bluuebunny/crossref_metadata_2025_split huggingface dataset:
The implications when offering percutaneous nephrostomy for the management of malignant obstructive uropathy secondary to urological malignancy: can we be more selective?
Authors: Osinibi Elizabeth , Doan Hong , Mercado-Campero Alejandro , Abbaraju Jayasimha , Masood Shikohe , Madaan Sanjeev 
Published: October 2023

Background & Objectives: Percutaneous nephrostomy (PN) for malignant ureteric obstruction (MUO) is increasingly accessible with high success rates. However, it is not without associated risks and morbidity, impacting quality of life, while not improving overall survival. In two UK hospitals, we investigated the outcomes of undergoing PN for MUO, to inform future patient counselling and selection for this intervention. Methods: A retrospective audit of electronic records identified patients that received PN for bladder, and prostate cancer (PCa) between January 2015 and December 2018. Hospital 1 had a 24-h nephrostomy service, while Hospital 2 had a limited service; Group A: recurrent or treatment-resistant PCa, Group B: primary PCa, Group C: Bladder cancer. Results: A total of 261 patients (Hospital 1 = 186, Hospital 2 = 75), had PN insertion. Seventy-eight had prostate or bladder cancer. Group A n = 30, Group B n = 12, Group C n = 36. Median age = 79 [interquartile range (IQR) = 72–86]. Following PN insertion, 12-month mortality was significantly greater in Hospital 1 at 82%, versus 52% in Hospital 2 ( p = 0.015). Median survival: Group A: 177 days (IQR = 80–266), Group B: 209 days (IQR = 77–352), Group C: 145 days (IQR = 97–362). There was no significant difference in same-admission mortality, although group A had the greatest same-admission mortality at 17%. A total of 69% of all patients received bilateral nephrostomies. Patients with bilateral versus unilateral PN had no difference in mortality or nadir creatinine. Conclusion: Most patients with malignant obstruction secondary to prostate or bladder cancer lived less than 12 months after PN insertion. When offering PN, careful consideration of disease prognosis should be made, and frank discussion of the implications of a life-long nephrostomy with patients and relatives.
Understanding the success of a deaf-funder’s restaurant between food and empathy’s appeal: The case of 1001 signes
Authors: Billion Julien , Lejealle Catherine 
Published: October 2023

Deaf from birth and of Moroccan origin, Sid Mouar has been a successful restaurant owner for 8 years. His restaurant specializes in serving Moroccan cuisine and employs individuals with disabilities. The ordering process utilizes sign language for communication. This case study delves into the reasons behind the restaurant’s success by examining the story of the deaf entrepreneur with a disability and by identifying all the service attributes mentioned in customer feedback. By utilizing the tetraclass model, the impact of each service attribute on customer satisfaction and dissatisfaction is evaluated. This analysis offers insights into what aspects are fundamental, crucial, additional, or secondary in terms of customer satisfaction, thus contributing to an understanding of the restaurant’s achievement. The case also delves into topics related to service quality, customer satisfaction, competitive advantages, promotional elements, and the restaurant’s future adaptations to remain competitive.
Urinary and anal incontinence in pregnancy in a Nigerian population: A prospective longitudinal study
Authors: UGWU Emmanuel Onyebuchi , DIM Cyril Chukwudi , ELEJE George Uchenna 
Published: October 2023

Objectives: There are several studies from sub-Saharan Africa on postpartum urinary incontinence and anal incontinence, but very rare in pregnancy. Such data will guide obstetric caregivers in providing appropriate counseling to the women as well as in minimizing the risk factors. This study aimed to determine the comparative effects of different trimesters of pregnancy on urinary incontinence and anal incontinence, and their possible risk factors. Methods: The study was longitudinal in design, and the study population consisted of 223 pregnant women receiving care at the two largest tertiary health institutions in Enugu, South-East Nigeria. The recruitment was in the first trimester and the women were followed up to term. Interviews were conducted at specific times in the three trimesters and data regarding urinary incontinence and anal incontinence symptoms were obtained using validated questionnaires. Results: The incidence of urinary incontinence increased across the trimesters: 22%, 30.5%, and 48% in the first trimester, second, and third trimesters, respectively, with a cumulative incidence rate of 50.2%. The incidence of anal incontinence also increased across the trimesters but not as high as urinary incontinence: 1.7%, 3.6%, and 5.8%, respectively, with a cumulative incidence rate of 6.7%. The risk factors for urinary incontinence were maternal age >35 years, multiparity, previous prolonged second-stage labor, and previous history of neonatal macrosomia, while that of anal incontinence were previous instrumental vaginal delivery and previous prolonged second stage of labor. Conclusion: Our study demonstrated an increase in the incidence of urinary incontinence and anal incontinence as pregnancy advances. Obstetricians are therefore encouraged to discuss these pelvic floor issues during antenatal care services and make more efforts toward reducing the modifying obstetric risk factors.
Factors Associated With Humeral Avulsion of Glenohumeral Ligament Lesions in Patients With Anterior Shoulder Instability: An Analysis of the MOON Shoulder Instability Cohort
Authors: Freshman Ryan D. , Zhang Alan L. , Benjamin Ma C. , Feeley Brian T. , Ortiz Shannon , Patel Jhillika , Dunn Warren , Wolf Brian R. , Hettrich Carolyn , Lansdown Drew ,   MOON Shoulder Group collaborators, Baumgarten Keith M. , Bishop Julie Y. , Bollier Matthew J. , Brophy Robert H. , Bravman Jonathan T. , Cox Charles L. , Cvetanovich Gregory L. , Grant John A. , Frank Rachel M. , Jones Grant L. , Kuhn John E. , Mair Scott D. , Marx Robert G. , McCarty Eric C. , Miller Bruce S. , Seidl Adam J. , Smith Matthew V. , Wright Rick W. 
Published: October 2023

Background: Humeral avulsion of the glenohumeral ligament (HAGL) lesions are an uncommon cause of anterior glenohumeral instability and may occur in isolation or combination with other pathologies. As HAGL lesions are difficult to detect via magnetic resonance imaging (MRI) and arthroscopy, they can remain unrecognized and result in continued glenohumeral instability. Purpose: To compare patients with anterior shoulder instability from a large multicenter cohort with and without a diagnosis of a HAGL lesion and identify preoperative physical examination findings, patient-reported outcomes, imaging findings, and surgical management trends associated with HAGL lesions. Study Design: Cross-sectional study; Level of evidence, 3. Methods: Patients with anterior glenohumeral instability who underwent surgical management between 2012 and 2020 at 11 orthopaedic centers were enrolled. Patients with HAGL lesions identified intraoperatively were compared with patients without HAGL lesions. Preoperative characteristics, physical examinations, imaging findings, intraoperative findings, and surgical procedures were collected. The Student t test, Kruskal-Wallis H test, Fisher exact test, and chi-square test were used to compare groups. Results: A total of 21 HAGL lesions were identified in 915 (2.3%) patients; approximately one-third (28.6%) of all lesions were visualized intraoperatively but not identified on preoperative MRI. Baseline characteristics did not differ between study cohorts. Compared with non-HAGL patients, HAGL patients were less likely to have a Hill-Sachs lesion (54.7% vs 28.6%; P = .03) or an anterior labral tear (87.2% vs 66.7%; P = .01) on preoperative MRI and demonstrated increased external rotation when their affected arm was positioned at 90° of abduction (85° vs 90°; P = .03). Additionally, HAGL lesions were independently associated with an increased risk of undergoing an open stabilization surgery (odds ratio, 74.6 [95% CI, 25.2-221.1]; P < .001). Conclusion: Approximately one-third of HAGL lesions were missed on preoperative MRI. HAGL patients were less likely to exhibit preoperative imaging findings associated with anterior shoulder instability, such as Hill-Sachs lesions or anterior labral pathology. These patients underwent open procedures more frequently than patients without HAGL lesions.
OralOpioids: Harnessing R Programming and Data Science to Combat Opioid Misuse
Authors: Banerjee Ankona , Stricker Erik 
Published: October 2023

Aims This study aims to introduce the OralOpioids R package, a novel research tool for the in-depth study and analysis of opioid prescriptions in Canada, which reports a significant per-capita pharmaceutical opioid consumption. Methods The OralOpioids R package employs data from Health Canada's Drug Product Database (DPD), focusing on authorized oral opioids. It systematically filters drug identification numbers (DINs) by narcotic schedules and administration routes. Moreover, it calculates the morphine equivalent dose (MED) for each DIN using the CDC table. Core functions include MED calculation for specific drugs, brand name retrieval, opioid content extraction, and unit computations based on Canadian MED guidelines. Results When juxtaposed against renowned opioid calculators such as MDCalc, Oregon Pain, and Ohio Pain, the OralOpioids package exhibited a near-perfect correlation, with R-squared values consistently at 0.99. Conclusions The OralOpioids package, distinctively tailored for research, marks a significant stride in understanding and monitoring Canada's opioid milieu. By encompassing data on discontinued opioids, it fosters a nuanced comprehension of the opioid panorama, enabling historical insight and post-marketing watchfulness. Primarily targeting researchers, its scope extends to healthcare providers, insurers, and administrative boards, all of whom can leverage its potent capabilities for informed decision-making. Although currently centered on Canadian opioids, its flexible design is primed for future expansion, potentially capturing a global audience and catalyzing efforts against the opioid crisis.
Incidence and Predictors of Inpatient Mortality Rate After Cases Started Care in the Intensive Care Unit in Debre Markos Referral Hospital
Authors: Shumet Tesfaye , Kebede Fassikaw 
Published: October 2023

Background The intensive care unit (ICU) is a separate area in which potential health care services for patients who are in critical condition with detailed observation, monitoring, and advanced treatment than other units. This study aimed to assess the incidence and predictors of inpatient mortality after inpatient treatment was started in Debre Markos Comprehensive Specialized Hospital. Methods A facility-based retrospective cohort study was employed among 384 ICU-admitted patients from December 30, 2020 to January 1, 2022. The collected data were entered into Epi Data version 4.2 and exported to STATA 14.0 for further analysis. The Cox proportional hazard regression model was fitted after checking using the Schoenfeld residual and log-log plot test. A categorical variable with an adjusted hazard ratio of 95% CI was claimed for predictors. Result Overall, 384 admitted adult patients were included in the final analysis with a mean (±SD) age of 42.1 (±17.1) years. At the end of the follow-up period, 150 (39.06%) cases died in the ICU. The overall incidence of the mortality rate was 16.9 (95% CI: 13.7-19.55) per 100 person per day. Epidemiologically, 347 (90.36%) cases were medical illness, 25 (6.51%) surgical, and 12 (3.13%) were obstetric cases, respectively. The median length of inpatient stay was found to be 4.9 (IQR  ±  2.8) days. In multivariable analysis; being (+) for human immunodeficiency virus (AHR  =  0.59, 95% CI: 0.39-0.91), age ≥65yearas (AHR  =  1.61, 95% CI: 1.11-2.32), and admission on weekend-time (AHR  =  1.48, 95% CI: 1.06-2.06) were predictors of inpatient death. Conclusion The overall in-hospital mortality rate was significantly higher than in the previous study in this hospital with a short median survival time. The inpatient mortality rate was significantly associated with age ≥65 years, being HIV positive, and admission during weekend time. Therefore, effective intervention strategies should be highly needed for ICU team members for early risk factors prevention.
The Compassionate Communities Connectors program: Effect on healthcare usage
Authors: Aoun Samar M. , Bear Natasha , Rumbold Bruce 
Published: October 2023

Background: Public health approaches to palliative and end-of-life care focus on enhancing the integration of services and providing a comprehensive approach that engages the assets of local communities. However, few studies have evaluated the relative costs and benefits of providing care using these service models. Objectives: To assess the effect on healthcare usage of a community-based palliative care program (‘Compassionate Communities Connectors’) where practical and social support was delivered by community volunteers to people living with advanced life-limiting illnesses in regional Western Australia. Design: Controlled before-and-after study/Cost-consequence analysis. Methods: A total of 43 community-based patients participated in the program during the period 2020–2022. A comparator population of 172 individuals with advanced life-limiting illnesses was randomly selected from usage data from the same set of health services. Results: Relative to controls, the intervention group had lower hospitalizations per month [Incidence rate ratio (IRR): 0.37; 95% CI: 0.18–0.77, p = 0.007], less hospital days per month (IRR: 0.23; 95% CI: 0.11–0.49, p < 0.001) and less emergency presentations (IRR: 0.56; 95% CI: 0.34–0.94, p = 0.028. The frequency of outpatient contacts overall was two times higher for the intervention group (IRR: 2.07; 95% CI: 1.11–3.86, p = 0.022), indicating the Connector program may have shifted individuals away from the hospital system and toward community-based care. Estimated net savings of $AUD 518,701 would be achieved from adopting the Connector program, assuming enrollment of 100 patients over an average 6-month participation period. Conclusion: This combined healthcare usage and economic analysis of the ‘Compassionate Communities Connectors’ program demonstrates the benefits of optimizing palliative care services using home-based and community-centered interventions, with gains for the health system through improved patient outcomes and reduced total healthcare costs (including fewer hospitalizations and readmissions). These findings, coupled with the other published results, suggest that investment in the Connectors program has the capacity to reduce net health sector expenditure while also improving outcomes for people with life-limiting illnesses. Trial Registration: Australian and New Zealand Clinical Trial Registry: ACTRN12620000326998.
Material Removal Mechanism and Force Modeling in Ultrasonic Vibration-Assisted Micro-Grinding Biological Bone
Authors: Sun Jingang , Li Changhe , Zhou Zongming , Liu Bo , Zhang Yanbin , Yang Min , Gao Teng , Liu Mingzheng , Cui Xin , Li Benkai , Li Runze , Dambatta Yusuf Suleiman , Sharma Shubham 
Published: October 2023

AbstractMicro-grinding with a spherical grinding head has been deemed an indispensable method in high-risk surgeries, such as neurosurgery and spine surgery, where bone grinding has long been plagued by the technical bottleneck of mechanical stress-induced crack damage. In response to this challenge, the ultrasound-assisted biological bone micro-grinding novel process with a spherical grinding head has been proposed by researchers. Force modeling is a prerequisite for process parameter determination in orthopedic surgery, and the difficulty in establishing and accurately predicting bone micro-grinding force prediction models is due to the geometric distribution of abrasive grains and the dynamic changes in geometry and kinematics during the cutting process. In addressing these critical needs and technical problems, the shape and protrusion heights of the wear particle of the spherical grinding head were first studied, and the gradual rule of the contact arc length under the action of high-speed rotating ultrasonic vibration was proposed. Second, the mathematical model of the maximum thickness of undeformed chips under ultrasonic vibration of the spherical grinding head was established. Results showed that ultrasonic vibration can reduce the maximum thickness of undeformed chips and increase the range of ductile and bone meal removals, revealing the mechanism of reducing grinding force. Further, the dynamic grinding behavior of different layers of abrasive particles under different instantaneous interaction states was studied. Finally, a prediction model of micro-grinding force was established in accordance with the relationship between grinding force and cutting depth, revealing the mechanism of micro-grinding force transfer under ultrasonic vibration. The theoretical model’s average deviations are 10.37% inx-axis direction, 6.85% iny-axis direction, and 7.81% inz-axis direction compared with the experimental results. This study provides theoretical guidance and technical support for clinical bone micro-grinding.
Bovine oviductal organoids: a multi-omics approach to capture the cellular and extracellular molecular response of the oviduct to heat stress
Authors: Menjivar Nico G. , Gad Ahmed , Thompson Riley E. , Meyers Mindy A. , Hollinshead Fiona K. , Tesfaye Dawit 
Published: October 2023

Abstract
Background
The mammalian oviduct is a complex, fibromuscular organ known for its role in orchestrating a series of timely and dynamic changes to suitably support early embryogenesis. Climate change-induced heat stress (HS) is one of the largest single stressors compromising reproductive function in humans and farm animals via systemic changes in the redox status of the maternal environment, adversely affecting fertilization and early embryonic development. Oviductal organoids represent a unique 3-dimensional, biomimetic model to study the physiology of the oviduct and its subsequent impact on embryo development under various environmental conditions.

Results
Our study is the first to demonstrate an innovative approach to understanding the cascade of molecular changes sustained by bovine oviductal organoids under HS and the subsequent maternal signals harnessed within their secreted extracellular vesicles (EVs). Transcriptomic analysis of oviductal organoids exposed to HS revealed 2,570 differentially expressed genes (1,222 up‐ and 1,348 downregulated), while EV-coupled miRNome analysis disclosed 18 miRNAs with significant differential expression (12 up- and 6 downregulated) in EVs from thermally stressed organoids compared to EVs released from organoids cultured under thermoneutral conditions. Genes activated in oviductal organoids in response to thermal stress, include: COX1, ACTB, CST6, TPT1, and HSPB1, while miR-1246, miR-148a, miR21-5p, miR-451, and miR-92a represent the top highly abundant EV-coupled miRNAs released in response to HS. Pathway analysis of genes enriched in organoids exposed to thermal stress showed the enrichment of endocrine resistance, cellular senescence, and notch signaling pathways. Similarly, EV-coupled miRNAs released from thermally stressed organoids showed their potential regulation of genes involved in cellular senescence, p53 signaling, and TGF-beta signaling pathways.

Conclusions
In conclusion, the cellular and extracellular response of bovine oviductal organoids to in vitro HS conditions reveal the prospective impact of environmental HS on the physiology of the oviduct and the probable subsequent impacts on oocyte fertilization and early embryo development. Future studies elucidating the potential impact of HS-associated EVs from oviductal organoids on oocyte fertilization and preimplantation embryo development, would justify the use of an organoid model to optimally understand the oviduct-embryo communication under suboptimal environments.
Determinants of immunosuppressive therapy in renal transplant recipients: an Italian observational study (the CESIT project)
Authors: Rosa Alessandro C. , Finocchietti Marco , Agabiti Nera , Menè Paolo , Bracaccia Maria Elena , Bellini Arianna , Massari Marco , Spila Alegiani Stefania , Masiero Lucia , Bedeschi Gaia , Cardillo Massimo , Lucenteforte Ersilia , Piccolo Giuseppe , Leoni Olivia , Ferroni Eliana , Pierobon Silvia , Nordio Maurizio , Ledda Stefano , Garau Donatella , Davoli Marina , Addis Antonio , Belleudi Valeria ,   on behalf of CESIT study group, Poggi Francesca R. , Marino Maria Lucia , Marino Claudia , Kirchmayer Ursula , Ricci Andrea , Puoti Francesca , Sparacino Vito , Fiaschetti Pamela , Trapani Silvia , Oliveti Alessandra , Peritore Daniela , Lombardozzi Lorella , Zorzi Manuel , Zanforlini Martina , Mazzone Arianna , Ercolanoni Michele , Nisic Andrea Angelo , Carta Paolo , Ientile Valentina , L’Abbate Luca , Tanaglia Matilde , Trifirò Gianluca , Moretti Ugo 
Published: October 2023

Abstract
Background
Very scanty evidence is available on factors influencing the choice of immunosuppressive drug therapy after kidney transplantation.

Methods
An Italian multiregional real-world study was conducted integrating national transplant information system and claims data. All patients undergoing kidney transplantation for the first time during 2009–2019 (incident patients) were considered. Multilevel logistic models were used to estimate Odds Ratio (OR) and corresponding 95% Confidence intervals. Factors with statistically significance were identified as characteristics associated with treatment regimens: cyclosporin-CsA vs tacrolimus-Tac and, within the latter group, mTOR inhibitors vs mycophenolate-MMF.

Results
We identified 3,622 kidney patients undergoing transplantation in 17 hospitals located in 4 Italian regions, 78.3% was treated with TAC-based therapy, of which 78% and 22% in combination with MMF and mTOR, respectively. For both comparison groups, the choice of immunosuppressive regimens was mostly guided by standard hospital practices. Only few recipient and donor characteristics were found associated with specific regimen (donor/receipt age, immunological risk and diabetes).

Conclusions
The choice of post-renal transplant immunosuppressive therapy seems to be mostly driven by standard Centre practices, while only partially based on patient’s characteristics and recognized international guidelines.