bluuebunny/crossref_metadata_2025_split huggingface dataset:
Uptake of retroviral pre-exposure prophylaxis and its associated factors among female sex workers, Northwest Ethiopia
Authors: Shibesh Belayneh Fentahun , Admas Aragaw Bitew , Lake Amarech Wondie , Getu Samuel Befekadu , Worede Daniel Tarekegn 
Published: November 2023

Abstract
Background
Pre-exposure prophylaxis is the use of antiretroviral medications by HIV-negative individuals to prevent infection before exposure. Ethiopia has made progress in reducing new HIV infections, but the burden remains high with ongoing challenges in prevention uptake. This study examined the utilization and factors associated with pre-exposure prophylaxis among female sex workers.

Methods
A community-based cross-sectional study design was conducted in Bahir Dar city administration among female sexual workers in 2022. The results were collected using a pre-tested and structured questionnaire. Epi data for data entry and social package for social science for analysis were used.

Result
Overall, 15.9% (CI: 12.0-21.1) of female sexual workers received pre-exposure prophylaxis. Parents’ living condition (only father alive [AOR = 0.23, 95% CI, 0.02–0.64], only mother alive [AOR = 0.31, 95% CI, 0.02–0.74]), marital status being single (AOR = 0.27, 95% CI, 0.06–0.94), having history of STI (AOR = 2.82, 95% CI, 1.60–4.77) were associated with pre-exposure prophylaxis uptake.

Conclusion
This study showed low pre-exposure prophylaxis uptake. The study identified a history of sexually transmitted infections, marital status, and parent living conditions as significant factors. To increase pre-exposure prophylaxis uptake and reduce HIV incidence, an awareness campaign, tailored support, targeted interventions, and addressing concerns of high-risk groups are needed.
Influence of the 2000-m ergometer test on indirect markers of intestinal injury in competitive elite rowers in different training phases
Authors: Dziewiecka Hanna , Kasperska Anna , Ostapiuk–Karolczuk Joanna , Cichoń-Woźniak Justyna , Basta Piotr , Skarpańska-Stejnborn Anna 
Published: November 2023

Abstract
Background
We examined the effect of the 2000-m ergometer test on gut injury in competitive elite rowers in two different training phases. Given that inflammatory markers during the competitive phase are higher, we hypothesise that markers of intestinal injury are also more elevated during that phase.

Methods
We performed this study during the preparatory phase (Test I) and competitive phase (Test II) of annual training. We included 10 competitive elite rowers, members of the Polish Rowing Team, in the study after applying the inclusion/exclusion criteria. The participants performed a 2000-m ergometer test during both phases (Tests I and II). We collected blood samples before the test, immediately after the test and after 1 h of recovery. We measured the levels of interleukin 6 (IL-6), intestinal fatty acid binding protein (I-FABP), lipopolysaccharide (LPS), lipopolysaccharide-binding protein (LBP), and zonulin.

Results
There were no significant changes over time in Test I and Test II in the gut integrity markers. There were significantly lower I-FABP and IL-6 levels after the test for Test II compared with Test I. The pre-test LPS level was significantly lower for Test II compared with Test I. The pre-test LBP and zonulin levels were numerically lower in Test II, but the differences were not significant.

Conclusions
The 2000-m ergometer test showed no influence on gut integrity markers. However, there were differences in the response to exercise between Tests I and II. The lower level of gut injury markers after extreme exercise tests carried out during the preparation period may be the result of adaptive mechanisms and could indicate that rationally conducted training significantly decreases intestinal injury.
Surgical strategies and outcomes for myocardial bridges coexisting with other cardiac conditions
Authors: Zhang Mingkui , Xu Xiruo , Wu Qingyu , Li Hongyin , Xu Zhonghua , Xue Hui , Jin Yongqiang , Fan Lixin , Li Lina 
Published: November 2023

Abstract
Background
Myocardial bridges are congenital coronary artery anomalies. There are still many controversies surrounding surgical treatment strategies for myocardial bridges combined with other heart disorders. The purpose of this study was to evaluate the surgical treatment strategies and outcomes in patients with these conditions.

Methods
Between March 2004 and October 2021, our institution witnessed 77 patients diagnosed with myocardial bridging who underwent surgical intervention. According to the myocardial bridge and combined heart disorder, four groups were identified: 1. isolated LAD supra-arterial myotomy group, 2. LAD CABG and(or not) myotomy group, 3. LAD supra-arterial myotomy and grafting of other branches group, and 4. LAD supra-arterial myotomy and other cardiac surgery group. The perioperative outcomes, symptoms, life quality, mortality, and major adverse cardiac events (MACEs) were analyzed.

Results
There were no deaths during hospitalization and no rethoractomy for postoperative bleeding or major adverse cardiac events (MACEs). The follow-up period ranged from 2 months to 199.2 months (55.61 ± 10.21) months, the 10-year cumulative survival rates for the four groups of patients were 95.0%, 100%, 100% and 74.1%, and the 10-year freedom rates from the MACEs were 83.9%, 92.0%, 87.5% and 76.2%, respectively.

Conclusions
Supra-arterial myotomy is preferred in patients with isolated myocardial bridge, and acceptable results can be achieved by choosing supra-arterial myotomy in combination with CABG or other cardiac surgery simultaneously for patients with myocardial bridges and other heart disorders.
Multisystem Inflammatory Syndrome (MIS) following SARS-CoV-2 vaccinations; a systematic review
Authors: Elsaid Mohamed , Nune Arvind , Hesham Deyaa , Fouad Fatma Mohamed , Hassan Hamsa , Hamouda Heba , Sherif Huda , Abdelwahab Maya Magdy , Hegazi Nourelhoda , El-Rahman Yasmena Abd 
Published: November 2023

Abstract
Background
Although SARS-CoV-2 vaccines are generally safe, there are growing concerns about their link to a potentially life-threatening multi-system inflammatory syndrome following vaccination (MIS-V). We conducted this systematic review to elucidate the prevalence of MIS, severity, treatment, and outcomes following SARS-CoV-2 vaccination.

Methods
We searched PubMed, Scopus, ScienceDirect, Google Scholar, Virtual Health Library (VHL), Cochrane Library, and Web of Science databases for articles and case reports about MIS-V. We performed a qualitative analysis of individual cases from the included studies.

Results
Of the 1366 studies identified by database search, we retrieved twenty-six case reports and two cohort studies. We analyzed the data of 37 individual cases extracted from 27 articles. The average age of the cases included in this review was 18 (1–67) years, with the most being male (M: F 3.1:1). Of the 37 included cases, the cardiovascular system was the most affected system by MIS (36, 97.3%), followed by the gastrointestinal tract (32, 86.5%).

Conclusion
MIS after SARS-CoV-2 vaccinations can be fatal, but the incidence is low. Prompt recognition of MIS and ruling out the mimickers are critical in the patient’s early recovery.
Thyroid and Adrenal Dysfunction in Hemoglobinopathies Before and After Allogeneic Hematopoietic Cell Transplant
Authors: Mandava Mamatha , Lew Jeffrey , Tisdale John F , Limerick Emily , Fitzhugh Courtney D , Hsieh Matthew M 
Published: November 2023

Abstract

Purpose
To determine the rate and clinical characteristics associated with abnormal thyroid and adrenal function in recipients of nonmyeloablative hematopoietic cell transplantation (HCT) for sickle cell disease (SCD) and beta-thalassemia.

Methods
We retrospectively reviewed patients who enrolled in 4 nonmyeloablative HCT regimens with alemtuzumab and total body irradiation (TBI). Baseline and annual post-HCT data were compared, which included age, sex, sickle phenotype, thyroid panel (total T3, free T4, thyroid stimulating hormone, antithyroid antibodies), cortisol level, ACTH stimulation testing, ferritin, medications, and other relevant medical history.

Results
Among 43 patients in haploidentical transplant and 84 patients in the matched related donor protocols with mostly SCD, the rate of any thyroid disorder pre-HCT was 3.1% (all subclinical hypothyroidism) and post-HCT was 29% (10 hypothyroidism, 4 Grave's disease, and 22 subclinical hypothyroidism). Ninety-two (72%) patients had ferritin &gt;1000 ng/dL, of which 33 patients (35.8%) had thyroid dysfunction. Iron overload was noted in 6 of 10 patients with hypothyroidism and 12 of 22 patients with subclinical hypothyroidism.
Sixty-one percent were on narcotics for pain control. With respect to adrenal insufficiency (AI) pre-HCT, 2 patients were maintained on corticosteroids for underlying rheumatologic disorder and 8 had AI diagnosed during pre-HCT ACTH stimulation testing (total 10, 7.9%). Post-HCT, an additional 4 (3%) developed AI from corticosteroid use for acute graft vs host disease, Evans syndrome, or hemolytic anemia.

Conclusion
Although iron overload was common in SCD, thyroid dysfunction pre-HCT related to excess iron was less common. Exposure to alemtuzumab or TBI increased the rates of thyroid dysfunction post-HCT. In contrast, AI was more common pre-HCT, but no risk factor was identified. AI post-HCT was infrequent and associated with corticosteroid use for HCT-related complications.
Volunteers’ psychological condition during the war in Ukraine – a survey
Authors: Rodek Patryk , Kucia Karolina , Pastuszka Artur , Mędrala Wojciech , Kucia Krzysztof 
Published: November 2023

Cel pracyCelem pracy była ocena wpływu wolontariatu na kondycję psychiczną wolontariuszy w trakcie wojny w Ukrainie.MetodaWykorzystując platformę społecznościową "Facebook" woluntariusze zostali poproszeni o wypełnienie autorskiego kwestionariusza, dotyczącego ich kondycji psychicznej. Link do ankiety pozostawał otwarty od kwietnia do maja 2022 roku. W sumie uzyskano 867 odpowiedzi, z czego do ostatecznej analizy włączono odpowiedzi 703 respondentów. Uczestnicy badania zostali podzieleni na trzy grupy w zależności od tego w jaki sposób wolontariat wpłynął na ich zdrowie psychiczne. Następnie wyodrębniono dwie grupy: woluntariuszy działających na terenie Ukrainy oraz tych przyjmujących uchodźców pod swój dach. W każdej z grup oceniono wpływ wolontariatu na kondycję psychiczną wolontariuszy.WynikiU 45.10% uczestników badania wolontariat miał pozytywny wpływ na kondycję psychiczną, 35.56% respondentów nie stwierdziło żadnego wpływu, a u 19.35% wolontariuszy doszło do pogorszenia kondycji psychicznej. Somatyczne objawy lęku występowały w 11.10% przypadków, a osiągały znaczne nasilenie w 8.25%. 14.10% uczestników częściej sięgało po substancje psychoaktywne. Wśród wolontariuszy przyjmujących uchodźców do swoich domów 52.23% odczuwało nasilone wewnętrzne napięcie i irytację. 18% wolontariuszy działających na terytorium Ukrainy zgłaszało potrzebę pomocy psychiatrycznej lub psychologicznej.WnioskiWpływ wolontariatu na jednostkowe zdrowie psychiczne wolontariuszy waha się od pozytywnego do negatywnego. Wyjściowy nastrój ma znaczący wpływ na kondycję psychiczną po zakończeniu wolontariatu. Zjawisko traumy pośredniej jest wciąż niewystarczająco poznane i wymaga dalszych badań.
Peculiarities of the formation of exocrine pancreatic insufficiency in patients with primary osteoarthritis under conditions of comorbidity
Authors: Halabitska Iryna 
Published: November 2023

Summary. The comorbidity of primary OA and diseases of the gastrointestinal tract, which EPI accompanies, is an extremely relevant, complex, and unstudied problem of modern medicine, as it has a number of unsolved problems both in the treatment and rehabilitation of such patients. Common pathogenetic mechanisms of the progression of such comorbidity often have a mutually aggravating effect, which requires further study.
The aim of the study is to analyze the changes in indicators of exocrine pancreatic insufficiency (EPI) in patients with primary OA under the conditions of comorbidity with diseases of the gastrointestinal tract (GI).
Research material and methods. 304 patients with primary OA in comorbidity with diseases of the gastrointestinal tract accompanied by non-exacerbation EPI were examined. The comparison group consisted of 30 practically healthy individuals who did not have clinical, anamnestic, and instrumental signs of diseases of the gastrointestinal tract and joints.
Results and discussion. It was established that in patients with primary OA in comorbidity with diseases that are accompanied by EPI, the levels of EPI indicators were statistically significantly different depending on the etiology of EPI.
Conclusion. Post hoc analysis established the ranking of the pathology of the gastrointestinal tract, accompanied by EPI, according to the indicators of EPI in primary OA, which was located as follows, starting from the highest: CP ˃ T2DM ˃ chronic non-calculous cholecystitis and functional diseases of the gallbladder and biliary system ˃ chronic gastroduodenitis (p ˂0.05).
RADIOLOGICAL AND CLINICAL OUTCOMES IN ADOLESCENT IDIOPATHIC SCOLIOSIS CORRECTIVE FUSION SURGERY
Authors: Blankson Benjamin , Dunn Robert , Noconjo Lubabalo 
Published: November 2023

Adolescent idiopathic scoliosis (AIS) is a complex three-dimensional deformity of the spine characterized by a Cobb angle of at least 10 degrees. The goal of surgery is to not only prevent progression but restore sagittal and coronal balance, protecting cardiopulmonary function and improving cosmesis.We reviewed the impact of deformity correction surgery in terms of radiology and patient reported outcome(PROMs).The senior authors prospectively maintained database from 2003 –2022 was retrospectively analysed in terms of pre- and post-operative patient reported outcome measures (SRS 22) as well as radiological parameters.44 patients with AIS were identified with pre and post op PROMS. The average age at surgery was 15yrs with 84% female. 38% had a Lenke 1 curve and 3 patients had Lenke 6 curves. 73% had posterior surgery.There was a total improvement in SRS 22 scores by 7.8%. Patients reported significant satisfaction with treatment 4.8/5 and improvement in self-image with a change of 0.4 (p<0.001). However, no difference in function, pain and mental health were recorded.Overall, proximal thoracic (PT) curves improved from 24 degrees to 11 degrees (p<0.001), Main thoracic (MT) curve 55 degrees to 19 degrees and Thoracolumbar/Lumbar curves (TL/L) 45 degreesto 11 degrees. Pre-operative flexibility and post-operative correction were 0.40 and 0.41 respectively for PT curve. MT was 0.32 and 0.67. That for TL/L was 0.57 and 0.71 respectively.Surgery yields significant main curve correction correlating with high patient reported satisfaction rate. Although total SRS 22 score yielded 7.8% improvement, sub-analysis of self-image showed the most significant improvement.
MORTALITY IN PATIENTS ADMITTED TO ACUTE SPINAL CORD UNIT IN CAPE TOWN, SOUTH AFRICA
Authors: Kruger Nicholas , Arnolds Delroy , Dunn Rob 
Published: November 2023

To analyse the causes and factors associated with mortality in patients admitted to ASCI unit in a low- or middle-income country. The study was performed at a Tertiary Hospital at Groote Schuur Hospital, Cape Town South AfricaData between 1996 –2022 were retrospectively collected from hospital records of patients admitted to the ASCI Unit. There was approximately 3223 admissions for the study period. 682 patients were confirmed dead 87% were male and 64% were unemployed. The mean age was 46 years (ranging from 14 – 87 years).A 1/3 of injuries were caused by a MVA, a ¼ by a fall (low energy and from a height), and 1/5 by a gunshot wound. Average length of stay was 47 days (SD = 52 days), ranging from as short as 1 day to 512 days for one patient. Majority (65%) were admitted for more than a week but less than 2 months 32% were ventilated, and 17% with a CPAP facemask. 10% of patients had a pre-existing ulcer prior to admission. 65% of patients had surgery via the posterior approach, 33% via the anterior approach. On average patients died within 5 years of being admitted to hospital, ranging from dying in the same year as the injury to 20 years later. 73% of the deaths were classified as natural deaths and 20% as unnatural.There is a high mortality in patients with acute spinal cord injury, causes are multifactorial, and in depth critical analyses is required to improve clinical outcomes and rationalise resource allocation.
CLINICAL OUTCOMES FOLLOWING GLENOHUMERAL DISLOCATION WITH GREATER TUBEROSITY FRACTURE
Authors: Hackney Rosemary , Toland Gemma , Crosbie Gearoid , Mackenzi Samuel , Clement Nick , Keating John 
Published: November 2023

A fracture of the tuberosity is associated with 16% of anterior glenohumeral dislocations. Manipulation of these injuries in the emergency department is safe with less than 1% risk of fracture propagation. However, there is a risk of associated neurological injury, recurrent instability and displacement of the greater tuberosity fragment. The risks and outcomes of these complications have not previously been reported. The purpose of this study was to establish the incidence and outcome of complications associated with this pattern of injury.We reviewed 339 consecutive glenohumeral dislocations with associated greater tuberosity fractures from a prospective trauma database. Documentation and radiographs were studied and the incidence of neurovascular compromise, greater tuberosity fragment migration and intervention and recurrent instability recorded.The mean age was 61 years (range, 18–96) with a female preponderance (140:199 male:female). At presentation 24% (n=78) patients had a nerve injury, with axillary nerve being most common (n=43, 55%). Of those patients with nerve injuries 15 (19%) did not resolve. Greater tuberosity displacement >5mm was observed in 36% (n=123) of patients with 40 undergoing acute surgery, the remainder did not due to comorbidities or patient choice. Persistent displacement after reduction accounted for 60 cases, later displacement within 6 weeks occurred in 63 patients. Recurrent instability occurred in 4 (1%) patients. Patient reported outcomes were poor with average EQ5D being 0.73, QDASH score of 16 and Oxford Shoulder Score of 41.Anterior glenohumeral dislocation with associated greater tuberosity fracture is common with poor long term patient reported outcomes. Our results demonstrate there is a high rate of neurological deficits at presentation with the majority resolving spontaneously. Recurrent instability is rare. Late tuberosity fragment displacement occurs in 18% of patients and regular follow-up for 6 weeks is recommended to detect this.
LONG-TERM FOLLOW-UP (14 TO 25 YEARS) OF PATIENTS TREATED WITH CLOSED REDUCTION, SPLINTING, AND EARLY MOVEMENT FOR SIMPLE DISLOCATION OF THE ELBOW
Authors: Mackinnon Thomas , Hayter Edward , Samuel Thomas , Lee George , Huntley Daniel , Hardman John , Anakwe Raymond 
Published: November 2023

We have previously reported on the medium-term outcomes following a non-operative protocol of a short period of splinting followed by early movement to treat simple dislocations of the elbow.We undertook extended follow up of our original patient study group to determine whether the excellent results previously reported were maintained in the very long-term. A secondary question was to determine the rate and need for any late surgical intervention.We attempted to contact all patients in the original patient study group. Patients were requested to complete the Oxford elbow score (OES), the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire and a validated patient satisfaction questionnaire. Patients were requested to attend a face-to-face assessment where they underwent a clinical examination including neurovascular assessment, range-of-motion and an assessment of ligamentous stability.Seventy-one patients (65%) from the original patient study group agreed to participate in the study.The mean duration of follow-up was 19.3 years. At final follow-up patients reported excellent functional outcome scores and a preserved functional range of movement in the injured elbows. The mean DASH score was 5.22 points and the mean Oxford Elbow Score was 91.6 points. The mean satisfaction score was 90.9 points.Our study shows that the excellent outcomes following treatment with a protocol of a short period of splinting and early movement remain excellent and are maintained into the very long term. These findings support our hypothesis that this treatment protocol is appropriate and suitable for most patients with simple dislocations of the elbow. The role for primary ligamentous repair for this patient group should be carefully considered. Work to more clearly define the anticipated benefits of surgery for specific patient groups or injury patterns would help to support informed decision making.
THE EFFICACY OF THE BIPOD METHOD, USING AN ARTIFICIAL LARS® LIGAMENT, IN REDUCING ACROMIOCLAVICULAR JOINT INJURIES: A RETROSPECTIVE CASE SERIES
Authors: Kriel Renier , de Beer Joe 
Published: November 2023

Acromioclavicular joint injuries are one of the most common injuries in the shoulder girdle complex. Surgical management is considered based on patient profile, level of activity, pain, and classification of injury. To date, a vast array of surgical techniques have been proposed and described in the literature, a possible reason being that the optimal solution is still uncertain. The aim of this study is to determine the efficacy of an alternative surgical technique.This study is a retrospective case series of 80 patients that have been operated by a single surgeon over a period of 6 years. A novel surgical technique, the ‘BiPOD method’, was applied where a synthetic artificial ligament (LARS®) is used to reconstruct and reduce the acromioclavicular joint.The technique is done in a reproducible manner, where a single continuous artificial ligament is used to reduce and reconstruct both, the coracoclavicular and acromioclavicular ligament complexes to achieve bidirectional stability. Patients were followed-up postoperatively, either clinically where possible or telephonically. The Acromioclavicular Joint Instability Score (ACJI) and radiographic measurements were used to determine the clinical and surgical outcome of the surgery.Radiographic parameters, measuring the reduction of the coracoclavicular- and acromioclavicular joint, were analysed and documented. The results showed marked improvement in both, the coracoclavicular distance and acromioclavicular distance. Clinically, using the ACJI scoring system, the patients reported substantial improvement in pain and function. Complications were recorded but were insignificant.The BiPOD surgical technique, making use of an artificial LARS® ligament, has proven acceptable outcomes in the surgical management of acromioclavicular joint dislocations.