bluuebunny/crossref_metadata_2025_split huggingface dataset:
Assessing and Comparing Musculoskeletal Knowledge and Red Flag Identification Skills: A Cross-Sectional Study of Physical Therapists and Primary Care Physicians
Authors: Almedlej Rahaf Fahad , Abdelkader Samiha , Alodaibi Faris , Alsobayel Hana 
Published: September 2023

Abstract
Background
Musculoskeletal disorders are one of the most common health issues often managed at the level of primary health care, putting a significant load on primary care physicians (PCPs). Enabling physical therapists to be first-contact practitioner for patients with musculoskeletal disorders could improve patient access, expedite management, enhance outcomes and reduce costs. However, this role requires a high level of musculoskeletal knowledge and the ability to detect red flags. To date, no study has assessed or compared these skills between physical therapists and PCPs in Saudi Arabia.
Methods
A cross-sectional study was undertaken using an electronic survey comprising 16 case scenarios for musculoskeletal disorders. The survey assessed participants’ knowledge and ability to identify red flags. Study participants included physical therapist and PCPs practicing at Ministry of Health hospitals and/or primary care centers in Riyadh, Saudi Arabia and were involved in the management of adults with musculoskeletal conditions and disorders.
Results
A total of 60 physical therapists and 76 PCPs (43 family medicine physicians, 33 general practitioners) participated. Good knowledge levels (total score ≥ 75%) were found for 7% of physical therapists compared to 18% of PCPs, and moderate knowledge levels (total score 60–75%) for 70% of physical therapists compared to 62% of PCP participants (P = .003).
Conclusion
Physical therapists and PCPs in Saudi Arabia demonstrated an overall moderate level of musculoskeletal knowledge and the ability to identify red flags. The results suggest that with further education on red flags identification, physical therapists in Saudi Arabia could potentially act as first-contact practitioners for patients with musculoskeletal conditions and disorders.
One case report of epilepsy and rapidly progressive dementia after levofloxacin treatment
Authors: Su Zhan , Zhang Guimei , Shen Yanxin , Li Xiangting , Wang Zixun , Zhang Haining 
Published: September 2023

Abstract
Objective: To report a case of seizure and rapidly progressive dementia 20 minutes after intravenous administration of levofloxacin.
Case summary: A 56-year-old woman was admitted to hospital with episodic unconsciousness and unresponsiveness. About 4 days ago, she experienced a loss of consciousness, fell to the floor, and yelled for 2 minutes, 20 minutes before the first intravenous dose of levofloxacin. The patient developed symptoms of cognitive impairment after the seizure. Levofloxacin is a synthetic third generation fluoroquinolone used to treat various infectious diseases. Upon admission, the patient was conscious and unresponsive. After 11 days of symptomatic and supportive treatment, the patient was discharged from the hospital with cognition restored to baseline level and no recurrence of seizures 10 months after discharge.
Discussion:Epilepsy is a rare adverse reaction to levofloxacin treatment. The patient in this case had infection-related signs before the onset of the disease, and the disease progressed rapidly with fluctuating changes. After ruling out degenerative, infectious, toxic, and autoimmune causes, the patient's symptoms may be attributed to levofloxacin, and this is the first case of seizure and rapidly progressive dementia after levofloxacin injection reported in the literature. Clinicians should be aware that unexplained, rapidly progressing dementia with infection-related signs before onset may be a rare side effect of antibiotics.
How can we improve engagement with gestational diabetes self-management guidance and lifestyle change during pregnancy and beyond? A thematic analysis amongst a diverse sample of UK women
Authors: Moore AP. , Astbury NM. , Poduval S. , Ross J. 
Published: September 2023

Abstract
Background
Optimal management of gestational diabetes (GDM) during in pregnancy is important because of serious risk to mother and child in cases where glucose levels are poorly controlled. Furthermore, following a GDM pregnancy up to 50% of women in some populations will go onto develop type 2 diabetes (T2D) later in life. A risk which is 10 times higher than for women who have a normoglycaemic pregnancy and which can be reduced by lifestyle change and annual screening. This study is needed because there is a paucity of data from the UK setting exploring these factors amongst ethnically diverse women and there has also been a fundamental shift towards online care provision and use of apps in maternity care in recent years, which may influence how women engage with self-management. The aim of our study was to explore experiences and identify factors which could help women engage with GDM self-management guidance during pregnancy and with T2D risk prevention strategies postpartum, amongst a diverse sample of UK women.
Methods
Women were recruited from the community and targeted primary and secondary care settings to take part in an online or face to face qualitative interview. Community recruitment was prioritised to encourage engagement of women who may not normally access the research process. Interviews were audio-recorded and professionally transcribed. An inductive thematic content analysis was conducted.
Results
Thirty-five women took part in the interviews (66% were from minority ethnicities; 43% first-generation immigrants). Factors influencing engagement with pregnancy guidance were summarised in 6 themes: a psychological burden, for your baby you find a way, coping with the everyday, building resilience, the service provision, relational interactions, and with postpartum guidance: left at sea.
Conclusions
The use of apps, online peer support groups, personally-tailored lifestyle advice and empathetic online or face to face healthcare interactions, supported GDM self-management. Postpartum knowledge about the risks and useful steps for diabetes prevention was low and confusion was exacerbated by mixed messages from healthcare teams. Some women may benefit from community-situated peer support and culturally salient guidance.
Meta-analysis of the efficacy of titanium alloy ossicles and autologous ossicles in ossiculoplasty A survey to evaluate the efficacy of titanium alloy ossicles
Authors: Wen Liting , Zhao Tianfeng , Lin Zengping , Zeng Xiaoxia , Chen Peixiong , Zeng Xianhai 
Published: September 2023

Abstract
Background：Chronic suppurative otitis media destroys the ossicular chain，which can be cured by ossiculoplasty using different materials. We were interested in the material which may have a different effect on the recovery outcome and carried out this review.
Methods：A meta-analysis to compare the efficacy of titanium alloy ossiculoplasty with autologous ossiculoplasty was conducted. In addition to the published Chinese literature, other unpublished internal data were also collected, and the quality of the literature was scored according to the inclusion and exclusion criteria. A meta-analysis of the sample data was performed using Review Manager 5.0 statistical software. In the meta-analysis of the single-group rate, I2 was greater than 50, the data analysis used a random model, the combined rate was basically the same and the P values were less than 0.05.
Results：The meta-analysis of efficacy comparisons showed that the data for titanium alloy ossicles and autologous ossicles were basically the same for air-conduction hearing and bone-conduction hearing. The combined effect size of air-conduction hearing was -3.8, the 95% confidence interval (CI) was -5.7– -1.89 and the combined effect size of bone-conduction hearing was -5.7–-1.89. The effect size was 0.85, and the 95% CI was -1.31–3. The follow-ups at three months and six months and the postoperative adverse reaction rate were significantly better when titanium alloy ossicular bone was used for ossiculoplasty than autologous ossicular bone. The homogeneity of the study effect size was significant (I2 = 0, P > 0.05), and a fixed-effects model was used; the P value was less than 0.05, so the data were statistically significant.
Conclusion：In conclusion, for ossiculoplasty, titanium alloy is an effective material with good clinical results.
Trial registration: The protocol was registered at PROSPERO-International prospective register of systematic reviews (Centre for reviews and dissemination, University of York, York, United Kingdom). CRD42022364358.
Hip Preservation Surgery in Patients with Femoroacetabular Impingement Syndrome and Acetabular Dysplasia Improves Functional Measures and Pain Catastrophizing
Authors: De Souza Rafael , Montanez Benjamin , Nakonezny Paul A. , Gaddis John , Laboret Bretton , Bialaszewski Ryan , Wells Joel E. 
Published: September 2023

Abstract

Background Chronic hip pain is a debilitating condition which severely reduces one’s quality of life. Prior studies uncovered a link between hip pathologies and pain catastrophizing, anxiety and depression. The purpose of this study was to investigate whether hip preservation surgery in patients with femoroacetabular impingement syndrome (FAIS) and acetabular dysplasia (AD) improves functional outcomes and pain catastrophizing. Methods Patients with FAIS and AD were requested to complete a hip questionnaire both preoperatively and postoperatively at a single academic center (University of Texas Southwestern Medical Center, Dallas, Texas, USA). Pain catastrophizing was evaluated utilizing the Pain Catastrophizing Scale (PCS) and pain level was assessed using the visual analog scale (VAS). Assessments of hip functional outcomes included the Hip Outcome Score (HOS) and Hip Disability and Osteoarthritis Outcome Score (HOOS). Outcome measures before and after treatment were compared using the dependent samples t-test. A correlation analysis, using the Spearman partial correlation coefficient (rs), was conducted to evaluate the relationship between variables. Results The results indicated a clinically significant improvement in functional measures and pain catastrophizing in patients who underwent hip preservation surgery. The most significant discovery was an inverse relationship between both HOOS quality of life and HOS activities of daily living and pain catastrophizing; however, similar improvements were seen in pain catastrophizing with improvements in other functional outcomes. Conclusion Undergoing hip preservation surgery for patients with AD or FAIS improved their hip functional measures and decreased pain catastrophizing postoperatively. The results of this study enable providers to more accurately portray the functional and psychological benefits of hip preservation surgery to patients in order to tailor expectations and improve patient satisfaction.
Scalp myiasis presenting as forehead edema in a returning traveller from Belize
Authors: Martínez-Lacalzada Miguel , Vera Isabel , Álvarez-Martínez Miriam José , Aylagas Cristian , Almuedo-Riera Alex , Antequera Alba , Balerdi-Sarasola Leire , Camprubí-Ferrer Daniel , Muñoz Jose , Rodríguez-Valero Natalia 
Published: September 2023

Abstract
Objective: We present a case of furuncular myiasis in a returning traveller from Belize, characteristically presented with forehead/eyelid edema and two crusted papules on the scalp, atypical symptoms that led to an incorrect initial diagnosis of rickettsial infection.
Clinical case: A 60-year-old Venezuelan woman with no previous medical history presented with a 4-day history of the forehead and left eyelid edema and two subcentrimetric crusted lesions on the scalp frontoparietal area after tourism travel to Belize in the preceding month. She presented to a dermatological clinic 10 days after her arrival and a diagnosis of rickettsial infection was suspected based on clinical and epidemiological information, prescribing treatment with oral corticosteroids and doxycycline. After posterior evaluation in our outpatient clinic vaseline occlusion was carried out due to suspicion of scalp myiasis and antibiotic was suspended. Both larvae could be removed and the patient showed complete resolution of symptoms and recovery from the skin infestation.
Conclusion: The diagnosis of scalp myiasis in the context of atypical symptoms is challenging. Health professionals should be aware of this possible aetiology in facial/forehead edema in returning travellers from endemic regions.
Associations of polyﬂuoroalkyl chemicals and chronic bronchitis in the U.S. adults
Authors: Chen Chen , Han Guiling , Yang Ting , Zhang Shunan 
Published: September 2023

Abstract
Perfluoroalkyl chemicals (PFCs), present everywhere in the environment, have been proven to impact the respiratory system of children and adolescents adversely. Nevertheless, their effects on chronic bronchitis (CB), one of the most common clinical phenotypes of COPD, have not been characterized. We aimed to evaluate relationships between serum PFCs and CB in adults, including the presence of self-reported CB, respiratory symptoms, and levels of inflammatory biomarkers in the blood. Participants aged ≥ 40 years (N = 2862) in cross-sectional research from the 2007–2012 NHANES were considered and investigated their serum levels of 12 major PFC. Multivariable logistic or linear regression was used for the analyses of relationships between serum PFCs and CB, and subgroup analyses of the participants were carried out based on their self-reported asthma. In multivariable-adjusted models, we found that serum levels of total PFCs as well as several individual PFCs, such as PFUA, PFDE, PFOS, PFNA, MPAH, PFOA, and PFHxS, especially the PFUA and PFDE, were negatively correlated with the prevalence of CB, respiratory symptoms, and inflammatory biomarkers in the whole population. Subgroup analyses showed the potential modification effects of asthma on the associations of PFCs levels with respiratory symptoms and inflammatory biomarkers, including a statistically significant negative correlation with respiratory symptoms (chronic cough, coughing phlegm, wheezing, and shortness of breath) and levels of inflammatory blood biomarkers (CRP, WBC, and NEU) only in participants without asthma; and a statistically significant positive correlation with respiratory symptoms (chronic cough, coughing phlegm, and shortness of breath) and eosinophil (EOS) counts in participants with asthma. Our preliminary findings suggested that there are associations between serum levels of PFCs and CB-related clinical indicators in adults aged ≥ 40 years and that asthma factors may influence those relationships. Further replications of the associations in generalizable prospective cohort studies are warranted.
Peridomicillary peculiarities of rural communities in Goiás-Brazil, with families affected by arboviruses
Authors: Silva Adivânia Cardoso da , Baumman Luis Rodrigo Fernandes , Scalize Paulo Sergio 
Published: September 2023

Abstract
Arboviral diseases such as dengue, Zika and chikungunya infect populations in countries with predominantly tropical and subtropical environments, where their vectors are adapted. This research aimed to identify potential favorable sites to Aedes aegypti reproduction at rural communities where dengue, Zika and chikungunya prevalence is high, geographically located in Goiás-Brazil, and to analyze the relationship between breeding sites quantity and these three arboviruses seroprevalence. In 137 families from 13 rural communities, information was obtained between October/2021 and November/2021. Data were analyzed quantitatively and qualitatively trough Pearson's correlation and Cluster analysis. 92.7% of the households, possessed, at least one potential mosquito breeding ground. Water containers, despite of being uncovered, retain water and create an ideal environment for mosquito's evolutionary cycle. Potential breeding grounds were observed related, mainly, to the lack or absence of precariousness of basic sanitation services. The community with the highest number of breeding grounds and suspected vectors of Aedes aegypti was also the one that resulted in the highest number of patients with dengue fever. The presence of places for Aedes aegypti development in the studied environment may be responsible for arboviruses spread, affecting a significant part of the population. Therefore, the present study might warn municipal health authorities for implementing public policies such universal sanitation, as a measure that indirectly provides vector control especially Aedes aegypti, when it also proliferates in rural areas, risking the population health.
Role of EVs as promotors for activation of leukemia-derived dendritic cell (DCleu)-mediated antileukemic immune response against AML-blasts
Authors: Lin Li , Görgens André , Mussack Veronika , Pepeldjiyska Elena , Hartz Anne , Aslan Hazal , Rackl Elias , Rank Andreas , Schmohl Jörg , Krämer Doris , El-Andaloussi Samir , Pfaffl Michael , schmetzer helga 
Published: September 2023

Abstract
Myeloid leukemia blasts can be converted into dendritic cells of leukemic origin (DCleu), which effectively activate and enhance immune-cells against leukemic blasts. EVs modulate a plethora of physiological and pathological activities. EVs secreted by dendritic cells (DCs) can activate T lymphocytes, displaying potential as promoters of adaptive immune responses. DC/DCleu generation of healthy donors’ (n=9) and AML patients’ (n=9) whole blood (WB) were treated with Kit M (GM-CSF and PGE1) (vs. control), T-cell enriched mixed lymphocyte culture (MLC) with treated vs un-treated WB and antileukemic functional assays were quantified via flow cytometry. Qualitative and quantitative characterization EVs from DC/MLC culture supernatants (DCS/MLCS) in healthy and AML samples were measured. Kit M significantly increased frequencies of (mature) DC/DCleu compared to control without induction of blast proliferation. Kit M increased significantly activated (leukemia-specific) cells of the adaptive and innate immune system after T cell-enriched MLC compared to control. EVs were qualitatively and quantitatively different in DCS/MLCS with Kit M treated vs untreated from healthy vs AML samples by TEM, fNTA and MBFCM. These EVs findings and correlations with clinical parameters contribute to understand the functional role of EVs in DCS/MLCS from healthy and AML samples, with respect to develop new EV biomarkers.
Successful management of intraoperative cesarean section bleeding due to cervical arteriovenous malformation: a case report
Authors: Poonyakanok Vitcha , Jarutatsanangkoon Kridtin , Talungchit Pattarawalai 
Published: September 2023

Abstract
Background
Cervical arteriovenous malformation (AVM) is an exceedingly rare condition that can cause antepartum hemorrhage, resulting in perinatal and maternal morbidity. Diagnosing this condition definitively prior to delivery can prove challenging, especially when extensive bleeding necessitates emergency surgery.
Case presentation:
We report a case of a 30-year-old primigravida woman, at a gestational age of 31+ 2 weeks, who presented to the hospital with an initial episode of third-trimester antepartum hemorrhage. A speculum examination revealed a 500 mL blood clot and fresh blood in the vagina. Notably, the cervical os appeared closed and devoid of any abnormal lesions. Her antenatal care history and second-trimester ultrasonography were unremarkable. Despite a thorough clinical examination and ultrasonography, the cause of the antepartum hemorrhage remained elusive. An emergency cesarean section was initiated 30 minutes postadmission due to a subsequent episode of bleeding accompanied by hypovolemic shock and a fetal NICHD category III assessment. Following the delivery of the fetus, a pulsatile tubular structure was identified at the endocervix. Suture ligation was executed, followed by Bakri balloon insertion, effectively controlling the bleeding with an estimated blood loss of 1200 mL. After transfusing 4 units of packed red blood cells, the patient’s postpartum course progressed without complications. The newborn was discharged 49 days postdelivery. A pathological biopsy confirmed the intraoperative diagnosis of AVM.
Conclusion
Cervical AVM, although rare, poses a life-threatening risk. Obstetricians should remain vigilant regarding this condition, especially when faced with inexplicable antepartum hemorrhage, even in primigravida cases. Our case underscores the effectiveness of a combined approach—suture ligation and balloon tamponade—in managing the hemorrhage arising from this condition.
Exploring the relationship between malnutrition and the Systemic Immune-inflammation Index in older inpatients: a study based on Comprehensive Geriatric Assessment
Authors: Ma Yu-Cen , Ju Yan-Min , Cao Meng-Yu , Yang Di , Zhang Ke-Xin , Liang Hong , Leng Ji-Yan 
Published: September 2023

Abstract
Background Malnutrition is a prevalent and major challenge among senior citizens, possibly due to the continual low-grade inflammatory state of the body. A novel inflammatory parameter, the systemic immune-inflammation index (SII), is highly valuable in evaluating and predicting the prognosis of a wide range of diseases. This study aims to explore the significance of the SII in assessing malnutrition in older inpatients.
Methods This retrospective study included 500 senior hospitalized patients who met the inclusion and exclusion criteria from the Comprehensive Geriatric Assessment database of the First Hospital of Jilin University. The Mini-Nutritional Assessment (MNA) questionnaire was used to evaluate the nutritional status of patients. The SII was calculated using complete blood counts, and we performed natural logarithm transformation of the SII [ln(SII)]. Multivariable logistic regression analysis was used to identify the association between ln(SII) and undernutrition. To ensure the stability of the findings, a sensitivity analysis was conducted.
Results The 500 patients had a mean age of 77.29±9.85 years, and 68.6% were male. In accordance with the MNA, 30.4% of the patients were malnourished or at risk of malnutrition, and patients in this group had considerably greater levels of ln(SII) than patients with normal nutritional status (P < 0.001). Age, history of coronary heart disease, body mass index (BMI), calf circumference, body composition parameters, scale testing results, and polypharmacy were all added sequentially to a multivariable logistic regression model. The findings demonstrated that ln(SII) was an independent risk factor for the possibility of malnutrition or undernutrition in older individuals. (OR 3.984, 95% CI = 2.426-6.543, P< 0.001). Other metrics from the geriatric comprehensive assessment, including BMI, calf circumference, fat ratio, activities of daily living and instrumental activities of daily living, and geriatric depression scale scores, were also independently correlated with nutritional status.
Conclusions According to our research, a high SII is an independent predictor of older inpatient malnutrition, and the SII aids in screening for malnutrition and may be a potential target for intervention. Geriatric comprehensive assessment parameters such as BMI, calf circumference, fat ratio, activities of daily living and depression were also linked to malnutrition.