bluuebunny/crossref_metadata_2025_split huggingface dataset:
A unique technique for thoracoabdominal aortic repair for 10 years: Normothermic iliac perfusion
Authors: Song Jian , Ji Yumeng , Hou Bin , Gao Shiqi , Zhou Chenyu , Cao Fangfang , Qiu Juntao , Yu Cuntao 
Published: August 2024

Background The modality of thoracoabdominal aortic repair (TAAR) is mainly based on left heart bypass (LHB) in western countries, while in our team, it is mainly based on a unique technique, normothermic iliac perfusion, and there is a lack of systematic reports and long-term results. To describe the operative technique and summarize the patient characteristics and outcomes of TAAR with normothermic iliac perfusion in our team in the last decade. Meanwhile, to explore the influence of different previous surgical history on prognosis. Methods 137 consecutive patients who received TAAR with normothermic iliac perfusionby single surgeon from 2012 to 2022 were retrospectively analyzed. Operative details were described and data were grouped according to previous surgical history. Early operative mortality and adverse events were summarized. Survival over time was estimated by the Kaplan–Meier curve. Results The average age of the cohort was 42.39 ± 11.76 years old, 70.07% were male. 63 (46%) patients had no previous surgery, 53 (39%) patients had total arch replacement with frozen elephant trunk (TAR_FET), and 21 (15%) patients had thoracic endovascular aortic repair (TEVAR). Operative mortality was 4.38%, the incidence of early paraplegia was 6.57%, and previous surgery had no significant effect on prognosis ( p = .294). Cumulative survival was 92.1% at 3 years and 90.8% at 5 years. Conclusions The normothermic iliac perfusionfor TAAR is feasible regardless of previous surgery, as long as there are no complicating factors. And the early outcomes are satisfactory and the long-term outcomes are reliable.
Safety of Phenobarbital Versus Benzodiazepines for Alcohol Withdrawal in Critically Ill Patients With Primary Neurologic Injuries
Authors: Deveau Robert , Wong Adrian , Eche Mary , Yankama Tuyen , Fehnel Corey R. 
Published: August 2024

Background: Alcohol withdrawal syndrome (AWS) is a complication of alcohol use disorder that manifests as a range of symptoms. Symptom-triggered benzodiazepines (BZDs) are often used as first-line treatment of AWS. However, recent literature suggests phenobarbital (PHB) may be safer and more efficacious, but studies are limited by exclusion of patients with neurological injuries. Objective: We aimed to evaluate the safety of PHB compared to BZDs for the management of AWS among patients with primary neurologic injuries. Methods: Retrospective cohort study of patients with primary neurologic injuries admitted to an ICU who received PHB or symptom-triggered BZD for AWS between December 2013 and February 2020. The primary outcome was incidence of oversedation, defined as Richmond Agitation Sedation Scale (RASS) scores from −5 to −3 within 24 hours of initial PHB or BZD dose. Secondary outcomes included largest decrease in RASS, need for mechanical ventilation, and additional sedative use within 24 hours of initial PHB or BZD dose. A multivariable analysis was performed to evaluate the association of PHB administration with the primary outcome. Results: Among 600 patients treated for AWS, 84 patients were included in our analysis (PHB, n = 56; BZD, n = 28). In the unadjusted analysis, there were no differences between the PHB and BZD groups for the primary outcome of oversedation (21.4 vs. 7.1%, P = 0.13), or secondary outcomes of decrease in RASS ( P = 0.34), or new ventilator requirement ( P = 0.55). Patients who received PHB had higher rates of additional sedative use ( P < 0.01). Multivariable regression revealed an increase in oversedation among intubated patients ( P = 0.014), while PHB administration was not independently associated with oversedation ( P = 0.516). Conclusion and Relevance Phenobarbital did not independently increase the risk of oversedation compared to BZD for AWS in patients with primary neurologic injuries. Future studies should determine optimal dosing of PHB in this population.
Use of a remote assessment pathway for diagnosis of carpal tunnel syndrome
Authors: Macdonald Katie , Pearson Hugh , Frew Georgina H. , Rust Philippa 
Published: August 2024

We undertook a retrospective cohort study of a remote carpal tunnel syndrome assessment pathway created in response to limitations caused by the COVID-19 pandemic. Between July 2020 and September 2021, 702 patients referred from primary care (general practice) were assessed in a nurse-led telephone clinic using the carpal tunnel questionnaire of Kamath and Stothard (2003) . Depending on their questionnaire score, patients were referred either for nerve conduction studies or a consultant hand surgeon review for diagnosis and treatment planning. Questionnaire scores of 3 and above accurately predicted a likely diagnosis of carpal tunnel syndrome in 83% of patients, and a diagnosis was unlikely in 90% of those with a score below 3. The pathway resulted in an estimated cost savings of £24,436 (€28,862, US$30,945) in comparison with the pre-pandemic service. However, some limitations in the pathway may have impacted effective patient management and we suggest possible improvements. Level of evidence: III
Comparing Emergency Nursing Measures Before and During COVID-19: A Retrospective Study of Assessment, Triage, and Workflow
Authors: Misan Nofar , Wilf-Miron Rachel , Saban Mor 
Published: August 2024

Background The COVID-19 pandemic significantly impacted emergency department (ED) operations and patient care. Understanding its effects on nursing processes, triage accuracy, and wait times is pivotal for optimizing outcomes. Objectives This study aimed to analyze the differences in nursing processes, triage accuracy, and wait times before and during the COVID-19 pandemic. Design A retrospective cohort study. Methods The study analyzed 224 electronic medical records from a single ED, with 120 records from the pre-pandemic period (January 2019–February 2020) and 104 records from the pandemic period (March 2020–March 2021). Dependent variables included missed nursing care per validated scales, triage accuracy per Emergency Severity Index, and wait times for nursing triage and physician examination. Independent factors encompassed sociodemographic, clinical characteristics, and organization dynamics. Results Sociodemographic and clinical profiles were comparable between periods. Triage accuracy remained high except for older patients. Nursing triage wait times differed little, yet physician examination and urgent case waits decreased amidst the pandemic. Nursing documentation completeness, such as recording patient status and mental state, augmented during this crisis period. Conclusion This evaluation identified differences in triage accuracy, wait times, and documentation completeness before and during the COVID-19 pandemic period at a single institution. Patient age and clinical status influenced some metrics. Lessons from comparing precrisis benchmarks to intra-pandemic nursing performance may guide pandemic preparedness strategies. Further research is warranted to optimize emergency processes and outcomes during public health emergencies, as well as examine strategies through multicenter investigations comparing prepandemic to intra-pandemic performance to provide broader insights into challenges and inform efforts to bolster emergency care through future crises.
Focused Extracorporeal Shock Wave Therapy for Painful Delayed Union or Nonunion of Fractures of Interphalangeal Coalition
Authors: Shimozono Yoshiharu , Mori Daisuke , Mizuno Yasuyuki , Funakoshi Noboru , Kobayashi Masahiko , Matsuda Shuichi , Yamashita Fumiharu 
Published: August 2024

Background: Interphalangeal coalition is characterized by fusion of interphalangeal joint between the middle and distal phalanges. Interphalangeal coalition fractures often result in delayed union or nonunion. The purpose of this study was to evaluate the results of focused extracorporeal shock wave therapy (ESWT) for painful delayed union or nonunion of fractures of the interphalangeal coalition. Methods: The study group consisted of 9 patients (9 feet) diagnosed with painful delayed union or nonunion due to persistent pain and no tendency toward bony union for at least 3 months after the interphalangeal coalition fracture on plain radiographs between 2021 and 2023 were included. The mean age was 51.3 years (23-64). Focused ESWT was performed in all patients. The mean time from the date of injury to the start of ESWT was 16.1 weeks (12-15). ESWT was performed every 2 weeks, with each session consisting of 3000 impulses (0.15-0.25 mJ/mm2). Plain radiographs were used to confirm bone union, and visual analog scale (VAS) scores were used for pain assessment. Results: Complete bony union was documented in all 9 patients. The application of focused ESWT was performed a mean of 2.7 times (2-4), and the mean duration from the initiation of treatment to the confirmation of bony union was 7.4 weeks (3.6-12.7). In all cases, the symptoms of swelling and pain were alleviated. The VAS scores exhibited significant improvement, with the mean VAS score decreasing from 3.8 (2-6) before ESWT to 0 after the achievement of union ( P < .001). Conclusion: In this small cohort, all patients with painful delayed union or nonunion of fractures at the interphalangeal coalitions achieved complete bony fusion after focused ESWT. Moreover, bony union was observed within 2 months of ESWT initiation. These findings suggest that focused ESWT may be a valuable treatment option for painful delayed union or nonunion of interphalangeal coalition fractures. Level of Evidence: Level IV, case series.
Association Between Klotho and Cardiac Abnormalities in Pre-dialysis CKD Patients
Authors: Kumar Manoj , Chaitanya Vinod , Verma Himanshu , Madan Charu , Ansari Anwar Hussain , Sharma Sourabh , Raju Sree Bhushan 
Published: August 2024

Introduction The onset and progression of chronic kidney disease (CKD) are strongly linked to a decrease in Klotho, which was once thought to have an anti-aging effect. The specific mechanism of this enzyme’s connection with CKD and its related co-morbidities has to be investigated further. Present study aimed to test Klotho levels in various phases of CKD and to study their correlation with cardiac morbidity. Methods Present study was single-center, observational, cross-sectional study conducted in all genders with age ≥18 years who presented with CKD stages G1-G5 ND. All cases underwent battery of investigations including estimation of serum Klotho & FGF 23 levels along with 2D echocardiography. Results Most study participants were found to be in CKD stage G2 (24%) followed by stages G4 and G5 (18% each). On cardiac evaluation, low LVEF was detected in 38% cases, diastolic dysfunction in 44% & LV hypertrophy in 48% cases. There was a negative correlation between serum Klotho levels and LVH ( P = .009), LVEF ( P = .015) or LV diastolic dysfunction ( P = .005). Likewise, there was positive correlation between serum FGF 23 levels and LVH ( P = .0001), LVEF ( P = .0001) or LV diastolic dysfunction ( P = .0001). Conclusions With our study, we want to emphasize the prognostic value of Klotho and FGF 23 in routine evaluation of CKD patients. Low serum Klotho & high FGF 23 levels were associated with low left ventricular ejection fraction (LVEF), left ventricular hypertrophy (LVH) and left ventricular dysfunction among CKD patients.
The relationship between lifestyle habits and obesity among students in the Eastern province of Saudi Arabia: using the Arab Teens Lifestyle (ATLS) questionnaire
Authors: Woodman Alexander , Coffey Margaret , Cooper-Ryan Anna-Mary , Jaoua Nizar 
Published: August 2024

Abstract
Background
The Arab Teens Lifestyle (ATLS) questionnaire was an initiative to assess the lifestyle habits influencing obesity rates in the Middle East and North Africa (MENA) region, including physical activity (PA) patterns, sedentary and eating behaviours. Since its implementation, the ATLS questionnaire has been used in several studies among different age groups and populations. This instrument has not previously been administered among the university students of the Eastern Province of Saudi Arabia, where the obesity rates are the highest in the country. This research was the first that aimed to identify lifestyle habits influencing the rates of obesity among 18-25-year-old university students in the Eastern Province of the Kingdom of Saudi Arabia (KSA) using the ATLS questionnaire.

Methods
Quantitative cross-sectional research among n = 426 students of the Eastern Province of Saudi Arabia using the ATLS questionnaire.

Results
Out of n = 426 participants, n = 200 (47%) were categorised (using body mass index) as normal weight; n = 113 (26.5%) were overweight, and n = 73 (17.1%) were obese. The findings showed that most of the nutritional, PA, and sedentary behavioural factors (e.g., screen time) in the questionnaire were not associated with obesity status amongst the participants. In the obese group, more of the males that consumed fruits, French fries, cakes, sweets and doughnuts more than three times per week were likely to be obese, which was not the case for females.

Conclusion
The reported lifestyles of the students could potentially lead to long-term negative health effects, which is of concern given the rising rates of overweight, obesity, and obesity-related non-communicable diseases (NCDs) among the Kingdom’s adult and ageing population. Further studies are recommended to explore the knowledge, attitudes, and perceptions of Saudi students in the Eastern Province in relation to PA, sedentary behaviours, and dietary habits, along with their views on how these can be improved.
Operationalisation of health equity principles in physiotherapy hospital triage policies
Authors: Pagano Lisa , Glenn Nick , Hutchinson Karen , Long Janet C. , Braithwaite Jeffrey , Sarkies Mitchell N. 
Published: August 2024

Abstract
Background
Healthcare triage policies are vital for allocating limited resources fairly and equitably. Despite extensive studies of healthcare equity, consensus on the applied definition of equity in triage remains elusive. This study aimed to investigate how the principles of equity are operationalised in Australian hospital physiotherapy triage tools to guide resource distribution.

Methods
A retrospective, qualitative content analysis of 13 triage policies from 10 hospitals across Australia was conducted. Triage policies from both inpatient and outpatient settings were sourced. Data were coded deductively using the five discrete domains of the multi-faceted operational definition of health equity posited by Lane et al. (2017): 1) point of equalisation in the health service supply/access/outcome chain, 2) need or potential to benefit, 3) groupings of equalisation, 4) caveats to equalisation, 5) close enough is good enough. Descriptive summative statistics were used to analyse and present the frequency of reported equity domains.

Results
Within the included triage tools, four out of five domains of equity were evident in the included documents to guide decision making. Allocation based on perceived patient need and overall health outcomes were the central guiding principles across both inpatient and outpatient settings. Equal provision of service relative to patient need and reducing wait times were also prioritised. However, explicit inclusion of certain equity domains such as discrimination, ensuring equal capability to be healthy and other patient factors was limited.

Conclusions
Physiotherapy triage policies consider various domains of equity to guide resource allocation decisions. Policymakers and service providers can use the insights gained from this study to review the application and operationalisation of equity principles within their healthcare systems through mechanisms such as patient triage tools.
The opioid epidemic and accessibility to free Wi-Fi: internet access is a human rights issue
Authors: Jozaghi Ehsan 
Published: August 2024

AbstractThe opioid epidemic has taken the lives of thousands of people across North America and Europe. Moreover, lack of housing, inflation, and a rapidly changing economy have affected millions of people, and many have become homeless. Many governments, researchers, health agencies, and not-for-profits have offered innovative ways to tackle this crisis, including many harm-reduction technologies that rely on Internet. In the age of the first artificial intelligence (AI) revolution, where reliance and accessibility to Internet have become a necessity for finding jobs, housing, affordable food, social services, social connection, and staying alive, the creation of free Wi-Fi zones around inner city neighborhood by towns and municipalities is not only a cost-effective way to reduce death, social costs, but a human rights issue during the initial stage of first A.I. revolution.
Doped holes and/or electrons induced superconductivity domes explained with the free volume concept
Authors: Hao Tian 
Published: August 2024

AbstractThe conductivity equation developed in our previous work without any restrictions to specific materials is employed to explore how superconductivity transition temperature $$T_{c}$$

T
c

changes with the doped hole or electron concentrations based on the free volume concept. The predicted relationship is used to fit experimental data available in the literature and a good agreement with observations is achieved. Our findings may provide an alternative explanation for doping-induced domes and/or double domes with a-dip phenomena observed among many superconductors.
Clinical Trials in Gastroesophageal Cancers: An Analysis of the Global Landscape of Interventional Trials From ClinicalTrials.gov
Authors: Falade Ayo S. , Adeoye Oluwatayo , Van Loon Katherine , Buckle Geoffrey C. 
Published: August 2024

PURPOSE To describe the global landscape of clinical research into interventions for gastroesophageal cancers (GECs), with examination of trial characteristics, geographic distribution of trial sites, and factors associated with trial termination. METHODS We queried ClinicalTrials.gov to identify all completed or terminated phase III interventional studies investigating GECs (esophageal squamous cell carcinoma [ESCC], esophageal adenocarcinoma [EAC], gastroesophageal junctional [GEJ], and gastric adenocarcinoma). Data on all reported trial characteristics were extracted. Pearson's chi-square and Fisher's exact tests were used to compare differences in completed and terminated trials. Multivariate logistic regression evaluated predictors of termination. RESULTS A total of 179 trials were identified; of these, 90% were therapeutic. Most included sites in Asia (61%) and Europe (32%); few included sites in Africa (4%). Thirty percent included sites in low- and middle-income countries (LMICs). Most (70%) focused on gastric or GEJ adenocarcinoma, 13% on EAC and ESCC, and 9% on ESCC alone. Sixteen percent (n = 29) of trials terminated prematurely. In multivariate analysis, study site number, location of recruitment sites, and patient population emerged as predictors of termination. Trials recruiting from US-based sites were more likely to terminate (odds ratio [OR], 7.22 [95% CI, 1.59 to 32.69]). Trials conducted exclusively in LMICs were less likely to terminate (OR, 0.04 [95% CI, 0.01 to 0.59] v conducted in high-income countries [HICs] alone). Studies on ESCC were more likely to terminate (OR, 17.74 [95% CI, 1.49 to 210.69]). CONCLUSION Although 80% of GECs occur in LMICs, trial activity disproportionately occurs in HICs. Few trials focus on EAC/ESCC despite being highly fatal, highlighting an unmet need. Overall, this study highlights (1) a missed opportunity to recruit patients from high-incidence regions globally; and (2) a pressing need for increasing funding, infrastructure, and support for GEC trials in LMICs.
Systematic Review on Cesarean Scar Pregnancy (CSP) Diagnosis, Treatment and Management
Authors: Marzec Marcelina Teresa , Łakoma Aleksandra , Marzec Weronika Zofia , Choiński Maciej , Wasiewicz-Ciach Paulina , Kuczyński Piotr , Marszałek Anna , Wydra-Rojek Aleksandra , Kutyła Katarzyna , Mokot Wojciech Jan 
Published: August 2024

Introduction
Cesarean scar pregnancy (CSP) is a rare but increasingly recognized complication where an embryo implants on the cesarean section scar. The incidence of CSP is rising in parallel with increasing global cesarean rates, posing significant health risks such as severe bleeding and uterine rupture. Early and accurate identification using criteria like the gestational sac's position within the scar and specific ultrasound features is crucial for preventing severe outcomes.
Aim of the Study
To evaluate the diagnostic criteria and various treatment strategies for CSP, assessing their effectiveness and challenges.
Materials and Methods
A review of the literature collected in the PubMed database was performed to gather information found under the key words cesarean scar pregnancy," “ectopic pregnancy,” "CSP treatment," "uterine artery embolization," "methotrexate," "hysteroscopy," "dilation and curettage," and "chemoembolization."

Summary
The review discusses various treatment strategies, including methotrexate administration, UAE, and surgical options like hysteroscopy and laparoscopy, highlighting their effectiveness and associated challenges. It emphasizes the importance of tailoring treatments to individual patient conditions, with newer methods like chemoembolization showing promise in minimizing complications. The findings underscore the need for a personalized treatment approach, considering patient-specific factors and health goals. Further research is needed to refine these strategies and improve outcomes for those affected by CSP.