bluuebunny/crossref_metadata_2025_split huggingface dataset:
Classification and Treatment of Pediatric Capitellar Fractures
Authors: Yang Daniel , Baghdadi Soroush , Värk Pille-Riin , Buttrick Eliza , Shah Apurva S. 
Published: March 2024

Background:
Fractures of the capitellum are rare in children. The purpose of this study was to report fracture characteristics, treatment, and outcomes of pediatric capitellar fractures at a single children’s hospital. We also aimed to update the classification of these fractures based on a large sample size by revising the Murthy (Boston) classification.

Methods:
In a retrospective study at a single tertiary care children’s hospital, fractures of the capitellum in patients below 18 years of age were queried and reviewed for demographics, injury characteristics, imaging, treatment, outcomes, and complications. Three surgeons reviewed all imaging to classify the fractures and assess interobserver and intraobserver reliability.

Results:
Forty-four patients (25 male) with capitellar fractures with a mean age of 11.7±3.7 years were identified. Seven fractures did not belong to an existing type and were grouped into a new type IV capitellar fracture, defined as LCL avulsions with extension to the articular surface of the capitellum. We found good to excellent inter-rater and intrarater reliability for the new classification system. Our raters believed that cross-sectional imaging was essential to classifying fractures in 84% of the cases. Thirty-three of 44 patients underwent early surgical intervention, with favorable outcomes. Five patients presented late with substantial elbow contracture and malunion and were treated surgically with the excision of the fragment.

Conclusions:
The new classification of pediatric capitellar fractures is more comprehensive and offers good to excellent reliability. We found excellent outcomes in the majority of cases with early diagnosis and management, but substantial risk for complications with missed and delayed diagnosis. Malunion and subsequent loss of ROM were the most common presentations of a missed diagnosis, which can be surgically treated with favorable outcomes.

Level of evidence:
Level III—retrospective cohort study.
Alcohol Withdrawal Severity Measures for Identifying Patients Requiring High-Intensity Care
Authors: To Daniel C. , Steel Tessa L. , Carey Kyle A. , Joyce Cara J. , Salisbury-Afshar Elizabeth M. , Edelson Dana P. , Mayampurath Anoop , Churpek Matthew M. , Afshar Majid 
Published: March 2024

OBJECTIVES:
Alcohol withdrawal syndrome (AWS) may progress to require high-intensity care. Approaches to identify hospitalized patients with AWS who received higher level of care have not been previously examined. This study aimed to examine the utility of Clinical Institute Withdrawal Assessment Alcohol Revised (CIWA-Ar) for alcohol scale scores and medication doses for alcohol withdrawal management in identifying patients who received high-intensity care.

DESIGN:
A multicenter observational cohort study of hospitalized adults with alcohol withdrawal.

SETTING:
University of Chicago Medical Center and University of Wisconsin Hospital.

PATIENTS:
Inpatient encounters between November 2008 and February 2022 with a CIWA-Ar score greater than 0 and benzodiazepine or barbiturate administered within the first 24 hours. The primary composite outcome was patients who progressed to high-intensity care (intermediate care or ICU).

INTERVENTIONS:
None.

MAIN RESULTS:
Among the 8742 patients included in the study, 37.5% (n = 3280) progressed to high-intensity care. The odds ratio for the composite outcome increased above 1.0 when the CIWA-Ar score was 24. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) at this threshold were 0.12 (95% CI, 0.11–0.13), 0.95 (95% CI, 0.94–0.95), 0.58 (95% CI, 0.54–0.61), and 0.64 (95% CI, 0.63–0.65), respectively. The OR increased above 1.0 at a 24-hour lorazepam milligram equivalent dose cutoff of 15 mg. The sensitivity, specificity, PPV, and NPV at this threshold were 0.16 (95% CI, 0.14–0.17), 0.96 (95% CI, 0.95–0.96), 0.68 (95% CI, 0.65–0.72), and 0.65 (95% CI, 0.64–0.66), respectively.

CONCLUSIONS:
Neither CIWA-Ar scores nor medication dose cutoff points were effective measures for identifying patients with alcohol withdrawal who received high-intensity care. Research studies for examining outcomes in patients who deteriorate with AWS will require better methods for cohort identification.
Accuracy of blood-based biomarkers for staging liver fibrosis in chronic liver disease: A systematic review supporting the AASLD Practice Guideline
Authors: Patel Keyur , Asrani Sumeet K. , Fiel Maria Isabel , Levine Deborah , Leung Daniel H. , Duarte-Rojo Andres , Dranoff Jonathan A. , Nayfeh Tarek , Hasan Bashar , Taddei Tamar H. , Alsawaf Yahya , Saadi Samer , Majzoub Abdul Mounaem , Manolopoulos Apostolos , Alzuabi Muayad , Ding Jingyi , Sofiyeva Nigar , Murad Mohammad H. , Alsawas Mouaz , Rockey Don C. , Sterling Richard K. 
Published: March 2024

Background and Aims:
Blood-based biomarkers have been proposed as an alternative to liver biopsy for noninvasive liver disease assessment in chronic liver disease. Our aims for this systematic review were to evaluate the diagnostic utility of selected blood-based tests either alone, or in combination, for identifying significant fibrosis (F2-4), advanced fibrosis (F3-4), and cirrhosis (F4), as compared to biopsy in chronic liver disease.

Approach and Results:
We included a comprehensive search of databases including Ovid MEDLINE(R), EMBASE, Cochrane Database, and Scopus through to April 2022. Two independent reviewers selected 286 studies with 103,162 patients. The most frequently identified studies included the simple aspartate aminotransferase-to-platelet ratio index and fibrosis (FIB)-4 markers (with low-to-moderate risk of bias) in HBV and HCV, HIV-HCV/HBV coinfection, and NAFLD. Positive (LR+) and negative (LR−) likelihood ratios across direct and indirect biomarker tests for HCV and HBV for F2-4, F3-4, or F4 were 1.66–6.25 and 0.23–0.80, 1.89–5.24 and 0.12–0.64, and 1.32–7.15 and 0.15–0.86, respectively; LR+ and LR− for NAFLD F2-4, F3-4, and F4 were 2.65–3.37 and 0.37–0.39, 2.25–6.76 and 0.07–0.87, and 3.90 and 0.15, respectively. Overall, the proportional odds ratio indicated FIB-4 <1.45 was better than aspartate aminotransferase-to-platelet ratio index <0.5 for F2-4. FIB-4 >3.25 was also better than aspartate aminotransferase-to-platelet ratio index >1.5 for F3-4 and F4. There was limited data for combined tests.

Conclusions:
Blood-based biomarkers are associated with small-to-moderate change in pretest probability for diagnosing F2-4, F3-4, and F4 in viral hepatitis, HIV-HCV coinfection, and NAFLD, with limited comparative or combination studies for other chronic liver diseases.
[It] Does Harden a Person Working in Such a Stressful Environment: U.S. Correctional Nurses Share Spillover Effects of Their Work
Authors: Keller Elizabeth , Boch Samantha , Davis Kermit G. , Gillespie Gordon L. , Hittle Beverly M. 
Published: March 2024

ABSTRACT

Background
The United States makes up 4.4% of the world's population but nearly a quarter of the world's incarcerated population. Despite caring for nearly 2 million incarcerated persons and managing their unique needs, little is known about how this work spills over and affects the nurses who work in correctional settings.

Study Objective
This descriptive study aimed to (a) examine write-in answers regarding correctional nurse perceptions of how their work impacts their health and their home lives and (b) explore correctional nurse responses for how to improve the work environment to better support their well-being.

Method
The researchers compiled and analyzed qualitative data from a cross-sectional study where U.S. correctional nurses (N = 270) completed an online survey. Manifest content analysis was used to analyze optional write-in data.

Results
Approximately 41% (n = 111) of participants answered qualitative questions. Participants were primarily White (77.3%) and non-Hispanic or Latino (88.7%), working in prisons (65.8%), and employed by the state (63.8%) as registered nurses (70%). Three major themes emerged: (a) “personal impact”: increased stress and burnout, overwhelming work hours, and emotional and physical effects; (b) “social relationships and family impacts”: withdrawn, strained homelife, and uncertainty; and (c) “need for change”: improved staffing, reduced mandatory overtime, and better support from management.

Conclusions
Correctional organizations may consider ways to support the well-being of their nurses through adequate staffing, flexible scheduling, decreased mandatory overtime, and hiring effective nurse managers as key members of the correctional team.
The Impact of Trauma-Sensitive Yoga on Persons Who Are Incarcerated: Identifying, Understanding, and Controlling Emotions
Authors: Collica-Cox Kimberly , Day George J. , Bennett Alicia , Maruszewski Cameron 
Published: March 2024

ABSTRACT

Background
While persons who are incarcerated have high rates of previous trauma, further traumatization can result from the experience of incarceration. The inability to effectively process trauma can lead to maladaptive behavior, a serious concern for correctional administrators. Acquiring the skills to regulate emotions and mitigate feelings of impulsivity help persons who are incarcerated take responsibility for their actions to make better decisions, simultaneously encouraging prosocial behavior, decreasing institutional misconduct, and reducing behaviors that place one at risk for repeated involvement in the criminal justice system.

Purpose
Trauma-sensitive yoga (TSY) is one correctional intervention that can effectively address misconduct issues. Yet, the specific impact of TSY on populations who are incarcerated has not been empirically investigated.

Methods
A mixed-methods study, utilizing pretest and posttest interviewing, was conducted with male residents in a New York jail who completed a 4-week TSY program.

Results
Data indicated that those who participated in TSY experienced statistically significant improvements in self-esteem, self-control, resilience, institutional conduct, self-efficacy, and emotion regulation. Qualitative data also indicated high levels of connectivity with other TSY class participants.

Implications
This research implies that cost-effective interventions like TSY have the ability to produce beneficial outcomes within a short time, which is integral to furthering rehabilitative efforts within the transient nature of the jail setting.
Effect of Cardiorespiratory Fitness Level on Physiological Responses and Task Performance During a High-Rise Firefighting Task
Authors: Stevenson Richard Daniel Mark , Warwick Joseph , Bilzon James Lee John 
Published: March 2024

Objectives
To determine the impact of cardiorespiratory fitness (CRF) on physiological and performance outcomes during a 120-m vertical high-rise ascent in firefighters with CRF levels at or above (higher-fit) and below (lower-fit [LF]) the national recommended minimum physical employment standard (V˙O2max 42.3 mL·kg−1·min−1).

Methods
Twenty-eight firefighters completed two high-rise firefighting trials (continuous and discontinuous ascent with predetermined 1-minute rest breaks). Task time, heart rate, ratings of perceived exertion, core body temperature, and thermal comfort were recorded at predetermined elevations.

Results
Task time was significantly longer in both trials for the LF group. Ratings of perceived exertion and thermal comfort were also significantly higher in the LF group, with three times more LF firefighters being unable to complete the ascent without sounding their low-air alarm.

Conclusions
Higher CRF improves performance and efficiency during stair-climbing in simulated high-rise firefighting tasks.
Association Between Physical Activity and Mental Health in Health Professionals in the Context of the Pandemic
Authors: Bernhard Joana Carolina , Tornquist Luciana , Marques Clândio Timm , Peroza Luis Ricardo 
Published: March 2024

Objective
The aim of the study was to verify the association between physical activity (PA) and mental health among health professionals in southern Brazil.

Methods
This is a cross-sectional study with 101 workers during the COVID-19 pandemic. Mental health and PA were assessed using the questionnaires. The association of PA with stress was tested by linear regression, and anxiety and depressive symptoms by Poisson regression.

Results
The stress was inversely associated with individuals who performed some PA (β: −3.53;95% CI: −6.63;−0.44) and who met the PA recommendations (active) (β: −6.84;95% CI: −12.44;−1.24). Workers who performed some PA (PR: 0.76;95% CI: 0.67;0.86) and were active (PR: 0.75;95% CI: 0.60;0.93) were less likely to have severe symptoms of anxiety. For depression, workers who performed some PA (PR: 0.81;95% CI: 0.71;0.92) and were active (PR: 0.69;95% CI: 0.54;0.88), the probability was also smaller.

Conclusions
The practice of PA was inversely associated with symptoms of stress, depression, and anxiety.
Age-related and cancer-related sarcopenia: is there a difference?
Authors: Bozzetti Federico 
Published: March 2024

Purpose of review
The aim of this review is the attempt to differentiating the pathophysiologic and clinical features of the aging-related sarcopenia from cancer-related sarcopenia. In fact, there is some controversy among the experts mainly regarding two points: is always sarcopenia, even that aging-related one, the expression of a generalized disease or may exist independently and without major alteration of the muscle function? Are always aging-related and cancer-related sarcopenia completely separated entities?

Recent findings
Literature shows that sarcopenia, defined as simple skeletal muscle mass loss, may range from a mainly focal problem which is common in many healthy elderly people, to a component of a complex multiorgan syndrome as cancer cachexia. Disuse, malnutrition and (neuro)degenerative processes can account for most of the aging-related sarcopenias while systemic inflammation and secretion of cancer-and immune-related molecules play an additional major role in cachexia.

Summary
A multimodal approach including physical exercise and optimized nutritional support are the key measures to offset sarcopenia with some contribution by the anti-inflammatory drugs in cancer patients. Results are more promising in elderly patients and are still pending for cancer patients where a more specific approach will only rely on the identification and contrast of the key mediators of the cachectic process.
Multidrug-resistant tuberculosis: latest opinions on epidemiology, rapid diagnosis and management
Authors: Nyasulu Peter S. , Doumbia Cheick Oumar , Ngah Veranyuy , Togo Antieme Combo Georges , Diarra Bassirou , Chongwe Gershom 
Published: March 2024

Purpose of review
This review addresses the escalating global challenge of multidrug-resistant tuberculosis (MDR-TB) in Sub-Saharan Africa, with a focus on its complex comorbidity with HIV/AIDS. Emphasizing the urgency of the issue, the review aims to shed light on the unique healthcare landscape shaped by the convergence of high prevalence rates and intersecting complexities with HIV/AIDS in the region.

Recent findings
A notable increase in MDR-TB cases across Sub-Saharan Africa is attributed to challenges in timely diagnoses, treatment initiation, and patient treatment defaulting. The literature underscores the critical need for proactive measures to address diagnostic and treatment gaps associated with MDR-TB, particularly concerning its comorbidity with HIV/AIDS.

Summary
To effectively manage MDR-TB and its co-morbidity with HIV/AIDS, proactive screening programs are imperative. The review highlights the necessity of active follow-up strategies to ensure treatment adherence and reduce default rates, offering evidence-based insights for improved disease management in the region.
Ferroptosis and oxidative stress in endometriosis: A systematic review of the literature
Authors: Ni Chenghong , Li Dingheng 
Published: March 2024

Background:
Endometriosis (EMT) a common gynecological condition in women, an inflammatory disease characterized by the presence of endometrial tissue on organs and tissues in the pelvis, and is mainly associated with chronic pelvic pain and infertility. As the etiology has not been fully elucidated, current treatment is limited to surgery, hormones and painkillers, with more side effects and difficulty in achieving long-term relief. Oxidative stress manifests itself as an overproduction of reactive oxygen species, which has an integral impact in the pathology of female reproductive disorders. In this review, we evaluate the mechanisms of iron overload-induced oxidative stress and ferroptosis in EMT and their pathophysiological implications.

Methods:
Because the etiology has not been fully elucidated, current treatments are limited to surgery, hormones, and painkillers, which have many side effects and are difficult to achieve long-term relief.

Results:
We interpreted that antioxidants as well as ferroptosis inducers show promising results in the treatment of EMT, but their application in this population needs to be further investigated.

Conclusion:
In combination with the interpretation of previous studies, it was shown that iron overload is present in the peritoneal fluid, endometriotic lesions, peritoneum and macrophages in the abdominal cavity. However, the programmed cellular ferroptosis associated with iron overload is resisted by endometriotic foci, which is critical to the pathophysiology of EMT with local iron overload and inflammation.
Efficacy of tyrosine kinase inhibitors in patients with advanced or metastatic sarcomas after prior chemotherapy: A meta-analysis
Authors: Li Wenxia , Liu Liwen , Liang Zhanpeng , Lai Huiqin , Wu Jiaming , Zhang Huatang , Fang Cantu 
Published: March 2024

Background:
Sarcoma is a heterogeneous malignancy arising from interstitial tissue. Anthracycline-based therapy is the first-line treatment recommended by guidelines for patients with locally advanced or metastatic unresectable sarcoma. Recently, targeted therapies, in particular tyrosine kinase inhibitors (TKIs), have made significant progress in the treatment of sarcoma, and their efficacy has been investigated in randomized controlled trials. The aim of this meta-analysis is to evaluate the efficacy of TKIs in patients with advanced or metastatic sarcoma who have previously received chemotherapy.

Methods:
We completed a meta-analysis after conducting literature searches in PubMed, Embase, and Cochrane. The single-drug, placebo-controlled, randomized controlled clinical trials of TKIs in patients with advanced or progressive sarcoma who have previously received chemotherapy are available for inclusion in the study. The observation results were objective response rate (ORR), disease control rate (DCR), progression-free survival (PFS), and overall survival (OS). The subgroup analysis was performed according to histological subtypes of sarcoma.

Results:
This study included 6 studies, including 1033 patients. The ORR (OR: 7.99, 95% CI: 3.62–19.61, P < .00001), DCR (OR: 2.54, 95% CI: 1.27–5.08, P = .009), PFS (HR: 0.46, 95% CI: 0.34–0.62, P < .00001), and OS (HR: 0.80, 95% CI: 0.67–0.96, P = .02) of patients treated with TKIs were better than those in the placebo group.

Conclusions:
In patients with advanced sarcoma, TKIs have been shown to have advantages in terms of ORR, DCR and PFS and OS. Multi-targeted TKIs may be considered as one of the second-line treatment options for sarcoma patients who have received prior chemotherapy.
Spontaneous uterine rupture with amniotic sac protrusion during the third trimester of a unicornuate uterus pregnancy: A rate case report
Authors: Yin Yin , Wang Linlin , Shi Zhihong , Ma Yuxin , Yina Juan 
Published: March 2024

Rationale:
Uterine rupture is an obstetrical emergency associated with severe maternal and fetal mortality. It is rare in the unscarred uterus of a primipara.

Patient concerns:
A 25-year-old woman in her 38th week of gestation presented with slight abdominal pain of sudden onset 10 hours before. An emergency cesarean section was done. After surgery, the patient and the infant survived.

Diagnoses:
With slight abdominal pain of clinical signs, ultrasound examination showed that the amniotic sac was found in the peritoneal cavity with a rupture of the uterine fundus.

Interventions:
Uterine repair and right salpingectomy.

Outcomes:
After surgery, the patient and the infant survived. The newborn weighed 2600 g and had an Apgar score of 10 points per minute. Forty-two days after delivery, the uterus recovered well.

Lessons:
Spontaneous uterine rupture should be considered in patients even without acute pain, regardless of gestational age, and pregnancy with abdominal cystic mass should consider the possibility of uterine rupture.
Efficacy of bone ring grafts for the reconstruction of alveolar ridge deficiencies: A systematic review. Part I: Clinical trials
Authors: Zhao Ruimin , Wang Yi , Lin Huijing , Cao Min , Xu Xu , Yuan Zhenfei , Gong Jiaming 
Published: March 2024

Background:
Bone ring (BR) grafts have been introduced to reconstruct alveolar ridge defects with simultaneous implant placement, but its clinical effectiveness remains undetermined. This systematic review aimed to comprehensively investigate BR grafts in diverse scenarios of ridge defect with simultaneous or staged implant placement.

Methods:
Electronic retrieval of MEDLINE, Embase, Cochrane Library(CENTRAL), Web of Science, Scopus, and citation search until August 3, 2023, was used to identify relevant clinical articles that utilized BR grafts for ridge defect reconstruction. The quality of evidence in the studies reviewed was assessed with the Joanna Briggs Institute Critical Appraisal tool. The protocol was registered in Prospective Register of Systematic Reviews (CRD42023453943).

Results:
Fourteen studies with 251 BRs were identified, of which 8 studies were for alveolar ridge augmentation, 4 studies were for extraction socket augmentation, and 2 studies were for sinus floor elevation. Reported sources of BRs included autografts, allografts, and xenografts. The follow-up period ranged from 4 months to 4.7 years. Regarding the primary outcomes, the utilization of BR grafts demonstrated favorable bone gain along with acceptable graft absorption and marginal bone loss. Regarding the secondary outcomes, satisfactory bone mineral density and implant stability were confirmed, accompanied by a recorded incidence of postoperative complications (20 cases) and an implant failure rate of 5.58%.

Conclusions:
BR grafting with simultaneous or staged implant insertion is an effective approach for reconstructing alveolar ridge deficiencies. The BR grafts demonstrate favorable bone remodeling and osteointegration with the alveolar bone and implant; however, its success may be compromised by complications. Future studies should further investigate the clinical efficacy of BR grafting comparing to other bone augmentation techniques in diverse scenarios.