bluuebunny/crossref_metadata_2025_split huggingface dataset:
Management of Humeral Shaft Fracture: A Network Metanalysis of Individual Treatment Modalities
Authors: Colasanti Christopher A. , Anil Utkarsh , Cerasani Michele N. , Li Zachary I. , Morgan Allison M. , Simovitch Ryan W. , Leucht Philipp , Zuckerman Joseph D. 
Published: April 2024

Objective:
The purpose of this study was to perform a network meta-analysis (NMA) of level I and II evidence comparing different management techniques to define the optimum treatment method for humeral shaft fractures (HSF).

Methods:

Data Sources: A systematic review of the literature using PRISMA guidelines of MEDLINE, EMBASE, and Cochrane Library was screened from 2010-2023.

Study Selection:
Inclusion criteria were evidence level I or II studies comparing nonoperative and/or operative repair techniques including open reduction internal fixation plate osteosynthesis (ORIF-Plate), minimally invasive percutaneous plating (MIPO), and intramedullary nail fixation (IMN) for the management of HSF (AO OTA 12A,B,C).

Data Extraction:
The risk of bias (ROB) and methodologic quality of evidence (MQOE) were assessed according to the guidelines designed by the Cochrane Statistical Methods Group and Cochrane Methods Bias Group.

Data Synthesis:
NMA were conducted with a frequentist approach with a random effects model using the netmeta package version 0.9-6 in R.

Results:
A total of 25 studies (1,908 patients) were included. MIPO resulted in the lowest complication rate (2.1%) when compared to ORIF-Plate (16.1%) (OR, 0.13;95%CI,0.04-0.49). MIPO resulted in the lowest nonunion rate (0.65%) compared to all management techniques (OR 0.28; 95%CI, 0.08-0.98), whereas Non-Op resulted in the highest (15.87%) (OR,3.48; 95%CI, 1.98-6.11). MIPO demonstrated the lowest rate of postoperative radial nerve palsy overall (2.2%) and demonstrated a significantly lower rate compared to ORIF-Plate (OR,0.22,95% CI, 0.07-0.71, p=0.02). IMN resulted in the lowest rate of deep infection (1.1%) when compared to ORIF-Plate (8.6%; p=0.013). MIPO resulted in a significantly lower DASH score (3.86±5.2) and higher ASES score (98.2± 1.4) than ORIF-Plate (19.5±9.0 & 60.0±5.4, p<0.05).

Conclusion:
The results from this study support that surgical management results in better postoperative functional outcomes, leads to higher union rates, reduces fracture healing time, reduces revision rate and decreases malunion rates in patients with HSFs. Additionally, MIPO resulted in statistically higher union rates, lowest complication rate, lowest rate of postoperative radial nerve palsy, and lower intraoperative time, while resulting in better postoperative DASH and ASES scores when compared to nonoperative and operative (ORIF & IMN) treatment modalities.

Level of Evidence:
Level II. See Instructions for Authors for a complete description of levels of evidence.
Mobility Is Medicine, Too: Creating a Culture of Mobility Amongst Hospitalized Patients With Cancer to Improve Patient Outcomes
Authors: Morjaria Sejal , Carmody Claire , Navlakha Saket , Zhou Wei , Braccia Donna , Aquino Jennifer , Roumm Adam , Martin Steve , Syrkin Grigory 
Published: April 2024

Background:
Despite decades of evidence demonstrating the effectiveness of multidisciplinary mobility initiatives in improving patient clinical outcomes, the impact of mobility programs in oncology-specific settings has been ignored.

Objective:
The objective of this initiative is to test evidence-based mobility interventions in a cancer care center to create a culture among clinicians that prioritizes patient mobilization.

Methods:
We compared postintervention and preintervention outcomes using logistic regression analysis and time-to-event modeling to assess hospital length of stay. Basic statistical methods assessed whether improving mobility influenced clinical outcomes and clinician culture.

Results:
Outcome data from 493 in the postintervention arm were compared to 498 patients in the preintervention arm. Patients in the postintervention group had 39% decreased odds of having the rapid response team called (confidence interval [CI] =0.39–0.97; P = .03) and 46% decreased odds of being admitted to the intensive care unit (CI = 0.29–1.02; P = .05) compared to the preintervention group. No safety issues were associated with these interventions.

Conclusions:
Hospitalized patients with cancer are especially prone to considerable debility due to their disease and treatment effects. Our initiative to create a mobility protocol in 1 medical unit resulted in positive clinical outcomes.

Implications for Practice:
Findings from this study can be used to increase recognition of the benefits of mobility programs for hospitalized cancer patients.

What is Foundational:
Promoting mobility in the hospital often involves collaboration among various healthcare professionals, including nurses, physical therapists, occupational therapists, and physicians. This interdisciplinary approach ensures that patients receive holistic care tailored to their specific needs.
Retinal Vascular Imaging Application in Women’s Reproductive Health: Clinical Implications and Future Directions
Authors: Lim Beth Shi Yu , Li Ling-Jun 
Published: April 2024

Abstract
Over the past two decades, population-based studies employing semiautomatic computer-assisted programs have uncovered associations between retinal microvascular features and various systemic conditions. As the recognition of retinal imaging in cardiometabolic health grows, there is increasing evidence supporting its application in women’s health, particularly during the reproductive age. This review aims to summarize the indications of retinal imaging in women’s health and intergenerational health, where suboptimal retinal imaging has been found to mirror pathological systemic changes, such as suboptimal hemodynamic circulation, inflammation, endothelial dysfunction, oxidative stress, and hypoxia in vivo. Findings from Singapore Growing Up in Singapore Towards Healthy Outcomes and Singapore Preconception Study of Long-Term Maternal and Child Outcomes cohorts have reported serial changes in retinal conventional microvascular features (e.g., retinal arteriolar narrowing, retinal venular widening) and retinal geometric microvascular features (e.g., sparse fractal dimension, enlarged branching angle, and increased curvature tortuosity) during the preconception and antenatal phases. These morphological abnormalities were found to be related to female fertility, maternal antenatal health conditions, postnatal maternal cardiometabolic health, and intergenerational health in the fetus. Given the compelling evidence of the ability to detect microvascular changes through noninvasive methods at an early stage, retinal imaging holds the potential to facilitate timely interventions, mitigate the progression of complications, and prevent adverse pregnancy outcomes. Looking ahead, the convergence of artificial intelligence and advanced imaging techniques heralds a promising era in women’s health research and clinical practice.
Pilot Test of A Gender-conscious Sexual Health Intake Questionnaire: Increasing Inclusivity and Mitigating Bias in Sexual History Taking
Authors: Zhang Tenny R. , Castle Elijah , Dubach-Reinhold Charlie , Blasdel Gaines , Kloer Carmen , Alford Ashley , Bluebond-Langner Rachel , Zhao Lee C. 
Published: April 2024

Background:
Sexual health is critical to overall health, yet sexual history taking is challenging. LGBTQ+ patients face additional barriers due to cis/heteronormativity from the medical system. We aimed to develop and pilot test a novel sexual history questionnaire called the Sexual Health Intake (SHI) form for patients of diverse genders and sexualities.

Methods:
The SHI comprises four pictogram-based questions about sexual contact at the mouth, anus, vaginal canal, and penis. We enrolled 100 sexually active, English-speaking adults from a gender-affirming surgery clinic and urology clinic from November 2022 to April 2023. All surveys were completed in the office. Patients also answered five feedback questions and 15 questions from the Patient-Reported Outcomes Measurement Information System Sexual Function and Satisfaction (PROMIS-SexFS) survey as a validated comparator.

Results:
One hundred patients aged 19–86 years representing an array of racial/ethnic groups, gender identities, and sexuality completed the study. Forms of sexual contact varied widely and included all possible combinations asked by the SHI. Feedback questions were answered favorably in domains of clinical utility, inclusiveness of identity and anatomy, and comprehensiveness of forms of sexual behavior. The SHI captured more positive responses than PROMIS-SexFS in corresponding questions about specific types of sexual activity. The SHI also asks about forms of sexual contact that are not addressed by PROMIS-SexFS, such as penis-to-clitoris.

Conclusions:
SHI is an inclusive, patient-directed tool to aid sexual history taking without cisnormative or heteronormative biases. The form was well received by a diverse group of participants and can be considered for use in the clinical setting.
Self-induced Hot Water Finger Burn Trying to Get Feeling Back after Ropivacaine Block
Authors: Rohde Rachel S. , Wong Alison , Lalonde Donald H. 
Published: April 2024

Summary:
This case report is about a patient with self-induced hot water burns several hours after an infraclavicular block with ropivacaine for a scaphoid fracture operation. This patient was honest about what happened. However, some patients are too embarrassed to admit what they did to themselves. The injury may be misdiagnosed by the emergency department physician or by the surgeon because the history is incomplete. The resulting burn, which can lead to fingertip loss when severe, can be erroneously misdiagnosed as an ischemic injury after lidocaine with epinephrine local anesthesia. Most hand surgeons have seen ischemic finger injuries the morning after failed finger replantation. Acutely ischemic fingers from arterial insufficiency do not have parallel hot water burn lines, reactive hyperemia at the base of the burn, or burn blisters at the fingertips. The purpose of this article and its video is to help physicians and nurses recognize the three signs of self-induced hot water finger burns after local anesthesia: (1) a parallel hot water line in the fingers at the proximal burn level; (2) reactive hyperemia just proximal to the burn line; (3) burn blisters in the submerged fingertips. When seeing postoperative patients with these signs, the examining clinician may tactfully ask: “Did you try to get the feeling back in your fingers by warming them?” It is hoped that the patient may then reveal that he tried warming the finger in water, and that may lead to the truth that the water was indeed too hot.
Clinical study on treatment of cervical spondylotic radiculopathy (Qi stagnation and blood stasis syndrome) with Gao’s nape needle and Shentong Zhuyu decoction
Authors: Haishen Zhao , Manya Wang , Hong Ye , Kejun Shi , Ruiqian Guan 
Published: April 2024

Background:
Cervical spondylotic radiculopathy is currently one of the common orthopedic diseases, mainly characterized by neck pain, stiffness, limited mobility, and related symptoms of nerve root compression, which seriously troubles people’s work and life.

Methods:
Ninety cases of cervical spondylotic radiculopathy (Qi stagnation and blood stasis syndrome) were randomly divided into treatment group and control group, 45 cases in each group. The control group was treated with western medicine (nerve nutrition, pain relief, and circulation improvement drugs), and the treatment group was treated with Gao’s nape needle combined with modified Shentong Zhuyu decoction on the basis of the control group. Before and after 2 weeks, TCM syndrome score, TCM curative effect, visual analogue scale score, numbness score, neck disability index score, related serum inflammatory factors (interleukin-10 [IL-10], interleukin-6 [IL-6], tumor necrosis factor-α [TNF-α]), related hemorheological indexes (plasma viscosity, high shear whole blood viscosity, low shear whole blood viscosity level) were used as evaluation indexes to evaluate the effect.

Results:
After treatment, the total effective rate of the treatment group was 91.11%, which was better than that of the control group (78.78%), and the TCM syndrome scores of the 2 groups were decreased, the treatment group was better than that of the control group, and the differences were statistically significant (P < .05). After treatment, the visual analogue scale score, numbness score, and neck disability index score were decreased in both groups, and the decrease in the treatment group was more significant than that in the control group, and the differences were statistically significant (P < .05). After treatment, the related serum inflammatory factors (IL-10, IL-6, TNF-α) and related hemorheological indexes (plasma viscosity, high-shear whole blood viscosity, low-shear whole blood viscosity) were decreased in both groups, and the decrease in the treatment group was more significant than that in the control group, and the differences were statistically significant (P < .05).

Conclusion:
The treatment of cervical spondylotic radiculopathy (Qi stagnation and blood stasis syndrome) with Gao’s nape needle and modified Shentong Zhuyu decoction can improve the curative effect of traditional Chinese medicine, improve the related discomfort symptoms (neck tenderness, adverse activity, numbness, etc), improve the neck function, reduce IL-10, IL-6, TNF-α, and other related serum inflammatory factors, and improve hemorheological indicators.
Effect of continuity nursing based on the theory of Knowledge-Attitude-Practice on quality of life, self-efficacy, and treatment compliance in elderly patients with benign prostatic hyperplasia
Authors: Mao Jing , Wang Juan , Li Rong , Xiang Juan , Zhao Turong , Chen Lin , Li Gang 
Published: April 2024

Objective:
The purpose of this study was to analyze the impact of continuity nursing based on the theory of Knowledge-Attitude-Practice (KAP) on the quality of life, self-efficacy, and treatment compliance in elderly patients with benign prostatic hyperplasia (BPH).

Methods:
In this single-center, randomized controlled study, a total of 232 elderly BPH patients who received treatment at our hospital from June 2020 to June 2022 were selected as the research subjects. They were randomly divided into the research group (n = 116) and the control group (n = 116). The control group received conventional interventions, while the research group received continuity nursing based on the theory of KAP on the basis of control group. Anxiety, depression, self-care agency, quality of life, self-efficacy, treatment compliance, and nursing satisfaction were compared between these 2 groups.

Results:
Before nursing intervention, both groups showed a decrease in SAS and SDS scores after the intervention. Furthermore, self-care ability, self-care responsibility, self-concept, health knowledge level, role function, emotional function, somatic function, cognitive function, social function, and General Self-Efficacy Scale scores increased. Additionally, the research group demonstrated lower/higher levels than the control group (P < .05). The research group exhibited higher treatment compliance (P = .002) and greater nursing satisfaction compared to the control group (P = .014).

Conclusion:
Continuity nursing based on the theory of KAP can improve negative emotions in elderly BPH patients, enhance their self-efficacy and treatment compliance, and achieve better clinical outcomes.
ALYREF m5C RNA methylation reader predicts bladder cancer prognosis by regulating the tumor immune microenvironment
Authors: Pan Wengu , Liu Xiaoli , Liu Shuangde 
Published: April 2024

Background:
5-Methylcytidine (m5C) methylation is a recently emerging epigenetic modification that is closely related to tumor proliferation, occurrence, and metastasis. This study aimed to investigate the clinicopathological characteristics and prognostic value of m5C regulators in bladder cancer (BLCA), and their correlation with the tumor immune microenvironment.

Methods:
Thirteen m5C RNA methylation regulators were analyzed using RNA-sequencing and corresponding clinical information obtained from the TCGA database. The Cluster Profiler package was used to analyze the gene ontology function of potential targets and enriched the Kyoto Encyclopedia of Genes and Genomes pathway. Kaplan–Meier survival analysis was used to compare survival differences using the log-rank test and univariate Cox proportional hazards regression. The correlation between signature prognostic m5C regulators and various immune cells was analyzed. Univariate and multivariate Cox regression analyses identified independence of the ALYREF gene signature.

Results:
Nine out of the 13 m5C RNA methylation regulators were differentially expressed in BLCA and normal samples and were co-expressed. These 9 regulators were associated with clinicopathological tumor characteristics, particularly high or low tumor risk, pT or pTNM stage, and migration. Consensus clustering analysis divides the BLCA samples into 4 clusters. Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment annotation and gene ontology function analysis identified 273 upregulated and 594 downregulated genes in BLCA. Notably, only ALYREF was significantly correlated with OS (P < .05). ALYREF exhibited significant infiltration levels in macrophage cells. Therefore, we constructed a nomogram for ALYREF as an independent prognostic factor. Additionally, we observed that both the mRNA and protein levels of ALYREF were upregulated, and immunofluorescence showed that ALYREF was mainly distributed in nuclear speckles. ALYREF overexpression was significantly associated with poor OS.

Conclusion:
Our findings demonstrated the potential of ALYREF to predict clinical prognostic risks in BLCA patients and regulate the tumor immune microenvironment. As such, ALYREF may serve as a novel prognostic indicator in BLCA patients.
Application of quality control circle in the management of early ambulation after cesarean section: An observational study
Authors: Zhu Yu-Ting , Jiang Yu-Xin , Pei Lei , Zhu Wei-Chao , Jin Xiao-Guo 
Published: April 2024

Background:
The quality control circle (QCC) model has achieved good results in clinical applications in many hospitals in China and has gained popularity. This study aims to explore the application of QCC activities on early ambulation after cesarean section.

Methods:
A QCC management group was established following standardized methods and techniques. The theme of the group was identified as “to enhance the implementation rate of the patient early ambulation after the cesarean section” through a matrix graph. The early ambulation rates after surgery of patients who received cesarean section were compared before and after QCC managements.

Results:
Our data suggested that the early ambulation rates after cesarean section increased from 37.5% to 81.25% after applying QCC management. The biggest factor influencing the ambulation activities 24 ± 4 hours after the surgery was patients and family members do not cooperate. In addition, outstanding improvements in terms of nurses’ sense of responsibility and self-confidence, communication and teamwork capacity in the problem-solving process were observed after the establishment of QCC.

Conclusion:
The application of QCC management had not only increase the early ambulation rates after cesarean section but also improved the quality of nursery care in general.
Intravascular guide wire aspiration in a patient on extracorporeal membrane oxygenation: A case report
Authors: Choi Jae Ho , Yoo Jae Hwa , Chang Won Ho , Park Young Woo , Kim Hyun Jo , Oh Hong Chul 
Published: April 2024

Rationale:
Guide wire aspiration during central venous catheter (CVC) insertion in a patient on extracorporeal membrane oxygenation (ECMO) is a very rare but dangerous complication. A guide wire aspirated inside the ECMO can cause thrombosis, the ECMO to break down or shut off, and unnecessary ECMO replacement.

Patient concerns:
A 58-year-old man was scheduled for venovenous ECMO for acute respiratory distress syndrome. After his vital signs stabilized, we inserted a CVC. During CVC insertion, the guide wire was aspirated into the ECMO venous line.

Intervention:
After confirming the guide wire inside the ECMO venous line, we replaced the entire ECMO circuit.

Outcomes:
ECMO was maintained for 57 days, and weaning was successful but the patient died 5 days afterward.

Lessons:
Care must be taken when inserting a CVC using a guide wire in ECMO patients: the guide wire should not be inserted deeply, it should be secured during insertion, the ECMO venous cannula tip requires proper positioning, and ECMO flow should be temporarily reduced.
Clinical efficacy and complications of blocking screw in the treatment of lower limb long bone fracture: An updated systematic review and meta-analysis
Authors: Chen Xiao , Chen Jing , Chen Chang 
Published: April 2024

Background:
Blocking screw technique has been widely applied in the treatment of long shaft fractures. However, the evidence with regard to whether intramedullary nail combined with blocking screw technique has better clinical efficacy over other is not clear. The aim of the study was to explore the clinical efficacy and complications of intramedullary nail combined with blocking screw technique in the treatment of femoral or tibial shaft fractures.

Methods:
The PuMed, Embase, OVID, Cochrane library, Web of Science, Wanfang, CNKI and Weipu data were searched for studies of intramedullary nail combined with blocking screw in treatment of femoral or tibial shaft fracture published up to Aug 31 2023. Methodological quality of the trials was assessed, relevant data were extracted, and RevMan 5.3 and Stata 15.0 software were used to perform the meta-analysis of parameters related to the consequences.

Result:
Twenty articles were included, including 1267 patients. Meta-analysis results showed that compared with the non-blocking screw group, the blocking screw group had longer operation time (WMD = 13.24; 95% CI = 5.68–20.79, P = .0006) and more intraoperative fluoroscopy times (WMD = 57.62; 95% CI = 25.82–89.42, P = .0002). However, the postoperative therapeutic response rate was higher (OR = 5.60; 95% CI = 2.10–14.93, P = .0006), postoperative ankle joint function was better (OR = 3.48; 95% CI = 1.20–10.13, P = .02), and fracture healing rate was higher (OR = 3.56; 95% CI = 1.43–8.89, P = .006), fracture healing time was shorter (WMD = −3.59; 95% CI = −4.96 to −2.22, P < .00001), intraoperative blood loss was less (WMD = −54.80; 95% CI = −88.77 to −20.83, P = .002), hospitalization time was shorter (WMD = −1.66; 95% CI = −2.08 to −1.24, P < .00001), and complications were less (OR = 0.38; 95% CI = 0.16–0.89, P = .01). There was no statistical significance in the range of motion of knee joint between the 2 groups (WMD = 10.04; 95% CI = −1.51 to 21.59, P = .09).

Conclusions:
Current evidence shows that intramedullary nail combined with blocking screw technique in the treatment of lower limb long bone fracture has the advantages of good clinical efficacy, high fracture healing rate, short fracture healing time, good joint function, less complications and so on, which is worthy of clinical recommendation.