bluuebunny/crossref_metadata_2025_split huggingface dataset:
Practice Patterns Among Fellowship-Trained Rhinologists: A Survey of Past American Rhinologic Society Fellows
Authors: Tang Dennis M. , Nasrollahi Tasha S. , Vasquez Missael , Borrelli Michela , Sindwani Raj , Wu Arthur W. 
Published: April 2024

Background The goals of this study were to understand the trends in recent and past rhinology fellows concerning their demographics, goals, and experiences. Methods An anonymous web-based survey was sent to graduates of the 35 rhinology fellowship programs. The survey included questions regarding the scope of practice, research contribution, societal involvement, fellow satisfaction with training, and current practice patterns. Chi-square testing and logistic regression were used to compare variables across cohorts: 0-5 years versus 6+ years from fellowship graduation, gender, and practice settings. Results Based on 171 respondents, we found no significant differences in 0-5 versus 6+ year graduates in their desire for an academic job post-fellowship. However, those who graduated 6+ years ago had significantly more success securing one (74% vs 96%, P = 0.004). Between males and females, there were no differences in goal of obtaining an academic job or success in obtaining an academic career. Females were more likely to report they attend academic society meetings regularly. Female rhinologists also reported less satisfaction with overall work-life balance and decreased satisfaction with clinical practice. Physicians in academic settings have poorer work-life balance. Conclusions Our findings suggest that finding an academic job may be more difficult for recent rhinology fellowship graduates, although still very possible for the majority of graduates. Understanding the reason for these changes may provide insight to current rhinology fellowship directors and trainees interested in pursuing fellowship training.
Stress wave attenuation in ultra-high performance fibre-reinforced concrete during ballistic impact
Authors: Das Nabodyuti , Ramagiri Bhaskar , Nanthagopalan Prakash 
Published: April 2024

Depending on material properties and boundary conditions, various waves propagate within the target, during an impact event. Stress wave attenuation during ballistic impact can be expressed in strain profiles regarding time and distance from the impact point. The design of a ballistic-resistant structure thus depends on the stress wave attenuation. This present study focused on stress wave attenuation under projectile impact in ultra-high performance fibre-reinforced concrete (UHPFRC). 3 mm strain gauges were found suitable for such measurements. Two different types (steel fibres) of UHPFRC (Single fibre (S2): 2 % of 6 mm steel fibre and Hybrid fibre combination (S0.5L1.5): 0.5 % of 6 mm + 1.5 % of 13 mm steel fibres) were used for investigation. During the ballistic impact event, strain profiles at specific distances from the point of impact on both the front and rear surfaces of UHPFRC targets were recorded. The scabbing damage due to tension was captured and analysed in this study through stress wave attenuation. The impact performance of hybrid (Short and Long fibres) S0.5L1.5 UHPFRC combinations was much better than S2 (only short fibres) UHPFRC targets. The hybrid steel fibre UHPFRC also shows higher strain attenuation (than short fibre based UHPFRC) in the range of 10-30 µε/mm. It was concluded that the efficiently designed ballistic-resistant UHPFRC should have higher wave attenuation, implying the concrete has enhanced capacity to absorb and localise energy, thereby mitigating the extent of damage inflicted upon the overall concrete slab.
Correlation of oxidative stress and vascular endothelial dysfunction with hippocampal perfusion in atrial fibrillation patients with cognitive impairment
Authors: Ke Hong hong , Li Jinyi , Liang Guicheng , Li Shuhu , Wang Shirong , Zhong Guoqiang 
Published: April 2024

Objectives: To evaluate the correlation of oxidative stress and vascular endothelial dysfunction with hippocampal perfusion in patients with atrial fibrillation and cognitive impairment. Methods: In total, 41 atrial fibrillation patients with cognitive impairment were compared to 45 atrial fibrillation patients without cognitive impairment. Oxidative stress, vascular endothelial dysfunction, hippocampal perfusion, and cognitive function were measured. Results: Serum level of oxidized low-density lipoprotein was significantly higher in the atrial fibrillation + cognitive impairment group than in the atrial fibrillation group. Serum levels of intercellular adhesion molecule-1 and vascular cell adhesion molecule-1 were significantly higher, and nitric oxide was lower, in the atrial fibrillation + cognitive impairment group than in the atrial fibrillation group. The regional cerebral blood volume, mean transit time, and time to peak were significantly higher in the atrial fibrillation + cognitive impairment group than in the atrial fibrillation group. Moreover, regional cerebral blood flow was significantly lower in the atrial fibrillation + cognitive impairment group than in the atrial fibrillation group. Age, left atrial diameter, and regional cerebral blood volume were negatively correlated with the cognitive function score in the atrial fibrillation + cognitive impairment group. Serum levels of oxidized low-density lipoprotein, regional cerebral blood volume, regional cerebral blood flow, mean transit time, and time to peak were significantly correlated with cognitive impairment in atrial fibrillation patients after multivariate logistic regression analysis. Conclusion: Hippocampal perfusion and oxidative stress were significantly correlated with cognitive impairment in atrial fibrillation patients.
Incidence and Characteristics of Knee Ligament and Meniscal Injuries in Patients With Posterolateral Tibial Plateau Fractures
Authors: Wang Binghao , Zhu Yi , Zhang Binbin , Wang Yukai , Yan Lifeng , Xie Xuetao , Luo Congfeng 
Published: April 2024

Background: Anterior cruciate ligament (ACL) tears are commonly seen with concomitant injuries to the posterolateral tibial plateau, while the occurrence of ACL injuries in posterolateral tibial plateau fractures (PTPFs) remains unclear. Purpose: To (1) explore the incidence of knee ligament (anterior or posterior cruciate ligament, medial or lateral collateral ligament) and medial or lateral meniscus injuries in patients with PTPF and (2) find reliable PTPF-related parameters to predict the risk of knee ligament and meniscal injuries. Study Design: Cross-sectional study; Level of evidence, 3. Methods: Patients diagnosed with PTPF who had computed tomography and magnetic resonance imaging (MRI) data were identified. Morphological parameters of the PTPF were measured on sagittal computed tomography images. Knee ligament and meniscal injuries were assessed using MRI. The association of ACL injuries with meniscal injuries was analyzed. Receiver operating characteristic (ROC) analysis was used to determine the value and cutoff point of the PTPF morphological parameters for diagnosing complete in-substance ACL tears. Results: Overall, 113 patients with PTPF were included. ACL injuries were present in 94 (83.2%) patients, including 43 (38.1%) avulsion fractures and 28 (24.8%) complete in-substance tears. Patients with in-substance ACL tears had a higher incidence of lateral meniscus posterior horn tears compared with the other patients ( PBonferroni < .001). ROC analysis revealed that both the fracture depression angle (cutoff point, 25.5°) and the posterior articular surface loss percentage (cutoff point, 37.5%) had a sensitivity >90% and a specificity >80% for the diagnosis of complete in-substance ACL tears. Conclusion: ACL injuries were seen in 83.2% of the study patients. Complete in-substance ACL tears were associated with an increased incidence of lateral meniscus posterior horn tears. Among PTPF parameters, fracture depression angle and posterior articular surface loss percentage showed a high predictive value for the presence of complete in-substance ACL tears, thereby reducing delays in diagnosis and treatment.
Nurses’ Attitudes, Practices, and Barriers to Assessing Symptoms of Discomfort in Mechanically Ventilated Patients: A Cross-Sectional Study
Authors: Takahashi Tomohiko , Oyama Yusuke , Sakuramoto Hideaki , Tamoto Mitsuhiro , Sato Tomoo , Nanjo Yuko , Hosoi Sayaka , Unoki Takeshi 
Published: April 2024

Introduction Critically ill patients experience various stressful symptoms of discomfort, including dyspnea, pain, and sleep disruption. Notably, ventilated patients have difficulty self-reporting discomfort symptoms. Nurses need to assess discomfort symptoms to alleviate them, but limited research exists on discomfort symptom assessment and management in critically ill patients. Objective To identify the practices, attitudes, and barriers among nurses related to the assessment of discomfort symptoms in mechanically ventilated patients. Methods Using a cross-sectional, descriptive study design, a web-based survey was conducted between May and June 2022 with critical care nurses sampled through Japanese academic societies and social networking services. The survey contained questions relative to the above-stated objective. Descriptive statistical analysis was performed without sample size calculation because of the descriptive and exploratory nature of this study. Results There were 267 respondents to the questionnaire. The discomfort symptoms that nurses perceived as important to assess were pain (median 100 [interquartile range, IQR 90–100]), insomnia (99 [80–100]), and dyspnea (96.5 [75–100]). Most participants (89.8%) routinely assessed pain in mechanically ventilated patients using a scale; however, other discomfort symptoms were assessed by less than 40% (dyspnea [28.4%], fatigue [8.1%], thirst [13.1%], insomnia [37.3%], and anxiety [13.6%]). Two major barriers to assessing discomfort symptoms were lack of assessment culture within the intensive care unit and lack of knowledge of the relevant evaluation scales. Conclusions Nurses were aware of the importance of using scales to assess the discomfort symptoms experienced by mechanically ventilated patients. However, except for pain, most nurses did not routinely use scales to assess discomfort symptoms. Barriers to routine discomfort symptom assessment included the lack of an assessment culture and the lack of knowledge of the assessment scales. Clinicians should be educated regarding the existence of validated rating scales and develop additional rating scales utilizable for minor discomforts in mechanically ventilated patients.
“I Wonder if my Years of Training and Expertise Will be Devalued by Machines”: Concerns About the Replacement of Medical Professionals by Artificial Intelligence
Authors: Rony Moustaq Karim Khan , Parvin Mst. Rina , Wahiduzzaman Md. , Debnath Mitun , Bala Shuvashish Das , Kayesh Ibne 
Published: April 2024

Background The rapid integration of artificial intelligence (AI) into healthcare has raised concerns among healthcare professionals about the potential displacement of human medical professionals by AI technologies. However, the apprehensions and perspectives of healthcare workers regarding the potential substitution of them with AI are unknown. Objective This qualitative research aimed to investigate healthcare workers’ concerns about artificial intelligence replacing medical professionals. Methods A descriptive and exploratory research design was employed, drawing upon the Technology Acceptance Model (TAM), Technology Threat Avoidance Theory, and Sociotechnical Systems Theory as theoretical frameworks. Participants were purposively sampled from various healthcare settings, representing a diverse range of roles and backgrounds. Data were collected through individual interviews and focus group discussions, followed by thematic analysis. Results The analysis revealed seven key themes reflecting healthcare workers’ concerns, including job security and economic concerns; trust and acceptance of AI; ethical and moral dilemmas; quality of patient care; workforce role redefinition and training; patient–provider relationships; healthcare policy and regulation. Conclusions This research underscores the multifaceted concerns of healthcare workers regarding the increasing role of AI in healthcare. Addressing job security, fostering trust, addressing ethical dilemmas, and redefining workforce roles are crucial factors to consider in the successful integration of AI into healthcare. Healthcare policy and regulation must be developed to guide this transformation while maintaining the quality of patient care and preserving patient–provider relationships. The study findings offer insights for policymakers and healthcare institutions to navigate the evolving landscape of AI in healthcare while addressing the concerns of healthcare professionals.
The Decline of Basic Ophthalmology in General Medical Education: A Scoping Review and Recommended Potential Solutions
Authors: Liao Jennifer , Wright Robin Redmon , Vora Gargi K 
Published: April 2024

OBJECTIVE This literature review aims to explore research and conceptual pieces on the state of ophthalmology education and suggest potential ways to address current challenges. METHODS A search was conducted in PubMed, ERIC, Web of Science, and Google Scholar with combinations of the following search terms: “ophthalmology education,” “undergraduate medical education,” “medical student,” “United States,” and “Canada.” Eliminating irrelevant articles yielded 47 articles. Three were excluded because of region and focus, leaving 44. After examining the citations, we generated an additional 22 texts for review, totaling 66 articles. RESULTS Four primary themes were identified: (1) challenges to ophthalmological education in the U.S. and Canada, (2) potential remedies for optimizing ophthalmology curriculum, (3) technology in ophthalmology education, and (4) innovative ophthalmology teaching approaches. Major challenges included the lack of a standardized curriculum and inadequate clinical exposure and skills training. A number of remedies were proposed, such as standardizing curriculum and furthering faculty involvement, utilizing technology as time-effective learning aids, and employing innovative teaching approaches such as service learning. CONCLUSION In light of challenges in ophthalmology education, curriculum designers should consider Cognitive Load Theory (CLT) to assist students to remember meaningful exposures to ophthalmology knowledge and techniques. Based on CLT, we suggest two potential approaches to incorporating ophthalmology curriculum. The first is to embrace interdisciplinary collaborations and place ophthalmology knowledge in varied contexts to facilitate schema construction. The second is to incorporate ophthalmology diagnostics requirements into OSCEs and utilize simulation models for students to gradually increase the fidelity of tasks and devote cognitive resources fully to learning.
Falls in the hospital: An Italian clinical risk management perspective
Authors: Buongiorno Luigi , Mele Federica , Solarino Biagio , Ferorelli Davide , Zotti Fiorenza , Dell’Erba Alessandro , Carabellese Felice Francesco , Catanesi Roberto , Ferracuti Stefano , Mandarelli Gabriele 
Published: April 2024

Background Hospital falls are a frequent sentinel event worldwide, yet prevention remains challenging. There is a need to standardize hospital fall management in healthcare facilities. This study aimed to analyze policies and procedures used by Italian healthcare facilities to reduce hospital falls. Methods The Italian hospitals’ public procedures on patients’ falls issued between November 2011 and June 2022 were retrieved by a web search using the Google search engine and further evaluated according to their compliance with the 2011 Italian Ministerial recommendation for the prevention of patients’ falls. Results We found 37 official online procedures, of which 45.6% showed full compliance with the 2011 Ministerial recommendation. All the documents explicitly addressed the issue of identifying patient-related fall risk profiles, whereas 28 set appropriate environmental risk factors. More than 80% of the retrieved procedures used the Conley scale. Forty-three percent of the procedures did not provide for national monitoring and reporting of patient falls. Conclusions Public procedures for preventing patient falls in Italian hospitals are scarcely compliant with the 2011 Ministerial recommendation. Local monitoring, compliance, and reporting of hospital falls are needed to improve patient outcomes and reduce the risk of litigation for staff and organizations. Additionally, standardized tools for evaluating the risk of falls, healthcare professionals’ training, and implementing environmental prevention strategies are needed to contrast this issue.
Dietary inflammatory index in relation to the progression of hepatic steatosis and liver fibrosis: evaluation by elastography/Fibroscan
Authors: Miryan Mahsa , Rashid Sameeah Abdulrahman , Navashenaq Jamshid Gholizadeh , Soleimani Davood , Nematy Mohsen , Moludi Jalal 
Published: April 2024

AbstractOne of the proposed mechanisms by which nutrition influences the progression of hepatic steatosis to fibrosis is inflammation. The study investigated how the inflammatory potential of the diet affects the risk of liver damage in patients with nonalcoholic fatty liver disease (NAFLD), a condition where fat accumulates in the liver. This cross-sectional study included 170 outpatients with newly diagnosed NAFLD. This study used a device called Fibroscan® to measure the degree of liver fibrosis, which is the scarring of the liver tissue due to chronic inflammation. The study also used a tool called the Dietary Inflammatory Index (DII) to measure the inflammatory potential of the diet based on the intake of different foods and nutrients. In the findings of the study, patients with more severe fat accumulation in the liver (hepatic steatosis) had higher DII scores, meaning they had more inflammatory diets. The study also found that higher DII scores were associated with higher weight and body mass index (BMI). One standard deviation (SD) increase in DII scores was associated with a 0.29 kilopascal (95% CI: 0.10–0.44; P-value 0.001) increase in the mean liver stiffness, an indicator of liver fibrosis. The study concluded that patients with higher DII scores had a higher risk of developing liver fibrosis than those with lower DII scores, even after adjusting for confounding factors (odds ratio: 5.89; P-value: 0.001). The study suggested that eating less inflammatory foods may help prevent or slow down the progression of hepatic steatosis and liver in patients with NAFLD.
Evaluation of models to predict prognosis in patients with advanced hepatocellular carcinoma treated with TACE combined with apatinib
Authors: Sun Fang , Liu Kai-Cai , Ul Ain Qurat , Lu Dong , Zhou Chun-Ze , Xiao Jing-Kun , Zhang Xing-Ming , Zhang Zheng-Feng , Cheng Deng-Lei , He Yu-Sheng , Lv Wei-Fu 
Published: April 2024

Abstract
Background
The HAP, Six-and-Twelve, Up to Seven, and ALBI scores have been substantiated as reliable prognostic markers in patients presenting with intermediate and advanced hepatocellular carcinoma (HCC) undergoing transarterial chemoembolization (TACE) treatment. Given this premise, our research aims to assess the predictive efficacy of these models in patients with intermediate and advanced HCC receiving a combination of TACE and Apatinib. Additionally, we have conducted a meticulous comparative analysis of these four scoring systems to discern their respective predictive capacities and efficacies in combined therapy.

Methods
Performing a retrospective analysis on the clinical data from 200 patients with intermediate and advanced HCC, we studied those who received TACE combined with Apatinib at the First Affiliated Hospital of the University of Science and Technology of China between June 2018 and December 2022. To identify the factors affecting survival, the study performed univariate and multivariate Cox regression analyses, with calculations of four different scores: HAP, Six-and-Twelve, Up to Seven, and ALBI. Lastly, Harrell’s C-index was employed to compare the prognostic abilities of these scores.

Results
Cox proportional hazards model results revealed that the ALBI score, presence of portal vein tumor thrombus (PVTT, )and tumor size are independent determinants of prognostic survival. The Kaplan-Meier analyses showed significant differences in survival rates among patients classified by the HAP, Six-and-Twelve, Up to Seven, and ALBI scoring methods. Of the evaluated systems, the HAP scoring demonstrated greater prognostic precision, with a Harrell’s C-index of 0.742, surpassing the alternative models (P < 0.05). In addition, an analysis of the area under the AU-ROC curve confirms the remarkable superiority of the HAP score in predicting short-term survival outcomes.

Conclusion
Our study confirms the predictive value of HAP, Six-and-Twelve, Up to Seven, and ALBI scores in intermediate to advanced Hepatocellular Carcinoma (HCC) patients receiving combined Transarterial Chemoembolization (TACE) and Apatinib therapy. Notably, the HAP model excels in predicting outcomes for this specific HCC subgroup.
Bacteremia caused by Nocardia farcinica: a case report and literature review
Authors: Wang Di , Hu Meng-Ting , Liu Wen-Jing , Zhao Ying , Xu Ying-Chun 
Published: April 2024

Abstract
Background
Nocardia farcinica is one of the most common Nocardia species causing human infections. It is an opportunistic pathogen that often infects people with compromised immune systems. It could invade human body through respiratory tract or skin wounds, cause local infection, and affect other organs via hematogenous dissemination. However, N. farcinica-caused bacteremia is uncommon. In this study, we report a case of bacteremia caused by N. farcinica in China.

Case presentation
An 80-year-old woman was admitted to Peking Union Medical College Hospital with recurrent fever, right abdominal pain for one and a half month, and right adrenal gland occupation. N. farcinica was identified as the causative pathogen using blood culture and plasma metagenomics next-generation sequencing (mNGS). The clinical considerations included bacteremia and adrenal gland abscess caused by Nocardia infection. As the patient was allergic to sulfanilamide, imipenem/cilastatin and linezolid were empirically administered. Unfortunately, the patient eventually died less than a month after the initiation of anti-infection treatment.

Conclusion
N. farcinica bacteremia is rare and its clinical manifestations are not specific. Its diagnosis depends on etiological examination, which can be confirmed using techniques such as Sanger sequencing and mNGS. In this report, we have reviewed cases of Nocardia bloodstream infection reported in the past decade, hoping to improve clinicians’ understanding of Nocardia bloodstream infection and help in its early diagnosis and timely treatment.