bluuebunny/crossref_metadata_2025_split huggingface dataset:
Enhanced recovery after thoracic surgery in low- and middle-income countries: Feasibility and outcomes
Authors: Hentati Abdessalem , Ayed Ahmed Ben , Jdidi Jihen , Chaari Zied , Halima Ghassen Ben , Frikha Imed 
Published: November 2023

Background Enhanced Recovery After Surgery (ERAS) applies multimodal, perioperative, and evidence-based practices to decrease postoperative morbi-mortality, the length of hospital stay, and hospitalization costs. Implementing enhanced recovery after thoracic surgery (ERATS) in low- and middle-income countries (LMIC) is problematic. This randomized controlled trial evaluated the feasibility and effectiveness of an ERATS protocol adapted to LMIC conditions in Tunisia. Materials and Methods We conducted this randomized controlled trial between December 2015 and August 2017 in the Thoracic and Cardiovascular Surgery Department at Habib Bourguiba University Hospital of Sfax, Tunisia. Results One hundred patients undergoing thoracic surgery were randomly allocated to the ERATS group or Control group. During the postoperative phase, 13 patients (13%) were excluded secondary. These complication rates were lower in the ERATS group: lack of reexpansion (14.63% vs 16.10%: p = 0.72), pleural effusion (0% vs 10.86%, p = 0.05), and prolonged air leak (17.07% vs 30.43%, p = 0.14). The pain level decreased significantly in the ERATS group from postoperative H3 ( p = 0.006). This difference was significant at H6 ( p = 0.001), H24 ( p = 0.05), H48 ( p = 0.01), discharge ( p = 0.002), and after 15 days ( p = 0.01), with a decreased analgesic consumption. The length of hospital stay was shorter in the ERAS group (median six days vs seven days, p = 0.17). Conclusion This study provides an adapted ERATS protocol, applicable regardless of the surgical approach or the type of resection and suitable for LMIC hospital's conditions. This protocol can improve the postoperative outcomes of thoracic surgery.
Preoperative versus postoperative misoprostol use for prevention of blood loss during caesarean section in pregnant women at term: a multi-centre randomised controlled trial
Authors: Ajah Leonard Ogbonna , Ajah Monique Iheoma , Ezegwui Hyginus Uzo , Nwankwo Theophilus Ogochukwu , Iyoke Chukwuemeka Anthony , Nwigboji Wilson Ndukwe 
Published: November 2023

Objective Caesarean section is associated with higher blood loss than vaginal delivery. This study was performed to compare the safety and efficacy of preoperative versus postoperative rectal and sublingual misoprostol use for prevention of blood loss in women undergoing elective caesarean delivery. Methods Eligible patients in Southeast Nigeria were randomly classified into those that received 600 µg of preoperative rectal, postoperative rectal, preoperative sublingual, and postoperative sublingual misoprostol. All patients received 10 units of intravenous oxytocin immediately after delivery. Data were analysed with SPSS Version 23. Results Preoperative sublingual misoprostol use caused the highest postoperative packed cell volume, least change in the packed cell volume, and lowest intraoperative blood loss. Preoperative sublingual and rectal misoprostol use was associated with better haematological indices and maternal outcomes than postoperative use by these routes. However, preoperative sublingual and rectal use caused more maternal side effects than postoperative use by these routes. Conclusion Preoperative sublingual misoprostol was associated with the most favourable haematological indices. Although preoperative sublingual and rectal misoprostol use caused more maternal side effects, these routes were associated with better haematological indices and maternal outcomes than postoperative sublingual and rectal misoprostol use.
Community Pharmacists’ Current Practice and Educational Needs in Breastfeeding Support in Jordan: A Cross-Sectional Study
Authors: Harahsheh Mea’ad M. , Mukattash Tareq L. , Al-shatnawi Samah , Abu-Farha Rana , Abuhammad Sawsan , D'Arcy Deirdre , Jarab Anan 
Published: November 2023

Background: Improving breastfeeding practices is a worldwide priority. Pharmacists have the opportunity to actively promote breastfeeding and educate parents as well as the general public about its benefits. Research Aims: The aims of this study are to investigate Jordanian pharmacists’ present breastfeeding support practices and perceptions regarding their need for education and training in breastfeeding support. Methods: To examine sociodemographic characteristics of community pharmacists in Jordan and their current breastfeeding support practices and educational needs, a descriptive cross-sectional online (self-report) survey was conducted. Through social media, pharmacists working in community pharmacies in Jordan were recruited between August 2021 and February 2022. The level of breastfeeding support participants had been provided with was measured using eight items in a 5-point Likert scale ranging from 5 ( Always) to 1 ( Never). Each participant self-reported the frequency of advice/information given to breastfeeding women in each of these areas. Univariate and multivariable linear regression models were used to identify factors associated with the level of breastfeeding support. Results: Participants ( N = 381) reported a high level of breastfeeding support, but expressed a need for training and education for further improvement. The breastfeeding support score of female participants was found to be 0.12 higher than that of males (Beta = 0.12, p = .02), 0.16 higher in married participants compared to non-married participants (Beta = 0.16, p = .03), and 0.10 higher in participants working in rural areas compared to those working in urban areas (Beta = 0.10, p = .04). Conclusion: While community pharmacists generally report a high level of breastfeeding support, our findings revealed demographic differences. Attention to specific areas of need might enhance what pharmacists could offer; however, additional research would be required to guide the specific educational content.
Does Consumer Credit Precede or Follow Changes in Cognitive Impairment Among Older Adults? An Investigation in the Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) Trial
Authors: Dean Lorraine T. , Chung Shang-En , Gross Alden L. , Clay Olivio J. , Willis Sherry L. , Crowe Michael , McDonough Ian M. , Thomas Kelsey R. , Marsiske Michael , Aysola Jaya , Thorpe Roland J. , Felix Cynthia , Berkowitz Melissa , Coe Norma B. 
Published: November 2023

Objectives We assessed the relationships between pre- and post-morbid consumer credit history (credit scores, debts unpaid, or in collections) and classification of mild (or greater) cognitive impairment (MCI). Methods Generalized Estimating Equation models assessed pre-and post-morbid credit history and MCI risk among 1740 participants aged 65+ in the Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) study, linked to TransUnion consumer credit data. Results Each 50-point increase in credit score was associated with up to 8% lower odds of MCI in the next 3 years. In contrast, new unpaid collections over doubled the odds of having MCI in the next 3 years. MCI was associated with subsequent credit score declines and a 47%–71% greater risk of having a new unpaid collection in the next 4 years. Discussion Credit declines may signal risk for future MCI. MCI may lead to financial challenges that warrant credit monitoring interventions for older adults.
Study on control limits for track longitudinal irregularities measured by 60 m chord on high-speed railway
Authors: Xin Tao , Dai Chuanqing , Wang Juguang , Yang Fei , Nadakatti Mahantesh M , Wang Sen 
Published: November 2023

The high-speed railway (HSR) operates at a high velocity, and the long-wavelength track irregularities can affect its safety and stability. The study was conducted to address control and management issues related to long-wavelength track irregularities on HSRs. It achieved this by establishing a vehicle-track dynamic analysis model based on the multi-rigid-body dynamics theory, aiming to provide recommendations for the development of standards for managing the track irregularities on HSRs. A simulation was conducted to analyze how the train speed, wavelength, and amplitude of track longitudinal irregularities affect the vehicle body’s dynamic response. The variation of the vehicle body’s dynamic response under different working conditions was analyzed, and the most unfavorable wavelength and sensitive wavelength ranges of the track longitudinal irregularities on HSR were studied. The control limits for track longitudinal irregularities measured by a 60 m chord were then determined. The findings indicate that the car body's vertical acceleration gradually decreased with the increase of wavelength but increased linearly with the increase of amplitude. The findings also indicate a gradual increase in the vehicle body’s vertical acceleration as the train speed increases. When the train speed is 250 km/h∼350 km/h, the sensitive wavelength range of long-wavelength track irregularities is 60 m∼110 m. Based on the results, the relationships between the wavelength and the amplitude of track irregularities, train speed, and the vehicle body’s vertical acceleration were acquired by the nonlinear least square method. Finally, a formula for calculating the control limits for track longitudinal irregularities measured by a 60 m chord is proposed.
Prediction of an intracompartmental septum and its effect on outcomes of endoscopic release for de Quervain’s syndrome
Authors: Cho Jae-Yong , Oh Jin-Chul , Oh Won-Taek , Koh Il-Hyun , Chun Yong-Min , Choi Yun-Rak 
Published: November 2023

This study investigates the predictive value of preoperative ultrasonography for the presence of an intracompartmental septum and the effect of a septum on clinical outcomes and complications in patients who underwent endoscopic first extensor compartment release for de Quervain’s syndrome. A total of 170 patients (181 wrists) were examined, and a septum was present in 118 (69%) patients. The sensitivity and specificity of the preoperative ultrasonography were 88% and 94%, respectively. Patients were assessed at a minimum of 12 months after endoscopic release. The Disabilities of Arm, Shoulder and Hand score (54 to 4.2), visual analogue scale pain score (8.0 to 1.0) and pinch strength (2.3 to 3.2 kg) were significantly improved compared to the preoperative status ( p < 0.001). There were no significant differences in clinical outcomes or complications between patients with and without a septum. Level of evidence IV
Diagnosis of carpal tunnel syndrome using a 10-s grip-and-release test with video and machine learning analysis
Authors: Tsukamoto Kazuya , Matsui Ryota , Sugiura Yuta , Fujita Koji 
Published: November 2023

We developed a finger motion-based diagnostic system for carpal tunnel syndrome by analysing 10 second grip-and-release test videos. Using machine learning, it estimated presence of carpal tunnel syndrome (89% sensitivity and 83% specificity) and correlated with severity on nerve conduction studies (coefficient 0.68). Level of evidence III
Patient-reported significant disability after major traumatic upper extremity amputation
Authors: Pyörny Joonas , Karelson Margit , Sletten Ida Neergård , Ukkola Anniina , Jokihaara Jarkko 
Published: November 2023

The aims of this study were to record patient-reported outcomes of treatment of proximal upper extremity amputation injuries and subsequent return to work. A consecutive cohort of 38 patients with a traumatic amputation at or proximal to the carpus had been treated with a replantation or revision (completion) amputation in Tampere University Hospital between 2009 and 2019, and 31 of them participated in this study. The primary outcome was the Disabilities of the Arm, Shoulder and Hand Outcome Measure (DASH). Patients reported significant disability indicated by DASH score after replantation (median 30; interquartile range [IQR] 21–47) and revision (completion) amputation (median 33; IQR 16–52). Most patients had cold intolerance and reported low hand function and aesthetics scores. Out of 17 working patients, 10 did not return to their previous work. Our study demonstrates the influence of major upper extremity amputation on daily life activities, even after a successful replantation. Level of evidence: IV
Analysis of the Effect of Different Physical Exercise Protocols on Depression in Adults: Systematic Review and Meta-analysis of Randomized Controlled Trials
Authors: Correia Érica M. , Monteiro Diogo , Bento Teresa , Rodrigues Filipe , Cid Luís , Vitorino Anabela , Figueiredo Nuno , Teixeira Diogo S. , Couto Nuno 
Published: November 2023

Context: Physical exercise (PE) is an effective treatment for depression, alone or as an adjunct. Objective: There is a lack of indicators regarding the frequency, intensity, duration, and type of physical exercise (PE). This study aims to synthesize and analyze the dose-effect of different PE protocols in adult subjects in the treatment of depression, based on the analysis of randomized controlled trials (RCTs). Data Sources: The search was conducted using Web of Science, PubMed, and Cochrane Library electronic databases. Study Selection: Studies with an exercise-based intervention published by December 31, 2021 were identified. RCTs and meta-analyses involving adults with depression were also included; 10 studies were selected, including a total of 956 subjects. Study Design: Systematic review and meta-analysis. Level of Evidence: Level 1. Results: Effect sizes were summarized using standardized mean differences (95% confidence interval) by effected randomized models. The results reinforce that exercise appears to be beneficial in improving depression among adults aged 18 to 65 years. Interventions lasting above 150 minutes per week of moderate intensity and group interventions seem to have a more significant effect on reducing depression. Studies have revealed that aerobic exercise, compared with resistance or flexibility, has a more positive effect on depression. Conclusion: PE can be a way to reduce depression and can be used as a possible adjunctive tool for pharmacological and/or alternative treatments. Considering the findings of this study, it is important that health professionals (eg, exercise physiologists, physicians, nurses, psychologists) promote the practice of PE as a complementary alternative and act early to prevent the worsening of depression. PROSPERO Registration Number: CRD42020188909
Lung Cancer Screening Outreach Program in an Urban Native American Clinic
Authors: Robichaux Camille , Anderson Madison , Freese Rebecca , Stately Antony , Begnaud Abbie 
Published: November 2023

Objectives: To evaluate uptake of lung cancer screening in an urban Native American clinic using 2 culturally targeted promotion strategies. Methods: Patients eligible for lung cancer screening from July 2019 to July 2021 were randomized to receive either a single culturally-targeted mailer from the clinic regarding possible eligibility for screening, or the same mailer plus a follow-up text message and additional mailing. Results: Overall, there were low rates of shared decision-making visit scheduling (8.5%) with no difference between promotion strategy groups (9.4% in control group vs 7.7% in culturally-targeted outreach group). Only about 50% of the lung cancer screening CT exams ordered were completed and returned to the clinic. Conclusions: While there was no difference between arms in this intervention, 8.5% of the sample did complete a shared decision-making visit after these low-cost interventions. The gap between the number of screening CTs ordered and number who completed the CT represents an area where further interventions should focus.
Utilization of Evidence-Based Nursing Practice and Associated Factors Among Nurses Working in Saint Paul’s Hospital Millennium Medical College, Ethiopia
Authors: Lamesa Dinka , Seifu Wubareg , Abdella Jabir , Ezo Elias 
Published: November 2023

Introduction Organizations still struggle with the best mechanisms to implement research into practice, and guideline developers need to continue to strive toward collaboration and avoidance of duplication. Objective To assess the utilization of evidence-based nursing practice and associated factors among nurses working in Saint Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia, 2022. Methods An institutional-based cross-sectional study was conducted from 10 September 2022 to 25 November 2022. The total sample size was 418, and a simple random sampling technique was used to select nurses. Data were collected through a self-administered questionnaire. Data were entered using EpiData version 4.6 and exported to SPSS version 25 for analysis. Multicollinearity was considered by using a variance inflation factor (VIF > 10). The goodness of fit test was done using the Hosmer–Lemeshow model. Binary logistic regression was done, and variables with a p-value of less than 0.25 in the bivariable analysis were taken into the multivariable analysis. Statistical significance was declared at a p-value of less than 0.05 with an adjusted odds ratio and 95% confidence interval. Result The utilization of evidence-based nursing practice was 58.1% [95% CI: 52.23–63.24]. Male sex [AOR 4.65, 95%CI: 2.51–8.63], work experience of >5 years [AOR 6.83, 95%CI: 2.27–20.58], head nurse role in the hospital [AOR 1.72, 95%CI: 1.02–3.18], master's degree educational status [AOR 2.78, 95%CI: 1.89–8.61], and availability of EBNP guideline in the ward [AOR 1.24, 95%CI: 1.04–5.32] were significantly associated. Conclusion About six in 10 nurses utilize EBNP at Saint Paul’s Hospital Millennium Medical College. Sex, experience of >5 years, head nurse role in the hospital, master's degree educational status, and availability of EBNP guidelines in the ward were significantly associated with the utilization of EBNP. Therefore, recruiting experienced nurses, learning master`s degrees, and availing the EBNP guidelines in the ward might increase the utilization of EBNP.
Impact of a Resident-Driven Research Club on Scholarly Activity in an Academic Internal Medicine Residency Program During the COVID-19 Pandemic
Authors: Olanipekun Titilope , Abe Temidayo , Effoe Valery , Charaf Christine , Ivonye Chinedu , Bakinde Nicolas 
Published: November 2023

OBJECTIVES Traditional journal clubs have been shown to be insufficient in improving residents’ scholarly productivity, often due to the inability to sustain residents’ interest and participation. Additionally, the 2019 novel coronavirus (COVID-19) pandemic restrictions caused a decline in academic scholarly productivity across residency programs. We evaluated the impact of a resident-led research club called ‘journal café' on residents’ scholarly productivity by comparing scholarly output between the journal café members and non-members during the COVID-19 pandemic. METHODS The journal café was established in the 2012/2013 academic year by internal medicine residents of a university residency program in Atlanta, Georgia, to foster self-directed collaboration among residents based on shared interests in academic research. The journal café runs independently of the residency program’s journal club. We categorized IM residents at our institution into journal café members and non-members and collected data on their research productivity during residency training and the COVID-19 pandemic. The survey was conducted between April and June 2021 and analyzed data presented using frequencies, tables, and appropriate charts. RESULTS Sixty-eight residents (29 journal café members and 39 non-members) completed the survey (response rate of 85%). A significantly higher number of journal café members reported having five or more research publications (55.1% vs 7.1%, P < .001) and scientific presentations (48.3% vs 2.6%, P < .001) compared with non-members. Additionally, more journal café members published COVID-19-related research in peer-reviewed journals compared with non-members (68% vs 32%, n  =  19). Finally, most of the residents cited the opportunity of a platform to share and brainstorm on research ideas as the reason for joining the journal café. CONCLUSION We found an association between journal café participation and increased scholarly activity, particularly during the COVID-19 pandemic. Independent resident-led research clubs supported by the residency program may complement the traditional journal clubs and enhance residents’ participation in research.
Weightbearing Computed Tomography vs Conventional Tomography for Examination of Varying Degrees of Lisfranc Injures: A Systematic Review of the Literature
Authors: Talaski Grayson M. , Baumann Anthony N. , Walley Kempland C. , Anastasio Albert T. , de Cesar Netto Cesar 
Published: November 2023

Background Lisfranc injuries, if not accurately diagnosed, can result in chronic pain and instability. Previous studies have examined ultrasonographs, radiographs, magnetic resonance imaging (MRI), and conventional computed tomography (CT) scan to differentiate Lisfranc instability, but they focused on a healthy/injured scale without differentiating subtle injury. Weightbearing CT (WBCT) has emerged as a diagnostic tool for detecting subtle Lisfranc injuries. This systematic review aimed to compare WBCT with conventional CT in diagnosing Lisfranc injury, and the ability to differentiate injuries of varying severities. Methods: The review encompassed PubMed, CINAHL, MEDLINE, SPORTDiscus, and Web of Science databases from inception until July 5, 2023. Inclusion criteria involved studies on CT and/or WBCT for Lisfranc injuries and nonoperative studies. Exclusion criteria composed case reports, commentaries, postoperative imaging studies, pediatric patients, studies with nonobjective radiographic measurements, studies exclusively focused on injury classification, and studies with fewer than 5 patients because of poor statistical power. Data extraction focused on radiographic measurements of the Lisfranc complex, categorized into conventional CT, partial WBCT, and total WBCT. Results: Out of the initially retrieved 489 articles, 9 met the inclusion criteria. Several studies consistently demonstrate that WBCT provides a higher level of accuracy in measuring the Lisfranc area, offering enhanced sensitivity to detect subtle alterations in joint structure. Moreover, WBCT exhibits superior sensitivity in distinguishing between healthy Lisfranc joints and those with injuries, particularly when identifying dorsal ligament damage. This imaging modality allows for the detection of significant variations in critical measurements like first-second metatarsal (M1-M2) distance, first cuneiform (C1)-M2 distance, and joint volumes, enabling a more comprehensive assessment of Lisfranc joint health especially with subtle instability. Conclusion This review evaluates the extant literature on WBCT’s utility in diagnosing Lisfranc injuries and compares its effectiveness to CT in distinguishing between injuries of varying severity. WBCT, with reliable measurement techniques, appears more adept at detecting subtle Lisfranc instability compared to CT, likely by allowing the assessment of injury under load.