bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Qualitative Study of Pediatric Residents’ Experiences at Morning Report
Authors: Lockwood Laura Z. , Williams Joshua T. B. , Tanverdi Melisa , Barry Seltz L. 
Published: November 2023

Objectives Morning Report is a prevalent classroom learning activity in residency programs. Yet, its contribution to resident education remains unclear. Our objective was to explore pediatric residents’ perceptions of the purpose of Morning Report as well as their experiences at Morning Report both as learners and resident presenters. Methods We performed a qualitative study with a grounded theory approach using semi-structured focus groups of pediatric residents (November 2016-July 2017) from a large academic health center. We analyzed data with the constant comparative method, generating codes using an iterative approach and collecting data until reaching saturation. We identified major themes and resolved disagreements by consensus. Results Twenty-six residents participated in five focus groups. Data analysis yielded four themes: Morning Report is Multipurpose, Socialization and Engagement Influence the Learning Environment, Potential for Emotional Discomfort, and Barriers to Prioritizing Morning Report Attendance. Residents felt the primary purpose of Morning Report was acquiring medical knowledge, but also acknowledged Morning Report's added benefits of providing an opportunity for socialization and a mental reprieve before work rounds. Residents felt Morning Report was educational when engaged in interactive discussion; however, it was challenging to meet the differing needs in this mixed learner level format. Some resident learners were hesitant to participate due to fears of being judged, and some resident presenters perceived a need to be topic experts. Clinical responsibilities and exhaustion following busy service rotations often precluded Morning Report attendance. Conclusion Pediatric residents described numerous purposes of Morning Report, including opportunities for valuable learning. Self-perceived learning was positively influenced by engagement and a sense of connection and challenged by emotional discomfort at times. Future work can explore how to best promote engagement and foster a safe learning environment.
Adolescents’ Experiences of Transition to Self-Management of Type 1 Diabetes: Systematic Review and Future Directions
Authors: Leocadio Paula , Kelleher Carol , Fernández Eluska , Hawkes Colin P. 
Published: November 2023

Purpose: The purpose of this systematic literature review was to explore studies that report the experiences of adolescents, their families, and health care professionals of adolescents’ transition to self-management of type 1 diabetes (T1DM). Methods: SocINDEX, PsycInfo, APA PsycArticles, and MEDLINE electronic databases were searched. Studies reporting on experiences of transition to self-management of T1DM for adolescents, their parents, siblings, and health care professionals published between January 2010 amd December 2021 were included. The Mixed Methods Appraisal Tool guided trustworthiness and relevance of selected studies. Results: A total of 29 studies met the inclusion criteria. Findings indicate that adolescents’ experiences of transitioning to self-management of T1DM are interconnected with the supports provided by others (eg, family, teachers, friends). Considering interdependence and collective lived experiences is essential to developing effective and personalized family, peer, and social interventions to facilitate transition and to avoid negative outcomes in later life. The renegotiation of roles within the network of supports that impact adolescents’ transition and adolescents’ self-negotiation have been neglected. Conclusion: Transition to self-management of T1DM is a dynamic and iterative process comprising of continuous shifts between interdependence and independence, making it challenging for all involved. A number of research gaps and avenues for future research are outlined.
A Soft Tissue Technique for Treating Knee Hyperextension or Recurvatum: Posterior Oblique Ligament Advancement
Authors: Franciozi Carlos E. , Mameri Enzo S. , Schumacher Felipe C. , Credidio Marcos V. , Kubota Marcelo S. , Luzo Marcus V. 
Published: November 2023

Background: Genu recurvatum is a challenging disorder and can negatively affect knee biomechanics, as reflected in its role as a risk factor for knee ligament injury and poor outcomes following ligament reconstruction or arthroplasty. Indication: Pathological recurvatum should be addressed in the presence of a causative correctible structural abnormality, whether due to decreased posterior tibial slope or due to multiligament injury. We described a posterior oblique ligament (POL) advancement technique for the treatment of knee recurvatum. Technique Description: After completion of all concomitant procedures such as ligament reconstructions, the procedure is initiated with a medial approach. The POL is isolated with an inverted L-shaped dissection and mobilized. Mattress sutures are passed through the resulting POL flap, and are re-tensioned and fixed anteriorly and distally, with the knee close to extension, in order for the imbrication to restrain hyperextension. Results: Anecdotal evidence points to satisfactory control of knee recurvatum postoperatively, which can potentially avoid its deleterious effects in surgical outcomes. Discussion/Conclusion: We present a promising option in the treatment of pathological recurvatum, with favorable cost-efficacy, low morbidity relative to slope-altering osteotomy or posterolateral soft tissue procedures, and focused on the biomechanically demonstrated main restrictors to knee hyperextension. Patient Consent Disclosure Statement: The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form of approval from the patient(s) with this submission for publication.
Reconstruction of the Anterior Cruciate Ligament and the Posterolateral Corner With a Single Combined Femoral Tunnel
Authors: Giardino Moreira da Silva Andre , Gobbi Riccardo Gomes , Bonadio Marcelo Batista , Angelini Fabio Janson , Pécora José Ricardo , Helito Camilo Partezani 
Published: November 2023

Background: Posterolateral knee injuries can occur in 16% of patients with acute ligament injuries, and up to 70% have a combined anterior cruciate ligament (ACL) tear. Studies have shown that, in different populations, the distance between the insertion of the popliteus tendon and the lateral collateral ligament (LCL) may be smaller than the 18.5 mm previously reported in the literature. When we have an associated injury of the ACL and the posterolateral corner (PLC), the confluence of tunnels in the lateral femoral condyle can be a potential problem during reconstruction surgery. Indications: The indication of this technique is the combined injury of the ACL and the PLC. Technique Description: The reconstruction is performed with 2 semitendinosus tendons and 1 gracilis tendon. The technique consists of making a tunnel in the lateral wall of the femur, from the outside-in, at the isometric point between the origin of the LCL and insertion of the popliteus tendon, and emerging in the inner wall of the lateral femoral condyle at the anatomic point of the ACL. The graft is passed from the tibia to the femur with the doubled gracilis tendon and the 2 simple semitendinosus tendons for the ACL graft. The remaining portions of the semitendinosus tendons are left for reconstruction of the PLC structures, with one of them going straight to the posterolateral tibial tunnel (reconstructing the popliteus tendon), and the other passing through the fibular head tunnel (reconstructing the LCL) and continuing from the fibular head to the posterolateral tibial tunnel (reconstructing the popliteofibular ligament). Results: Patients undergoing this technique achieved good functional outcomes and a failure rate similar to that reported in the literature for combined ACL and PLC reconstruction. Discussion/Conclusion: This technique is an excellent option for patients with the combined injury of the ACL and the PLC, avoiding the confluence of tunnels in the lateral femoral condyle. It presents good results and acceptable complication rates, compatible with the severity of this lesion. Patient Consent Disclosure Statement: The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form of approval from the patient(s) with this submission for publication.
Causes and consequences of clonal hematopoiesis
Authors: Weeks Lachelle D. , Ebert Benjamin L. 
Published: November 2023

Abstract
Clonal hematopoiesis (CH) is described as the outsized contribution of expanded clones of hematopoietic stem and progenitor cells (HSPCs) to blood cell production. The prevalence of CH increases dramatically with age. CH can be caused by somatic mutations in individual genes or by gains and/or losses of larger chromosomal segments. CH is a premalignant state; the somatic mutations detected in CH are the initiating mutations for hematologic malignancies, and CH is a strong predictor of the development of blood cancers. Moreover, CH is associated with nonmalignant disorders and increased overall mortality. The somatic mutations that drive clonal expansion of HSPCs can alter the function of terminally differentiated blood cells, including the release of elevated levels of inflammatory cytokines. These cytokines may then contribute to a broad range of inflammatory disorders that increase in prevalence with age. Specific somatic mutations in the peripheral blood in coordination with blood count parameters can powerfully predict the development of hematologic malignancies and overall mortality in CH. In this review, we summarize the current understanding of CH nosology and origins. We provide an overview of available tools for risk stratification and discuss management strategies for patients with CH presenting to hematology clinics.
Impact of estradiol, testosterone and their ratio on left and right auricular myofilament function in male and female patients undergoing coronary artery bypass grafting
Authors: Bening C. , Genser B. , Keller D. , Müller-Altrock S. , Radakovic D. , Penov K. , Hassan M. , Aleksic I. , Leyh R. , Madrahimov N. 
Published: November 2023

Abstract
Background
The impact of sex hormones on right and left auricular contractile apparatus function is largely unknown. We evaluated the impact of sex hormones on left and right heart contractility at the level of myocardial filaments harvested from left and right auricles during elective coronary artery bypass surgery.

Methods
150 patients (132 male; 18 female) were enrolled. Preoperative testosterone and estradiol levels were measured with Immunoassay. Calcium induced force measurements were performed with left- and right auricular myofilaments in a skinned fiber model. Correlation analysis was used for comparison of force values and levels of sex hormones and their ratio.

Results
Low testosterone was associated with higher top force values in right-sided myofilaments but not in left-sided myofilaments for both sexes (p = 0.000 in males, p = 0.001 in females). Low estradiol levels were associated with higher top force values in right-sided myofilaments (p 0.000) in females and only borderline significantly associated with higher top force values in males (p 0.056). In females, low estradiol levels correlated with higher top force values in left sided myofilaments (p 0.000). In males, higher Estradiol/Testosterone ratio (E/T ratio) was only associated with higher top force values from right auricular myofilaments (p 0.04) In contrast, in females higher E/T ratio was associated with lower right auricular myofilament top force values (p 0.03) and higher top force values in left-sided myofilaments (p 0.000).

Conclusions
This study shows that patients’ comorbidities influence left and right sided contractility and may blur results concerning influence of sex hormones if not eliminated. A sex hormone dependent influence is obvious with different effects on the left and right ventricle. The E/T ratio and its impact on myofilament top force showed divergent results between genders, and may partially explain gender differences in patients with cardiovascular disease.
The effect of anesthetic depth on postoperative delirium in older adults: a systematic review and meta-analysis
Authors: Wang Yafeng , Zhu Hongyu , Xu Feng , Ding Yuanyuan , Zhao Shuai , Chen Xiangdong 
Published: November 2023

Abstract
Background
Postoperative delirium (POD) is an important complication for older patients and recent randomised controlled trials have showed a conflicting result of the effect of deep and light anesthesia.

Methods
We included randomised controlled trials including older adults that evaluated the effect of anesthetic depth on postoperative delirium from PubMed, Embase, Web of Science and Cochrane Library. We considered deep anesthesia as observer’s assessment of the alertness/ sedation scale (OAA/S) of 0–2 or targeted bispectral (BIS) < 45 and the light anesthesia was considered OAA/S 3–5 or targeted BIS > 50. The primary outcome was incidence of POD within 7 days after surgery. And the secondary outcomes were mortality and cognitive function 3 months or more after surgery. The quality of evidence was assessed via the grading of recommendations assessment, development, and evaluation approach.

Results
We included 6 studies represented 7736 patients aged 60 years and older. We observed that the deep anesthesia would not increase incidence of POD when compared with the light anesthesia when 4 related studies were pooled (OR, 1.40; 95% CI, 0.63–3.08, P = 0.41, I2 = 82%, low certainty). And no significant was found in mortality (OR, 1.12; 95% CI, 0.93–1.35, P = 0.23, I2 = 0%, high certainty) and cognitive function (OR, 1.13; 95% CI, 0.67–1.91, P = 0.64, I2 = 13%, high certainty) 3 months or more after surgery between deep anesthesia and light anesthesia.

Conclusions
Low-quality evidence suggests that light general anesthesia was not associated with lower POD incidence than deep general anesthesia. And High-quality evidence showed that anesthetic depth did not affect the long-term mortality and cognitive function.

Systematic review registration
CRD42022300829 (PROSPERO).
Risk factors associated with Crimean-Congo hemorrhagic fever virus circulation among human, livestock and ticks in Mauritania through a one health retrospective study
Authors: El Ghassem Abdellahi , Apolloni Andrea , Vial Laurence , Bouvier Romain , Bernard Celia , Khayar Mariem Seyidna , Cheikh Ahmed Mariem , Fausther-Bovendo Hugues , Beyit Abdallahi Diambar , Yahya Barry , Ould El Mamy Mohamed Bezeid , Elbara Ahmed , Bollahi Mohamed Abdellahi , Cêtre-Sossah Catherine , Ould Mohamed Salem Boukhary Ali 
Published: November 2023

Abstract
Background
Crimean Congo hemorrhagic fever (CCHF) is endemic in Southern Mauritania where recurrent outbreaks have been constantly observed since the 1980’s. The present study is the first to assess CCHFV antibodies and RNA in humans.

Methods
A retrospective study was conducted using 263 humans and 1380 domestic animals serum samples, and 282 tick specimens of Hyalomma genus collected from 54 settings in 12 provinces across Mauritania. Antibodies targeting CCHF viral nucleoprotein were detected in animal and human sera using double-antigen ELISA. CCHFV specific RNA was detected in human and animal sera as well as tick supernatants using a CCHFV real time RT-PCR kit. Individual characteristics of sampled hosts were collected at the same time and data were geo-referenced. Satellite data of several environmental and climatic factors, were downloaded from publicly available datasets, and combined with data on livestock mobility, animal and human density, road accessibility and individual characteristics to identify possible risk factors for CCHFV spatial distribution. To this end, multivariate logistic models were developed for each host category (human, small and large ruminants).

Results
The overall CCHFV antibody prevalence was 11.8% [95% CI: 8.4–16.3] in humans (17.9% in 2020 and 5.4% in 2021; p = 0.0017) and 33.1% (95% CI: 30.1–36.3) in livestock. CCHFV-specific antibodies were detected in 91 (18.1%) out of 502 sheep, 43 (9.0%) out of 477 goats, 144 (90.5%) out of 161 dromedaries and 179 (74.6%) out of 240 cattle. CCHFV RNA was detected in only 2 (0.7%) sera out of 263 animals herders samples from Hodh El Gharbi province and in 32 (11.3%) out of 282 Hyalomma ticks. In humans as well as in animals, seropositivity was not associated with sex or age groups. The multivariate analysis determined the role of different environmental, climatic and anthropic factors in the spatial distribution of the disease with animal mobility and age being identified as risk factors.

Conclusion
Results of the present study demonstrate the potential risk of CCHF for human population in Mauritania primarily those living in rural areas in close vicinity with animals. Future studies should prioritize an integrative human and veterinary approach for better understanding and managing Crimean-Congo hemorrhagic fever.
Novel approach of prophylactic radiation to reduce toxicities comparing 2-step40 with 56-Gy simultaneous integrated boost intensity-modulated radiation therapy for locally advanced squamous cell carcinoma of the head and neck, an intergroup phase III trial (JCOG1912, NEW BRIDGE)
Authors: Yokota Tomoya , Zenda Sadamoto , Kodaira Takeshi , Kiyota Naomi , Fujimoto Yasushi , Wasano Koichiro , Takahashi Ryo , Mizowaki Takashi , Homma Akihiro , Sasaki Keita , Machida Ryunosuke , Sekino Yuta , Fukuda Haruhiko ,   Japan Clinical Oncology Group Radiation Therapy Study Group,   Japan Clinical Oncology Group Head and Neck Cancer Study Group
Published: November 2023

Abstract
Background
Chemoradiotherapy (CRT) with concurrent cisplatin is the standard of care as a nonsurgical definitive treatment for patients with locally advanced squamous cell carcinoma of the head and neck (LA-SCCHN). However, CRT is associated with increased severe late adverse events, including swallowing dysfunction, xerostomia, ototoxicity, and hypothyroidism. Few strategies aimed at less invasive CRT without compromising treatment outcomes have been successful. The purpose of this study is to confirm the non-inferiority of reduced dose prophylactic radiation with 40 Gy compared to standard dose prophylactic radiation with 56 Gy in terms of the time to treatment failure (TTF) among patients with clinical stage III-IVB LA-SCCHN.

Methods
This study is a multicenter, two-arm, open-label, randomized phase III trial. Patients with LA-SCCHN excluding p16 positive oropharynx cancer are randomized to the standard arm or experimental arm. A total dose of 70 Gy for tumors with concurrent cisplatin at 100 mg/m2 are administered in both arms. For prophylactic field, patients in the standard arm receive a total dose of 56 Gy in 35 fractions for 7 weeks using simultaneous integrated boost (SIB56) and those in the experimental arm receive 40 Gy in 20 fractions using two-step methods for 4 weeks (2-step40). A total of 400 patients will be enrolled from 52 Japanese institutions within 5 years. The primary endpoint is TTF, and the secondary endpoints are overall survival, complete response rate, progression-free survival, locoregional relapse-free survival, acute and late adverse events, quality of life score, and swallowing function score.

Discussion
If the experimental arm is non-inferior to the standard arm in terms of TTF and superior on the safety endpoints, the 2-step40 procedure is the more useful treatment than SIB56 for definitive CRT.

Trial registration
This trial has been registered in the Japan Registry of Clinical Trials as jRCTs031210100 (https://jrct.niph.go.jp/latest-detail/jRCTs031210100). Date of Registration: May 2021.
A pan-cancer analysis revealing the role of LFNG, MFNG and RFNG in tumor prognosis and microenvironment
Authors: Gong Xun , Zheng Chenglong , Jia Haiying , Liu Yangruiyu , Yang Rui , Chen Zizhou , Pan Yihang , Li Xiaowu , Liu Yuchen 
Published: November 2023

Abstract
Background
Fringe is a glycosyltransferase involved in tumor occurrence and metastasis. However, a comprehensive analysis of the Fringe family members lunatic fringe (LFNG), manic fringe (MFNG), radical fringe (RFNG) in human cancers is lacking.

Methods
In this study, we performed a pan-cancer analysis of Fringe family members in 33 cancer types with transcriptomic, genomic, methylation data from The Cancer Genome Atlas (TCGA) project. The correlation between Fringe family member expression and patient overall survival, copy number variation, methylation, Gene Ontology enrichment, and tumor-infiltrating lymphocytes (TILs) was investigated by using multiple databases, such as cBioPortal, Human Protein Atlas, GeneCards, STRING, MSigDB, TISIDB, and TIMER2. In vitro experiments and immunohistochemical assays were performed to validate our findings.

Results
High expression levels of LFNG, MFNG, RFNG were closely associated with poor overall survival in multiple cancers, particularly in pancreatic adenocarcinoma (PAAD), uveal melanoma (UVM), and brain lower-grade glioma (LGG). Copy number variation analysis revealed that diploid and gain mutations of LFNG was significantly increased in PAAD and stomach adenocarcinoma (STAD), and significantly associated with the methylation levels in promoter regions. Significant differential genes between high and low expression groups of these Fringe family members were found to be consistently enriched in immune response and T cell activation pathway, extracellular matrix adhesion pathway, RNA splicing and ion transport pathways. Correlation between the abundance of tumor-infiltrating lymphocytes (TILs) and LFNG, MFNG, and RFNG expression showed that high LFNG expression was associated with lower TIL levels, particularly in PAAD. In vitro experiment by using pancreatic cancer PANC1 cells showed that LFNG overexpression promoted cell proliferation and invasion. Immunohistochemical assay in 90 PAAD patients verified the expression level of LFNG and its relationship with the prognosis.

Conclusions
Our study provides a relatively comprehensive understanding of the expression, mutation, copy number, promoter methylation level changes along with prognosis values of LFNG, MFNG, and RFNG in different tumors. High LFNG expression may serve as a poor prognosis molecular marker for PAAD.