bluuebunny/crossref_metadata_2025_split huggingface dataset:
Anterior Lumbar Interbody Fusion (ALIF) Versus Full-Endoscopic/Percutaneous TLIF With a Large-Footprint Interbody Cage: A Comparative Observational Study
Authors: Morgenstern Christian , Nogueras Francisco , Delbos Geoffrey , Morgenstern Rudolf 
Published: January 2025

Study Design Exploratory prospective observational case-control study. Objectives Aim of this study was to compare clinical and radiologic outcome, as well as peri-operative complications, of anterior lumbar interbody fusion (ALIF) and full-endoscopic/percutaneous trans-Kambin transforaminal lumbar interbody fusion (pTLIF) with a large-footprint interbody cage. Methods Patients that underwent elective ALIF and pTLIF with a large-footprint interbody cage were prospectively evaluated. Clinical follow-up was measured pre- and post-operatively with Visual Analogic Scale and Oswestry Disability Index scores. Radiologic outcome was assessed with a computed tomography scan and standing films at 12 months. Results 44 patients underwent ALIF and 43 pTLIF surgery (total 87 cases). Clinical pre- and post-operative scores were comparable between both groups with 33.4 months mean follow-up. Median surgical time was significantly lower for pTLIF (28 minutes) compared to ALIF (72 minutes). Radiologic outcome was favorable for ALIF with a significantly higher increase in segmental lordosis compared to pTLIF. Fusion rates did not significantly differ between both groups. ALIF showed significantly less cage subsidence than pTLIF. Complications included 9 (21%) cases with transitory post-operative radiculitis for ALIF and 12 (28%) for pTLIF; post-operative partial muscle weakness 3(6%) cases for ALIF and 4 (9%) for pTLIF. Two (4%) cases required revision surgery for pTLIF. Conclusions ALIF and trans-Kambin pTLIF obtained comparable clinical outcome and fusion rates, while segmental lordosis restoration was favorable for ALIF. pTLIF required less surgery time and presented less intra-operative complications, while ALIF reported lower rates of post-operative subsidence, revision surgery and complications during follow-up.
A Unique Simulation Methodology for Practicing Clinical Decision Making
Authors: Amar Shimon , Bitan Yuval 
Published: January 2025

BACKGROUND While bedside teaching offers invaluable clinical experience, its availability is limited. Challenges such as a shortage of clinical placements and qualified teaching physicians, coupled with increasing medical student numbers, exacerbate this issue. Simulation-based learning encompasses varied educational values and has the potential to serve as an important tool in medical students’ education. OBJECTIVES In this study, we evaluate a new Clinical Decision Making Integrated Digital Simulation (CDMIDS) method that was developed in order to enhance the clinical decision-making competency and self-confidence of medical students early in their clinical training through practicing fundamental core skills. METHODS The study compares 108 4th-year medical students’ questionnaire responses pre-/postself-assessments following practice of a new clinical decision-making simulation methodology. RESULTS Results indicate a positive participant experience, with the simulation perceived as a valuable platform for practicing integrated bedside decision making. Notably, participants demonstrated a statistically significant increase in willingness to make clinical decisions. The simulation contributed to enhanced knowledge, professional skills, and self-confidence in clinical decision making. CONCLUSION The use of a CDMIDS method integrates clinical decision making as part of early medical school curriculum. Moreover, the method boosts learners’ professional confidence, self-directed learning, and additional experiences. The method is flexible and can be applied in any medical school, especially those with limited resources, by making specific, localized modifications.
Untreated exstrophy-epispadias complex: outcomes of Indiana pouch and primary abdominal wall closure
Authors: Kumar Niraj , Mandal Avishek , Kumar Sandeep , Yadav Siddharth , Karmungikar Somanath , Vasudeva Pawan 
Published: January 2025

Abstract

Background
We assessed the outcomes of adult patients with untreated exstrophy-epispadias complex who underwent Indiana continent catheterisable pouch type of urinary diversion along with primary closure of the abdominal wall utilizing the de-epithelised muscular coat of the vesical remnant.

Methods
This retrospective study analysed data between July 2019 and December 2023. All patients underwent a standard evaluation and surgical procedure and were followed up at 6 weeks, 3, 6 and 12 months and then annually. At each visit, renal function test and ultrasonography were performed and a 3 day CIC diary was obtained. The objective success was defined as complete diurnal and nocturnal continence with a pouch capacity of at least 300 ml, whereas the subjective success was defined as the Patient Global Impression of Improvement (PGI-I) score of 1 or 2 at 12 months post-surgery.

Results
A total of ten patients were included, and the mean operative time was 370 min, the mean blood loss was 400 ml and the mean hospital stay was 17 days. The overall complication rate was 40% and there was 1 Clavien IIIb complication. The mean duration of follow-up was 15.6 months and the mean maximum capacity of the pouch was 450 ml and the mean CIC frequency was 4.9 per day. The objective and subjective success rates were 100% and 100%, respectively.

Conclusion
Indiana pouch continent cutaneous urinary diversion is a feasible option with acceptable complication rates. It is a technically simpler procedure and obviates the need for extensive reconstructions and inter-departmental expertise and provides durable results.
The role of informal caregivers in suicide prevention for men– findings from a psychological autopsy study
Authors: Hofmann Laura , Springer Anna-Lena , Wagner Birgit 
Published: January 2025

Abstract

Background
Men have a significantly higher risk of dying by suicide than women and at the same time are less likely to make use of psychosocial support services. Therefore, informal caregivers who care for a person at risk play a significant role. This study aims to highlight the distress and support needs of informal caregivers for men in suicidal crises.

Methods

N = 15 participants who lost a man to suicide in the last 3–12 months were interviewed using psychological autopsy interviews. The interviews were analyzed using a comprehensive category system while following a deductive-inductive approach.

Results
The majority of participants reported experiencing significant stress as well as anxiety about leaving the affected men unsupervised. Only four participants indicated that they openly discussed their stress with their social environment, and just two sought professional support. Notably, only two caregivers anticipated the possibility of suicide. There was also little professional support for caregivers, resulting in participants using internet resources to inform themselves about suicidal ideation and behavior.

Conclusion
These findings highlight the significant stress and burden experienced by informal caregivers in suicide prevention for men. Lack of open communication and insufficient access to support exacerbate the emotional burden on caregivers. These results highlight the need for accessible resources and assistance to better support both caregivers and the individuals they care for.

Trial registration
German Clinical Trials Register, DRKS00030758, Registered on 11.11.2022.
Design and maintenance of medical oxygen concentrators in Sub-Saharan Africa: a systematic review
Authors: Ibrahim Nahimiya Husen , Wallace James , Piaggio Davide , Pecchia Leandro 
Published: January 2025

Abstract

Background
Oxygen therapy is critical and vital treatment for hypoxemia and respiratory distress, however, access to reliable oxygen systems remains limited in SSA. Despite WHO initiatives that distributed over 30,000 OC oxygen concentrators worldwide, SSA faces significant challenges related to their maintenance and use, due to harsh environmental conditions, technical skill shortages and inadequate infrastructure. This review aims to systematically identify and assess the literature on OC design adaptations, maintenance challenges, and knowledge gaps in SSA, providing actionable recommendations to inform innovative and context-sensitive solutions to improve healthcare delivery in the region.

Methods
The study focused on medical oxygen concentrators in SSA countries. It was conducted by following the PRISMA statement and searching three databases, i.e., Scopus, PubMed, and Web of Science, for publications in the period 2001–2023, using the search terms: oxygen concentrator, therapy, cylinder, plant, supply, delivery, and availability, design, and maintenance. The screening process involved evaluating manuscripts based on their titles, abstracts and full texts, based on specific inclusion and exclusion criteria. The extracted information included the author’s publication year, country, study aim, and key findings.

Results
Overall, 1,057 papers were returned for our analysis, of which 20 met the inclusion criteria. These studies primarily examined the design, availability and cost-effectiveness of oxygen concentrators compared to cylinders, revealing a significant supply and demand gap for these devices in SSA. It also illustrated how the environmental challenges impacted the devices durability, highlighting the need for more locally adapted resilient solutions. Solar-powered systems provide a sustainable option in areas with unstable power supplies, although initial costs remain high. Robust maintenance strategies, capacity building and strict procurement protocols proved essential to ensuring equipment long-term functionality.

Conclusion
This review synthesized and critically assessed the current in the body of literature, enabling highlighting valuable insights for innovators and stakeholders with an interest in enhancing the oxygen availability in SSA. It highlighted a pressing need for improved healthcare infrastructure investment, context-aware OC design and novel standards and regulatory frameworks to support frugal innovation.
Maintaining operability at a high personal cost – a mixed method study on maternal healthcare workers’ experiences during the COVID-19 pandemic
Authors: Akerstrom Magnus , Wessberg Anna , Hadžibajramović Emina , Graner Sofie , Carlsson Ylva , Andersson Ola , Jonsson Maria , Naurin Elin , Veje Malin , Sengpiel Verena , Linden Karolina 
Published: January 2025

Abstract

Introduction
The COVID-19 pandemic forced leaders and employees in health care services to take difficult decisions to manage risks associated with employee health and the organizations’ functioning. This study aims to identify the changes in employee working routines, job demands, and job resources within Swedish maternal healthcare during the COVID-19 pandemic, and how these changes affected workload and health.

Methods
Data were derived from the longitudinal COPE Staff study involving midwives and physicians within maternal healthcare. Three focus group discussions with midwives and physicians (n = 13), and open-ended survey responses (n = 604) during the third wave of the pandemic (January to May 2021) were analyzed using deductive content analysis based on the Job Demands-Resources model. Quantitative measures of workload and burnout from three survey waves, both during the pandemic (January to May 2021 [n = 782] and January to March 2022 [n = 503]) and after the pandemic (February to March 2023 [n = 759]), were analyzed.

Results
Multiple changes in working routines were implemented to adhere to national and local guidelines aiming to decrease the spread of Sars-CoV-2. As a result, midwives and physicians experienced increased job demands, including an increased workload and higher emotional and cognitive demands. To balance these demands, new working routines were introduced, and managers increased their efforts to communicate and support the employees. Collegial support also grew. When surveyed, however, most of the maternal healthcare workers said they experienced a high workload. It was found that between 3–7% likely experienced burn out, while another 10% were at risk of burnout during and after the pandemic.

Conclusions
The pandemic had a large effect on maternal healthcare employees. Strategies and adaptations on an organizational, managerial, and individual level played an important role in modifying the impact on the organization’s operations and employees.
Long COVID and its risk factors in migrants: a nationwide register study from Sweden
Authors: Cederström Agneta , Mkoma George Frederick , Benfield Thomas , Agyemang Charles , Nørredam Marie , Rostila Mikael 
Published: January 2025

Abstract

Background
Many studies have found more severe COVID-19 outcomes in migrants and ethnic minorities throughout the COVID-19 pandemic, while recent evidence also suggests higher risk of longer-term consequences. We studied the risk of a long COVID diagnosis among adult residents in Sweden, dependent on country of birth and accounting for known risk factors for long COVID.

Methods
We used linked Swedish administrative registers between March 1, 2020 and April 1, 2023, to estimate the risk of a long COVID diagnosis in the adult population that had a confirmed COVID-19 infection. Poisson regressions were used to calculate incidence rate ratios (IRR) of long COVID by country/region of birth. The contribution of sex, preexisting health status, disease severity, vaccination status, and socioeconomic factors to differences in long COVID diagnosis by country/region of birth were further investigated.

Results
Of the 1,869,188 persons diagnosed with COVID-19 that were included, 7539 had received a long COVID diagnosis. Compared with residents born in Sweden, we found higher risks of long COVID among migrants from East Europe (IRR: 1.44 CI: 1.29–1.60), Finland (IRR: 1.36 CI: 1.15–1.61), South Asia (IRR: 1.28 CI: 1.03–1.59), Other Asia (IRR: 1.35 CI: 1.13–1.62), Other Africa (IRR: 1.48 CI: 1.17–1.87), and the Middle East (IRR: 1.43 CI: 1.27–1.63) in models adjusted for age and sex. We discovered that disease severity, i.e., whether the person was hospitalized (IRR: 18.6 CI: 17.3–20.0) or treated in an intensive care unit (IRR: 120.5 CI: 111.7–129.8), primarily contributed to the higher risk of long COVID found in migrants while the contribution of vaccinations and social conditions were moderate. Preexisting health problems did not contribute to the increased risk of long COVID in migrants.

Conclusions
The greater exposure and impact of the COVID-19 virus among migrants also affected longer-term consequences. Disease severity was the most important risk factor for long COVID in migrants. The findings emphasize the need for targeted health interventions for migrant communities during an infectious disease pandemic, such as strategic vaccination campaigns and extending social insurance schemes, focusing on reducing disease severity to mitigate the longer-term health consequences of an infection.
Alpha/beta values in pediatric medulloblastoma: implications for tailored approaches in radiation oncology
Authors: Jazmati Danny , Sohn Dennis , Hörner-Rieber Juliane , Qin Nan , Bölke Edwin , Haussmann Jan , Schwarz Rudolf , Niggemeier Niklas David , Borkhardt Arndt , Babor Florian , Brozou Triantafyllia , Felek Melissa , Tamaskovics Balint , Melchior Patrick , Beez Thomas , Timmermann Beate , Remke Marc , Corradini Stefanie , Schulz Rémi Till , Preugschas Ronja-Linda , Budach Wilfried , Matuschek Christiane 
Published: January 2025

Abstract

Background
Medulloblastoma is the most common malignant pediatric brain tumor, typically treated with normofractionated craniospinal irradiation (CSI) with an additional boost over about 6 weeks in children older than 3 years. This study investigates the sensitivity of pediatric medulloblastoma cell lines to different radiation fractionation schedules. While extensively studied in adult tumors, these ratios remain unknown in pediatric cases due to the rarity of the disease.

Materials and methods
Five distinct medulloblastoma cell lines (ONS76, UW228-3, DAOY, D283, D425) were exposed to varying radiation doses and fractionation schemes. In addition, ONS76 and UW228-3 stably overexpressing MYC were analyzed. Alpha/beta values, representing fractionation sensitivity, were quantified using the linear-quadratic model of radiation survival.

Results
The study unveiled elevated alpha/beta ratios across diverse medulloblastoma cell lines, with a weighted mean alpha/beta value of 11.01 Gy (CI: 5.23–16.79 Gy). Neither TP53 status nor the levels of MYC expression influenced fractionated radiosensitivity. Furthermore, differences in alpha/beta values cannot be correlated with molecular subgroups (p = 0.07) or radiosensitivity (SF2).

Conclusion
These in vitro findings strongly recommend normofractionated or hyperfractionated radiotherapy for paediatric medulloblastoma cases due to consistently high alpha/beta values across subgroups. Conversely, hypofractionated radiotherapy is not advisable within a curative approach. This study presents significant potential by enabling the estimation of radiobiological fractionations and dose effects in young, vulnerable patients, highlighting its importance for advancing patient-specific therapeutic strategies.
Molecular and cellular characteristics of cerebrovascular cell types and their contribution to neurodegenerative diseases
Authors: Garcia Francisco J. , Heiman Myriam 
Published: January 2025

Abstract
Many diseases and disorders of the nervous system suffer from a lack of adequate therapeutics to halt or slow disease progression, and to this day, no cure exists for any of the fatal neurodegenerative diseases. In part this is due to the incredible diversity of cell types that comprise the brain, knowledge gaps in understanding basic mechanisms of disease, as well as a lack of reliable strategies for delivering new therapeutic modalities to affected areas. With the advent of single cell genomics, it is now possible to interrogate the molecular characteristics of diverse cell populations and their alterations in diseased states. More recently, much attention has been devoted to cell populations that have historically been difficult to profile with bulk single cell technologies. In particular, cell types that comprise the cerebrovasculature have become increasingly better characterized in normal and neurodegenerative disease contexts. In this review, we describe the current understanding of cerebrovasculature structure, function, and cell type diversity and its role in the mechanisms underlying various neurodegenerative diseases. We focus on human and mouse cerebrovasculature studies and discuss both origins and consequences of cerebrovascular dysfunction, emphasizing known cell type-specific vulnerabilities in neuronal and cerebrovascular cell populations. Lastly, we highlight how novel insights into cerebrovascular biology have impacted the development of modern therapeutic approaches and discuss outstanding questions in the field.
Identification of major trauma using the simplified abbreviated injury scale to estimate the injury severity score: a diagnostic accuracy and validation study
Authors: Eidenbenz David , Gauss Tobias , Zingg Tobias , Darioli Vincent , Vallot Cécile , Carron Pierre-Nicolas , Bouzat Pierre , Ageron François-Xavier 
Published: January 2025

Abstract

Background
The Abbreviated Injury Scale (AIS) and Injury Severity Score (ISS) grade the severity of injuries and are useful for trauma audit and benchmarking. However, AIS coding is complex and requires specifically trained staff. A simple yet reliable scoring system is needed. The aim of this study was two-fold. First, to develop and validate a simplified AIS (sAIS) chart centred on the most frequent injuries for use by non-trained healthcare professionals. Second, to evaluate the diagnostic accuracy of the sAIS (index test) to calculate the simplified ISS (sISS) to identify major trauma, compared with the reference AIS (rAIS) to calculate the reference ISS (rISS).

Methods
This retrospective study used data (2013–2014) from the Northern French Alps Trauma Registry to develop and internally validate the sAIS. External validation was performed with data from the Trauma Registry of Acute Care of Lausanne University Hospital, Switzerland (2019–2021). Both datasets comprised a random sample of 100 injured patients. Following the Standards for Reporting of Diagnostic Accuracy Studies 2015 guidelines, all patients completed the rAIS and the sAIS. The sISS and the rISS were calculated using the sAIS and the rAIS, respectively. Accuracy was evaluated with the mean difference between the sISS and the rISS and the Pearson correlation coefficient. A clinically relevant equivalence limit was set at ± 4 ISS points. Precision was analyzed using Bland-Altmann plots with 95% limits of agreement.

Results
Accuracy was good. The mean ISS difference of 0.97 (95% CI, −0.03 to 1.97) in the internal validation dataset and − 1.77 (95% CI, − 3.04 to 0.50) in the external validation dataset remained within the equivalence limit. The Pearson correlation coefficient was 0.93 in the internal validation dataset (95% CI, 0.90–0.95) and 0.82 in the external validation dataset (95% CI, 0.75–0.88). The limits of agreement were wider than the predetermined relevant range.

Conclusions
The sAIS is accurate, but slightly imprecise in calculating the ISS. The development of this scale increases the possibilities to use a scoring system for severely injured patients in settings with a reduced availability of the AIS.

Trial registration: Retrospectively registered.