bluuebunny/crossref_metadata_2025_split huggingface dataset:
The reconstruction of fingertip injury by mini hallux toenail flap pedicled with the hallux transverse artery and toe pulp vein transplantation technique based on the equivalent design theory
Authors: Fan Xiao , Zhou Yimin , Zhou Jian , Dai Shiyou , Liu Jinhai , Lao Kecheng 
Published: August 2023

Abstract
Introduction
How to reconstruct the damaged fingertip is a clinical problem. Our team propose the theory of equivalent design and use the mini toenail flap pedicled with the hallux transverse artery and toe pulp vein transplantation technique to reconstruct Allen’s type II fingertip injury. Thus, we perform the retrospective study to evaluate the effects of this technique on fingertip injury.

Materials and methods
A retrospective analysis was performed on 56 patients admitted to our hospital from January 2015 to January 2020 who used equivalently designed miniature hallux toenail flaps for the plastic repair of fingertip damage. We recorded the size of the miniature hallux toenail flap, operation time, intraoperative blood loss, and complications and calculated the survival rate of the transplanted miniature hallux toenail flap. During routine follow-up after surgery, we recorded nail growth time and observed finger appearance. At the last time of follow-up, we recorded Semmes-Weinstein evaluating tactile sensation and Two-point discrimination testing (TPD). The efficacy was evaluated by Zook score evaluation.

Results
The size of the mini hallux toenail flap was 0.71 cm × 1.22 cm to 0.88 cm × 1.71 cm. The operation time was (3.54 ± 0.58) hours, the intraoperative blood loss was (20.66 ± 4.87) ml, and the survival rate of mini hallux toenail flaps was 100%. The postoperative follow-up time was (30.82 ± 11.21) months, and the total nail growth time was (9.68 ± 2.11) months. The average tactile sensation evaluated by the Semmes-Weinstein test was (0.32 ± 0.14) g, and the average TPD was (7.33 ± 1.02) mm. According to Zook score, the curative effect of fifty-six cases were all excellent or good with 100% excellent and good rate, and all patients had beautiful appearances and good function of damaged fingertips.

Conclusions
Based on the equivalent design theory, the mini hallux toenail flap pedicled with the hallux transverse artery and toe pulp vein transplantation technique is an effective method to reconstruct Allen’s type II fingertip injury with a beautiful appearance and good function.

Type of study/level of evidence
Therapeutic IV.
Effect of knee arthroscopic debridement combined with peripatellar denervation on restoration of knee function in patients with knee osteoarthritis
Authors: Wang Zhijia , Wang Rui , Gao Congliang 
Published: August 2023

Abstract
Background
This research examines knee osteoarthritis (OA), a prevalent orthopedic disease marked by cartilage degeneration and chronic synovitis, leading to pain, restricted mobility, and eventual loss of knee function. Notably, patellofemoral osteoarthritis constitutes a significant proportion of knee OA cases. Our study aims to assess the impact of knee arthroscopic debridement coupled with peripatellar denervation on restoring knee function in OA patients and analyze the risk factors affecting treatment outcomes. By doing so, we hope to contribute to the informed selection of clinical treatment plans, addressing a disease that, if untreated, significantly impairs patients’ quality of life.

Methods
A total of 211 patients with knee osteoarthritis treated in our hospital from June 2020 to June 2022 were analyzed retrospectively. Among them, 116 patients received arthroscopic knee debridement treatment alone as the control group, and 95 in the observation group were combined with denervation treatment based on the control group. The clinical efficacy of the two groups of patients after treatment was evaluated, and patients’ pain was counted using the pain visual analogue score (VAS) method. The knee range of motion (ROM) was used to count the mobility of the patients and to compare the operative time, intraoperative perfusion volume, and length of stay between the two groups. According to the effectiveness after treatment, patients were divided into the improvement group (effective + markedly effective) and the non-improvement group, and the risk factors affecting the clinical efficacy of patients after treatment were analyzed by logistic regression.

Results
The total treatment efficiency of patients in the control group was lower than that of those in the observation group (P < 0.05). There was no difference in intraoperative perfusion volume and length of stay between patients in both groups (P > 0.05). However, the operative time was shorter in the control group compared with that in the observation group (P < 0.001). The post-treatment VAS scores of patients in the observation group were lower than those in the control group, while the ROM scores were higher than those of the control group (P < 0.001). Age, BMI, and preoperative VAS score were found to be independent risk factors for patient outcome by logistic regression analysis (P < 0.05).

Conclusion
knee arthroscopic debridement combined with peripatellar denervation has a significant improvement in the restoration of knee function in patients with knee osteoarthritis and reduces their level of pain.
Revitalize splenic functions. Following a splenectomy for trauma, a small amount of splenic autotransplantation was performed
Authors: Saad Hassan A. , Elsayed Rasha S , Riad Mohamed , El-Taher Ahmed K. , Eraky Mohamed E , Abdelmonem Ashraf 
Published: August 2023

Abstract
Introduction
The spleen is a responsible significant part of the immune system; after Splenectomy following trauma, the immune system changes; splenic autotransplantation can preserve the immune system after trauma and Splenectomy.

Background
Patients can be protected from immune dysfunction by autotransplanting splenic tissues after splenectomy following trauma because their immune systems and spleens are changed. Patients can gain their immune function after splenic autotransplantation.

Methods
Patient classification methods are into three categories, Group A, 6 cases with auto-translation; Group B, 6 cases without transplantation; Group C, seven regular people serving as the control.

Aim of work
The aim of the work is not to compare outcome methods or compare types of autotransplantation; This work aims to document postoperative radiological, immunological, clinical, and hematological investigations. We concentrated on the results of investigations more than the types of operation or approach or types of autotransplantation.

Results
We showed that, after comparing each group with normal individuals subjects, patients who did not undergo autotransplantation had significantly higher platelet counts, a more significant percentage of micronucleated reticulocytes, increased levels of naive B lymphocytes, changes in class-switched memory and class-unswitched memory B cells, and higher levels of PD1 on CD8 + T lymphocytes. Nevertheless, neither splenic autotransplant patients nor the average general population showed any appreciable variations in any of the parameters.

Conclusions
Spleen’s activities with adequate hemocatheter activity and recovery of the immunological deficit after splenic autotransplantation.
“Our services are not the same”: the impact of the COVID-19 pandemic on care interactions in women’s shelters
Authors: Burd Caitlin , McLean Isobel , MacGregor Jennifer C. D. , Mantler Tara , Veenendaal Jill , Wathen C. Nadine 
Published: August 2023

AbstractBackgroundGuidelines and regulations in response to the COVID-19 pandemic have significantly impacted the health care sector. We explore these impacts in the gender-based violence (GBV) services sector and, more specifically, in the context of women’s shelters.MethodsUsing an interpretive description and integrated knowledge mobilization approach, we interviewed 8 women’s shelter clients, 26 staff, and conducted focus groups with 24 Executive Directors.ResultsWe found that pandemic responses challenged longstanding values that guide work in women’s shelters, specifically feminist and anti-oppressive practices. Physical distancing, masking, and closure of communal spaces intended to slow or stop the spread of the novel coronavirus created barriers to the provision of care, made it difficult to maintain or create positive connections with and among women and children, and re-traumatized some women and children. Despite these challenges, staff and leaders were creative in their attempts to provide quality care, though these efforts, including workarounds, were not without their own challenges.ConclusionsThis research highlights the need to tailor crisis response to sector-specific realities that support service values and standards of care.
A cross-sectional survey on the use of herbal tea among Cameroonian adults (18–65 years)
Authors: Suh Nchang Abenwie , Njong Sylvia , Noukimi Sandra Fankem , Shinyuy Lahngong Methodius , Bambara Sylvie , Kalimba Edgar M. , Kamga Joseph , Souopgui Jacob , Ghogomu Stephen Mbigha , Frederich Michel , Talom Jean Lesort Louck , Robert Annie 
Published: August 2023

Abstract
Background
In respect of the WHO’s commendation to incorporate traditional medicine (TM) in health care, the Cameroon government wants to promote the use of the traditional medicine and is resolute on encouraging the treatment of patients with alternative medicine from traditional sources. This study explores the use of herbal tea by Cameroonian adults to prevent or treat diseases and the socio-demographic determinants of tea use among participants.

Methods
A cross-sectional survey was conducted among 307 Cameroonian adults (18–65 years) randomly selected within 4 hospitals and 4 communities in the Centre and Southwest regions of Cameroon between 04/01–20/04/2022, using interviewer administered semi-structured questionnaires. Binary logistic regression analysis was conducted to determine the association between variables.

Results
Over four-fifth (89.3%) of participants had taken herbal teas at least once within the last 2 years prior to the survey, and most participants used the teas for the prevention and treatment of Covid-19 (67.9%), malaria (59.7%) and typhoid fever (35%). Most respondents took the teas warm (75%), and the treatment dosage used by most respondents (51%) was “one glass in the morning and evening for one to two weeks”. The teas taken by 70% of users had bad or bitter taste and 52.2% of them were uncomfortable with the bad taste. However, the majority of users completed their treatment dosage (72%), 90.5% of them were willing to use teas for treatment if prescribed in health facilities in future, and 90.1% were in support that herbal teas should be prescribed in hospitals. There was no significant association (p ≥ 0.05) between sociodemographic characteristics of participants and herbal tea use. However, the major motivating factor for acceptability of herbal tea use was treatment effectiveness (52.7%).

Conclusion
There is high prevalence of herbal tea use among adults Cameroonians in the studied settings in the Centre and Southwest regions of Cameroon, with a positive opinion and willingness to use teas if prescribed in health facilities. Authorities must ensure the effectiveness and safety of traditional medicine served in health facilities, to enhance compliance and adequate use.
Establishing a clinical ethics support service: lessons from the first 18 months of a new Australian service – a case study
Authors: Hoon Elizabeth , Edwards Jessie , Harvey Gill , Eliott Jaklin , Merlin Tracy , Carter Drew , Moodie Stewart , O’Callaghan Gerry 
Published: August 2023

Abstract
Background
Although the importance of clinical ethics in contemporary clinical environments is established, development of formal clinical ethics services in the Australia health system has, to date, been ad hoc. This study was designed to systematically follow and reflect upon the first 18 months of activity by a newly established service, to examine key barriers and facilitators to establishing a new service in an Australian hospital setting.

Methods: how the study was performed and statistical tests used
A qualitative case study approach was utilised. The study gathered and analysed data using observations of service committee meetings, document analysis of agendas and minutes, and semi-structured interviews with committee members to generate semantic themes. By interpreting the thematic findings in reference to national capacity building resources, this study also aimed to provide practice-based reflections for other health agencies.

Results: the main findings
An overarching theme identified in the data was a strong commitment to supporting clinicians facing difficult patient care decisions and navigating difficult discussions with patients and families. Another key theme was the role of the new clinical ethics support service in providing clinicians with a pathway to raise system-wide issues with the organisation Executive. While there was strong clinical engagement, consumer and community participation remained a challenge, as did unresolved governance issues and a need for clearer policy relationship between the service and the organisation.

Conclusions: brief summary and potential implications
Considering these themes in relation to the national capacity building resources, the study identifies three areas likely to require ongoing development and negotiation. These are: the role of the clinical ethics support service as a link between the workforce and the Executive; the incorporation of consumers and patients; and ethical reasoning. To improve the effectiveness of the service, it is necessary to increase clarity on the service’s role at the governance and policy level, as well as develop strategies for engaging consumers, patients and families. Finally, the capacity of the service to reflect on complex cases may be enhanced through explicit discussions of various different ethical frameworks and ways of deliberating.
Preferences of healthcare workers for provider payment systems in The Gambia’s National Health Insurance Scheme
Authors: Njie Hassan , Ilboudo Patrick G. C. , Gopinathan Unni , Chola Lumbwe , Wangen Knut Reidar 
Published: August 2023

Abstract
Background
The Government of The Gambia introduced a national health insurance scheme (NHIS) in 2021 to promote universal health coverage (UHC). Provider payment systems (PPS) are strategic purchasing arrangements that can enhance provider performance, accountability, and efficiency in the NHIS. This study assessed healthcare workers’ (HCWs’) preferences for PPS across major service areas in the NHIS.

Methods
A facility-based cross-sectional study was conducted using a probability proportionate to size sampling technique to select an appropriate sample size. Health care workers were presented with options for PPS to choose from across major service areas. Descriptive statistics explored HCW socio-demographic and health service characteristics. Multinomial logistic regressions were used to assess the association between these characteristics and choices of PPS.

Results
The majority of HCW did not have insurance coverage, but more than 60% of them were willing to join and pay for the NHIS. Gender, professional cadre, facility level, and region influenced HCW’s preference for PPS across the major service areas. The preferred PPS varied among HCW depending on the service area, with capitation being the least preferred PPS across all service areas.

Conclusion
The National Health Insurance Authority (NHIA) needs to consider HCW’s preference for PPS and factors that influence their preferences when choosing various payment systems. Strategic purchasing decisions should consider the incentives these payment systems may create to align incentives to guide provider behaviour towards UHC. The findings of this study can inform policy and decision-makers on the right mix of PPS to spur provider performance and value for money in The Gambia’s NHIS.
CFTR dysfunction in smooth muscle drives TGFβ dependent airway hyperreactivity
Authors: Kramer Elizabeth L. , Hudock Kristin M. , Davidson Cynthia R. , Clancy John P. 
Published: August 2023

Abstract
Background
The primary underlying defect in cystic fibrosis (CF) is disrupted ion transport in epithelia throughout the body. It is unclear if symptoms such as airway hyperreactivity (AHR) and increased airway smooth muscle (ASM) volume in people with CF are due to inherent abnormalities in smooth muscle or are secondary to epithelial dysfunction. Transforming Growth Factor beta 1 (TGFβ) is an established genetic modifier of CF lung disease and a known driver of abnormal ASM function. Prior studies have demonstrated that CF mice develop greater AHR, goblet cell hyperplasia, and ASM hypertrophy after pulmonary TGFβ exposure. However, the mechanism driving these abnormalities in CF lung disease, specifically the contribution of CFTR loss in ASM, was unknown.

Methods
In this study, mice with smooth muscle-specific loss of CFTR function (Cftrfl/fl; SM-Cre mice) were exposed to pulmonary TGFβ. The impact on lung pathology and physiology was investigated through examination of lung mechanics, Western blot analysis, and pulmonary histology.

Results
Cftrfl/fl; SM-Cre mice treated with TGFβ demonstrated greater methacholine-induced AHR than control mice. However, Cftrfl/fl; SM-Cre mice did not develop increased inflammation, ASM area, or goblet cell hyperplasia relative to controls following TGFβ exposure.

Conclusions
These results demonstrate a direct smooth muscle contribution to CF airway obstruction mediated by TGFβ. Dysfunction in non-epithelial tissues should be considered in the development of CF therapeutics, including potential genetic therapies.
Empagliflozin improves insulin sensitivity in patients with recent acute coronary syndrome and newly detected dysglycaemia
Authors: Fortin Elena , Lundin Magnus , Mellbin Linda , Norhammar Anna , Näsman Per , Smetana Stina , Sörensson Peder , Ferrannini Ele , Rydén Lars , Ferrannini Giulia 
Published: August 2023

Abstract
Background
Empagliflozin reduces the risk of cardiovascular disease (CVD) in patients with type 2 diabetes (T2DM) and high cardiovascular risk via mechanisms which have not been fully explained. The mechanisms of such benefit have not been fully understood, and whether empagliflozin can be safely administered as first-line treatment in patients with CVD at the initial stages of glycaemic perturbations remains to be established. We investigated the effects of empagliflozin on insulin resistance, insulin sensitivity and β-cell function indexes in patients with a recent acute coronary event and newly detected dysglycaemia, i.e., impaired glucose tolerance (IGT) or T2DM.

Methods
Forty-two patients (mean age 67.5 years, 19% females) with a recent myocardial infarction (n = 36) or unstable angina (n = 6) and newly detected dysglycaemia were randomized to either empagliflozin 25 mg daily (n = 20) or placebo (n = 22). Patients were investigated with stress-perfusion cardiac magnetic resonance imaging before randomization, 7 months after the start of study drug and 3 months following its cessation. Indexes of insulin resistance, sensitivity and β-cell function were calculated based on glucose and insulin values from 2-hour oral glucose tolerance tests (OGTT) and fasting C-peptide. The differences in glucose, insulin, C-peptide, mannose levels and indexes between the two groups were computed by repeated measures ANOVA including an interaction term between the treatment allocation and the time of visit.

Results
After 7 months, empagliflozin significantly decreased glucose and insulin values during the OGTT, whereas C-peptide, mannose and HbA1c did not differ. Empagliflozin significantly improved insulin sensitivity indexes but did not impact insulin resistance and β-cell function. After cessation of the drug, all indexes returned to initial levels. Insulin sensitivity indexes were inversely correlated with left ventricular mass at baseline.

Conclusions
Empagliflozin improved insulin sensitivity indexes in patients with a recent coronary event and drug naïve dysglycaemia. These findings support the safe use of empagliflozin as first-line glucose-lowering treatment in patients at very high cardiovascular risk with newly diagnosed dysglycaemia.

Trial registration number
EudraCT number 2015-004571-73.
Inhibition of hyaluronic acid degradation pathway suppresses glioma progression by inducing apoptosis and cell cycle arrest
Authors: Yan Tao , Yang He , Xu Caixia , Liu Junsi , Meng Yun , Jiang Qing , Li Jinxing , Kang Guiqiong , Zhou Liangjian , Xiao Shuai , Xue Yanpeng , Xu Jiayi , Chen Xin , Che Fengyuan 
Published: August 2023

Abstract
Background
Abnormal hyaluronic acid (HA) metabolism is a major factor in tumor progression, and the metabolic regulation of HA mainly includes HA biosynthesis and catabolism. In glioma, abnormal HA biosynthesis is intimately involved in glioma malignant biological properties and the formation of immunosuppressive microenvironment; however, the role of abnormal HA catabolism in glioma remains unclear.

Methods
HA catabolism is dependent on hyaluronidase. In TCGA and GEPIA databases, we found that among the 6 human hyaluronidases (HYAL1, HYAL2, HYAL3, HYAL4, HYALP1, SPAM1), only HYAL2 expression was highest in glioma. Next, TCGA and CGGA database were further used to explore the correlation of HYAL2 expression with glioma prognosis. Then, the mRNA expression and protein level of HYAL2 was determined by qRT-PCR, Western blot and Immunohistochemical staining in glioma cells and glioma tissues, respectively. The MTT, EdU and Colony formation assay were used to measure the effect of HYAL2 knockdown on glioma. The GSEA enrichment analysis was performed to explore the potential pathway regulated by HYAL2 in glioma, in addition, the HYAL2-regulated signaling pathways were detected by flow cytometry and Western blot. Finally, small molecule compounds targeting HYAL2 in glioma were screened by Cmap analysis.

Results
In the present study, we confirmed that Hyaluronidase 2 (HYAL2) is abnormally overexpressed in glioma. Moreover, we found that HYAL2 overexpression is associated with multiple glioma clinical traits and acts as a key indicator for glioma prognosis. Targeting HYAL2 could inhibit glioma progression by inducing glioma cell apoptosis and cell cycle arrest.

Conclusion
Collectively, these observations suggest that HYAL2 overexpression could promote glioma progression. Thus, treatments that disrupt HA catabolism by altering HYAL2 expression may serve as effective strategies for glioma treatment.