bluuebunny/crossref_metadata_2025_split huggingface dataset:
Arthroscopic Posterior Labral Repair for Posterior Shoulder Instability
Authors: Nammour Michael A. , James Michael , Arner Justin W. , Bradley James P. 
Published: July 2023

Background: Posterior shoulder instability occurs in 2% to 10% of shoulder instability cases and is more commonly due to repetitive microtrauma as opposed to the more traumatic onset seen in anterior shoulder instability. In posterior instability, the posterior capsulolabral complex becomes attenuated or torn. Thus, surgical treatment aims to restore the posterior soft-tissue stabilizers typically with an arthroscopic, suture-anchor-based labral repair. Indications: Surgical indications include posterior instability with traumatic cause and associated soft-tissue and/or osseous pathology and for those patients with repetitive microtrauma who have failed nonsurgical management. Technique Description: Following diagnostic arthroscopy, the glenoid is prepared using an arthroscopic elevator, rasp, and chisel first viewing from the posterior portal, then from the anterior portal using a 70° arthroscope. An all-suture anchor is placed at the 7 o’clock position using a curved guide which obviates the need for an accessory 7 o’clock portal. The repair suture is then shuttled through the labrum using a suture lasso and monofilament. This repair suture is then shuttled through the suture anchor using the inbuilt shuttling fiberlink. The repair suture is then tightened to secure the labrum. The remainder of the repair uses knotless 2.9-mm biocomposite suture anchors and free suture tape as the all-suture anchor and associated curved guide are typically only necessary for the angle of the most inferior portal. Following a 3 to 5 anchor repair, the posterior portal capsular rent is closed to avoid leaving a stress riser. Posterior capsular closure is achieved using monofilament suture passed with a birdbeak and tied blindly in the subacromial space. Results: In a study of 200 shoulders at 36 months, patients undergoing posterior stabilization had improvements in their American Shoulder and Elbow Surgeons (ASES) scores and improvements in stability, pain and function. Ninety percent of patients were able to return to sport and 64% of patients returned to the same level. Failure rate was low at 6%. Discussion/Conclusion: Posterior labral repair is a technically nuanced but reliable procedure for the management of posterior instability. Patient Consent Disclosure Statement: The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form of approval from the patient(s) with this submission for publication.
Investigating the anticancer and anti-angiogenic effects of graphene oxide nanoparticles containing 6-gingerol modified with chitosan and folate
Authors: Al-Janabi Angham Hakim Abdulzahra , Hayati Roodbari Nasim , Homayouni Tabrizi Masoud 
Published: July 2023

Abstract
Objective
The use of nanocarriers to improve the targeting of treatment plays a key role in the treatment of many diseases, including cancer. This study was carried out to synthesize graphene oxide (GO) containing 6-gingerol (Ging) modified with chitosan (CS)-folic acid (FA) nanoparticles (Ging-GO-CS-FA) to improve the anti-cancer effects of Ging.

Methods
After the synthesis of nanoparticles, the average size, surface charge, and dispersion index (DPI) of nanoparticles were analyzed by the dynamic light scattering (DLS) method. Field emission scanning electron microscope (FESEM) and Fourier transform infrared spectroscopy (FTIR) were utilized to assess the morphology and functional groups of synthesized nanoparticles, respectively. The 2,5-diphenyl-2H-tetrazolium bromide (MTT) method was performed to assess the toxicity effect of nanoparticles on different types of cancer cells. The antioxidant power of nanoparticles was evaluated by ABTS and DPPH methods. In addition, the chorioallantoic membrane (CAM) test was conducted to investigate the anti-angiogenic effects of nanoparticles. Finally, the real-time quantitative PCR (qPCR) method was carried out to detect the changes in the expression of angiogenic and antioxidant genes in cancer cells.

Results
The nanoparticles have an average size of 73.21 nm, a DPI of 0.27, and a surface charge of 29.5. The encapsulation rate of Ging in nanoparticles was reported to be 81.7%. According to the MTT test, the most sensitive cell line to the Ging-GO-CS-FA nanoparticles was reported to be gastric cancer cells (IC50 ~ 27). The results of the antioxidant test showed the high antioxidant power of nanoparticles in the laboratory environment by inhibiting ABTS and DPPH free radicals. The pro-oxidant power of Ging-GO-CS-FA against cancer cells was confirmed by reducing the amount of the superoxide dismutase (SOD) gene in the treated cells. The decreasing effects of Ging-GO-CS-FA on angiogenesis were observed by reducing the average length, the number of blood vessels, average height, and weight of treated embryos. In addition, the decrease in the expression of VEGF and VEGF-R genes confirmed the anti-angiogenic of Ging-GO-CS-FA.

Conclusions
These results show the promising effect of Ging-GO-CS-FA on gastric cancer cells by inhibiting angiogenesis and increasing the level of oxidants.
Brief cognitive behavior therapy for stigmatization, depression, quality of life, social support and adherence to treatment among patients with HIV/AIDS: a randomized control trial
Authors: Abbas Qasir , Nisa Mehru , Khan Muhammad Umar , Anwar Nida , Aljhani Sumayah , Ramzan Zoobia , Shahzadi Mafia 
Published: July 2023

Abstract
Objective
Individuals living with HIV/AIDs are at a high risk of many problems like depression, stigma, quality of life, decreased adherence to treatment, and lack of social support. The present study aimed to investigate the impact of brief-cognitive behavior therapy (B-CBT) on reducing depression and stigma and improving treatment adherence, quality of life, and social support among patients with HIV/AIDS attending antiretroviral therapy (ART).

Materials and methods
This randomized clinical trial was conducted at ART Clinic in the Tehsil Headquarters Hospital Shahkot Nankana Sahib from July 2021 to October 2021. After baseline screening, 126 patients met the eligibility criteria and 63 were allocated to the experimental group (EXPg = 63) and 63 to waitlist-control group (WLCg = 63). Participants’ age range was from 20 to 55 years. Participants who were taking ART treatment were enrolled for the CBT treatment. Before this, all the participants completed a baseline assessment to ensure a level of severity and diagnosis. A total of eight CBT based therapeutic sessions were conducted individually with EXPg. To assess the outcomes among patients receiving ART, we used Demographic form, Patient health questionnaire, HIV stigma scale, General medication adherence scale, Multidimensional scale of perceived social support, and WHOQOL BREF scale.

Results
Findings suggest that B-CBT significantly reduced the level of depression (i.e. F (1, 78) = 101.38, p < .000, η2 = .599), and social stigma (i.e. F (1, 78) = 208.47, p < .000, η2 = .787) among patients with HIV/AIDS. Furthermore, CBT substantially improved the level of adherence to treatment (i.e. F(1,78) = 24.75, p < .000, η2 = .503), social support (i.e. F (1, 78) = 128.33, p < .000, η2 = .606), and quality of life (i.e. F (1, 78) = 373.39, p < .000, η2 = .837) among patients with HIV/AIDS. Significant mean difference M(SD) on PHQ at post-analysis in the EXPg vs. WLCg was seen 1.22(0.47) vs. 2.30(0.68) and similarly, on MPSS at a post-analysis in the EXPg vs. WLCg 2.85(0.36) vs. 1.70(0.51) which indicates sound therapeutic outcomes.

Conclusions
Cognitive behavioral therapy effectively decreases the level of depression and stigma and enhances the level of social support, quality of life, and adherence to treatment among HIV/AIDS patients. It is concluded that cognitive behavior therapy is an effective treatment approach for patients with HIV/AIDS.

Trial registration
Thai clinical trial registry (i.e. TCTR = TCTR20210702002).
Is fixation of both clavicle and scapula better than clavicle alone in surgical treatment of floating shoulder injury? A retrospective study
Authors: Shao Yijie , Zhu Xu , Liu Bo , Ji Chenchen , Sun Jiajia , Chen Guangdong 
Published: July 2023

Abstract
Background & objective
Little research was available to explore which surgical fixation was better between fixation of both clavicle and scapula and clavicle alone in management of floating shoulder injury.

Methods
Total 69 patients with floating shoulder injury receiving surgery from February 2005 to July 2020 participated in the study. 49 patients underwent fixation of the clavicle alone (Group C) while 20 patients underwent fixation of both clavicle and scapula (Group C + S). They were further divided into subgroups according to age: Group C1, Group C + S1 (age ≤ 55 years old) and Group C2, Group C + S2 (age>55 years old). The radiological parameter (glenopolar angle (GPA)) and clinical outcomes (Herscovici score, Constant-Murley shoulder outcome score (CSS score), and Visual Analogue Scale score (VAS score)) were collected and compared between these groups. The correlation between age and radiological parameter and clinical outcomes was calculated by the Spearman correlation analysis.

Results
All people were followed up for at least 1 year. The degree of change in GPA before and after surgery in Group C + S is significantly better than that in Group C. The Herscovici and CSS score in Group C + S2 were significantly higher than those in Group C2 at 1 month, 3 months and 1 year after surgery. However, no significant difference in Herscovici and CSS score was found at final follow-up (1 year after surgery) between Group C + S1 and Group C1. The VAS score in Group C + S2 at final follow-up was significantly lower than that in Group C2. No significant difference in VAS score at final follow-up was found between Group C + S1 and Group C1. In addition, the VAS score was negatively correlated with Herscovici and CSS score. No correlation was found between VAS score and GPA.

Conclusions
Both types of surgical fixation are effective in management of floating shoulder injury. For young people with floating shoulder injury, both types of surgical fixation are equally effective. However, for older people with floating shoulder injury, fixation of both clavicle and scapula is better in prognosis than fixation of clavicle alone.
Evaluation of the effectiveness of four alternative approaches for the classical cough test during a urodynamic study in the context of the COVID-19 global pandemic
Authors: Zeng Xiao , Liu Shuang , Shen SiHong , Shen Hong , Luo De-yi 
Published: July 2023

AbstractBackgroudTo evaluate four different alternatives to the classical cough test during a urodynamic study in the context of the COVID-19 pandemic.MethodsPatients who needed to undergo a urodynamic study (UDS) at the West China Hospital of Sichuan University between April 2021 and May 2021 were randomly selected according to the inclusion and exclusion criteria. During the UDS process, we used four alternative methods to the “cough test”: 1) quickly pressing the bladder area, 2) performing the Valsalva maneuver, 3) performing the Kegel maneuver, and 4) letting the patient close their mouth while performing the cough test. The "cough" waveform amplitudes and characteristics of the graphics were obtained and compared with the classical cough test.ResultsA total of 120 patients (89 men, 31 women) were included in the study. There was no significant difference between the cough waveform amplitude induced by the Valsalva maneuver compared with the classical cough test (P = 0.182); there was no significant difference between the cough waveform amplitude induced by the cough test with the mouth closed and the classical cough test (P = 0.342); there was no significant difference between pressing quickly on the bladder area and the classical method (P = 0.076); and there was a significant difference between the data obtained by the Kegel maneuver and the classical method (P < 0.05). The average "cough" amplitudes obtained were 73.14 ± 22.48 cm H2O, 66.17 ± 17.12 cm H2O, 82.93 ± 18.95 cm H2O, 26.50 ± 8.68 cm H2O, and 68.90 ± 20.32 cm H2O by the classical cough test, by quickly pressing the bladder area, by the Valsalva maneuver, by the Kegel maneuver, and by coughing with a closed mouth, respectively.ConclusionQuickly pressing the bladder area, performing the Valsalva maneuver, and letting the patient close their mouth while performing the cough test can all provide effective cough waveforms and amplitudes.Trial registrationNo. 2021–183.
FSCN1 promotes proliferation, invasion and glycolysis via the IRF4/AKT signaling pathway in oral squamous cell carcinoma
Authors: Li Liang , Chen Lihui , Li Zhangwei , Huang Shiqin , Chen Yaoyao , Li Zhiyong , Chen Wenkuan 
Published: July 2023

Abstract
Background
Oral squamous cell carcinoma (OSCC) is a disease with increasing incidence worldwide that leads to deformity and death. In OSCC, fascin actin-bundling protein 1 (FSCN1) is an oncogene involved in the tumorigenesis process. However, the functions and potential mechanisms of FSCN1 in the OSCC tumorigenesis process have not been reported thus far.

Methods
We used qRT‒PCR to detect the expression of FSCN1 in 40 paired OSCC tumor tissues (tumor) and neighboring noncancerous tissues. The role of FSCN1 was also assessed in vitro through colony formation, CCK-8, and transwell assays. Moreover, glucose consumption was detected. Western blotting was used to confirm the interaction of FSCN1, IRF4 and AKT.

Results
FSCN1 was remarkably overexpressed in OSCC tissues and cell lines compared to corresponding controls. In addition, colony formation, CCK-8, and transwell assays revealed a notable reduction in OSCC growth and invasion when FSCN1 was silenced. FSCN1 silencing remarkably suppressed OSCC glycolysis. Mechanistic studies showed that FSCN1 achieves its function partially by activating interferon regulatory factor 4 (IRF4) and the AKT pathway in OSCC.

Conclusion
In conclusion, our study investigated the functions and mechanisms of the FSCN1/IRF4/AKT pathway in OSCC progression. In OSCC, FSCN1 is likely to be a biomarker and therapeutic target.
Effect of N-Acetylcysteine on initial Carious Enamel Lesions in primary teeth: an In-vitro study
Authors: Mahfouz Omer Shaimaa M. , El-Sherbiny Randa H. , EL-Desouky Shaimaa S. 
Published: July 2023

AbstractBackgroundDental caries initiates with non-cavitated enamel lesions as the first stage. The cariogenic potential of N-Acetylcysteine (NAC) may be due to its usage frequency and form. This study aimed to evaluate the impact of exposure time of NAC on initial enamel caries-like lesions in primary teeth by assessing the morphological alteration using a scanning electron microscope (SEM) and mineral content using energy dispersive x-ray spectroscopy (EDX).MethodsForty primary incisor teeth were randomly divided into 4 groups S, S1, S2, and S3 (10 specimens/group). Teeth crowns were cut from their roots and inserted into an acrylic mold with its buccal surface directed upward. Centrally isolated enamel window (2 × 2 mm) on the tooth was done. Ten specimens were selected to evaluate normal enamel while the remaining thirty specimens were immersed in demineralizing solution for 96 h to produce enamel caries-like lesions. PH cycling was performed by immersing each tooth sample in 20 mL of demineralizing solution for 3 h then, preserved for the remaining day hours in 10 ml of artificial saliva interspersed with treatments applications with 10 ml NAC for 10 min twice a day for one- or three-months different treatment modalities. Thermocycling was done for all specimens then they were subjected to SEM and EDX analysis. ANOVA and Bonferroni post hoc tests were utilized in data analysis.ResultsIn teeth treated by NAC for 3 months (group-S3), SEM images showed severe loss of enamel architecture with large NAC deposits detected. A meaningful difference was observed among different groups concerning calcium, phosphorus, fluoride, ca/P ratio, carbon, nitrogen, and oxygen contents (P < 0.05).ConclusionNAC had a detrimental impact on enamel caries-like lesions in human primary teeth.
Structured viva validity, reliability, and acceptability as an assessment tool in health professions education: a systematic review and meta-analysis
Authors: Abuzied Abdelhamid Ibrahim Hassan , Nabag Wisal Omer Mohamed 
Published: July 2023

AbstractBackgroundThe viva, or traditional oral examination, is a process where the examiners ask questions and the candidate answers them. While traditional viva has many disadvantages, including subjectivity, low validity, and low reliability, it is advantageous for assessing knowledge, clinical reasoning, and self-confidence, which cannot be assessed by written tests. In order to overcome these disadvantages, structured viva was invented and is claimed to be highly valid, reliable, and acceptable, but this was not confirmed by an overall systematic review or meta-analysis of the studies. The research aims to investigate the studies to reach an overall decision regarding the quality of structured viva as an assessment tool according to the agreed standards in medical education in terms of validity, reliability, and acceptability.MethodsThis systematic review was done following the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines. PubMed, Best Evidence Medical Education (BEME) website reviews, Google Scholars, and ScienceDirect databases were searched for any article addressing the research questions from inception to December 2022. Data analysis was done by the OpenMeta Analyst open-source app, version Windows 10.ResultsA total of 1385 studies were identified. Of them, 24 were included in the review. Three of the reviewed studies showed higher validity of structured viva by a positive linear correlation coefficient compared with MCQs, MCQs and Objective Structured Clinical Examination (OSCE), and structured theory exam. In the reviewed studies, the reliability of structured viva was high by Cronbach alpha α = 0.80 and α = 0.75 in two different settings, while it was low α = 0.50 for the traditional viva. In the meta-analysis, structured viva was found to be acceptable by overall acceptability of (79.8%, P < 0.001) out of all learners who participated in structured viva as examinees at different levels in health professions education using the available numeric data of 12 studies. The heterogeneity of the data was high (I^2 = 93.506, P < 0.001) thus the analysis was done using the binary random-effects model.ConclusionStructured viva or structured oral examination has high levels of validity, reliability, and acceptability as an assessment tool in health professions education compared to traditional viva.
Preventing and developmental factors of sustainability in healthcare organisations from the perspective of decision makers: an exploratory factor analysis
Authors: Calabrese Mario , Suparaku Shefqet , Santovito Savino , Hysa Xhimi 
Published: July 2023

Abstract
Background
UN Sustainable Development Goals are part of the political agenda of most developed countries. Being a developing country, Albania has only recently adhered to this trend. Prior research at national level has sporadically focused on environmental sustainability, neglecting a holistic view of the phenomenon. To fill this gap, this study aims to explore preventing and developmental factors of sustainability in healthcare organisations from the perspective of decision makers by relying to a Triple Bottom Line approach.

Methods
Data were collected through a questionnaire administered to healthcare facilities and analysed through the Exploratory Factor Analysis. Findings revealed that the factors influencing the sustainability of the national healthcare system were five: Barriers of Organisational Sustainability; Stakeholders Pressure (regarding sustainable issues); Awareness (knowledge and measures taken for sustainability); Institutional Engagement; and Personal Interest and Involvement. The underlying factors included 19 items suitable for this sample, representing 64.371% of the total variance.

Results
The findings show the existence of 4 factors: Barriers of Organisational Sustainability, Stakeholders Pressure regarding Sustainable issues, Awareness/knowledge and measures taken for sustainability, Personal Interest and Involvement.

Conclusions
It is evident that national health organisations should continuously improve its strategies to be consistent with the sustainable development goals of international organisations, so that their initiatives could reflect the integration of sustainability approaches at the organisational level.
Barriers to adherence to cytology exam: a case study in low-income Colombian women
Authors: Bermúdez Paula C. , Arrivillaga Marcela , Torres Poveda Kirvis , Castrillón Libreros Diana M. , Castillo Castillo Lorena E. , Neira Acevedo Daniela 
Published: July 2023

AbstractBackgroundCervical cytology is essential for the early detection of cervical cancer. However, in Colombia, only 50% of women with subsidized health insurance were screened in 2019, compared to 100% of women with contributory insurance. This disparity highlights significant barriers that must be addressed. This study aimed to identify the factors that contribute to or hinder adherence to cervical cytology screening among low-income women with subsidized health insurance in a public primary care network in Cali, Colombia, from 2014 to 2018.MethodsIn a qualitative case study, the experience of women and health care and administrative personnel was recovered. Forty-seven women participated in seven focus group discussions. Five other women using the program participated in in-depth interviews. Finally, we interviewed eight people from the healthcare area and the health services administration. The qualitative data collected underwent content analysis, guided by the theoretical framework of Social Determinants of Health. Within this framework, five interconnected dimensions that influence adherence were incorporated.ResultsAdherence is a multifactorial phenomenon, and in relation to attendance at cervical cytology, the analysis delved into the mechanisms that affect it in a low-income context. Barriers to adherence were identified across multiple dimensions, including social and economic factors, health conditions, and patient-related factors, among both adherent and non-adherent women. Among adherent women, barriers and facilitators related to the healthcare team and system, as well as patient-related factors, were identified.ConclusionsThe findings of this research can be useful in developing personalized interventions and strategies to improve adherence and screening outcomes in low-income settings. It is necessary to increase the resources of health insurance entities to establish effective communication channels with women who attend the cervical cancer prevention program.