bluuebunny/crossref_metadata_2025_split huggingface dataset:
Perceived mental health skills and competence among occupational health physicians
Authors: Majuri M , Malin M , Antila A , Luukkonen R , Palosaari M , Reijula K 
Published: August 2024

Abstract

Background
Mental-health-based consultations in occupational health (OH) are increasing due to ongoing changes in working life.

Aims
We studied the self-assessed mental health competence of trainees and trainers in OH specialist physician training.

Methods
We conducted an online survey from June to August 2022. We analysed how trainees and trainers in OH assessed their own competence in mental health practice with N (%) and means (standard deviation [SD]). We analysed the underlying assumptions about competences specific to OH using an explanatory factor analysis. We applied the Kruskal–Wallis test to determine differences between trainees and trainers using the variables in the factor analysis.

Results
Respondents’ perceptions of mental health competence were more positive among trainers (mean 3.97, SD 0.72) than trainees (mean 3.66, SD 1.08, P = 0.2123). Based on trainee physicians’ own assessments, more experience increases competence, until after 7 years, when the perceived competence seems to decrease. The trainer physicians’ self-assessed mental health competence decreased over time. With factor analyses, we identified five competence factors: general mental health, workplace risks and resources, rehabilitation, promotion and prevention, and special skills. In our results, individual-level mental health competences such as work ability evaluation and to manage return-to-work processes were evaluated better than community-based proactive processes.

Conclusions
Physicians in OH specialist physician training self-assessed their mental health competence better at the employee level than at the workplace level. Based on our results, we need to develop the curriculum of OH specialist physician training to meet the needs of working life in support of mental health.
Hepatocyte MMP14 mediates liver and inter-organ inflammatory responses to diet-induced liver injury
Authors: Kelly Shannon C , Higgins Cassandra B , Sun Jiameng , Adams Joshua A , Zhang Yiming , Ballentine Samuel , Miao Yong , Cui XiaoXia , Milewska Małgorzata , Wandzik Ilona , Yoshino Jun , Swarts Benjamin M , Wada Shun-ichi , DeBosch Brian J 
Published: August 2024

Abstract
The matrix metalloproteinase MMP14 is a ubiquitously expressed, membrane-bound, secreted endopeptidase that proteolyzes substrates to regulate development, signaling, and metabolism. However, the spatial and contextual events inciting MMP14 activation and its metabolic sequelae are not fully understood. Here, we introduce an inducible, hepatocyte-specific MMP14-deficient model (MMP14LKO mice) to elucidate cell-intrinsic and systemic MMP14 function. We show that hepatocyte MMP14 mediates diet-induced body weight gain, peripheral adiposity, and impaired glucose homeostasis and drives diet-induced liver triglyceride accumulation and induction of hepatic inflammatory and fibrotic gene expression. Single-nucleus RNA sequencing revealed that hepatocyte MMP14 mediates Kupffer cell and T-cell accumulation and promotes diet-induced hepatocellular subpopulation shifts toward protection against lipid absorption. MMP14 co-immunoprecipitation and proteomic analyses revealed MMP14 substrate binding across both inflammatory and cytokine signaling, as well as metabolic pathways. Strikingly, hepatocyte MMP14 loss-of-function suppressed skeletal muscle and adipose inflammation in vivo, and in a reductionist adipose–hepatocyte co-culture model. Finally, we reveal that trehalose-type glucose transporter inhibitors decrease hepatocyte MMP14 gene expression and nominate these inhibitors as translatable therapeutic metabolic agents. We conclude that hepatocyte MMP14 drives liver and inter-organ inflammatory and metabolic sequelae of obesogenic dietary insult. Modulating MMP14 activation and blockade thus represents a targetable node in the pathogenesis of hepatic inflammation.
Neurodiversity in the healthcare profession
Authors: Johnson Jo-Anne , Ahluwalia Sanjiv 
Published: August 2024

Abstract
The term neurodiversity was coined in the 1990s to describe a diversity in thinking, learning, and processing the world around us, and is associated with strengths as well as challenges. Rates of diagnosis of neurodivergent conditions are rising rapidly amongst patients and healthcare professionals, largely due to a recent surge in awareness and understanding of neurodiverse conditions and more inclusive diagnostic criteria. Societal adaptation, however, has lagged, and likely explains some of the psychosocial comorbidities of neurodiversity, as individuals are forced to adapt their personality and how they display their emotions to fit societal norms. There remains a lack of awareness and understanding of neurodiversity amongst the healthcare professions. There is also very limited published literature on the challenges and strengths of this group in the clinical environment. Here, we use a case study, focusing on attention deficit hyperactivity disorder to explore the relationship between neurodiversity and work from the perspective of a neurodiverse health care professional. We challenge the notion that neurodiversity itself is a disability, but more likely a result of lack of societal awareness and adaption. We suggest accommodations and training in the clinical environment to raise awareness and support neurodiverse healthcare professionals in order that they flourish rather than struggle in the workplace.
Human Papillomavirus Vaccination in the Postpartum Period
Authors: Brenner Sara E. , Modesitt Susan , Bednarczyk Robert A. , Dilley Sarah E. 
Published: August 2024

OBJECTIVE:
To assess whether routine postpartum human papillomavirus (HPV) vaccination is acceptable and feasible and to identify key themes and strategies that can be used to increase postpartum HPV vaccination rates.

DATA SOURCES:
PubMed and ClinicalTrials.gov were queried from inception to July 2024 for postpartum and HPV vaccination. Studies were limited to human subjects and the English language.

METHODS OF STUDY SELECTION:
Screening was performed for studies of any method that evaluated HPV vaccination in the postpartum period (N=60). Only original research that reported either uptake or acceptability of the HPV vaccine was included. Thirty-nine studies were eliminated after abstract review because they did not meet the inclusion criteria.

TABULATION, INTEGRATION, AND RESULTS:
Nine studies were categorized according to the primary aim of the study (defining the problem, assessing patient perspectives, or testing interventions to increase vaccination) and demonstrated that postpartum HPV vaccination programs can significantly increase HPV vaccination rates and are feasible and acceptable to patients.

CONCLUSION:
Incorporating HPV vaccination into standard postpartum care provides an opportunity to reach vulnerable patient populations, reduces cost for patients, and has the ability to prevent HPV-related cancers.
Effects of Minimally Invasive Versus Open Pancreatoduodenectomy on Short-Term Surgical Outcomes and Postoperative Nutritional and Immunological Statuses: A Single-Institution Propensity Score-Matched Study
Authors: Yumoto Shinsei , Hayashi Hiromitsu , Mima Kosuke , Ogawa Daisuke , Itoyama Rumi , Kitano Yuki , Nakagawa Shigeki , Okabe Hirohisa , Baba Hideo 
Published: August 2024

Objective:
To evaluate the feasibility and clinical impact of minimally invasive pancreatoduodenectomy (MIPD) versus open pancreatoduodenectomy (OPD) on postoperative nutritional and immunological indices.

Background:
The surgical advantages of MIPD over OPD are controversial, and the postoperative nutritional and immunological statuses are unknown.

Methods:
In total, 306 patients who underwent MIPD (n = 120) or OPD (n = 186) for periampullary tumors from April 2016 to February 2024 were analyzed. Surgical outcomes and postoperative nutritional and immunological indices (albumin, prognostic nutritional index [PNI], neutrophil-to-lymphocyte ratio [NLR], and platelet-to-lymphocyte ratio [PLR]) were examined by 1:1 propensity score matching (PSM) with well-matched background characteristics.

Results:
PSM resulted in 2 balanced groups of 99 patients each. Compared with OPD, MIPD was significantly associated with less estimated blood loss (P < 0.0001), fewer intraoperative blood transfusions (P = 0.001), longer operative time, shorter postoperative hospital stay (P < 0.0001), fewer postoperative complications (P = 0.001) (especially clinically relevant postoperative pancreatic fistula [P = 0.018]), and a higher rate of textbook outcome achievement (70.7% vs 48.5%, P = 0.001). The number of dissected lymph nodes and the R0 resection rate did not differ between the 2 groups. In elective cases with textbook outcome achievement, the change rates of albumin, PNI, NLR, and PLR from before to after surgery were equivalent in both groups.

Conclusions:
MIPD has several surgical advantages (excluding a prolonged operative time), and it enhances the achievement of textbook outcomes over OPD. However, the postoperative nutritional and immunological statuses are equivalent for both procedures.
Large-scale HEV genotype 3 outbreak on New Caledonia Island
Authors: Abravanel Florence , Vignon Clémence , Mercier Ambroise , Gaumery Jean-Baptiste , Biron Antoine , Filisetti Clément , Goujart Marie-Amélie , Colot Julien , Chamillard Xavier , Demortier Justine , Raz Maxime , Boutet Catherine , Dupont Laura , Duval Sylvie , Castric Catherine , Desoutter Denise , Desoutter Anais , Verge Marjorie , De Smet Clémentine , Demmou Sofia , Lhomme Sébastien , Gourinat Ann-Claire , Nicot Florence , Izopet Jacques 
Published: August 2024

Background and Aims:
Several symptomatic cases of HEV infections were reported to the New Caledonia Island Public Health Service between August and December 2023. This prompted epidemiological and virological investigations to identify the source of infection.

Approach and Results:
HEV RNA was assessed in symptomatic patients, various food items, and pig farms on the Island. HEV strains were characterized by sequencing. A seroprevalence study was also conducted on asymptomatic blood donors before and after the outbreak. One hundred twenty-seven symptomatic cases were reported. Hospitalization was required for 29/127 patients (22.8%). Hospitalized patients presented more frequently with comorbidities, including liver and cardiovascular diseases (80.7% vs. 27%, p < 0.01), and 3 persons died (2.3%). Among the 100 HEV RNA-positive samples received at the French National Reference Centre for HEV, viral sequencing was possible for 76 samples. All strains were identified as HEV genotype 3, and 74/76 strains were grouped together (nucleotide identity: 98%–100%). Full-length sequencing indicated a new HEV-3 subtype within HEV-3 subclade abk. Only genotype 3f strains were detected on the Island’s pig farms. No food items tested positive for HEV RNA. The seroprevalence of HEV IgG and IgM in blood donors was 9.2% (9/98) and 0%, respectively, in 2020, rising to 17.3% (17/98) and 2% (2/98) in 2024.

Conclusions:
Although all previous large-scale epidemics in Asia and Africa were associated with HEV-1 or 2, the New Caledonia outbreak was linked to HEV-3. A high number of symptomatic cases were admitted to the hospital, with a case-fatality rate of 2.3%.
A case report of a bleeding case after removal of chest drain after lung surgery
Authors: Liang Qichen , He Baoyu , Zhang Bin , Zhang Ziteng 
Published: August 2024

Rationale:
Postoperative bleeding after lobectomy is relatively rare. By analyzing and discussing the case history and management of hemorrhagic shock caused by chest tube removal after lobectomy, we can achieve the purpose of preventing postoperative bleeding after thoracic surgery and reducing postoperative complications, which can help avoid the risk of second surgery, shorten the patient’s hospital stay, reduce the cost of medical care, and improve the patient’s quality of life.

Patient concerns:
A case of bleeding from tube removal after lobectomy. The bleeding from chest drain removal on the 3rd day after thoracoscopic lobectomy resulted in hemorrhagic shock, which was stopped by thoracoscopic exploration again under active antishock, and there was no recurrence of bleeding after the operation, and the patient was discharged from the hospital after chest drain removal.

Diagnoses:
Enhanced computed tomography of the chest revealed a space-occupying lesion in the middle lobe of the right lung.

Interventions:
Thoracoscopy was performed again on the condition of active anti-shock.

Outcomes:
On the third day after thoracoscopic lobectomy, the patient underwent removal of the chest drain and subsequently experienced hemorrhagic shock. Given the necessity of maintaining anti-shock measures, the patient was subjected to a second thoracoscopic exploration with the objective of halting the hemorrhage. Following this procedure, the patient did not present with any further episodes of bleeding. Subsequently, a new chest drain was placed, and once the drainage flow had diminished to an acceptable level, the chest drain was removed. The patient subsequently made a full recovery and was discharged from the hospital.

Lessons:
Even if the safely inserted drain tube is removed, the thoracic surgeon must be aware of possible vascular bleeding.
Comparison of the efficacy and safety of different puncture routes for ultrasound-guided fascia iliaca compartment block for early analgesia after hip arthroplasty: A meta-analysis
Authors: Yang Zhi , Xu Wang , Xu Shan 
Published: August 2024

Background:
This study aimed to compare the effect of ultrasound-guided fascia iliaca compartment block with different puncture sites on postoperative analgesia in patients undergoing hip arthroplasty.

Methods:
We searched the PubMed, Web of Science, EBSCO, Wiley Library, Embase, China National Knowledge Infrastructure, and Wanfang databases for literature on ultrasound-guided fascia iliaca compartment block through different puncture sites in hip replacement patients. The software package R (4.2.1) was used in the meta-analysis.

Results:
The meta results showed the suprainguinal approach (SA) puncture pathway had a significantly longer operative time than the infrainguinal approach (IA) pathway (mean deviation [MD] = 0.97, 95% confidence interval [CI] [0.09, 1.84], P < .01) when performing orthopedic surgery. In terms of nerve block efficacy, only the block rates of the obturator nerve, lateral femoral cutaneous nerve, and femoral nerve groups did not show significant differences between the SA and IA pathways. In contrast, the results of the Meta combined effect size of visual analogue scale scores during postoperative activity showed that the SA puncture pathway significantly reduced patients’ pain scores compared with the IA pathway at the T1 (3–6 h) and T2 (8 h) time points (MD = −0.39, 95% CI [−0.77, −0.01], P = .04 in the T1 group; MD = −0.58, 95% CI [−0.95, −0.21], P < .01). The differences in pain scores at the T3 (12 h) and T4 (24 h) time points were not significant, and in terms of adverse reaction rates, the differences in the incidence of pruritus, sedation, urinary retention, and nausea and vomiting were not significant.

Conclusions:
This study demonstrates that the SA puncture pathway has a significant advantage over the IA pathway in reducing active pain in early postoperative pain management without increasing the risk of adverse events. This finding supports the prioritization of SA pathway in clinical practice where postoperative pain control is considered. Future research should continue to explore the use of SA pathway in different patient populations and types of surgery, as well as their impact on long-term postoperative recovery, with the aim of optimizing individualized postoperative pain management strategies.
Efficacy and safety of therapeutic vaccines for the treatment of chronic hepatitis B: A systematic review and meta-analysis of randomized controlled trials update
Authors: Geta Mekuanint , Mengistu Getachew , Yizengaw Endalew , Manyzewal Tsegahun , Hailu Asrat , Woldeamanuel Yimtubeznash 
Published: August 2024

Background:
Most people diagnosed with chronic hepatitis B (CHB) need treatment to help reduce the risk of liver disease and limit disease transmission. Therapeutic vaccine (TV) candidates have been under study for their clinical effects on inducing HBV-specific host immune responses. This review aimed to systematically synthesize updated evidence on the efficacy and safety of TVs in patients with CHB.

Methods:
This systematic review was performed by searching different databases from January to February 2021. Completed randomized controlled trials that reported TVs' efficacy and/or safety for treating CHB compared with the standard of care (SOC) or placebo were included. Efficacy and safety estimates were reported as the logarithm of the odds ratio and risk differences, respectively. I
2 > 50% was considered significant heterogeneity. Significant publication bias was considered when Egger’s test P value < .10. The risk of bias was assessed using the Cochrane Risk of Bias tool. The GRADE methodology was used to assess the certainty of the evidence for each outcome.

Results:
Twenty-four articles with 2889 pooled samples were included. TVs made a significant difference in hepatitis B envelope antigen (HBeAg) SC (log OR = 0.76, P = .01) and (log OR = 0.40, P = .03) compared to placebo and combination therapy, respectively. HBeAg SC was significantly affected by TVs at the end of follow up (log OR = 0.49, P = .01), with significant HBsAg mean difference (MD = −0.62, P = .00). At the end of treatment, the TVs had no significant effect on HBV DNA negativity over the SOC (log OR = 0.62, P = .09) or placebo (log OR = −0.07, P = .91). TVs do not significantly affect the risk of serious adverse events (RD 0.02, 95% CI 0.00–0.04).

Conclusion:
In patients with CHB, TVs had significant effects on HBeAg SC compared to the SOC or placebo. There was no significant difference between serious adverse events. TVs are promising treatment strategy to overcome CHB.
“Muscle foreshortening after free gracilis transfer for smile: Where, when, why?”
Authors: Yver Christina M. , McGonagle Elizabeth R. , Hadlock Tessa A. 
Published: August 2024

Background:
Gracilis free muscle transfer (GFMT) remains the standard for smile restoration in patients with long-standing facial palsy. Resting oral commissure lateralization (ROCL) following GFMT is aesthetically unappealing and can cause functional problems including dysarthria and oral incompetence. The risk factors for ROCL following GFMT are poorly understood.

Methods:
Of all patients who underwent GFMT for smile restoration from 2003 – 2021, patients with subsequent ROCL were identified from a facial nerve database using pre-determined search criteria. Medical records were reviewed to identify potential risk factors for muscle foreshortening.

Results:
Of 412 patients who underwent successful GFMT since 2003, we identified 41 (10%) patients who subsequently developed ROCL. ROCL rates varied significantly based on gracilis innervation source, with ipsilateral CN VII innervation and dual-innervation (cross-facial nerve graft (CFNG) plus ipsilateral nerve-to-masseter (NTM)) demonstrating the highest foreshortening rates (27.3% and 15.4%, respectively), compared to the lowest rates of foreshortening when gracilis was innervated by CNFG alone (3.2%), p=0.005. Patients with a history of radiation to the surgical field were significantly more likely to develop ROCL (22%) compared to those without a history of radiation (8.6%), p<0.001. Furthermore, the rate of ROCL was significantly higher among patients who underwent concurrent stabilization of the nasolabial fold using a wide band of fascia lata (20.8%) compared to those who did not (6.6%), p<0.001.

Conclusions:
Herein we report potential risk factors for ROCL following GFMT for smile restoration, including innervation source, radiation history, and concurrent fascia lata static suspension.
Shorter Drainage Tube to the Pancreatic Stump Reduces Pancreatic Fistula After Distal Pancreatectomy
Authors: Nagaoka Tomoyuki , Sakamoto Katsunori , Ogawa Kohei , Hikida Takahiro , Ito Chihiro , Iwata Miku , Sakamoto Akimasa , Shine Mikiya , Nishi Yusuke , Uraoka Mio , Honjo Masahiko , Tamura Kei , Takada Yasutsugu 
Published: August 2024

Background:
We investigated the relationship between the length of a prophylactic closed-suction drainage tube and clinically relevant postoperative pancreatic fistula (CR-POPF) in distal pancreatectomy (DP).

Materials and Methods:
The clinical data of 76 patients who underwent DP using a reinforced stapler for the division of the pancreas at Ehime University Hospital between December 2017 and May 2023 were retrospectively analyzed. Laparoscopic DP was performed in 41 patients (53.9%). Closed-suction drainage was performed using a 19 Fr ExuFlow Round Drain with a vacuum bulb. The drainage tube length was defined as the distance between the peripancreatic stump site and the abdominal wall insertion site using abdominal radiography.

Results:
CR-POPF was observed in 12 patients (15.8%). Univariate analyses demonstrated that male sex (P=0.020), American Society of Anesthesiologists Physical Status (P=0.017), current smoking (P=0.005), and drainage tube length (P<0.001) were significantly associated with CR-POPF. The optimal cut-off value of drainage tube length for CR-POPF was 220 mm (area under the receiver operating characteristic curve=0.80). In multivariate analyses, drainage tube length (≥220 mm) was the sole independent predictor for CR-POPF (odds ratio, 6.59; P=0.023). According to computed tomography performed ∼1 week after surgery, the median volume of peripancreatic fluid collection was significantly higher in the long drainage tube group than in the short drainage tube group (P<0.001).

Conclusion:
A drainage tube inserted at a shorter distance to the pancreatic stump may reduce the incidence of CR-POPF after DP.