bluuebunny/crossref_metadata_2025_split huggingface dataset:
“Don’t Turn a Blind Eye”: An Instruction for Supporting Meaningful Conversations About Gender-Based Violence During Perinatal Care
Authors: Mirlashari Jila , Pederson Ann , Lyons Janet , Brotto Lori A. 
Published: May 2023

Background and purpose Evidence suggests that Gender-based violence (GBV) is prevalent throughout the perinatal period. Women during this time have frequent contact with healthcare providers (HCPs), and there are many opportunities that HCPs can identify GBV and support women by early intervention during routine prenatal care. However, evidence shows that HCPs are still hesitant to address this issue. This study was conducted to explore the experiences of Survivors and HCPs on how to manage a meaningful conversation about GBV with survivors during perinatal care. Methods A thematic approach has been used in this qualitative study. Results Twenty-eight semi-structured interviews were conducted with survivors and HCPs. Three main themes emerged from the data analysis, including: “Knock gently on the door to enter the client's private world”, “Show interest in clients’ stories that are beyond their physical problems” and “Gradually and cautiously cross the hidden borders.” Conclusion HCPs play a pivotal role in identifying GBV and providing support for survivors, particularly during their perinatal period. However, initiating a conversation around this sensitive topic needs time, skill, and enough knowledge. Validating survivors’ experiences, providing a private and safe atmosphere without judgment, and creating empathy could lead to more disclosure of GBV. To have a meaningful conversation, HCPs need to have a holistic approach toward care, show interest in clients’ stories beyond their physical problems, and support clients who have shared sensitive information.
Self-reported autistic traits and psychosocial outcomes among university students in Malaysia
Authors: Low Hui Min , Zainal Mohd Syazwan , Pang Jee Ching , Ang Yammy , de Vries Marieke 
Published: May 2023

An autism spectrum condition is considered a lifelong condition. Affected individuals typically experience poorer psychosocial outcomes compared to non-autistic individuals. However, in Southeast Asian countries such as Malaysia, research about autism spectrum conditions beyond the early childhood context is scarce, and therefore, the prevalence and psychosocial outcomes of young adults with autism spectrum conditions remain largely unknown. This study aims to explore self-reported autistic traits among university students in Malaysia, and their relation to emotion regulation, stress, self-efficacy and quality of life. Data from 2732 students revealed that 0.3% of the students reported having an autism spectrum condition diagnosis, while 2.5% reported that they suspected having an autism spectrum condition, but did not obtain a formal diagnosis. This indicates that an estimated 2.8% of students might have a diagnosed or suspected autism spectrum condition. These two categories of students were found to have poorer self-efficacy, higher perceived stress and poorer quality of life, as compared to their peers. However, these students were not significantly different from their peers in emotion regulation. Overall, the findings pointed to negative psychosocial outcomes associated with autism spectrum condition and culture-specific associations between autistic traits and psychosocial outcomes. Lay abstract Most research on autism spectrum conditions is done on young children and not as much on young adults with autism spectrum conditions. Because of this, not much is known about how common autism spectrum conditions are in young adults and how they affect their mental and social health, especially in Southeast Asia. Based on self-reports, 2.8% of the 2732 university students we looked at in Malaysia might have been diagnosed or thought to have an autism spectrum condition. Students who said they had or thought they had autism spectrum conditions had lower self-efficacy, more stress and a lower quality of life than students who said they did not have autism spectrum conditions. The results showed that university students with autism spectrum condition are more likely to have bad psychological and social outcomes than their peers without autism spectrum condition. Also, the link between autistic traits and psychosocial outcomes could depend on the culture.
Long-Term Outcomes of Sternal-Sparing Versus Sternotomy Approaches for Mitral Valve Repair: Meta-Analysis of Reconstructed Time-to-Event Data
Authors: Sá Michel Pompeu , Jacquemyn Xander , Erten Ozgun , Van den Eynde Jef , Caldonazo Tulio , Doenst Torsten , Ruhparwar Arjang , Weymann Alexander , de Souza Rodrigo Oliveira Rosa Ribeiro , Rodriguez Roberto , Ramlawi Basel , Goldman Scott 
Published: May 2023

Objective: Since there are concerns about the durability of mitral valve repair (MVRp) with minimally invasive techniques in patients with mitral regurgitation (MR), we aimed to evaluate the long-term outcomes of these sternal-sparing approaches when compared with conventional approaches with sternotomy in patients undergoing MVRp. Methods: We performed a systematic review according to a preestablished protocol and performed a pooled analysis of Kaplan–Meier–derived reconstructed time-to-event data from studies with longer follow-up comparing sternal-sparing versus sternotomy approaches for MVRp. Our outcomes of interest were survival, freedom from recurrent MR, and freedom from reoperation. Results: Eleven studies met our eligibility criteria comprising 7,596 patients with follow-up (sternal sparing, n = 4,246; sternotomy, n = 3,350). Patients who underwent sternal-sparing MVRp had a significantly lower risk of mortality over time compared with patients who underwent MVRp with sternotomy (hazard ratio [HR] = 0.29, 95% confidence interval [CI]: 0.23 to 0.36, P < 0.001) in the overall analysis. However, we found no statistically significant difference between the groups in the sensitivity analysis with adjusted populations (HR = 0.85, 95% CI: 0.63 to 1.15, P = 0.301). Regarding the outcomes freedom from recurrent MR and freedom from reoperation, we found no statistically significant differences between the groups in the follow-up in both overall and sensitivity analyses. Conclusions: In comparison with MVRp with sternotomy approaches, sternal-sparing MVRp was not associated with worse outcomes in terms of survival, recurrent MR, and reoperations over time.
Case report: Prolonged amelioration of mild red-green color vision deficiency following psilocybin mushroom use
Authors: Barnett Brian S. , Sweat Noah Wiles , Hendricks Peter S. 
Published: May 2023

Background Recent survey data indicate that some people report long-term improvement in color vision deficiency (CVD), also known as color blindness, following use of psychedelics such as lysergic acid diethylamide (LSD) and psilocybin. However, there are no objective data reported in the medical literature quantifying the degree or duration of CVD improvement associated with psychedelic use. Case presentation Here we present the case of a subject with red-green CVD (mild deuteranomalia) who self-administered the Ishihara Test to quantify the degree and duration of CVD improvement following the use of 5 g of dried psilocybin mushrooms. Self-reported Ishihara Test data from the subject revealed partial improvement in CVD peaking at 8 days and persisting for at least 16 days post-psilocybin administration. This improvement may have lasted longer, though the subsequent observations are confounded by additional substance use. Conclusion A single use of psilocybin may produce partial improvements in CVD extending beyond the period of acute effect, despite this condition typically resulting from a genetic defect. Systematic exploration of this possible phenomenon is needed to confirm our findings, gauge their generalizability, and determine the mechanism of action.
An artificial intelligence-based chatbot for prostate cancer education: Design and patient evaluation study
Authors: Görtz Magdalena , Baumgärtner Kilian , Schmid Tamara , Muschko Marc , Woessner Philipp , Gerlach Axel , Byczkowski Michael , Sültmann Holger , Duensing Stefan , Hohenfellner Markus 
Published: May 2023

Introduction Artificial intelligence (AI) is increasingly used in healthcare. AI-based chatbots can act as automated conversational agents, capable of promoting health and providing education at any time. The objective of this study was to develop and evaluate a user-friendly medical chatbot (prostate cancer communication assistant (PROSCA)) for provisioning patient information about early detection of prostate cancer (PC). Methods The chatbot was developed to provide information on prostate diseases, diagnostic tests for PC detection, stages, and treatment options. Ten men aged 49 to 81 years with suspicion of PC were enrolled in this study. Nine of ten patients used the chatbot during the evaluation period and filled out the questionnaires on usage and usability, perceived benefits, and potential for improvement. Results The chatbot was straightforward to use, with 78% of users not needing any assistance during usage. In total, 89% of the chatbot users in the study experienced a clear to moderate increase in knowledge about PC through the chatbot. All study participants who tested the chatbot would like to re-use a medical chatbot in the future and support the use of chatbots in the clinical routine. Conclusions Through the introduction of the chatbot PROSCA, we created and evaluated an innovative evidence-based health information tool in the field of PC, allowing targeted support for doctor–patient communication and offering great potential in raising awareness, patient education, and support. Our study revealed that a medical chatbot in the field of early PC detection is readily accepted and benefits patients as an additional informative tool.
An Analysis of Nicotine Pouch Use by Middle School and High School Students Surveyed by the National Youth Tobacco Survey in 2021 and a Review of the Literature
Authors: Speciale Zachary , Rao Sanjana , Yang Shengping , Nugent Kenneth 
Published: May 2023

Objectives: The use of alternative nicotine products by middle and high school students is a growing concern due to industry marketing techniques, availability, and popularity of new products, and ambiguous nicotine concentrations. The 2021 National Youth Tobacco Survey (NYTS) provides information about the frequency, and characteristics of middle, and high school students who have used nicotine pouches. Methods: The National Youth Tobacco Surveys provide important information about the frequency of use of tobacco and alternative nicotine products by a representative sample of students in schools in the United States. The 2021 survey included questions about the use of nicotine pouches/dissolvable tobacco products. The results from the survey were analysis using descriptive statistics, and logistic regression to model the association between the use of these alternative nicotine products, and the use of electronic cigarettes or the use of conventional cigarettes. Results: A total of 20 413 students participated in the survey year 2021; 17 842 were included in the final data analysis. Their ages ranged from 9 to 18+. Identified risk factors for the use of alternative nicotine products included race, and age. The adjusted odds ratio (OR) was lower in non-Hispanic Black and Hispanic students, as compared to non-Hispanic White students. Older students had a substantially higher risk of using nicotine/dissolvable tobacco products, specifically, compared to students less than or equal to 13 years old. The OR increased 174% (OR: 2.74; 1.70-4.41) in 17-year-old students. The perception of harm associated with electronic cigarettes increased the likelihood of using alternative nicotine products. Students who did not smoke cigarettes (OR: 0.39; 0.27-0.56) or did not smoke electronic cigarettes (OR: 0.20; 0.18-0.40) had significantly lower OR for using alternative nicotine products. Conclusions: The 2021 National Youth Tobacco Survey indicates that a relatively small percentage of middle school and high school student have used nicotine pouches. However, with the increase in new, alternative tobacco products, understanding adolescent use in comparison to other tobacco products is an important trend to monitor.
The Effect of COVID-19 on Spine Surgery
Authors: Mills Emily S. , Mertz Kevin , Faye Ethan , Ton Andy , Wang Jeffrey C. , Hah Raymond J. , Alluri Ram K. 
Published: May 2023

Study Design Retrospective cohort analysis Objective To characterize the impact of COVID-19 on utilization of the ten most common spine procedures and percentages of outpatient procedures. Methods The PearlDiver national database was queried from January 2010 to April 2021 for short (<6 segments) and long segment posterior instrumented fusion (≥6 segments), posterior cervical fusion, anterior cervical decompression and fusion (ACDF), cervical laminectomy, laminoplasty, and disc arthroplasty, lumbar laminectomy, microdiscectomy, and interbody fusion. Annual procedure utilization between January 2010 through April 2021 was recorded and compared. Monthly trends were compared to January 2020. Outpatient trends were compared between 2010-2019 and 2019-2021 using segmented linear regression. Results Overall, all ten procedures decreased 4.3% in 2020 compared to 2019 and increased 6.3% in 2021 compared to 2019. March and April of 2020 had the largest decreases, with March 2020 decreasing 18.2% and April 2020 decreasing 51.6% compared to January 2020. Despite increasing COVID cases in January 2021, overall procedure utilization decreased only 1.8% compared to January 2020, and increased later in 2021 with April 2021 case volumes increasing by 138% compared to January 2020. Outpatient utilization of short segment posterior lumbar fusion and lumbar interbody fusion significantly increased during this time ( P < .001). Conclusion The greatest impact on spine surgery volume from the COVID-19 pandemic occurred in March and April 2020. Spine procedure utilization was otherwise similar or increased compared to January 2020. Additionally, the volume of outpatient short segment posterior fusion and lumbar interbody fusions increased during this time period.
Risk Factors for Postoperative Ileus Following Spine Surgery: A Systematic Review With Meta-Analysis
Authors: Chang Yu , Wong Chia-En , Chen Wei-Cheng , Hsu Hao-Hsiang , Lee Po-Hsuan , Huang Chi-Chen , Lee Jung-Shun 
Published: May 2023

Study design Systematic review and meta-analysis Objectives Postoperative ileus (POI) can negatively impact patient recovery and surgical outcomes after spine surgery. Emerging studies have focused on the risk factors for POI after spine surgery. This study aimed to review the available literature on risk factors associated with POI following elective spine surgery. Methods Electronic databases were searched to identify relevant studies. Meta-analysis was performed using random-effect model. Risk factors for POI were summarized using pooled odds ratio (OR) with 95% confidence intervals (CI). Results Twelve studies were included in the present review. Meta-analysis demonstrated males exhibited a higher risk of POI than females odds ratio (OR, 1.76; 95% CI, 1.54-2.01). Patients with anemia had a higher risk of POI than those without anemia (OR, 1.48; 95% CI, 1.04-2.11). Patients with liver disease (OR, 3.3; 95% CI, 1.2-9.08) had a higher risk of POI. The presence of perioperative fluid and electrolyte imbalances was a predictor of POI (OR, 3.24; 95% CI, 2.62-4.02). Spine surgery involving more than 3 levels had a higher risk of POI compared to that with 1-2 levels (OR, 1.82; 95% CI, 1.03-3.23). Conclusions Male sex and the presence of anemia and liver disease were significant patient factors associated with POI. Perioperative fluid and electrolyte imbalance and multilevel spine surgery significantly increased the risk of POI. In addition, through this comprehensive review, we identified several perioperative risk factors associated with the development of POI after spine surgery.
Do Outcomes Differ After Proximal Hamstring Repair for Patients Receiving Workers’ Compensation?
Authors: Sullivan Kali J. , Nemec Sophie M. , Mahendraraj Kuhan A. , Swanson Daniel P. , Saini Sundeep S. , Miller Suzanne L. 
Published: May 2023

Background: Patients with workers’ compensation (WC) insurance claims are often shown to experience inferior patient-reported outcomes (PROs) after an orthopaedic surgical intervention compared with patients without WC claims. Purpose: To compare the postoperative PROs of patients with WC claims (WC patients) versus those without WC claims (non-WC patients) after proximal hamstring repair (PHR). Study Design: Cohort study; Level of evidence, 3. Methods: WC patients who underwent PHR between November 2011 and to September 2020 were propensity score matched at a 1:2 ratio to non-WC patients according to age, sex, and body mass index. Comorbidity data were collected as well as minimum 1-year postoperative PRO scores for the Lower Extremity Functional Scale (LEFS), the Hip Outcome Score (HOS), and the 12-Item Short From Health Survey (SF-12) Physical Component Summary (PCS) and Mental Component Summary (MCS). The type of work was characterized according to national WC insurance guidelines as light (maximum 20 lbs [9.1 kg]), medium (maximum 50 lbs [22.7 kg]), or heavy (≥50 lbs) [>/=22.7 kg]. Results: A total of 30 patients (10 WC and 20 non-WC) were included. The work type and baseline demographic characteristics of patients did not differ between groups. There were no significant between-group differences in postoperative PRO scores as measured by the LEFS ( P = .488), HOS ( P = .233), or SF-12 PCS ( P = .521). However, the WC cohort showed inferior SF-12 MCS scores compared with the non-WC group (49.28 ± 9.97 vs 54.26 ± 9.69, respectively; P = .032). The WC status was also associated with an increased time needed for patients to return to full-duty work capacity (21 ± 9 vs 9 ± 8 weeks; P = .005). Conclusion: Our findings suggest that WC and non-WC patients who undergo PHR have comparable outcomes. Differences in SF-12 MCS scores and return to work time for full-duty capacity warrant further investigation.
Nasal Cavity Length or Analyzed Nasal Segment of Acoustic Rhinometry in Thai Adults
Authors: Assanasen Paraya , Suwanwech Triphoom , Pinkaew Bannapuch , Khongsri Anupa , Keskool Phawin 
Published: May 2023

Background Nasal cavity length (NCL) is important for determining analyzed nasal segment (ANS) of acoustic rhinometry (AR). AR is a technique for nasal airway assessment which nasal cross-sectional areas and nasal volume (NV) are obtained. NCL or ANS is the important parameter to determine NV measured by AR. The ANS used to calculate NV in previous literatures vary from 4 to 8 cm. However, there has not been any study regarding NCL of Asians which is probably different from that of Western countries. Objectives To measure NCL in Thai adults using nasal telescope and compared NCL between left and right sides as well as male and female as well as among age groups. Design Prospective study Methods This study was performed on patients, aged 18–95 years, who underwent nasal telescopy under local anesthesia at the Department of Otorhinolaryngology, Siriraj Hospital. Baseline characteristics (sex and age) of patients were collected. NCL (from anterior nasal spine to posterior edge of nasal septum) of both nasal cavities was measured using rigid nasal telescope of 0 degree. Mean NCL length of both nasal cavities was calculated. Results There were 1277 patients, with 498 (39%) male and 779 (61%) female. The mean ± standard deviation (SD) of NCL of male was 6 ± 0.6 cm whereas that of female was 5.7 ± 0.5 cm. There were no significant differences in NCL between left and right sides as well as among age groups in each gender (p > 0.05 all). However, male had significantly longer NCL compared with that of female (p < 0.001). The mean ± SD of NCL of total population was 5.9 ± 0.6 cm. Conclusion The NCL of Thais was approximately 6 cm. These data are useful to determine ANS used to calculate NV when AR is performed. Plain Language Summaries The length of nasal cavity (LNC) is important variable for acoustic rhinometry (AR) which is the instrument to measure nasal volume (NV). We use AR in clinical researches to diagnose and monitor the results of treatment of nose and sinus diseases The LNC used to calculate NV in previous studies vary from 4 to 8 cm. However, there has not been any study of LNC of Asians which is probably different from that of Western countries We measured LNC in 1277 Thai adults, aged 18–95 years, with 498 (39%) male and 779 (61%) female using nasal rigid endoscope and compared LNC between male and female. The average of LNC was 5.9 cm. Male had longer LNC compared with that female. The LNC of Thais was approximately 6 cm. These data are useful for AR to calculate NV.
Melatonin and erastin emerge synergistic anti-tumor effects on oral squamous cell carcinoma by inducing apoptosis, ferroptosis, and inhibiting autophagy through promoting ROS
Authors: Wang Leilei , Wang Chuan , Li Xuan , Tao Zhuoying , Zhu Wangyong , Su Yuxiong , Choi Wing Shan 
Published: May 2023

Abstract
Background
Oral squamous cell carcinomas are one of the most common cancers worldwide with aggressive behavior and poor prognosis. Reactive oxygen species (ROS) are associated with cancer and cause various types of regulated cell death (RCD). Inducing the RCD pathway by modulating ROS levels is imperative to conquer cancers. The aim of this study is to investigate the synergistic anticancer effects of melatonin and erastin on ROS modulation and subsequent RCD induction.

Methods
Human tongue squamous cell carcinoma cell lines (SCC-15 cells) were treated with melatonin, erastin, or their combination. Cell viability, ROS levels, autophagy, apoptosis, and ferroptosis levels were tested according to the results of the PCR array, which were verified with/without the induction and inhibition of ROS by H2O2 and N-acetyl-L-cysteine, respectively. In addition, a mouse-based subcutaneous oral cancer xenograft model was constructed to identify the effects of melatonin, erastin, and their combination on the autophagy, apoptosis, and ferroptosis levels in isolated tumor tissues.

Results
ROS levels were increased by the administration of melatonin at high concentrations (mM), and the combination of melatonin with erastin enhanced the levels of malonic dialdehyde, ROS, and lipid ROS, and reduced the levels of glutamate and glutathione. SQSTM1/p62, LC3A/B, cleaved caspase-3, and PARP1 protein levels in SCC-15 cells were also increased by melatonin plus erastin treatment, which further increased as ROS accumulated, and decreased as ROS levels were suppressed. Combined treatment of melatonin and erastin markedly reduced the tumor size in vivo, demonstrated no obvious systemic side effects, and significantly enhanced the apoptosis and ferroptosis levels in the tumor tissues, in parallel with decreased autophagy levels.

Conclusions
Melatonin combined with erastin exhibits synergistic anticancer effects without adverse reactions. Herein, this combination might become a promising alternative strategy for oral cancer treatment.

Graphical Abstract