bluuebunny/crossref_metadata_2025_split huggingface dataset:
Sexual dysfunction prevalence, risk factors, and help-seeking behavior in opioid agonist treatment and general psychiatry: a cross-sectional study
Authors: Meyer Maximilian , Westenberg Jean N. , Brunner Patrick , Gürtler Martin , Wiesbeck Gerhard A. , Lang Undine E. , Vogel Marc , Dürsteler Kenneth M. 
Published: August 2023

BackgroundMental disorders pose a high risk for the occurrence of sexual dysfunctions (SD). This study aimed to investigate prevalence of risk factors and help-seeking behavior for sexual dysfunctions in patients with opioid use disorder compared to patients seeking psychotherapeutic help.MethodsNinety-seven patients at two opioid agonist treatment (OAT) centers and 65 psychotherapeutic patients from a psychiatric practice (PP) in Switzerland were included in the study. Self-report assessments comprised sexual functioning (IIEF: International Index of Erectile Function; FSFI: Female Sexual Function Index), depressive state, psychological distress, alcohol consumption, nicotine use, and a self-designed questionnaire on help-seeking behavior. We used chi-squared and Mann–Whitney U tests for group comparisons and binary logistic regression models to identify variables predicting the occurrence of sexual dysfunctions.ResultsThere was no statistically significant difference (p = 0.140) in the prevalence of SD between OAT (n = 64, 66.0%) and PP sample (n = 35, 53.8%). OAT patients scored significantly higher in scales assessing nicotine use (p &lt; 0.001) and depressive state (p = 0.005). Male OAT patients scored significantly worse on the Erectile Function scale (p = 0.005) and female PP patients scored significantly worse on the FSFI Pain domain (p = 0.022). Opioid use disorder, higher age, and being female predicted the occurrence of SD in the total sample. In the OAT sample, only higher age remained predictive for the occurrence of SD. A lack of help-seeking behavior was observed in both groups, with only 31% of OAT patients and 35% of PP patients ever having talked about their sexual health with their treating physician.ConclusionSD are common among psychiatric patients receiving OAT and general psychiatric patients seeking psychotherapy. Professionals providing mental healthcare to patients must emphasize prevention and routine assessments of sexual functioning needs.
Perception, willingness, and practices of telemedicine in patients with chronic diseases: implication of digital health in patients' perspective at a tertiary care hospital in Ethiopia
Authors: Belachew Eyayaw Ashete , Getachew Demis , Netere Adeladlew Kassie , Gizachew Eshetie , Sendekie Ashenafi Kibret 
Published: August 2023

BackgroundTechnology-based healthcare services have important implications for the diagnosis, prevention, and treatment of diseases, as well as providing access to high-quality care that both the patient and the healthcare practitioner can benefit from. To access medical information, patients have also searched for methods of technology-based healthcare services like telemedicine (TM). However, little is known regarding the perceptions, willingness, and practices of TM among Ethiopian patients, especially in the study setting.ObjectiveThis study assessed the perceptions, willingness, and practice of TM among patients with chronic disease at the University of Gondar Comprehensive Specialized Hospital (UoGCSH), Northwest Ethiopia.MethodsA cross-sectional study was conducted from June 1 to July 30, 2022, among patients with chronic diseases who were on follow-up at the UoGCSH. Eligible participants were included in the study using a systematic random sampling technique. A structured questionnaire was used and recorded in the Kobo data collection tool. The collected data were managed and analyzed using the Statistical Package for Social Science (SPSS) version 26.ResultsOut of 422 patients approached, 384 (91% response rate) were included in the final analysis. The mean (±SD) age of the participants was 48.07 ± 16.17 years. The overall perceptions mean (±SD) score of the respondents was 3.92 ± 1.06. Generally, near to three-fourths (71.1%) of the participants had a positive perception of TM services, and around two-thirds (63.3%) had a willingness to be involved in the TM service. However, only around one-fourth (24.5%) of the participants were perceived to have a high level of TM practice currently.ConclusionThe findings suggest that although the level of perception and willingness of TM services among patients with chronic diseases was positive, their level of practice was low. Therefore, creating awareness and suitable conditions to improve their utilization of TM could be important.
Exposure to insulating materials and risk of coronary artery diseases: a cross-sectional study
Authors: Moitra Subhabrata , Tabrizi Ali Farshchi , Khadour Fadi , Henderson Linda , Melenka Lyle , Lacy Paige 
Published: August 2023

BackgroundAlthough previous reports link exposure to insulating materials with an increased risk of mesothelioma and chronic respiratory diseases, studies evaluating their associations with the risk of coronary artery diseases (CAD) are lacking.AimsWe aimed at evaluating the associations between exposure to insulating materials and the 10-year risk of CAD among insulators.MethodsIn this cross-sectional study, we recruited 643 adults (≥18 years), full-time insulators from the Local 110 Heat and Frost Insulators and Allied Workers Union in Edmonton, Alberta. We obtained demographic information, personal and family history, and job-exposure history, including experience (years) and types of exposure to insulating materials. Clinical profiling including Framingham risk scores (FRS) was assessed.ResultsOf all insulators, 89% were men (mean ± SD age: 47 ± 12 years), 27% had a parental history of cardiac diseases, and 22% had a comorbid chronic respiratory disease. In total, 53% reported exposure to asbestos, while 61, 82, and 94% reported exposure to ceramic fibers, fiberglass, and mineral fibers, respectively. In single-exposure multivariable regression models adjusted for experience, marital status, and body mass index (BMI), asbestos was found to be associated with higher FRS (β: 1.004; 95%CI: 0.003–2.00). The association remained consistent in multi-exposure models and a higher association was found between asbestos exposure and FRS among insulators with comorbid chronic respiratory disease.ConclusionOur study demonstrates that apart from cancer and chronic respiratory diseases, asbestos exposure may also have a cardiac effect, thus warranting the need for systematic surveillance to protect workers from the adverse effects of these materials.
Supraspinous ligament arc tangent guided freehand thoracic pedicle screw insertion technique: high parallelism between screws and upper endplate
Authors: Peng Fushuai , Gao Meng , Li Qiang , Jiang Zhensong , Chen Fei , Sun Mingtong , Lai Yudong , Wang Haoyu , Wang Xingpeng , Li Tao , Zhang Wen 
Published: August 2023

Research objectiveTo propose a technique for placing pedicle screws in the thoracic spine using the Supraspinous ligament Arc Tangent (SLAT) as a guide to increase the safety and stability of screw placement.Content and methodsA retrospective analysis of postoperative anteroposterior and lateral x-ray images was performed for 118 patients with thoracic spine diseases who received conventional freehand technique from January 2016 to May 2020 and SLAT-guided technique since June 2020 to present. The diagnoses included thoracic spinal stenosis, deformity, fractures, infections, and tumors. The angle between the screw and the upper endplate was categorized as grade 1 (0°–5°), grade 2 (5°–10°), and grade 3 (&gt;10°). Three surgeons with more than 10 years of experience in spinal surgery measured the angle between the screw and the upper endplate in the lateral view. Chi-square test was used for statistical analysis, and p &lt; 0.05 was considered statistically significant.ResultsA total of 1315 pedicle screws were placed from T1 to T12 in all patients. In the conventional freehand technique group, 549 screws were grade 1, 35 screws were grade 2, and 23 screws were grade 3. In the SLAT-guided freehand technique group, 685 screws were grade 1, 15 screws were grade 2, and 8 screws were grade 3. The data of each group was p &lt; 0.05 by Chi-squared test, which was statistically significant, indicating that the SLAT-guided freehand technique resulted in a higher rate of parallelism between the screws and the upper endplate. All patients underwent intraoperative neurophysiological monitoring, immediate postoperative neurological examination, postoperative x-ray examination, and assess the eventual recovery. The screws were safe and stable, and no complications related to pedicle screw placement were found.ConclusionThe SLAT-guided freehand technique for placing pedicle screws in the thoracic spine can achieve a higher rate of screw-upper endplate parallelism, making screw placement safer and more accurate. Our method provides a convenient and reliable technique for most spinal surgeons, allowing for increased accuracy and safety with less fluoroscopic guidance.
Short Physical Performance Battery and Study of Osteoporotic Fractures Index in the Exploration of Frailty Among Older People in Cameroon
Authors: Metanmo Salvatore , Simo-Tabue Nadine , Kuate-Tegueu Callixte , Bonnet Michel , Gbessemehlan Antoine , Metanmo Fabiola , Dramé Moustapha , Tabue-Teguo Maturin 
Published: August 2023

Objectives: To investigate the relationship between the Short Physical Performance Battery (SPPB) and the Study of Osteoporotic Fractures (SOF) index.Methods: We present data from a cross-sectional survey conducted in Cameroon. Frailty was defined as an SOF index &gt; 0. The sensitivity and specificity of the SPPB were investigated. Principal component analysis (PCA) was performed to assess the contribution of each subtest of the SPPB to the relationship with the SOF.Results: Among 403 people included (49.6% women), average age of 67.1 (±6.2) years, 35.7% were frail according to the SOF. After determining the best SPPB threshold for diagnosing frailty (threshold = 9, Se = 88.9%, Sp = 74.9%), 47.9% were frail according to the SPPB. The first dimension of PCA explained 55.8% of the variability in the data. Among the subtests of the SPPB, the chair stand test item was the component most associated with the SOF index.Conclusion: Despite the overlap between the SOF and the SPPB, our results suggest that a negative result on the five chair-stands test alone would be sufficient to suspect physical frailty.
Understanding primary care perspectives on supporting women’s health needs: a qualitative study
Authors: Toye Francine , MacLellan Jennifer , Dixon Sharon , McNiven Abigail 
Published: August 2023

BackgroundA consultation for the Women’s Health Strategy for England in 2022 highlighted a need to understand and develop how general practice can support women’s health needs.AimTo understand the perspectives and experiences of primary care practitioners (PCPs) about supporting women’s healthcare needs.Design and settingInterpretive qualitative research set in general practice in England.MethodPCPs working in general practice settings were recruited through research and professional networks. Semi-structured interviews were conducted via telephone or Microsoft Teams, audiorecorded, transcribed verbatim, and analysed through reflexive thematic analysis.ResultsIn total, 46 PCPs were interviewed. Participants had a range of roles and worked in a variety of primary care settings. Results are presented within six themes: 1) being alongside a person from cradle to grave; 2) maintaining the balance between general and specialist skills; 3) generalists and specialists combined make more than the sum of their parts; 4) striving for equity in a collapsing system; 5) firefighting with limited resources; and 6) the GP is being cast as the villain.ConclusionThe findings show that relationships and advocacy are valued as fundamental for women’s health in general practice, and highlight the adverse impact of threats to these on staff and services. Developing specialist roles and bespoke services can foster staff wellbeing and could support retention. However, care is needed to ensure that service configuration changes do not result in clinician deskilling or rendering services inaccessible. Care is needed when services evolve to ensure that core aspects of general practice are not diminished or devalued. GP teams are well placed to advocate for their patients, including commitment to seeking equitable care, and these skills and specialist knowledge should be actively recognised, valued, and nurtured.
DEVELOPMENT OF THE CONCEPT FOR A TOURIST CENTER IN THE CITY OF SALEKHARD
Authors: Yakunenkova M. , Antonova L. , Bogorodskaya V. 
Published: August 2023

In the context of growing interest in the development of Arctic cities, it is necessary to form new public spaces. In the system of organizing tourist flows, the need to create public, business and cultural centers is determined.
The object of the study is the system of organization of public space for tourists and residents of the northern city: the system of functional organization and features of the volume-spatial solution associated with the conditions of the Arctic climate. The specifics of the developing northern region of Salekhard are considered.
The methodological basis is a generalization of the experience of designing tourist centers and public spaces of northern cities, as well as a historical and cultural analysis of the territory of Salekhard. The result of the study is the definition of the functional and spatial organization of the tourist center. The tourist center system is presented in the design concept
Off-pump coronary bypass grafting with or without the use of intracoronary shunts
Authors: Salah Eldin Elsharkawe Ehab , Mahmoud Nasser Hend , Fathy Ali Hosam 
Published: August 2023

Background: There is scarce literature comparing the role of the intracoronary shunt during off-pump coronary artery bypass grafting (CABG). This study aimed to compare off-pump CABG using intracoronary shunt versus the coronary clamp during distal coronary artery anastomosis.
Methods: We conducted this randomized study between January and June 2018. We randomized 30 patients into two groups. Group A (n= 15) included patients who had coronary clamping during off-pump CABG, and Group B (n= 15) included patients who had intracoronary shunt during off-pump CABG. Study endpoints were anastomosis time and postoperative cardiac enzyme levels.
Results: The mean age of the shunt group was higher than the mean age of the clamp group (61.06 ± 7.26 vs. 56.72 ± 12.44, respectively, p=0.03). Our study showed no statistical difference between the two groups regarding sex (p˃0.99), hypertension (p˃0.99), and diabetes (p=0.14). The distal anastomosis time was longer in the shunt group than in the clamp group (39.80±4.55 vs. 32.27±6.06 minutes, respectively, p=0.001). The postoperative troponin I (0.61±0.11 vs. 0.26±0.089 ƞg/ml, p<0.001), and CK-MB levels (44.27±5.34 vs. 35.5±4.86 IU/L, p<0.001) were significantly higher in the clamp group.
Conclusion: The intracoronary shunt could be associated with lower cardiac enzyme release compared to the clamp technique. However, it was associated with a longer distal anastomosis time.
Ultrafast-track extubation after pediatric cardiac surgery; benefits and safety
Authors: Elgazzar Mohamed , Abdelrahman Mohamed , Khedr Amany , Abdelgawad Basem 
Published: August 2023

Background: Ultrafast-track extubation after cardiac surgery my facilitate rapid recovery. However, the overall risk-benefit is still debatable. The objective of this study was to report the effect of ultrafast-track extubation in pediatric patients undergoing cardiac surgery.
Methods: This is a retrospective study that included 260 patients who had surgery for congenital heart diseases between 2015 and 2019. Patients were divided into two groups. Group A included patients who had ultrafast-track extubation protocol (n = 140), and group B was the conventional anesthesia group (n = 120).
Results: The mean age was 3.68 ± 2.1 and 3.8 ± 1.6 years for groups A and B, respectively (p= 0.08). The total operative time was higher in group A (326± 18.15 vs. 274.6±28.1 minutes; p 0.001), and the degree of pulmonary hypertension were higher in group B (p= 0.02). The rate of ventilator-related complications was higher in group B (P = 0.02). There was a significant reduction in mean length of intensive care unit stay between the ultrafast-track extubation and the conventional groups (65.3 ± 33.7 and 81.6±70.2 hours, respectively; p= 0.001). The total hospital stay was significantly reduced in group A (6.7 ± 2.7 vs. o 7.43±2.65 days for group A and B, respectively, p= 0.03).
Conclusions: The application of ultrafast-track extubation protocol could lead to a reduction in the ventilator-related complications, the length of intensive care unit and hospital stays without increasing postoperative complications.
Comparative study between aortic valve replacement through full sternotomy versus mini-sternotomy
Authors: Amr Mourad Faisal , Abdel Azim Mostafa , Ibrahim Rezk Ahmed , Gamal Moustafa , Mubarak Sarah 
Published: August 2023

Background: The superiority of minimally invasive aortic valve replacement (AVR) over the standard approach is the subject of ongoing research. The aim of this study was to compare the outcomes of AVR through full sternotomy versus mini-sternotomy.
Methods: We included 60 patients who had AVR; 30 patients underwent AVR through J- or T-shaped mini-sternotomy, and 30 patients had a full sternotomy. We included patients who had isolated AVR and excluded patients who had a concomitant cardiac procedure, redo surgery, or those who needed annular dilatation. All patients had aortic and right atrial cannulation for cardiopulmonary bypass. Study endpoints were operative times, postoperative complications and duration of ICU and hospital stays.
Results: There were no differences between the two groups preoperatively. Cardiopulmonary bypass time was longer in the mini-sternotomy group (median: 100 (range: 65- 170) vs. 85 (55-160) min, respectively; p= 0.024). Operative time was non-significantly longer in the mini-sternotomy group 5 (4-6) hours vs. 4.5 (4-6) hours in the full sternotomy group (p=0.62). Ventilation time was 10 (4- 50) hours in the mini-sternotomy group vs. 14 (8- 45) hours in the full sternotomy group (p<0.001). ICU stay was shorter in the mini-sternotomy group (2 (1-6.5) vs. 2.5 (1-7) days, respectively, p= 0.014). The total mediastinal drainage was 100 (50 400) ml in the mini-sternotomy group vs. 275 (50- 1000) ml in the full sternotomy group (p= <0.001). There was no difference in wound infection (p= 0.35), tamponade (p˃0.99), and hemothorax (p˃0.99) between both groups.
Conclusion: Mini-sternotomy AVR had longer cardiopulmonary bypass times; however, there were no differences in the postoperative complications compared to the full sternotomy approach. Mini-sternotomy could be a safe alternative approach to the full median sternotomy for aortic valve replacement.
Management of glucose 6-phosphate dehydrogenase (G6PD) deficient patients undergoing open-heart surgery
Authors: Hassan Mansour Hassan Amr , Al Kindi Adil H. , Deebis Ahmed 
Published: August 2023

Background: There are scarce studies on the management of glucose 6-phosphate dehydrogenase (G6PD) deficient patients during cardiac surgery. The purposes of this retrospective study were to present and evaluate our experience with G6PD deficient patients who underwent cardiac surgery with cardiopulmonary bypass (CPB).
Methods: We included 20 patients with G6PD deficiency who had cardiac surgeries from 2015 to 2019. We used free radical scavenging strategy and careful perioperative management. The patients were compared to a control group of 20 patients with normal G6PD enzyme activity who underwent the same type of operations in the same period.
Results: Males represented 80% of G6PD deficient patients. There were significant elevations in preoperative total bilirubin (1.03±0.33 vs. 0.57±0.11 mg/dl, p< 0.001) and reticulocytes (1.87±0.62 vs. 0.54±0.18%) in G6PD deficient patients. Valve surgery was done for 60% of G6PD deficient patients. There were no significant differences between both groups regarding the type of surgery, aortic cross-clamp, CPB, and total operative time. G6PD deficient patients had significantly lower postoperative hemoglobin levels (9.44±0.94 vs. 10.0±0.59 g/dl, p= 0.04) and significantly higher postoperative total bilirubin (1.51±0.51 vs. 0.98±0.45 mg/dl; p=0.002) and reticulocytes (1.85±0.51 vs. 0.57±0.13%; p< 0.001). There was no significant difference regarding postoperative urea and creatinine levels. Ventilation time (10.3±2.7 vs. 8.2±1.9 hours; p=0.01), ICU stay (3.1±0.87 vs. 2.3±0.71 days; p=0.004), and hospital stay (3.1±0.87 vs. 6.0±1.02 days; p<0.001) significantly increased in G6PD deficient patients. The mortality rate was 5% (one patient) in G6PD deficient patients.
Conclusion: Despite the management strategy, G6PD deficient patients undergoing cardiac surgery are more liable to hemolysis and hypoxia with more need for blood transfusion and longer ventilation time, ICU, and hospital stays when compared to patients with normal G6PD enzyme activity. Further research to improve the outcomes in G6PD deficient patients is required.
Right mini-thoracotomy versus median sternotomy for mitral valve replacement
Authors: EL-badawy Mohamed A. , Elshafey Mhmoud A. , Abdelraof Mostfa M. , Emara Mona Sobhy , Emara Ahmed Sobhy 
Published: August 2023

Background: The advantages of minimally invasive mitral valve surgery over the conventional approach is still debated. This study aimed to evaluate early outcomes after mitral valve replacement (MVR) using the right mini-thoracotomy (RMT) versus median sternotomy (MS).
Methods: We prospectively included 60 patients who had MVR from May 2015 to June 2017. We classified patients into two groups; Group A (n= 30) had RMT, and Group B (n= 30) had MS. Postoperative pain score, wound satisfaction, and clinical and echocardiographic outcomes were compared between both groups.
Results: The mean age was 39.90 ± 12.34 years in Group A and 45.75 ± 13.10 years in Group B (p= 0.08). Preoperative and echocardiographic data showed no statistical significance difference between the groups. Group A had longer aortic cross-clamp (118.85 ± 40.56 vs. 70.75 ± 24.81 minutes, p<0.001) and cardiopulmonary bypass times (186.70 ± 67.44 vs. 104.65 ± 42.60 minutes, p<0.001). Group B had more blood loss (565 ± 344.3 vs. 241.5 ±89.16 ml/24 hours, p<0.001). The median pain score was 1 (range: 1- 3) in Group A and 4 (2- 8) in Group B (p<0.001), and the median wound satisfaction was 1.5 (1- 4) in Group A and 4 (1- 7) in Group B (p<0.001). Wound infection occurred in 1 (3.3%) patient in Group A and 6 (20%) patients in Group B (p=0.04).
Conclusion: Mitral valve replacement through the right mini-thoracotomy could be a safe alternative to median sternotomy. The right mini-thoracotomy was associated with longer operative times but better pain and wound satisfaction scores and lower wound infection.