bluuebunny/crossref_metadata_2025_split huggingface dataset:
School Health Teachers as Partners in Diabetes Caring: Maternal Perspectives
Authors: Uhm Ju-Yeon , Choi Mi-Young 
Published: August 2023

Background: The absence of primary care providers’ participation in school health care may require close collaboration between school health teachers and parents. This study explores maternal perspectives on obstacles and improvements in partnerships with school health teachers of children with type 1 diabetes. Methods: Participants were recruited using purposive sampling through an online type 1 diabetes self-help group in South Korea. Twenty-two mothers whose children were aged between 7 and 13 and had been diagnosed with type 1 diabetes at least 1 year ago were included. Individual interviews were conducted based on a semi-structured interview guide from February to June 2019. Qualitative data were analyzed using inductive content analysis comprising open coding, coding sheets, grouping, categorization, and abstraction. Results: Mothers recognized obstacles in eight categories and improvements in nine categories under institutional, interpersonal, and intrapersonal aspects of the partnership with school health teachers. Respondents recognized insufficient legal coverage and guidelines, and also health teacher shortage and workload as obstacles in the institutional dimension. Mothers perceived building trust, compromising to balance responsibilities, and constant and open communication as improvements in the interpersonal dimension. They recognized practical competency and tailored care for ordinary school life as school health teacher-related improvements. Conclusions: The findings indicate that school health teachers should compromise to balance responsibilities to improve partnerships with parents in the school health care setting. Institutional improvements, such as establishing robust laws and clear guidelines and increasing the number of school health teachers, should be prioritized.
Radiomics analysis of pericoronary adipose tissue based on plain CT for preliminary screening of coronary artery disease in patients with type 2 diabetes mellitus
Authors: Chen Meng , Hu Jingcheng , Chen Can , Hao Guangyu , Hu Su , Xu Jialiang , Hu Chunhong 
Published: August 2023

Background Type 2 diabetes mellitus (T2DM) is associated with a markedly increased prevalence of coronary artery disease (CAD). Radiomics features of pericoronary adipose tissue (PCAT) were correlated with inflammation, which may have potential value in the prediction of CAD. Purpose To determine whether radiomics analysis of PCAT captured by plain computed tomography (CT) could predict obstructive CAD in patients with T2DM. Material and Methods The study included 155 patients with T2DM with suspected CAD between January 2020 and December 2021. Volumes of right coronary artery of 10–50 mm were delineated in the plain CT to extract radiomics features and PCAT CT attenuation (PCATa). Least absolute shrinkage and selection operator was used to select the useful radiomics features to calculate the radiomics score (Rad-score). Univariate and multivariable logistic regression were applied to select independent predictors. The predictive performance was evaluated by the area under the receiver operating characteristics curve (AUC). Results Rad-score (per 0.1 increments: odds ratio [OR] = 1.297; P < 0.001), coronary artery calcium score (CACS) (OR = 1.003; P = 0.037), and sex (OR = 3.245; P = 0.026) were identified as independent predictors for obstructive CAD. Rad-score (AUC = 0.835) outperformed CACS (AUC = 0.780), sex (AUC = 0.665), and PCATa (AUC = 0.550) in predicting obstructive CAD ( P = 0.017 and 0.003 for Rad-score vs. sex and PCATa, respectively); however, the improvement between Rad-score and CACS had no statistical significance ( P = 0.490). Conclusion Plain CT-derived Rad-score may be used as a preliminary screening tool for obstructive CAD in patients with T2DM.
Bletilla striata composite nanofibrous membranes prepared by emulsion electrospinning for enhanced healing of diabetic wounds
Authors: Zhao Kai , Hu Zhengbo , Zhou Mingyuan , Chen Yuchi , Zhou Fangmei , Ding Zhishan , Zhu Bingqi 
Published: August 2023

Diabetic wounds impose enormous distress and financial burden on patients, and finding effective dressings to manage wounds is critical. As a Chinese herbal medicine with a long history of Clinical application, Bletilla striata has significant medicinal effects in the therapy of various wounds. In this study, PLA and the pharmacodynamic substances of Bletilla striata were prepared into fibrous scaffolds by emulsion electrospinning technology for the management of diabetic wounds in mice. The results of scanning electron microscopy showed that the core-shell structure fibre was successfully obtained by emulsion electrospinning. The fibre membrane exhibited excellent water absorption capability and water vapor transmission rate, could inhibit the growth of Staphylococcus aureus and Pseudomonas aeruginosa, had good compatibility, and achieved excellent healing effect on diabetic wounds. Especially in the in vivo wound healing experiment, the wound healing rate of composite fibre membrane treatment reached 98.587 ± 2.149% in 16 days. This work demonstrated the good therapeutic effect of the developed fibrous membrane to diabetic wound, and this membrane could be potentially applied to chronic wound healing.
Selenium- and/or copper-substituted hydroxyapatite: A bioceramic substrate for biomedical applications
Authors: Korowash Sara I , Keskin-Erdogan Zalike , Hemdan Bahaa A , Barrios Silva Lady V , Ibrahim Doreya M , Chau David YS 
Published: August 2023

Atomic substitution or doping of a bioceramic material hydroxyapatite (HA) with specific ions is an appealing approach for improving its biocompatibility and activity, as well as imparting antibacterial properties. In this study, selenium- and/or copper-substituted hydroxyapatite powders were synthesized by an aqueous precipitation method and using the freeze-drying technique. The molar concentrations of constituents were calculated based on the proposed mechanism whereby selenium (Se4+) ions partially substitute phosphorus (P5+) sites, and copper (Cu2+) ions partially substitute (Ca2+) sites in the HA lattice. Dried precipitated samples were characterized using Inductively coupled plasma optical emission spectroscopy (ICP-OES), X-ray diffraction analysis (XRD), Fourier-transform infrared spectroscopy (FTIR) and Field-emission scanning electron microscopy with energy dispersive X-ray spectroscopy (FESEM-EDX). Accordingly, substitution of Se4+ and/or Cu2+ ions took place in the crystal lattice of HA without the formation of any impurities. The presence of sulphur (S2-) ions in the hydroxyapatite was detected by ICP-OES in all samples with copper substituted in the lattice. The cytotoxicity of the powders on osteoblastic (MC3T3-E1) cells was evaluated in vitro. Selenium substituted hydroxyapatite (SeHA), at the concentration (200 μg/mL), demonstrated higher populations of the live cells than that of control (cells without powders), suggesting that selenium may stimulate the proliferation of these cells. In addition, the copper substituted hydroxyapatite (CuHA) and the selenium and copper substituted hydroxyapatite (SeCuHA) at the concentrations (200 and 300 μg/mL) and (200 μg/mL), respectively demonstrated better results than the unsubstituted HA. Antimicrobial activity was assessed using a well-diffusion method against Streptococcus mutans and Candida albicans, and superior results has obtained with SeCuHA samples. Presented findings imply that selenium and/or copper substituted modified hydroxyapatite nanoparticles, may be an attractive antimicrobial and cytocompatible substrate to be considered for use in a range of translational applications.
The nurses’ perception of the factors influencing professional misconduct: A qualitative study
Authors: Ghobadi Akram , Sayadi Leila , Nayeri Nahid Dehghan , Shabestari Alireza Namazi , Varaei Shokoh 
Published: August 2023

Background Professional misconduct undermines safe and quality care; however, little is known about its nature and influential factors. Aim This study aimed to explain the factors influencing professional misconduct in nurses. Research Design This qualitative study was conducted using the conventional content analysis method. Participants and Research Context Data were collected using semi-structured interviews with 19 nurses working in the hospital selected through a purposeful method and analyzed by Graneheim and Lundman approach. Ethical Considerations The ethics committee of Tehran University of Medical Sciences approved this study with the ethics code IR.TUMS.FNM.REC.1400.187. Informed consent was obtained from all participants. Participants were assured of confidentiality. Findings Factors influencing professional misconduct by nurses were categorized into three main categories: human factors (nurses’ professional characteristics, personal characteristics of nurses and patient/companion, patient’s clinical condition), procedural factors (procedural conditions, possibility of proving misconduct), and organizational factors (recruitment process, conditions of resources, managing misconduct, bureaucracy, and ward characteristics). Conclusion This study assists in explaining the factors influencing professional misconduct by nurses. Therefore this study’s results can help managers and planners develop interventions to prevent and correct factors that contribute to misconduct and strengthen factors that prevent misconduct in order to ensure quality and safe patient care.
Histopathologic Findings in Large for Gestational Age Placentas and Correlation With CD15 Immunohistochemistry
Authors: Mehreen Ansa , Suresh Sunitha , Freedman Alexa A. , Ernst Linda M. 
Published: August 2023

Background: The histopathology and CD15 expression in large for gestational age (LGA) placentas is not well-documented. Methods: To analyze this, we utilized 2 separate cohorts of placentas from singleton term deliveries. LGA and appropriate for gestational age (AGA) placentas were compared for major histopathologies including acute and chronic inflammation, maternal and fetal vascular malperfusion, delayed villous maturation (DVM), and villous hypervascularity/chorangiosis. We also examined CD15 immunohistochemistry in LGA and AGA placentas. Stained slides were reviewed blinded to the placental weight. Five random 20× fields were scored semi-quantitatively for CD15 staining of villous capillaries on a scale of 0 to 5 (0 = 0%, 1 = 1%-5%, 2 = 5%-25%, 3 = 25%-50%, 4 = 50%-75%, and 5 = >75%). Results: In 1 cohort, 1238 LGA and 7908 AGA placentas were identified. Patients with LGA placentas were significantly more likely to have higher birthweight babies, obesity, hypertensive disorders, pre-gestational, and gestational diabetes. Also, LGA placentas had a higher prevalence of fetal vascular malperfusion, DVM, and villous chorangiosis. In other cohort of 75 LGA placentas and 73 AGA controls, the average score of CD15 staining in villous capillaries was significantly higher amongst LGA placentas. Conclusion: We conclude that LGA placentas have increased expression of CD15 in villous capillary endothelium and higher prevalence of FVM, DVM, and villous chorangiosis than AGA placentas.
Nerve ultrasound reference values in children and adolescents: Echogenicity and influence of anthropometric factors including hand volume
Authors: Yusuf Ifirae , Mork Hannah , Erdlenbruch Bernhard , Schellinger Peter Dieter , Philipps Jörg 
Published: August 2023

Background Nerve cross-sectional area (CSA) reference values in high-resolution ultrasound for children and adolescents are influenced by demographic and anthropometric factors such as age, height and weight. Objectives The influence of hand volume as an additional morphometric factor was evaluated and nerve echogenicity was analyzed in a prospective cross-sectional study. Methods CSA were measured in 30 healthy children and adolescents from 2 to 17 years in the median, ulnar, radial, tibial, peroneal and sural nerves. Height, weight, age, handedness and gender were recorded, the volume of the hands was measured using the water displacement method. The intra-nerve CSA variability (INV), left/right ratios and absolute differences were calculated. Age groups were compared by the Kruskal-Wallis test. The influence of demographic factors was analyzed using Spearman correlation and multiple linear regression. Echogenicity and fraction of black were determined for each nerve segment. Results Nerve CSA values were consistently lower than those reported for adults and correlated in all measured nerve sites with age, height, weight and hand volume. Weight showed the highest correlation coefficient (R = .95) with the best fitting model predicting CSA. Correlation coefficients were higher in a linear than in a logarithmic model. Ratios were stable, the absolute differences increased with age and were significantly different between age groups. Most nerves showed a mixed or hypoechogenic pattern in echogenicity analysis, hyperechogenicity is less frequently observed. Conclusions Nerve CSA in children and adolescents is lower than in adults and increases proportionally during growth with a constant INV and left/right ratio in different age groups. Weight and age are predominant anthropometric factors predicting nerve size. Hand volume is correlated with nerve size, but does not predict CSA independently. Echogenicity can provide additional information on nerve structure.
Portal Selection for Suture Anchor Placement During Hip Arthroscopic Labral Repair: A Study Based on 3-Dimensional Model Reconstruction
Authors: Chen Qi , Zou Jiyang , Wang Fusheng , Qiao Kai , Li Han , Zhang Weiguo , Tian Kang 
Published: August 2023

Background: Arthroscopic suture repair is the main treatment option for hip labral tears; however, anchor insertion and placement from arthroscopic portals is difficult. Purpose: To quantitatively evaluate the safety of various arthroscopic portals for suture anchor placement during hip labral repair. Study Design: Descriptive laboratory study. Methods: The computed tomography scans of 20 patients with normally developed hip joints were used to create 3-dimensional models. The distances from the anchor to the articular cartilage (DAC) and from the acetabular insertion point to the cortical bone (DCB) were measured in the anterolateral portal (AL), posterolateral portal (PL), midanterior portal (MAP), medial MAP, and 3 distal anterolateral accessory portals (DALAs): DALA-proximal, DALA-middle, and DALA-distal. Labral tears were divided into anterior (4, 3, and 2 o’clock), lateral (1, 12, and 11 o’clock), and posterior (10, 9, and 8 o’clock) acetabular zones, and the Kruskal-Wallis and Mann-Whitney U test were used to compare DAC and DCB in the zones. The success rate was defined as anchors placed with DAC ≥1 mm and DCB ≥15 mm. Results: The DAC was significantly smaller in the AL at 1 o’clock (0.68 ± 0.32 mm; P < .001) and 12 o’clock (0.37 ± 0.30 mm; P < .001), and in the PL at 12 o’clock (-0.35 ± 0.38 mm; P < .001) and 11 o’clock (0.60 ± 0.24 mm; P < .001). The DCB was significantly smaller in the DALA-P at 3 o’clock (8.93 ± 2.12 mm; P < .001) and 11 o’clock (9.59 ± 2.84 mm; P < .001), the MAP at 12 o’clock (13.76 ± 3.89 mm; P < .001) and 11 o’clock (0.27 ± 0.27 mm; P < .001), and the MMA at 12 o’clock (5.96 ± 2.31 mm; P < .001) and 11 o’clock (0 mm; P < .001). Success rates were high for MAP and MMA between 4 o’clock and 1 o’clock, for DALA-proximal at 12 o’clock, for AL at 11 o’clock, and for PL between 10 o’clock and 8-o’clock. Conclusion: There were significant differences in the success rate of anchor placement using different portals during hip arthroscopic labral repair. Clinical Relevance: MAP is recommended for labral repair between 4 o’clock and 1 o’clock, DALA-P is recommended between 2 o’clock and 12 o’clock, AL is suitable at 11 o’clock, and PL is suitable between 10 o’clock and 8 o’clock.
Lateral Opening Wedge Distal Femur Osteotomy and Medial Patellofemoral Ligament Reconstruction for Recurrent Patellar Instability
Authors: Moran Thomas E. , Tagliero Adam J. , Klosterman Emma , Ramamurti Pradip , Sumpter Anna E. , Diduch David R. 
Published: August 2023

Background: A uniplanar, varus-producing distal femur osteotomy (DFO) may improve patellar tracking by effectively medializing the tibial tubercle, decreasing the Q-angle, and reducing the dislocation vector on the patella. Indications: A 17-year-old female with 8° of genu valgum presented with 18 months of symptomatic left knee patellar instability episodes that limit her function. Technique Description: A lateral subvastus approach to the distal femur was performed. Medial patellofemoral ligament reconstruction (MPFL-R) was conducted up to the point of femoral-sided graft fixation. A lateral opening wedge DFO was made with a sagittal saw and osteotomes, with care taken to maintain the medial cortical hinge. After distraction of the osteotomy site and femoral head allograft wedge placement, the osteotomy was secured with a lateral distal femoral locking plate. Finally, femoral-sided graft fixation for the MPFL-R was completed. Results: There were no immediate complications after surgery. Surgical management led to improvement of the patient's patellar instability, which allowed return to the prior baseline level of function. Discussion/Conclusion: The senior author's preferred technique for a lateral opening wedge DFO in association with an MPFL-R is presented. A varus-producing DFO is a surgical option for patients with genu valgum and recurrent patellar instability who have failed conservative management. This case demonstrates the efficacy of a lateral opening wedge DFO in improving patellar tracking and improving knee function by resolving recurrent patellar instability episodes. Patient Consent Disclosure Statement: The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form of approval from the patient(s) with this submission for publication.
Evaluation of a Distance Reiki Program for Frontline Healthcare Workers’ Health-Related Quality of Life During the COVID-19 Pandemic
Authors: Dyer Natalie L. , Baldwin Ann L. , Pharo Rosemary , Gray Feona 
Published: August 2023

Background Reiki is a biofield therapy which is based on the explanatory model that the fields of energy and information of living systems can be influenced to promote relaxation and stimulate a healing response. Objective To conduct a pragmatic within-subject pilot trial of a remote Reiki program for frontline healthcare workers’ health-related symptoms during the COVID-19 pandemic. Methods Healthcare professionals in the UK (eg, physicians, nurses, and paramedics) were eligible to sign up for a distance Reiki program and were also invited to participate in the research study. Eight Reiki practitioners simultaneously gave each participant Reiki remotely for 20 minutes on 4 consecutive days. Feasibility of the research was assessed, including recruitment, data completeness, acceptability and intervention fidelity, and preliminary evaluation of changes in outcome measures. Participants’ stress, anxiety, pain, wellbeing, and sleep quality were evaluated with 7-point numerical rating scales. Measures were completed when signing up to receive Reiki (pre) and following the final Reiki session (post). Pre and post data were analyzed using Wilcoxon signed ranks tests. Results Seventy-nine healthcare professionals signed up to receive Reiki and took the baseline measures. Of those, 40 completed post-measures after the 4-day intervention and were therefore included in the pre-post analysis. Most participants were female (97.5%), and the mean age was 43.9 years old (standard deviations = 11.2). The study was feasible to conduct, with satisfactory recruitment, data completeness, acceptability, and fidelity. Wilcoxon signed ranks tests revealed statistically significant decreases in stress (M = −2.33; P < .001), anxiety (M = −2.79; P < .001) and pain (M = −.79; P < .001), and significant increases in wellbeing (M = −1.79; P < .001) and sleep quality (M = −1.33; P = .019). Conclusions The Reiki program was feasible and was associated with decreased stress, anxiety and pain, and increased wellbeing and sleep quality in frontline healthcare workers impacted by the COVID-19 pandemic.
Sustained remissions in CLL after frontline FCR treatment with very-long-term follow-up
Authors: Thompson Philip A. , Bazinet Alexandre , Wierda William G. , Tam Constantine S. , O’Brien Susan M. , Saha Satabdi , Peterson Christine B. , Plunkett William , Keating Michael J. 
Published: August 2023

Abstract
Chemoimmunotherapy with fludarabine, cyclophosphamide, and rituximab (FCR) achieves durable remissions, with flattening of the progression-free survival (PFS) curve in patients with mutated immunoglobulin heavy chain variable gene (IGHV-M). We updated long-term follow-up results from the original 300-patient FCR study initiated at MD Anderson in 1999. The current median follow-up is 19.0 years. With this extended follow-up, the median PFS for patients with IGHV-M was 14.6 years vs 4.2 years for patients with unmutated IGHV (IGHV-UM). Disease progression beyond 10 years was uncommon. In total, 16 of 94 (17%) patients in remission at 10 years subsequently progressed with the additional follow-up compared with the patients in our prior report in 2015. Only 4 of 45 patients (9%) with IGHV-M progressed beyond 10 years. Excluding Richter transformation, 96 of 300 patients (32%) developed 106 other malignancies, with 19 of 300 (6.3%) developing therapy-related myeloid neoplasms (tMNs), which were fatal in 16 of 19 (84%). No pretreatment patient characteristics predicted the risk of tMNs. In summary, FCR remains an option for patients with IGHV-M chronic lymphocytic leukemia (CLL), with a significant fraction achieving functional cure of CLL. A risk-benefit assessment is warranted when counseling patients, balancing potential functional cure with the risk of late relapses and serious secondary malignancies.
BRAF
V600E is associated with higher incidence of second cancers in adults with Langerhans cell histiocytosis
Authors: Acosta-Medina Aldo A. , Kemps Paul G. , Zondag Timo C. E. , Abeykoon Jithma P. , Forma-Borst Jelske , Steenwijk Eline C. , Feijen Elizabeth A. M. , Teepen Jop C. , Bennani N. Nora , Schram Susan M. , Shah Mithun V. , Davidge-Pitts Caroline , Koster Matthew J. , Ryu Jay H. , Vassallo Robert , Tobin W. Oliver , Young Jason R. , Dasari Surendra , Rech Karen , Ravindran Aishwarya , Cleven Arjen H. G. , Verdijk Robert M. , van Noesel Carel J. M. , Balgobind Brian V. , Bouma Gerrit Joan , Saeed Peerooz , Bramer Jos A. M. , de Groen Ruben A. L. , Vermaat Joost S. P. , van de Sande Michiel A. J. , Smit Egbert F. , Langerak Anton W. , van Wezel Tom , Tonino Sanne H. , van den Bos Cor , van Laar Jan A. M. , Go Ronald S. , Goyal Gaurav , van Halteren Astrid G. S. 
Published: August 2023

Abstract
In this retrospective study, BRAF mutation status did not correlate with disease extent or (event-free) survival in 156 adults with Langerhans cell histiocytosis. BRAFV600E was associated with an increased incidence of second malignancies, often comprising hematological cancers, which may be clonally related.