bluuebunny/crossref_metadata_2025_split huggingface dataset:
Locking plate fixation versus intramedullary nail fixation for the treatment of multifragmentary proximal humerus fractures (OTA/AO type 11C): a preliminary comparison of clinical efficacy
Authors: Wang Minghui , Wang Xiuhui , Cai Pan , Guo Shengyang , Fu Beigang 
Published: June 2023

Abstract
Background
This study aimed to compare the clinical efficacy of locking plate and intramedullary nail fixations in the treatment of patients with OTA/AO type 11C proximal humerus fractures.

Methods
We retrospectively analyzed the data of patients with OTA/AO type 11C1.1 and 11C3.1 proximal humerus fractures who underwent surgery at our institution from June 2012 to June 2017. Perioperative indicators, postoperative morphological parameters of the proximal humerus, and Constant–Murley scores were evaluated and compared.

Results
Sixty-eight patients with OTA/AO type 11C1.1 and 11C3.1 proximal humerus fractures were enrolled in this study. Overall, 35 patients underwent open reduction and plate screw internal fixation, and 33 patients underwent limited open reduction and locking of the proximal humerus with intramedullary nail internal fixation. The total cohort had a mean follow-up duration of 17.8 months. The mean operation time of the locking plate group was significantly longer than that of the intramedullary nail group (P < 0.05), while the mean bleeding volume was significantly higher in the locking plate group than that in the intramedullary nail group (P < 0.05). The initial neck–shaft angles, final neck–shaft angles, forward flexion ranges, or Constant–Murley scores did not show significant differences between the two groups (P > 0.05). Complications, including screw penetrations, acromion impingement syndrome, infection, and aseptic necrosis of the humeral head, occurred in 8 patients (8/35, 22.8%) in the locking plate group and 5 patients in the intramedullary nail group (5/33, 15.1%; including malunion and acromion impingement syndrome), with no significant difference between the groups (P > 0.05).

Conclusions
Similar satisfactory functional results can be achieved with locking plates and intramedullary nailing for OTA/AO type 11C1.1 and 11C3.1 proximal humerus fractures, with no significant difference in the number of complications between these two techniques. However, intramedullary nailing has advantages over locking plates for OTA/AO type 11C1.1 and 11C3.1 proximal humerus fractures in terms of operation time and bleeding volume.
Segmental ureterectomy for high-risk ureteral carcinoma: a preliminary report
Authors: Wei Wei , Liu Junfeng , Wang Lingdian , Duan Xiaoyu , Ding Degang 
Published: June 2023

AbstractBackgroundEAU guidelines strongly recommend kidney sparing surgery (KSS) as the primary treatment option for the low-risk UTUC patients. While there are few reports involving the KSS treated for the high-risk counterparts, especially the ureteral resection.ObjectiveTo evaluate the effectiveness and safety of the segmental ureterectomy (SU) for the patients with high-risk ureteral carcinoma.Materials and methodsWe included 20 patients from May 2017 to December 2021 who underwent segmental ureterectomy (SU) in Henan Provincial People’s Hospital. The overall survival (OS) and progression free survival (PFS) were evaluated. Besides, the ECOG scores and postoperative complications were also included.ResultsAs of December 2022, the mean OS was 62.1months (95%CI:55.6-68.6months) and the mean PFS was 45.0months (95%CI:35.9-54.1months). The median OS and median PFS were not reached. The 3-year OS rate was 70% and the 3-year PFS rate was 50%. The percentage of Clavien I and II complications was 15%.ConclusionFor the selected patients with high-risk ureteral carcinoma, the efficacy and safety of segmental ureterectomy were satisfactory. But we still need to conduct prospective or randomized study to validate the value of SU in patients with high-risk ureteral carcinoma.
Recurrent bilateral adrenal infarction with myelodysplastic/myeloproliferative neoplasm-unclassifiable (MDS/MPN-U): a case report
Authors: Hoshino Yoshitomo , Manaka Katsunori , Sato Junichiro , Asatsuma Yui , Horikoshi Hirofumi , Takeuchi Maki , Ito Nobuaki , Fujita Megumi , Yasunaga Megumi , Matsuda Kensuke , Honda Akira , Maki Hiroaki , Masamoto Yosuke , Kurokawa Mineo , Nangaku Masaomi , Makita Noriko 
Published: June 2023

Abstract
Background
Bilateral adrenal infarction is rare and only a small number of cases have been reported so far. Adrenal infarction is usually caused by thrombophilia or a hypercoagulable state, such as antiphospholipid antibody syndrome, pregnancy, and coronavirus disease 2019. However, adrenal infarction with myelodysplastic/myeloproliferative neoplasm (MDS/MPN) has not been reported.

Case presentation
An 81-year-old man with a sudden severe bilateral backache presented to our hospital. Contrast-enhanced computed tomography (CT) led to the diagnosis of bilateral adrenal infarction. Previously reported causes of adrenal infarction were all excluded and a diagnosis of MDS/MPN-unclassifiable (MDS/MPN-U) was reached, which was considered to be attributed to adrenal infarction. He developed a relapse of bilateral adrenal infarction, and aspirin administration was initiated. Partial primary adrenal insufficiency was suspected as the serum adrenocorticotropic hormone level was persistently high after the second bilateral adrenal infarction.

Conclusion
This is the first case of bilateral adrenal infarction with MDS/MPN-U encountered. MDS/MPN has the clinical characteristics of MPN. It is reasonable to assume that MDS/MPN-U may have influenced bilateral adrenal infarction development, considering the absence of thrombosis history and a current comorbid hypercoagulable disease. This is also the first case of recurrent bilateral adrenal infarction. It is important to carefully investigate the underlying cause of adrenal infarction once adrenal infarction is diagnosed, as well as to assess adrenocortical function.
Effect of different interfacial surface treatments on the shear bond strength of veneering ceramic and zirconia core
Authors: Youssef Marwa K. , Abdelkader Sanaa H. , Aly Yasser M. 
Published: June 2023

Abstract
Background
Several interfacial surface treatments of zirconia surfaces have been proposed to improve adhesion to ceramic veneering. However, information regarding the durability and effect of such treatments on the bond strength following such treatments is lacking.

Aim of the study
This study aimed to evaluate the shear bond strength between veneering ceramic and zirconia core after different interfacial surface treatments.

Materials and methods
Fifty-two discs (8 mm in diameter and 3 mm in height) were fabricated from zirconia blanks using a microtome cutting machine. Zirconia discs were divided into four groups (n = 13). Group I was subjected to air-borne abrasion using (Al2O3), group II was coated by bioglass, group III was coated with ZirLiner, and group IV was subjected to wash firing (sprinkle technique). A cylinder (4 mm in diameter and 3 mm in height) of veneering ceramic was fired on top of the zirconia core. Shear bond strength (SBS) between zirconia core and veneering ceramic was evaluated by using a universal testing machine. The data was collected and statistically analysed using One-Way ANOVA followed by multiple pairwise comparisons using Bonferroni adjusted significance level. The failure modes were assessed using a stereomicroscope for each group.

Results
The highest mean bond strength was recorded in group III (17.98 ± 2.51 MPa), followed by group II (15.10 ± 4.53 MPa), then group I 14.65 ± 2.97 MPa. The lowest mean bond strength was recorded in group IV (13.28 ± 3.55 MPa).

Conclusions
Surface treatments had an effect on the zirconia-veneer shear bond strength. Liner coating revealed the highest shear bond strength values, significantly higher in comparison to wash firing (sprinkle technique) .
Medical student perceptions and experiences of incivility: a qualitative study
Authors: Griffin Louise , Baverstock Anna 
Published: June 2023

Abstract
Background
Incivility is rude, dismissive or aggressive behaviour in the workplace. Rates of incivility are increasing in healthcare settings, with minority groups at greatest risk. Medical students are particularly vulnerable to incivility whilst on clinical placements, with detrimental consequences on students’ learning and mental health. Therefore, this study explored the perceptions and experiences of incivility from healthcare workers amongst medical students.

Methods
An online qualitative questionnaire study employing a thematic analysis. Students in years 3–5 or intercalating at a large West Midlands medical school were recruited between May–June 2022. Qualitative free-text questions explored students’ experiences of incivility from healthcare workers over the past 12 months, and actions in response to incivility. Data were analysed using thematic analysis. All researchers agreed thematic saturation was reached at 50 responses, with all year-groups represented.

Results
Five core themes were identified: abuse of hierarchy; exclusion; discrimination; response to incivility; barriers to action. Participants reported a range of uncivil behaviour from staff, including mocking, exclusion and discrimination. Discriminatory incivility targeted students’ protected characteristics, including race, sex, sexual orientation and disability. In response to experiencing or witnessing incivility, participants varied in their preferred mode of action. Many viewed formal escalation to senior staff as favourable action. Meanwhile, other participants would not escalate concerns and instead respond with peer support or allyship. Marked barriers prevented students from challenging or reporting incivility, including a lack of confidence; failures and fears of reporting systems; and perceived severity of abuse.

Conclusion
Our findings identify the extensive incivility experienced by medical students on clinical placements, which is frequently perpetuated by abusive workplace hierarchy. Whilst students recognise the importance of reporting uncivil behaviours, barriers to reporting include unrecognised incivility, psychological consequences and failed reporting systems. In order to reform toxic educational environments, we recommend medical schools to integrate formal civility training into the curriculum and restructure accessible, supportive reporting systems.
The prevalence of depressive and anxiety symptoms among first-year and fifth-year medical students during the COVID-19 pandemic: a cross-sectional study
Authors: Alshehri Abdullah , Alshehri Badr , Alghadir Omar , Basamh Abdullah , Alzeer Meshari , Alshehri Mohammed , Nasr Sameh 
Published: June 2023

Abstract
Background
Medical students have higher risk of psychological disorders due to the relatively stressful environment. Educators are becoming increasingly aware of the impact of stresses on the students general well-being. The objective of the current study was to examine the prevalence of and risk factors for depressive and anxiety symptoms among first-year and fifth-year medical students. Additionally, we aimed to determine whether the COVID-19 pandemic has affected students’ mental well-being.

Methods
A cross-sectional study was performed at the College of Medicine at King Saud University between September 2020 and January 2021. The target population was first-year and fifth-year medical students. Depressive symptoms were screened using the 9-item Patient Health Questionnaire (PHQ-9), while anxiety symptoms were screened using the 7-item Generalized Anxiety Disorder assessment (GAD-7). Students were also directly asked about the effect of the COVID-19 pandemic on their mental well-being. Outcomes were compared between groups using the chi-squared test and Student’s t test. Multivariate logistic regression analysis was performed to identify factors associated with depressive and anxiety symptoms.

Results
A total of 182 medical students were included. Depressive symptoms (52.9% versus 35.8%, p = 0.020) and anxiety symptoms (35.6% versus 26.3%, p = 0.176) were higher in the first-year students than in the fifth-year students. Approximately 19.2% of the students were worried about acquiring COVID-19, 49.4% were worried about academic performance, and 30.8% were feeling sad, depressed or anxious during the COVID-19 pandemic. Independent risk factors for depressive symptoms included having concomitant anxiety, being worried about acquiring COVID-19, being worried about academic performance, and feeling sad, depressed or anxious. Independent risk factors for anxiety included having a lower grade point average and having concomitant depressive symptoms.

Conclusion
Medical students have an alarmingly high prevalence of depressive and anxiety symptoms, which might have been negatively impacted by the COVID-19 pandemic. There is a need for a special mental health program targeting new and current medical students.
How experienced wound care nurses conceptualize what to do in pressure injury management
Authors: Lee Ye-Na , Chang Sung Ok 
Published: June 2023

Abstract
Background
Conceptual understanding of the perceptions that wound care nurses use to determine how to manage pressure injuries may provide information for improving their pressure injury care competency. The aim of this study is to explore and describe the way wound care nurses experience and perceive pressure injury management.

Methods
A qualitative, phenomenographic approach, a method designed to explore the different ways in which people comprehend a phenomenon and develop a practical knowledge-based framework, was used in this study. Semi-structured interviews were used for data collection with twenty wound care nurses. All participants were female with a mean age of 38.0, mean total clinical experience of 15.2 years and mean clinical experience as wound care nurse of 7.7 years. The eight steps of qualitative data analysis for a phenomenographic study were employed to develop an understanding of participants’ experience of pressure injury management.

Results
The analysis resulted in an assessment domain and an intervention domain, each containing three descriptive categories based on five identified conceptions. The categories were as follows: “comparison”, “consideration”, and “monitoring” in assessment, and “creation”, “conversation” and “judgement” in intervention.

Conclusions
This study has created a framework for understanding pressure injury management based on practical knowledge. This framework of the nurses’ pressure injury care reflected the need for an awareness of a harmonious approach to patients and wounds. There is a pattern of transcending a reliance on only theoretical knowledge, and this key factor in the framework should be considered when developing education programs and tools for improving nurse pressure injury care competency and patient safety.
Glycosyltransferase GLT8D1 and GLT8D2 serve as potential prognostic biomarkers correlated with Tumor Immunity in Gastric Cancer
Authors: Xu Huimei , Huang Ke , Lin Yimin , Gong Hang , Ma Xueni , Zhang Dekui 
Published: June 2023

Abstract
Background
Glycosylation involved in various biological function, aberrant glycosylation plays an important role in cancer development and progression. Glycosyltransferase 8 domain containing 1 (GLT8D1) and GLT8D2, as members of the glycosyltransferase family proteins, are associated with transferase activity. However, the association between GLT8D1/2 and gastric cancer (GC) remains unclear. We aimed to investigate the potential prognostic value and oncogenic role of GLT8D1/2 in GC.

Methods
The relationship between GLT8D1/2 and GC was evaluated through comprehensive bioinformatics approaches. A series of factors like gene expression patterns, Kaplan-Meier survival analyses, Cox regression analyses, prognostic nomogram, calibration curves, ROC curves, function enrichment analyses, tumor immunity association, genetic alterations, and DNA methylation were included. Data and statistical analyses were performed using R software (v3.6.3).

Results
Both GLT8D1 and GLT8D2 expression were significantly upregulated in GC tissues(n = 414) compared with normal tissues(n = 210), and high expression of GLT8D1/2 was remarkably correlated with poor prognosis for GC patients. Cox regression analyses implied that GLT8D1/2 could act as independent prognostic factors in GC. Furthermore, gene function analyses indicated that multiple signaling pathways involving tumor oncogenesis and development enriched, such as mTOR, cell cycle, MAPK, Notch, Hedgehog, FGF, and PI3K-Akt signaling pathways. Moreover, GLT8D1/2 was significantly associated with immune cell infiltration, immune checkpoint genes, and immune regulators TMB/MSI.

Conclusion
GLT8D1/2 may serve as potential prognostic markers of poor prognosis in GC correlated with tumor immunity. The study provided an insight into identifying potential biomarkers and targets for prognosis, immunotherapy response, and therapy in GC.
HLA-B*27 is associated with CNO in a European cohort
Authors: O’Leary Daire , Al Julandani Dalila Ali , Zia Muhammad , Klotsche Jens , Minden Kirsten , Roderick Marion , Ramanan Athimalaipet V. , Killeen Orla G. , Wilson Anthony G. 
Published: June 2023

Abstract
Objectives
To determine the influence of HLA-B27 positivity on risk of developing chronic nonbacterial osteomyelitis (CNO).

Methods
HLA-B*27 genotype was assessed in 3 European CNO populations and compared with local control populations (572 cases, 33,256 controls). Regional or whole-body MRI was performed at diagnosis and follow-up in all cases which reduces the risk of disease misclassification. Genotyping was performed using either next generation DNA sequencing or PCR based molecular typing. Statistical analysis used Fisher’s exact test with Bonferroni correction and a fixed effects model for meta-analysis of odds ratios.

Results
HLA-B*27 frequency was higher in all 3 populations compared with local controls (combined odds ratio (OR) = 2.2, p-value = 3 × 10–11). This association was much stronger in male compared with female cases (OR = 1.99, corrected p-value = 0.015). However, the HLA-B*27 status was not statistically significantly associated with co-occurrence of psoriasis, arthritis or inflammatory bowel disease.

Conclusion
Carriage of HLA-B*27 is associated with greater risk of developing CNO, particularly in male cases.
Effects of the reaching married adolescents program on modern contraceptive use and intimate partner violence: results of a cluster randomized controlled trial among married adolescent girls and their husbands in Dosso, Niger
Authors: Silverman Jay G. , Brooks Mohamad I. , Aliou Sani , Johns Nicole E. , Challa Sneha , Nouhou Abdoul Moumouni , Tomar Shweta , Baker Holly , Boyce Sabrina C. , McDougal Lotus , DeLong Stephanie , Raj Anita 
Published: June 2023

Abstract
Background
Niger has the highest rate of adolescent fertility in the world, with early marriage, early childbearing and high gender inequity. This study assesses the impact of Reaching Married Adolescents (RMA), a gender-synchronized social behavioral intervention designed to improve modern contraceptive use and reduce intimate partner violence (IPV) among married adolescent couples in rural Niger.

Methods
We conducted a four-armed cluster-randomized trial in 48 villages across three districts in Dosso region, Niger. Married adolescent girls (ages 13–19) and their husbands were recruited within selected villages. Intervention arms included home visits by gender-matched community health workers (CHWs) (Arm 1), gender-segregated, group discussion sessions (Arm 2), and both approaches (Arm 3). We used multilevel mixed-effects Poisson regression models to assess intervention effects for our primary outcome, current modern contraceptive use, and our secondary outcome, past year IPV.

Results
Baseline and 24-month follow-up data were collected April–June 2016 and April–June 2018. At baseline, 1072 adolescent wives were interviewed (88% participation), with 90% retention at follow-up; 1080 husbands were interviewed (88% participation), with 72% retention at follow-up. Adolescent wives had higher likelihood of modern contraceptive use at follow-up relative to controls in Arm 1 (aIRR 3.65, 95% CI 1.41–8.78) and Arm 3 (aIRR 2.99, 95% CI 1.68–5.32); no Arm 2 effects were observed. Relative to those in the control arm, Arm 2 and Arm 3 participants were significantly less likely to report past year IPV (aIRR 0.40, 95% CI 0.18–0.88 for Arm 2; aIRR 0.46, 95% CI 0.21–1.01 for Arm 3). No Arm 1 effects were observed.

Conclusions
The RMA approach blending home visits by CHWs and gender-segregated group discussion sessions is the optimal format for increasing modern contraceptive use and decreasing IPV among married adolescents in Niger.
Trial registration This trial is retrospectively registered with ClinicalTrials.gov, Identifier NCT03226730
Designing, implementing and evaluating an educational program regarding the effects of second-hand smoke in pregnancy on the knowledge, attitude and performance of male smokers
Authors: Karimiankakolaki Zohreh , Mazloomy Mahmoodabad Seyed Saeed , Kazemi Ashraf 
Published: June 2023

AbstractIntroductionContact with second-hand cigarette smoke includes inhalation of cigarette smoke caused by the burning of the cigarette itself and inhalation of smoke exhaled by the smoker. Wife's pregnancy can be a motivating factor to change the behavior of men who smoke. Therefore, this study was conducted with the aim of designing, implementing and evaluating an educational program regarding the effects of second-hand smoke in pregnancy on the knowledge, attitude and performance of male smokers.MethodologyThe present study is an interventional type of pre-test and post-test. In this phase, sampling from health centers in Isfahan was done randomly between March and July 2019, the participants were 140 smoking spouses of pregnant women, who visited health centers to receive pregnancy care, and were divided into two intervention groups and control were divided. The data collection tool was a researcher-made questionnaire on men's awareness, attitude and performance regarding second-hand smoke. All data were analyzed with SPSS18 software and Chi-score, Fisher, t-test.ResultsThe average age of the participants was 34 years. There was no significant difference between the comparison of demographic variables in the intervention and control groups (p > 0.05). The results of the paired t-test for comparing before and after the training showed that the average score of the emotional dimension of attitude in the two groups of intervention (p < 0.001) and control (p < 0.001), awareness (p < 0.001) and behavior (p < 0.001) was significantly increased in the intervention group after the training, and according to the independent t-test, the average score of the items mentioned after the training in the intervention group was higher than the control group (p < 0.05). Regarding perceived sensitivity (p = 0.066) and perceived severity (p = 0.065), no significant difference was observed.ConclusionThe awareness, emotional aspect of men's attitude and behavior regarding secondhand smoke increased, but the perceived sensitivity and severity in this regard was not significant despite the increase, so the current training package is effective in training, but considering more training sessions It is necessary with more concrete training with model or training videos in order to improve the sensitivity and perceived intensity of men.Trial registration: Registration of this randomized control trial has been completed with the Iranian Registry of Clinical Trials, IRCT20180722040555N1.