bluuebunny/crossref_metadata_2025_split huggingface dataset:
Mid-term results of the treatment of complex acetabular fractures with combined acute fixation and total hip replacement in the older patient
Authors: Bassett James W , Diamond Owen J , Spence David J , Ward Anthony J , Acharya Mehool R , Chesser Tim JS 
Published: December 2022

Introduction: The incidence of acetabular fractures in older patients is increasing. The management of these patients is evolving due to the recognition of risks associated with prolonged immobility with conservative treatment. Materials and methods: Consecutive patients undergoing fixation and total hip replacement (THR) for displaced acetabular fractures undergoing single operation with acetabular fixation and THR were identified. Outcomes were assessed using radiographs, clinical notes, Oxford Hip Score and EuroQol-5L. Results: 77 patients were identified with 51 completing outcome scores. Mean age 68 years at time of injury. Mean follow-up 5 (2–12) years, OHS 40, EQ-5D 0.78. Revision surgery performed in 7 patients (9%). Discussion: Acute fixation combined with THR for acetabular fractures in the elderly patient, offers good functional outcomes and a low complication rate in the mid-term.
The Correlations Between Serum Hcy Level and Seizures and Cognitive Function in Patients After Stroke
Authors: Lan Chen , Huang Zhiqiang , Luo Xinxin , Zhang Yongcheng 
Published: December 2022

Backgrounds Post-stroke cognitive dysfunction (PSCI), a set of illnesses ranging from moderate cognitive impairment to dementia, which is one of the most prevalent consequences following a stroke. Homocysteine (Hcy) has been related to a number of neurological and systemic diseases. It’s also a known risk factor for cardiovascular disease and systemic atherosclerosis (CVD). The link between Hcy and PSCI, on the other hand, is unknown. Methods Our hospital evaluated 325 patients with acute cerebral infarction between January 1, 2018 and December 1, 2021. There are biological markers and baseline data available. Patients were divided into two groups based on the results of the Montreal Cognitive Assessment (MoCA). The researchers performed logistic regression analysis to find variables that may be linked to PSCI. Results HCY levels were significantly higher in PSCI patients than in non-PSCI patients. Age, education, seizure manifestation, and income level were all shown to be independent risk variables for PSCI in a multivariate logistic analysis. Hcy levels in PSCI patients differed considerably between the high and low groups. The high and low Hcy levels groups had significantly varied hypertension histories and urine levels. Hcy levels in PSCI patients differed considerably between the high and low groups. The high and low Hcy levels groups had significantly varied hypertension histories and urine levels. Conclusion Serum Hcy levels have been linked to PSCI in post-stroke patients, and researchers believe that serum Hcy levels will diminish PSCI.
Wrist Arthrodesis Using the Medartis Carpometacarpal Joint Sparing Plate
Authors: Briotti Joshua , Wilson Stuart , Goh Geraldine , Lawson-Smith Matthew 
Published: December 2022

Background: Total wrist arthrodesis is a well-established surgical technique that provides reliable pain relief in patients with advanced wrist disease. Key limitations of existing plating systems include hardware pull-out, hardware failure, and nonunion. There is limited literature on the newer style carpometacarpal joint (CMCJ) sparing plating system, produced by Medartis. The objective of this study was to determine the long-term clinical and radiological outcomes of wrist arthrodesis with a CMCJ sparing wrist plate. Methods: This study retrospectively identified 23 wrist arthrodeses using the Medartis CMCJ sparing plate for review. This study assessed the outcomes of 18 unilateral wrist fusions and 1 bilateral wrist fusion. The study group consisted of 12 men and 5 women with an average age of 56 years (range: 29-82 years) with a mean follow-up period of 17 months. Results: At the time of follow-up, all patients’ wrists had fused without postsurgical complication. The final grip strength in the operative hand was 28.2 kg/cm2, which was 87% of the contralateral side. The mean Quick Disabilities of the Arm, Shoulder, and Hand score at follow-up was 23.9, with all patients returning to daily living activities and work. Patients reported minimal pain (1.3/10), with almost all (17/18) satisfied with the outcome of the surgery and describing that they would recommend this procedure. Conclusion: Our case series highlights that the Medartis wrist arthrodesis plate is a newer design that is a well-tolerated option for wrist arthrodesis based on clinical assessment, functional hand assessment, and patient satisfaction, when compared with the existing literature on traditional plating systems.
Effectiveness of vagus nerve stimulation therapy in refractory hypoxic-ischemic encephalopathy-induced epilepsy
Authors: Guo Mengyi , Wang Jing , Tang Chongyang , Deng Jiahui , Zhang Jing , Xiong Zhonghua , Liu Siqi , Guan Yuguang , Zhou Jian , Zhai Feng , Luan Guoming , Li Tianfu 
Published: December 2022

Background: Epilepsy is one of the important long-term sequelae of neonatal hypoxic-ischemic encephalopathy (HIE) and is typically characterized by drug resistance and poor surgical outcomes. Vagus nerve stimulation (VNS) is a promising neuromodulation therapy for refractory epilepsy. Objectives: The present study aimed to first evaluate the effectiveness of VNS in patients with refractory HIE-induced epilepsy and scrutinize potential clinical predictors. Methods: We retrospectively collected the outcomes of VNS in all patients with refractory HIE-induced epilepsy and at least 2 years of follow-up. Subgroups were classified as responders and nonresponders according to the effectiveness of VNS (⩾50% or <50% reduction in seizure frequency). Preoperative data were analyzed to screen for potential predictors of VNS effectiveness. Results: A total of 55 patients with refractory HIE-induced epilepsy who underwent VNS therapy were enrolled. Responders represented 56.4% of patients, and 12.7% of patients achieved seizure freedom at the last follow-up. In addition, the responder rate increased over time with rates of 23.6%, 38.2%, 50.9%, and 56.4% at the 3-, 6-, 12- and 24-month follow-ups, respectively. After multivariate analysis, neonatal seizure was identified as a negative predictor (OR: 4.640, 95% CI: 1.129–19.066), and a predominant seizure type of generalized onset was identified as a positive predictor (OR: 0.261, 95% CI: 0.078–0.873) of VNS effectiveness. Conclusion: VNS therapy was effective in patients with refractory HIE-induced epilepsy and was well tolerated over a 2-year follow-up period. VNS therapy demonstrated better effectiveness in patients without neonatal seizures or with a predominant seizure type of generalized onset.
Evaluating the Impact of Applying Personal Glucose Targets in a Closed-Loop System for People With Type 1 Diabetes
Authors: Fattah Mustafa , Boughton Charlotte K. , Ware Julia , Allen Janet M. , Hartnell Sara , Willinska Malgorzata E. , Thankamony Ajay , de Beaufort Carine , Campbell Fiona M. , Fröhlich-Reiterer Elke , Hofer Sabine E. , Kapellen Thomas M. , Rami-Merhar Birgit , Ghatak Atrayee , Randell Tabitha L. , Besser Rachel E. J. , Elleri Daniela , Trevelyan Nicola , Denvir MD Louise , Davis Nikki , Bally Lia , Thabit Hood , Leelarathna Lalantha , Evans Mark L. , Mader Julia K. , Hovorka Roman 
Published: December 2022

Background CamAPS FX is a hybrid closed-loop smartphone app used to manage type one diabetes. The closed-loop algorithm has a default target glucose of 5.8 mmol/L (104.5 mg/dL), but users can select personal glucose targets (adjustable between 4.4 mmol/L and 11.0 mmol/L [79 mg/dL and 198 mg/dL, respectively]). Method In this post-hoc analysis, we evaluated the impact of personal glucose targets on glycemic control using data from participants in five randomized controlled trials. Results Personal glucose targets were widely used, with 20.3% of all days in the data set having a target outside the default target bin (5.5-6.0 mmol/L [99-108 mg/dL]). Personal glucose targets >6.5 mmol/L (117 mg/dL) were associated with significantly less time in target range (3.9-10.0 mmol/L [70-180 mg/dL]; 6.5-7.0 mmol/L [117-126 mg/dL]: mean difference = −3.2 percentage points [95% CI: −5.3 to −1.2; P < .001]; 7.0-7.5 mmol/L [126-135 mg/dL]: −10.8 percentage points [95% CI: −14.1 to −7.6; P < .001]). Personal targets >6.5 mmol/L (117 mg/dL) were associated with significantly lower time (<3.9 mmol/L [<70 mg/dL]; 6.5-7.0 mmol/L [117-126 mg/dL]: −1.85 percentage points [95% CI: −2.37 to −1.34; P < .001]; 7.0-7.5 mmol/L [126-135 mg/dL]: −2.68 percentage points [95% CI: −3.49 to −1.86; P < .001]). Conclusions Discrete study populations showed differences in glucose control when applying similar personal targets.
The Impact of the Healthcare Environment on Patient Experience in the Emergency Department: A Systematic Review to Understand the Implications for Patient-Centered Design
Authors: Rowe Aidan , Knox Michelle 
Published: December 2022

Background: The emergency department (ED) is a complex, volatile, and limited-resource healthcare setting. Many environmental factors, including high patient volumes, overburdened staff, long waits, and a tense atmosphere, converge in the ED. The objective of this study was to perform a systematic review of extant literature to understand how the ED environment drives patient experience and identify methodological or empirical insights for patient-centered ED design. Methods: We searched eight academic databases (Web of Science, PubMed, Scopus, Medline [Ovid], CINAHL, PyscInfo, Compendex, and IEEE Explore) to identify studies that employed observational (descriptive) or interventional (evaluative) methodology. We performed a co-citation analysis of potentially eligible articles and a qualitative synthesis of findings from studies included in our final sample. Results: Our search yielded 117 records. Of the 35 potentially relevant articles, 18 were published in the last 5 years, and 50% were authored by investigators in the United States. We used 33 articles for a co-citation analysis, revealing three interdisciplinary clusters and promising potential for collaboration across fields. Thirty articles were subjected to a full-text analysis, resulting in the identification of three overarching dimensions linking the ED environment to patient experience. Conclusion: The most commonly identified factors influencing patient experience in the ED included overcrowding and wait times, privacy, and communication; however, existing literature is limited. More research is needed to understand how ED environments configure patient experience and can be improved through design. Particularly, there is little research on participatory interventional strategies in the ED, despite strong evidence suggesting a need for stakeholder participation.
Toward New Assessment of Knee Cartilage Degeneration
Authors: Aubonnet Romain , Ramos Jorgelina , Recenti Marco , Jacob Deborah , Ciliberti Federica , Guerrini Lorena , Gislason Magnus K. , Sigurjonsson Olafur , Tsirilaki Mariella , Jónsson Halldór , Gargiulo Paolo 
Published: December 2022

Objective Assessment of human joint cartilage is a crucial tool to detect and diagnose pathological conditions. This exploratory study developed a workflow for 3D modeling of cartilage and bone based on multimodal imaging. New evaluation metrics were created and, a unique set of data was gathered from healthy controls and patients with clinically evaluated degeneration or trauma. Design We present a novel methodology to evaluate knee bone and cartilage based on features extracted from magnetic resonance imaging (MRI) and computed tomography (CT) data. We developed patient specific 3D models of the tibial, femoral, and patellar bones and cartilages. Forty-seven subjects with a history of degenerative disease, traumatic events, or no symptoms or trauma (control group) were recruited in this study. Ninety-six different measurements were extracted from each knee, 78 2D and 18 3D measurements. We compare the sensitivity of different metrics to classify the cartilage condition and evaluate degeneration. Results Selected features extracted show significant difference between the 3 groups. We created a cumulative index of bone properties that demonstrated the importance of bone condition to assess cartilage quality, obtaining the greatest sensitivity on femur within medial and femoropatellar compartments. We were able to classify degeneration with a maximum recall value of 95.9 where feature importance analysis showed a significant contribution of the 3D parameters. Conclusion The present work demonstrates the potential for improving sensitivity in cartilage assessment. Indeed, current trends in cartilage research point toward improving treatments and therefore our contribution is a first step toward sensitive and personalized evaluation of cartilage condition.
The Chemo-Gut Study: A Cross-Sectional Survey Exploring Physical, Mental, and Gastrointestinal Health Outcomes in Cancer Survivors
Authors: Deleemans Julie M. , Toivonen Kirsti , Reimer Raylene A. , Carlson Linda E. 
Published: December 2022

Background Cancer treatments, such as chemotherapy, may adversely affect gastrointestinal (GI), physical and mental health in survivors of cancer. Objective This study investigated associations between GI, mental and physical health outcomes, and cancer treatment-related variables, such as chemotherapy, in adult cancer survivors. Methods A one-time cross-sectional survey with patient-reported outcomes was used. Cancer survivors (N = 317) aged ≥18 years, living in Canada, who completed cancer treatments were included. Descriptive statistics, correlation, and linear regression analyses are reported. Results Mean age at diagnosis was 40.90 ± 15.40 years. Most survivors received chemotherapy (86.1%). Persistent GI symptoms include constipation (53.6%), diarrhea (50.5%), and bloating/pain (54.9%). Mean GI symptom duration was 30.53 ± 33.42 months. Severity of GI symptom interference was moderate to extreme for 51.9% of survivors. Compared to normative values of 50 in healthy people, survivors scored poorer for mental health (M = 42.72 ± 8.16) and physical health (M = 45.55 ± 7.93), and reported more belly pain (M = 56.10 ± 8.58), constipation (M = 54.38 ± 6.81), diarrhea (M = 55.69 ± 6.77), and gas/bloating (M = 56.08 ± 8.12). Greater GI symptom severity was associated with poorer mental and physical health ( P < .01). Chemotherapy was associated with increased belly pain ( B = 4.83, SE = 1.65, P < .01) and gas/bloating ( B = 3.06, SE = 1.45, P = .04). Conclusion We provide novel evidence that many cancer survivors experience chronic, moderate to severe GI symptoms lasting for years after cancer treatment, which are associated with worse mental and physical health. Chemotherapy is associated with specific GI symptoms. Integrative therapies are needed to address GI symptoms in cancer survivors.
A Comparative Study of Levetiracetam and Phenobarbital for Neonatal Seizures as a First Line Treatment
Authors: Akeel Nagwa Elsayed , Suliman Hany Abdelaziz , Al-Shokary Ashraf Hamed , Ibrahim Asmaa Obada , Kamal Naglaa M. , Abdelgalil Abobakr Abosree , Elmala Moustafa Kotb , Elshorbagy Hatem Hamed , Nasef Khaled Amin , Attia Ahmed Mahmoud , Fathallah Mohamed Gamal El Din 
Published: December 2022

Objectives We aimed to evaluate the use of intravenous levetiracetam as the first-line treatment of neonatal seizures compared with phenobarbital. Methods The study was conducted on 104 neonates (0-28 days) with clinical seizures after inclusion criteria. They were assigned in equal ratio into 2 groups; 1 included neonates who received phenobarbitone, and the other included neonates who received levetiracetam. Neonates were loaded with 20 mg/kg of intravenous drug-A (phenobarbitone) or drug-B (levetiracetam). In persistent seizures, a second loading dose of the same drug was given. Crossover to other drugs occurred if seizures persisted after the second dose of the same drug. The proportion of neonates who achieved cessation of seizures following the first or second loading dose of either drug-A or drug-B (PB or LEV) was the main outcome measure provided that they remained free of seizure for the following 24 hours. Results After 1 or 2 doses of Levetiracatam or Phenobarbitone, clinical seizures stopped (and remained seizure-free for 24 hours) in 41 (78.84%) and 34 (65.38%) patients, respectively ( P = .01). Neonates in the LEV group showed better seizure control than neonates in the PB group (RR = 0.57; 95% CI (0.17, 0.80). We did not report any adverse drug reactions in the LEV group. However, 12 (23.07%) neonates developed adverse drug reactions in the PB Group. Conclusion Levetiracetam is considered an effective and safe drug as a first-line AED in neonatal seizures.
Serum S-100B adds incremental value for the prediction of symptomatic intracranial hemorrhage and brain edema after acute ischemic stroke
Authors: Honegger Tim , Schweizer Juliane , Bicvic Antonela , Westphal Laura P , Schütz Valerie , Inauen Corinne , Pokorny Thomas , Bracher Katja , Arnold Marcel , Fischer Urs , Bonati Leo H , De Marchis Gian Marco , Nedeltchev Krassen , Kahles Timo , Cereda Carlo , Kägi Georg , Montaner Joan , Bustamante Alejandro , Palà Elena , Ntaios George , Foerch Christian , Luft Andreas , Spanaus Katharina , Saleh Lanja , von Eckardstein Arnold , Arnold Markus , Katan Mira 
Published: December 2022

Background: Early identification of patients developing symptomatic intracranial hemorrhage and symptomatic brain edema after acute ischemic stroke is essential for clinical decision-making. Astroglial protein S-100B is a marker of blood-brain barrier disruption, which plays an important role in the formation of intracranial hemorrhage and brain edema. In this study, we assessed the prognostic value of serum S-100B for the development of these complications. Methods: Serum S-100B levels were measured within 24 h from symptom onset in 1749 consecutive acute ischemic stroke patients from the prospective, observational, multicenter BIOSIGNAL cohort study (mean age 72.0 years, 58.3% male). To determine symptomatic intracranial hemorrhage or symptomatic brain edema, follow-up neuroimaging was performed in all patients receiving reperfusion therapy or experiencing clinical worsening with an NIHSS increase of ⩾4. Results: Forty six patients (2.6%) developed symptomatic intracranial hemorrhage and 90 patients (5.2%) developed symptomatic brain edema. After adjustment for established risk factors, log10S-100B levels remained independently associated with both symptomatic intracranial hemorrhage (OR 3.41, 95% CI 1.7–6.9, p = 0.001) and symptomatic brain edema (OR 4.08, 95% CI 2.3–7.1, p < 0.001) in multivariable logistic regression models. Adding S-100B to the clinical prediction model increased the AUC from 0.72 to 0.75 ( p = 0.001) for symptomatic intracranial hemorrhage and from 0.78 to 0.81 ( p < 0.0001) for symptomatic brain edema. Conclusions: Serum S-100B levels measured within 24 h after symptom onset are independently associated with the development of symptomatic intracranial hemorrhage and symptomatic brain edema in acute ischemic stroke patients. Thus, S-100B may be useful for early risk-stratification regarding stroke complications.
Polycyclic Aromatic Hydrocarbons: Evaluation of concentrations in environmental media in Bayelsa State
Authors: Ephraim-Emmanuel Benson C , Okokon Enembe , Ordinioha Best 
Published: December 2022

Background and aim Artisanal refining of crude oil is an illegal refining process that contributes to environmental pollution through the release of Polycyclic Aromatic Hydrocarbons (PAHs). PAHs compounds are known for their destructive effects on the environment as well as their harmful effects on human health. This study thus assessed the concentrations of PAHs in water, soil, and fish in communities where artisanal refining of crude oil is practiced in Bayelsa State. Materials and methods This descriptive, comparative study was conducted in Sampou (mildly exposed community), Gbarain, and Nembe (severely exposed communities) in Bayelsa State. Water, fish, and soil samples were collected using pre-existing environmental media collection guidelines and sent to the laboratory for GC-FID determination of the PAH concentrations. The data obtained were analyzed using the Statistical Package for Social Sciences (SPSS) software. Results Mean and (total) PAHs concentration in water samples obtained from Sampou was 3.50 ± 4.51 (59.59) μg/L; Gbarain 1.76 ± 4.35 (29.87) μg/L and Nembe 1.90 ± 4.20 (32.25) μg/L. A significant difference in the concentrations was also identified p-value: of 0.021. The mean concentration of PAHs in soil samples obtained from Sampou was 10.73 ± 15.53 (183.38) μg/kg; Gbarain 12.00 ± 19.57 (204.32) μg/kg and Nembe was 8.49 ± 10.07 (144.48) μg/kg. Finally, the mean concentration in fish samples obtained from Sampou was 5.62 ± 5.92 (95.43) μg/kg; Gbarain 3.81 ± 5.57 (64.75) μg/kg and Nembe 4.61 ± 5.33 (78.35) μg/kg. The difference in these concentrations was however not significant. Source diagnostic ratios of the PAHs in the water included Flt/(Flt + Pyr) ratio of 0.23, 0.16, and 0.21; Ant/(Ant + Phe) ratio of 0.87, 0.76, and 0.87 as well as BaA/(BaA + Chr) ratio of 0.43, 0.51 and 0.66 in Sampou, Gbarain and Nembe respectively. Conclusion Concentrations of total PAHs in water and fish samples obtained from the three communities exceeded the acceptable limits for ƩPAHs of 2.0 μg/L and 2 μg/kg in water and fish respectively stipulated by the United States Environmental Protection Agency and the Nigerian Petroleum Regulatory Authority. ƩPAHs concentrations from the samples obtained from Sampou were also higher than the other two communities. There is a need for regular environmental monitoring of PAH concentrations, especially in oil-producing communities, and a shift of focus toward the elimination of pyrolytic sources of PAH pollution.
Experiences of Patients Adopting and Adapting to Closed-Loop Insulin Delivery Systems (CLIDS)
Authors: Manero Chrystina 
Published: December 2022

Purpose: The purpose of the study was to explore the perspectives and experiences of adults with type 1 diabetes (T1DM) who are currently using the closed-loop insulin delivery system (CLIDS). Methods: Eleven adults with T1DM who used closed-loop insulin pumps for at least 6 months participated in this qualitative descriptive study. Results: Four themes emerged from the rich descriptions: (1) striving for improvement, (2) missing a magic wand effect, (3) seeking support, and (4) barriers to adaptation. These themes represent both process-based and psychosocial implications for nursing practice and patient education. Conclusions: To optimize CLIDS use and outcome, the antecedent conditions that contribute to patients’ decision to adopt it must be understood. Then, interventions that focus on setting realistic expectations must be created. Patients need support as they incorporate CLIDS into their T1DM self-management. Training health care providers on the idiosyncrasies of adapting to CLIDS is critical. Patients must learn to relinquish control and trust the machine and manage the anxiety the system’s intrusive alarms cause them so they can be better supported cognitively and psychosocially.