bluuebunny/crossref_metadata_2025_split huggingface dataset:
TikTok as a source of information regarding premature ejaculation: a qualitative assessment
Authors: Bernstein Ari , Zhu Michael , Loloi Justin , Babar Mustufa , Winokur Nick , Wysocki Matthew , Cohen Seth 
Published: March 2023

AbstractBackgroundPatients are increasingly looking to social media platforms for medical information.AimIn this study we aimed to evaluate the quality of information regarding premature ejaculation (PE) on TikTok.MethodsThe term “premature ejaculation” was searched on TikTok on a single day in May 2022. Videos were sorted by 3 reviewers as reliable or unreliable based on the accuracy of video content. Relevant user metrics were collected for each video, including the numbers of likes, shares, and followers, and the video length, source of upload, and speaker type. The quality of information was objectified with 2 validated tools, with mean scores obtained from the 3 reviewers, the Patient Education Materials Assessment Tool (PEMAT) and the 5-point modified DISCERN instrument.OutcomesOutcomes were video reliability categorization, video and user metrics as described above, and video quality as quantified by PEMAT and DISCERN scores.ResultsEight videos were categorized as reliable and 32 videos were categorized as unreliable. The mean number of “likes” per video was higher in the reliable than in the unreliable group (1238 vs 126, P &lt; .018). Accounts posting reliable videos had higher mean numbers of followers than those posting unreliable videos (55 050 vs 12 042, P = .025). The majority of unreliable videos (75%) vs reliable videos (12.5%) were posted by self-identified patients or individual users, whereas 62.5% of reliable videos vs versus 6.3% of unreliable videos were posted by individual physicians or physician groups. Few videos overall mentioned PE definition, indications for PE treatment, types of treatment, or value of psychological intervention (12.5%, 15%, 22.5%, and 5.0% of videos, respectively). Video length and number of shares did not differ between groups. Reliable videos had higher PEMAT (73.0 vs 45.1, P &lt; .001) and DISCERN (2.7 vs 0, P &lt; .001.) scores.Clinical implicationsThere exists a critical need for enhanced quality of medical information on social media platforms in hopes of encouraging patients with impaired sexual function to seek appropriate medical care.Strength and limitationsStrengths of this study include the objective use of validated quality assessment tools and a focus on TikTok as an emerging social media platform. Limitations include large numbers of excluded videos.ConclusionThe quality of available information regarding PE on TikTok is low, with a significant percentage of videos on this topic fraught with inaccuracies. Given TikTok’s prominence as a social media platform primarily geared toward younger audiences, we emphasize the need for improvement in the quality of information available regarding PE and its management.
Mediating trust and estate disputes
Authors: Behrens James 
Published: March 2023

Abstract
This article explains how best to use mediation to resolve disputes which concern trusts and estates. It does not seek to teach the skills of mediation, though it contains much information which will be useful to mediators. Rather it is aimed at those personally or professionally involved in trust and estate disputes, who are considering the use of mediation to resolve these disputes. This article shows you what to consider when preparing for a mediation, and how to make the best use of the day itself in order to maximise the prospects of achieving a good and lasting settlement.
RIPK necrotic cell death pathway in both donor photoreceptor and host immune cells synergize to affect photoreceptor graft survival
Authors: Maidana Daniel E. , Gonzalez‐Buendia Lucia , Miller Joan W. , Vavvas Demetrios G. 
Published: March 2023

AbstractPhotoreceptor transplant has been put forward as a repair strategy to tackle degenerated retinas. Nonetheless, cell death and immune rejection seriously limit the success of this strategy, with only a small fraction of transplanted cells surviving. Improving the survival of transplanted cells is of critical importance. Recent evidence has identified receptor‐interacting protein kinase 3 (RIPK3) as a molecular trigger controlling necroptotic cell death and inflammation. However, its role in photoreceptor transplantation and regenerative medicine has not been studied. We hypothesized that modulation of RIPK3 to address both cell death and immunity could have advantageous effects on photoreceptor survival. In a model of inherited retinal degeneration, deletion of RIPK3 in donor photoreceptor precursors significantly increases the survival of transplanted cells. Simultaneous RIPK3 deletion in donor photoreceptors and recipients maximizes graft survival. Lastly, to discern the role of RIPK3 in the host immune response, bone marrow transplant experiments demonstrated that peripheral immune cell RIPK3 deficiency is protective for both donor and host photoreceptor survival. Interestingly, this finding is independent of photoreceptor transplantation, as the peripheral protective effect is also observed in an additional retinal detachment photoreceptor degeneration model. Altogether, these results indicate that immunomodulatory and neuroprotective strategies targeting the RIPK3 pathway can aid regenerative therapies of photoreceptor transplantation.
Clinical Reasoning Curricula in Preclinical Undergraduate Medical Education: A Scoping Review
Authors: Hawks Matthew K. , Maciuba Joseph M. , Merkebu Jerusalem , Durning Steven J. , Mallory Renee , Arnold Michael J. , Torre Dario , Soh Michael 
Published: March 2023

PurposeClinical reasoning is the process of observing, collecting, analyzing, and interpreting patient information to arrive at a diagnosis and management plan. Although clinical reasoning is foundational in undergraduate medical education (UME), the current literature lacks a clear picture of the clinical reasoning curriculum in preclinical phase of UME. This scoping review explores the mechanisms of clinical reasoning education in preclinical UME.MethodA scoping review was performed in accordance with the Arksey and O’Malley framework methodology for scoping reviews and is reported using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis for Scoping Reviews.ResultsThe initial database search identified 3,062 articles. Of these, 241 articles were selected for a full-text review. Twenty-one articles, each reporting a single clinical reasoning curriculum, were selected for inclusion. Six of the reports included a definition of clinical reasoning, and 7 explicitly reported the theory underlying the curriculum. Reports varied in the identification of clinical reasoning content domains and teaching strategies. Only 4 curricula reported assessment validity evidence.ConclusionsBased on this scoping review, we recommend 5 key principles for educators to consider when reporting clinical reasoning curricula in preclinical UME: (1) explicitly define clinical reasoning within the report, (2) report clinical reasoning theory(ies) used in the development of the curriculum, (3) clearly identify which clinical reasoning domains are addressed in the curriculum, (4) report validity evidence for assessments when available, and (5) describe how the reported curriculum fits into the larger clinical reasoning education at the institution.
The Culture and Justice Quorum at University of California, San Diego: A Departmental Approach to Dismantling Structural Racism
Authors: Ha Diana , Ghebrendrias Selam , Meadows Audra , LaCoursiere Daphne Yvette , Lewis Amanda , Lawson Mark , Morales Michael , Gyamfi-Bannerman Cynthia , Brubaker Linda 
Published: March 2023

Problem
Structural racism is embedded within the structure and function of academic medical institutions. Although many institutions have begun to incorporate racial justice within academic medicine, it needs to be integral to every discipline and all aspects of medical education, research, and health system practice. Guidance is lacking, however, on how to create and sustain department-level action to shift culture and encourage antiracist work.

Approach
To address the culture, uphold racial justice, and address the challenges of racism in medicine with dynamic and innovative solutions, the Department of Obstetrics, Gynecology and Reproductive Sciences at University of California, San Diego, formed a Culture and Justice Quorum (the Quorum) in September 2020. All department faculty, residents, fellows, and staff were invited to participate in the Quorum as ambassadors who commit to meet and facilitate Quorum work or as supporters who pledge Quorum support without regular meeting participation.

Outcomes
In all, 153 of 155 invited individuals (98.7%) responded, with 36 (23.2%) requesting to participate as ambassadors and 117 (75.5%) as supporters. Quorum ambassadors have worked together to assess the climate of the department, university, and health system, including incorporating input and amplifying efforts of the department’s resident leadership council. The Quorum has implemented initiatives to promote health equity and developed a report card to demonstrate activities, monitor progress, and ensure accountability.

Next Steps
Through the innovative Culture and Justice Quorum, the department aims to address structural racism, foster justice, and dismantle the foundational injustices embedded within departmental clinical, educational, and research work and within the wider culture. The Quorum offers a model for creating and sustaining department-level action to shift culture and encourage antiracist work. Since established, it has received institutional recognition, including receiving the 2022 Inclusive Excellent Award for Department-Organizational Unit, which recognizes outstanding institutional contributions for inclusion and diversity efforts.
Postoperative Chest X-Rays After Open Reduction Internal Fixation of Clavicle Fractures May Not Be Cost-Effective or Necessary
Authors: Hertzberg Michelle , Maier Lindsay , Heil Hailey , Hoegler Joseph , Guthrie S. Trent , Hakeos William 
Published: March 2023

Objectives:
To assess the use of chest x-rays after open-reduction internal fixation of clavicle fractures. Particularly in detection of acute postoperative pneumothorax and cost-effectiveness of obtaining routine chest x-rays postoperatively.

Design:
A retrospective cohort study.

Setting:
Level I trauma center.

Patients:
Two hundred thirty-six patients who underwent ORIF from 2013 to 2020 between the ages of 12 and 93.

Intervention:
Chest x-ray performed postoperatively.

Main outcome measurement:
Presence of acute postoperative pneumothorax.

Results:
Of the 236 patients who underwent surgery, 189 (80%) patients received a CXR postoperatively and 7 (3%) patients experienced respiratory symptoms. All patients who had respiratory symptoms received a postoperative CXR. Those who did not receive a CXR postoperatively did not experience any respiratory complications. Two patients in the cohort had a postoperative pneumothorax, which was present preoperatively and unchanged in size postoperatively. Both of these patients were managed with general anesthesia and endotracheal intubation for surgery. The most common finding on CXR postoperatively was atelectasis. The cost of a portable CXR can be upward of $594 when including technology, personnel fees, and radiologic interpretation.

Conclusion:
Postoperative chest x-rays after clavicle open reduction and internal fixation did not detect any acute postoperative pneumothorax in asymptomatic patients. It is not cost-effective to routinely get chest x-rays in patients after open-reduction internal fixation of clavicle fractures. In our study, of the 189 chest x-rays performed, only 7 patients experienced postoperative respiratory symptoms. Our health care system as a total could have saved upward of $108,108 in total for these patients because they may have been considered nonreimbursable by an insurance provider.

Level of Evidence:
Diagnostic Level IV. See Instructions for Authors for a complete description of levels of evidence.
Krackow Suture Technique Effect on Patella Tendon Vascularity: Quantitative MRI Analysis
Authors: Page Brian J. , Stevens Trenton T. , Barth Kathryn A. , Klinger Craig E. , Dyke Jonathan P. , Behrens Steve B. , Dziadosz Daniel , Lyden John P. , DiFelice Gregory S. , Ricci William M. 
Published: March 2023

Objectives:
To assess the effects of Krackow suture technique on the vascularity of the patellar tendon.

Methods:
Six fresh-frozen matched pair cadaveric knee specimens were used. The superficial femoral arteries were cannulated in all knees. The experimental knee underwent an anterior approach, patellar tendon transection from the inferior pole of the patella, 4-strand Krackow stitch placement, patellar tendon repair via 3-bone tunnels, and standard skin closure. The control knee underwent the identical procedure without Krackow stitching. All specimens then underwent precontrast and postcontrast enhanced quantitative magnetic resonance imaging assessment (with gadolinium-based contrast agent). Region of interest analysis was performed to assess for variation in signal enhancement between the experimental and control limbs in various patellar tendon regions and subregions. Latex infusion and anatomical dissection were performed to further evaluate vessel integrity and assess extrinsic vascularity.

Results:
Quantitative magnetic resonance imaging analysis demonstrated no statistically significant difference in overall arterial contributions. A small but nonsignificant decrease of 7.5% (SD ± 7.1%) in arterial contributions to the entire tendon was observed. Small nonstatistically significant regional decreases throughout the tendon were also detected. In the regional analysis, the largest to smallest decreases in arterial contributions after suture placement were found in the inferomedial, superolateral, lateral, and inferior tendon subregions. In the anatomical dissection, nutrient branches were seen dorsally and posteroinferiorly.

Conclusion:
The vascularity of the patellar tendon was not significantly affected by Krackow suture placement. Analysis demonstrated small and not statistically significant decreases in arterial contributions, suggesting this technique does not significantly compromise arterial perfusion.
Extensive heterotopic pancreas in a rare site: A case report and a review of literature
Authors: Zhang Xiaohan , Peng Lihua , Wang Zikai , Pan Fei , Ren Rongrong , Li Yan , Zhang Xiuli 
Published: March 2023

Rationale:
Heterotopic pancreas is a pancreatic tissue that occurs outside the normal anatomical site, the most common site is antrum. Due to the lack of specific imaging and endoscopic signs, heterotopic pancreas especially those occurring in the rare site, are often misdiagnosed, and leading to unnecessary surgical treatment. Endoscopic incisional biopsy and endoscopic ultrasound-guided fine-needle aspiration are effective means for diagnosing heterotopic pancreas. We reports a case of extensive heterotopic pancreas in a rare site, which was finally diagnosed by this way.

Patient concerns:
A 62-year-old man was admitted due to the presence of an angular notch lesion, which was suspected as gastric cancer before. He denied any history of tumor or gastric disease.

Diagnoses:
No abnormality was found in the physical examination and laboratory testing after admission. Computed tomography showed localized thickening of the gastric wall measuring 30 mm in the long diameter. Gastroscope revealed a nodular-like submucosal protuberance at the angular notch with size of about 3*4 cm. Ultrasonic gastroscope showed that the lesion was located in the submucosa. The lesion exhibited mixed echogenicity. The diagnosis can not be identified.

Interventions:
2 times of incision biopsy were performed to make a clear diagnosis. Finally, appropriate tissue specimens were obtained for pathology testing.

Outcomes:
The patient was diagnosed as heterotopic pancreas according to pathology. He was recommended to undergo observation and regular follow-ups rather than surgery. Then he was discharged home with no discomfort.

Lessons:
Heterotopic pancreas occurring in the angular notch is extremely rare, the site is scarcely reported in the relevant literature. Therefore, it is easy to be misdiagnosed. In the cases of an vague diagnosis, endoscopic incisional biopsy or endoscopic ultrasound-guided fine-needle aspiration may be a good choice.
Efficacy of dexmedetomidine on myocardial ischemia/reperfusion injury in patients undergoing cardiac surgery with cardiopulmonary bypass: A protocol for systematic review and meta-analysis
Authors: Liang Gencheng , Li Yueyong , Li Sheng , Huang Zhaohe 
Published: March 2023

Background:
Cardiac surgery using cardiopulmonary bypass has been shown to cause reversible postischemic cardiac dysfunction and is associated with reperfusion injury and myocardial cell death. Therefore, it is very important to have a series of measures in place to reduce oxygen consumption and provide myocardial protection. We performed a protocol for systematic review and meta-analysis to evaluate the effect of dexmedetomidine administration on myocardial ischemia/reperfusion injury in patients undergoing cardiac surgery with cardiopulmonary bypass.

Methods:
This review protocol is registered in the PROSPERO International Prospective Register of systematic reviews, registration number CRD42023386749. A literature search is performed in January 2023 without restriction to regions, publication types or languages. The primary sources were the electronic databases of PubMed, Embase, Web of Science, the Cochrane Central Register of Controlled Trials, Chinese National Knowledge Infrastructure database, Chinese Biomedical Database, and Chinese Science and Technology Periodical database. Risk of bias will be assessed according to the Cochrane Risk of Bias Tool. The meta-analysis is performed using Reviewer Manager 5.4.

Results:
The results of this meta-analysis will be submitted to a peer-reviewed journal for publication.

Conclusion:
This meta-analysis will evaluate the efficacy and safety of dexmedetomidine in patients undergoing cardiac surgery with cardiopulmonary bypass.
Identification microenvironment immune features and key genes in elderly stroke patients
Authors: Peng Yisheng , Liu Zhengli , Fu Guanqi , Zhao Boxiang , Gong Maofeng , Lu Zhaoxuan , Zhou Yangyi , Chen Liang , Su Haobo , Lou Wensheng , Chen Guoping , He Xu , Gu Jianping , Kong Jie 
Published: March 2023

Background:
The purpose of this study was to identify the signaling pathways and immune microenvironments related to elderly stroke patients.

Methods:
We downloaded the public transcriptome data (GSE37587) from the gene expression omnibus and divided the patients into young and old groups and identified differentially expressed genes (DEGs). Gene ontology function analysis, Kyoto encyclopedia of genes and genomes pathway analysis, and gene set enrichment analysis (GSEA) were performed. A protein-protein interaction network was constructed and hub genes were identified. Gene-miRNA, gene-TF, and gene-drug networks were constructed using the network analyst database. The immune infiltration score was evaluated using single-sample gene set enrichment analysis GSEA, its correlation with age was computed and visualized using R software.

Results:
We identified 240 DEGs, including 222 upregulated and 18 downregulated DEGs. Gene ontology enrichment was significantly enriched in response to the virus, type I interferon signaling pathway, cytological component, focal adhesion, cell-substrate adherents junction, and the cytosolic ribosome. GSEA identified the following mechanisms: heme metabolism, interferon gamma response, and interferon alpha response. Ten hub genes included interferon alpha-inducible protein 27, human leucocyte antigen-G, interferon-induced protein with tetratricopeptide repeats 2, 2’-5’-oligoadenylate synthetase 2, interferon alpha-inducible protein 6, interferon alpha-inducible protein 44-like, interferon-induced protein with tetratricopeptide repeats 3, interferon regulatory factor 5, myxovirus resistant 1, and interferon-induced protein with tetratricopeptide repeats 1. Quantitative analysis of immune infiltration showed that increased age was significantly positively correlated with myeloid-derived suppressor cells and natural killer T cells, and negatively correlated with immature dendritic cells.

Conclusion:
The present research could help us better understand the molecular mechanisms and immune microenvironment of elderly patients with stroke.
The clinical effects of two non-invasive ventilation modes on premature infants with respiratory distress syndrome: A randomized controlled trial
Authors: Wang Hui , Chen Wenxiang , Zhang Yinlong 
Published: March 2023

Background:To compare the safety and effectiveness of nasal noninvasive high- frequency oscillatory ventilation (NHFOV) and duo positive airway pressure (DuoPAP) applications in preterm babies with respiratory distress syndrome (RDS).Methods:This was a randomized controlled trial. Forty-three premature infants with RDS treated in the neonatal intensive care unit of Huaibei Maternal and Child Health Hospital from January 2020 to November 2021 were selected as the research participants. They were randomly divided into the NHFOV group (n = 22) and DuoPAP group (n = 21). General conditions, including the arterial oxygen partial pressure (PaO2), carbon dioxide partial pressure (PaCO2), oxygenation index (OI), the incidence of apnea at 72 hours, duration of noninvasive respiratory support, maternal high-risk factors, total oxygen consumption time, total gastrointestinal feeding time, and the frequency of intraventricular hemorrhage (IVH), neonatal necrotizing enterocolitis (NEC), and bronchopulmonary dysplasia (BPD) and apnea were compared between the NHFOV group and DuoPAP group at 12 and 24 hours after noninvasive respiratory support.Results:There was no noteworthy difference between the 2 groups with respect to PaO2, PaCO2, OI, IVH, and NEC and BPD at different nodes (allP> .05).Conclusion:The endpoints of PaO2, PaCO2and OI and complications of IVH, NEC, BPD and Apnea, and did not reveal any statistical differences between NHFOV and DuoPAP during the respiratory support in preterm babies with RDS.