bluuebunny/crossref_metadata_2025_split huggingface dataset:
Analysis of Barriers to Medical Opioid Pain Medication Using the Japanese Version of the Barriers Questionnaire II (JBQ-II): Pharmacists and Nurses Perspective in Japan
Authors: Chisaki Yugo , Oomoto Mika , Sakurano Yuika , Imanishi Takashi 
Published: May 2024

Background Some Japanese patients with cancer pain have negative beliefs regarding opioid therapy. The Japanese version of the Barriers Questionnaire II (JBQ-II) determines barriers to cancer pain management. Few studies reported JBQ-II scores in Japan, and none focused on pharmacists. Accordingly, we aimed to explore the relationship between health care professionals’ knowledge of and willingness to use opioids, and their JBQ-II scores. Additionally, the variances in JBQ-II scores among nurses, hospital pharmacists, and pharmacy pharmacists were assessed. Methods This cross-sectional survey employed the JBQ-II for nurses and pharmacists in hospitals and pharmacies across Japan. Participants were requested to respond to the JBQ-II concerning their affiliation, knowledge of opioid analgesics, and willingness to utilize these drugs for medical practice. Results A total of 55 hospital pharmacists, 25 pharmacy pharmacists, and 24 nurses responded to the survey. The group-knowledgeable about medical use of narcotics had significantly lower total JBQ-II scores (25.43, standard deviation [SD]: 15.11) than those had by the group with insufficient knowledge (34.50, SD: 18.41). There was no statistically significant difference in total JBQ-II scores among those willing to use opioids medically. The total JBQ-II scores of hospital pharmacists, pharmacy pharmacists, and nurses were 31.00 (SD: 15.11), 33.96 (SD: 19.25), and 27.21 (SD: 15.56), respectively. However, the differences were not statistically significant. Conclusions Health care professionals in Japan with knowledge about opioids for medical purposes had a significantly lower total JBQ-II score than those with insufficient knowledge. Thus, health care professionals’ knowledge plays a crucial role in reducing barriers to using narcotic drugs.
Effect of Elevated Blood Glucose on Postoperative Complications Among Diabetic Patients After Surgical Treatment of Torsional Ankle Fracture
Authors: Chen Dong , Liu Shenghe , Liu Pei , Song Wenqi 
Published: May 2024

Background: This study aims to evaluate the association of elevated blood glucose and postoperative complications among diabetic patients after surgical treatment of torsional ankle fracture. Methods: This was a retrospective study of consecutive diabetic patients treated surgically for a torsional ankle injury between January 2017 and December 2021 at a large tertiary hospital. All patients who met inclusion and exclusion criteria were divided into a high-HbA1c group or a low-HbA1c group according to the HbA1c cutoff of 7.0% within 3 months of operation, then a propensity score match was performed to control potential confounding factors. The primary outcomes were postoperative complications, and secondary outcomes were unplanned secondary procedures. Results: A matched cohort of 238 patients was finally included, with 119 patients with high HbA1c levels and 119 with low HbA1c levels. Patients with high HbA1c levels experienced more complications (31.1% vs 18.5%, P < .01) and more secondary procedures (22.7% and 8.4%, P < .01) than those with low HbA1c levels. Multivariate logistic regression indicated that patients with high HbA1c levels were significantly associated with higher proportions of any complications (OR 2.25, 95% CI 1.08-4.69; P = .03), superficial infection (OR 4.03, 95% CI 2.13-5.41; P < .01), deep infection (OR 1.42, 95% CI 1.23-2.02; P < .01), and any unplanned secondary operations (OR 3.72, 95% CI 1.62-8.52; P < .01) compared with those with low HbA1c levels after controlling for potential confounders. Multivariate linear regression showed that high HbA1c levels were significantly associated with a higher number of complications (β = 4.61, 95% CI 2.63-18.18; P < .01) and a higher number of secondary procedures (β = 4.44, 95% CI 2.79-10.87; P < .01). Conclusion: Patients with an HbA1c >7.0% within 3 months of operation are more likely to have a wound issue/infection and more likely to undergo a secondary procedure after surgical treatment of torsional ankle fractures in diabetic patients than patients with an HbA1c ≤7.0% within 3 months of operation.
Comparative analysis of track damping effect of structure jointly constructed by subway tunnels and high-rise buildings
Authors: Zhang Song , Liu Bo , Wang Kun , Yan Yinan , Fan Huanhuan , Pan Yue 
Published: May 2024

The joint construction of subways and other public buildings is a relatively newer type of construction. There is little research experience in the vibration characteristics and track damping design for this type of structure. In this study, a field test was adopted to conduct site measurement analysis on the vibration response of the joint construction project consisting of a subway tunnel and a building with typical frame structures. Numerical simulation methods were also adopted to, respectively, assume the use of ordinary tracks and steel-spring floating slab tracks for the subway for the situation where the Cologne-egg high-elastic fasteners were used on the track for damping purposes. Comparisons were performed to analyze the difference in the system vibration response between three different types of track. The results showed that the high-elastic fastener track and floating slab track both have a certain degree of damping effect compared with an ordinary track. Specifically speaking, the former has a damping advantage for frequency bands below 20 Hz, while the latter has the advantage for frequency bands above 20 Hz under the impact of the structural vibration characteristics for this joint construction. For this jointly construction structure, affected by the natural vibration characteristics of the structure, the natural frequency of the floating slab track is within 4 ∼ 10 Hz, and the similar vibration reduction effect can be achieved. This indicates that the structural vibration characteristic of the jointly constructed structure is an important factor determining the appropriate natural frequency of the floating slab track.
Endovascular Salvage of Type Ia and Ib Endoleaks Using a Physician-Modified Fenestrated/Branched Endograft and an Iliac Branch Device Via Unilateral Transfemoral Arterial Access
Authors: Gittinger Mackenzie , Nguyen Trung , Jokisch Christine , Parikh Rajavi S. , Shames Murray , Arnaoutakis Dean J. 
Published: May 2024

Purpose: This study aims to explore the feasibility and effectiveness of a unilateral transfemoral access endovascular salvage technique for complex abdominal aortic aneurysms with concurrent type Ia and Ib endoleaks following previous endovascular repair. Case Report: A 69-year-old female with multiple comorbidities presented with an extent IV thoracoabdominal aortic aneurysm complicated by type Ia and Ib endoleaks and chronically occluded left iliac endoprosthesis after prior endovascular repair. Given the patient’s medical complexities, open explant repair was deemed high risk. The case was successfully managed using a physician-modified fenestrated/branched endograft (PM-F/BEVAR) and an iliac branch device (IBD) deployed through a single percutaneous transfemoral access. Conclusion: The presented case demonstrates the safety and efficacy of PM-F/BEVAR with concomitant IBD deployment via unilateral transfemoral access. This innovative approach allows endovascular salvage in cases with restricted iliofemoral access and avoids the complexities associated with upper extremity or aortic arch manipulation. While acknowledging the technical challenges, this technique offers a viable alternative for salvaging failed endovascular repairs, emphasizing the importance of real-time modifications in achieving successful outcomes. Further studies and long-term follow-up are warranted to validate the broader applicability and durability of this approach in the management of complex abdominal aortic aneurysms with multiple endoleaks. Clinical Impact Although not the conventional approach, unilateral transfemoral access can be utilized to implant either a physician-modified fenestrated aortic endograft or an iliac branch device. Such an approach avoids complicating issues related to upper extremity access. This innovative technique may be necessary when there is a failed prior EVAR in the setting of significant contralateral iliofemoral occlusive disease. Doing both procedures in the same setting to resolve a type Ia and Ib endoleak is feasible as demonstrated in this case report. Expanding the endovascular armamentarium to address EVAR failure will be increasingly useful in the future, especially given the morbidity profile of EVAR explantation.
3-Year Outcomes for Degenerative Mitral Regurgitation Repair in a Medicare Population
Authors: Thourani Vinod H. , James Edelman J. , Murphy Shannon M. E. , Vemulapalli Sreekanth , Moore Matt , Gammie James S. , Nguyen Tom C. 
Published: May 2024

Objective: Mitral valve repair (MVr) has become the standard therapy for degenerative mitral regurgitation (DMR), but real-world late mortality, reintervention, and readmission data are lacking. This study estimates MVr outcomes for DMR to 3 years in the Medicare fee-for-service population. Methods: There were 4,219 DMR patients older than 65 years undergoing MVr within the Medicare 100% standard analytic file from October 2015 to December 2018 who were evaluated. Outcomes were analyzed for isolated MVr patients ( n = 2,433) and patients undergoing MVr with certain concomitant procedures: MVr + tricuspid valve surgery (TVS; n = 619), MVr + cardiac ablation (CA; n = 540), and MVr + left atrial appendage closure ( n = 627). Outcomes over a 3-year period included all-cause mortality, reintervention, rehospitalization, and common complications. All outcomes were modeled with adjustments for patient demographics and comorbid conditions. Results: The average age for all patients was 71.9 ± 5.2 years. Adjusted all-cause mortality and MV reintervention (surgery or transcatheter) at 3 years for the primary cohort of isolated MVr was 3.5% and 1.6%, respectively. Directionally higher mortality at 3 years was observed in patients with concomitant TVS or CA. All-cause readmission and cardiac readmission for isolated MVr was 37.0% and 14.1%, with the highest rates for those with concomitant TVS or CA. Acute kidney injury and stroke/transient ischemic attack were the most common adverse events over 3 years for all patients. Conclusions: The 3-year mortality and reintervention rates in Medicare patients undergoing degenerative MVr are low. Those undergoing concomitant TVS or CA had directionally higher mortality and cardiac readmission rates. These results help refine outcome benchmarks as new transcatheter MVr procedures continue to emerge.
Two Miniplates Versus Three Dimensional Plate in Management of Mandibular Condylar Fractures: A Systematic Review and Meta-Analysis
Authors: Kuna Santhosh Kumar , Jain Anuj , Kuna Vishala 
Published: May 2024

Study Design Systematic Review and Meta-analysis. Objective This systematic review and meta-analysis aimed to compare the efficacy of 2 miniplates vs a three-dimensional plate in the management of mandibular condylar fractures. The primary objective was to assess key parameters, including intraoperative time, maximum mouth opening, complications, and functional outcomes, to determine potential differences between the 2 fixation methods. Methods A comprehensive literature search was conducted to identify relevant studies. Inclusion criteria were applied, and the selected studies underwent systematic review. The key parameters were extracted and subjected to meta-analysis to quantify and compare the outcomes associated with the use of 2 miniplates and three-dimensional plates. The methodologies of the included studies were critically evaluated to address potential biases and confounding factors. Results The meta-analysis results indicated that there were no statistically significant differences between the 2 fixation methods in terms of intraoperative time, maximum mouth opening, complications, and functional outcomes. However, concerns were raised regarding the high risk of bias, confounding factors, and considerable heterogeneity observed across the reviewed studies. Conclusions The findings suggest that both 2 miniplates and three-dimensional plates are viable options for the management of mandibular condylar fractures. Despite the lack of statistical significance in the observed differences, the study highlights the need for further prospective research with enhanced methodologies, standardized protocols, larger sample sizes, and reduced bias to refine our understanding and potentially influence clinical management protocols.
Evaluating the efficacy of a modified mindfulness program in enhancing psychosocial wellbeing and cognitive functions of community dwelling older adults
Authors: Foo Samuel Dun Hai , Tham Leanne Li Yan , Tay Kirsten Anne Yu En , Koo Isabel Yi Xuan , Ong Jin En , Chee Chew Sim 
Published: May 2024

Objective To assess the effects of a modified Mindfulness for Senior Wellbeing (MSW) program on older adults’ psychosocial wellbeing (flourishing, sleep quality, self-transcendence, purpose and meaning) and cognitive functions (working memory, episodic memory, speed of processing, cognitive flexibility). Methods Twenty-eight community dwelling older adults were recruited to participate in the 5-week mindfulness training out of which nineteen (mean age = 69.7 years) who met the training requirements were included in the data analysis. Due to practical limitations, a single-group pre–post study design was adopted. Participants completed the outcome measures before and after the training program. Results Participants experienced significant improvements in their levels of mindfulness, sleep quality, and some aspects of cognitive functions (working memory, episodic memory, cognitive flexibility), and reduced worrying thoughts related to a financial subscale of flourishing. Other outcome measures showed slight improvements albeit not statistically significant. Conclusion Taken together, these preliminary findings shed light on the feasibility and potential of the locally tailored mindfulness program to bring about positive benefits to the older adults.
Improvements in sleep problems and their associations with mental health symptoms: A study of children and adolescents participating in a digital mental health intervention
Authors: Lawrence-Sidebottom Darian , Huffman Landry Goodgame , Beam Aislinn , Parikh Amit , Guerra Rachael , Roots Monika , Huberty Jennifer 
Published: May 2024

Objective A growing number of youth are utilizing digital mental health interventions (DMHIs) for treatment of mental health problems such as anxiety, depression, and ADHD. Although these mental health symptoms are closely related to sleep problems, it is unknown whether nonsleep DMHIs indirectly confer improvements in sleep. Using retrospective data, the current study assesses (1) whether youth sleep problems improve over participation in a nonsleep DMHI, and (2) whether mental health symptom severity and improvement are correlated with sleep problem severity over time. Methods Sleep problems and mental health symptoms were assessed every 30 days among children (ages 5–12) and adolescents (ages 13–17) participating in a pediatric digital mental health intervention (DMHI; N = 1219). Results Children and adolescents with elevated sleep problems (39.3%; n = 479) were older (P < .001), more predominantly female (P < .001), and more likely to have elevated anxiety (P < .001), depressive (P < .001) and inattention symptoms (P = .001), as compared to those with nonelevated sleep problems (60.7%; n = 740). From the baseline to last assessment, 77.3% (n = 269) of members with elevated sleep problems exhibited improvements, with sleep problems decreasing significantly over each month in care (P < .001). Members with improvements in anxiety, depressive, and/or ADHD symptoms had larger improvements in sleep over time compared to their peers with no improvement in their mental health symptoms (Months in care*Change type: P < .001 for all). Conclusions Our results provide preliminary evidence that participation in a pediatric DMHI is associated with improvements in sleep problems, even when youth are not being treated directly for sleep problems. These findings highlight a valuable secondary benefit of participating in mental health care within pediatric DMHIs and warrant further experimental research.
Effectiveness of Trans-Theoretical Model-Based Health Education Intervention in the Promotion of Lifestyle Changes among Adults with Metabolic Syndrome: A Randomized Controlled Trial
Authors: Okube Okubatsion Tekeste , Kimani Samuel T. 
Published: May 2024

Background Evidence revealed that, 60% of deaths in the underdeveloped nations are linked to adoption of unhealthy lifestyles. The Trans-theoretical Model (TTM) has been considered a useful interventional approach in smoking cessation, drug addiction and weight control. However, its effectiveness in improving changes in dietary pattern, physical activity and alcohol consumption has not been reported. Purpose The study aimed at evaluating the effectiveness of the TTM-based health education intervention in the promotion of lifestyle changes among adults with metabolic syndrome. Methods This was an experimental design where 352 participants with metabolic syndrome were allocated to intervention and control groups. The participants were randomly assigned to receive either standard CVD care or a TTM stage-based lifestyle modification intervention for 12-months. Lifestyle patterns were assessed at baseline and endpoint. The mean difference of the subtotal TTM concept scores between pre and post intervention was evaluated using paired t-test. The chi-square test of independence was used to detect between group differences in the categorical data. Results Most of the participants were in the pre-action stage of change for their dietary intake patterns and physical activity habits at the baseline assessment with no difference between the groups. The intervention group's total level of change toward adopting a healthy lifestyle was markedly ( p < 0.001) improved than the control group at the endpoint. The mean scores for the intervention group's stage of change, self-efficacy, and pros and cons of decisional balance all improved significantly ( p < 0.001) from the baseline. The mean scores for the control group's pros and cons of decisional balance and stage of change also considerably ( p < 0.05) improved from baseline to the endpoint. Conclusion The TTM- based health education intervention was effective in improving the participants’ lifestyles that includes diet and physical activity. Health care providers, particularly nurses should implement TTM staged-matched educational intervention for individuals who are at risk for cardiovascular diseases.
Bridge-Enhanced Anterior Cruciate Ligament Restoration: Surgical Technique
Authors: Bond Elizabeth , Wu Kevin A. , Mills Frederic Baker , O’Donnell Ryan , Cochran Grant , Lau Brian C. 
Published: May 2024

Background: Anterior cruciate ligament (ACL) repair has historically had poor outcomes and fell out of favor in the 1980s with the majority of surgeons opting to do an ACL reconstruction instead due to the high failure rate. The Bridge-Enhanced ACL Restoration or BEAR technique utilizes a de-cellularized, bovine-derived, type I collagen implant to aid in the ACL repair. The device is implanted to augment the healing of the ACL. Indications: The BEAR technique is indicated to augment ACL repair in cases of complete rupture where there is a residual tibial stump of sufficient length and good tissue quality. Results: In our experience to date, patients undergoing an ACL repair with BEAR recover range of motion quickly and have less quadriceps atrophy and less postoperative swelling than those undergoing ACL reconstruction requiring autograft harvest. We will continue to follow up our patient cohort to assess for re-rupture rate as they return to sport. Conclusion: The BEAR technique is a promising development that enables ACL repair as an alternative option to reconstruction. This article describes our approach including tips and tricks to successfully perform this procedure. Patient Consent Disclosure Statement: The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form.
Changes in fatigue symptoms following an exercise-based rehabilitation programme for patients with long COVID
Authors: Daynes Enya , Baldwin Molly M. , Annals Matthew , Gardiner Nikki , Chaplin Emma , Ward Sarah , Greening Neil J. , Evans Rachael A. , Singh Sally J. 
Published: May 2024

BackgroundThere is evidence to support COVID-19 rehabilitation programmes improving persistent COVID-19 symptoms; however, there is concern that therapies that include an exercise component may increase fatigue and post-exertional symptom exacerbation (PESE). The objectives of the present study were to determine the effect of a 6-week COVID-19 rehabilitation programme on fatigue and PESE in individuals with ongoing COVID-19 symptoms.MethodsAfter a routine medical assessment, individuals with persistent COVID-19 symptoms were enrolled on a 6-week COVID-19 specific rehabilitation programme. The programme included symptom-titrated exercise, education and self-management advice. Fatigue was assessed pre- and post-programme using the Functional Assessment Chronic Illness Therapy Fatigue questionnaire (FACIT). Exercise capacity (Incremental and Endurance Shuttle Walking Test (ISWT and ESWT)) and PESE (DePaul Symptom Questionnaire (DSQ)) were also assessed pre- and post-programme. Composite scores were calculated for the frequency and severity domains of the DSQ.Results148 patients (median (IQR) age 59 (49–72) years, 82 (55%) female, 81 (54%) hospitalised) completed the COVID-19 rehabilitation programme. FACIT score was reduced pre- to post-programme by a mean (CI) change of −5 (−7– −4); p<0.01. Exercise capacity increased by 82 (65–99) m for the ISWT and 398 (333–462) s for the ESWT (n=148). PESE was assessed in 44 patients. The DSQ frequency and severity composite score improved by 20 (13–28) and 19 (13–26) points, respectively (p<0.01, n=44).ConclusionThese data demonstrate the potential benefits of a COVID-19 rehabilitation programme in improving fatigue, exercise capacity and symptom exacerbation in those with persistent COVID-19 symptoms.