bluuebunny/crossref_metadata_2025_split huggingface dataset:
Acceptability and usability of assistive equipment and technology by individuals with multiple sclerosis: A qualitative study with occupational therapists
Authors: Barnett Courtney , Murphy Angela , Cezar da Cruz Daniel 
Published: May 2024

Introduction: Assistive equipment and technology (AE&T) is often part of occupational therapy practice for individuals with multiple sclerosis (MS). We aim to explore the acceptability and usability of AE&T by people with MS from the perspective of occupational therapists. Methods: Our study applied a qualitative descriptive design, using semi-structured interviews conducted with five qualified occupational therapists with at least 6 months of experience in providing occupational therapy to adults with MS. Reflexive thematic analysis was used for data analysis. Findings: Three developed themes describe the occupational therapists’ experiences: ‘The cognitive impact of the illness rather than the physical’, ‘There’s a drive to not let the MS win’ and ‘They have to experience it by doing’. Therapists perceive cognitive changes, the meaning of technology and a person-centred approach as elements influencing the acceptability and usability of AE&T. Conclusion: Our findings highlight the importance of using core occupational therapy principles and approaches to best support people with MS in using AE&T effectively.
Health-Related Behaviors and Academic Achievement Among College Students
Authors: Lederer Alyssa M. , Oswalt Sara B. , Hoban Mary T. , Rosenthal Melissa N. 
Published: May 2024

Purpose College students’ academic achievement has crucial implications for their future success. Students’ health may be a key determinant of academic performance, but more research is needed to understand this relationship. Design/Setting/Subjects Secondary analysis of the American College Health Association-National College Health Assessment III pre-COVID-19 Spring 2020 dataset. N = 39 146 undergraduates at 75 higher education institutions (14% mean response rate, comparable with other large-scale national college health surveys). Measures Self-reported grade point average (GPA) and 33 health behaviors in the categories of dietary behavior, physical activity, sedentary behavior, substance use, sexual risk behavior, violence-related behavior, mental health, and sleep behavior. Analysis Weighted cross-tabulations examining the association between GPA and health behaviors; multinomial logistic regressions assessing if behaviors predicted GPA, controlling for year, sex/gender, and race/ethnicity. Individual GPA categories were also compared to a D/F referent group. Results There were gradient trends across GPA categories for A through D/F (18 behaviors) or A through C (12 behaviors) ( P < .001). Each health behavior predicted GPA differences ( P < .001), except heroin use ( P = .052). The A GPA group was significantly different from the D/F GPA group for 27 behaviors ( P < .001). In general, protective behaviors corresponded with higher GPAs and most risk behaviors were associated with lower GPAs. Conclusions There is a link between numerous health behaviors and academic performance. Stakeholders invested in college students’ health and academics should engage in mutually beneficial strategies to safeguard students’ current and future well-being and success.
A Study to Evaluate the Efficacy of Preoperative Low-dose Nebulised Dexamethasone in Decreasing the Incidence of Postoperative Sore Throat in Patients Undergoing Surgery Under General Anaesthesia
Authors: Parvez Arbal , Gupta Ritu , Kour Arvinpreet , Singh Ajaydeep 
Published: May 2024

Background and Aims: Postoperative sore throat (POST) is a stereotypical postoperative complication that usually occurs in approximately 21%–65% of patients who are under general anaesthesia and is ranked around eighth among the most undesirable subjective and unpleasant complaints by the society of American anaesthesiologist after general anaesthesia. As airway management is a crucial factor in the causation of POST, various methods, especially non-pharmacological, are used to reduce the incidence of postoperative sore throat with the use of a small-sized endotracheal tube with low intracuff pressures. The tracheal tube is applied with other agents that may help in reducing the symptoms such as steroids, lozenges, lignocaine, ketamine gargles, inhalation of steroids (also included in pharmacological methods used for reducing the incidence of postoperative sore throat). Aim and Objective: The aim of this study was to evaluate the efficacy of prophylactic low-dose nebulised dexamethasone for decreasing the incidence of post-extubation sore throat and to evaluate the complications of low-dose dexamethasone nebulisation in patients undergoing surgery under general anaesthesia. Patients and Methods: The study was done in the Anaesthesiology Department of Maharishi Markandeshwar Institute of Medical Sciences and Research (MMIMSR) Mullana, Ambala, after institutional ethical committee approval and written, informed consent was obtained from the patients from March 2021 to March 2022 with a group size of Group S – 25 patients and Group D – 25 patients. Observation and Results: The results showed that patients in the dexamethasone group had a lower POST rate compared to the control group. Conclusion: We concluded that a low dose of 4 mg dexamethasone was effective in reducing the incidence and severity of POST in patients after anaesthesia, and no side effects compared to 4 mg normal saline.
Gingivoperiosteoplasty in Children with Cleft Lip and Palate: The Need for Alveolar Bone Grafting
Authors: Balumuka Darius , Daly Gwendolyn E. , Krakauer Kelsi , Burch Samantha , Jedrzejewski Breanna , Johnson Alicia , Howell Lori K. , Wolfswinkel Erik M. 
Published: May 2024

Objective This study aimed to determine the efficacy of gingivoperiosteoplasty (GPP) in preventing alveolar bone grafting (ABG) among children with cleft lip and palate (CLP). Design/Setting Retrospective university hospital single center study. Patients Children with CLP treated with GPP from 2000-2015 were included. Those under eight years of age, without definitive conclusions regarding need for ABG or with incomplete data were excluded. Interventions Included patients were analyzed for demographics, cleft type, age at GPP, associated cleft surgery, use of nasoalveolar molding (NAM), indication for ABG, operating surgeon and presence of residual alveolar fistula. T-tests and Fisher's exact tests were utilized for statistical analysis. Main Outcome Measure The need for ABG. Results Of the 1682 children identified with CLP, 64 underwent GPP and met inclusion criteria. 78% of patients with CLP who underwent GPP were recommended for ABG. Those who received GPP at a younger age ( P = .004) and at the time of initial cleft lip repair ( P = .022) were less likely to be recommended for ABG. Patients with complete CLP were more likely to be recommended for ABG than patients with cleft lip and alveolus only ( P = .015). The operating surgeon impacted the likelihood of ABG ( P = .004). Patient gender, race, ethnicity, laterality, and NAM were not significantly associated with recommendation for ABG. Conclusion GPP does not preclude the need for ABG. Therefore, the success of ABG after GPP and maxillary growth restriction should be analyzed further to determine if GPP is a worthwhile adjunct to ABG in cleft care.
New Score Models for Predicting Bleeding and Ischemic of Ticagrelor Therapy in Patients with Diabetes Mellitus
Authors: Xia Xiaotong , Chen Shu , Cao Chang , Ye YanRong , Shen Yun 
Published: May 2024

Purpose Ticagrelor is an antiplatelet drug, and its use increases the risk of bleeding. Coronary artery disease is significantly influenced by the widespread occurrence of diabetes mellitus. In order to decrease the incidence of clinical adverse events, a novel bleeding and thrombosis score is developed in this research. Methods We conducted a retrospective analysis of patient data from two medical centers who were diagnosed with diabetes mellitus and treated with ticagrelor. We gathered information on every patient from the electronic database of the hospital and follow-up. The collected data were statistically analyzed to obtain risk factors for bleeding and ischemic events. Results A total of 851 patients with diabetes mellitus who have been administered ticagrelor are included in our investigation. A total of 76 patients have bleeding events and 80 patients have ischemic events. The analysis of multiple variables indicates that characteristics like the age of >65, having a previous occurrence of bleeding, experiencing anemia, using aspirin, and taking atorvastatin are linked to a higher likelihood of bleeding. Additionally, the age of >65, smoking, having a history of blood clots, and having a BMI ≥ 30 are found to increase the risk of ischemia. Conclusion The A4B score established in this study was better than the HAS-BLED score，and the same is true for the ABST score to the CHA2DS-VASc score. This new risk assessment model can potentially detect patients who are at high risk for bleeding and ischemic events. For high-risk patients, the dose of ticagrelor can be adjusted appropriately or the medication can be adjusted.(2023-09-11, ChiCTR2300075627)
Oral Rivaroxaban Versus Warfarin After inferior Vena cava Filter Implantation: A Retrospective Cohort Study
Authors: Schastlivtsev Ilya , Pankov Aleksey , Tsaplin Sergey , Stepanov Evgeny , Zhuravlev Sergey , Lobastov Kirill 
Published: May 2024

Objectives To assess the efficacy and safety of rivaroxaban compared to warfarin after inferior vena cava (IVC) filter implantation. Method This retrospective analysis includes data from 100 patients with deep vein thrombosis (DVT) who underwent IVC filter implantation due to a free-floating thrombus (n = 64), thrombus propagation (n = 8), or acute bleeding (n = 8) on therapeutic anticoagulation, catheter-directed thrombolysis (n = 8), or had previously implanted filter with DVT recurrence. Patients were treated with warfarin (n = 41) or rivaroxaban (n = 59) for 3-12 months. Symptomatic venous thromboembolism (VTE) recurrence and bleeding events were assessed at 12 months follow-up. Results Three (7.3%) cases of VTE recurrence without IVC filter occlusion occurred on warfarin and none on rivaroxaban. The only (2.4%) major bleeding occurred on warfarin. Three (5.1%) clinically relevant non-major bleedings were detected on rivaroxaban. No significant differences existed between groups when full and propensity scores matched datasets were compared. Conclusions Rivaroxaban seems not less effective and safe than warfarin after IVC filter implantation.
A cost comparison of pembrolizumab: Fixed and weight-based dosing
Authors: Slee Ann-Louise , Coutsouvelis John , Tong Bianca , Poole Susan , Zalcberg John 
Published: May 2024

Background Pembrolizumab, an immune checkpoint inhibitor, indicated to treat multiple cancers, was initially approved in Australia as weight-based dosing at 2 mg/kg every 3 weeks (Q3W). Subsequent approvals used ‘fixed’ dosages of 200 mg Q3W or 400 mg every 6 weeks (Q6W). Pharmacokinetic equivalence was demonstrated between dosing strategies, with no significant differences in efficacy or toxicity. Fixed dosing regimens are routinely used in Australia. Aim To model and compare the cost of weight-based dosing of pembrolizumab to standard fixed dosing regimens. Method A single centre, retrospective review was conducted. Patients, identified from dispensing software, who commenced on pembrolizumab between January and December 2022 were included. Patient demographic and treatment data was extracted from electronic medical records. Costs of weight-based doses were calculated and compared to the cost of fixed dosing. Variables such as acquisition cost, funding mechanisms and ‘vial sharing’ were considered. Results Fifty-two patients were included (63% male, median age 68 years). Of the 211 doses of pembrolizumab administered (average 4.1 doses/patient), 161 were Q3W doses, and 50 were Q6W doses. The acquisition cost for a fixed 200 mg and 400 mg dose was $7646, and $15,292, respectively. The average patient weight was 77.6 kg (SD 19 kg), which equated to $5933 for a weight-based Q3W dose, and $11,867 for the Q6W dose; a potential cost avoidance of $1965 and $3930 per dose, respectively. This represented a possible 23.5% avoidance in medication acquisition cost. Over the study period of 1 year, using weight-based dosing for pembrolizumab had the potential to reduce medication expenditure by $467,996. Discussion Significant cost avoidance could be achieved via weight-based pembrolizumab dosing. Given the substantial total cost of pembrolizumab, the growing number of indications and the expected equivalent treatment outcomes with weight-based pembrolizumab, the potential cost reductions of weight-based pembrolizumab at both institution and government level should be further explored.
Cold-associated laryngopharyngeal dysesthesia syndrome after oxaliplatin treatment
Authors: Babacan Arzu 
Published: May 2024

Objective Oxaliplatin is a platinum-group chemotherapeutic agent commonly used in the treatment of colorectal cancer. In addition to hematological and gastrointestinal side effects, laryngopharyngeal dysesthesia associated with cold is reported as a rare side effect. In this article, seven cases with pharyngolaryngeal dysesthesia were presented and the diagnosis and treatment planning were reviewed in the light of literature findings. Material and Methods Patient records of cancer patients with laryngopharyngeal dysesthesia were retrospectively analyzed between 2020 and 2023. Demographic characteristics, presenting complaints, vital signs, physical examination, and laboratory tests of the patients diagnosed with laryngopharyngeal dysesthesia were recorded. Results Seven patients who had gastrointestinal malignancy and oxaliplatin chemotherapy were diagnosed with laryngopharyngeal dysesthesia. The symptoms most commonly developed due to cold weather. The symptoms of three patients had developed while receiving treatment, while four patients were admitted to emergency service after oxaliplatin infusion. The physical examinations revealed no pathological findings of the allergic reaction at presentation or during follow-up skin. Patients were monitored and nasal oxygen therapy was administered. A 5 mg intravenous infusion was given for anxiety symptoms in three patients. Patients were discharged after 4 hours of follow-up with resolution of all symptoms Conclusion Laryngopharyngeal dysesthesia should be kept in mind in patients treated with oxaliplatin and presenting with shortness of breath and a feeling of suffocation after cold exposure.
Topical 5-Fluorouracil 0.5% as primary treatment for Ocular Surface Squamous Neoplasia
Authors: Teixeira Gabriela Carneiro , de Resende Mateus Inacio Lemes , Morales Melina Correia , Fernandes Arthur Gustavo 
Published: May 2024

Purpose To evaluate the efficacy of topical treatment with 5-Fluorouracil (5-FU) 0.5% in cases of Ocular Surface Squamous Neoplasia (OSSN), and to assess the tolerance of patients undergoing treatment. Methods Patients with clinical diagnosis of OSSN referred to the Ocular Oncology division from the Federal University of Sao Paulo, Brazil, were recruited for the current study. Patients were treated with topical 5-FU 0.5% using a regimen of 4 times daily for 10 days, followed by a 3-week drug holiday, continued up to 3 cycles before an alternative treatment. Lesions were evaluated at baseline and throughout treatment. Treatment adherence was assessed using the Morisky Medication Adherence scale. Any adverse events along the treatment were noted. Results A total of 30 eyes of 30 patients adherent to the treatment were included in the study. Among the total cases treated with 5-FU 0.5%, 24 patients achieved therapeutic success after a mean treatment duration of 21.71 ± 7.77 days, representing a success rate of 80.00% (95% CI: 60.75–91.18%). For each 1 mm2 increase in the lesion area, the odds of treatment success decrease by 6% (OR: 0.94; 95%CI: 0.88–0.99; p = 0.033). Only mild adverse events such as ocular discomfort, ocular burning and tearing were observed along the treatment in 8 patients. Conclusions Topical 5-FU 0.5% is an effective therapeutic option in the treatment of OSSN, with an 80% therapeutic success rate, showing good tolerability. The size of the lesion was identified as a factor influencing treatment success, therefore it should be taken into consideration when defining treatment approaches.
The Initial Results of Physician-Modified Fenestrated-Branched Endovascular Repairs of the Aortic Arch and Lessons Learned From the First 21 Cases
Authors: DiBartolomeo Alexander D. , Kazerounim Kayvan , Fleischman Fernando , Han Sukgu M. 
Published: May 2024

Introduction: Physician-modified fenestrated-branched endovascular aortic repair (PM-FBEVAR) for the aortic arch provides a minimally invasive treatment option for patients who are too high-risk for open repair. Improvements in technique are gained with ongoing experience with these complex repairs. This study aims to describe outcomes of arch PM-FBEVAR and technical lessons. Materials and Methods: A retrospective review of consecutive patients who underwent PM-FBEVAR with zone 0 proximal sealing at a single institution between January 2019 and July 2023 was performed. Cases completed using initial techniques (early technique) were compared with cases using the current techniques (current technique). Modification technique changed to include a self-orienting spine trigger wire and anatomically specific fenestrations or inner branches in the current group. The primary outcome was in-hospital mortality. Secondary outcomes included technical success and 30 day stroke. Results: A total of 21 patients underwent arch PM-FBEVAR, with 7 in the early group and 14 in the current group. Severe comorbidities were present in both groups including chronic obstructive pulmonary disease (COPD) (43% vs 36%), prior open ascending aortic repair (57% vs 43%), and prior stroke (86% vs 21%), respectively. Technical success was the same (86% vs 86%, p=1.0). Fluoroscopy time (56 vs 24 min, p=0.012) and in-hospital death (43% vs 0%, p=0.026) were significantly lower in the current group. A 30 day stroke rate (29% vs 7%, p=0.247) was non-significantly decreased in the current group. All-cause mortality was 100% vs 7% during median follow-up of 8 and 6 months (p<0.001). Three deaths in the early group were related to their aortic arch repair including aortic rupture during endograft advancement and 2 postoperative strokes. Conclusion: There is a significant learning curve associated with aortic arch PM-FBEVAR. This study suggests that gained experience, use of the spine trigger wire technique, and precise creation of fenestrations or inner branches can lead to a shorter procedure time and lower complications. Clinical Impact Physician modified fenestrated branched endografting is feasible for the aortic arch. The high rate of stroke and perioperative mortality was reduced with incorporation of self-orienting spine trigger wire and anatomically specific inner branch creation.
Assessing Muscular Pain and Ergonomics Among Robotic Surgeons in China: A Validation
Authors: Saikali Shady , Patel Ela , Mascarenhas Anya , Jaber Abdelrahman , Gamal Ahmad , Moschovas Marcio Covas , Cui Liang , Li Xuesong , Patel Vipul 
Published: May 2024

Introduction Robotic surgery has transformed minimally invasive procedures, offering precision and efficiency. However, the ergonomic aspects of robotic consoles and their impact on surgeon health remain understudied. This review investigates the burden of ergonomics and muscle fatigue among robotic surgeons in China, comparing the findings to a multinational study. Methodology A literature review identified themes related to physical discomfort in robotic surgery. A questionnaire was administered to Chinese robotic surgeons, yielding 40 responses. The study assessed demographic characteristics, surgeon experience, ergonomic practices, reported discomfort, and pain-relief mechanisms. Results The study revealed that most surgeons experienced shoulder and neck pain, with mixed opinions on whether robotic surgery was the primary cause. Stretching exercises were commonly used for pain relief. Surgeons believed that case volume and surgery duration contributed to discomfort. Comparisons with a multinational study suggested potential demographic and experience-related differences. Conclusion While the study has limitations, including a small sample size and potential translation issues, it underscores the importance of addressing ergonomic concerns and providing proper training to robotic surgeons to ensure their well-being and longevity in the field. Further research with larger cohorts and platform-specific analyses is warranted.
Radiocarpal and midcarpal kinematics in scapholunate instability: a four-dimensional CT study in vivo
Authors: Amarasooriya Melanie , Al Dirini Rami , Bryant Kimberley , Ian Bain Gregory 
Published: May 2024

The distribution of motion between the radiocarpal and midcarpal joints in scapholunate instability is poorly understood. This has potential implications in predicting degenerative changes and in selecting salvage procedures. We studied 19 healthy wrists and 19 wrists with scapholunate instability using dynamic computed tomography during wrist extension to flexion and ulnar to radial deviation. Radiocarpal and midcarpal kinematics of the scaphoid and the lunate were computed. In scapholunate instability, in the radial column, there was increased motion in the radiocarpal joint when the wrist was radially deviating beyond 10° or moving from 70° to 40° extension. In both groups, the capitolunate joint was the dominant articulation in the central column. In scapholunate instability, there was significantly more capitolunate motion during 70° to 30° extension. These changes may predict the development of radioscaphoid arthritis and enable identifying a kinematically abnormal wrist. The motion distribution in scapholunate instability was abnormal beyond 10° of radial deviation and between 70° and 40° of wrist extension. Level of evidence: III
A modified partial wedge-shaped metaphyseal ulnar osteotomy for the treatment of ulnar impaction syndrome with reverse oblique sigmoid notch
Authors: Liu Yuchen , Li Xiucun , Su Xiangmeng , Yin Huawei , Xu Wendong , Shen Yundong 
Published: May 2024

We describe a modified metaphyseal ulnar osteotomy to treat ulnar impaction syndrome with a reverse oblique sigmoid notch. Based on a computational analysis of radiographs, a modified wedge metaphyseal ulnar osteotomy was devised with its apex positioned at the ulnar styloid base to avoid impaction between the sigmoid notch and ulnar head. Subsequently, nine patients with ulnar impaction syndrome and a reverse oblique sigmoid notch underwent this operation, combined with arthroscopic exploration and transosseous triangular fibrocartilage complex repair. The mean follow-up was 14 months. All patients achieved bone union within 5 weeks, with no degenerative changes being observed during the follow-up assessments. The final follow-up assessments revealed decreases in ulnar variance and in the scores for Visual Analogue Scale, Quick Disabilities of the Arm, Shoulder and Hand questionnaire and the Patient-Rated Wrist Evaluation. All patients achieved excellent or good grades on the Modified Mayo Wrist Score. This technique is effective in treating the ulnar impaction syndrome with a reverse oblique sigmoid notch. Level of evidence: IV