bluuebunny/crossref_metadata_2025_split huggingface dataset:
Outcomes of press-fit radial head arthroplasty in unconstructable radial head fractures with associated elbow injuries: An average 5-year follow up
Authors: Eyre-Brook AI , Kankanalu P , Majkowski L , Zreik N , Jones V , Thyagarajan DS , Ali AA , Booker SJ 
Published: August 2024

Aims Unstable and nonreconstructable radial head fractures require radial head arthroplasty (RHA) to restore stability. Multiple implant designs are available with varying survival rates (76 to 97%). There is concern that loosening of the press-fit stems leads to implant failure. We review our outcomes using the Acumed press-fit prosthesis for trauma. Methods Between February 2008 and November 2020, all primary RHA for trauma from a single-centre were reviewed. Primary outcome was implant survivorship. Secondary outcome were clinical, radiographic and patient related outcome measures. Results In total, 96 cases were included. Seven revisions were recorded, all within 24-months of implantation. Kaplan–Meier estimated 10-year survival was 92.1% (95% confidence interval (CI) 84.0–96.1%). Median follow-up time was 5.7 years (Interquartile range (IQR) 3.2–8.5 years). Median Oxford Elbow Score was 43 (IQR 29–46) for and median Mayo Elbow Performance Score was 90 (IQR 72–100). 72% were able to fully-return to pre-injury activities. Radiographic analysis identified osteolysis around radial neck (48%), loosening (32%), valgus stem position (20%), heterotopic ossification (16%) and capitellar erosion (15%). No radiological findings were associated with long-term poor clinical outcomes. Conclusion Our study demonstrates an excellent survival of press-fit RHA of 92.1% at 10-years. No radiographic features on follow-up were associated with poorer patient recorded outcome measures.
Mental Healthcare Consumers’ Experiences of Mental Health Care: Variation in Knowledge by the Family Members and Support
Authors: Shimange Mihloti E. , Shilubane Hilda Nwamuhohova , Ndou Nthomeni Dorah , Mulondo Adrinah Seani 
Published: August 2024

Introduction Knowledge and support by members of the family towards the care of the consumers of mental health services is the core priority and is noticeable by the users as it gives and eases the life of the users during therapy and rehabilitation. However, there have been documented instances of families that neglect their relatives with mental illnesses. Objective This study explored the experiences of mental healthcare consumers regarding family members’ knowledge of mental disorders and support. Methods Participants who were granted leave of absence were selected through nonprobability, purposive sampling. Data were collected using face-to-face unstructured discussions. Data were analyzed using Colaizzi's technique. Results Findings revealed misconceptions versus insight on the cause of mental disorders, knowledge deficit on the effect of treatment, poor support from family members, financial challenges perceived as a source of poor support, and lack of psychological support and its consequences. Mental healthcare consumers verbalized limited support from family members. They reported variation in terms of family members' knowledge of their mental condition. Conclusion Training family members on mental health illness is critical to the future of health care as there will be no misunderstanding between them and the consumers of mental health care. Healthcare consumers’ feelings of sadness and anxiety could be avoided by avoiding conflicts over their social grants. The government should invest in assisting family members of mental healthcare consumers.
Exploring the Association Between Behavioural Modification in Response to the Prevailing Economic Crisis and Mental Health Outcomes of Nurses from Teaching Hospitals, Sri Lanka
Authors: Senevirathne C.P , Senarathne L. , Fernando M. 
Published: August 2024

Introduction The nursing profession is a cornerstone in the healthcare workforce. Yet, it remains vulnerable to severe mental health challenges, stemming from a complex interplay of social and occupational factors. It is evident that crisis situations have profound influence on the mental-wellbeing of nurses. Objective To explore the association between behavioural modification in response to the prevailing economic crisis and mental health outcomes of nurses from teaching hospitals, Sri Lanka. Methods This cross-sectional study was carried out among nursing professionals ( n = 261) who are employed in distinct teaching hospitals ( n = 7) in Sri Lanka. Considering the bed-capacity of each hospital, participants were purposively selected and invited to complete an online-based self-administered questionnaire to collect demographic characteristics and lifestyle modifications to deal with the economic crisis, while Depression, Anxiety, and Stress Scale (DASS-21) a set of three self-reported scales to assess the level of depression, anxiety, and stress, was used. Data was analyzed using the SPSS 23.0 version, Descriptive analysis was performed to present frequencies of both demographic characteristics and lifestyle and symptoms of depression, anxiety, and stress, while the Chi-square test was used to determine the association between selected independent variables and mental health outcomes. A multivariate regression model was performed to determine the predictors of mental health outcomes of the study participants. Results There were a total of 261 participants, 86.2% were married, and 66.2% had children. The proportion of mild to extreme depression, anxiety, and stress were 58.2%, 65.9%, and 72.0% respectively. In response to the economic challenges, 91.6% of study participants reported reducing expenditures on general household needs, while the proportion of participants who curtailed spending on food, monthly savings, and entertainment were 75.9%, 79.3%, and 73.6% respectively. Notably, 81.6% of participants initiated the process of applying for overseas employment, and 50.6% pursued academic programs to be eligible for foreign placements. Conclusion The present study observed a higher level of depression, anxiety and stress among nurses from teaching hospitals in Sri Lanka. It was noted that nurses had taken steps to respond to financial strain by reducing essential elements of their routine. Additionally, study participants chose to seek foreign placements as a solution to the economic burden, as a result just over half of the respondents completed an academic program in order to be qualified for jobs abroad. Further, these initiatives are significantly associated with negative emotional disorders of the participants. Therefore, interventions should be implemented to promote positive mental health outcomes of nursing professionals in Sri Lanka.
Designing an Interdisciplinary Health Course: A Qualitative Study of Undergraduate Students’ Experience of Interdisciplinary Curriculum Design and Learning Experiences
Authors: Mirbahai Leda , Noordali Farhan , Nolan Helen 
Published: August 2024

OBJECTIVES Research into interdisciplinary education, where concrete examples and empirical evidence of interdisciplinary teaching is explored, is limited. Furthermore, there are no standardized guidelines on best practices for designing and implementing an interdisciplinary curriculum. Recently, in healthcare settings there has been a drive to adopt interdisciplinary or transdisciplinary practices, creating a need for training individuals capable of working across discipline-specific boundaries, or to even adopt a transdisciplinary practice. This is partially attributed to recognizing that local and global complex health challenges are interlinked and share common factors and often require a new integrated approach to management. In response, a new interdisciplinary course using a modified snowflake model of interdisciplinary course design was launched at a medical school. The course aimed to provide a broad foundation for lifelong learning with a strong emphasis on the development of knowledge, skills, and professional values essential for interdisciplinary and transdisciplinary practice in applied health promotion for individuals and society. METHODS A semi-structured focus group with students ( n = 15% of the inaugural cohort) having completed at least 1 year of the course was undertaken to investigate student perspectives on best approaches for the development and delivery of interdisciplinary learning and teaching. RESULTS Results highlighted the importance of providing training and opportunity for students to practice integration within the curriculum. Additionally, it was noted that including a module to introduce students to different disciplines and guiding students to explore their inherent interconnectedness is essential in helping them develop interdisciplinary thinking and skills. Crucially, the role of integrated assessments was also recognized as fundamental for demonstrating and practicing interdisciplinarity. CONCLUSION Overall, this study provides valuable insights and recommendations for educators with the objective of developing interdisciplinary learning in new or existing higher education courses or those seeking to prepare learners for contemporary and emergent societal challenges more generally.
Dysregulated lipid metabolism and intervertebral disc degeneration: the important role of ox-LDL/LOX-1 in endplate chondrocyte senescence and calcification
Authors: Bing Tan , Shanlin Xiang , Jisheng Wang , Jie Hao , Ruichao Cao , Zhiwei Zhang , Bin Yu , Zhaoxin Ma , Zhenming Hu , Nian Zhou 
Published: August 2024

Abstract
Background
Lipid metabolism disorders are associated with degeneration of multiple tissues and organs, but the mechanism of crosstalk between lipid metabolism disorder and intervertebral disc degeneration (IDD) has not been fully elucidated. In this study we aim to investigate the regulatory mechanism of abnormal signal of lipid metabolism disorder on intervertebral disc endplate chondrocyte (EPC) senescence and calcification.

Methods
Human intervertebral disc cartilage endplate tissue, cell model and rat hyperlipemia model were performed in this study. Histology and immunohistochemistry were used to human EPC tissue detection. TMT-labelled quantitative proteomics was used to detect differential proteins, and MRI, micro-CT, safranin green staining and immunofluorescence were performed to observe the morphology and degeneration of rat tail intervertebral discs. Flow cytometry, senescence-associated β-galactosidase staining, alizarin red staining, alkaline phosphatase staining, DCFH-DA fluorescent probe, and western blot were performed to detect the expression of EPC cell senescence, senescence-associated secretory phenotype, calcification-related proteins and the activation of cell senescence-related signaling pathways.

Results
Our study found that the highly expressed oxidized low-density lipoprotein (ox-LDL) and Lectin-like oxidized low-density lipoprotein receptor 1 (LOX-1) in human degenerative EPC was associated with hyperlipidemia (HLP). TMT-labelled quantitative proteomics revealed enriched pathways such as cell cycle regulation, endochondral bone morphogenesis and inflammation. The rat model revealed that HLP could induce ox-LDL, LOX-1, senescence and calcification markers high expression in EPC. Moreover, we demonstrated that ox-LDL-induced EPCs senescence and calcification were dependent on the LOX-1 receptor, and the ROS/P38-MAPK/NF-κB signaling pathway was implicated in the regulation of senescence induced by ox-LDL/LOX-1 in cell model.

Conclusions
So our study revealed that ox-LDL/LOX-1-induced EPCs senescence and calcification through ROS/P38-MAPK/NF-κB signaling pathway, providing information on understanding the link between lipid metabolism disorders and IDD.
Repeated complete atrioventricular block during remifentanil administration in a pediatric patient with brain tumor and acute hydrocephalus: a case report
Authors: Ura Akihiro , Fujii Keisuke , Tanioku Tadashi , Kawamata Tomoyuki 
Published: August 2024

Abstract
Background
Remifentanil, an ultra-short-acting µ-opioid receptor agonist, is commonly used for anesthetic management due to excellent adjustability. Remifentanil is known to cause sinus bradycardia, however, because it has a direct negative chronotropic effect on the cardiac conduction system and there is an indirect negative chronotropic effect via the parasympathetic nervous system.

Case presentation
An 8-year-old Japanese boy was diagnosed with acute hydrocephalus due to a brain tumor in the fourth ventricle and underwent emergency surgery. Imaging examination showed brainstem compression. Endoscopic third ventriculostomy and ventriculoperitoneal shunt surgery were scheduled. Remifentanil was started during induction of general anesthesia, but electrocardiogram showed sinus bradycardia, then Wenckebach-type atrioventricular block, and then complete atrioventricular block. Remifentanil was immediately discontinued, and we administered atropine sulfate. Complete atrioventricular block was restored to sinus rhythm. When remifentanil was restarted, however, the electrocardiogram again showed sinus bradycardia, Wenckebach-type atrioventricular block, and then complete atrioventricular block. Remifentanil was again immediately discontinued, we administered adrenaline, and then complete atrioventricular block was restored to sinus rhythm. Fentanyl was used instead of remifentanil with continuous infusion of dopamine. There has since been no further occurrence of complete atrioventricular block.

Conclusions
This is the first known case of complete atrioventricular block in a pediatric patient with increased intracranial pressure seemingly caused by administration of remifentanil.
Development of a short-term prognostic model for anti-N-methyl-D-aspartate receptor encephalitis in Chinese patients
Authors: Zhang Jingxiao , Li Yatong , Liu Lei , Dai Feifei , Peng Yujing , Ma Qiuying , Li Lin , Hong Yu , Liu Aihua , Zhang Xinghu , Wang Xiaohui , He Junying , Bu Hui , Guo Yanjun , Jiang Hanqiu , Cui Shilei , Sun Houliang , Wang Jiawei 
Published: August 2024

Abstract
Background
Recognizing the predictors of poor short-term prognosis after first-line immunotherapy in patients with anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis is essential for individualized treatment strategy. The objective of this study was to ascertain the factors that forecast short-term prognosis in patients with anti-NMDAR encephalitis, develop a prognostic prediction model, and authenticate its efficacy in an external validation cohort. Further, all patients were followed-up long-term to assess the factors of long-term outcome and relapses.

Methods
A prospective enrollment of patients diagnosed with anti-NMDAR encephalitis was conducted across five clinical centers in China from June 2014 to Mar 2022. The enrolled patients were divided into the derivation and validation sets based on enrollment time. The short-term prognostic model was visualized using a nomogram. Further, all patients were followed-up long-term to assess the factors of long-term outcome.

Results
This study found that poor short-term prognosis was a risk factor for poor long-term outcome (6-month prognosis, OR 29.792, 95%CI 6.507-136.398, p < 0.001; 12-month prognosis, OR 15.756, 95%CI 3.384–73.075, p < 0.001; 24-month prognosis, OR 5.500, 95%CI 1.045–28.955, p = 0.044). Abnormal behavior or cognitive dysfunction (OR 8.57, 95%CI 1.48–49.79, p = 0.017), consciousness impairment (OR19.32, 95%CI 3.03-123.09, p = 0.002), autonomic dysfunction or central hypoventilation (OR 5.66, 95%CI 1.25–25.75, p = 0.025), CSF pleocytosis (OR 4.33, 95%CI 1.48–12.65, p = 0.007), abnormal EEG (OR 5.48, 95% CI 1.09–27.54, p = 0.039) were independent predictors for a poor short-term prognosis after first-line immunotherapy. A nomogram that incorporated those factors showed good discrimination and calibration abilities. The area under the curve (AUC) for the prognostic model were 0.866 (95%CI: 0.798–0.934) with a sensitivity of 0.761 and specificity of 0.869.

Conclusion
We established and validated a prognostic model that can provide individual prediction of short-term prognosis after first-line immunotherapy for patients with anti-NMDAR encephalitis. This practical prognostic model may help neurologists to predict the short-term prognosis early and potentially assist in adjusting appropriate treatment timely.
Association of serum homocysteine with vitamin B12 and folate levels in women with pre-eclampsia in a tertiary health care center in Nepal
Authors: Yadav Binod Kumar , Maskey Suvana , Bhattarai Aseem , Pradhananga Salina , Shakya Sabina , Regmi Astha 
Published: August 2024

AbstractBackgroundPre-eclampsia is a syndrome that chiefly includes the development of new-onset hypertension and proteinuria after 20 weeks of pregnancy. Pre-eclampsia is one of the major causes of mortality and morbidity in Nepal. Hyperhomocysteinemia may be a cause of the endothelial dysfunction provoked by oxidative stress in pre-eclampsia. This study was designed to evaluate the association of homocysteine with Vitamin B12 and folate in patients with pre-eclampsia.MethodAn observational cross sectional study was performed in the Gynecology and Obstetrics Department of TUTH involving seventy two subjects with pre-eclampsia. Blood pressure, urinary protein levels, serum homocysteine, Vitamin B12 and folate levels were compared in both mild and severe forms of pre-eclampsia. Concentration of Vitamin B12 and folate were measured using Vitros ECI and homocysteine was measured using CLIA. SPSS 23.0 was used to analyze the data. Tests were performed with Mann Whitney Test and Spearman’s rank correlation test. A p-value < 0.05 was considered statistically significant.ResultsThis study showed no significant difference in age and weeks of gestation in both mild and severe forms of pre-eclampsia. Mean concentration of homocysteine was higher (13.1 ± 6.4 micromol/L) in severe Pre-eclampsia as compared to mild cases (7.6 ± 2.8 micromol/L). Mean concentration of folate was lower in severe cases (35.4 ± 24.1 micromol/L) when compared with mild cases of pre-eclampsia (57 ± 23.4 micromol/L).ConclusionHomocysteine levels were increased in severe Pre-eclampsia when compared with mild pre-eclampsia and this finding can be used to predict and prevent complications in patients with pre-eclampsia.
miR-1915-3p regulates megakaryocytic and erythroid differentiation by targeting SOCS4
Authors: Yuan Xin , Liu Pengcong , Xu Lei , Liang Liqing , Dong Qian , Fan Tao , Yue Wen , Qu Mingyi , Pei Xuetao , Xie Xiaoyan 
Published: August 2024

Abstract
Background
Proper control of the lineage bias of megakaryocytic and erythroid progenitor cells (MEPs) is of significant importance, the disorder of which will lead to abnormalities in the number and function of platelets and erythrocytes. Unfortunately, the signaling pathways regulating MEP differentiation largely remain to be elucidated. This study aimed to analyze the role and the underlying molecular mechanism of miR-1915-3p in megakaryocytic and erythroid differentiation.

Methods
We utilized miRNA mimics and miRNA sponge to alter the expression of miR-1915-3p in megakaryocytic and/or erythroid potential cells; siRNA and overexpression plasmid to change the expression of SOCS4, a potential target of miR-1915-3p. The expression of relevant surface markers was detected by flow cytometry. We scanned for miR-1915-3p target genes by mRNA expression profiling and bioinformatic analysis, and confirmed the targeting by dual-luciferase reporter assay, western blot and gain- and lost-of-function studies. One-way ANOVA and t-test were used to analyze the statistical significance.

Results
In this study, overexpression or knockdown of miR-1915-3p inhibited or promoted erythroid differentiation, respectively. Accordingly, we scanned for miR-1915-3p target genes and confirmed that SOCS4 is one of the direct targets of miR-1915-3p. An attentive examination of the endogenous expression of SOCS4 during megakaryocytic and erythroid differentiation suggested the involvement of SOCS4 in erythroid/megakaryocytic lineage determination. SOCS4 knockdown lessened erythroid surface markers expression, as well as improved megakaryocytic differentiation, similar to the effects of miR-1915-3p overexpression. While SOCS4 overexpression resulted in reversed effects. SOCS4 overexpression in miR-1915-3p upregulated cells rescued the effect of miR-1915-3p.

Conclusions
miR-1915-3p acts as a negative regulator of erythropoiesis, and positively in thrombopoiesis. SOCS4 is one of the key mediators of miR-1915-3p during the differentiation of MEPs.
Identifying the essential elements to inform the development of a research agenda for Paramedicine in Ireland: a Delphi Study
Authors: Bowles Kelly-Ann , Batt Alan M. , O’Toole Michelle , Knox Shane , Hemingway Liam , Williams Julia , Williams Brett , Cummins Niamh M. 
Published: August 2024

Abstract
Background
Paramedicine is a dynamic profession which has evolved from a “treat and transport” service into a complex network of health professionals working in a diverse range of clinical roles. Research is challenging in the paramedicine context, and internationally, research capacity and culture has developed slowly. International examples of research agendas and strategies in paramedicine exist, however, research priorities have not previously been identified in Ireland.

Methods
This study was a three round electronic modified Delphi design which aimed to establish the key aspects of the research priorities via end-user consensus. Participants included interested stakeholders involved in prehospital care or research in Ireland. The first round questionnaire consisted of open-ended questions with results coded and developed into themes for the closed-ended questions used in the second and third round questionnaires. A consensus level of 70% was set a priori for second and third rounds.

Results
Research Priorities that reached consensus included Staff Wellbeing, Education and Professionalism and Acute Medical Conditions. Respondents indicated that these three areas should be a priority in the next 2 years. Education, Staffing and Leadership were imperative Key Resources that required change. Education was a Key Processes change deemed imperative to allow the future research to occur. Outcomes that should be included in the future research strategy were Patient Outcomes, Practitioner Development, Practitioner Wellbeing, Alternate Pathways, Evidence-based Practice and Staff Satisfaction.

Conclusion
The results of this study are similar to previously published international studies, with some key differences. There was a greater emphasis on Education and Practitioner Wellbeing with the latter possibly attributed to the timing of the research in relation to the COVID-19 pandemic. The disseminated findings of this study should inform sustainable funding models to aid the development of paramedicine research in Ireland.