bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Experience of Survivors of Firearm Suicide Attempts: A Retrospective Case Series
Authors: Savarino Jeffrey R. , Rubin Emily , Masiakos Peter T. , McLellan Rachel , Rolle Myron L. , Nanda Pranav , Stapleton Christopher J. , Sacks Chana A. 
Published: April 2024

Objective:
We sought to identify people who survived firearm suicide attempts to describe the acute stressors, substance use, and mental health conditions related to the attempt.

Background:
Most firearm deaths in the United States are the result of suicide. Because firearm suicide attempts have a case fatality rate of approximately 90%, little is known about the precipitating factors that lead to firearm suicide attempts.

Methods:
We conducted a retrospective case series of patients admitted to a large hospital system between 2000 and 2019 who survived intentional, self-inflicted gunshot wounds to the head. Through the electronic medical record, we collected information about acute stressors, substance use, and mental health diagnoses before or at the time of the suicide attempt.

Results:
Thirty-four patients were included in the study cohort. Patients were predominantly White (74%) and male (88%), with a mean age of 44 (range, 14–82). Nineteen (56%) patients were acutely intoxicated with alcohol upon hospitalization and 17 (50%) patients had a positive urine drug screen. Acute stressors involving interpersonal relationships (53%), work/school (32%), and legal disputes (18%), among others, were documented in 82% of patients. Most patients (65%) had been diagnosed with depression before their index hospitalization. Most patients were discharged to an acute rehabilitation center (41%) or an inpatient psychiatric facility (41%).

Conclusions:
Acute stress and alcohol intoxication were common in this cohort of patients who attempted suicide using firearms. These data offer an ability to learn from the experience of survivors of firearm suicide attempts, a rare population.
Addition of Ketorolac to Local Anesthesia for Wound Infiltration in Multilevel Posterior Lumbar Spinal Fusion
Authors: Chaibhuddanugul Nattharut , Weerakul Santi , Laoruengthana Artit , Varakornpipat Panapol , Sudbanthad Pawin , Mahatthanatrakul Akaworn 
Published: April 2024

Study Design.
Randomized double-blind controlled trial.

Objective.
The purpose of this study was to determine the efficacy of pain control and opioid consumption after administration of ketorolac directly to paraspinal muscle after spinal fusion.

Summary of Background Data.
Ketorolac is added to multimodal analgesia regimens to improve pain control, reduce opioid consumption following orthopaedics and spine surgery. However, evidence of the efficacy of adding ketorolac to local anesthesia for intrawound infiltration after spine surgery is still limited.

Materials and Methods.
The patients who underwent multilevel lumbar decompression and posterolateral fusion were recruited and randomized to the control group which received 0.5% bupivacaine hydrochloride injected into paraspinal muscles before wound closure, and the ketorolac group which received 30 mg ketorolac in addition to 0.5% bupivacaine hydrochloride. Postoperative numerical rating scale (NRS) for back pain, leg pain, morphine consumption, and adverse events were recorded.

Results.
A total of 47 patients were randomized (24 in the ketorolac group and 23 in the control group). The mean age was 60.9±6.9 years old. The mean NRS for back pain at 6 hours after surgery was 5.8±3.0 points for the control group and 3.3±2.1 points for the ketorolac group (P<0.01). The ketorolac group consumed lesser morphine than the control group by 9.1 mg in the first 24 hours, 13.8 mg at 48 hours, 14.3 mg at 72 hours, and 13.9 mg at 96 hours after the surgery (P<0.05). Postoperative complications were not different between the two groups.

Conclusions.
The addition of ketorolac to bupivacaine for wound infiltration after posterior lumbar spine decompression and fusion reduces early postoperative pain and total morphine consumption as compared with bupivacaine alone.
The Relationship Between Self-Efficacy and Functional Capacity Among Discharged Heart Failure Patients in Jordan
Authors: Abusafieh Ahmad Moh’d , Shajrawi Abedalmajeed Methqal , Al-Smadi Ahmed Mohammad , Saleh Akram , Masa'deh Rami , Ismaile Samantha , Abdelhaq Mohammad Jamil 
Published: April 2024

BackgroundSelf-efficacy is an important factor associated with healthy lifestyle changes in heart failure treatment. Functional capacity testing of heart failure patients (HFPs) can stratify prognosis. Reduced functional capacities in HFPs are linked to a poor heart failure prognosis. Limited research has examined the potential relationship between self-efficacy and functional capacity.AimThe aims of this study were to assess self-efficacy level and functional capacity among HFPs after hospitalization, and examine whether there is a relationship between them.MethodsA descriptive correlational design was used. A convenience sample of 220 HFPs was recruited from 2 hospitals in Jordan. The Arabic version of Cardiac Self-Efficacy Questionnaire was used to assess self-efficacy, the 6-Minute Walking Test (6-MWT) was used to assess functional capacity, and the Borg rating of perceived exertion scale (Borg Scale) was used to assess exertion during 6-MWT.ResultThe sample included 46.8% male (n = 103) and 53.2% female (n = 117). The mean age was 52.66 ± 8.91 years. Most of the HFPs were categorized based on New York Heart Association classification as class I, 35.9% (n = 79), and class II, 41.4% (n = 91). The mean ejection fraction was 41.46±9.44. The global self-efficacy was moderate (32.98 ± 9.92), and the mean score for the 6-MWT was 494.35 ± 143.37. The Borg Scale mean was 10.94±3.34. In addition, there was a positive relationship between self-efficacy and 6-MWT (r= 0.63, n = 220,P= .01).ConclusionThis study provides baseline data for further research on treatment of HFPs, and the development of evidence-based tailored health interventions to maintain and improve self-efficacy and functional capacity among these service users. Moreover, replicated researches can test the study results considering different methodologies, such as using objective functional capacity tool and longer follow-up periods.
Management Strategies for Malignant Left-Sided Colonic Obstruction: A Systematic Review and Network Meta-analysis of Randomized Controlled Trials and Propensity Score Matching Studies
Authors: McHugh Fiachra T. , Ryan Éanna J. , Ryan Odhrán K. , Tan Jonavan , Boland Patrick A. , Whelan Maria C. , Kelly Michael E. , McNamara Deirdre , Neary Paul C. , O’Riordan James M. , Kavanagh Dara O. 
Published: April 2024

BACKGROUND:
The optimal treatment strategy for left-sided malignant colonic obstruction remains controversial. Emergency colonic resection has been the standard of care; however, self-expanding metallic stenting as a bridge to surgery may offer short-term advantages, although oncological concerns exist. Decompressing stoma may provide a valid alternative, with limited evidence.

OBJECTIVE:
To perform a systematic review and Bayesian arm random effects model network meta-analysis comparing the approaches for management of malignant left-sided colonic obstruction.

DATA SOURCES:
A systematic review was conducted from inception to August 22, 2023, of PubMed, Embase, Cochrane Library, and Google Scholar databases.

STUDY SELECTION:
Randomized controlled trials and propensity score matched studies.

INTERVENTIONS:
Emergency colonic resection, self-expanding metallic stent, decompressing stoma.

MAIN OUTCOME MEASURES:
Oncologic efficacy, morbidity, successful minimally invasive surgery, primary anastomosis, and permanent stoma rates.

RESULTS:
Nineteen articles from 5225 identified met our inclusion criteria. Stenting (risk ratio 0.57, 95% credible interval: 0.33, 0.79) and decompressing stomas (risk ratio 0.46, 95% credible interval: 0.18, 0.92) both resulted in a significant reduction in the permanent stoma rate. Stenting facilitated minimally invasive surgery more frequently (risk ratio 4.10, 95% credible interval: 1.45, 13.13) and had lower overall morbidity (risk ratio 0.58, 95% credible interval: 0.35, 0.86). A pairwise analysis of primary anastomosis rates showed an increase in stenting (risk ratio 1.40, 95% credible interval: 1.31, 1.49) as compared with emergency resection. There was a significant decrease in the 90-day mortality with stenting (risk ratio 0.63, 95% credible interval: 0.41, 0.95) when compared with resection. There were no differences in disease-free and overall survival rates, respectively.

LIMITATIONS:
There is a lack of randomized controlled trial and propensity score matching data comparing short and long-term outcomes for diverting stomas compared to self-expanding metallic stents. Two trials compared self-expanding metallic stents and diverting stomas in left-sided malignant colonic obstruction.

CONCLUSION:
This study provides high-level evidence that bridge-to-surgery strategy is safe for the management of left-sided malignant colonic obstruction, and may facilitate minimally invasive surgery, increase primary anastomosis rates, and reduce permanent stoma rates and postoperative morbidity as compared to emergency colonic resection.
Examining Tear Film Dynamics Using the Novel Tear Film Imager
Authors: Mangwani-Mordani Simran , Baeza Drew , Acuna Kelly , Antman Gal , Harris Alon , Galor Anat 
Published: April 2024

Purpose:
The purpose of this study was to examine Tear Film Imager (TFI, AdOM, Israel) generated parameters across controls and dry eye (DE) subgroups and examine the changes in TFI parameters with contact lens (CL) placement.

Methods:
The retrospective study (n = 48) was conducted at the Miami Veterans Hospital. Symptoms were assessed through validated questionnaires and signs of tear function by tear break-up time and Schirmer scores. Participants were grouped as 1) healthy, 2) evaporative, 3) aqueous deficient, and 4) mixed DE based on tear function. Seventeen individuals had a baseline scan and a repeat scan following CL placement. Descriptives were compared across groups and over time.

Results:
The median age was 27 years, 74% self-identified as White, 45% as male, and 51% as Hispanic. Subjects in the aqueous deficiency category had lower muco-aqueous layer thickness (MALT) (2672 vs. 3084 nm) but higher lipid layer thickness (47.5 vs. 38.3 nm), lipid break-up time (4.4 vs. 2 seconds), and interblink interval (13.9 vs. 5.4 seconds) compared with the evaporative group. Subjects in the evaporative group had the highest MALT values (3084 vs. 2988, 2672, 3053 nm) compared with healthy, aqueous-deficient, and mixed groups. Symptoms were not significantly correlated with TFI parameters. CL placement significantly decreased MALT values (2869 → 2175 nm, P = 0.001).

Conclusions:
The TFI provides unique information regarding the dynamic function of the tear film not captured by clinical examination. TFI generated metrics demonstrate a thinner aqueous layer in individuals with aqueous deficiency but highlight a thicker aqueous layer in those with evaporative DE.
The Efficacy of Fibrin Sealant in Sutureless Deep Sclerectomy—Preliminary Outcomes
Authors: Baxant Alina-Dana , Pencak Martin , Vranova Jana , Netukova Magdalena , Urbaniova Katarina , Holubova Lucie , Pluhovsky Patrik , Rosina Jozef , Studeny Pavel 
Published: April 2024

Précis:
Deep sclerectomy (DS) with fibrin adhesive can constitute a safe alternative to the classic procedure using sutures, providing nonallergenic, nontoxic, and secure adhesion with no sign of aqueous humor outflow obstruction postoperatively.

Objective:
To evaluate short and medium-term postoperative results of DS with a fibrin sealant.

Patients and Methods:
This prospective, noncomparative, interventional case series involves 12 eyes of 12 patients with uncontrolled open angle glaucoma who underwent DS with Esnoper (Clip or V2000) implant between February 2021 and March 2022. A novel method of wound closure (sclera, Tenon fascia, and conjunctiva) employing fibrin glue was used instead of classic sutures. Surgical outcomes assessed include: intraocular pressure and glaucoma therapy reduction, best-corrected visual acuity changes, and number of complications registered peri and postoperatively. All measurements were performed preoperatively, as well as at 1 day, at 1 and 2 weeks, and at 1, 2, 3, 6, 9, and 12 months after surgery.

Results:
The mean intraocular pressure decreased from 24.0 ± 9.1 mm Hg to 13.8 ± 6.3 mm Hg at 1 year postoperatively (P < 0.001). Kaplan-Meier survival analysis revealed complete and qualified success rates of 83.3% and 91.7%. The mean glaucoma therapy decreased from 3.2 ± 1.1 to 0.8 ± 1.3 drugs 12 months after surgery (P < 0.001). Nd:YAG goniopunture was performed in 2 eyes at 1 and 12 months postoperatively. No significant best-corrected visual acuity changes were registered. Perioperatively, we noted a trabeculo-descemet microperforation in 1 eye, transient hypotony in 5 eyes, and mild hyphema in 2 eyes.

Conclusions:
Fibrin adhesive provided an effective closure in sutureless DS in the patients included in our study. This modification of classical DS may simplify the surgical technique, ensure secure wound adaptation, optimize healing, and lower the risk of inflammation and fibrosis postoperatively.
Impact of stress coping strategy in modifying perceptions of school stress among adult learners enrolled in Home Economics and Indigenous Textiles Education in Nigerian Universities
Authors: Nwadi Calister Lebechukwu , Ede Moses Onyemaechi , Nwakpadolu Glory Mmachukwu , Okoro Joy Oluchukwu , Onu Eucharia Amaka , Emeghebo Udochukwu M. , Ezeanwu Amaka Bibian , Ogbonna Kingsley Asogu , Agu Patricia U. , Nkemjika Ogechi , Nwosu Nneka , Okereke Godwin Keres , Onah Sebastian O. , Uba Mercy Benedette Ifeoma , Obeagu Emmanuel Ifeanyi 
Published: April 2024

Background/Objective:
Studying some professions is so demanding that if not well managed it leads to severe stress, withdrawal, burnout, and other health-related problems. Hence, practical engagement and exhibition of catering, cooking, and home management are so tasking as they are time-consuming and very intensive. Many students in the specialties experience excess academic loads and internal and external demands. Given these, this study tested the impact of cognitive behavior coping strategy on school stress among adult learners enrolled in Home Economic and Indigenous Textile Education.

Methods:
A pretest-posttest randomized control group design was applied. Ninety-five students (43 [45.3%] males; 52 [54.7%] females) participated in the current study. Stress assessment was induced and then students were randomly allocated to the cognitive behavior coping strategy group and the waitlist conditions. Later, students on the waitlist received the cognitive behavior coping strategy contents. Data collected were analyzed using analysis of covariance.

Results:
Results showed that at pretest, there was no significant difference among the participants in the 2 groups as measured by Educational Stress Scale and Perceived Stress Scale scores. However, the post-intervention test result showed a long-term impact of cognitive behavior coping strategy in improving the management of school stress among students.

Conclusion:
This study suggests that cognitive behavior coping strategy has a long-term impact on modifying the students’ perception of school stress in a sample of adult learners enrolled in Home Economic and Indigenous Textile Education.
Thrombectomy for delayed thromboembolism in a recurrent cerebral aneurysm previously treated with coiling: A case report
Authors: Shao Ya , Yang Yuan , Huang Haidong , Wang Ting , Li Jinglun , Jiang Yushan , Yuan Ziwei , Tang Jiayi , Wang Dihu , Xiang Zerui , Zeng Xue , Yu Zhou , He Zhongchun , Yuan Zhengzhou 
Published: April 2024

Rationale:
Giant intracranial aneurysms pose a significant threat due to high mortality rates upon rupture, prompting interventions such as neurosurgical clipping or endovascular coiling.

Patient Concerns:
We present a rare case involving a 47-year-old female with a history of successfully treated ruptured giant intracranial aneurysms. Six months post-surgical clipping, she developed symptoms of acute ischemic stroke, prompting the decision for neurosurgical coiling and stent-assisted aneurysm coil embolization due to recurrent intracranial aneurysms.

Diagnoses:
Subsequently, occlusion occurred at the previously implanted stent site during embolization, necessitating exploration of alternative therapeutic options. Digital subtraction angiography confirmed stent occlusion in the right middle cerebral artery.

Interventions:
Despite an initial unsuccessful attempt using a direct aspiration first-pass technique, the patient underwent successful mechanical thrombectomy with a retrievable stent, leading to successful reperfusion. This study aims to highlight the challenges and therapeutic strategies in managing delayed cerebral vascular occlusion following stent-assisted coil embolization, emphasizing the significance of exploring alternative interventions to enhance patient outcomes.

Outcomes:
The patient achieved successful reperfusion, and the study underscores the importance of recognizing and addressing delayed cerebral vascular occlusion after stent-assisted coil embolization for recurrent cerebral aneurysms.

Lessons:
Our findings suggest that retrievable stent mechanical thrombectomy may serve as a viable therapeutic option in challenging scenarios, emphasizing the need for further exploration of alternative interventions to enhance patient care.
Pregnancy- and lactation-associated osteoporosis: A case series of 6 patients
Authors: Qian Ying , Wang Jingming , Wu Aifang , Huang Weimin 
Published: April 2024

Rationale:
There is still information about pregnancy- and lactation-associated osteoporosis, which is a type of osteoporosis that occurs in women with normal bone in the late pregnancy or lactation period.

Patient concerns:
Six cases of pregnancy- and lactation-associated osteoporosis diagnosed in our Endocrinology and Orthopedics Departments from January 2018 to June 2020 were retrospectively studied. The baseline characteristics, clinical features, laboratory findings, radiological manifestations, and follow-up outcomes were analyzed and compared with previous reports.

Diagnoses:
All six patients underwent magnetic resonance imaging scans and vertebral compressive fractures were detected in four patients.

Outcomes:
All six patients received conservative treatment and no surgical intervention. After a mean follow-up of 27.3 months (range 24–31 months), the symptoms of the six patients were significantly relieved, although four patients still had low back pain to varying degrees.
The efficacy and safety of using a combination of rocuronium and sugammadex for awake craniotomy anesthesia: A randomized clinical trial
Authors: Chen Yun , Yang Ruixin , Sun Mei , He Huan , Lin Yuanyuan , Bai Hongming , Xiong Ming , Xu Bo 
Published: April 2024

Background:
Awake craniotomy (AC) is a neurosurgical method for the resection of brain lesions located in eloquent areas to achieve maximal and safe resection. A patient’s arousal quality is essential for the success of the operation. This study compared the arousal time and quality after AC achieved by 2 different drug combinations: rocuronium with sugammadex and propofol with remifentanil.

Methods:
This prospective, randomized, controlled trial included 42 adult patients undergoing AC with a laryngeal mask, who were randomly assigned to either a rocuronium-sugammadex group (RS; n = 21) or a propofol-remifentanil without muscle relaxant group (nRS; n = 21). The primary outcomes were the arousal time and arousal quality. The secondary outcomes included the number of laryngeal mask airway (LMA) adjustments and diaphragmatic excursion length.

Results:
This study included 42 participants. The median (IQR) arousal time was 13.5 minutes (7–20) in the RS group and 21 minutes (16.5–26.5) in the nRS group (P = .005). There was no significant difference in arousal quality between the 2 groups (P = .229). LMA adjustments were significantly less frequent in the nRS group than in the RS group [0.25 times (±0.62) vs 1.26 times (±1.17), P = .001]. Adverse events, such as spontaneous movements and brain swelling, were more frequent in the nRS group than in the RS group.

Conclusions:
Using a combination of rocuronium and sugammadex with propofol and remifentanil may shorten the awakening time, reduce the duration of laryngeal mask adjustment, and do not affect the arousal quality and postoperative outcomes for patients undergoing awake craniotomy, compared to propofol and remifentanil alone.
Iatrogenic aortic dissection in patients undergoing coronary artery bypass grafting surgery: A systemic review of published literatures
Authors: Yuan Xi , Sun Yanting , Chen Huaqiu , Lan Qiqing , Wu Wen , Yao Yuntai ,   The Evidence in Cardiovascular Anesthesia (EICA) Group
Published: April 2024

Background:
Iatrogenic aortic dissection (IAD) is a rare but highly lethal complication that may occur following coronary artery bypass grafting (CABG) surgery. Aortic dissection (AD) is often asymptomatic, making early detection difficult. We aimed to optimize preoperative evaluation strategies of CABG surgery for minimizing the incidence of IAD and assess early recognition and management of IAD for improving outcomes.

Methods:
Electronic databases were searched to identify all case reports of patients undergoing CABG surgery who developed IAD. Clinical characteristics, operative information, perioperative management, and patient outcomes were compiled and analyzed.

Results:
Nineteen case reports involving 27 patients aged 50 to 81 were included. Patients were from Europe (n = 23) and Asia (n = 4), mostly men (n = 25). The aorta was described as normal, abnormal, and unmentioned (n = 8, 5, and 14, respectively). Sixteen patients had a bypass with more than 3 grafts. Most patients (n = 25) experienced type A dissection. There were intraoperative (n = 12) and postoperative (n = 15) cases. Surgery (n = 19) was the most common treatment, with 9 patients selecting deep hypothermic circulatory arrest. Eighteen patients were restored to health, while 9 patients died (3 died before treatment).

Conclusions:
Our study focused on patients with IAD and developed a recommended management protocol for patients undergoing CABG surgery.