bluuebunny/crossref_metadata_2025_split huggingface dataset:
Arthroscopic Fixation Using Bioabsorbable Pins With Bone Grafting via a Medial Malleolus Approach to Treat Osteochondral Lesion of the Talus
Authors: Nakasa Tomoyuki , Ikuta Yasunari , Sumii Junichi , Nekomoto Akinori , Kawabata Shingo , Adachi Nobuo 
Published: September 2022

Fixation of the osteochondral fragment has the advantage to restore the naturally congruent morphology of the talar dome with native hyaline cartilage in the treatment of the osteochondral lesion of the talus (OLT). Surgical treatment of medial talar osteochondral lesions is commonly done through a medial malleolar osteotomy. However, a medial malleolar osteotomy is an invasive procedure and gives negative impacts on clinical outcomes. Fixation for the posteromedial lesion of the OLT without the medial malleolar osteotomy may provide good clinical outcomes. We showed arthroscopic fixation for medial OLT without the medial malleolar osteotomy. Curettage and bone grafting between the fragment and its bed were performed, and then 2-mm bone tunnel in the medial malleolus was created. Bioabsorbable pins were inserted through the tunnel to fix the osteochondral fragment. Three cases (mean age 18.6 years) were treated using this technique for medial OLT and followed at 16 months (range, 12-24 months). The Japanese Society for Surgery of the Foot scale improved from 73.3 ± 1.2 points before surgery to 95.7 ± 7.5 points at the final follow-up. Bone union of the osteochondral fragment was confirmed on magnetic resonance imaging (MRI). Arthroscopic fixation for medial OLT is less invasive and yields good clinical outcomes. Levels of Evidence: Level V
Increased Prevalence of Eosinophilic Esophagitis in Patients With Chronic Rhinosinusitis
Authors: Simmons Jordan K. , Leiman David A. , Patil Sarita U. , McCoul Edward , Chen Philip G. , Tang Dennis M. , Kuan Edward C. , Chang Elena E. , Wu Arthur W. 
Published: September 2022

Background Chronic rhinosinusitis (CRS) and eosinophilic esophagitis (EoE) are immune-mediated inflammatory conditions that share common histopathologic features. Once considered two separate pathologies, preliminary data has suggested that a higher prevalence of EoE may exist in patients with CRS. Objectives We aimed to expand the base of evidence across geographic regions and investigate the association between EoE and CRS, including CRS with nasal polyposis (CRSwNP). Methods Quantitative data detailing the prevalence of CRS, CRSwNP, and EoE were pooled from 6 large academic institutions spread across the United States using Epic electronic medical record system. One-way analysis of variance was then used to analyze the data. Results The mean prevalence of EoE in our general population sample of over 26 million individual records was 0.058% (range, 0.013%-0.103%). The mean prevalence of EoE in our sub-populations of individual with diagnoses of CRS and CRSwNP was 0.43% (F(1,12)  =  [8.194], P  =  .01) and 0.84% (F(1,12)  =  [23.61], P < .01) respectively. Conclusion This study reveals an 8-fold greater prevalence of concurrent EoE in patients with CRS. Importantly, this is the first study to describe the association of EoE and the CRSwNP subtype, and we demonstrate a 14-fold greater prevalence of EoE in patients with CRSwNP.
The prevalence and associated predictors for Bethesda III–VI for reporting thyroid cytopathology in Royal Commission Hospital, Kingdom of Saudi Arabia
Authors: Alyousif Hussain , Adam Ishag , Alamin Naser A. , Sid Ahmed Mona A. , Al Saeed Ayat , Hassoni Abdulmuhsen Hussein , Musa Imad R. 
Published: September 2022

Background: Thyroid cancer is increasing globally and is currently the most prevalent endocrine malignancy. Recent data show an increase in the incidence of thyroid cancer in the Kingdom of Saudi Arabia (KSA). Thyroid ultrasound and fine-needle aspiration cytology (FNAC) are the cornerstones in managing thyroid nodules. We conducted this study to evaluate the prevalence and the associated predictors for thyroid nodule Bethesda III–VI in eastern KSA. Methods: A retrospective study was conducted between January 2015 and 31 August 2021. The participants were recruited patients who received a thyroid ultrasound and ultrasound-guided thyroid FNAC, using the thyroid imaging reporting and data system (TI-RADS) and the Bethesda Classification, respectively. Result: Three hundred and ten patients who underwent thyroid FNAC were enrolled in the study. The median (interquartile, IQR) age was 47.0 (20.0) years, and 266 (85.8%) of them were females. The median (IQR) body mass index was 30.2 (7.6) kg/m2. Out of these participants, 64.8% were euthyroid, 27.4% had hypothyroidism and 7.7% had hyperthyroidism. The ACR TI-RADS-3, 4 and 5 were 51.3%, 46.1% and 2.6%, respectively. The Bethesda outcome of thyroid FNAC I–VI was 5.2%, 63.9%, 15.5%, 5.8%, 3.5% and 6.1%, respectively. The risk for malignancy (Bethesda III–VI) was documented in 31.0% and atypia of undetermined significance was most prevalent (15.5%). A higher ACR TI-RADS score was associated with a higher risk of malignancy: ACR TI-RADS-3 (20.8%), ACR TI-RADS-4 (39.2%) and ACR TI-RADS-5 (87.5%). In a multivariate analysis, only the ACR TI-RADS score was significantly associated with the outcome of thyroid FNAC: ACR TI-RADS-4 [OR = 2.59 (95% CI = 1.54–4.36)] and ACR TI-RADS-5 [OR = 29.03 (95% CI = 3.44–245.07)]. Conclusion: There was a high prevalence of Bethesda III–VI and atypia of undetermined significance was most prevalent. A thyroid ultrasound report for TI-RADS was significantly associated with the outcome of thyroid FNAC and is a reliable tool in the absence of molecular testing for thyroid cancer.
An innovative use of Quick Response codes to provide patients information in Urology
Authors: Mittal Aaina , Kum Francesca , Rice Myles , Mak Quentin , Cakir Onur , Jalil Rozh 
Published: September 2022

Objective: The use of Quick Response (QR) codes has the potential to overcome some of the healthcare challenges we currently face, especially those presented by the COVID-19 pandemic. The aim of this research was to evaluate the use of QR codes poster in delivering patient information effectively in a Urology Outpatient department. Methods: A national online survey of Urologists was distributed, and leaflet costs were estimated. QR codes for the British Association of Urological Surgeons (BAUS) patient information leaflets were incorporated into a poster for the Urology Outpatient department. Feedback on the poster was sought from patients. Results: Overall, 108 Urologists responded to the initial survey; 44% were consultants. However, 54% provided > 50% of patients with an information leaflet during face-to-face clinics prior to the Covid-19 pandemic, decreasing to 33% during COVID-19. Using departmental outgoings, a cost of £3120 was calculated for printed leaflets per year normally. Rise in telephone clinics during the pandemic meant 47% of patients were provided an Internet link or asked to use Google in the clinical letter, up from 17% prior to the pandemic. In response to the QR codes poster, in a patient population, mostly male (82%) and older people(60% between 60 and 80 years of age), 40% were familiar with QR codes, 73% could access Internet and 53% used it to find information, 46% found the poster easy to use or follow and 61% found it informative. Conclusion: QR codes offer benefits, including capability for touch-free access, cost-effectiveness, potential to increase engagement and understanding, enable user-initiated learning and improve adherence. Patient perception varies with age group and smartphone access and usage. Level of Evidence: 4
Ultrasonographic and colour Doppler features of intrapancreatic splenic tissue in a cat
Authors: Peschard Anne-Lorraine , Jamont Wiktoria , Shields Claire , Cronin Anna 
Published: September 2022

Case summary A 2-year-old female neutered domestic longhair cat was referred for a 3-day history of lethargy and anorexia. Physical examination documented abdominal distension and pain, which, alongside marked electrolyte imbalances on blood biochemistry, was highly suspicious for a gastrointestinal obstruction. This was confirmed on diagnostic imaging, with abdominal ultrasonography also identifying an incidental, well-defined small lobular hypoechoic nodule adjacent to the tail of the spleen, with high vascularity on Doppler interrogation. This was identified as a focal nodule at the tip of the left limb of the pancreas at surgery, and resected via partial pancreatectomy. Histopathological examination confirmed intrapancreatic splenic tissue. Relevance and novel information This case report presents the first available ultrasonographic description and images of intrapancreatic splenic tissue in a cat. It is thought to be a benign lesion of low clinical significance and therefore defining its imaging characteristics may allow for improvement in diagnostic suspicion without resorting to excisional surgery.
Global use and outcomes of the hearWHO mHealth hearing test
Authors: De Sousa Karina C , Smits Cas , Moore David R , Chada Shelly , Myburgh Herman , Swanepoel De Wet 
Published: September 2022

ObjectivesThe objective of this study was to examine the uptake, user characteristics, and performance of the free WHO smartphone hearing screening test ( hearWHO) as a global hearing health promotion initiative.MethodWe retrospectively examined the data of 242 626 tests conducted by adults (> 18 years) on the hearWHO app between February 2019 and May 2021. Test uptake was evaluated by country, WHO world region, test date, and demographics of age and gender.ResultsThe hearWHO test was completed in nearly every country globally ( n = 179/195), with the greatest uptake seen in China and India. Uptake was greatest in the Western Pacific (32.9%) and European (24.8%) WHO regions. There was a high uptake of tests (44%) by young adults under the age of 30 years. Referral rates were typically higher for older age groups in most WHO regions, except for the African and Eastern Mediterranean regions, where overall hearWHO test uptake was lowest. Most testing (49%) took place in March (2019–2021) coinciding with World Hearing Day (3rd of March) each year.ConclusionsDigital mhealth tools provide many benefits in healthcare, including health promotion, access to information, and services for hearing loss. The hearWHO test was mainly reaching younger adults, positioning it as an important measure for public health advocacy to prevent hearing loss. Since hearing loss is primarily age related, more targeted campaigns or community-based initiatives should be directed toward older adults.
Comparison of Treatment Methods for Syndesmotic Injuries With Posterior Tibiofibular Ligament Ruptures: A Cadaveric Biomechanical Study
Authors: Takahashi Katsunori , Teramoto Atsushi , Murahashi Yasutaka , Nabeki Shogo , Shiwaku Kousuke , Kamiya Tomoaki , Watanabe Kota , Yamashita Toshihiko 
Published: September 2022

Background: Studies on ankle syndesmosis have focused on anterior inferior tibiofibular ligament (AITFL) and interosseous membrane injuries; however, the characteristics of posterior inferior tibiofibular ligament (PITFL) ruptures remain unclear. Purpose/Hypothesis: This study evaluated the biomechanical characteristics of syndesmotic instability caused by PITFL injury and compared various treatment methods. We hypothesized that PITFL injury would lead to syndesmotic internal rotational instability and that the stability would be restored with suture tape (ST) PITFL augmentation. Study Design: Controlled laboratory study. Methods: Ten uninjured fresh-frozen cadaveric leg specimens were tested via forces applied to the external and internal rotation of the ankle joint. The fibular rotational angle (FRA) related to the tibia, anterior tibiofibular diastasis (aTFD), and posterior tibiofibular diastasis (pTFD) were measured using a magnetic tracking system. Six models were created: (1) intact, (2) AITFL injury; (3) AITFL + PITFL injury; (4) suture button (SB) fixation; (5) SB + anterior ST (aST) fixation; and (6) SB + aST + posterior ST fixation. The FRA, aTFD, and pTFD were statistically compared between the intact ankle and each injury or fixation model. Results: In the intact state, the changes in FRA and aTFD were 1.09° and 0.33 mm when external rotation force was applied and were 0.57° and 0.41 mm when internal rotation force was applied. In the AITFL injury model, the changes in FRA and aTFD were 2.38° and 1.51 mm when external rotation force was applied, which were significantly greater versus intact ( P = .032 and .008, respectively). In the AITFL + PITFL injury model, the changes in FRA and pTFD were 2.12° and 1.02 mm when internal rotation force was applied, which were significantly greater versus intact ( P = .007 and .003, respectively). In the SB fixation model, the change in FRA was 2.98° when external rotation force was applied, which was significantly higher compared with intact ( P < .001). There were no significant differences between the SB + aST fixation model and the intact state on any measurement. Conclusion: PITFL injury significantly increased syndesmotic instability when internal rotation force was applied. SB + aST fixation was effective in restoring syndesmotic stability. Clinical Relevance: These results suggest that SB + aST fixation is sufficient for treating severe syndesmotic injury with PITFL rupture.
Existing Health Practices in Shaping the Decision to Participate During Breast Cancer Screening Among 50–69 Years Old Women in Estonia
Authors: Lubi Kadi , Sildver Kaire , Sokolova Diana , Savicka Vita , Nool Irma , Mets-Oja Silja , Tupits Mare 
Published: September 2022

Introduction Breast cancer is easily detectable by mammography and many countries run national screening programs for women as a target group. Yet, the majority of these countries have screening participation rates below the recommended level of 70%. Objective The aim of the present article was to examine a connection between existing health practices and a decision to participate during breast cancer screening. Methods Methodologically, this research was a web panel and quantitative telephone survey. The survey was conducted among 1200 Estonian women in the age group 50–69 years. Statistical data analysis was performed with SPSS using a descriptive and logistic regression model. Results The findings revealed that among different background variables, age and existing health practices significantly influenced the decision-making for participating in the screening. Results also highlighted that the possibility to participate in the screening increased with existing supportive health practices and with the increasing age. Other sociodemographic factors did not have a significant influence on the decision-making of participation. Conclusions There is a need to educate people from an early age about the developments in health practices that could support a healthy lifestyle in terms of individual responsibility. Thus, public health campaigns should not only call for action but also focus on health education in terms of the role of preventive medicine and health practices.
Ophthalmic Manifestations as First Presenting Sign of Evans Syndrome
Authors: Mazharuddin Anam A. , Rehmani Ahmad , Puthenparambil Larry , Alappatt John J. , Lee Wen-Hsiang 
Published: September 2022

Purpose: This work reports a case of Evans syndrome first presenting with ophthalmic signs. Methods: A 27-year-old previously healthy man presented with headaches and bilateral blurred vision for 2 weeks. The visual acuity was 20/30-1 and 20/60-2 in the right eye and left eye, respectively. A fundus examination revealed Roth spots, diffuse multilayer retinal hemorrhages in the macula and periphery, and tortuous vessels in both eyes. Optical coherence tomography showed a disrupted foveal contour from intraretinal fluid and hemorrhage in both eyes. Fluorescein angiography demonstrated dilated and tortuous vessels with scattered blocking defects from hemorrhages. Results: A workup revealed warm hemolytic anemia with severe thrombocytopenia consistent with the diagnosis of Evans syndrome. Conclusions: Evans syndrome is a rare blood dyscrasia that can first present as subacute vision loss and should be added to the differential of diffuse bilateral retinal hemorrhages spanning a multitude of retinal layers.
An international survey of Death Doula training organizations: the views of those driving Death Doula training and role enactment
Authors: Rawlings Deb , Miller-Lewis Lauren , Tieman Jennifer , Swetenham Kate 
Published: September 2022

Context: Death Doulas are working globally to provide non-medical end-of-life care. They have different training experiences and views on the role and whether it should be standardised. Objective: To seek the views of organisations responsible for training Death Doulas in order to determine what the drivers are behind this emerging role. Methods: We conducted an online survey with Death Doula training organisations in five countries utilising both a targeted and snowball approach. Qualitative analysis was undertaken with themes pre-determined (apriori) due to the nature of the survey categories. Results: In total, representatives from 13 organisations in Australia, New Zealand, Sweden, Canada, United Kingdom, and United States responded. The organisations had provided training for 0 to 20 years, with one just starting and another training birth doulas and now expanding. Owners and trainers hold an array of qualifications such as academic, medical, non-medical, and life experience. Curricula have usually been developed locally, and not always included pedagogical consideration, a strategic business model, nor mapping processes such as gap analysis. The organisations are run similarly, and curricula have several consistent topics but with distinctly different approaches. Trainers’ views are also mixed about the way to proceed with registration of the Death Doula role. Conclusion: The contrasting views of training organisations explain much of the ambiguity of Death Doulas themselves regarding standardisation of registration, education and role enactment. If heading towards the ultimate goal of professionalisation of the role then a challenging path lies ahead with little in the way of agreement in what this would require.
What respiratory physicians should know about parasomnias
Authors: Meurling Imran Johan , Leschziner Guy , Drakatos Panagis 
Published: September 2022

Parasomnias have significant quality-of-life, prognostic and potentially forensic implications for patients and their bed-partners. Identifying key clinical features will accelerate diagnosis and appropriate management for these patients. Parasomnias are undesirable physical events or experiences that arise out of, or during, sleep. They can include movements, behaviours, emotions, perceptions, dreams or autonomic nervous system activity. While more common during childhood, they can persist into, or presentde novo, during adulthood. Parasomnias can arise out of non-rapid eye movement (NREM) sleep, as in confusional arousals, sleepwalking, sleep terrors or sleep-related eating disorder, or out of REM sleep, as in REM behaviour disorder, recurrent isolated sleep paralysis or nightmare disorder. Sleep-related hypermotor epilepsy is an important differential diagnosis to consider in patients presenting with a parasomnia. A thorough clinical history, including a collateral history if available, is crucial to identify characteristic clinical features. Video polysomnography is useful to identify macro- and micro-sleep architectural features, characteristic behavioural events, and any concomitant sleep pathologies. Treatment of parasomnias involves a combined approach of pharmacological and non-pharmacological intervention, including safety measures, sleep hygiene and medicines such as clonazepam or melatonin to improve sleep consolidation and reduce behavioural activity. As parasomnias can not only be disruptive for the patient and their bed-partner but have important prognostic or forensic consequences, an understanding of their pathophysiology, clinical features and management is valuable for any respiratory physician who may encounter them.Educational aimsTo understand the common features of NREM and REM parasomnias.To differentiate between the causes of motor behaviours during sleep.To discuss the treatment approach for NREM and REM parasomnias.
Transition from paediatric to adult care in cystic fibrosis
Authors: Office Daniel , Heeres Inge 
Published: September 2022

In the decades since cystic fibrosis (CF) was first clinically defined in the 1930s, there have been many advancements in the treatment and management of this disease. Initially it was considered a disease of childhood where the majority of those affected died before reaching adolescence. Now, through advancements in management and treatment, the vast majority of those affected will live into adulthood. Therefore, paediatric and adult CF services must collaborate to ensure that young people and their families experience a positive and supportive transition into adult services. Key aspects of transition will be discussed, including when to begin the transition process, who should coordinate this and how the transition process should be structured. Challenges of the transition process and potential pitfalls when transition does not run smoothly will also be discussed, as well as tools that may be used to support a positive transition for young people and their families.Educational aimsTo familiarise readers with factors that make the transition process positive.To make suggestions regarding the application of the transition process.To highlight factors which may impact on the success of the transition process and the risks associated with disengagement at the point of transition.To discuss tools which can be used by care teams to ensure a smooth transition process.
LncRNA KCNQ1OT1 promotes the metastasis of ovarian cancer by increasing the methylation of EIF2B5 promoter
Authors: He Si-Li , Chen Ya-Ling , Chen Qi-Hua , Tian Qi , Yi Shui-Jing 
Published: September 2022

Abstract
Background
Long non-coding RNAs (lncRNAs) have emerged as regulators of human malignancies, including ovarian cancer (OC). LncRNA KCNQ1OT1 could promote OC progression, and EIF2B5 was associated with development of several tumors. This project was aimed to explore the role of lncRNA KCNQ1OT1 in OC development, as well as the involving action mechanism.

Methods
Reverse transcription quantitative polymerase chain reaction (RT-qPCR) or Western blotting was employed to determine the expression levels of KCNQ1OT1 and EIF2B5. OC cell proliferation was evaluated by MTT and colony formation assays, and wound healing and Transwell assays were implemented to monitor cell migration and invasion, respectively. The methylation status of EIF2B5 promoter was examined by MS-PCR, to clarify whether the expression of EIF2B5 was decreased. The binding activity of KCNQ1OT1 to methyltransferases DNMT1, DNMT3A and DNMT3B was determined by dual luciferase reporter assay or RIP assay, to explore the potential of KCNQ1OT1 alters the expression of its downstream gene. ChIP assay was carried out to verify the combination between EIF2B5 promoter and above three methyltransferases.

Results
Expression of lncRNA KCNQ1OT1 was increased in OC tissues and cells. EIF2B5 expression was downregulated in OC, which was inversely correlated with KCNQ1OT1. Knockdown of KCNQ1OT1 inhibited OC cell proliferation and metastasis. KCNQ1OT1 could downregulate EIF2B5 expression by recruiting DNA methyltransferases into EIF2B5 promoter. Furthermore, interference of EIF2B5 expression rescued KCNQ1OT1 depletion-induced inhibitory impact on OC cell proliferation and metastasis.

Conclusion
Our findings evidenced that lncRNA KCNQ1OT1 aggravated ovarian cancer metastasis by decreasing EIF2B5 expression level, and provided a novel therapeutic strategy for OC.