bluuebunny/crossref_metadata_2025_split huggingface dataset:
Waist Reduction through Conversion from False to Floating Ribs
Authors: Manzaneda Raúl M. , Adrianzen Gerardo A. 
Published: June 2024

Background:
Waist reduction by ultrasound-guided monocortical fracture (RibXcar), usually performed on floating ribs, may show limitations when performed on false ribs (9 and 10) because of the stress force exerted on the anterior fixation point (cartilage union to sternum). Hence, we introduced a procedure for conversion from false to floating ribs to improve the final result of the treatment of false ribs through a rib treatment scheme.

Methods:
Forty-nine female patients undergoing rib surgery were recruited. Waist measurements and angular variations were compared between two groups of patients, the first (26 patients) consisting of patients who underwent RibXcar with conversion surgery (ribs 9 and 10) and the second (23 patients) consisting of patients who underwent RibXcar without conversion surgery (ribs 9 and 10).

Results:
The waist measurements taken after 6 months showed a mean decrease of 8.70 cm in the group where only RibXcar was performed, whereas a statistically significant mean reduction of 17.04 cm was observed in the group where RibXcar was performed with rib conversion surgery.

Conclusions:
The false-to-floating-rib conversion technique combined with RibXcar demonstrated more reduction in waist circumference and a more efficient rib angulation compared with RibXcar alone.
Operability of the Southampton Hand Assessment Procedure (SHAP) Tasks Using Voluntary Closing and Voluntary Opening Body-Powered Prosthesis Simulator
Authors: Nishizaka Chika , Mano Hiroshi , Shibata Teruki , Noguchi Satoko , Kobayashi Mio , Haga Nobuhiko , Ohnishi Kengo , Fujiwara Sayaka 
Published: June 2024

ABSTRACT

Introduction
Body-powered prostheses are still essential in practice. There are two types of mechanisms to manipulate body-powered prostheses: voluntary closing (VC) and voluntary opening (VO). However, there are no studies investigating which is better suited for what type of movement in daily life.

Materials and Methods
The participants were eight right-handed, able-bodied adults. They were divided into two groups: a VC-to-VO group, in which the VC type was practiced first and then the VO type, and a VO-to-VC group, in which they practiced in the opposite order. VC/VO-type terminal device (EquiluxTM) was attached to a body-powered prosthesis simulator for the left hand, and the Southampton Hand Assessment Procedure (SHAP) tasks were practiced repeatedly. We compared the VC type and VO type for the number of practices to reach a plateau, Index of Functionality (IOF) score, the six prehensile pattern scores, and the time required for the 26 SHAP tasks. Scores were also compared before and after practice. In addition, changes in IOF and scores for each of the six patterns with proficiency were compared between VC type and VO type.

Results
Significant improvements were observed with manipulation practice for both types of devices. The mean SHAP scores at the plateau were 82.6 for VO type and 92.0 for VC type, with VC type significantly higher than VO type. In the six prehensile pattern scores, only two patterns, Tripod and Power, showed significant differences. When comparing the time required, Food Cutting task was an exception and significantly faster in the VC type, while there were no significant differences for the other tasks.

Conclusions
It was suggested that the VC type is more suitable for tasks requiring grip strength.

Clinical Relevance
We believe that this research will improve the daily lives of individuals with upper-limb amputation.
De Hoogstraat Xperience Prosthesis Transhumeral: An Innovative Test Prosthesis
Authors: de Backer-Bes Femke , Lange Maaike , Brouwers Michael , van Wijk Iris 
Published: June 2024

ABSTRACT

Introduction
To choose a suitable prosthesis, clients need to experience both the weight and the control of a prosthesis. A few years ago, De Hoogstraat Rehabilitation Center developed the Xperience Prosthesis for children and adults with a transradial congenital or acquired limb deficiency. Because of the positive effects, we developed a reusable test prosthesis for the transhumeral level. Xperience Prosthesis Transhumeral is an innovative test prosthesis and an essential tool in managing expectations when providing clients with a suitable upper-limb prosthesis.
Xperience Prosthesis Transhumeral is a 3D-printed, reusable adjustable socket system with a passive elbow unit and the possibility to fit and experience myoelectric, static, and passive terminal devices.

Conclusions
Xperience Prosthesis Transhumeral is a practical and easy-to-handle tool for professionals. For clients, this tool is a unique way to experience the weight, function, and control of a prosthesis before making a final choice.

Clinical Relevance
Using Xperience Prosthesis Transhumeral in an expert rehabilitation center for upper-limb clients guides professionals to choose the right prosthesis with the client.
Evaluation of a Suspected Overdose Form for Timely Surveillance of Fatal Drug Overdoses, Multnomah County, OR, 2020-2021
Authors: Walters Jaime K. , Lewis Paul , Dileo Kim 
Published: June 2024

Objectives:
There is a significant delay in finalization of drug overdose deaths, and a need to more quickly identify suspected overdoses to improve public health response. The objective of our study was to describe creation of a suspect overdose form and evaluate its use.

Design:
Evaluation of a suspected overdose form used to record information related to death investigation with matching to state vital records. We calculated the toxicology turnaround time for matched records, and also calculated sensitivity, specificity, positive predictive value, and negative predictive value of the form compared to vital records as the gold standard.

Setting:
Multnomah County, Oregon, deaths investigated by the County Medical Examiner between January 2020 and December 2021.

Main Outcome Measure:
Sensitivity of the suspected overdose form.

Results:
We analyzed 2818 matched death records in total during the study period. The average turnaround time for the 1673 records with toxicology results was 101 days. In 2020, sensitivity of the form was 74%, but this increased to nearly 95% in 2021.

Conclusions:
Multnomah County’s suspected evaluation form provides a timelier indicator of deaths suspected to be from drug overdose, has good sensitivity to detect true overdoses, and can help guide more rapid public health and public safety response activities.
Emergency Medical Services and Public Health Perspectives on Alternative Emergency Response Models
Authors: Miller Alison K. , Gage Christopher B. , Parrish Matthew , Toliver Isaac , Ulintz Alexander , Powell Jonathan , Frey Jennifer A. , Panchal Ashish R. 
Published: June 2024

Context:
New approaches to emergency response are a national focus due to evolving needs and growing demands on the system, but perspectives of first responders and potential partners have not been evaluated.

Objective:
This project aimed to inform the development and implementation of alternative emergency response models, including interdisciplinary partnerships, by identifying the perspectives of the frontline workforce regarding their evolving roles.

Design:
An electronic survey was sent, querying respondents about their perceived roles in emergency response, interdisciplinary partnerships, and resources needed.

Setting:
This study took place in a metropolitan, midwestern county with participants from 2 public health agencies and 1 emergency medical services (EMS) agency.

Participants:
The survey was completed by 945 EMS clinicians and 58 public health workers.

Main Outcome Measures:
The main outcome measures were agreement levels on each group’s roles in prevention, response, and recovery after emergencies, as well as general feedback on new models.

Results:
Overall, 97% of EMS clinicians and 42% of public health workers agreed that they have a role in immediate response to 9-1-1 emergencies. In mental health emergencies, 87% of EMS clinicians and 52% of public health workers agreed that they have a role, compared to 87% and 30%, respectively, in violent emergencies. Also, 84% of respondents felt multidisciplinary models are a needed change. However, 35% of respondents felt their agency has the resources necessary for changes.

Conclusions:
We observed differences between EMS clinicians and public health workers in their perceived roles during emergency response and beliefs about the types of emergencies within their scope. There is strong support for alternative approaches and a perception that this model may improve personal well-being and job satisfaction, but a need for additional resources to develop and implement.
Understanding the Roles, Responsibilities, and Factors for Success of Health Equity Officers in Health Care Settings: A Qualitative Study
Authors: Adler Rachel R. , Pomer Alysa , Diviti Saathvika , Lewis Joy , Tan-McGrory Aswita , Weissman Joel S. 
Published: June 2024

Context:
Recent national guidelines aimed at addressing equity in health care settings have contributed to an increase in equity officer positions, yet little is known about their roles, responsibilities, or strategies for engaging in health equity work.

Objective:
To understand the roles and responsibilities of equity officers, as well as facilitators and barriers to their success.

Design:
In-depth semi-structured interviews with selected respondents from the Equity Officer National Study.

Setting:
Hospitals and health care systems across the United States.

Participants:
Twenty-six equity officers who had responded to the Equity Officer National Study survey.

Main Outcome Measures:
The interview guide explored strategies, facilitators, and barriers for engaging in health equity work in hospitals/health systems and communities.

Results:
The job roles described by participants fell into 4 categories: community benefits/relations, population/community health, workforce, and health equity. Equity officers described key areas to support success at the individual equity officer level: knowledge and expertise, professional skills, and interpersonal skills; at the hospital level: leadership, workforce, infrastructure and resources, and policies and processes; at the community level: leadership and partnerships; and at the system level: requirements and regulations, investment and resources, and sociocultural and political characteristics of the community. These key areas have been organized to create a Framework for Equity Officer Success.

Conclusions:
The Framework for Equity Officer Success should be incorporated into hospital board, community stakeholder, and policymaker discussions about how to support health equity work in hospitals and health care systems.
The Future Frontier of Liver Transplantation Exploring Young Donor Allocation Strategies for HCC Recipients
Authors: Akabane Miho , Esquivel Carlos O. , Kim W. Ray , Sasaki Kazunari 
Published: June 2024

Background.
The role of donor age in liver transplantation (LT) outcomes for hepatocellular carcinoma (HCC) is controversial. Given the significant risk of HCC recurrence post-LT, optimizing donor/recipient matching is crucial. This study reassesses the impact of young donors on LT outcomes in patients with HCC.

Methods.
A retrospective review of 11 704 LT cases from the United Network for Organ Sharing database (2012–2021) was conducted. The study focused on the effect of donor age on recurrence-free survival, using hazard associated with LT for HCC (HALT-HCC) and Metroticket 2.0 scores to evaluate post-LT survival in patients with HCC.

Results.
Of 4706 cases with young donors, 11.0% had HCC recurrence or death within 2 y, and 18.3% within 5 y. These outcomes were comparable with those of non-young donors. A significant correlation between donor age and post-LT recurrence or mortality (P = 0.04) was observed, which became statistically insignificant after tumor-related adjustments (P = 0.32). The Kaplan-Meier curve showed that recipients with lower HALT-HCC scores (<9) and Metroticket 2.0 scores (<2.2) significantly benefited from young donors, unlike those exceeding these score thresholds. Cox regression analysis showed that donor age significantly influenced outcomes in recipients below certain score thresholds but was less impactful for higher scores.

Conclusions.
Young donors are particularly beneficial for LT recipients with less aggressive HCC, as indicated by their HALT-HCC and Metroticket 2.0 scores. These findings suggest strategically allocating young donors to recipients with less aggressive tumor profiles, which could foster more efficient use of the scarce donor supply and potentially enhance post-LT outcomes.
Brown Adipose Tissue as a Unique Niche for Islet Organoid Transplantation: Insights From In Vivo Imaging
Authors: Sun Aixia , Hayat Hanaan , Kenyon Elizabeth , Quadri Tahnia , Amos Darius , Perkins Keenan , Nigam Saumya , Tarleton Deanna , Mallett Christiane L. , Deng Cheri X. , Qiu Zhen , Li Wen , Sempere Lorenzo , Fan Jinda , Aguirre Aitor , Wang Ping 
Published: June 2024

Background.
Transplantation of human-induced pluripotent stem cell (hiPSC)-derived islet organoids is a promising cell replacement therapy for type 1 diabetes (T1D). It is important to improve the efficacy of islet organoids transplantation by identifying new transplantation sites with high vascularization and sufficient accommodation to support graft survival with a high capacity for oxygen delivery.

Methods.
A human-induced pluripotent stem cell line (hiPSCs-L1) was generated constitutively expressing luciferase. Luciferase-expressing hiPSCs were differentiated into islet organoids. The islet organoids were transplanted into the scapular brown adipose tissue (BAT) of nonobese diabetic/severe combined immunodeficiency disease (NOD/SCID) mice as the BAT group and under the left kidney capsule (KC) of NOD/SCID mice as a control group, respectively. Bioluminescence imaging (BLI) of the organoid grafts was performed on days 1, 7, 14, 28, 35, 42, 49, 56, and 63 posttransplantation.

Results.
BLI signals were detected in all recipients, including both the BAT and control groups. The BLI signal gradually decreased in both BAT and KC groups. However, the graft BLI signal intensity under the left KC decreased substantially faster than that of the BAT. Furthermore, our data show that islet organoids transplanted into streptozotocin-induced diabetic mice restored normoglycemia. Positron emission tomography/MRI verified that the islet organoids were transplanted at the intended location in these diabetic mice. Immunofluorescence staining revealed the presence of functional organoid grafts, as confirmed by insulin and glucagon staining.

Conclusions.
Our results demonstrate that BAT is a potentially desirable site for islet organoid transplantation for T1D therapy.
Detecting accelerated retinal decline in mental disorders through normative modeling
Authors: Georgiadis Foivos , Kallen Nils , Cecere Giacomo , Rabe Finn , Edkins Victoria , Barthelmes Daniel , Roguski Amber , Smith Daniel , Kirschner Matthias , Homan Philipp 
Published: June 2024

AbstractObjectiveSeveral studies have found thinner retinal tissue in mental disorders compared to healthy controls. Because the retina is part of the human brain, this suggests that informative brain structure readouts can be obtained efficiently through retinal imaging. Instead of focusing on group-level case-control differences, we used normative modeling to estimate age-related decline of the human retina (and its expected variation) and compared it to the decline seen in schizophrenia (SZ), bipolar disorder (BD), and major depression (MDD). We hypothesized accelerated retinal decline in mental disorders compared to controls, with SZ being most affected, followed by BD, then MDD.MethodsUsing UK Biobank data, we estimated age-related retinal decline in healthy controls (HC, N = 56,545) for total macular thickness (including coronal subfields) and two sublayers (retinal nerve fiber layer; RNFL; and ganglion cell-inner plexiform layer; GC-IPL). We then compared the decline in SZ (N = 171), BD (N = 256), and MDD (N = 102) to the normative decline in HC.ResultsFor HC, the pattern of age-related decline for total macular thickness, RNFL, and GC-IPL was curve-like rather than linear and more pronounced in males compared to females. For mental disorders, the decline-pattern was generally faster, driven by SZ and disorder-specific macular subfields. There was also an enrichment of individuals with extremely low (infranormal) values. These results were confirmed in robustness checks that ruled out unspecific confounders.ConclusionThese findings suggest that mental disorders, particularly SZ, involve accelerated neurodegenerative decline that can be detected in the human retina.
Did institutional racism contribute to adverse COVID-19 clinical outcomes in ethnic minority healthcare staff? Systematic review
Authors: Adewole Oluwatomisin , Lalli Kismet , Peters Holly , Price Chris , Lumb Blanche , Gal Micaela , Cooper Alison 
Published: June 2024

AbstractIntroductionOf the United Kingdom National Health Service (NHS) healthcare workers who died during the first wave of the pandemic, 63% belonged to an ethnic minority background, despite making up 21% of the NHS workforce. Previous research has considered biological and social causes such as obesity or overcrowded housing. This review aims to explore whether elements of institutional racism contributed to ethnic disparities in adverse COVID-19 clinical outcomes among healthcare staff.MethodEleven databases were searched including MEDLINE and the Cochrane Library. Eight healthcare organisations within the grey literature were also searched. A narrative synthesis was conducted.Results20 studies were included for review. There were ethnic disparities in the rate of COVID-19 infection, mortality and wellbeing. Three elements of institutional racism were identified associated with these adverse outcomes, namely, overrepresentation of ethnic minority staff in frontline roles, discriminatory redeployment and harassment and bullying.ConclusionThe pandemic exacerbated pre-existing racial inequalities within the UK healthcare workforce. Further research is required to clarify the definition of institutional racism and increase understanding of how this manifests in a healthcare setting and can be mitigated.Funding statementThe Wales COVID-19 Evidence Centre was funded for this work by Health and Care Research Wales on behalf of Welsh Government.
Background and Foreground: Connections & Distinctions when Health Professions Faculty Teach Both Interprofessional Collaborative Practice and Quality Improvement – A Case Study
Authors: Stevenson Katherine , Thor Johan , D’Eon Marcel , Headrick Linda A. , Gäre Boel Andersson 
Published: June 2024

AbstractDespite decades of effort, programs continue to struggle to integrate competencies related quality improvement (QI) and interprofessional collaborative practice (ICP) into health professions education. Additionally, while QI and ICP may seem intuitively linked and there exists some examples of a coordinated approach, the literature regarding competencies, including knowledge, skills, and attitudes (KSAs), is still largely focused on QI and ICP as separate fields of knowledge and practice. This study explored distinctions and connections between quality improvement (QI) and interprofessional collaborative practice (ICP) competency domains in health professions education. The authors used a qualitative case study approach with an instrumental case, i.e., the University of Missouri-Columbia (MU), where QI and ICP were intentionally integrated as part of core curricula in health professional schools and programs. Eleven faculty members from medicine, nursing, pharmacy, and health care administration participated in interviews exploring their teaching choices in either classroom or clinical settings. Study participants defined the goal of teaching QI and ICP as enabling learners to deliver safe and patient-centered care and described the knowledge and skills required for QI and the attitudes and skills required for ICP. Furthermore, they described the relationship between QI and ICP as one mediated by systems thinking, where ICP is backgrounded as a critical pre-requisite and QI is foregrounded as a vector for developing interprofessional competencies. The MU case elucidates the potential synergies that occur when faculty address quality improvement and interprofessional collaborative practice competencies with an integrated approach that leverages connections, while also respecting distinctions. For health professions education programs looking to improve the effectiveness and efficiency of their curricular approach to these fields, it may be fruitful to consider ICP as background and QI as foreground, remembering that without each other, ICP risks losing meaning and QI risks losing impact.
Exploring Kp,uu,BBB Values Smaller than Unity in Remoxipride: A Physiologically-Based CNS Model Approach Highlighting Brain Metabolism in Drugs with Passive Blood-Brain Barrier Transport
Authors: Zhang Mengxu , Vuist Ilona M. , Rottschäfer Vivi , de Lange Elizabeth CM 
Published: June 2024

Abstract(Aim)Kp,uu,BBBvalues are crucial indicators of drug distribution into the brain, representing the steady-state relationship between unbound concentrations in plasma and in brain extracellular fluid (brainECF). Kp,uu,BBBvalues < 1 are often interpreted as indicators of dominant active efflux transport processes at the blood-brain barrier (BBB). However, the potential impact of brain metabolism on this value is typically not addressed. In this study, we investigated the brain distribution of remoxipride, as a paradigm compound for passive BBB transport with yet unexplained brain elimination that was hypothesized to represent brain metabolism.(Methods)The physiologically-based LeiCNS pharmacokinetic predictor (LeiCNS-PK model) was used to compare brain distribution of remoxipride with and without Michaelis-Menten kinetics at the BBB and/or brain cell organelle levels. To that end, multiple in-house (IV 0.7, 3.5, 4, 5.2, 7, 8, 14 and 16 mg/kg) and external (IV 4 and 8 mg/kg) rat microdialysis studies plasma and brainECF data were analysed.(Results)The incorporation of active elimination through presumed brain metabolism of remoxipride in the LeiCNS-PK model significantly improved the prediction accuracy of experimentally observed brainECF profiles of this drug. The model integrated with brain metabolism in both barriers and organelles levels is named LeiCNS-PK3.5.(Conclusion)For drugs with Kp,uu,BBBvalues < 1, not only the current interpretation of dominant BBB efflux transport, but also potential brain metabolism needs to be considered, especially because these may be concentration dependent. This will improve the mechanistic understanding of the processes that determine brain PK profiles.