bluuebunny/crossref_metadata_2025_split huggingface dataset:
Platelet-Rich Plasma Injections for the Treatment of Ankle Osteoarthritis
Authors: Paget Liam D.A. , Reurink Gustaaf , de Vos Robert-Jan , Weir Adam , Moen Maarten H. , Bierma-Zeinstra Sita M.A. , Stufkens Sjoerd A.S. , Goedegebuure Simon , Krips Rover , Maas Mario , Meuffels Duncan E. , Nolte Peter A. , Runhaar J. , Kerkhoffs Gino M.M.J. , Tol Johannes L. 
Published: July 2023

Background: Ankle osteoarthritis is debilitating and usually affects relatively young people, often as a result of previous ankle traumas, frequently occurring in sports. Platelet-rich plasma (PRP) injections for ankle osteoarthritis have shown no evidence of benefit over the course of 26 weeks. Previous studies on PRP for knee osteoarthritis showed that clinically significant improvements with PRP occurred between 6 to 12 months in the absence of initial benefit. No studies have evaluated the effect of PRP from 6 to 12 months in ankle osteoarthritis. Purpose: To assess the efficacy of PRP injections in ankle osteoarthritis over the course of 52 weeks. Study Design: Randomized controlled trial; Level of evidence, 1. Methods: In this 52-week follow-up trial, 100 patients with ankle osteoarthritis were randomized to a PRP group or placebo (saline) group. Patients received 2 intra-articular talocrural injections: at inclusion and after 6 weeks. Patient-reported outcome measures were used to assess pain, function, quality of life, and indirect costs over 52 weeks. Results: Two patients (2%) were lost to follow-up. The adjusted between-group difference for the patient-reported American Orthopaedic Foot & Ankle Society score over 52 weeks was −2 points (95% CI, −5 to 2; P = .31) in favor of the placebo group. No significant between-group differences were observed for any of the secondary outcome measures. Conclusion: For patients with ankle osteoarthritis, PRP injections did not improve ankle symptoms and function over 52 weeks compared with placebo injections. Registration: NTR7261 (Netherlands Trial Register).
Pandemic ethics and beyond: Creating space for virtues in the social professions
Authors: Banks Sarah 
Published: July 2023

Background During the pandemic, social and health care professionals operated in ‘crisis conditions’. Some existing rules/protocols were not operational, many services were closed/curtailed, and new ‘blanket’ rules often seemed inappropriate or unfair. These experiences provide fertile ground for exploring the role of virtues in professional life and considering lessons for professional ethics in the future. Research design and aim This article draws on an international qualitative survey conducted online in May 2020, which aimed to explore the ethical challenges experienced by social workers during Covid-19. Participants and research context 607 social workers responded from 54 countries, giving written online responses. This article first summarises previously published findings from the survey regarding the range of ethical challenges experienced, then develops a new analysis of social workers’ accounts of ethically challenging situations from a virtue ethics perspective. This analysis took a narrative ethics approach, treating respondents’ accounts as stories featuring the tellers as moral agents, with implicit or explicit implications for their professional ethical identity and character. The article is illustrated with accounts from the 41 UK respondents, drawing particularly on two case examples. Ethical considerations Ethical approval was gained from Durham University and anonymity was ensured for participants. Findings/results This article explores the nature of the ethical space created during the pandemic showing how practitioners were able to draw more on ‘inner resources’ and professional discretion than usual, displaying virtues such as professional wisdom, care, respectfulness and courage as they took account of the specific contexts of their work, rather than simply adhering to blanket rules. Conclusion Exploring practice through a virtue ethical lens provides valuable lessons for ‘building back better’ in social and health care professions.
Early Experiences With Single-Position Prone Lateral Lumbar Interbody Fusion: Safety and Outcomes
Authors: Subramanian Tejas , Maayan Omri , Shahi Pratyush , Du Jerry , Araghi Kasra , Amen Troy B. , Shinn Daniel , Song Junho , Dalal Sidhant , Sheha Evan , Dowdell James , Iyer Sravisht , Qureshi Sheeraz A. 
Published: July 2023

Background: Performing lateral lumbar interbody fusion (LLIF) in a single prone position may pose many advantages over the traditional lateral decubitus position, but there are questions concerning its safety profile and outcomes. Purpose: We sought to study the safety and efficacy of LLIF performed with the patient in the prone position. Methods: We conducted a retrospective cohort study including patients who underwent primary LLIF in the prone position for degenerative lumbar conditions. Complications and patient-reported outcome measures (PROMs) (Oswestry Disability Index [ODI], and visual analogue scale [VAS] scores for leg and back pain) were collected. Patients who underwent single-position prone LLIF were then propensity score matched for age, race, comorbidity index, number of levels, body mass index, and smoking status with patients who underwent single-position lateral LLIF. Patient-reported outcome measures and complications were compared between the 2 groups. Two postoperative timepoints were defined: early (<6 months) and late (≥6 months). Results: Twenty single-position prone LLIF patients were included (35% 1-level, 35% 2-level, 15% 3-level, and 15% 4-level). No intraoperative complications were reported. Eleven (55%) patients experienced transient postoperative anterior thigh weakness. Five (25%) patients experienced postoperative complications such as anemia, urinary retention, ileus, and new-onset sensory symptoms. Oswestry Disability Index, VAS leg, and VAS back scores all improved at the >6-month time point compared with preoperative states. There were no significant differences at any postoperative time point for PROMs between prone and lateral LLIF groups. Among the matched cohort, complications were observed in 3 (21%) of patients compared with only 1 (7%) in the lateral group although this difference was not statistically significant. Conclusion: This retrospective study suggests that prone LLIF procedures may be safe and effective. Ergonomic and logistic benefits from the approach may make it a beneficial approach for surgeons to begin implementing.
Barriers and facilitators of self-management behaviors among patients with chronic obstructive pulmonary disease and chronic comorbidities: A mixed-methods investigation
Authors: Muellers Kimberly A , O'Conor Rachel , Russell Andrea M , Wismer Guisselle , Griffith James W , Wolf Michael S , Wisnivesky Juan P , Federman Alex D 
Published: July 2023

Objectives We investigated how individuals with chronic obstructive pulmonary disease (COPD) and multi-morbidity (MM) navigate barriers and facilitators to their health management. Methods We conducted a mixed-methods study using semi-structured interviews and survey assessments of adults with COPD, hypertension, and/or diabetes. We recruited 18 participants with an average age of 65, with 39% being male, 50% Black, and 22% Hispanic/Latino/a. Five investigators used an iterative, hybrid-coding process combining a priori and emergent codes to analyze transcripts and compare quantitative and qualitative data for themes. Results Participants reported a generalized approach to their health rather than managing MMs separately. Individuals with good or mixed adherence found daily routines facilitated regular medication use, while those with poor adherence experienced complex prescriptions and life stressors as barriers. Walking was viewed as beneficial but challenging due to limited mobility. Most participants viewed diet as important to their MMs, but only two reported high diet quality and many held inaccurate beliefs about healthy diet choices. Discussion Participants with MM were highly motivated to engage in self-management activities, but some individuals experienced barriers to maintaining them. Emphasizing an individualized clinical approach to assessing and solving patient barriers may improve self-management outcomes in this complex population.
Clinical impact of videocapsule endoscopy and device-assisted enteroscopy in non-bleeding small bowel lesions
Authors: Topa Matilde , Nandi Nicoletta , Scaramella Lucia , Puricelli Michele , Pennazio Marco , Sidhu Reena , Sanders David S. , Tontini Gian Eugenio , Penagini Roberto , Vecchi Maurizio , Elli Luca 
Published: July 2023

Background: Videocapsule endoscopy (VCE) and double-balloon enteroscopy (DBE) are part of the diagnostic and therapeutic work-up of indications other than suspected small bowel bleeding (OSBB). The literature is currently lacking studies describing these procedures in this particular setting. Objectives: We assessed the clinical impact of VCE and DBE in a large monocentric cohort of OSBB patients, as compared to a control group of suspected small bowel bleeding (SSBB) patients who underwent enteroscopy over the same period. Design: Monocentric, retrospective, cohort study. Methods: We collected the data of consecutive patients with OSBB undergoing VCE and/or DBE from March 2001 to July 2020. The demographic and clinical parameters of the patients, technical characteristics, and adverse events for each procedure were collected. The impact of VCE and DBE was defined in terms of diagnostic yield (DY). The patients were subdivided according to the main indication into four groups: celiac disease, Crohn’s disease (CD), neoplasia, and persistent gastrointestinal symptoms. Results: A total of 611 VCEs and 387 DBEs were performed for OSBB. The main indications were complicated celiac disease and CD. The DYs of VCE and DBE overall were 53 and 61.7%, respectively, with some variance among the four groups. We report no statistical differences in the DY of VCE and DBE in SSBB vs OSBB (57.7% vs 53%, p = 0.0859 and 68.8% vs 61.7%, p = 0.0582, respectively). OSBB patients were significantly younger than those with SSBB. However, similarly to SSBB ( k = 0.059), poor agreement between the enteroscopic techniques was found in the OSBB population ( k = 0.109). The safety of both procedures in OSBB was comparable to that in SSBB patients. Conclusion: VCE and DBE are effective and safe in suspected OSBB, where their role is similar to that in SSBB, their main indication.
Arthroscopic Bankart repair versus nonoperative management for first-time anterior shoulder instability: A cost-effectiveness analysis
Authors: Li Zachary I , Hurley Eoghan T , Garra Sharif , Blaeser Anna M , Markus Danielle H , Shen Michelle , Campbell Kirk A , Strauss Eric J , Jazrawi Laith M , Gyftopoulos Soterios 
Published: July 2023

Purpose Arthroscopic Bankart repair (ABR) may be more effective than nonoperative management for patients with anterior shoulder instability following first-time dislocation. The purpose of the study was to determine the most cost-effective treatment strategy by evaluating the incremental cost-effectiveness ratio (ICER) for ABR versus nonoperative treatment. Methods This cost-effectiveness study utilized a Markov decision chain and Monte Carlo simulation. Probabilities, health utility values, and outcome data regarding ABR and nonoperative management of first-time shoulder instability derived from level I/II evidence. Costs were tabulated from Centers for Medicaid & Medicare Services. Probabilistic sensitivity analysis was performed using >100,000 repetitions of the Monte Carlo simulation. A willingness-to-pay (WTP) threshold was set at $50,000. Results The expected cost for operative management higher than nonoperative management ($32,765 vs $29,343). However, ABR (5.48 quality-adjusted life years (QALYs)) was the more effective treatment strategy compared to nonoperative management (4.61 QALYs). The ICER for ABR was $3943. Probabilistic sensitivity analysis showed that ABR was the most cost-effective strategy in 100% of simulations. Discussion ABR is more cost-effective than nonoperative management for first-time anterior shoulder dislocation. The threshold analysis demonstrated that when accounting for WTP, ABR was found to be the more cost-effective strategy.
A holistic view of facilitators and barriers of electronic health records usage from different perspectives: A qualitative content analysis approach
Authors: Griesser Anna , Bidmon Sonja 
Published: July 2023

Background: Electronic health records (EHR) are seen as a promising endeavour, in spite of policies, designs, user rights and types of health data varying across countries. In many European countries, including Austria, EHR usage has fallen short when compared to the deployment plans. Objective: By adopting a qualitative approach, this research aimed to explore facilitators and barriers experienced by patients and physicians across the entire EHR usage process in Austria. Method: Two studies were conducted: In Study 1, discussions were held with four homogeneously composed groups of patients ( N = 30). In Study 2, eight expert semi-structured interviews were conducted with physicians to gain insights into potential facilitators and barriers Austrian physicians face when utilising personal EHR. Results: A wide range of barriers and facilitators were identified along the entire EHR usage spectrum, emerging on three different levels: the micro-level (individual level), the meso-level (level of the EHR system) and the macro-level (level of the health system). EHR literacy was identified as a booster to support EHR adherence. Health providers were identified as crucial gatekeepers with regard to EHR usage. Conclusion: The implications for mutual benefits arising out of EHR usage among the triad of health policymakers, providers and patients for both theory and practice are discussed.
Stroke clinical coding education program in Australia and New Zealand
Authors: Kilkenny Monique F , Sanders Ailie , Burns Catherine , Sanders Lauren M , Ryan Olivia , Read Carla , Lum On Miriam , Ranta Anna , Purvis Tara , Inman Carys , Cadilhac Dominique A , Carter Helen , Rowlands Stella , Nedkoff Lee , Olaiya Muideen T ,   on behalf of the Australia and New Zealand Stroke Coding Working Group
Published: July 2023

Background: Accurate coded diagnostic data are important for epidemiological research of stroke. Objective: To develop, implement and evaluate an online education program for improving clinical coding of stroke. Method: The Australia and New Zealand Stroke Coding Working Group co-developed an education program comprising eight modules: rationale for coding of stroke; understanding stroke; management of stroke; national coding standards; coding trees; good clinical documentation; coding practices; and scenarios. Clinical coders and health information managers participated in the 90-minute education program. Pre- and post-education surveys were administered to assess knowledge of stroke and coding, and to obtain feedback. Descriptive analyses were used for quantitative data, inductive thematic analysis for open-text responses, with all results triangulated. Results: Of 615 participants, 404 (66%) completed both pre- and post-education assessments. Respondents had improved knowledge for 9/12 questions ( p < 0.05), including knowledge of applicable coding standards, coding of intracerebral haemorrhage and the actions to take when coding stroke (all p < 0.001). Majority of respondents agreed that information was pitched at an appropriate level; education materials were well organised; presenters had adequate knowledge; and that they would recommend the session to colleagues. In qualitative evaluations, the education program was beneficial for newly trained clinical coders, or as a knowledge refresher, and respondents valued clinical information from a stroke neurologist. Conclusion: Our education program was associated with increased knowledge for clinical coding of stroke. To continue to address the quality of coded stroke data through improved stroke documentation, the next stage will be to adapt the educational program for clinicians.
Lenalidomide plus rituximab for the initial treatment of frail older patients with DLBCL: the FIL_ReRi phase 2 study
Authors: Gini Guido , Tani Monica , Tucci Alessandra , Marcheselli Luigi , Cesaretti Marina , Bellei Monica , Pascarella Anna , Ballerini Filippo , Petrini Mauro , Merli Francesco , Olivieri Attilio , Lanza Francesco , Annibali Ombretta , Zilioli Vittorio Ruggero , Liberati Anna Marina , Tisi Maria Chiara , Arcari Annalisa , Marino Dario , Musuraca Gerardo , Pavone Vincenzo , Fabbri Alberto , Pozzi Samantha , Mannina Donato , Plenteda Caterina , Celli Melania , Luminari Stefano 
Published: July 2023

Abstract
Treatment of diffuse large B-cell lymphoma (DLBCL) in older patients is challenging, especially for those who are not eligible for anthracycline-containing regimens. Fondazione Italiana Linfomi (FIL) started the FIL_ReRi study, a 2-stage single-arm trial to investigate the activity and safety of the chemo-free combination of rituximab and lenalidomide (R2) in ≥70-year-old untreated frail patients with DLBCL. Frailty was prospectively defined using a simplified geriatric assessment tool. Patients were administered a maximum of 6 28-day cycles of 20 mg oral lenalidomide from days 2 to 22 and IV rituximab 375 mg/m2 on day 1, with response assessment after cycles 4 and 6. Patients with partial response or complete response (CR) at cycle 6 were administered lenalidomide 10 mg/d from days 1 to 21 for every 28 cycles for a total of 12 cycles or until progression or unacceptable toxicity. The primary end point was the overall response rate (ORR) after cycle 6; the coprimary end point was the rate of grade 3 or 4 extrahematological toxicity. The ORR was 50.8%, with 27.7% CR. After a median follow-up of 24 months, the median progression-free survival was 14 months, and the 2-year duration of response was 64%. Thirty-four patients experienced extrahematological toxicity according to the National Cancer Institute Common Terminology Criteria for Adverse Events grade ≥3. The activity of the R2 combination was observed in a significant proportion of subjects, warranting further exploration of a chemo-free approach in frail older patients with DLBCL. This trial was registered at EudraCT as #2015-003371-29 and clinicaltrials.gov as #NCT02955823.
In vivo CRISPR/Cas9 screening identifies Pbrm1 as a regulator of myeloid leukemia development in mice
Authors: Li Bin E. , Li Grace Y. , Cai Wenqing , Zhu Qian , Seruggia Davide , Fujiwara Yuko , Vakoc Christopher R. , Orkin Stuart H. 
Published: July 2023

Abstract
CRISPR/Cas9 screening approaches are powerful tool for identifying in vivo cancer dependencies. Hematopoietic malignancies are genetically complex disorders in which the sequential acquisition of somatic mutations generates clonal diversity. Over time, additional cooperating mutations may drive disease progression. Using an in vivo pooled gene editing screen of epigenetic factors in primary murine hematopoietic stem and progenitor cells (HSPCs), we sought to uncover unrecognized genes that contribute to leukemia progression. We, first, modeled myeloid leukemia in mice by functionally abrogating both Tet2 and Tet3 in HSPCs, followed by transplantation. We, then, performed pooled CRISPR/Cas9 editing of genes encoding epigenetic factors and identified Pbrm1/Baf180, a subunit of the polybromo BRG1/BRM-associated factor SWItch/Sucrose Non-Fermenting chromatin–remodeling complex, as a negative driver of disease progression. We found that Pbrm1 loss promoted leukemogenesis with a significantly shortened latency. Pbrm1-deficient leukemia cells were less immunogenic and were characterized by attenuated interferon signaling and reduced major histocompatibility complex class II (MHC II) expression. We explored the potential relevance to human leukemia by assessing the involvement of PBRM1 in the control of interferon pathway components and found that PBRM1 binds to the promoters of a subset of these genes, most notably IRF1, which in turn regulates MHC II expression. Our findings revealed a novel role for Pbrm1 in leukemia progression. More generally, CRISPR/Cas9 screening coupled with phenotypic readouts in vivo has helped identify a pathway by which transcriptional control of interferon signaling influences leukemia cell interactions with the immune system.
The 16S rDNA high-throughput sequencing correlation analysis of milk and gut microbial communities in mastitis Holstein cows
Authors: Jiang Chenxi , Hou Xiaolu , Gao Xiaona , Liu Pei , Guo Xiaoquan , Hu Guoliang , Li Qingqing , Huang Cheng , Li Guyue , Fang Weile , Mai Wanrui , Wu Cong , Xu Zheng , Liu Ping 
Published: July 2023

AbstractThis study aimed to understand the changes in the milk and gut microbiota of dairy cows with mastitis, and to further explore the relationship between mastitis and the microbiota. In this study, we extracted microbial DNA from healthy and mastitis cows and performed high-throughput sequencing using the Illumina NovaSeq sequencing platform. OTU clustering was performed to analyze complexity, multi-sample comparisons, differences in community structure between groups, and differential analysis of species composition and abundance. The results showed that there were differences in microbial diversity and community composition in the milk and feces of normal and mastitis cows, where the diversity of microbiota decreased and species abundance increased in the mastitis group. There was a significant difference in the flora composition of the two groups of samples (P < 0.05), especially at the genus level, the difference in the milk samples was Sphingomonas (P < 0.05) and Stenotrophomonas (P < 0.05), the differences in stool samples were Alistipes (P < 0.05), Flavonifractor (P < 0.05), Agathobacter (P < 0.05) and Pygmaiobacter (P < 0.05). In conclusion, the microbiota of the udder and intestinal tissues of dairy cows suffering from mastitis will change significantly. This suggests that the development of mastitis is related to the endogenous pathway of microbial intestinal mammary glands, but the mechanisms involved need further study.
Conservative management of complete fetal expulsion into the abdominal cavity after silent uterine rupture - case report
Authors: Hruban Lukas , Jouzova Anna , Janku Petr , Weinberger Vit , Seidlova Dagmar , Juren Tomas , Senkyrik Jan , Kadlecova Jana , Hausnerova Jitka , Jandakova Eva 
Published: July 2023

Abstract
Background
Clinically silent uterine rupture with complete fetal expulsion into the abdominal cavity is an extremely rare complication. Diagnosis can be difficult and the risk to the mother and fetus is high. Conservative management has been described only in a few cases of partial expulsion of the fetus so far.

Case presentation
We present a case of 43-year-old tercigravida with a history of previous laparotomic myomectomy and subsequent cesarean section. The subsequent pregnancy was complicated by uterine wall loosening and rupture at the site of the previous uterine scar after myomectomy and complete fetal expulsion into the abdominal cavity. The diagnosis was made at 24 + 6 weeks of gestation. Considering the absence of clinical symptomatology and the good condition of the fetus, a conservative approach was chosen with intensive monitoring of the maternal and fetal conditions. The pregnancy ended by elective cesarean section and hysterectomy at 28 + 0 weeks of gestation. The postpartum course was uneventful and the newborn was discharged to home care 63 days after delivery.

Conclusions
Fetal expulsion into the abdominal cavity after silent uterine rupture of the scarred uterus may be accompanied by minimal symptomatology making early diagnosis difficult. This rare complication must be considered in the differential diagnosis in women after major uterine surgery. In selected cases and under conditions of intensive maternal and fetal monitoring, conservative management may be chosen to reduce the risks associated with prematurity.