bluuebunny/crossref_metadata_2025_split huggingface dataset:
Long-term Effectiveness and Outcome-Determining Factors of Arthroscopic Bankart Repair for Recreational Sports Population: An Assessment of 100 Patients With a Mean Follow-up of 12.7 Years
Authors: Kim Jae Soo , Kim Su Cheol , Park Jong Hun , Kim Hyun Gon , Kim Dae Yeung , Lee Sang Min , Yoo Jae Chul 
Published: January 2024

Background: A limited number of studies have reported the long-term effectiveness of and associated factors for recurrence of anterior shoulder instability after arthroscopic Bankart repair (ABR). Purpose: To report the long-term clinical outcomes after ABR in a recreational sports population and identify the associated factors that influence the final instability status. Study Design: Case series; Level of evidence, 4. Methods: A retrospective study was performed in patients treated with ABR between 2007 and 2013 by a single surgeon. Patient data, magnetic resonance imaging measurements of bone loss and glenoid track, and intra- and perioperative factors were analyzed. After a minimum follow-up of 10 years, patient-reported outcomes including the Western Ontario Shoulder Instability Index score, the Rowe score, the visual analog scale for pain and function, the American Shoulder and Elbow Surgeons score, and sports activity were assessed. The current instability status was classified into 3 groups: stable, apprehensive, and redislocated. These groups were statistically compared with respect to outcomes and associated factors. Results: A total of 100 patients with a mean age of 22.4 ± 5.5 years and a mean follow-up of 12.7 ± 2.1 years were included. At the final follow-up, 38 patients (38%) showed recurrent symptoms: 19 patients (19%) with subjective apprehension and 19 patients (19%) with redislocation, including 10 patients (10%) with revision surgery. At the final follow-up, the redislocated group showed the lowest patient-reported outcomes and return to sports (both P < .001). The apprehensive group also showed a lower Western Ontario Shoulder Instability Index score ( P = .011), Rowe score ( P = .003), American Shoulder and Elbow Surgeons score ( P = .027), and return to sports ( P = .005) than the stable group. Participation in contact sports ( P = .026), glenoid bone loss ( P = .005), size of Hill-Sachs lesion ( P = .009), and off-track lesions ( P = .016) were all associated with recurrent symptoms, whereas age <20 years ( P = .012), participation in contact sports ( P = .003), and off-track lesions ( P = .042) were associated with redislocation. Conclusion: After long-term follow-up in a recreational sports population, ABR demonstrated a 19% rate of subjective apprehension and 19% rate of redislocation, with a gradual decline in clinical outcomes and sports activity over time. Therefore, candidates for ABR should be selected based on consideration of risk factors such as off-track lesions, age <20 years, and participation in contact sports.
The Effect of Wearable-Based Real-Time Feedback on Running Injuries and Running Performance: A Randomized Controlled Trial
Authors: Van Hooren Bas , Plasqui Guy , Meijer Kenneth 
Published: January 2024

Background: Running technique and running speed are considered important risk factors for running injuries. Real-time feedback on running technique and running speed by wearables may help reduce injury risk. Purpose: To investigate whether real-time feedback on spatiotemporal metrics and relative speed by commercially available pressure-sensitive insoles would reduce running injuries and improve running performance compared with no real-time feedback. Study Design: Randomized controlled trial; Level of evidence, 1. Methods: A total of 220 recreational runners were randomly assigned into the intervention and control groups. Both groups received pressure-sensitive insoles, but only the intervention group received real-time feedback on spatiotemporal metrics and relative speed. The feedback aimed to reduce loading on the joint/segment estimated to exhibit the highest load. Injury rates were compared between the groups using Cox regressions. Secondary outcomes compared included injury severity, the proportion of runners with multiple injuries, changes in self-reported personal best times and motivation (Behavioral Regulation in Exercise Questionnaire–2), and interest in continuing wearable use after study completion. Results: A total of 160 participants (73%) were included in analyses of the primary outcome. Intention-to-treat analysis showed no significant difference in injury rate between the groups (Hazard ratio [HR], 1.11; P = .70). This was expected, as 53 of 160 (33%) participants ended up in the unassigned group because they used incorrect wearable settings, nullifying any interventional effects. As-treated analysis showed a significantly lower injury rate among participants receiving real-time feedback (HR, 0.53; P = .03). Similarly, the first-time injury severity was significantly lower (–0.43; P = .042). Per-protocol analysis showed no significant differences in injury rates, but the direction favored the intervention group (HR, 0.67; P = .30). There were no significant differences in the proportion of patients with multiple injuries (HR, 0.82; P = .40) or changes in running performance (3.07%; P = .26) and motivation. Also, ~60% of the participants who completed the study showed interest in continuing wearable use. Conclusion: Real-time feedback on spatiotemporal metrics and relative speed provided by commercially available instrumented insoles may reduce the rate and severity of injuries in recreational runners. Feedback did not influence running performance and exercise motivation. Registration: NL8472 (Dutch Trial Register).
Ginsenoside Rg5 induces NSCLC cell apoptosis and autophagy through PI3K/Akt/mTOR signaling pathway
Authors: Zhang Caidie , Jin Yan 
Published: January 2024

Objective Ginsenoside Rg5 (Rg5) is a minor ginsenoside of ginseng and has a strong anti-tumor potential. This study focused on deciphering the function of Rg5 in non-small cell lung cancer (NSCLC) and investigating its related mechanism. Methods After treating human NSCLC cell lines (H1650 and A549) and bronchial epithelial cells (BEAS-2B) with increasing concentration of Rg5, cell viability was examined using methyl thiazolyl tetrazolium (MTT) assay. NSCLC cell proliferation and apoptosis were evaluated by colony formation assay and flow cytometry, respectively. The levels of proteins associated with cell cycle progression, cell apoptosis, and autophagy as well as the key markers in the PI3K/Akt/mTOR pathway were measured using western blot. A xenograft nude mouse model was established to explore the function of Rg5 in vivo. Results NSCLC cell viability was dose- and time-dependently suppressed after Rg5 treatment. Rg5 restrained NSCLC cell proliferation by inducing G2/M phase arrest via regulation of cell cycle-related genes including p21, cyclin B1, and Cdc2. Additionally, Rg5 promoted caspase-dependent apoptosis in NSCLC cells by regulating the intrinsic mitochondrial signaling pathway. Rg5 induced autophagy via the regulation of autophagy-related proteins. The in vivo experiments revealed the inhibitory impact of Rg5 on xenograft growth. Rg5 also inactivated the PI3K/Akt/mTOR signaling pathway in NSCLC cells and mouse tumors. Conclusion Rg5 induced autophagy and caspase-dependent apoptosis in NSCLC cells by inhibiting the PI3K/Akt/mTOR signaling pathway, suggesting that Rg5 might become a promising and novel anti-tumor agent for the clinical treatment of NSCLC patients.
Cultural Sensitivity of a Group of Nursing Students’ and Attitudes Toward Refugees
Authors: Türkan Işik Meryem , Can Özdemir Rana 
Published: January 2024

Background: The aim of this study was to evaluate the attitude of nursing students in providing health care to refugees due to cultural differences and to reveal individual factors (age, gender, marital status) affecting negative attitudes. Method: This cross-sectional descriptive correlational study was conducted to determine the intercultural competence of nursing students and their attitudes toward immigrants in Turkey. The sample of the study consisted of 316 nursing students. Results: The Negative Attitude Toward Immigrants Scale scores of the participants were high, however, the intercultural competence level of the health professionals was positive. A weak negative statistically significant relationship was found the Negative Attitude Toward Immigrants Scale and the Cross-Cultural Competence of Healthcare Professionals Scale ( r = −.247, p = .000). Conclusion: Our study revealed that nursing students have negative attitudes toward immigrants, and factors such as gender and caring for patients from a different ethnic origin, discomfort in providing care impacted their attitudes.
Surveillance after resection of pancreatic ductal adenocarcinoma: How to do it and what are the benefits?
Authors: Andersson Roland , Ansari Daniel , Haglund Caj 
Published: January 2024

Background and objective: Surveillance following resection with curative intent of pancreatic cancer varies widely, and supporting evidence is limited. Recurrence is although frequent, not at least during the first 2 years. Surveillance may be costly, but evidence on how this influences overall survival is not fully elucidated. Methods, Results: There are reports implying that signs of biological recurrence (increasing CA 19-9) precede radiologically demonstrated recurrence by months. Conclusions: The possibility of initiating salvage therapy earlier is discussed, potentially based on improved future biomarker panels.
Food Insecurity and Psychosocial Burden in a National Community-Based Sample of Households Managing Food Allergy
Authors: Sansweet Samantha , Roach Anita , Pappalardo Andrea A. , Yost Jennaveve C. , Asante Justine , Warren Christopher 
Published: January 2024

Background Experiencing food allergies and food insecurity has been linked to socioeconomic, physical, and mental health-related challenges, but less is known about the intersection of these experiences. This study aims to better understand the impact of food insecurity on food allergy patients and their caregivers, with the intention of informing ongoing efforts to improve screening for food insecurity and mental health concerns and reducing their burden among households managing food allergy. Method As part of a community needs assessment, a cross-sectional survey was administered to a large, national sample (N=5,940) of US households with at least one food-allergic individual, The Hunger Vital Sign was utilized to assess food insecurity, the Patient Health Questionnaire (PHQ-4) and Food Allergy Independent Measure (FAIM) were leveraged to measure psychosocial outcomes. Results Among respondents, 69.9% screened at-risk of food insecurity on the Hunger Vital Sign, while 5.6% reported very low food security. Both adults and children with food allergy (FA) from households at risk for food insecurity were more likely to report FA-related anxiety, anger, loneliness, fear of eating, and bullying victimization than their counterparts from households not at risk of food insecurity (p < .0001 for all). Among these specific experiences, FA-related anxiety was the most common (25.4%/30.1% of children/adults). Perceived risk of food allergy-related fatality was positively associated with food insecurity status. Conclusion Individuals with food allergies who are concomitantly experiencing food insecurity are at greater risk of a variety of mental health concerns, including those specific to food allergy as well as more general anxiety and depressive symptoms.
Endovascular Repair of Juxtarenal and Pararenal Abdominal Aortic Aneurysms Using a Novel Low-Profile Fenestrated Custom-Made Endograft: Technical Details and Short-Term Outcomes
Authors: Yeung K. K. , Nederhoed J. H. , Tran B. L. , Di Gregorio S. , Pratesi G. , Bastianon M. , Melani C. , Riambau V. , Bloemert-Tuin T. , Hazenberg C. E. V. B. , van Herwaarden J. A. , Balm R. , Lely R. J. , van der Meijs B. B. , Blankensteijn J. D. , Hoksbergen A. W. J. , Jongkind V. 
Published: January 2024

Introduction: The aim of this study is to share preliminary experiences and outcomes with a novel custom-made fenestrated TREO® Abdominal Stent-Graft System to treat juxtarenal and pararenal abdominal aortic aneurysms (AAAs). Methods: Juxtarenal and pararenal AAA patients treated with the custom-made fenestrated TREO® Abdominal Stent-Graft System were included from 4 high-volume European academic medical centers from June 2021 to September 2023. Technical success and 30-day/in-hospital mortality and complications were analyzed. Technical success was defined as successful endovascular implantation of the stent graft with preservation of antegrade flow to the target vessels, and absence of type 1 or 2 endoleak (EL) at the first postoperative computed tomography angiography (CTA). Results: Forty-two consecutive patients were included. The majority of the devices were constructed with 2 (N=4; 9.5%), 3 (N=9; 21.4%), or 4 (N=27; 64%) fenestrations. In 1 case, the device was constructed with a single fenestration (2.4%) and 1 device contained 5 fenestrations (2.4%); 17% had previous AAA repair. Target vessel cannulation with placement of a bridging stent was successful in all but 1 vessel (99, 3%). One aneurysm-related death occurred in the direct postoperative period and 2 limb occlusions necessitated reintervention during admission. In the median follow-up period of 101 (2–620) days, 3 more patients died due to non–aneurysm-related causes. Technical success was achieved in 90% of the cases. Nineteen ELs were seen on the first postoperative CT scan: 1 type 1b EL (N=1; 2%), 15 type 2 ELs (N=15; 36%), and 3 type 3 ELs (N=3%). Eleven patients received more than 1 CT scan during a median follow-up of 361 days (82-620): 3 type 2 ELs resolved and 1 type 3 EL was treated in this period. In the follow-up, 1 patient had a coagulation disorder that caused occlusions of the branches. Conclusion: The results of the first experiences using the custom-made fenestrated TREO® Abdominal Stent-Graft System in Europe are promising. There was a low short-term mortality and morbidity rate in these patients of which 17% had previous AAA repair. Mid-term and long-term follow-up data are needed to evaluate endograft durability and performance. Clinical Impact This study shows the first experiences and short-term results of a novel low-profile custom-made device: the custom-made fenestrated TREO® Abdominal Stent-Graft System. Showing these results and experiences can help the physicians in clinical decision-making for their patients.
Identifying Diabetes Related-Complications in a Real-World Free-Text Electronic Medical Records in Hebrew Using Natural Language Processing Techniques
Authors: Saban Mor , Lutski Miri , Zucker Inbar , Uziel Moshe , Ben-Moshe Dror , Israel Ariel , Vinker Shlomo , Golan-Cohen Avivit , Laufer Izhar , Green Ilan , Eldor Roy , Merzon Eugene 
Published: January 2024

Background: Studies have demonstrated that 50% to 80% of patients do not receive an International Classification of Diseases (ICD) code assigned to their medical encounter or condition. For these patients, their clinical information is mostly recorded as unstructured free-text narrative data in the medical record without standardized coding or extraction of structured data elements. Leumit Health Services (LHS) in collaboration with the Israeli Ministry of Health (MoH) conducted this study using electronic medical records (EMRs) to systematically extract meaningful clinical information about people with diabetes from the unstructured free-text notes. Objectives: To develop and validate natural language processing (NLP) algorithms to identify diabetes-related complications in the free-text medical records of patients who have LHS membership. Methods: The study data included 2.3 million records of 41 469 patients with diabetes aged 35 or older between the years 2012 and 2017. The diabetes related complications included cardiovascular disease, diabetic neuropathy, nephropathy, retinopathy, diabetic foot, cognitive impairments, mood disorders and hypoglycemia. A vocabulary list of terms was determined and adjudicated by two physicians who are experienced in diabetes care board certified diabetes specialist in endocrinology or family medicine. Two independent registered nurses with PhDs reviewed the free-text medical records. Both rule-based and machine learning techniques were used for the NLP algorithm development. Precision, recall, and F-score were calculated to compare the performance of (1) the NLP algorithm with the reviewers’ comments and (2) the ICD codes with the reviewers’ comments for each complication. Results: The NLP algorithm versus the reviewers (gold standard) achieved an overall good performance with a mean F-score of 86%. This was better than the ICD codes which achieved a mean F-score of only 51%. Conclusion: NLP algorithms and machine learning processes may enable more accurate identification of diabetes complications in EMR data.
Trifecta rate and its predictor variables according to calibres in percutaneous nephrolithotomy
Authors: Szczesniewski Juliusz Jan , Boronat Catalá Juan , García-Cano Alba María , Rodríguez Castro Percy Miguel , Torres Pérez Diego , Llanes González Luis 
Published: January 2024

Objective: The aim of this study is to determine and compare the number of patients who met the trifecta criteria using standard, Mini-15Fr and Ultra-Mini percutaneous nephrolithotomy (PCNL). Material and methods: Retrospective study of PCNL in Galdakao-modified supine Valdivia position with standard, Mini-15Fr and Ultra-Mini PCNL. Results: A total of 164 consecutive patients were analysed. Forty-six patients underwent standard PCNL (29.6%), 58 patients Mini-15Fr (34.4%) and 61 patients Ultra-Mini (36%). The Ultra-Mini had the lowest rate of complications (15%) followed by standard PCNL (18.6%) and Mini-15Fr (20.7%). There was no difference in stone-free rate (SFR). The trifecta rate was slightly higher in the Ultra-Mini at 65%, followed by the Mini-15Fr group (55%) and PCNL standard with 50% ( p = 0.280). Univariate logistic regression found that lower surgical time (odds ratio (OR) = 1.01), tubeless technique (OR = 2.87) and shorter hospitalization (OR = 1.72) time were factors to favourable accomplishment of trifecta. In multivariate logistic regression, shorter hospitalization was established as independent predictor for achievement of trifecta (OR = 1.74). Conclusions: The miniaturized calibres in our study had a similar SFR and complications compared to the standard calibre in lithiasis smaller than 5 cm in diameter. The tubeless rate was higher and mean hospitalization was lower in the Mini-15Fr and Ultra-Mini. Tubeless technique and shorter hospitalization were predictors of trifecta. Level of evidence: 2c
A multi-institutional assessment of low-dose protocols in chest computed tomography: Dose and image quality
Authors: Tonkopi Elena , Tetteh Mercy Afadzi , Gunn Catherine , Ashraf Haseem , Rusten Sigrid Lia , Safi Perkhah , Tinsoe Nora Suu , Colford Kylie , Ouellet Olivia , Naimi Salma , Johansen Safora 
Published: January 2024

Background Low-dose CT (LDCT) chest protocols have widespread clinical applications for many indications; as a result, there is a need for protocol assessment prior to standardization. Dalhousie University and Oslo Metropolitan University have a formally established cooperative relationship. Purpose The purpose is to assess radiation dose and image quality for LDCT chest protocols in seven different hospital locations in Norway and Canada. Material and methods Retrospective dosimetry data, volumetric CT dose index (CTDIvol), and dose length product (DLP) from 240 average-sized patients as well as CT protocol parameters were included in the survey. Effective dose (ED) and size-specific dose estimate (SSDE) were calculated for each examination. For a quantitative image quality analysis, noise, CT number, and signal-to-noise ratio (SNR) were determined for three regions in the chest. The contrast-to-noise ratio (CNR) was calculated for lung parenchyma in comparison to the subcutaneous fat. Differences in dose and image quality were evaluated by a single-factor ANOVA test. A two-sample t-test was performed to determine differences in means between individual scanners. Results The ANOVA test revealed significant differences ( p < .05) in dose values for all scanners, including identical scanner models. Statistically significant differences ( p < .05) were determined in mean values of the SNR distributions between the scanners in all three measured regions in the chest, as well as the CNR values. Conclusion The observed variations in dose and image quality measurements, even within the same hospitals and between identical scanner models, indicate a potential for protocol optimization in the involved hospitals in both countries.
Operative Management of Lateral Ankle Instability: Examination Under Anesthesia, Ankle Arthroscopy and Stabilization Technique
Authors: Ashy Cody C. , Rodriguez Materon Solangel , Goodloe J. Brett , Scott Daniel J. 
Published: January 2024

Background: Ankle sprains are common injuries that can result in chronic ankle instability. Indications: Indications for surgical management include recurrent instability, failed conservative management for 3 to 6 months, and inability to return to play or activity. Technique Description: The patient’s ankle is initially examined under anesthesia with anterior drawer testing to confirm the diagnosis of ankle instability. Ankle arthroscopy is then preformed to identify and treat additional intra-articular pathology prior to modified Broström repair. During arthroscopy, care is taken to protect the superficial peroneal nerve. Routinely we perform a “drive-through sign” to assess syndesmotic stability and also debride pathologic intra-articular tissue such as hypertrophied synovium. Following the completion of arthroscopy, an incision is made directly over the fibula. The anterior talofibular ligament (ATFL), calcaneofibular ligament (CFL), and distal fibular periosteum are dissected off the fibula. Two 3.0-mm suture anchors are placed at the origin of the CFL ligament and the ATFL ligament, and previously dissected tissue is incorporated for repair. We reinforce the CFL and ATFL tissues with incorporation of the distal fibular periosteum. Suture tape augmentation is considered for patients at high risk of recurrence, such as those with ligamentous laxity. After completion of our repair, the ankle is again examined under anesthesia with satisfactory confirmation of improved ankle stability. Results: Outcomes of our technique are promising, with improvement in patient-reported outcome measures, restoration of range of motion, return to sport as high as 94%, and low failure rates. Discussion: For patients with chronic instability, our described technique for sequential examination under anesthesia, ankle arthroscopy, and our modified Broström result in satisfactory improvement in ankle stability and patient symptoms. 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.