bluuebunny/crossref_metadata_2025_split huggingface dataset:
Healthcare Worker Attitudes to Living Donation Prior to Planned Withdrawal of Care
Authors: Rath Smruti , Luo Claire , Washburn Laura , Price Matthew Brent , Goss Matthew , Moolchandani Priyanka , Parsons Sandra , Rana Abbas , Goss John , Galván Nhu Thao Nguyen 
Published: July 2024

Background and Aims:
This study assesses the attitudes of healthcare practitioners toward Living Donation Prior to Planned Withdrawal of Care (LD-PPW): the recovery of a living donor organ before withdrawal of life-sustaining measures in a patient who does not meet criteria for brain death, but for whom medical care toward meaningful recovery is deemed futile.

Methods:
An electronic survey was administered to 1735 members of the American Society of Transplant Surgeons mailing list with 187 responses (10.8%).

Results:
Data from this study revealed that 70% of responding practitioners agreed with LD-PPW due to principles of beneficence and autonomy. Also, 65% of participants felt confident in their ability to declare the futility of care and 70% felt that LD-PPW should be added as an option when registering to become an organ donor.

Conclusion:
Currently, nearly half of all donation after circulatory determination of death do not proceed to donation. LD-PPW has been proposed as an alternative procedure targeted at increasing the quality and quantity of transplantable organs while respecting the donor’s right to donate, though its implementation has been hindered by concerns over public and provider perception. This study revealed support for LD-PPW among healthcare practitioners as an alternative procedure to increase the quality and quantity of transplantable organs while respecting the donor’s right to donate.
A Retrospective Study of Ballistic Pelvic Fractures With Focus on Short-Term Clinical Outcomes
Authors: Benson Dillon , Goldberg Ellen , Christiano Anthony , Erdman Mary-Kate , Lee Adam , Strelzow Jason 
Published: July 2024

OBJECTIVES:
To evaluate the orthopaedic management, associated injuries, and outcomes in patients treated for low-velocity ballistic pelvic fractures.

METHODS:

Design:
Retrospective chart review.

Setting:
Single, urban, Level I trauma center.

Patient Selection Criteria:
Patients 15 years or older treated for low-velocity ballistic pelvic (OTA/AO 61 and 62) fractures from May 2018 to August 2021.

Outcome Measures and Comparisons:
Primary study measures included pelvic fracture location, concomitant associated injuries, surgical interventions, and antibiotic treatment. Postinjury sequelae evaluated include infection, neurologic deficit, and need for orthopaedic removal of foreign body. Risk factors of postinjury sequelae were investigated.

RESULTS:
A total of 156 patients with ballistic pelvic fractures were included. The cohort consisted of 135 (86.5%) male patients with a mean age of 29.8 years. One hundred ten (70.5%) patients sustained 2 or more gunshot wounds. Ninety-eight (62.8%) patients underwent an exploratory laparotomy with 79 (50.6%) having a confirmed concomitant intestinal injury. Additional associated injuries included nerve injury (13.5%), vascular injury requiring repair or embolization (10.9%), and bladder injury (10.3%). Nine (5.7%) patients underwent orthopaedic operative management—five (3.2%) patients for operative fixation and 4 (2.5%) patients for removal of intra-articular foreign bodies. Diabetes (odds ratio [OR]: 33.1, P = 0.025), neurologic deficit on presentation (OR: 525.2, P < 0.001), vascular injury requiring repair or embolization (OR: 8.7, P = 0.033), and orthopaedic pelvic fixation (OR: 163.5, P = 0.004) were positively associated with the defined postinjury sequelae at 30 and 90 days of follow-up. There was not a statistically significant association between infection and retained foreign body (OR: 3.95 [95% CI 0.3–58.7, P = 0.318]) or bowel contamination (OR: 6.91 [95% CI 0.4–58.7, P = 0.178]).

CONCLUSIONS:
Ballistic fractures of the pelvis and acetabulum rarely required operative fixation (3.2%) or irrigation and debridement. Neither retained foreign body nor presumed bowel contamination of pelvic fractures had a statistically significant association with infection, which further supports conservative management of these injuries. Patients with diabetes, neurologic deficit on presentation, vascular injury necessitating intervention, and orthopaedic fixation of pelvic fracture are associated with increased risk of postinjury sequelae.

LEVEL OF EVIDENCE:
Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
High-Energy Transsyndesmotic Ankle Fracture Dislocation—Does Deltoid Ligament Repair Influence the Progression of Posttraumatic Arthritis in Logsplitter Injuries?
Authors: Sogbein Olawale A. , Saad Lorenzo , Barton Kristen I. , Halai Mansur , Sanders David W. , Lawendy Abdel Rahman , MacLeod Mark , Del Balso Christopher 
Published: July 2024

OBJECTIVE:
To determine the effect of deltoid ligament repair on the development of posttraumatic arthritis in logsplitter ankle injuries.

METHODS:

Design:
Retrospective cohort.

Setting:
Academic, Level I trauma center.

Patient Selection Criteria:
Patients ≥18 years of age with logsplitter injuries (OTA/AO 44B, 44C) treated with open reduction internal fixation (ORIF) with or without deltoid ligament repair from January 2008 to October 2021.

Outcome Measures and Comparison:
The rate of posttraumatic arthritis (PTOA) development at the final follow-up (minimum 6 months) after ORIF was evaluated using the Kellgren–Lawrence scale. The achievement of acceptable reduction indicated by articular reduction <2 mm, and a medial clear space ≤4 mm was assessed at 6 weeks postoperatively with weight-bearing radiographs. The effect of deltoid ligament repair on the development of PTOA was investigated.

RESULTS:
Fifty-nine patients aged 49.1 ± 17.2 years met inclusion criteria with a mean follow-up of 16.6 months (range = 6 to 96). Twenty-six of 59 patients (44%) had developed PTOA at the final follow-up. Acceptable reduction was achieved in 83.1% (49/59) of fractures. The acceptable reduction rate in fractures undergoing deltoid ligament repair was 100% versus 78% in those without deltoid ligament repair (13/13 vs. 36/46, P = 0.017). The rate of PTOA development was significantly lower in patients who underwent deltoid ligament repair (15%) than those who did not (52%), P = 0.026. Patients who underwent deltoid ligament repair had a significantly reduced rate of PTOA development leading to arthrodesis compared with those who did not (0% vs. 17%, P = 0.013).

CONCLUSIONS:
Logsplitter injuries resulted in a high rate of development of posttraumatic arthritis. An acceptable reduction is required to minimize the risk of development of PTOA and progression to arthrodesis. Deltoid ligament repair during ORIF may facilitate acceptable reduction and decrease the rate of PTOA and progression to arthrodesis in these injuries.

LEVEL OF EVIDENCE:
Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
From maca to marijuana: cultural influences on joint pain symptoms and management in urban perimenopausal and early postmenopausal Latinas
Authors: Cortés Yamnia I. , Altemus Margaret , Reame Nancy E. 
Published: July 2024

Abstract

Objective
The purpose of this qualitative study was to explore the symptom experience and coping strategies for managing joint pain during the menopause transition in urban Latina women.

Methods
We conducted focus groups with 13 English-speaking peri and early postmenopausal Latinas living in Upper Manhattan in New York City in 2014. Eligible participants were self-identified Latinas aged 45 to 60 years with new onset or worsening joint pain and spontaneous amenorrhea, recruited through flyers and snowball sampling. Focus group interviews conducted in English were audiotaped, transcribed, and analyzed by a bilingual research team, using NVivo software (QSR International) to organize and code themes.

Results
On average, participants were aged 51.7 ± 4.8 years and overweight (body mass index of 29.3 ± 6.7 kg/m2); 10 (76.9%) were Puerto Rican, and the last menstrual period was 1 month to 5 years ago. The following four themes emerged: 1) menopause and joint pain are an alarming package; 2) pain disrupts life and livelihood; 3) medical management is unsatisfactory and raises worries about addiction; and 4) home remedies for coping with pain—from maca to marijuana. Despite access to a world-class medical facility in their neighborhood, women seeking pain relief preferred to self-manage joint pain with exercise, over-the-counter products, and other culturally valued home remedies. Many suffered through it.

Conclusions
For midlife Latinas, joint pain symptoms may emerge or worsen unexpectedly as part of the menopause transition and carry distressing consequences for daily activities and quality of life. There is a need to develop more culturally specific approaches for menopause-related pain management in this underserved population.
Public awareness and provider counseling regarding postmenopausal bleeding as a symptom of endometrial cancer
Authors: Wise Meredith K. , Schefter Alexandra M. , Brill Joshua , Bharucha Kharmen A. , Tessier Katelyn M. , Terrell Carrie A. , Erickson Britt K. 
Published: July 2024

Abstract

Objectives
Our study aims to understand public knowledge of postmenopausal bleeding as an endometrial cancer symptom and how past provider counseling on postmenopausal bleeding affects knowledge and care-seeking behaviors related to postmenopausal bleeding.

Methods
This was a cross-sectional survey study of people assigned female at birth. Study participants were recruited at a university research facility located at the Minnesota State Fair in September 2021. Participants answered questions about demographics, endometrial cancer knowledge, whether they had received counseling about postmenopausal bleeding, and whether and when they would present for care after experiencing postmenopausal bleeding.

Results
Six hundred forty-eight surveys were completed and included in analyses. Sixty-three percent of participants identified postmenopausal bleeding as a symptom of endometrial cancer. Those who correctly selected this symptom were more likely to be born in the United States, have a college education or higher, and have private insurance. Of the 145 postmenopausal participants, 46.5% reported that their provider counseled them on postmenopausal bleeding. Fifty-nine percent of the postmenopausal participants reported that they would tell their provider if they had postmenopausal bleeding after only one episode.

Conclusions
There is a need for increased recognition of postmenopausal bleeding and provider counseling on postmenopausal bleeding, and educational interventions should focus on public and provider awareness of endometrial cancer risks and symptoms.
Genomic and transcriptomic analyses of chemical hepatocarcinogenesis aggravated by oncoprotein loss
Authors: Wang Xinyi , Liu Yingluo , Zhang Shuo , Zhang Jiemeng , Lin Xiaoxue , Liang Yan , Zong Min , Hanley Kaisa L. , Lee Jin , Karin Michael , Feng Gen-Sheng 
Published: July 2024

Background and Aims:
The chemical carcinogen diethylnitrosamine (DEN) is often used to induce HCC in mice. Curiously, several labs have reported that the removal of oncoproteins from hepatocytes exacerbated DEN-induced HCC, with mechanisms unknown. This study aimed at deciphering molecular mechanisms underlying the tumor suppressive effect of oncoproteins.

Approach and Results:
We generated mutant mouse lines with hepatocyte-specific deletions of Met, Ptpn11/Shp2, Ikkβ, or Ctnnb1/β-catenin and assessed DEN-induced tumorigenesis in the wild-type and mutant mice. To systematically examine genetic and molecular signaling alterations, we performed whole exome and RNA-sequencing on liver samples collected at the pre-cancer and established cancer stages. Although the mutational profiles of DEN-induced tumors were barely different in wild-type and mutant mice, oncoprotein ablation increased DEN-induced mutational burdens, especially in Shp2-deficient tumors. RNA-sequencing revealed multiple changes in signaling pathways, in particular, upregulated epithelial-mesenchymal transition, cell migration, and tumor metastasis, as well as downregulated small molecule metabolism that was affected by oncoprotein ablation. We identified key molecules and pathways that are associated with hepatic innate immunity and implicated in liver tumorigenesis. In addition, we unveiled markedly changed expression of a few miRNAs in the human HCC database.

Conclusions:
The aggravation of DEN-induced HCC progression seen on oncoprotein ablation could be caused by common and distinct genomic and signaling alterations. This study reveals a new level of complexity in hepatocarcinogenesis and elucidates molecular mechanisms underlying tumor evolution and recurrence.
Attitudes and Behaviors Regarding Compliance With Contact Lens Wear and Care Among Contact Lens Users at a University Hospital in Turkey
Authors: Oruz Oğuzhan , Harbiyeli İbrahim İnan , Erdem Elif , Yağmur Meltem , Ateş Eylem Gül 
Published: July 2024

Objectives:
To investigate the level of compliance with contact lens (CL) care habits among CL wearers of different age and occupation groups.

Methods:
This survey study included 205 CL wearers followed in the tertiary reference center between 2016 and 2022. The survey was employed to probe each user's demographic data and noncompliant behaviors. To this end, the study compared CL compliance levels of patients in different age and occupation groups.

Results:
There were 85 (41.5%) patients in the good compliant group, 72 (35.1%) in the average compliant group, and 48 (23.4%) in the poor compliant group. The most common noncompliant behavior was disruption of aftercare visits. Except for two noncompliant behaviors (storage of fresh lens solution and exceeding the recommended lens case replacement time), other noncompliant behaviors were found more frequently in the ≤25 age group. The differences between the age groups were significant in hand washing and water activities (P=0.004 and P=0.023, respectively). Exceeding lens replacement time and sleeping with lenses criteria were found to be significantly noncompliant in health care workers compared to non-health care workers (P=0.006 and P=0.001, respectively). The level of compliance was found to be lower in users with 6 to 7 days of CL use per week than in those with fewer days (P=0.006).

Conclusion:
We found that the compliance rate was lower in younger patients and health care workers. We also observed that long-term use of CL reduces the level of compliance. Therefore, it might be necessary to focus on modifiable risk factors in these patient groups.
A Systematic and Critical Review on the Anatomy of the Ethmoidal Foramina
Authors: Durante Miriam , Bonente Denise , Fagni Niccolò , Mandalà Marco , Barone Virginia , Nicoletti Claudio , Bertelli Eugenio 
Published: July 2024

Purpose:
The osteologic anatomy of the orbit is still a field of intense research, particularly as far as vascular channels are concerned. Among them, ethmoidal foraminas (EFs) are certainly those that have more clinical importance and indeed have been deeply investigated. Unfortunately, the vast production of articles, far from clarifying their anatomy, generated a certain degree of confusion.

Methods:
A search on Pubmed and Scopus databases updated up to December 31, 2023, has been carried out with the keyword “ethmoidal foramen” yielding a list of 357 items. With a careful screening process, 31 articles were enlisted to be included in the present review.

Results:
A critical review process confirmed that many results published over the years appear inconsistent, particularly as far as EFs topography is concerned. The possible reasons for this lack of consistency can be traced back to inter-ethnical differences, uncertainty on the anterior bony landmarks employed in the investigations, and lack of a general consensus over EFs classification. A novel approach, based on the normalization of the distance of the anterior landmarks relative to the length of the orbit (relative depth index), should overcome some of the major problems encountered so far.

Conclusions:
Novel and clear guidelines to classify EFs and to locate them on the medial wall are required. Determining the relative depth index of EFs may be an interesting approach to solve the matter. Other methods can be also devised. However, direct measurements from bony landmarks, without any further analysis seem inadequate and possibly misleading
The effect of dexamethasone and bupivacaine on postoperative pain and nausea and vomiting by preperitoneal nerve blocking in laparoscopic cholecystectomy: a randomized clinical trial
Authors: Eslamian Mohammad , Sheikhbahaei Erfan , Esparham Ali , Zefreh Hamidreza , Fasahat Amirhossein , Firouzfar Alireza , Talebzadeh Hamid 
Published: July 2024

Background:
This study aims to examine the effects of preperitoneal administration of dexamethasone and bupivacaine surrounding laparoscopic trocars on postoperative pain (POP) and nausea and vomiting (PONV) in patients undergoing laparoscopic cholecystectomy (LC).

Method:
In this randomized triple-blinded trial with a 1:1 randomization ratio, 104 patients with chronic cholecystitis were candidates for elective LC. A total of 40 mg (8 ml) of bupivacaine was mixed with 8 mg (2 ml) of dexamethasone or normal saline. The solution was injected preperitoneally via an 18G needle parallel and lateral to trocars until a bulge in the interior surface of the parietal peritoneum was observed by the camera. Primary outcomes were the severity of POP based on 0–10 Likert visual analog scale (VAS) and rates of PONV and secondary outcomes were rate of postoperative opioid usage and any side-effects.

Result:
The mean VAS score was significantly lower in the dexamethasone group (3.5 vs. 6.2, P<0.001). The dexamethasone group had 46.2% and 26.9% lower rates of nausea and vomiting after LC compared to the other group (P=0.001 and 0.015, respectively). Postoperative opioid use was lower in the dexamethasone group, but its difference was insignificant (P=0.3).

Conclusions:
Preperitoneal dexamethasone injection around laparoscopic trocars may lower the intensity of POP and PONV rates. Perioperative local corticosteroids can be used as an effective, available, and inexpensive analgesic and antiemetic prevention for laparoscopic procedures.
A cross-sectional study measuring the magnitude of depression and associated factors among patients attending orthopedic outpatient clinic at Ambo University Referral Hospital, Ambo Town, Oromia, Ethiopia, 2023
Authors: Duresa Daditau B. , Benti Tsegaye , Birhanu Adamu , Teshome Zenebe B. , Mulugeta Wondwossen 
Published: July 2024

Background:
Depression is a leading cause of major public health problems globally, and its frequency has been increasing, particularly in low-income and middle-income countries. The prevalence of depression in sub-Saharan Africa ranges from 15 to 30%. In Ethiopia, depression is found to be the seventh leading cause of disease burden, yet no study was done in West Shewa, Ethiopia. Therefore, this study aimed to assess the magnitude of depression and associated factors among adult orthopedic outpatients getting treatment at Ambo University Referral Hospital, West Shewa, Oromia, Ethiopia, in 2023.

Methods:
An institution-based cross-sectional study was conducted among 391 adult orthopedic patients from January 1–30, 2023. A systematic random sampling technique was used to select the study subjects. The data were collected by using a structured questionnaire and checklist through face-to-face interviews and chart review techniques. The collected data were entered into Epi-data, version 4.6, and then exported to SPSS, version 26.0, for statistical analysis. The binary logistic regression model was fitted, and both bivariable and multivariable logistic regression analyses were employed.

Result:
The magnitude of depression was found to be 38.9% (95% CI: 34.5%, 43.9%), being female [adjusted odds ratio (AOR)=2.41; 95% confidence interval (CI): 1.45–4.00], chewing chat (AOR=2.39; 95% CI: 1.29–4.43), and no disorder on the lower limb (AOR=0.24; 95% CI: 0.07–0.85), had ligament injury (AOR=2.62; 95% CI: 1.23–5.59), had no complication (AOR=0.07; 95% CI: 0.01–0.52), and had amputation (AOR=3.83; 95% CI: 2.09–7.00) were significantly associated with depression.

Conclusion and recommendation:
The study found that the prevalence of depression among orthopedic patients was considerable; nearly half of the participants developed depression at Ambo University Referral Hospital, and being female, chewing chat, having no disorder on the lower limb, having a ligament injury, having a complication, and being amputated were significantly associated with depression. Therefore, due attention is needed from concerned bodies in order to tackle this problem.
Assessment of predictive value of thyromental height in predicting difficult laryngoscopy compared with Mallampati, and thyromental distance among surgical patient who will take general anesthesia at selected governmental hospital cross-sectional study: Ethiopia, 2022
Authors: Ashebir Zewetir , Fentie Fissiha , Mohammed Zebiba 
Published: July 2024

Background:
Anesthesiologists must always perform a preoperative airway examination to identify individuals who will have challenging laryngoscopy. In an effort to identify the most accurate airway predictor, numerous authors have evaluated a number of predictive assays. Thyromental height test (TMHT), a new airway predictor, has recently been demonstrated to have good predictive value in determining difficult airways. This study’s main objective was to assess the diagnostic effectiveness of the TMHT and compare it to other known airway predictors, such as the modified Mallampati test (MMT) and the thyromental distance (TMD).

Objective:
To assess the predictive value of TMHT in predicting difficult laryngoscopy compared to modified MMT and TMD among patients who will take general anesthesia.

Method:
In this prospective, observational study, which took place from March 2021 to May 2021, 247 people of either sex who were older than 18 but not more than 65 and scheduled for elective surgery under general anesthesia participated. The receiver operating characteristic (ROC) curve was used to identify the proper cut-off values for TMHT, and the Fisher exact test was used to calculate the correlation.

Result:
Incidence of Difficult laryngoscopy was 13.4%. For TMHT the cut-off values were 4.9 cm and it had a sensitivity of 78.8%, a specificity of 89.7%, a positive predictive value (PPV) of 54.2%, and a negative predictive value (NPV) of 96.5%, respectively. When compared to other parameters, like TMD, and MMT. TMHT had the highest sensitivity, specificity, PPV, and NPV. (P<0.000)

Conclusion and recommendation:
Of all the airway assessments, the TMHT had the highest accuracy and odds ratio for predicting difficult laryngoscopy with the highest odds ratio and accuracy. TMHT has to be validated in broader patient groups because it appears to be a possible single anatomical marker for predicting the likelihood of a difficult laryngoscopy. It needs more research because it isn’t assessed in pediatrics and pregnant women.