bluuebunny/crossref_metadata_2025_split huggingface dataset:
Utility of Follow-up Radiographs in Type 1 Supracondylar Humerus Fractures
Authors: Nihalani Shrey , Bloodworth Adele , Frith Katie , Ashley Philip , Williams Kevin A. , Conklin Michael J. 
Published: March 2024

Objective:
Supracondylar humerus (SCH) fractures are common among pediatric patients, with the severity categorized using the Gartland classification system. Type 1 SCH fractures are nondisplaced and treated with immobilization, while more displaced fractures require surgery. The need for follow-up radiographs, particularly for type 1 fractures, is an area where evidence is lacking. This study investigates the clinical value and financial implications of follow-up radiographs for type 1 SCH fractures, hypothesizing that they do not alter clinical management and, therefore, represent an unnecessary expense.

Methods:
This retrospective cohort study, approved by the Institutional Review Board, focused on patients under 18 with nondisplaced SCH fractures treated nonoperatively. One hundred one type 1 SCH fractures, in which the fracture was visible on presenting radiographs, were chosen from patients presenting between January 2021 and December 2022. Charts were reviewed for demographic information, time of cast removal, and complications. A pediatric orthopaedic surgeon and orthopaedic resident reviewed the radiographs to confirm the injury to be a type 1 SCH fracture.

Results:
Among the 101 patients, after the initial presentation, 79 attended an interim visit and 101 attended a “3-week follow-up” at an average of 23 days postinjury. All patients underwent radiographs during these visits for a total of 180 radiographs after confirmation of type 1 SCH fracture. No changes in management resulted from follow-up radiographs. One instance of refracture was noted ~3 months after cast removal. There were 180 superfluous follow-up radiographs taken at subsequent clinic visits. The total charge for these radiographs was $76,001.40, averaging $752.49 per patient.

Conclusion:
Follow-up radiographs for type 1 SCH fractures did not lead to changes in clinical management, aligning with previous findings in more severe SCH fractures. This approach can reduce costs, radiation exposure, and clinic time without compromising patient care. The study can reassure providers and parents about the lack of necessity for follow-up radiographs to document healing.

Level of Evidence:
Level—IV.
Oxidative Stress in Postbariatric Patients: A Systematic Literature Review Exploring the Long-term Effects of Bariatric Surgery
Authors: Pradel-Mora Jessica Juliana , Marín Gerardo , Castillo-Rangel Carlos , Hernández-Contreras Karla Aketzalli , Vichi-Ramírez Micheel Merari , Zarate-Calderon Cristofer , Herran Motta Fanny Stella 
Published: March 2024

Background:The present study investigates the impact of oxidative stress after bariatric surgery in patients with obesity. This field of study has gained great interest in recent years due to the role that oxidative stress plays in metabolic diseases. Obesity, by itself, can generate an increase in reactive oxygen and nitrogen species, intensifying cellular damage and promoting the progression of adverse metabolic conditions. In this context, bariatric surgery emerges as a candidate capable of modifying oxidative stress biomarkers, facilitating the patient’s metabolic recovery.Methods:A systematic review was carried out, identifying 30 studies found in databases such as PubMed, Scopus, Web of Science, and Google Scholar. It looked at the link between oxidative stress and recovery after bariatric surgery in patients. The selection of studies was based on the measurement of oxidative stress biomarkers before and after surgical intervention.Results:The results reveal a significant decrease in oxidative stress biomarkers after bariatric surgery. However, a notable variability in antioxidant activity is observed between different patients, as well as a significant influence of comorbidities.Conclusions:Bariatric surgery is postulated as an effective intervention in reducing oxidative stress in patients with obesity, enhancing antioxidant activity and improving patient recovery. This finding highlights the importance of considering oxidative stress management as an integral part of postoperative care, suggesting the need to implement complementary treatment strategies to optimize health outcomes.
Introducing a Customized Low-Cost Macular Buckle
Authors: Kortuem Friederike C. , Ziemssen Focke , Neubauer Jonas , Bartz-Schmidt Karl Ulrich , Dimopoulos Spyridon 
Published: March 2024

Purpose:
To demonstrate a novel surgical technique that is a low-cost alternative to commercial implants for macular buckling in high myopia.

Methods:
A silicon encircling band serves as the anchor. A second silicon circling band is employed, with a 10-mm silicon strip to widen the posterior scleral indentation. This band is inserted posteriorly into the lateral and inferior rectus muscles and pushed behind the globe, orienting it in a superior-temporal to inferior-nasal position with the silicone strip directly under the macula. For better visualization, the placement of the macular buckle is done under the microscope.

Results:
The placement of the macular buckle led to reattachment of the central retina in treated patients during long-term follow-up. This technique eliminates the need for detaching a rectus muscle. Visual acuity remained stable throughout the follow-up period.

Conclusion:
This customized macular buckle technique can improve the anatomical outcome in patients with central retinal detachment due to high myopia.
Nursing Innovation
Authors: Beaudet Oriana 
Published: March 2024

Abstract
Organizations that foster psychologically safe environments create space for innovative cultures to emerge. The prioritization of nurse-led innovation signals broader cultural values around learning, a willingness to invest in people and their ideas, and an organizational focus around growth and operational excellence. Embracing innovative behaviors can propel emerging areas of nursing science, practice, and workforce solutions. This month's Magnet® Perspectives explores innovation and the critical role of nurse leadership in shaping today's healthcare environment, and the future of nursing.
The Voice of Travel Nurses
Authors: Hickey Patricia A. , Connor Jean Anne , Whiting Jon , Wood Laura J. 
Published: March 2024

OBJECTIVE
The aim of this study was to explore the experience and perceived value of travel nurses in a children's hospital.

BACKGROUND
Children's hospitals face unique challenges related to highly specialized care requirements and workforce expansion limitations. Travel nurses can augment nurse staffing capacity during times of intense demand and may offer insights as organizations seek to strengthen work environments.

METHODS
Pediatric travel nurses currently contracted at the hospital were invited to participate in a focus group or interview. Content analysis was used to summarize information and identify themes.

RESULTS
From the 56 participants, 5 themes emerged. The themes were financial, flexibility, searching for healthy work environments, nursing care, and solutions.

CONCLUSIONS
Hearing the voices of travel nurses may offer valuable feedback to strengthen future professional practice environments.
Sustained morphine exposure alters spinal NMDA receptor and astrocyte expression and exacerbates chronic pain behavior in female rats
Authors: Gonçalves Sara V. , Woodhams Stephen G. , Li Li , Hathway Gareth J. , Chapman Victoria 
Published: March 2024

Abstract

Introduction:
Sustained opioid use has long-term negative impacts on future pain experience, particularly in women. This study aimed to investigate the underlying spinal neurobiology of this clinical observation in an experimental model of joint pain.

Objectives:
In this study, we tested the hypothesis that sustained opioid treatment exacerbates chronic pain responses and alters spinal cord dorsal horn astrogliosis and the expression of GluN2B-containing N-methyl-d-aspartate receptors in female rats.

Methods:
Subcutaneous morphine (3 mg/kg) or saline was administered twice daily for 1 week before inducing a model of joint knee pain (intra-articular injection of 2 mg of monosodium iodoacetate [MIA]) in adult female Sprague-Dawley rats, with pain-free controls receiving 50 µL of saline. Pain behavior (weight-bearing and mechanical paw withdrawal thresholds) was measured at baseline and at intervals thereafter. Twice-daily morphine/saline treatment was continued for up to 3 weeks after intra-articular injections, and spinal cord tissue was collected for Western blot analyses.

Results:
Area under the curve analysis of weight-bearing asymmetry confirmed a significant exacerbation of pain behavior in the morphine/MIA group, compared with the saline/MIA group (F(3,18) = 46.3, P < 0.0001), despite comparable joint damage in both groups. Sustained morphine treatment was associated with significant elevations in dorsal horn expression of astrocytic glial fibrillary acidic protein (27 ± 5% increase) and neuronal GluN2B (80 ± 30% increase), but not microglial IBA1, irrespective of the model of joint pain.

Conclusion:
These data suggest that sustained morphine treatment in female rats drives spinal cord plasticity, including spinal astrogliosis and the expression of GluN2B-containing N-methyl-d-aspartate receptors, priming the dorsal horn to incoming sensory inputs and producing exacerbated pain responses.
Comparative Effectiveness of Tofacitinib and Adalimumab in Axial Spondyloarthritis
Authors: Goswami Rudra Prosad , Sinha Debanjali , Chatterjee Moumita , Bhadu Danveer , Das Shyamashis 
Published: March 2024

Introduction
Tofacitinib, an oral Janus kinase inhibitor, is a putative choice in the treatment of axial spondyloarthritis (AxSpA). The objective of this study was to compare the effectiveness and tolerability of tofacitinib with adalimumab, in AxSpA, in a real-world clinical setting.

Methods
In this multicentric medical records review study, adult patients with active AxSpA treated with either tofacitinib 5 mg twice daily or adalimumab 40 mg subcutaneously fortnightly were recruited. Effectiveness was measured with Ankylosing Spondylitis Disease Activity Score (ASDAS) and Bath Ankylosing Spondylitis Disease Activity Index (BASDAI). Drug-cost analysis was calculated with Incremental Cost-Effectiveness Ratio (ICERdrug).

Results
Among the 266 patients, 135 were treated with tofacitinib and 131 with adalimumab (follow-up: 6.5 ± 1.6 months). Mean improvement of BASDAI (3.39 ± 0.09 vs. 3.14 ± 1.16, respectively) and that of ASDAS (1.78 ± 0.68 vs. 2.07 ± 2.08, respectively) were comparable between the adalimumab and tofacitinib groups. A higher proportion of patients achieved BASDAI50 response in the second (49.5% vs. 31.6%) and fourth month (83.9% vs. 62.8%) and ASDAS low disease activity in the fourth month (71.6% vs. 47.9%) in the adalimumab group. All disease activity measurements were similar by the sixth month in both groups. A higher proportion of patients in the tofacitinib group than in the adalimumab group required change in therapy (14.8% vs. 7.6%, respectively). ICERdrug for adalimumab compared with tofacitinib was US $188.8 per patient in the adalimumab group for each person-month with BASDAI <4.

Conclusions
Tofacitinib showed comparable effectiveness with adalimumab in patients with AxSpA at the sixth month, despite lesser response in the initial months, with favorable ICERdrug.
Prolonged hourly neurological examinations are associated with increased delirium and no discernible benefit in mild/moderate geriatric traumatic brain injury
Authors: Fonseca Ricardo A. , Canas Melissa , Diaz Leonardo , Aldana Jose A. , Afzal Hussain , De Filippis Alejandro , Del Toro Drew , Day Aaron , McCarthy Jennifer , Stansfield Kristin , Bochicchio Grant V. , Niziolek Grace , Kranker Lindsay M. , Rosengart Matthew R. , Hoofnagle Mark , Leonard Jennifer 
Published: March 2024

BACKGROUND
Serial neurological examinations (NEs) are routinely recommended in the intensive care unit (ICU) within the first 24 hours following a traumatic brain injury (TBI). There are currently no widely accepted guidelines for the frequency of NEs. Disruptions to the sleep-wake cycles increase the delirium rate. We aimed to evaluate whether there is a correlation between prolonged hourly (Q1)-NE and development of delirium and to determine if this practice reduces the likelihood of missing the detection of a process requiring emergent intervention.

METHODS
A retrospective analysis of patients with mild/moderate TBI, admitted to the ICU with serial NEs, was performed. Cohorts were stratified by the duration of exposure to Q1-NE, into prolonged (≥24 hours) and nonprolonged (<24 hours). Our primary outcomes of interest were delirium, evaluated using the Confusion Assessment Method; radiological progression from baseline images; neurological deterioration (focal neurological deficit, abnormal pupillary examination, or Glasgow Coma Scale score decrease >2); and neurosurgical procedures.

RESULTS
A total of 522 patients were included. No significant differences were found in demographics. Patients in the prolonged Q1-NE group (26.1%) had higher Injury Severity Score with similar head Abbreviated Injury Score, significantly higher delirium rate (59% vs. 35%, p < 0.001), and a longer hospital/ICU length of stay when compared with the nonprolonged Q1-NE group. No neurosurgical interventions were found to be performed emergently as a result of findings on NEs. Multivariate analysis demonstrated that prolonged Q1-NE was the only independent risk factor associated with a 2.5-fold increase in delirium rate. The number needed to harm for prolonged Q1-NE was 4.

CONCLUSION
Geriatric patients with mild/moderate TBI exposed to Q1-NE for periods longer than 24 hours had nearly a threefold increase in ICU delirium rate. One of five patients exposed to prolonged Q1-NE is harmed by the development of delirium. No patients were found to directly benefit as a result of more frequent NEs.

LEVEL OF EVIDENCE
Prognostic and Epidemiological; Level IV.
Current diagnosis and management of acute colonic diverticulitis: What you need to know
Authors: Kodadek Lisa M. , Davis Kimberly A. 
Published: March 2024

ABSTRACT
Acute colonic diverticulitis is a common disease treated by acute care surgeons. Acute uncomplicated colonic diverticulitis involves thickening of the colon wall with inflammatory changes and less commonly requires the expertise of a surgeon; many cases may be treated as an outpatient with or without antibiotics. Complicated diverticulitis involves phlegmon, abscess, peritonitis, obstruction, stricture, and/or fistula and usually requires inpatient hospital admission, treatment with antibiotics, and consideration for intervention including operative management. This review will discuss what the acute care surgeon needs to know about diagnosis and management of acute colonic diverticulitis.
Recessive variants in the intergenicNOS1AP-C1orf226locus cause monogenic kidney disease responsive to anti-proteinuric treatment
Authors: Buerger Florian , Salmanullah Daanya , Liang Lorrin , Gauntner Victoria , Krueger Kavita , Qi Maggie , Sharma Vineeta , Rubin Alexander , Ball David , Lemberg Katharina , Saida Ken , Merz Lea Maria , Sever Sanja , Issac Biju , Sun Liang , Guerrero-Castillo Sergio ,   Nephrotic Syndrome Study Network (NEPTUNE), Gomez Alexis C. , McNulty Michelle T. , Sampson Matthew G. , Al-Hamed Mohamed H. , Saleh Mohammed M. , Shalaby Mohamed , Kari Jameela , Fawcett James P. , Hildebrandt Friedhelm , Majmundar Amar J. 
Published: March 2024

ABSTRACTIn genetic disease, an accurate expression landscape of disease genes and faithful animal models will enable precise genetic diagnoses and therapeutic discoveries, respectively. We previously discovered that variants inNOS1AP, encoding nitric oxide synthase 1 (NOS1) adaptor protein, cause monogenic nephrotic syndrome (NS). Here, we determined that an intergenic splice product of NOS1AP/Nos1apand neighboringC1orf226/Gm7694, which precludes NOS1 binding, is the predominant isoform in mammalian kidney transcriptional and proteomic data.Gm7694-/-mice, whose allele exclusively disrupts the intergenic product, developed NS phenotypes. In two human NS subjects, we identified causativeNOS1APsplice variants, including one predicted to abrogate intergenic splicing but initially misclassified as benign based on the canonical transcript. Finally, by modifying genetic background, we generated a faithful mouse model ofNOS1AP-associated NS, which responded to anti-proteinuric treatment. This study highlights the importance of intergenic splicing and a potential treatment avenue in a mendelian disorder.
A method for measuring mitochondrial DNA copy number in pediatric populations
Authors: Maggo Simran , North Liam Y. , Ozuna Aime , Ostrow Dejerianne , Yander Grajeda I , Hesmedin Hakimjavadi , Cotter Jennifer A. , Judkins Alexander R. , Levitt Pat , Gai Xiaowu 
Published: March 2024

AbstractThe mitochondrion is a multifunctional organelle that modulates multiple systems critical for homeostasis during pathophysiological stress. Variation in mitochondrial DNA (mtDNA) copy number (mtDNAcn), a key mitochondrial change associated with chronic stress, is an emerging biomarker for disease pathology and progression. mtDNAcn can be quantified from whole blood samples using qPCR to determine the ratio of nuclear DNA to mtDNA. However, the collection of blood samples in pediatric populations, particularly in infants and young children, can be technically challenging, yield much smaller volume samples, and can be distressing for the patients and their caregivers. Therefore, we have validated a mtDNAcn assay utilizing DNA from simple buccal swabs (Isohelix SK-2S) and report here it’s performance in specimens from infants (age = <12 months). Utilizing qPCR to amplify ∼200bp regions from two mitochondrial (ND1, ND6) and two nuclear (BECN1, NEB) genes, we demonstrated absolute (100%) concordance with results from low-pass whole genome sequencing (lpWGS). We believe that this method overcomes key obstacles to measuring mtDNAcn in pediatric populations and creates the possibility for development of clinical assays to measure mitochondrial change during pathophysiological stress.
Navigating stroke care during the COVID-19 pandemic: A scoping review
Authors: Ménard Alixe , Yang Michelle , Oostlander Samantha , Sarwal Kanika , Manji Irfan , O’Sullivan Tracey , Fraser Sarah 
Published: March 2024

AbstractBackgroundPrevious viral outbreaks have highlighted implications for the management of complex health conditions. This study delves into the repercussions of the COVID-19 pandemic on stroke care, by examining evidence of shifts in healthcare utilization, the enduring effects on post-stroke recovery, and the overall quality of life experienced by stroke survivors.MethodsA scoping review was conducted following the Joanna Briggs Institute Methodology for Scoping Reviews. The search strategy encompassed electronic databases (APA PsycInfo, Embase, Medline, and CINAHL). English language articles published between December 2019 and January 2022 were included, focusing on individuals who experienced a stroke during the COVID-19 pandemic. Data extraction involved identifying study characteristics and significant findings, facilitating a qualitative and narrative synthesis of the gathered evidence.ResultsSeven domain summaries were identified. They all described the aspects of systemic transformations in stroke care during the COVID-19 pandemic: (1) patient behavior and awareness; (2) telemedicine and remote care; (3) delays in treatment; (4) impact on healthcare resources; (5) quality of care; (6) changes in stroke severity; and (7) reduction in stroke admissions.ConclusionsThis study underscored the critical need to encourage swift patient response to acute stroke symptoms, by finding new avenues for treatment, mitigating hospital-related infection fears, and advocating for the establishment of centralized stroke centers. These measures are integral to optimizing stroke care delivery and ensuring timely interventions, particularly in the challenging context of a pandemic.
AsianMus musculus: Subspecies Divergence, Genetic Diversity, and Historical Biogeography
Authors: Afzali Yaser Amir 
Published: March 2024

ABSTRACTThe house mouse,Mus musculus, is a model organism that has greatly contributed to evolutionary research. Despite its significance, there remain gaps in our understanding of its phylogeography and population genetic structure in Asian regions. This comprehensive study, aims to elucidate the evolutionary history, genetic diversity, and distribution patterns ofM. musculus. A diverse dataset of 281M. musculussamples from across Asia was collected, covering 101 localities in 19 countries. Phylogenetic analysis using Cytochromeb(Cytb) and D-Loop (DL) region, unveiled well-supported lineages. These lineages correspond to four major subspecies:Mus musculus musculus,M. m. domesticus,M. m. castaneus, andM. m. bactrianus. The analysis suggests a monophyletic origin of these subspecies approximately 0.59 million years ago (Mya), followed by two main lineages: one consisting ofM. m. domesticus(∼0.59 Mya) and the other comprisingM. m. castaneus,M. m. bactrianus, andM. m. musculus(∼0.56 Mya). Genetic diversity varied among subspecies, withM. m. domesticusexhibiting the highest diversity due to its extensive global distribution andM. m. bactrianusexhibiting the lowest diversity due to restriction in the southwest Asia. Pairwise genetic distances andFSTvalues confirmed significant genetic differentiation among the subspecies, underlining their historical isolation. Additionally, a Mantel test indicated that geographical distance played a pivotal role in shaping genetic differentiation. Demographic analysis revealed evidence of population expansions inM. m. domesticus,M. m. musculus, andM. m. castaneus, whileM. m. bactrianusshowed characteristics of neutral selection and genetic drift. Species distribution modeling, assessing both Current Conditions and the Last Glacial Maximum, indicated habitat shifts and losses during glacial periods, particularly in the eastern and northern regions of Asia. However, each subspecies displayed unique responses to climatic changes, reflecting their distinct ecological adaptations. Historical biogeography analysis pointed to complex origins and a network of dispersal and vicariance events that led to the contemporary distribution of subspecies. Deserts and Xeric Shrublands emerged as critical areas for diversification and speciation. This study contributes to our understanding of the phylogeography and population genetics ofM. musculusin Asia, highlighting the significance of geographical factors and climatic fluctuations in shaping its evolutionary history and genetic diversity.