bluuebunny/crossref_metadata_2025_split huggingface dataset:
Associative Network Method
Authors: Peroni Lea , Armaingaud Didier , Henry-Ducos Charlotte , Rothan-Tondeur Monique 
Published: June 2023

Abstract

Background
The associative network method is a technique for studying social representations of a phenomenon. Although it is little known and used, it can be widely used in nursing research, particularly to understand the representations of a population on a disease or a professional practice.

Objectives
This article aims to describe the associative network method, proposed by De Rosa in 1995, through a concrete example.

Methods
The associative network is a technique that allows us to identify the content, structure, and polarity of social representations of a phenomenon. It was used with 41 participants to describe their representations of urinary incontinence. First, the data were collected following the four steps described by De Rosa. The analysis was then carried out manually and using Microsoft Excel. The different themes evoked by the 41 participants, the number of words in each theme, the rank of appearance of the themes, the indices of polarity and neutrality, and the rank of hierarchy were thus analyzed.

Results
We were able to describe in depth the representations of caregivers and people from the general population on urinary incontinence and, more specifically, their content and structure. The spontaneous answers of the participants allowed us to explore several dimensions of their representations. We were also able to obtain rich information, both qualitatively and quantitatively.

Discussion
The associative network—which is easy to understand and implement—is a method that can be adapted to various studies.
Which Trauma Severity Scores Are Useful in Predicting Pediatric Mortality?
Authors: Chedid Imane , Bachir Rana , Rizk Jennifer , El Sayed Mazen , Sawaya Rasha Dorothy 
Published: June 2023

Background and Objectives
Trauma is the leading cause of death in children. Several trauma severity scores exist: the shock index (SI), age-adjusted SI (SIPA), reverse SI (rSI), and rSI multiplied by Glasgow Coma Score (rSIG). However, it is unknown which is the best predictor of clinical outcomes in children. Our goal was to determine the association between trauma severity scores and mortality in pediatric trauma.

Design and Methods
A multicenter retrospective study was performed using the 2015 US National Trauma Data Bank, including patients 1 to 18 years old and excluding patients with unknown emergency department dispositions. The scores were calculated using initial emergency department parameters. Descriptive analysis was carried out. Variables were stratified by outcome (hospital mortality). Then, for each trauma score, a multivariate logistic regression was conducted to determine its association with mortality.

Results
A total of 67,098 patients with a mean age of 11 ±5 years were included. Majority of the patients were male (66%) and had an injury severity score <15 (87%). Eighty-four percent of patients were admitted: 15% to the intensive care unit and 17% directly to the operating room. The mortality at hospital discharge was 3%.
There was a statistically significant association between SI, rSI, rSIG, and mortality (P < 0.05). The highest adjusted odds ratio for mortality corresponded to rSIG, followed by rSI then SI (8.51, 1.9, and 1.3, respectively).

Conclusion
Several trauma scores may help predict mortality in children with trauma, the best being rSIG. Introduction of these scores in algorithms for pediatric trauma evaluations can impact clinical decision-making.
Treatment of Concomitant Congenital Pseudarthrosis of the Fibula With Propeller Periosteal Flap
Authors: El-Gammal Tarek Abdalla , Ali Amr El-Sayed , Kotb Mohamed Mostafa , Saleh Waleed Riad , Ragheb Yasser Farouk , Refai Omar Ahmed , Morsy Mohamed Mohamed , El-Gammal Yousif Tarek 
Published: June 2023

Introduction
Congenital pseudarthrosis of the fibula is not an uncommon condition to accompany congenital pseudarthrosis of the tibia. Persistence of the fibular pseudarthrosis has been linked to inferior outcomes including tibial union and alignment, refractures, and ankle alignment. In this report, we present the results of a pedicled periosteal propeller flap technique for the treatment of fibular pseudarthrosis.

Methods
Ten children with an average age at surgery of 5.3 years who had congenital pseudarthrosis of both tibia and fibula were studied. The tibia was treated with free vascularized fibular grafting, and the ipsilateral fibula was treated with a technique after resection of the pseudarthrosis. A periosteal flap from the proximal healthy part of the fibula is harvested off the bone, rotated 180° based on a branch from the peroneal vessels to cover the fibular defect and fashioned in the form of a tube filled with bone fragments.

Results
The periosteal flap size ranged from 5 to 7 cm. Follow-up averaged 37.2 months. The tibia was united in all cases; in 2 of them, refractures occurred and healed with conservative management. The fibula was united in 8 cases. At final follow-up, 5 cases showed residual tibial deformity, and 5 showed residual ankle deformity. Average leg-length discrepancy was 1.4 cm (0–3 cm).

Conclusion
The pedicled periosteal propeller flap presents a useful new technique for managing concomitant congenital fibular pseudarthrosis.
Omitting Foley Catheter Use in Mastectomy Patients With or Without Immediate Reconstruction
Authors: Huang Siu-Yuan , Panuccio Alexandria , Mohabbatizadeh Borna , Chu Michael , Leung Anna , Carre Antoine L. 
Published: June 2023

Background
Foley catheter placement is often advised in surgeries anticipated to exceed 3 hours; however, this time cutoff does not take into account the type of surgery. Complications from Foley catheter placement include urinary tract infections and genitourinary trauma that may be costly to healthcare systems. Our objective was to determine whether mastectomy with or without reconstruction can be done without Foley use, without an increase in urinary retention risk.

Methods
One hundred eighty-seven patients who underwent unilateral or bilateral mastectomies with or without reconstruction in 2020 and 2021 were reviewed. Chart review included intraoperative fluids given, estimated blood loss, lymph node dissection, and duration of procedure.

Results
After excluding patients with case duration under 180 minutes, 145 remained. Ninety-four patients did not have a Foley and 51 patients had an intraoperative Foley. None of the patients without a Foley experienced postoperative urinary retention, including 3 patients who also underwent lymphatic microsurgical preventive healing approach. Eighty-six percent of patients were discharged on the day of surgery. Patients with or without a Foley did not differ significantly in terms of race, rate of axillary lymph node dissection, body mass index, rate of same-day discharge, presence of hypertension or diabetes, estimated blood loss, or age.

Conclusions
Patients undergoing unilateral and bilateral mastectomies with or without reconstruction or lymphatic microsurgical preventive healing approach may avoid Foley catheter placement without increased risk of urinary retention, even if the case is anticipated to exceed 3 hours. Advantages include elimination of catheter-associated urinary tract infections and their associated hospital costs, as well as avoiding genitourinary trauma.
NARROWING THE GAP: PRECLINICAL TRAUMA WITH POSTINJURY SEPSIS MODEL WITH INCREASED CLINICAL RELEVANCE
Authors: Munley Jennifer A. , Kelly Lauren S. , Gillies Gwendolyn S. , Pons Erick E. , Coldwell Preston S. , Kannan Kolenkode B. , Whitley Elizabeth M. , Bible Letitia E. , Efron Philip A. , Mohr Alicia M. 
Published: June 2023

ABSTRACT

Background: Overall outcomes for trauma patients have improved over time. However, mortality for postinjury sepsis is unchanged. The use of relevant preclinical studies remains necessary to understand mechanistic changes after injury and sepsis at the cellular and molecular level. We hypothesized that a preclinical rodent model of multicompartmental injury with postinjury pneumonia and chronic stress would replicate inflammation and organ injury similar to trauma patients in the intensive care unit. Methods: Male and proestrus female Sprague-Dawley rats (n = 16/group) were subjected to either polytrauma (PT) (lung contusion, hemorrhagic shock, cecectomy, and bifemoral pseudofracture), PT with daily chronic restraint stress (PT/CS), PT with postinjury day one Pseudomonas pneumonia (PT + PNA), PT/CS with pneumonia (PT/CS + PNA) or naive controls. Weight, white blood cell count, plasma toll-like receptor 4 (TLR4), urine norepinephrine (NE), hemoglobin, serum creatinine, and bilateral lung histology were evaluated. Results: PT + PNA and PT/CS + PNA groups lost more weight compared with those without sepsis (PT, PT/CS) and naive rats (P < 0.03). Similarly, both PT + PNA and PT/CS + PNA had increased leukocytosis and plasma TLR4 compared with uninfected counterparts. Urine NE was elevated in PT + PNA and PT/CS + PNA compared with naive (P < 0.03), with PT/CS + PNA exhibiting the highest levels. PT/CS + PNA exhibited worse acute kidney injury with elevated serum creatinine compared with PT/CS (P = 0.008). PT/CS + PNA right and left lung injury scores were worse than PT + PNA (P < 0.01). Conclusions: Sepsis, with postinjury pneumonia, induced significant systemic inflammation, organ dysfunction following polytrauma and chronic stress. Advanced animal models that replicate the critically ill human condition will help overcome the classic limitations of previous experimental models and enhance their translational value.
Laparoscopic Surgery for Acute Right-colon Diverticulitis: Video Vignette and Systematic Review With Meta-analysis of Current Evidence of Minimally Invasive Versus Conventional Surgery
Authors: Guerra Francesco , Coletta Diego 
Published: June 2023

Background:
Over the last decade, there has been growing diffusion of minimally invasive surgery in the setting of abdominal emergencies. However, right-colon diverticulitis is still mainly approached by conventional celiotomy.

Materials and Methods:
A video vignette is presented showing the details of an emergent laparoscopic right colectomy as performed to treat a 59-year-old woman who presented with clinical signs of peritonitis, and radiologic findings suggestive of acute right-colon diverticulitis complicated by perforation of the hepatic flexure and periduodenal abscess. We also aimed to evaluate the relative outcomes of laparoscopic versus conventional surgery by meta-analyzing the currently available comparative evidence on the argument.

Results:
A total of 2848 patients were included in the analysis, of which 979 patients received minimally invasive surgery and 1869 had conventional surgery. Laparoscopic surgery had a longer operating time and resulted in an abbreviated hospital stay. Overall, patients receiving laparoscopy had significantly lower morbidity than those whose surgery was undertaken by laparotomy, while there was no statistically significant difference in terms of postoperative mortality.

Conclusions:
According to the existing literature, minimally invasive surgery improves the postoperative outcomes of patients receiving surgery for right-sided colonic diverticulitis.
Transoral Endoscopic Thyroidectomy Vestibular Approach Versus Gasless Transaxillary Endoscopic Thyroidectomy for Patients With Unilateral Papillary Thyroid Carcinoma: A Retrospective Study
Authors: Zhang Wei-dong , Dai Lei , Le Qi , Yu Ke-jie , Wang Ying-chun , Wu Xian-jiang 
Published: June 2023

Background:
Transoral endoscopic thyroidectomy vestibular approach (TOETVA) and gasless transaxillary endoscopic thyroidectomy (GTET) are 2 newly applied technologies. This study is to compare the 2 approaches from the aspects of effectiveness and safety.

Materials and Methods:
A total of 339 patients who underwent TOETVA or GTET with unilateral papillary thyroid carcinoma were enrolled in this study from March 2019 to February 2022. The 2 groups were compared in terms of patient characteristics, perioperative clinical results, and postoperative outcomes.

Results:
The operative time of the TOETVA group was significantly longer than the GTET group (141.39±16.11 vs. 98.45±12.24, P<0.05). The TOETVA group had advantages over GTET group when the reduction of parathyroid hormone was compared (19.18±17.43 vs. 23.07±15.72, P<0.05). Meanwhile, more parathyroids were detected in central neck specimens in GTET group (40/181 vs. 21/158, P<0.05). TOETVA had an advantage on total number of central lymph nodes over GTET (7.65±3.11 vs. 4.99±2.45, P<0.05), whereas the number of positive central lymph nodes was similar (P>0.05). No differences were found between the 2 groups on other data.

Conclusions:
TOETVA and GTET are both safe and effective for unilateral papillary thyroid carcinomas. TOETVA has advantage on protection of inferior parathyroid glands and harvest of central lymph node dissection. Meanwhile, GTET can save more time compared with TOETVA. Surgeons and patients should freely choose the approaches based on their demands.
Exploring New Electroencephalogram Parameters in Electroconvulsive Therapy
Authors: Schreiner Jakob Emil , Kessler Ute , Oedegaard Ketil Joachim , Mardal Kent-Andre , Oltedal Leif 
Published: June 2023

Background
Electroconvulsive therapy (ECT) is an effective treatment against severe depressive episodes, which has been shown to induce volume changes in the hippocampus. The power spectrum of the electroencephalogram (EEG) follows a characteristic power-law relation, but its utility as a metric of ECT-induced seizures has not been explored.

Objective
This pilot study aims to evaluate a novel metric based on the power spectrum of the EEG recordings from ECT-induced seizures—its association to volume changes in the hippocampus after ECT and improvement in depression rating scores.

Methods
Depressed patients treated with ECT underwent brain magnetic resonance imaging before and after treatment and the EEG from each seizure was recorded (N = 29). Hippocampal volume changes and EEG parameters were recorded in addition to clinician-rated and self-reported measures of depressive symptoms. The slope of the power law in the power spectral density of the EEG was calculated. Multivariate linear models relating seizure parameters to volume change or clinical outcome were systematically and successively simplified. The best models were selected according to Akaike information criterion.

Results
The slope of the power law was steeper in the right than the left hemisphere (P < 0.001). Electroencephalogram measures were included in the best models of volume change for both hippocampi as well as in the models explaining clinical outcome (P = 0.014, P = 0.004).

Conclusions
In this pilot study, novel EEG measures were explored and contributed in models explaining the variation in volume change in the hippocampus and in clinical outcome after ECT.
What Our Patients and Their Families Are Reading
Authors: Ekinci Okan 
Published: June 2023

Objectives
The Internet is now more widely used than before by psychiatric patients and their families to search for medical conditions and treatments. To our knowledge, no study has addressed the quality and readability of online information about electroconvulsive therapy (ECT). We aimed to examine the quality and readability of English-language Internet information related to ECT.

Methods
An advanced search of Internet Web sites containing information about ECT was conducted by using the search term “ECT or electroconvulsive therapy.” The resulting Web sites were categorized into 1 of 3 categories (commercial, nonprofit, or professional organizations). Their quality was evaluated using Health on the Net code certification, the Journal of the American Medical Association (JAMA) benchmark criteria, and the DISCERN tool. The readability of the Web sites was assessed using the Flesch Reading Ease, Flesch-Kincaid Grade Level Formula, Simple Measure of Gobbledygook, and Gunning Fog indexes.

Results
A total of 86 Web sites were included in the analysis. Of all these Web sites, 18 (20.9%) had a Health on the Net code certificate, and 16 (18.6%) were accepted as high quality (JAMA total score ≥3). The commercial Web sites had significantly lower DISCERN and JAMA benchmark scores compared with the other Web sites. A total of 30.23% of all the Web sites reached the recommended readability level (Flesch-Kincaid Grade Level Formula ≤ 8). Moreover, only 4 scored at the grade 5 to 6 reading level, which is considered ideal for patient educational materials.

Conclusions
Our study indicates that both the quality and readability of online information about ECT are not at the desired level. Physicians, patients, and their families should consider this failure in relation to online information about ECT. In addition, Web site creators and health authorities should be aware of their responsibilities for providing quality and readable health information to the public.
Monitoring of azathioprine metabolite concentrations and cytokine levels in neuromyelitis optica spectrum disorder
Authors: Huang Qingmeng , Wei Junjie , Luo Chunfang , Qin Junhui , Tang Chunnv , Li Lijing , Zhou Huijie , Zhong Kang , Lin Bailing , Tang Yulan 
Published: June 2023

ABSTRACTBackgroundThe pathogenesis of NMOSD has been linked to the cytokines interleukins (IL) -6, NOD-, LRR-and pyrin domain-containing 3 (NLRP3) and IL-18 that contribute to development of inflammatory reactionsmay. Although azathioprine (AZA) is efficacious in preventing NMOSD recurrence, it may have adverse effects (AEs) maybe related to the plasma concentrations.ObjectiveWe would monitor the blood concentrations of azathioprine in NMOSD, and their relationship with cytokines, severity, efficacy, and safety range of the drug.MethodsA total of 53 NMOSD patients were included in the study, which included 20 patients who had received AZA treatment within one month, and 16 patients who had received AZA treatment within six months, as well as 17 patients who had received AZA treatment over one year. The patient’s immunotherapy regimen was low-dose hormone combined with AZA. AZA was started at small doses and added every two weeks after no AEs, namely 50 mg qd for two weeks, 50mg bid for two weeks, and maintained at 50mg tid. The following clinical data were collected: gender, age, clinical symptoms, EDSS score, number of recurrences and AEs, etc. Healthy controls (HC) comprised 10 individuals. AZA metabolite concentrations 6-thioguaninenucleotides (6-TGN) and 6-methylmercaptopurine nucleotides (6-MMPN) were measured by High-performance liquid chromatography (HPLC). Levels of IL-6, NLRP3 and IL-18 were measured by Enzyme-linked immunosorbent assay (ELISA).ResultsTreatment with AZA decreased the EDSS score and the ARR. The 6-TGN and 6-MMPN concentrations gradually increased as the medication time increased, and was basically stable by 6 months of medication. EDSS score improvement was positively correlated with 6-TGN concentrations. Patients with AEs had higher concentrations of 6-TGN and 6-MMPN than those without. The serum levels of IL-6, NLRP3, and IL-18 were higher in the patients than in the HC. NLRP3 level was higher in neuropathic pain (NP) patients than in those without NP.ConclusionConsequently, AZA was confirmed to be an effective drug used to treat NMOSD. AEs increased when 6-TGN reached 155.604 pmol/8×108RBC or 6-MMPN reached 2583.168 pmol/8×108RBC. In NMOSD remission, IL-6 and NLRP3 levels were significantly higher than in normal subjects, suggesting that they may contribute to the pathogenesis of NMOSD. A high level of NLRP 3 may lead to NP.
From Answers to Insights: Unveiling the Strengths and Limitations of ChatGPT and Biomedical Knowledge Graphs
Authors: Hou Yu , Yeung Jeremy , Xu Hua , Su Chang , Wang Fei , Zhang Rui 
Published: June 2023

AbstractLarge Language Models (LLMs) have demonstrated exceptional performance in various natural language processing tasks, utilizing their language generation capabilities and knowledge acquisition potential from unstructured text. However, when applied to the biomedical domain, LLMs encounter limitations, resulting in erroneous and inconsistent answers. Knowledge Graphs (KGs) have emerged as valuable resources for structured information representation and organization. Specifically, Biomedical Knowledge Graphs (BKGs) have attracted significant interest in managing large-scale and heterogeneous biomedical knowledge. This study evaluates the capabilities of ChatGPT and existing BKGs in question answering, knowledge discovery, and reasoning. Results indicate that while ChatGPT with GPT-4.0 surpasses both GPT-3.5 and BKGs in providing existing information, BKGs demonstrate superior information reliability. Additionally, ChatGPT exhibits limitations in performing novel discoveries and reasoning, particularly in establishing structured links between entities compared to BKGs. To overcome these limitations, future research should focus on integrating LLMs and BKGs to leverage their respective strengths. Such an integrated approach would optimize task performance and mitigate potential risks, thereby advancing knowledge in the biomedical field and contributing to overall well-being.
A participatory approach to designing and implementing an occupational health intervention for the nail salon community in the Greater Philadelphia region
Authors: Hùynh Trân B , Nguyễn Dương T , Vũ Nga , Robinson Lucy , Trần Emily , Nguyễn Nancy , Carroll-Scott Amy , Burstyn Igor 
Published: June 2023

ABSTRACTBackgroundThe nail salon industry in the US comprises mostly immigrant-owned, small mom-and-pop salons that employ primarily first-generation immigrant workers from Asia. Because of the cultural and language barriers, both owners and workers may not avail themselves of the occupational safety resources. We formed an academic-community partnership to co-design a feasibility study and multi-level occupational health intervention for Vietnamese-speaking salon owners, workers, and community-based organization.MethodsThe intervention for each salon included 1) two-hour in-person training covering chemical safety, infection control, musculoskeletal prevention, and workers’ rights for both the owners and their employees, 2) a tailored recommendation report for the owner, and 3) check-ins with the owners during the three-month follow-up. Community partner was trained to deliver the in-language training with technical assistance from the research team. Baseline and post-intervention individual data about health symptoms and behaviors, as well as personal chemical exposures were collected and analyzed.ResultsA total of 44 participants from 12 consented salons enrolled in the study. One salon dropped out follow-up due to change of ownership. Analysis of the differences between post-and pre-intervention showed a tendency toward reduction in self-reported symptoms in the respiratory system, skin, and eyes, neurotoxicity score, as well as some chemical exposures. We could not rule out seasonality as an explanation for these trends. Increase in self-efficacy in some areas was observed post-intervention.ConclusionsOur study demonstrated a successful academic-community partnership to engage community members in the intervention study. While the intervention effects from feasibility study should be interpreted with caution, our preliminary results indicated that our community-based intervention is a promising approach to reduce work-related exposures among nail salon worker workers from Asia.