffarini Mo , Godenèche Arnaud 
Published: August 2024

Purpose To investigate whether the preoperative shoulder range of motion (ROM), would increase the risk of postoperative shoulder stiffness, or whether it would be associated with other preoperative patient characteristics. Methods The authors retrospectively analysed the 372 shoulders that underwent rotator cuff repair by 4 surgeons, between January 2010 and January 2011. All patients were followed up at 3 and 6 months by 2 independent observers to collect the ROM, including active forward elevation (AFE), passive forward elevation (PFE), and external rotation (ER), as well as subjective shoulder value (SSV). Results Of the initial cohort of 372 patients, 10 were lost to follow-up (2.7%), leaving a final cohort of 362 patients available for outcome assessment at a minimum follow-up of 6 months. Of the 362 patients, 281 did not require corticosteroid infiltration, 68 received corticosteroid infiltrations for shoulder stiffness with no apparent cause, and 13 received corticosteroid infiltrations for other reasons. None of the variables were associated with infiltration for shoulder stiffness. Older patients had greater SSV scores (β = 0.3; 95% CI [0.1, 0.6]; P = .015), while both manual and repetitive workers had lower SSV scores (β = −10.7; 95% CI [−15.8, −5.6]; P < .001, and β = −10.2; 95% CI [−15.1, −5.3]; P < .001). Conclusion Postoperative SSV was significantly associated with age, as well as manual or repetitive work. Furthermore, postoperative PFE, AFE, and ER were significantly associated with preoperative PFE. Finally, at 3 and 6 months postoperative, patients who required infiltration for shoulder stiffness had significantly lower PFE, AFE, and ER compared to patients who did not require infiltration. Level of Evidence IV, Case series.
A Novel Uni- and Biplanar External Fixator for Initial and Definitive Complex Foot Trauma
Authors: Pablo Randolino Juan , Gaitán Laura , Slullitel Gastón , Gonzalez Emanuel , Lopez Valeria 
Published: August 2024

Background: Evidence concerning the complex foot trauma, especially its definitive management, is scarce. Soft tissue envelope sequalae are the primary parameters that delay or make internal fixation implausible. Stability conferred by external fixators makes them a reasonable initial treatment choice. Although AO or circular fixators can be applied around the foot, this can involve a learning curve and substantial costs, especially for the circular fixator. There is little evidence as to how well external fixators work as a definite method of fixation in patients where progression to internal fixation cannot be made. Methods: We prospectively evaluated 10 adult patients with severe and complex foot trauma who were consecutively treated at our clinic. Initial reduction and stabilization were performed with an external fixator that was initially conceived for distal radius fractures, applied during the initial procedure and mantained throughout the treatment. Results: Fracture healing was obtained in all 10 cases, and both internal and external column length was restored. One of the patients developed chronic osteomyelitis. At the 1-year follow-up visit, these patients averaged 45.6 points in the physical and 44.8 points on the mental status sections of the 12-Item Short Form Health Survey (SF-12). The Foot Function Index findings for pain, disability, and daily activities limitations were 33.3, 39, and 41.5, respectively, which suggest moderate residual impairment. Conclusion: In this relatively small case series of complex foot trauma, we found that the use of simple external fixation as definitive treatment worked reasonably well. Level of Evidence: Level III, prospective cohort study.
Health services interventions to improve the quality of care in rare disease: a scoping review
Authors: Chou Cody , Wiredu Sydney O. , Von Imhof Liesel , Tan Anran , Agarwal Sasha , Lydston Melis , Merker Vanessa L. 
Published: August 2024

Background: Rare diseases are often complex, multisystem disorders requiring specialized, lifelong care. These diseases share significant challenges in healthcare delivery, including diagnostic delays, limited access to specialists, and lack of effective treatments. Objectives: To aggregate and critically examine innovative health services interventions for rare diseases, with the goal of identifying potentially scalable strategies to improve care. Eligibility criteria: Peer-reviewed original research published in English reporting results of interventions to improve guideline-concordant care, care coordination, and care transitions in rare disease populations. Using Covidence software, two researchers independently screened all texts against preestablished inclusion and exclusion criteria, with conflicts resolved through consensus discussion with a third researcher. Sources of evidence: Comprehensive searches were conducted in April 2022 in Ovid MEDLINE, Embase.com, Web of Science Core Collection, Cochrane Central Register of Controlled Trials (CENTRAL), and ClinicalTrials.gov. Charting methods: Two researchers independently extracted study characteristics and results from eligible full texts using Covidence software, with any conflicts resolved through consensus discussion with a third researcher. Results: Our search identified 2899 articles. After screening for eligibility criteria, 12 articles describing health services interventions in rare diseases were identified. Most studies were conducted in Europe and involved adult participants. Three main intervention targets were identified: (1) increasing patients’ access to multidisciplinary expertise (e.g. using expert panels/tumor boards, integrating additional disciplines into care teams, and creating a hotline for specialist advice); (2) using technology to give point-of-care physicians access to information (e.g. electronic medical record templates/decision-support); and (3) standardizing care through clinical care pathways. Conclusion: This review identified several efficacious interventions to improve healthcare delivery for individuals with a single rare disease. Testing these strategies across broader groups of rare disease patients could more efficiently improve healthcare delivery for the rare disease community, facilitating patients’ timely access to treatments, improving their health outcomes, and potentially reducing healthcare costs with economies of scale.
The use of art as a creative research method to understand psychosocial care needs for children with rare diseases
Authors: Buckle Niamh , O’Neill Amy , Sweeney Alison , McNulty Sandra , Bracken Shirley , Awan Atif , Sinnott Shannon , Gibbs Lisa , Larkin Philip , Kroll Thilo , Somanadhan Suja 
Published: August 2024

Background: Even though a disease might be labelled as ‘rare’, it is estimated that 450 million people globally are affected by rare diseases, and 70% of these conditions are among children. All children have the right to good quality healthcare and to be heard despite the country or state they live in. While children’s drawings are increasingly used in qualitative research to understand children’s experiences and perceptions of illness, few studies in the rare disease field utilize this method. Objective: This study examined drawings of children with rare diseases to gain insight into their experience living with their condition. Design: A qualitative phenomenological research study was employed to explore and understand children’s and young people’s experiences and perceptions of living with rare diseases through research participants’ artistic expression in drawings and responses to semistructured interview questions. Methods: A purposively selected sample of children ( n = 7) attending tertiary paediatric healthcare was invited to participate in a once-off art session facilitated by an art therapist, followed by semi- structured interviews. A practical iterative framework for art-based data analysis was developed to incorporate art interpretations, semi-structured interviews and reflexive analysis. Results: As drawing is an open visual medium, a framework was developed to analyse the drawings thematically. The themes that emerged from the drawings were fitting in versus feeling different and supportive relationships. These themes highlight the contradictory experience of living with a rare disease and the role of family and friends in influencing the participants’ experiences. Conclusion: Developing an art analysis framework benefitted the thematic analysis of the participants’ drawings. This study concludes that art can help offer opportunities for children to express themselves and for health and social care professionals to understand the impact of rare diseases on their everyday lives.
Delay in seeking treatment and associated factors among women with pelvic organ prolapse in Bale Zone, Southeast Ethiopia: a hospital-based cross-sectional study
Authors: Ejigu Neway , Seyoum Kenbon , Gomora Degefa , Kene Chala , Mengistu Sheleme , Geta Girma , Abdella Mujib , Ayele Alemitu , Admasu Yaregal , Embiale Ayinamaw , Mesfin Telila , Eshetu Derese , Shifera Wondu , Wardofa Tadele , Atlaw Daniel , Sarbecha Negussie , Beressa Girma 
Published: August 2024

Background: Pelvic organ prolapse (POP) is a major reproductive health problem that severely affects women’s quality of life in several ways. Women who suffer from POP silently wait to heal from their problem without seeking care until the disease progressively worsens. Objective: The aim of this study was to assess factors associated with delay in seeking treatment among women with POP at public hospitals in Bale Zone, Southeast Ethiopia. Design: Facility-based cross-sectional study. Methods: A total of 344 study participants were enrolled at public hospitals in Bale Zone, Southeast Ethiopia, from 20 February to 20 May 2023. A consecutive sampling method was used to select the respondents. Data were collected using a pretested interviewer-administered structured questionnaire. Both bivariable and multivariable logistic regressions were used to identify the predictors of the outcome variable. Both the crude odds ratio (COR) and adjusted odds ratio (AOR) along with a 95% confidence interval (CI) were used to estimate the strength of the association between predictors and the response variable. Results: This study revealed that out of 333 participants, 76.9% (95% CI: 72.1, 81.4) were delayed in the treatment of POP. The median time of delay for POP treatments was 36 [interquartile range (IQR): 24–96] months. Being a rural resident [adjusted odds ratio (AOR) = 2.02, 95% CI: 1.23, 4.00], autonomous decision-making (AOR = 5.46, 95% CI: 2.30, 10.85), lack of support (AOR = 3.94, 95% CI: 1.64, 9.48), an embarrassment to see male health care providers (AOR = 2.04, 95% CI: 1.09, 3.81), and a lack of knowledge about successful POP treatment (AOR = 2.29, 95% CI: 1.27, 4.14) were significantly associated with delay of treatment for POP. Conclusion: A large number of women with POP did not seek health care in this study: Being in rural, autonomous decision-making, a lack of support, an embarrassment to see male health care providers, and a lack of knowledge on successful treatment were associated with treatment delay. Educating women and the community to make them aware that it is a treatable condition and encourage women’s independence in decision-making on health care services in the family will improve their quality of life.