bluuebunny/crossref_metadata_2025_split huggingface dataset:
Ileal conduit to small intestine fistula following extensive abdominopelvic resection and radiation for metastatic colon cancer
Authors: Kwon Alvin G. , Brinzevich Daria , Borovik Alexander , Bhalla Rakesh 
Published: December 2023

A woman in her mid-60s presented with decreased output from urostomy, which was an opening from the neobladder (ileal conduit). Presentation was preceded by a 6-month history of alternating faecaluria and increased colostomy output. Laboratory studies were notable for normal anion gap metabolic acidosis. Creatinine level of the colostomy output was 17.7 mg/dL, a finding indicative of the presence of urine in the sample. CT enterography and X-ray loopogram confirmed neobladder to small intestine fistula.Neobladder creation is commonly performed in patients with bladder cancer requiring resection. Fistulas between the neobladder and intestine are observed in fewer than 2.7% of cases. The patient’s history of extensive abdominopelvic resection, colostomy creation and radiation likely contributed to fistula development. We highlight the need for a high index of suspicion for a fistula in a patient with a neobladder experiencing recurrent urinary tract infections or a high colostomy output concurrently with low neobladder output.
Detailed measurements of the four extraocular rectus muscles’ contribution to the perfusion of the anterior segment of the eye
Authors: Engqvist Linn , Sheikh Rafi , Öhnell HannaMaria , Dahlstrand Ulf 
Published: December 2023

Background/aimsAnterior segment ischaemia (ASI) is a rare but serious complication of strabismus surgery, which may be caused by damage to the anterior ciliary arteries that run along the rectus muscles. To avoid ASI, clinical praxis is to operate on a maximum of two rectus muscles at a time. The aim of this study was to perform a detailed study of the contribution of the four ocular rectus muscles to the perfusion of the anterior segment using laser speckle contrast imaging (LSCI).MethodsThe four rectus muscles were successively detached during enucleation in nine patients with suspected uveal melanoma. Perfusion of the anterior segment was monitored with LSCI during the detachment of each of the rectus muscles, and after the ophthalmic artery had been severed.ResultsPerfusion of the anterior segment, measured in the paralimbal tissue, decreased gradually as the four rectus muscles were detached, showing a decrease to 98% when the first (lateral rectus) muscle was detached, to 88% when the second (medial rectus), and 69% when the third (inferior rectus) muscles were detached. The decrease was more pronounced and statistically significant when the fourth (superior rectus) muscle was detached (to 28%, p=0.0102).ConclusionLSCI is a valuable perfusion monitoring tool, as it has the capability to visualise the gradual decrease in anterior segment perfusion as the rectus muscles are successively detached. Further studies are needed to determine how many rectus muscles can be safely detached during strabismus surgery without risking ASI.
Effect of mobile-assisted education on health promoting lifestyle and blood sugar of women with gestational diabetes: a randomised controlled trial
Authors: Maleki Maryam , Mousavi Parvaneh , Abedi Parvin , Rokhafrooz Dariush , Maraghi Elham 
Published: December 2023

BackgroundThe gestational diabetes causes complications for the mother and the baby.MethodsIt was a randomised controlled trial that was conducted in Public Health Center No 1 in Baghmalek, Khuzestan province, Iran. Seventy-six women with gestational diabetes mellitus (GDM) were recruited and randomly allocated into an intervention (n=38) and a control group (n=38). A mobile app was developed, and the content of the educational programme was designed according to the six dimensions of Health Promotion Lifestyle Profile (HPLP). Participants in the intervention group followed instructions about healthy lifestyle for 4 weeks, whereas the control group received only routine care. A demographic questionnaire, and the HPLP-II were used to gather the data.Health promoting lifestyle and blood sugar of participants were measured after 4 weeks.ResultsThe total score of HPLP was 98.34±13.99 and 92.39±14.56 before the intervention in intervention and control groups, respectively, which was improved significantly in the intervention group compared with the control group after intervention (143.13±23.41 vs 100.39±16.69, p<0.0001). Also, the scores of stress management, responsibility, interpersonal relationship, spiritual growth, nutrition and physical activity were significantly improved in the intervention group. Fasting blood sugar and blood sugar 2 hours after meal significantly reduced in the intervention group compared with the control group (86.05±7.71 mg/dL vs 93.92±5.52 mg/dL) and (113.65±10.96 mg/dL vs 124.97±9.15 mg/dL), (p=0.001), respectively.ConclusionsOur results showed that offering educational programmes based on mobile apps can improve healthy lifestyle and blood sugar in women with GDM.Trial registration numberIRCT20200817048434N1Website addresshttps://www.irct.ir/search/result?query=IRCT20200817048434N1
Familial risk of vasospastic angina: a nationwide family study in Sweden
Authors: Ricci Fabrizio , Banihashemi Behzad , Pirouzifard Mirnabi , Sundquist Jan , Sundquist Kristina , Sutton Richard , Fedorowski Artur , Zoller Bengt 
Published: December 2023

ObjectivesVasospastic angina (VSA) is a complex coronary vasomotor disorder associated with an increased risk of myocardial infarction and sudden death. Despite considerable advances in understanding VSA pathophysiology, the interplay between genetic and environmental factors remains elusive. Accordingly, we aimed to determine the familial VSA risk among first-degree relatives of affected individuals.MethodsA population-based multigenerational cohort study was conducted, including full-sibling pairs born to Swedish parents between 1932 and 2018. Register-based diagnoses were ascertained through linkage to the Swedish Multigeneration Register and National Patient Register. Incidence rate ratios (IRRs) and adjusted HRs were calculated for relatives of individuals with VSA compared with relatives of individuals without VSA.ResultsThe total study population included 5 764 770 individuals. Overall, 3461 (0.06%) individuals (median age at disease onset 59 years, IQR: 63–76) were diagnosed with VSA. Of these, 2236 (64.61%) were women. The incidence rate of VSA for individuals with an affected sibling was 0.31 (95% CI: 0.24 to 0.42) per 1000 person-years compared with 0.04 (95% CI: 0.04 to 0.04) per 1000 person-years for those without an affected sibling, yielding an IRR of 7.58 (95% CI: 5.71 to 10.07). The risk of VSA for siblings with an affected sibling was significantly increased in the fully adjusted model (HR: 2.56; 95% CI: 1.73 to 3.79). No increased risk of VSA was observed in spouses of affected individuals (HR: 0.63; 95% CI: 0.19 to 2.09).ConclusionsIn this nationwide family study, we identified high familial risk for VSA independent of shared environmental risk factors. Our findings indicate that VSA tends to cluster in families, emphasising the need to explore genetic and non-genetic factors that may contribute.
Recommendation to implementation of remote patient monitoring in rheumatology: lessons learned and barriers to take
Authors: Hamann Philip , Knitza Johannes , Kuhn Sebastian , Knevel Rachel 
Published: December 2023

Remote patient monitoring (RPM) leverages advanced technology to monitor and manage patients’ health remotely and continuously. In 2022 European Alliance of Associations for Rheumatology (EULAR) points-to-consider for remote care were published to foster adoption of RPM, providing guidelines on where to position RPM in our practices. Sample papers and studies describe the value of RPM. But for many rheumatologists, the unanswered question remains the ‘how to?’ implement RPM.Using the successful, though not frictionless example of the Southmead rheumatology department, we address three types of barriers for the implementation of RPM: service, clinician and patients, with subsequent learning points that could be helpful for new teams planning to implement RPM. These address, but are not limited to, data governance, selecting high quality cost-effective solutions and ensuring compliance with data protection regulations. In addition, we describe five lacunas that could further improve RPM when addressed: establishing quality standards, creating a comprehensive database of available RPM tools, integrating data with electronic patient records, addressing reimbursement uncertainties and improving digital literacy among patients and healthcare professionals.
Sarcopenia and Hypoxia in Patients with Obstructive Sleep Apnea
Authors: Kim Jinseung , Lee Ho-Joon , Lee Dong Ah. , Park Kang Min 
Published: December 2023

Objectives. Obstructive sleep apnea (OSA) is associated with a variety of health issues. Both OSA and sarcopenia are associated with metabolic disorders; however, there is limited literature assessing the correlation between them. Therefore, we aimed to investigate sarcopenia using temporal muscle thickness (TMT) in patients with obstructive sleep apnea (OSA) and the association between sarcopenia and hypoxia. Methods. We enrolled patients with OSA and healthy controls. Both groups underwent brain magnetic resonance imaging (MRI) scans, including three-dimensional T1-weighted imaging. TMT, a marker for sarcopenia, was obtained based on the T1-weighted imaging and compared between the groups. Additionally, we analyzed the correlation between TMT and clinical factors in patients with OSA. Results. In total, 40 patients with OSA and 52 healthy controls were evaluated. There was no difference in TMT between patients with OSA and healthy controls (

10.425
±
2.13

vs.

10.400
±
1.94

mm,

p
=
0.953

). In the correlation analysis, age was negatively correlated with TMT (

r
=
−
0.356

,

p
=
0.023

), and lowest oxygen saturation (

r
=
−
0.558

,

p
<
0.001

) in patients with OSA. Conclusion. Our results demonstrated negative correlations between TMT and lowest oxygen saturation in the patients with OSA. These findings suggest potential relationships between sarcopenia and hypoxia in patients with OSA. Thus, these results underline the importance of maintaining oxygen saturation in patients with OSA by implementing active treatment. This study also demonstrates the feasibility of sarcopenia assessment by measuring TMT through conventional head MRI in patients with various neurological disorders.
Spousal Concordance of Hypertension Among Middle‐Aged and Older Heterosexual Couples Around the World: Evidence From Studies of Aging in the United States, England, China, and India
Authors: Varghese Jithin Sam , Lu Peiyi , Choi Daesung , Kobayashi Lindsay C. , Ali Mohammed K. , Patel Shivani A. , Li Chihua 
Published: December 2023

Background
Health concordance within couples presents a promising opportunity to design interventions for disease management, including hypertension. We compared the concordance of prevalent hypertension within middle‐aged and older heterosexual couples in the United States, England, China, and India.

Methods and Results
Cross‐sectional dyadic data on heterosexual couples were used from contemporaneous waves of the HRS (US Health and Retirement Study, 2016/17, n=3989 couples), ELSA (English Longitudinal Study on Aging, 2016/17, n=1086), CHARLS (China Health and Retirement Longitudinal Study, 2015/16, n=6514), and LASI (Longitudinal Aging Study in India, 2017/19, n=22 389). Concordant hypertension was defined as both husband and wife in a couple having hypertension. The prevalence of concordant hypertension within couples was 37.9% (95% CI, 35.8–40.0) in the United States, 47.1% (95% CI, 43.2–50.9) in England, 20.8% (95% CI, 19.6–21.9) in China, and 19.8% (95% CI, 19.0–20.5) in India. Compared with wives married to husbands without hypertension, wives married to husbands with hypertension were more likely to have hypertension in the United States (prevalence ratio, 1.09 [95% CI, 1.01– 1.17), England (prevalence ratio, 1.09, 95% CI, 0.98–1.21), China (prevalence ratio, 1.26 [95% CI, 1.17–1.35), and India (prevalence ratio, 1.19 [95% CI, 1.15–1.24]). Within each country, similar associations were observed for husbands. Across countries, associations in the United States and England were similar, whereas they were slightly larger in China and India.

Conclusions
Concordance of hypertension within heterosexual couples was consistently observed across these 4 socially and economically diverse countries. Couple‐centered interventions may be an efficient strategy to prevent and manage hypertension in these countries.
Trust in Shared Narratives
Authors: Nyam Esther , Hediger Vinzenz 
Published: December 2023

Abstract
Stories are a function of violent conflicts. Stories provide reasons for and can serve to instigate conflicts, they make conflicts readable, and they provide narrative closure, i.e., a sense of finality, and thus potentially restore trust between conflict parties. This study focuses on a specific form of storytelling used in a conflict setting, namely docudrama and re-enactment of traumatic experiences of conflict. The study posits that, in the absence of other forms of effective civic dissent to force better outcomes in governance and particularly the provision of security through the state, docudrama and the re-enactment of personal experiences of violence can lead to conscientization and healing, even as the stories expressed in re-enactment lay the groundwork for post-conflict narrative closure. The location of study is in Benue and Plateau States, Nigeria. Because of climate change and migratory pressures in the wake of the drying up of Lake Chad these states are prone to violent land disputes. The target population of the study are refugees affected by conflicts between Fulani herdsmen and farmers, who are currently estimated at over 100,000. The study offers an opportunity to be active participants and to acquire skills and training in storytelling and re-enactment primarily to women, children and youths. Interviews, focus group discussions (FGD s), and participatory observation are used to collect data. A pilot study in Daudu camp in Guma LGA (Local Government Area) and later in 2023, a Theatre for Development and a feature film was carried out in Adeke, Ogondu and Asyoko community of Benue State and a Theatre for Development Drama and Feature Film production carried out in Mikang LGA of Plateau State illustrate the methods and aims of the study. Anchored in “Reflective African Theory” the study uses Brecht’s “Forum Theatre” technique to show how docudrama can be used to explore the motives of the violent conflict and contribute to the rebuilding of trust in situations of conflict. The study, which results from a collaboration between the authors in the framework of the World Academy of Sciences, aims to contribute to the corpus of African studies and offer new perspectives for peace and conflict studies.
Balloon atrial septostomy versus left atrial cannulation for left heart decompression in children with dilated cardiomyopathy and myocarditis on extracorporeal membrane oxygenation: An ELSO registry analysis
Authors: Perry Tanya , Greenberg Jason W , Cooper David S , Smith Reanna , Benscoter Alexis L , Koh Wonshill , Ryan Thomas D , Lehenbauer David G , Brown Tyler N , Zafar Farhan , Thiagarajan Ravi R , Sweberg Todd M , Morales David LS 
Published: December 2023

Introduction In children with myocarditis or dilated cardiomyopathy (DCM) on extracorporeal membrane oxygenation (ECMO) for cardiogenic shock, it is often necessary to decompress the left heart to minimize distension and promote myocardial recovery. We compare outcomes in those who underwent balloon atrial septostomy (BAS) versus direct left atrial (LA) drainage for left heart decompression in this population. Methods Retrospective study of the Extracorporeal Life Support Organization (ELSO) multicenter registry of patients ≤ 18 years with myocarditis or DCM on ECMO who underwent LA decompression. Descriptive and univariate statistics assessed association of patient factors with decompression type. Multivariable logistic regression sought independent associations with outcomes. Results 369 pediatric ECMO runs were identified. 52% myocarditis, 48% DCM, overall survival 74%. 65% underwent BAS and 35% LA drainage. Patient demographics including age, weight, gender, race/ethnicity, diagnosis, pre-ECMO pH, mean airway pressure, and arrest status were similar. 89% in the BAS group were peripherally cannulated onto ECMO, versus 3% in the LA drainage group ( p < .001). On multivariable analysis, LA drainage (OR 3.96; 95% CI, 1.47-10.711; p = .007), renal complication (OR 2.37; 95% CI, 1.41-4.01; p = .001), cardiac complication (OR 3.14; 95% CI, 1.70-5.82; p < .001), and non-white race/ethnicity (OR 1.75; 95% CI, 1.04-2.94; p = .035) were associated with greater odds of mortality. There was a trend toward more episodes of pulmonary hemorrhage in BAS ( n = 17) versus LA drainage group ( n = 3), p = .08. Comparing only those with central cannulation, LA drainage group was more likely to be discontinued from ECMO due to recovery (72%) versus the BAS group (48%), p = .032. Conclusions In children with myocarditis or DCM, there was a three times greater likelihood for mortality with LA drainage versus BAS for LA decompression. When adjusted for central cannulation groups only, there was better recovery in the LA drainage group and no difference in mortality. Further prospective evaluation is warranted.
Adapted, Adopted, and Novel Interventions: A Whole-Population Meta-Analytic Replication of Intervention Effects
Authors: Olsson Tina M. , von Thiele Schwarz Ulrica , Hasson Henna , Vira Emily G. , Sundell Knut 
Published: December 2023

Background A challenge to implementation is management of the adaptation-fidelity dilemma or the balance between adopting an intervention with fidelity while assuring fit when transferred between contexts. A prior meta-analysis found that adapted interventions produce larger effects than novel and adopted interventions. This study attempts to replicate and expand previous findings. Methods Meta-analysis was used to compare effects across a whole-population of Swedish outcome studies. Main and subcategories are explored. Results The 523 studies included adapted (22%), adopted (33%), and novel (45%) interventions. The largest effect was found for adapted followed by novel and adopted interventions. Interventions in the mental health setting showed the highest effects, followed by somatic healthcare and social services. Conclusions These results replicate and expand earlier findings. Results were stable across settings with the exception of social services. Consistent with a growing body of evidence results suggest that context is important when transferring interventions across settings.
The effects of health education and exercise style changes on the maturation of autologous arteriovenous fistula in hemodialysis patients: A randomized controlled trial
Authors: Cao Ming-Cong , Jia Ru-Fu , Wang Ya-Fei , Pan Ke-Li , Hu Jing 
Published: December 2023

Background: Upper limb exercise has long been considered to be the main means to promote autogenous arteriovenous fistula (AVF) maturation, but in practice exercise intensity and compliance are both typically lacking. Several randomized controlled trials (RCTs) have demonstrated the good effects of functional resistance or pressure exercise in patients with AVF. However, many patients’ have difficulty complying with upper limb exercise programs without systematic health education. Therefore, we argue that resistance and pressure exercise supported by health education is actually the most beneficial for AVF patients. Methods: We randomly divided 114 patients into a control group and an experimental group of 57 patients each. In the control group, conventional care was used, and in the experimental group, online health education based on the IMB (Information-Motivation-Behavior skills) model and functional resistance and pressure upper limb exercises was implemented with the AVF side arm. The failure rate of AVF maturation, clinical maturation time, cephalic venous blood flow, vessel diameter, and vessel skin thickness were compared between the two groups. Results: Fifty-five cases were included for each in the final study. The primary outcome of this study was the failure rate of AVF maturation. Secondary outcomes included clinical maturation time, cephalic vein flow, vessel diameter, and vessel thickness. The failure rate of AVF maturation in the experimental group was significantly lower than that in the control group, and the clinical maturation time in the experimental group was significantly shorter than that in the control group. For the remaining three indicators, there were between-group effects, time effects, and interaction effects in both groups. Comparison between groups showed that there was no statistical difference in the observed indicators of cephalic vein flow, vessel diameter, or vessel thickness between the two groups before the intervention but that there was a statistical difference at the end of the 4th, 8th, and 12th weeks of the intervention. A 2 × 2 comparison also showed that there was a statistical difference between the three indicators at each time point within the two groups. Conclusion: IMB model-based online health education combined with functional resistance and pressure exercises can improve AVF maturation status and accelerate AVF maturation within 12 weeks of surgery.
Real-time ultrasound-guided hemostasis using suture-mediated closure device
Authors: Kwak JungWon , Bum Cho Sung 
Published: December 2023

Purpose: Suture-mediated hemostasis device takes a long time to train and have limitations in finding appropriate compression point depending on the tactile sense of the hands. If the appropriate compression point is determined using ultrasound and the instrument is used under ultrasound guidance, it is expected to reduce the technical failure and additional manual compression. Materials and methods: This retrospective study included 104 patients in whom the ProGlide vascular closure device (Abbott Vascular, Redwood City, CA, USA) was deployed to close common femoral artery access between January 2022 and June 2022. Ultrasound-guided hemostasis was performed in 54 patients and 50 conventional hemostasis was performed. We analyzed the medical records (procedure, patient body mass index, coagulation function, visual imaging, ultrasound imaging, time to achieve hemostasis) and post-treatment medical records (progress records, nursing records) to investigate the technical success rate and complications (hematoma, pseudoaneurysm formation, SFA occlusion, access site infection) of the procedure. Results: Technical success rate was 52/54 (Ultrasound guided group) and 47/50 (conventional group), respectively ( p > 0.05). Mean hemostasis time was 271 s (US guided group) and 317 s (conventional group), respectively ( p > 0.05). Additional manual compression was applied in 7/54 (US guided group) and 15/50 (conventional group) ( p < 0.05). In both groups, complications such as hematoma formation, access site infection and SFA occlusion did not occur. Conclusion: Using ultrasound guidance when using the suture mediated closing device reduces the frequency of additional manual compression without increased risk of complication.