bluuebunny/crossref_metadata_2025_split huggingface dataset:
Optimizing post-operative imaging: a retrospective cohort study comparing two methods of lateral hip radiography after cephalomedullary nail surgery
Authors: Huang Da , Chen Gui-Yue , Liu Hui , Cui Hai-Wen , Wang Li-Xin , Chen Yu-Jing , Yang Xi-Shuai 
Published: May 2023

Abstract
Background
Currently, there is no consensus on the most appropriate technique for obtaining lateral hip radiographs after cephalomedullary nail (CMN) surgery. The aim of this study was to investigate the distribution of two commonly used postoperative lateral hip radiographic methods (classic lateral view and modified lateral view) and try to find out which one is better suited for this situation.

Methods
A retrospective analysis was conducted on 146 patients who underwent surgical fixation for extracapsular hip fractures between January 2018 and June 2022. The main outcome measured was the angle between the straight part of the CMN and the lag screw/blade on hip lateral X-rays (CMNA). The lateral hip radiographs were categorized into two groups based on different lateral hip radiographic methods. CMNA, patient age, gender, fracture classification based on the 2018 AO classification, nail length (short/long), surgical side (left/right), height, weight, BMI, preoperative waiting time, postoperative imaging interval were collected and compared between the two groups.

Results
The distribution trend of CMNA significantly differs between two types of hip joint lateral radiographic methods. Specifically, the classic lateral method exhibits a significantly bimodal and skewed distribution with a median (p25, p75) of -21.6° (-31.2°, -8°), whereas the modified lateral method presents a normal distribution with a mean ± SD of +7.57° ± 14.4°. The difference in the Mean Rank between the classic (47.10) and the modified (102.96) lateral methods is statistically significant (P < 0.001).

Conclusions
The CMNA method is an excellent tool for studying the lateral distribution.We recommend using the modified lateral view as the preferred option for obtaining lateral hip radiographs after CMN surgery due to its superior distribution of CMNA and greater patient-friendliness.
Neoadjuvant camrelizumab plus chemotherapy in locally advanced oesophageal squamous cell carcinoma: a retrospective cohort study
Authors: Zhou Rui-Qin , Luo Jun , Li Lin-Jun , Du Ming , Wu Qing-Chen 
Published: May 2023

Abstract
Background
Neoadjuvant therapy is recommended to improve the prognosis of oesophageal squamous cell carcinoma (ESCC). As a PD-1 inhibitor developed in China, camrelizumab is more accessible and available for Chinese ESCC patients. Camrelizumab plus neoadjuvant chemotherapy has shown promising efficacy with acceptable toxicity for resectable ESCC in the NIC-ESCC2019 trial. However, this was a single-arm trial, so we conducted a retrospective cohort study to compare neoadjuvant camrelizumab plus chemotherapy with neoadjuvant chemotherapy alone in terms of the safety and efficacy in patients with locally advanced ESCC.

Methods
Between January 2017 and December 2021, patients with stage II–IVa ESCC who received neoadjuvant therapy at the First Affiliated Hospital of Chongqing Medical University and underwent radical oesophagectomy were enrolled in our study. These included 19 patients who received neoadjuvant chemotherapy plus camrelizumab (group 1) and 40 patients who only received neoadjuvant chemotherapy (group 2).

Results
The baseline characteristics of the patients were comparable between the two groups. The pathological complete response (pCR) rate in group 1 was significantly higher than that in group 2 (26.3% vs. 2.5%, P = 0.018). All patients in group 1 achieved complete resection (R0), compared with 39 (97.5%) patients in group 2. Adverse events occurred in 16 (84%) patients in group 1 versus 35 (87.5%) patients in group 2. No grade ≥ 4 adverse events occurred in either group. No significant difference was found in surgical outcomes or postoperative complications. The 90-day mortality rate was comparable between the two groups (1 patient died in group 1 versus 2 patients in group 2).

Conclusions
Neoadjuvant camrelizumab plus chemotherapy followed by surgery was associated with a promising pCR rate and a manageable safety profile for patients with locally advanced ESCC.
The impact of surgical guide design and bone quality on heat generation during pilot implant site preparation: an in vitro study
Authors: Abuhajar Eman , Salim Nesreen A. , Sallam Malik , Jarab Fadi , Satterthwaite Julian D. 
Published: May 2023

Abstract
Background
Surgical guides restrict the flow of cooling agent to osteotomy site, which will lead to a temperature rise that provokes tissue injury. Few studies compared differences in the temperature changes between non-limiting ‘conventional’ and limiting ‘guided’ surgical guides during implant site preparation. The objective of this study was to investigate the difference in temperature changes during bone drilling for implant placement using non-limiting and limiting surgical guides at cortical and cancellous bone levels.

Methods
Forty-four bovine rib samples were used for implant bed preparation in this study with a minimum thickness of 11 mm was chosen for the ribs. The bone was stored in a freezer at 10 °C until it was used. On the day of the study, the bone was defrosted and soaked in water at 21 °C for three hours before embarking on drilling to make sure each sample was at the same temperature when tested. Forty-four bone specimens were prepared and randomly allocated to receive either a limiting or a non-limiting surgical guides (22 for each group). The osteotomy site was prepared by one operator following the manufacturer’s instructions, using limiting and non-limiting surgical guides. Temperature changes were recorded during implant bed preparation using thermocouples that fit into 7 mm-horizontal channels at two different depths (Coronally) and (Apically) at 1 mm distance from the osteotomy site. The data were tested for homogeneity of variances using Levene’s test, then data were analyzed using an Independent sample t-test and the significance level was set at P ≤ 0.05.

Results
The mean temperature rise for all samples was 0.55 °C. The mean temperature rises for the limiting and non-limiting surgical guides were 0.80 °C and 0.33 °C respectively. There was a statistically significant difference in temperature rise between the limiting and non-limiting surgical guides (P = 0.008). In relation to position of temperature recording (coronal vs. apical), there was no significant difference (P > 0.05). No significant difference was noted between the two groups at cancellous bone level (P = 0.68), but the difference was significant at cortical bone level (P = 0.036).

Conclusion
Limiting surgical guides showed higher readings than non-limiting. However, for both techniques, temperature rise was not significant clinically and within a safe range.
Spatial patterns and the associated factors for breast cancer hospitalization in the rural population of Fujian Province, China
Authors: Song Mengjie , Huang Xiaoxi , Wei Xueqiong , Tang Xuwei , Rao Zhixiang , Hu Zhijian , Yang Haomin 
Published: May 2023

Abstract
Background
Despite the known increasing incidence of breast cancer in China, evidence on the spatial pattern of hospitalization for breast cancer is scarce. This study aimed to describe the disparity of breast cancer hospitalization in the rural population of Southeast China and to explore the impacts of socioeconomic factors and heavy metal pollution in soil.

Methods
This study was conducted using the New Rural Cooperative Medical Scheme (NRCMS) claims data covering 20.9 million rural residents from 73 counties in Southeast China during 2015–2016. The associations between breast cancer hospitalization and socioeconomic factors and soil heavy metal pollutants were evaluated with quasi-Poisson regression models and geographically weighted Poisson regressions (GWPR).

Results
The annual hospitalization rate for breast cancer was 101.40/100,000 in the studied area and the rate varied across different counties. Overall, hospitalization for breast cancer was associated with road density (β = 0.43, P = 0.02), urbanization (β = 0.02, P = 0.002) and soil cadmium (Cd) pollution (β = 0.01, P = 0.02). In the GWPR model, a stronger spatial association of Cd, road density and breast cancer hospitalization was found in the northeast regions of the study area while breast cancer hospitalization was mainly related to urbanization in the western regions.

Conclusions
Soil Cd pollution, road density, and urbanization were associated with breast cancer hospitalization in different regions. Findings in this study might provide valuable information for healthcare policies and intervention strategies for breast cancer.
Understanding the perspective of women who use the Billings Ovulation Method®: a focus group study
Authors: Ayala-Ramirez Montserrat , Grewe Mary E. , Kaiser Julie , Kennedy Emily , Winn Martha , Urrutia Rachel Peragallo 
Published: May 2023

Background
The Billings Ovulation Method®(the Billings Method) is a fertility awareness-based method (FABM) of family planning that relies on the observation of patterns of fertility and infertility based on vulvar sensations and appearance of discharges. This allows people to choose when to have intercourse, depending on whether they want to avoid or achieve pregnancy. Few studies have documented user experiences with FABMs.

Methods
We conducted four virtual focus groups (FGs) in May and June 2021 with current adult women users of the Billings Method. We asked questions about users' reasons for selecting a FABM and the Billings Method, positive experiences and challenges learning and using the Billings Method, and suggestions for improving the user experience. We performed a content analysis of the transcribed FGs to explore key themes from the discussions. COREQ guidelines were followed.

Results
Twenty women between the ages of 23 and 43 participated in the FGs. Reasons women described choosing a FABM included to follow religious beliefs, to avoid side effects of hormonal contraception, and/or to learn more about their bodies. Reasons for selecting the Billings Method included perceiving it as more precise and easier to understand than other FABMs, having a scientific basis, and being recommended by family and friends. Experiences related to learning and using the Billings Method were mainly positive. They included finding the method easy to use and learn, successfully using it to either postpone or achieve a pregnancy and increasing their awareness of their bodies. Challenges for participants included the inherent learning curve for identifying sensations at the vulva and the required periods of abstinence. Participants provided suggestions and recommendations for improving users' experience, including raising awareness of the Billings Method among healthcare providers.

Conclusions
Users of the Billings Method expressed an overall positive experience when learning and using it for family planning and body awareness. Some challenges were identified that offer opportunities to improve how the Billings Method is taught and delivered. These findings can also enhance healthcare providers' interactions with FABM users, including those of the Billings Method.
Effect of educational intervention based on theory of planned behaviour on promoting preventive behaviours of oral cancer in rural women
Authors: Najafi Siamak , Mohammadkhah Fatemeh , Harsini Pooyan Afzali , Sohrabpour Mojtaba , Jeihooni Ali Khani 
Published: May 2023

Abstract
Background
Oral cancer has created an alarming situation around the world, and being the 16th most common cancer worldwide, it has become a global concern. The present study aimed to investigate the effect of educational intervention based on a theory of planned behavior (TPB) on promoting preventive behaviors of oral cancer in rural women.

Methods
This quasi-experimental study was conducted on 120 female hookah users referring to rural health centers in Fasa and Shiraz city, Fars province, Iran. The subjects were divided into experimental and control groups by simple random sampling. The educational intervention for the experimental group consisted of 8 training sessions of 50 min. Both groups completed a questionnaire including demographic characteristics and constructs of TPB before and four months after the educational intervention. Data were analyzed using SPSS 22 software through independent t-test, chi-square, and paired t-test (p = 0.05).

Results
The mean age of the experimental and control group subjects were 41.12 ± 8.86 and 40.63 ± 9.62 years, respectively (p = 0.185). The mean age of onset of hookah use in the experimental and control group was 24.16 ± 9.50 and 23.35 ± 9.44 years, respectively (p = 0.182). Also, before the educational intervention, there was a significant difference between the experimental and control groups in terms of knowledge (p < 0.189), attitude (p < 0.122), perceived behavioral control (p < 0.142), subjective norms (p < 0.236), behavioral intention (p < 0.126), oral cancer prevention behaviors (p < 0.108) and nicotine dependence (p < 0.218); however, four months after the educational intervention, there was a significant increase in the experimental group in all variables except nicotine dependence (p < 0.005).

Conclusion
Due to the alarming situation of oral cancer and the prevalence of hookah use among women, educational programs based on TPB could effectively prevent hookah use and oral cancer.
Assessing the agreement between the partners at care transitions measure and the care transitions measure for elderly patients with chronic diseases
Authors: Liu La-mei , Sun Meng-jie , Liu Meng-ting , Wang Jia-nan , Zhang Yi-zhen , Dela Rosa Ronnell D 
Published: May 2023

Abstract
Background
Elderly patients with chronic diseases are very vulnerable during the transition from hospital to home and have a high need for transitional care. The quality of transitional care is closely related to patient health outcomes. Using appropriate scales to evaluate the quality of transitional care is important for efforts aimed at improving it. The study aimed to analyze the consistency between the Chinese version of the Partners at Care Transitions Measure (PACT-M) and the Care Transition Measure (CTM) in assessing the quality of transition care in elderly patients with chronic diseases.

Methods
This is a cross-sectional study, we used a convenience sampling method to investigate patients with chronic diseases aged ≧ 65 years who were about to be discharged from the three affiliated hospitals of Zhengzhou University in Henan Province, from August 2021 to May 2022. The sample consisted of 196 elderly patients with chronic diseases. Data were collected using a demographic survey, PACT-M, and CTM. We used EpiData 3.1 software for systematic logical error checking, SPSS 21.0 to analyze the data, and the Bland–Altman analysis to analyze the consistency of the two scales.

Results
The mean total scores for PACT-M and CTM were 65.52 ± 6.23 and 52.07 ± 7.26, respectively. The 95% confidence interval (CI) for the mean difference and ratios were (-31.52, 4.61) and (0.85, 1.72), with 3.57% and 5.10% of the points outside the 95% CI limits, separately.

Conclusions
The difference analysis of Bland–Altman showed a good consistency of the two scales, while the rate analysis did not meet the a priori definition of good consistency, but it is very close to 5%. Therefore, the consistency of the two scales in assessing the quality of transitional care for elderly patients with chronic diseases needs to be further validated.
The managerial role of healthcare professionals in public hospitals: a time-driven analysis of their activities
Authors: Pratici Lorenzo , Francesconi Andrea , Lanza Gianluca , Zangrandi Antonello , Fanelli Simone 
Published: May 2023

Abstract
Background
New Public Management theory affected reforms of public sectors worldwide. In Italy, an important reform of the healthcare sector changed the profile of public hospitals, creating new management related positions in 1992. The reform defined the role of the clinician-manager: a hybrid figure, in charge of managing an entire unit. This paper aims to investigate how much clinician-managers feel like managers and how much they still feel like professionals, using time as a driver to conduct the analysis.

Methods
A survey-questionnaire was administered to a set of 2,011 clinician-managers employed in public hospitals, with a response rate of 60.42%. The managerial role of healthcare professionals in public hospitals: A time-driven analysis of their activities. The questionnaire aimed to identify the difference between how much time clinician-managers actually spend on daily activities and how much time they would think be appropriate. To better cluster different type of management styles, subgroups were identified based on the type of organisations respondents work for, geographical location, and professional specialty.

Results
Findings suggest that clinician-managers spend more time on clinical activities than management. Clear differences are found according to professional specialty, and there are fewer differences in geographical location and the type of organisation.

Conclusions
The absence of clear differences in the responses between different geographical areas implies that a shared organisational culture characterizes the whole sector. However, differences in how the clinician-manager role is perceived based on the professional specialty suggest that closer integration may be needed.
Exploring quality improvement for diabetes care in First Nations communities in Canada: a multiple case study
Authors: Fournie Meghan , Sibbald Shannon L. , Harris Stewart B. 
Published: May 2023

Abstract
Background
Indigenous peoples in Canada experience higher rates of diabetes and worse outcomes than non-Indigenous populations in Canada. Strategies are needed to address underlying health inequities and improve access to quality diabetes care. As part of the national FORGE AHEAD Research Program, this study explores two primary healthcare teams’ quality improvement (QI) process of developing and implementing strategies to improve the quality of diabetes care in First Nations communities in Canada.

Methods
This study utilized a community-based participatory and qualitative case study methodology. Multiple qualitative data sources were analyzed to understand: (1) how knowledge and information was used to inform the teams’ QI process; (2) how the process was influenced by the context of primary care services within communities; and (3) the factors that supported or hindered their QI process.

Results
The findings of this study demonstrate how teams drew upon multiple sources of knowledge and information to inform their QI work, the importance of strengthening relationships and building relationships with the community, the influence of organizational support and capacity, and the key factors that facilitated QI efforts.

Conclusions
This study contributes to the ongoing calls for research in understanding the process and factors affecting the implementation of QI strategies, particularly within Indigenous communities. The knowledge generated may help inform community action and the future development, implementation and scale-up of QI programs in Indigenous communities in Canada and globally.
Characteristics of the pulmonary opacities on chest CT associated with difficulty in short-term liberation from veno-venous ECMO in patients with severe ARDS
Authors: Nishikimi Mitsuaki , Ohshimo Shinichiro , Fukumoto Wataru , Anzai Tatsuhiko , Awai Kazuo , Ogura Takayuki , Abe Toshikazu , Masuda Mamoru , Fujizuka Kenji , Nakamura Mitsunobu , Kyo Michihito , Takahashi Kunihiko , Shime Nobuaki 
Published: May 2023

AbstractBackgroundIt is clinically important to predict difficulty in short-term liberation from veno-venous extracorporeal membrane oxygenation (V-V ECMO) in patients with severe acute respiratory distress syndrome (ARDS) at the time of initiation of the support. The aim of this study was to identify the characteristics of pulmonary opacities on chest CT that is associated with difficulty in short-term liberation from V-V ECMO (< 14 days).MethodsThis multicenter retrospective study was conducted in adult patients initiated on V-V ECMO for severe ARDS between January 2014 and June 2022. The pulmonary opacities on CT at the time of initiation of the ECMO support were evaluated in a blinded manner, focusing on the following three characteristics of the opacities: (1) their distribution (focal/diffuse on the dorso-ventral axis or unilateral/bilateral on the left-right axis); (2) their intensity (pure ground glass/pure consolidation/mixed pattern); and (3) the degree of fibroproliferation (signs of traction bronchiectasis or reticular opacities).ResultsAmong the 153 patients, 72 (47%) were successfully liberated from ECMO in the short term, while short-term liberation failed in the remaining 81 (53%) patients. Multivariate logistic regression analysis showed that the presence of mixed-pattern pulmonary opacities and signs of traction bronchiectasis, but not the distribution of the opacities, were independently associated with difficulty in short-term liberation (OR [95% CI]; 4.8 [1.4–16.5] and 3.9 [1.4–11.2], respectively).ConclusionsThe presence of a mixed pattern of the pulmonary opacities and signs of traction bronchiectasis on the chest CT were independently associated with difficulty in short-term liberation from V-V ECMO in severe ARDS patients.