bluuebunny/crossref_metadata_2025_split huggingface dataset:
Nitinol Staple Use in Primary Arthrodesis of Lisfranc Fracture-Dislocations
Authors: Dombrowsky Alexander R. , Strickland Carson D. , Walsh Devin F. , Hietpas Kayla , Conti Matthew S. , Irwin Todd A. , Cohen Bruce E. , Ellington J. Kent , Jones Carroll P. , Shawen Scott B. , Ford Samuel E. 
Published: June 2024

Background: Primary arthrodesis of Lisfranc fracture-dislocations is a reliable treatment option, yet concerns remain about nonunion. Nitinol staple use has recently proliferated in midfoot arthrodesis. The purpose of this study is to examine the union rate of primary arthrodesis of acute Lisfranc fracture-dislocations treated with nitinol staples compared with traditional plate-and-screw fixation. The secondary objective is to assess the difference in operative times and reoperation rates. Methods: Midfoot fracture-dislocations treated with primary arthrodesis by 7 foot and ankle orthopaedic surgeons were reviewed. Of 160 eligible patients, 121 patients (305 joints) met the required 4-month minimum radiographic follow-up. Radiographic outcomes were analyzed at the individual joint level. Each joint was classified as either staples alone (45 patients, 154 joints), staples plus plates and screws (hybrid) (45 patients, 40 joints), or plates and screws alone (31 patients, 111 joints). The primary outcome was arthrodesis union at each joint fused. Results: Nonunion was more common (9.0%, 10/111) among joints fixed with plate and screws than with hybrid (2.5%, 1/40) or staples only (1.3%, 2/154) ( P = .0085). Multivariable regression demonstrated that autograft use was independent associated with union ( P = .0035) and plate-and-screw only fixation was an independent risk factor for nonunion ( P = .0407). Median operating room and tourniquet times were shorter for hybrid (92 and 83 minutes) and staple only (67 and 63 minutes) constructs compared to plate-and-screw only fixation (105 and 95 minutes) ( P  ≤ .0001 and .0003). There was no difference in reoperation rates among patients with different fixation types. Conclusion: We found that use of nitinol compression staple and bone autograft in primary arthrodesis of Lisfranc and midfoot fracture-dislocations was associated with both improved union rates and shorter tourniquet and operative times compared to traditional plate-and-screw fixation techniques. Level of Evidence: Level III, therapeutic.
XEN45 gel stent in the treatment of pigmentary glaucoma: A two-year follow-up
Authors: Gassel Caroline J , Nasyrov Emil , Wenzel Daniel A , Voykov Bogomil 
Published: June 2024

Purpose To investigate safety and efficacy of the XEN gel stent in patients with pigmentary glaucoma (PG). Methods A retrospective analysis of 26 eyes of 19 patients with PG undergoing XEN gel stent implantation was performed. Best-corrected visual acuity, intraocular pressure (IOP), and number of antiglaucoma medications were analyzed preoperatively, and at 2 weeks and 3, 6, 12, and 24 months after surgery. Success, needling, and complications were analyzed. Complete success was defined as an IOP reduction of >20% and achieving a target IOP of ≤18, ≤15, or ≤12 mmHg without antiglaucoma medication. Qualified success was indicated if the IOP target was reached with or without medication. Results Mean IOP decreased significantly from 27.6 ± 14.3 (standard deviation, SD) mmHg to 14.3 ± 4.6 mmHg after one year ( p < 0.001) and 15.1 ± 2.7 mmHg ( p < 0.001) after two years. The median number of hypotensive drugs declined significantly from 4 (range: 3–5) to 0 (0–2) and 0 (0–3) after one and two years, respectively. After two years, complete success with an IOP of ≤18 mmHg and ≤15 mmHg was achieved in 73.1% and 61.5%, respectively. Half of the eyes required needling after a median time of 8 months (0.5–34 months). No sight-threatening complications were observed. Conclusion The XEN gel stent is a safe and effective surgical treatment option for PG. Needling is an important part of the procedure and should be communicated preoperatively to the patients.
Enlarged perivascular spaces are associated with brain microangiopathy and aging in multiple sclerosis
Authors: Borrelli Serena , Guisset François , Vanden Bulcke Colin , Stölting Anna , Bugli Céline , Lolli Valentina , Du Pasquier Renaud , van Pesch Vincent , Absinta Martina , Pasi Marco , Maggi Pietro 
Published: June 2024

Background: Growing evidence links brain-MRI enlarged perivascular spaces (EPVS) and multiple sclerosis (MS), but their role remains unclear. Objective: This study aimed to investigate the cross-sectional associations of EPVS with several neuroinflammatory and neurodegenerative features in a large multicentric-MS cohort. Methods: In total, 207 patients underwent 3T axial-T2-weighted brain-MRI for EPVS assessment (EPVS dichotomized into high/low according to ⩾ 2/< 2 rating categories). MRI biomarkers included brain-predicted age and brain-predicted age difference (brain-PAD), central vein sign (CVS)-positive lesion percentage (CVS%), paramagnetic rim and cortical lesions, T2-lesion load, and brain volumetry. The variable relative importance for EPVS-category prediction was explored using a classification random forest approach. Results: High EPVS patients were older (49 vs 44 years, p = 0.003), had ⩾ 1 vascular risk factors (VRFs; p = 0.005), lower CVS% (67% vs 78%, p < 0.001), reduced brain volumes (whole brain: 0.63 vs 0.73, p = 0.01; gray matter: 0.36 vs 0.40; p = 0.002), and older brain-predicted age (58 vs 50 years, p < 0.001). No differences were found for neuroinflammatory markers. After adjusting for age and VFRs (multivariate analyses), the high EPVS category correlated with lower CVS% (odds ratio (OR) = 0.98, 95% confidence interval (CI) = 0.96–0.99; p = 0.02), lower whole brain (OR = 0.01, 95% CI = 0.0003–0.5; p = 0.02), gray matter (OR = 0.0004, 95% CI = 0.0000004–0.4; p = 0.03) volumes, and higher brain-PAD (OR = 1.05, 95% CI = 1.01–1.09; p = 0.02). Random forest identified brain-PAD as the most important predictor of high EPVS. Conclusion: EPVS in MS likely reflect microangiopathic disease rather than neuroinflammation, potentially contributing to accelerated neurodegeneration.
Preparation and mechanical properties of absorbing composites based on nickel plated fabric
Authors: Yuan Yunxiang , Ma Yizhi , Li Xinchao , Liu Ruixue , Sun Luning , Zhang Hongchao , Wei Sainan 
Published: June 2024

A high purity Ni plating layer was obtained on the surface of the plain cotton fabric by electroless nickel plating. The micromorphology and elemental composition of the Ni plating layer were characterized by scanning electron microscopy (SEM) and energy dispersive spectroscopy (EDS). Structural absorbing composites with glass fiber (GFs)/epoxy resin (EP) as permeable layer, nickel coated fabric/EP as absorbing layer and carbon fiber UD cloth (UDCFs)/EP as reflecting layer were prepared by vacuum assisted resin perfusion (VARI). The effects of different thicknesses on the microwave absorption properties and mechanical properties of composites were investigated. The results show that the lowest reflection loss (RL) is −31.02 dB, the effective absorbing bandwidth (RL < −10 dB) is 6.21 GHz (11.55 GHz - 17.76 GHz), and the maximum tensile and bending loads endured are 41.36 KN and 1.63 KN at 15.14 GHz with a thickness of 2.5 mm, which provides a good reference value for the subsequent preparation of magnetic/dielectric composites with both excellent microwave absorption and mechanical properties.
Endovascular treatment for brain arteriovenous malformations via the anterior choroidal artery for casting Onyx-18
Authors: Su Han , Yu Jinlu 
Published: June 2024

Background: Few studies have investigated the safety of endovascular treatment (EVT) for brain arteriovenous malformations (BAVMs) via the anterior choroidal artery (AchA); therefore, this topic is worth studying further. Materials and methods: This was a retrospective study of 18 consecutive patients with BAVMs that were treated via the AchA with Onyx casting. Clinical and angiographic data were collected from the patients and analyzed. Results: The ages of the 18 patients ranged from 13 to 67 years (mean 39.2 ± 14.7 years), and eight patients were male (44.4%, 8/18). All patients had intracranial hemorrhages, including 2 with previous hemorrhages. All 18 BAVMs were mainly fed by the AchA and were treated via the AchA as the route for casting Onyx-18. Of the 13 single-trunk AchAs, after EVT, all proximal segments were preserved. For the 5 double-trunk AchAs, EVT was performed via the lower trunk; the proximal segments of the lower trunk were occluded for 2 of these AchAs. Among the 18 BAVMs, 16 niduses were embolized to different degrees, as were twelve associated aneurysms. Five (27.8%, 5/18) of the 18 patients experienced complications, and appropriate management was provided. During long-term follow-up, 14 (77.8%, 14/18) patients achieved good outcomes. Conclusion: EVT for BAVMs via the AchA has significant risks, but overall, good long-term outcomes were achieved in approximal 80% of the patients. This study highlights the potential of this technique for embolizing BAVMs via the AchA.
Intention to use picture archiving and communication system and its predictors among physicians and nurses at specialized teaching hospitals in Amhara region, Northwest Ethiopia
Authors: Kelkay Jenberu Mekurianew , Negatu Addisu Alem , Molla Rediet Abebe , Beri Henok Molla , Tefera Abel Melaku , Wubneh Henok Dessie 
Published: June 2024

Background: Picture archiving and communication system is an innovation system in the health information that reduces costs, facilitates access to medical image, and improves workflow in radiology department. However, studies indicated that intention and usage of picture archiving and communication system is limited in middle-income and developing countries. Objective: This study aimed to assess the intention to use picture archiving and communication system and its predictors among physicians and nurses at specialized teaching hospitals in Amhara region, Northwest Ethiopia. Method: Institution-based cross-sectional study design was conducted from October 11 to November 12, 2023. Proportional allocation and a simple random sampling were used to select participants of the study. A self-administered structured English questionnaire was used, and a 5% pretest was performed. Data were entered into Epi data 4.6 and exported to SPSS 26 and AMOS 23. Descriptive and structural equation modeling analysis was performed. The hypothesis was tested using a path coefficient and a p-value <0.05. Results: About 54.7% (95%: CI: 50.9–58.4) of the participant intended to use picture archive and communication system with a 90.38% of response rate. Performance expectancy (β = 0.146, p-value <0.05), perceived enjoyment (β = 0.397, p-value <0.001), and computer literacy (β = 0.191, p-value <0.001) had positive influence on intention to use picture archiving and communication system. Conclusions: Overall, more than half of physicians’ and nurses’ intention to use picture archiving and communication system were at hopeful stage for future. Performance expectancy, perceived enjoyment and computer literacy had direct positive effect on intention to use picture archiving and communication system among physicians and nurses. The designers, developers, and managers of the picture archiving and communication system should consider these variables. Furthermore, using this system can improve quality of health service through change workflow in to digital image, clinicians evaluate image more quickly and saving resources.
Patients’ acceptability of self-selected digital health services to support diet and exercise among people with complex chronic conditions: Mixed methods study
Authors: Barnett Amandine , Catapan Soraia de Camargo , Jegatheesan Dev K , Conley Marguerite M , Keating Shelley E , Mayr Hannah L , Webb Lindsey , Brown Riley C C , Coombes Jeff S , Macdonald Graeme A , Isbel Nicole M , Burton Nicola W , Campbell Katrina L , Hickman Ingrid J , Kelly Jaimon T 
Published: June 2024

Objective The acceptability of being offered a choice from a suite of digital health service options to support optimal diet and exercise behaviors in adults with complex chronic conditions was evaluated. This study sought to understand many areas of acceptability including satisfaction, ease of use, usefulness and user appropriateness and perceived effectiveness. Methods This mixed-methods study was embedded within a randomized-controlled feasibility trial providing digital health services managing diet and exercise for adults from specialist kidney and liver disease clinics. Post study surveys and semistructured interviews were used to determine patients’ acceptability of the trial interventions. Quantitative (surveys) and qualitative (surveys and interviews) results were merged using integrative analysis and mapped to each construct of the modified version of the Theoretical Framework of Acceptability. Results Seventeen interviews (intervention group) and 50 surveys ( n = 24 intervention, n = 26 comparator) completed from a possible 67 participants were analyzed. In the intervention group, the survey results revealed high areas of acceptability for the digital health services including overall support received, ease of use, timely advice and feeling safe. The interviews also revealed high areas of acceptability including convenience, ability to adopt healthier behaviors and having regular interactions with health professionals. However, the interviews also revealed lower areas of acceptability as a result of absence of individualization, low digital literacy, and limitations from life circumstances. Conclusions Recipients of digital health services that supported diet and exercise interventions found these useful, effective, and safe. Individualized care, technical support and patient confidence remain important to improve the acceptability of digital health service interventions.
Application of a mobile health data platform for public health surveillance: A case study in stress monitoring and prediction
Authors: Velmovitsky Pedro Elkind , Alencar Paulo , Leatherdale Scott T , Cowan Donald , Morita Plinio Pelegrini 
Published: June 2024

Background Public health surveillance involves the collection, analysis and dissemination of data to improve population health. The main sources of data for public health decision-making are surveys, typically comprised of self-report which may be subject to biases, costs and delays. To complement subjective data, objective measures from sensors could potentially be used. Specifically, advancements in personal mobile and wearable technologies enable the collection of real-time and continuous health data. Objective In this context, the goal of this work is to apply a mobile health platform (MHP) that extracts health data from the Apple Health repository to collect data in daily-life scenarios and use it for the prediction of stress, a major public health issue. Methods A pilot study was conducted with 45 participants over 2 weeks, using the MHP to collect stress-related data from Apple Health and perceived stress self-reports. Apple, Withings and Empatica devices were distributed to participants and collected a wide range of data, including heart rate, sleep, blood pressure, temperature, and weight. These were used to train random forests and support vector machines. The SMOTE technique was used to handle imbalanced datasets. Results Accuracy and f1-macro scores were in line with state-of-the-art models for stress prediction above 60% for the majority of analyses and samples analysed. Apple Watch sleep features were particularly good predictors, with most models with these data achieving results around 70%. Conclusions A system such as the MHP could be used for public health data collection, complementing traditional self-reporting methods when possible. The data collected with the system was promising for monitoring and predicting stress in a population.
Testing the feasibility of mobile ecological momentary assessment for symptom burden and management among metastatic cancer patients
Authors: Brasky Theodore M. , Newton Alison M. , Stephens Julie A. , Strassels Scott A. , Benzo Roberto M. , Hays John L. , Stevens Erin , Wagener Theodore L. , Hedeker Donald , Krok-Schoen Jessica L. 
Published: June 2024

Background Individuals who have metastatic cancer experience substantial physical and psychological distress (e.g., pain, depression, anxiety) from their disease and its treatment compared to patients with less advanced disease. As the burden of symptoms varies over time, ecological momentary assessment (EMA) may be used to better understand patients’ symptom trajectories, complimenting traditional longitudinal data collection methods. However, few have used EMA in patients with metastatic disease. The current study adds to the existing literature by exploring interrelated, common cancer-related symptoms of pain, anxiety, and depression and use of cannabis-based products, opioid medications, other (nonopioid) pain medications, and medications for anxiety or depression. Methods An eight-day prospective observational feasibility study was conducted among 50 patients with metastatic cancer recruited from seven solid cancer clinics at The Ohio State University Comprehensive Cancer Center. Participants completed a week of interval-contingent mobile EMA, administered daily at 9 a.m., 3 p.m., and 8 p.m., and a comprehensive interviewer-administered questionnaire on Day 8. Participants were queried on their symptom burden and management strategies (i.e., use of medications and cannabis). We considered EMA to be feasible if a priori retention (80%) and adherence goals (75%) were met. Results Seventy-nine percent of eligible patients contacted enrolled in the study ( n = 50 of 63). Among those enrolled, 92% were retained through Day 8 and 80% completed >90% of EMAs, exceeding a priori objectives. Participants’ average pain, anxiety, and depressive symptoms across the week of EMA ranged from 1.7 to 1.8 (1 to 5 scale). Symptoms varied little by day or time of administration. On Day 8, significant proportions of participants reported past-week use of medications and cannabis for symptom management. Conclusions Participants exceeded a priori adherence and retention objectives, indicating that mobile EMA is feasible among metastatic cancer patients, addressing a gap in the existing literature and informing future research. Restricting eligibility to participants with a minimum cutoff of symptom burden may be warranted to increase observations of symptom variability and provide opportunities for future health interventions. Future research is needed to test the acceptability and quality of data over a longer study period in this patient population.
Knowledge and Attitudes Regarding Depression Among a Sample of Iraqi Non-Psychiatric Nurses: A Cross-Sectional Study
Authors: Ahmed Sirwan Khalid , Abdulqadir Salar Omar , Omar Rukhsar Muhammad , Mohamed Mona Gamal , James Rachel , Hussein Safin Hassan , Aziz Tahir Abdullah , Fahrni Mathumalar Loganathan 
Published: June 2024

Introduction Nurses, comprising the largest profession in healthcare, play a significant role in the identification and management of mental health disorders in hospitals. Objectives The study assessed the knowledge and attitudes of non-psychiatric nurses and their encounters with depressive patients throughout their careers. Methods This was a cross-sectional descriptive study with 400 non-psychiatric nurses from different hospitals in the Kurdistan Region of Iraq during October and November 2022. The independent Student's t-test, one-way analysis of variance, and binary logistic regression were used to assess possible factors associated with knowledge and attitude toward depression. Results In this study, 400 non-psychiatric nurses were examined, revealing a mean age of 31.57 ± 8.59 years. Their mean scores for knowledge and attitude toward depression were 5.41 out of a maximum of 11 (standard deviation 1.15) and 5.15 out of 18 (standard deviation 1.83), respectively. Notably, differences in mean knowledge scores were observed concerning participant marital status ( P = .044), while disparities in mean attitude scores are related to participant gender ( P = .010). Upon binary logistic regression analysis, none of the independent variables exhibited an association with good knowledge. Nevertheless, gender emerged as a significant factor influencing attitude toward depression (odds ratio: 0.51; 95% confidence interval: 0.30–0.86; P = .012). Subsequently, in the multivariate binary logistic regression analysis, gender sustained significance (adjusted odds ratio: 0.573; 95% confidence interval: 0.348–0.942; P = .028) as the key variable impacting attitudes toward depression among non-psychiatric nurses. Conclusion Based on the results of this study, nurses have insufficient awareness and management skills for depression. It has been experienced and reported that nurses lack knowledge and an attitude toward depression management. The study highlights a significant gap in nurses’ skills for managing depression, urging the immediate improvement of training programs. Customizing these programs to enhance nurses’ abilities in identifying and managing depression is crucial.
Association of Food and Housing Insecurity on Outcomes in Pregnant Patients With Substance Use Disorder
Authors: Chilukuri Pranaya , Patel Neil , Cockerham Cynthia , Su Leon , Stromberg Arnold , O’Brien John , Parilla Barbara 
Published: June 2024

Objectives: Food insecurity (FI) may be associated with worsened neonatal abstinence syndrome severity in infants born to individuals with substance use disorder. This study evaluates FI and housing insecurity (HI) influence on maternal and neonatal outcomes. Methods: This was a cohort study of patients receiving obstetric care through a multispecialty program in Kentucky from 2015 to 2023. Inclusion criteria were: (1) program participants over age 18 consenting to observational research, (2) delivering at University of Kentucky, and (3) not withdrawing from research at any time. Initially, a subset of patients for whom FI and HI concerns were heightened were screened. In 2019, FI and HI screening became standard of care at the clinic. Housing was assessed on enrollment. A validated 2-question Hunger Vital Sign FI screen was utilized for a subset of patients. Maternal and neonatal outcomes, including adverse delivery outcomes, maternal comorbidities, and birth complications, were observed. Fisher’s exact and 2 sample t tests were performed. Results: Of 494 participants, 188 (38%) identified at risk for HI. At enrollment, 221 (45%) individuals reported owning their primary residence, 85 (17%) were in group residential treatment, 34 (6.9%) had no housing, and 134 (27%) lived at another’s residence. Disposition of a child to a relative or not the patient’s own care was greater with HI, 51% versus 47%. Of 155 respondents, 96 (62%) reported FI, associated with increased neonatal intensive care unit (NICU) admission, 86% versus 74%. Using the validated tool, Abuse Assessment Screen, abuse was significantly greater with FI, 76% versus 58%. Edinburgh Postpartum Depression Scales >12 indicating depression were more common with FI, 63% versus 32%, P < .05. Anxiety scores were also higher with FI, P < .05. Patients with FI were more likely to experience abuse. Conclusions: FI and HI were health-related needs associated with increased anxiety, depression, infant NICU admission, and loss of child custody.