bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Use of Liposomal Bupivacaine for Pain Control After Shoulder Surgery: A Systematic Review and Meta-analysis
Authors: Fares Mohamad Y. , Daher Mohammad , Boufadel Peter , Khan Adam Z. , Abboud Joseph A. 
Published: January 2025

Background: Liposomal bupivacaine (LB) is a relatively novel anesthetic agent used in the management of postoperative pain in patients who have undergone shoulder surgery. Purpose: To explore the literature on LB in the setting of shoulder surgery and assess its efficacy and utility in managing postoperative pain. Study Design: Systematic review and meta-analysis; Level of evidence, 1. Methods: PubMed, Cochrane, and Google Scholar (pp 1-20) were searched for articles published up to November 2023. Inclusion criteria consisted of randomized controlled trials comparing anesthetic modalities using LB with other anesthetic modalities using alternative drugs in patients who underwent shoulder surgery. Complications, pain levels in the first 24 hours postoperatively, and opioid consumption intraoperatively and in the first, second, and third 24 hours postoperatively were assessed. Results: A total of 15 randomized controlled trials were included in the meta-analysis. In 4 studies comparing periarticular injections of LB (196 patients) with nerve blocks of other anesthetic agents (201 patients), there was no significant difference in pain levels ( P = .74) and complication rates ( P = .37); however, intraoperative opioid consumption was significantly greater in patients with periarticular injections of LB ( P = .005). In 3 studies comparing single-injection LB nerve blocks (83 patients) with interscalene nerve block catheters (102 patients) and in 8 studies comparing single-injection LB nerve blocks (311 patients) with other nerve blocks (308 patients), single-injection LB nerve blocks demonstrated clinical superiority. Single-injection LB nerve blocks resulted in significantly lower pain levels and lower opioid consumption in the first, second, and third 24 hours postoperatively compared with other single-injection nerve blocks and both single-injection nerve blocks and interscalene catheters combined. Conclusion: LB is a promising anesthetic component with efficacy in providing analgesia after shoulder surgery. Single-injection LB nerve blocks were found to be superior in reducing pain levels and opioid consumption compared with other anesthetic modalities.
Adequate Failure Loads for Modified Lemaire Lateral Extra-articular Tenodesis Are Achieved With an Interference Screw, Staple, and Suture Anchor: A Biomechanical Study of Structural Properties
Authors: Tollefson Luke V. , Shoemaker Evan P. , Slette Erik L. , Carlson Mitchell , LaPrade Robert F. , Engebretsen Lars , Moatshe Gilbert , Geeslin Andrew G. 
Published: January 2025

Background: A lateral extra-articular tenodesis (LET) is increasingly being utilized to augment an anterior cruciate ligament reconstruction because it has been shown to reduce the risk of postreconstruction graft failure or recurrent rotatory instability. Various femoral fixation techniques are available, including the use of an interference screw, staple, or suture anchor. Purpose: To determine and compare the biomechanical properties of an LET graft when using an interference screw, staple, or suture anchor for the femoral fixation for a modified Lemaire LET. Study Design: Controlled laboratory study. Methods: Eighteen fresh-frozen cadaveric knees were obtained and randomly assigned via a random group generator to undergo a modified Lemaire LET using either an interference screw, a staple, or a suture anchor for femoral fixation. The specimen underwent load-to-failure testing at 20 mm/min until graft failure. The maximum failure load, stiffness, and failure mode for each specimen were recorded. Results: The mean failure load was highest for the interference screw (252.7 ± 131.2 N), followed by the staple (151.8 ± 34.1 N) and the suture anchor (105.7 ± 16.4 N). There was a significant difference in failure load between the interference screw and the suture anchor ( P = .015). There was no significant difference between the staple and the interference screw ( P = .101) or the suture anchor ( P = .577). There was no significant difference in graft stiffness across all fixation methods ( P = .089). Conclusion: All 3 femoral fixation methods achieved adequate failure loads, although the interference screw had a greater failure load than the suture anchor and there was no significant difference between these implants and the staple. There were no significant differences in stiffness between the fixation methods. Clinical Relevance: The maximum failure load occurred with an interference screw for femoral fixation of a modified Lemaire LET; however, because of socket size, this implant may be at greater risk of anterior cruciate ligament reconstruction tunnel collision compared to a smaller-diameter suture anchor drill hole. The failure load of the suture anchor was the lowest; however, it appears sufficient for stable fixation based on the force experienced by an LET graft reported in the literature.
Is preloading with amikacin a measure able to mitigate sequestration? A preliminary in vitro study
Authors: Houzé Pascal , Raphalen Jean-Herlé , Maulet Valentin , Lamhaut Lionel , Baud Frédéric J 
Published: January 2025

Introduction: Amikacin is sequestered in polyacrylonitrile filters. Methods mitigating sequestration are unknown. Amikacin elimination in a polyacrylonitrile-derived filter preloaded with amikacin was studied in a preliminary study. Methods: Amikacin concentrations were determined using an immunochemical method. Prismaflex™, Baxter-Gambro, and the ST™150 filter were used. Sessions were performed in a continuous diafiltration mode. Diafiltration flow rate was set to 2500 mL/h and filtration to 500 mL/h pre- and 1000 mL/h post-dilution. Net loss was set to zero. In sessions with preload, a 150 mg dose of amikacin was injected in the first 1 L bag of physiological saline when starting the priming. NeckEpur® method was used for pharmacokinetic calculations. Results: In the central compartment (CC), the mean initial concentration in the sessions without and with preload was 81.8 ± 6.0 mg/L. There were no significant differences in the AUCcc and AUCinlet without or with preload. The preloading dose induced a significant increase in the AUCoutlet. Compared with sessions without preload, the clearance from the CC in sessions with preload decreased from 4.94 ± 0.43 to 3.75 ± 0.32 L/h, respectively. The elimination rates by diafiltration and sequestration in the sessions without and with preload were 82.3 ± 6.2/17.8 ± 6.2% and 125 ± 9.2%/0 ± 0%, respectively. The 150 mg loading dose was eliminated by diafiltration (42.5%) and by sequestration (57.5%). Conclusion: Preloading filter with amikacin modifies the disposition of amikacin by preventing further sequestration. Studies are needed to define an efficient preloading dosage regimen in actual condition of use.
Mechanobiological enhancement of electrospun PCL/nHA membranes for guided tissue regeneration applications
Authors: Dadgari Niki , Fotoukian Hamidreza , Haghbin Nazarpak Masoumeh , Solati-Hashjin Mehran 
Published: January 2025

This study aims to investigate the effects of adding nano-hydroxyapatite (nHA) to electrospun polycaprolactone (PCL) membranes for use in dental root regeneration. Porous membranes containing varying amounts of nHA (0, 1, 1.5, and 2.5 wt%) were fabricated using the electrospinning method. The physicochemical, mechanical, and biological properties of the membranes were evaluated. The synthesized nHA particles had an average size of 52 nm. Electrospun membranes exhibited uniform fibrous morphology with porosities ranging from 56% to 86%. Cyclic thermal stress (5°C–50°C) improved the mechanical properties of the composite membranes, resulting in a decrease in ultimate tensile strength (UTS) for pristine PCL from 3 ± 0.12 MPa to 1.7 ± 0.11 MPa, while the UTS for PCL membranes containing 1.5% nHA increased from 3.3 ± 0.30 MPa to 4.18 ± 0.28 MPa. In vitro bioactivity in simulated body fluid (SBF) showed enhanced apatite formation, particularly after 21 and 28 days. Cytotoxicity assays with MG-63 osteoblast-like cells demonstrated good biological performance. The incorporation of nHA not only improved the mechanical properties but also enhanced the bioactivity and cytocompatibility of the electrospun PCL membranes, making them promising candidates for guided tissue regeneration (GTR) applications.
Enoxaparin-Induced Bullous Hemorrhagic Dermatosis and Enoxaparin Rechallenge: A Case Report
Authors: Tokuo Momoko , Cohen Kaplon Stacey 
Published: January 2025

Purpose: A case of enoxaparin-induced bullous hemorrhagic dermatosis is reported. Summary: A 69-year-old male with past medical history including chronic atrial fibrillation and a re-do aortic valve replacement, anticoagulated on warfarin, received an enoxaparin bridge for a molar extraction. On day 7 after restarting enoxaparin post-procedure at a therapeutic dose of 90 mg every 12 hours, the patient noticed multiple small, dark, raised lesions on his forearm and ankle. The patient denied pain, itchiness, or initiation of new medications other than enoxaparin. The patient had never experienced this side effect in the past, although he had two prior exposures to enoxaparin. A review of the available literature on cutaneous side effects from enoxaparin was performed and it was determined that the patient experienced enoxaparin-induced bullous hemorrhagic dermatosis. There is currently limited guidance on management of this rare side effect and whether enoxaparin rechallenge is safe. As benefit outweighed risk for the patient, the enoxaparin bridge was continued for an additional 3 doses, until the patient completed his supply of enoxaparin at home. Approximately within 1 week after enoxaparin was discontinued, the hemorrhagic bullae disappeared. The patient was re-exposed to enoxaparin 6 months later for a colonoscopy and the side effect did not reoccur. Conclusion: It may be safe to continue enoxaparin while experiencing enoxaparin-induced bullous hemorrhagic dermatosis as the condition is typically self-limiting. This case report shows that re-exposure to enoxaparin may be safe as it may not result in reoccurrence of the side effect.
Preparation of thermally rearranged (TR) copolybenzoxazoles with enhanced gas permeability
Authors: Suzuki Tomoyuki 
Published: January 2025

Gas transport properties of thermally rearranged polybenzoxazoles without fluorene rings (TR- coPBOs) were studied. Specific volumes ( V sps) of the TR- coPBOs were larger than the values predicted by the theoretical additive rule, stating that copolymerizing heterogeneous structures into a part of the rigid main chains caused inhibition of molecular chain packing. Gas permeability coefficients of the TR- coPBOs exceeded those predicted by the theoretical semi-logarithmic additivity and came to be maximized at the copolymerization of 10 mol% of heterogeneous units. The increasing gas permeability could be attributed to the increasing free volumes due to the copolymerization of heterogeneous units. Despite the specific increase in CO2 permeability by the copolymerization, the TR- coPBOs possessed high CO2/CH4 selectivity. This fact demonstrated the TR- coPBOs could achieve simultaneously high CO2 permeability and CO2/CH4 selectivity, maintaining inherent high CO2/CH4 permselectivity.
Tomatidine, A Promising Steroidal Alkaloid Alleviates Various Noxious Stimuli Induced Nociception in Mice Model
Authors: Chen Jiajia , Wang Xi , Wang Dan , Yin Hengming , Ma Guoping 
Published: January 2025

Background Nociception, often described as the body’s ability to sense and respond to harmful stimuli, represents a global discomfort that profoundly impacts individuals across the globe. It functions as a fundamental warning process, alerting organisms against potential threats and promoting protective behaviors. However, when dysregulated or chronic, nociception can become a significant burden, leading to persistent pain and diminished quality of life. Various analgesic drugs play a crucial role in alleviating pain and improving the quality of life for millions of people worldwide. While analgesic drugs provide significant relief for acute and chronic pain conditions, they can cause side effects ranging from mild gastrointestinal disturbances, drowsiness, and constipation to major complications such as cardiovascular damage and nephrotoxicity. Purpose Hence, we investigated the potency of a phytochemical tomatidine against various noxious stimuli-induced nociception. Methods Tomatidine pain-relieving potency has been assessed against heat stimuli and chemical-induced visceral pain. The neuropathic pain-relieving potency of tomatidine was examined with glutamate and capsaicin-induced mice models. Results Tomatidine potency against intense pain was examined with a formalin-induced biphasic nociception model. Carrageenan induced an inflammatory response, peritoneal leukocyte infiltration, and air pouch model were performed to analyze the anti-inflammatory effect of tomatidine against inflammatory cytokines-induced nociception. The antisedative potency of tomatidine was confirmed with open-field test analysis. Our results confirm that tomatidine effectively inhibited nociception induced by thermal and chemical stimuli. It also alleviates the inflammatory cytokines stimulated pain and does not render any sedative effect in mice models. Conclusion To conclude tomatidine is a potent nonsedative antinociceptive drug that can be formulated as an analgesic.
Study of Clinical Profile and Short-term Outcome of Dissociative Disorder in Children and Adolescents—An Observational Study
Authors: Mohamed Raiza , Koparde Vinayak , Chate Sameeran , Patil Nanasaheb 
Published: January 2025

Introduction: Dissociative disorder is a common and distressing condition seen in children and adolescents, especially in the Indian population. It is associated with impairment in routine functioning, school absenteeism, and a significant distress and economic burden on the caregivers. There is scarcity of outcome studies in the Indian population. Aims: This study aimed to evaluate the sociodemographic and clinical profile of children and adolescents with dissociative disorder and find the outcome with treatment as usual at the end of one month. Methods: This was an observational study conducted in a tertiary care hospital over a period of one year. Fifty-one children and adolescents with mean age 14.2 years (± 2.050) with dissociative disorder (International Classification of Diseases, 10th revision [ICD-10]) were included in the study. Sociodemographic and clinical details were assessed using semi-structured proforma and Children Global Assessment Scale (CGAS), and Clinical Global Impression-Severity (CGI-S) were used to assess baseline functioning. After one month of treatment, as usual, outcome was assessed either face-to-face or through telecommunication using CGAS, CGI-S scales. Results: Dissociative stupor (37.3%) was the most common type of presentation followed by dissociative convulsions (21.6%). Most prevalent stressor was familial (39.2%) and parenting style was authoritative (19.6%). Slow-to-warm-up temperament was most frequent (39.2%) in study subjects. At the end of one month of treatment as usual on CGAS, the percentage of subjects with obvious or serious problems reduced to 7.9 from 35.3% which was statistically significant ( P <.05). On CGI-S 56.8% of the participants significantly improved on follow-up ( P < .05). On CGI-I, 51% had much improvement, 19.1% showed very much improvement from baseline, whereas, 31.4% had minimal improvement. Conclusion: Dissociative disorders are common in adolescent age and most commonly associated with familial stressors and authoritative parenting in our study. We found a significant number improved at the end of one month with treatment as usual indicating good short-term outcomes.
Prevalence and Factors Associated with Domestic Violence Among Pregnant Women Attending Tertiary Level Hospital
Authors: Thapa Savina , Rokaya Yagya , Thapa Nabin , Lama Monika , Rai Maya , Giri Rajendra Mani , Pahadi Nirmala Kumari , Maharjan Ramu , Sign Lokjan , Kumar Anil 
Published: January 2025

Introduction This study aimed to determine the prevalence and factors associated with domestic violence among pregnant women who attended a tertiary-level hospital. Methods A cross-sectional study was conducted among 385 pregnant women who attended the maternal and child health clinic of a tertiary-level hospital using a structured interview schedule. A consecutive sampling technique was used for data collection. Descriptive and inferential statistical methods were applied for data analysis. Results The study revealed that domestic violence was prevalent among 63.1% of the pregnant women. Among 243 women who experienced domestic violence, 29.9% reported emotional violence, 42.6% reported physical violence, and 51.4% reported sexual violence. Logistic regression analysis showed that relationships with family and husbands were statistically significant in reducing the risk of domestic violence, with odds ratios below 1 and P values < .05. Conclusion The study highlighted the alarming prevalence of domestic violence among pregnant women, underscoring the need for targeted interventions, support systems, and increased awareness to protect the well-being of both mothers and unborn children.
The Quality Evaluation of Antibiotics for the Treatment of Diabetic Foot Ulcers in the Intensive Care Unit of Public Private Hospital, Semarang City
Authors: Farizi Gilang Rizki Al , Vidiani A.A.P. Paramitha , Gloria Fransisca , Karlina Dewi , Astuti Enggar Budi 
Published: January 2025

Background Diabetic ulcers are infections caused by the loss of the deepest skin tissue on the feet of patients with diabetes mellitus. Appropriate treatment, such as antibiotic therapy, is necessary to prevent the spread of infection and antibiotic resistance. Purpose This study aims to evaluate the use of antibiotics to treat diabetic foot ulcers (DFU) qualitatively using Gyssens analysis in the intensive care units (ICUs). Methods The study was held retrospectively by analyzing the quality of antibiotics used with Gyssens. Data collection was held at Roemani Muhammadiyah Semarang Hospital, Semarang City. Subjects involved in this study included all ICU patients who were prescribed antibiotics from January 2020 until December 2022. Results The results showed that the highest of single-use antibiotics was Meropenem (7.14%), the dual antibiotic combination was Clindamycin plus Meropenem (7.14%) and a triple antibiotic combination was Metronidazole plus Ceftriaxone plus Ciprofloxacin (3.57%), Ceftriaxone plus Meropenem plus Levofloxacin (3.57%). The accuracy of antibiotic use based on Gyssens analysis was obtained from 41 prescriptions it was the category appropriate were 16 prescriptions (39.02%), inappropriate doses were six prescriptions (14.63%), too short use was 13 prescriptions (31.71%), and more effective antibiotics needed were six patients (14.63%). Conclusion The utilization rate among antibiotics for the treatment of DFU was deemed inappropriate. It was also necessary to perform a bacterial culture before deciding on the mode of administration.
Prognostic Value of Surgical Resection for Non-small-cell Lung Cancer Patients Comorbid With Minimal Pleural Effusion
Authors: Wang Haibo , Lu Tao , Zheng Xinlong , Jiang Kan , Zhang Longfeng , Zheng Xiaobin , Miao Qian , Wu Shiwen , Zou Zihua , Yang Shanshan , Li Yujing , Chen Sihui , Xu Yiquan , Lin Gen 
Published: January 2025

Background The proportion and impact of minimal pleural effusion (PE) on prognosis remain blurred in operable non-small cell lung cancer (NSCLC) patients who reported minimal PE on imaging. Methods Clinical and prognostic data of operable NSCLC patients who presented no distant metastasis, no direct pleural invasion, but minimal PE on preoperative imaging were retrospectively analyzed. The patients were divided into surgical (81 cases) and non-surgical (10 cases) cohorts. Potential or suspected malignant PE or pleural metastases were confirmed by surgery. The overall survival (OS) was analyzed by Kaplan-Meier curve and prognostic factors by multivariate Cox regression. Results The surgical cohort reported no pleural invasion on preoperative imaging and no pleural metastases by postoperative pathology, with an overall median disease-free survival of 36.7 (28.6, 44.7) months and a median OS of 59.8 (45.7, 73.2) months, with the latter significantly longer in the surgical cohort than in the non-surgical cohort (59.8 months vs 20.37 months, P < 0.001). Multivariate analysis indicated surgical treatment as an independent prognostic factor for OS. Conclusion Malignant PE is rare in operable NSCLC patients who report the presence of minimal PE but no distant metastasis or direct pleural invasion on preoperative imaging. Surgery may be the preferred treatment for these patients.
Healthcare resource utilization and costs after initiating direct-acting oral anticoagulants or low molecular weight heparins in patients with venous thromboembolism
Authors: Okoye Godwin , Ben-Umeh Kenechukwu C , Avanceña Anton LV , Onukwugha Eberechukwu 
Published: January 2025

Background: Venous thromboembolism (VTE) can lead to significant healthcare resource utilization (HcRU) and costs. First-line treatments such as direct-acting oral anticoagulants (DOAC) and low molecular weight heparin (LMWH) are utilized for VTE management. There are limited observational studies to determine which first-line drug for VTE is associated with lower HcRU and cost. Therefore, we sought to compare HcRU and costs of commercially insured patients with VTE who initiated DOAC or LMWH in the US. Methods: We utilized Merative MarketScan Research Database (2016–2021) to identify adults initiating DOAC or LMWH for VTE. Baseline measures were assessed 12 months prior to the index date of drug initiation. Inverse probability of treatment weighting was used to control confounding. For HcRU, logistic regression was used to model emergency room and inpatient visits and the negative binomial count model was used for outpatient visits. The average marginal effect for total healthcare cost comparing DOAC with LMWH users was estimated using a generalized linear model. HcRU and costs were evaluated for 12 months posttreatment initiation. Results: DOAC users had lower odds of inpatient visits (adjusted odds ratio [aOR] 0.53, 95% CI 0.46 to 0.59), emergency room visits (aOR 0.86, 95% CI 0.73 to 0.99), and outpatient visits (adjusted incident rate ratio 0.52, 95% CI 0.50 to 0.54) in comparison to LMWH users. DOAC users had lower total healthcare costs of −$9573 (95% CI −$11,149 to −$7997) (US dollars). Conclusion: This cohort study suggests that DOAC use is associated with fewer inpatient, outpatient, and emergency room visits, and lower healthcare costs compared to LMWH use for VTE management.