bluuebunny/crossref_metadata_2025_split huggingface dataset:
Understanding the Impact of Trauma Admissions to Nonsurgical Services
Authors: Kim Jennie S. , Schellenberg Morgan , Navarette Sixta , Demetriades Demetrios 
Published: June 2023

Background The American College of Surgeons Committee on Trauma (ACS COT) delineates trauma center standards, one of which limits the number of injured patients admitted to nonsurgical services. Performance improvement review of nonsurgical admissions (NSAs), particularly those with Injury Severity Score (ISS) > 9, is required. Objective To examine trauma patients with NSA for appropriateness of admission and any potential clinical effect as a result of NSA. Methods All trauma patients presenting to our ACS COT-verified level 1 trauma center in Southern California (05/2021-04/2022) were retrospectively screened. Nonsurgical admissions with ISS > 9 were included without exclusions. Appropriateness and clinical impact of NSA were assessed by the Trauma Medical Director (TMD) and Associate TMD. Results Forty patients met study criteria, with a mean age of 54 years (range 5 d-99 y). The mean ISS was 19 (range 10-30). Nonsurgical admissions most commonly sustained traumatic brain injury (TBI) (n = 27, 68%) after ground level falls (GLF) (n = 32, 80%). All NSAs were evaluated by ≥1 surgical service, commonly neurosurgery (n = 33, 83%) and trauma surgery (n = 13, 33%). Sixteen patients (40%) died, 75% (n = 12) of which were secondary to catastrophic TBI. Upon detailed review, all NSAs were deemed appropriate and without potential clinical impact. Conclusions All NSAs in this study were appropriate admissions without clinical effect from lack of surgical admission. Nonsurgical admissions were typically elderly patients with head injuries after GLF. With the anticipated increase in geriatric trauma due to our aging population, NSA with surgical consultation may be an important way to manage trauma admissions without compromising care of injured patients.
Ultrasound-guided percutaneous laser ablation of tributary varicose veins using a slim-type radial fiber
Authors: Utoh Junichi , Tsukamoto Yoshiharu 
Published: June 2023

Objective This study presents the efficacy of ultrasound-guided percutaneous laser ablation of tributary varicose veins using a slim-type radial 2-ring fiber. Methods One thousand consecutive patients who underwent endovenous laser ablation (EVLA) of incompetent saphenous veins were included. The tributary varicose veins were punctured with a 16G venule needle and ablated with a 1470 nm laser system and a slim-type radial 2-ring fiber with a diameter of 1.27 mm. The EVLA was performed with a power of 5W and linear endovenous energy density of around 30 J/cm. Results Percutaneous varicose ablation was safely performed in 939 legs with an average of 5.9 times punctures per leg. No skin burn or nerve injury was observed after varicose ablation. Ultrasonography revealed complete occlusion of the treated veins 1 month after EVLA. Conclusions This study suggests that percutaneous varicose ablation with a slim-type radial 2-ring fiber is a safe and effective alternative to cover the weak point of ambulatory phlebectomy.
Survivorship After Lateral Meniscal Allograft Transplantation Plus Concurrent Cartilage Procedure in Patients With Poor Cartilage Status: A Comparative Study
Authors: Lee Jongjin , Bin Seong-Il , Kim Jong-Min , Lee Bum-Sik , Jeon Taehyeon , Bae Kinam , Kim Donghyok 
Published: June 2023

Background: The effect of a concurrent cartilage procedure in lateral meniscal allograft transplantation (MAT) in patients with bipolar cartilage lesions (high-grade lesions on both the femoral and the tibial side) is not well studied. An objective evaluation of graft status after MAT and a concurrent cartilage procedure has not been reported. Purpose: To investigate the effect of concurrent cartilage procedures and lateral MAT on objective and clinical outcomes, including survival, in patients with bipolar cartilage lesions. Study Design: Cohort study; Level of evidence, 3. Methods: A total of 149 patients with high-grade (International Cartilage Regeneration & Joint Preservation Society grade 3 or 4) cartilage lesions were enrolled and assigned to 1 of 3 groups based on the cartilage procedure and cartilage status at the time of MAT. Femoral cartilage procedures (microfracture, n = 18; osteochondral autograft transfer, n = 13) and lateral MAT were performed in 31 patients with bipolar cartilage lesions (cartilage procedure group). Another 70 patients with bipolar lesions underwent only lateral MAT without cartilage procedure (bipolar lesion group). The remaining 48 patients, who had high-grade lesions only on the tibial side and underwent lateral MAT without a cartilage procedure, were selected as a control group (unipolar lesion group). Anatomic survival was objectively assessed by follow-up magnetic resonance imaging and second-look arthroscopy. Clinical survivorship was determined with a Lysholm score <65 or need for additional surgery, such as revision MAT. Results: The mean Lysholm score improved from 67.2 ± 15.9 preoperatively to 86.7 ± 11.1 with a mean follow-up of 78.0 ± 51.2 months ( P < .001). The postoperative scores were not significantly different between the 3 groups. The estimated 5-year anatomic survival rate in the cartilage procedure group (86.7%) was higher than that in the bipolar lesion group (65.0%; P = .043) but comparable with that in the unipolar lesion group (90.2%; P = .572). The estimated 5-year clinical survival rates were not significantly different between the groups ( P = .187). Conclusion: A concurrent femoral cartilage procedure improved the anatomic survival rate in patients with bipolar chondral lesions who underwent lateral MAT. This finding suggests that the cartilage procedure is an effective treatment choice and may improve the status of an allograft after lateral MAT for patients with bipolar cartilage lesions.
Relationship between nurses’ ethical ideology, professional values, and clinical accountability
Authors: Hussein Azza Hassan Mohamed , Abou Hashish Ebtsam Aly 
Published: June 2023

Background Nurses are challenged with many situations that require them to solve ethical dilemmas and make moral decisions based on professional values and a sense of accountability and responsibility. To support their decisions, it is important to know how they perceive and relate their ethical ideology, professional values, and clinical accountability in their workplace. Purpose The study’s aim was twofold: to investigate the ethical ideology and perceived importance of professional values and accountability among nurses. Further, explore the relationship between each of ethical ideology and professional values with nurses’ work accountability. Methods A correlational study was conducted in an Egyptian hospital. All nurses were invited to participate = 192, and 150 nurses (78.3%) completed the study questionnaires. The Ethical Position Questionnaire, the Professional Values Scale, and the Clinical Vignettes Assessment for Clinical Accountability were proven to be reliable study measures. Ethical considerations Ethics Committee approval, written informed consent, data privacy and confidentiality, and participants’ right to voluntary participation and withdrawal were maintained. Results Nurses showed good ethical ideology (75 ± 6.2) and are more idealistic while maintaining professional values (108 ± 10.8). Most nurses believed they were accountable for documenting errors, completing incident reports, and calling physicians to discuss or manage the situations. Ethical ideology and the idealism subscale were positively correlated with overall nurses’ professional values (r = 0.321, p < 0.004, r =0.464, p 0.000), respectively. On the other hand, work accountability showed a partial correlation in some areas with ethical ideology and professional values. Discussion Professional values and nurses' accountability appear to be influenced by ethical positions and ideology. Conclusion Healthcare organizations should provide a supportive work environment to help nurses develop self-awareness, and knowledge of their ethical ideologies, which improve professional values and clinical accountability in their practice. Ethical ideology and professional values should be emphasized more in nursing curricula.
Clinical Profile and Outcomes of Neonates Exposed to Maternal COVID-19 Infection in a Tertiary Care Centre—A Cohort Study (NeOCoM Study)
Authors: Anitha Murugesan , Premkumar Segaran , Sathya Jagannathan , Manikumar Solaiappan , Narayanan Ethirajan 
Published: June 2023

Background COVID-19 infection during pregnancy was reported to cause adverse outcomes. Such knowledge stands low quality evidence due to lack of internal controls and inferential statistics. Objectives To assess impact of COVID-19 in pregnancy on fetal and neonatal outcomes. Study Design Prospective analytical cohort study (July 2020 to March 2021). Setting Level III NICU of teaching hospital in India. Participants COVID positive mothers (exposed = 239) each matched with 2 women delivered consecutively by same mode without COVID (unexposed = 478) and enrolled at admission during delivery. Procedure Maternal demographic, comorbidities, and obstetric characteristics; fetal growth, pregnancy complications, and neonatal details of 242 and 482 neonates born to exposed and unexposed mothers respectively were analyzed. Infants were followed until neonatal period. Outcomes Incidence of prematurity was primary outcome. Secondary outcomes were incidence of abortions, IUD, stillbirth, neonatal mortality, neonatal resuscitation at birth, SFD, NICU admission, neonatal morbidities, length of hospitalization, in-hospital mortality, infant positivity rate for SARS COV-2. Results Incidence of prematurity was not significantly different between mothers with and without COVID-19 infection [42(17.3%) vs 94(19.3%), IRR (95%CI) 1.04(0.83,1.31), P = .833]. Neonatal mortality, adverse fetal outcomes, PROM, fetal distress, SGA, neonatal resuscitation, NICU admission did not differ significantly between groups. Gestational hypertension was associated with COVID-19 infection [14(5.9%) vs 11(2.3%), (p=0.014)]. Infant swab positivity was 7%. Swab positivity and neonatal symptoms were associated significantly (10/17(58.8%) vs 7/17(41.1%), P = .0001). Conclusion Asymptomatic COVID-19 infection during pregnancy does not increase adverse fetal and neonatal outcomes. COVID positive neonates become symptomatic and hence need monitoring in health-care facility.
Effect of Recorded Chants of the “OM” Mantra as an Interventional Music Therapy on Reducing Stress in Newborns Admitted to the Neonatal Intensive Care Unit: An Observational Study
Authors: Singh Shailendra Kumar , Patra Saikat , Chetan Chinmay , Gupta Girish 
Published: June 2023

Introduction Newborns admitted to the neonatal intensive care unit (NICU) are under tremendous stress. The “OM” sound is known to have a calming effect on adults. The effect of administering chants of “OM” to newborns is unknown. Objectives Primary Objective To evaluate the effect of the “OM” sound on vital parameters in newborns admitted to the NICU. Secondary Objectives To observe the duration of the effect of the “OM” sound on vital parameters after the music therapy and to observe its effect at various gestational ages. Methods Prospective observational study was carried out over 4 months. 57 newborns enrolled were administered music therapy by playing recorded chants of “OM” mantra (MTOM). Vitals were recorded before, during, and after MTOM. Results The heart rate (HR) before and with MTOM was 142 ± 7 and 130 ± 11 bpm ( p = .001). The decrease in HR persisted even after 1 h of stoppage of MTOM ( p = .001). A significant decrease in HR was observed in all gestations ( p = .001). There was no significant difference in respiratory rate (RR) and SpO2 before and with MTOM. Conclusion MTOM significantly reduces HR in newborns of all gestational ages, and its effect persists for at least 1 h after stopping MTOM.
Resilience-enhancing interventions for family caregivers: A systematic review
Authors: Chi Nai-Ching , Han Soojeong , Lin Shih-Yin , Fu Ying-Kai , Zhu Zilin , Nakad Lynn , Demiris George 
Published: June 2023

Objectives To synthesize interventions designed to enhance resilience in family caregivers (FCs). Methods Electronic databases including PubMed, CINAHL, PsycINFO, and Scopus, were searched using index and keyword methods for articles published before January 2020. The review process followed the PRISMA review guidelines. Study quality was assessed using the Mixed Methods Appraisal Tool (MMAT). Results Six studies (seven articles) were included in this review. Quantitative evidence supports the benefits of psychoeducation, mindfulness-based intervention, and cognitive behavioral therapy (CBT)-based intervention but not expressive writing in improving in FCs’ resilience. Four of the six included studies were randomized controlled trials. All included studies only met 40% to 60% of the MMAT criteria, indicating low to moderate levels of study quality. Conclusion This review showed emerging evidence that psychoeducation, mindfulness-based intervention, and CBT-based intervention may improve caregiver resilience. However, it remains unclear which intervention and what dosage is the most effective in promoting FCs’ resilience. Due to the small number of relevant studies and a low-to-moderate level of overall study quality, more rigorous clinical trials are needed to strengthen the current limited evidence base for FC resilience interventions.
Student perspectives on the integration of artificial intelligence into healthcare services
Authors: Ahmad Muna N , Abdallah Saja A , Abbasi Saddam A , Abdallah Atiyeh M 
Published: June 2023

Background Healthcare workers are often overworked, underfunded, and face many challenges. Integration of artificial intelligence into healthcare service provision can tackle these challenges by relieving burdens on healthcare workers. Since healthcare students are our future healthcare workers, we assessed the knowledge, attitudes, and perspectives of current healthcare students at Qatar University on the implementation of artificial intelligence into healthcare services. Methods This was a cross-sectional study of QU-Health Cluster students via an online survey over a three-week period in November 2021. Chi-squared tests and gamma coefficients were used to compare differences between categorical variables. Results One hundred and ninety-three QU-Health students responded. Most participants had a positive attitude towards artificial intelligence, finding it useful and reliable. The most popular perceived advantage of artificial intelligence was its ability to speed up work processes. Around 40% expressed concern about a threat to job security from artificial intelligence, and a majority believed that artificial intelligence cannot provide sympathetic care (57.9%). Participants who felt that artificial intelligence can better make diagnoses than humans also agreed that artificial intelligence could replace their job (p  =  0.005). Male students had more knowledge (p  =  0.005) and received more training (p  =  0.005) about healthcare artificial intelligence. Participants cited a lack of expert mentorship as a barrier to obtaining knowledge about artificial intelligence, followed by lack of dedicated courses and funding. Conclusions More resources are required for students to develop a good understanding about artificial intelligence. Education needs to be supported by expert mentorship. Further work is needed on how best to integrate artificial intelligence teaching into university curricula.
Risk Factors for Graft Failure After Meniscal Allograft Transplantation: A Systematic Review and Meta-analysis
Authors: Kunze Kyle N. , Davie Ryann A. , Ramkumar Prem Narayan , Chahla Jorge , Nwachukwu Benedict U. , Williams Riley J. 
Published: June 2023

Background: Graft failure after meniscal allograft transplantation (MAT) may necessitate revision surgery or conversion to arthroplasty. A comprehensive understanding of the risk factors for failure after MAT of the knee may facilitate more informed shared decision-making discussions before surgery and help determine whether MAT should be performed based on patient risk. Purpose: To perform a systematic review and meta-analysis of risk factors associated with graft failure after MAT of the knee. Study Design: Systematic review; Level of evidence, 4. Methods: The PubMed, OVID/Medline, and Cochrane databases were queried in October 2021. Data pertaining to study characteristics and risk factors associated with failure after MAT were recorded. DerSimonian-Laird binary random-effects models were constructed to quantitatively evaluate the association between risk factors and MAT graft failure by generating effect estimates in the form of odds ratios (ORs) with 95% CIs. Qualitative analysis was performed to describe risk factors that were variably reported. Results: In total, 17 studies including 2184 patients were included. The overall pooled prevalence of failure at the latest follow-up was 17.8% (range, 3.3%-81.0%). In 10 studies reporting 5-year failure rates, the pooled prevalence of failure was 10.9% (range, 4.7%-23%). In 4 studies reporting 10-year failure rates, the pooled prevalence was 22.7% (range, 8.1%-55.0%). A total of 39 risk factors were identified, although raw data presented in a manner amenable to meta-analysis only allowed for 3 to be explored quantitatively. There was strong evidence to support that an International Cartilage Regeneration & Joint Preservation Society grade >3a (OR, 5.32; 95% CI, 2.75-10.31; P < .001) was a significant risk factor for failure after MAT. There was no statistically significant evidence to incontrovertibly support that patient sex (OR, 2.16; 95% CI, 0.83-5.64; P = .12) or MAT laterality (OR, 1.11; 95% CI, 0.38-3.28; P = .85) was associated with increased risk of failure after MAT. Conclusion: Based on the studies reviewed, there was strong evidence to suggest that degree of cartilage damage at the time of MAT is associated with graft failure; however, the evidence was inconclusive on whether laterality or patient sex is associated with graft failure.
Implementation science in plain language: The use of nonjargon terms to facilitate collaboration
Authors: Dorsey Shannon , Johnson Clara , Soi Caroline , Meza Rosemary D. , Whetten Kathryn , Mbwayo Anne 
Published: June 2023

Background Interdisciplinary collaboration and stakeholder engagement are key ingredients in implementation science research. However, effective and efficient collaboration can be limited by the complexity of implementation science terms. In this article, we argue that the development and use of plain language implementation science terms is an essential step to facilitate collaboration and engagement. Method We present an example of plain language development to portray the process and the potential benefits plain language can have on implementation science research. Implementation scientists and intervention experts codeveloped plain language implementation terms as a part of an implementation-effectiveness trial in western Kenya and in preparation for a stakeholder collaborative design meeting. Results The developed plain language terms facilitated wider stakeholder understanding and integration of implementation science findings that could inform the design of a stakeholder-led implementation coaching program. Conclusions We encourage the use of the plain language terms presented in this article, further translation, and additional development of other plain language terms for implementation science constructs.
Genome-wide association study of chronic sputum production implicates loci involved in mucus production and infection
Authors: Packer Richard J. , Shrine Nick , Hall Robert , Melbourne Carl A. , Thompson Rebecca , Williams Alex T. , Paynton Megan L. , Guyatt Anna L. , Allen Richard J. , Lee Paul H. , John Catherine , Campbell Archie , Hayward Caroline , de Vries Maaike , Vonk Judith M. , Davitte Jonathan , Hessel Edith , Michalovich David , Betts Joanna C. , Sayers Ian , Yeo Astrid , Hall Ian P. , Tobin Martin D. , Wain Louise V. 
Published: June 2023

BackgroundChronic sputum production impacts on quality of life and is a feature of many respiratory diseases. Identification of the genetic variants associated with chronic sputum production in a disease agnostic sample could improve understanding of its causes and identify new molecular targets for treatment.MethodsWe conducted a genome-wide association study (GWAS) of chronic sputum production in UK Biobank. Signals meeting genome-wide significance (p<5×10−8) were investigated in additional independent studies, were fine-mapped and putative causal genes identified by gene expression analysis. GWASs of respiratory traits were interrogated to identify whether the signals were driven by existing respiratory disease among the cases and variants were further investigated for wider pleiotropic effects using phenome-wide association studies (PheWASs).ResultsFrom a GWAS of 9714 cases and 48 471 controls, we identified six novel genome-wide significant signals for chronic sputum production including signals in the human leukocyte antigen (HLA) locus, chromosome 11 mucin locus (containingMUC2,MUC5ACandMUC5B) andFUT2locus. The four common variant associations were supported by independent studies with a combined sample size of up to 2203 cases and 17 627 controls. The mucin locus signal had previously been reported for association with moderate-to-severe asthma. The HLA signal was fine-mapped to an amino acid change of threonine to arginine (frequency 36.8%) in HLA-DRB1 (HLA-DRB1*03:147). The signal nearFUT2was associated with expression of several genes includingFUT2, for which the direction of effect was tissue dependent. Our PheWAS identified a wide range of associations including blood cell traits, liver biomarkers, infections, gastrointestinal and thyroid-associated diseases, and respiratory disease.ConclusionsNovel signals at theFUT2and mucin loci suggest that mucin fucosylation may be a driver of chronic sputum production even in the absence of diagnosed respiratory disease and provide genetic support for this pathway as a target for therapeutic intervention.
Sarcoidosis lung transplantation waitlist mortality, a national registry database study
Authors: Fleitas Sosa Derlis C. , Gayen Shameek , Zheng Matthew , Gangemi Andrew J. , Zhao Huaqing , Kim Victor , Sehgal Sameep , Criner Gerard J. , Gupta Rohit , Mamary A. James 
Published: June 2023

BackgroundThe Lung Allocation Score (LAS) prioritises lung transplantation candidates, balancing waitlist mortality and post-transplant survival. The score groups sarcoidosis candidates based on mean pulmonary artery pressure: those with ≤30 mmHg (sarcoidosis A) are grouped with COPD and those with >30 mmHg (sarcoidosis D) with idiopathic pulmonary fibrosis (IPF). We hypothesise that sarcoidosis candidates have a higher waitlist mortality than other candidates within their LAS grouping.MethodsThis is a retrospective cohort study of consecutive lung transplantation candidates from the Scientific Registry of Transplant Recipients database from May 2005 to May 2019. We included candidates aged ≥18 years diagnosed with sarcoidosis, COPD or IPF. Univariate, multivariate and survival estimate analyses were performed.ResultsWe identified 385 sarcoidosis A, 642 sarcoidosis D, 7081 COPD and 10 639 IPF lung transplantation candidates. 17.3% of sarcoidosis D, 14.8% of IPF, 14.3% of sarcoidosis A and 9.8% of COPD candidates died awaiting transplant. Sarcoidosis A was an independent risk factor for waitlist mortality. Sarcoidosis A had a lower waitlist survival probability compared to COPD. Sarcoidosis D had the highest waitlist mortality. IPF candidates had lower waitlist survival probability than sarcoidosis D in the first 60 days after listing.ConclusionBased on our results, the grouping of candidates with sarcoidosis in allocation systems should be revised to mitigate waitlist mortality disparity.