bluuebunny/crossref_metadata_2025_split huggingface dataset:
Five-Stranded Hamstring Tendon Autograft for Anterior Cruciate Ligament Reconstruction
Authors: Zacharias Anthony , Baer Geoffrey 
Published: September 2022

Background: Hamstring tendon (HT) autograft for anterior cruciate ligament (ACL) reconstruction has shown equivalent graft failure rates to bone-patellar-tendon-bone (BTB) with decreased prevalence of anterior knee pain. It should be noted that young athletes, particularly females athletes, may have increased graft failure rates with HT versus BTB. Additionally, HT graft diameters <8 mm have shown worse patient-reported outcomes and higher graft failure rates. Five-strand HT autograft offers a method to increase graft size without utilization of allograft tissue or synthetic material. Indications: This presentation describes the technique for 5-strand HT autograft reconstruction of the ACL. Tips and tricks on graft prep, tunnel placement, tunnel depth, and avoiding pitfalls in surgery are provided. Technique Description: Gracilis and semitendinosus tendon harvest is performed through an L-shaped flap of sartorial fascia. If the 4-strand configuration is <8 mm, the semitendinosus is tripled for a 5-strand configuration. Graft is attached to a 15-mm fixed-length button construct for femoral fixation. The tibial tunnel is typically drilled with the guide through the accessory anteromedial portal. Independent femoral tunnel drilling is then performed via the accessory anteromedial tunnel with the knee in hyperflexion, using an offset guide to aid in tunnel placement. Femoral tunnel is initially reamed to depth of 25 mm and then drilled through the far cortex with a 4.5-mm drill to allow for suspensory fixation. Total length to the lateral cortex is measured and reaming of the tunnel is performed to achieve a 5- to 7-mm difference between total tunnel length to the lateral cortex and reamed tunnel length, assuring room for the button to flip on the femoral cortex. Tibial fixation is achieved by interference fixation versus tying the free suture limbs over a post with a washer. Results: Recent studies show the HT autograft to have similar re-rupture rates for ACL reconstruction compared with other autograft options. Additionally, this option has low donor-site morbidity and has demonstrated significant less anterior knee pain and kneeling pain postoperatively. Discussion/Conclusion: ACL reconstruction with 5-strand HT autograft has shown to be an effective method to increase the graft diameter with low rates of donor-site morbidity.
Patient perspectives on testing for clonal hematopoiesis of indeterminate potential
Authors: Sella Tal , Fell Geoffrey G. , Miller Peter G. , Gibson Christopher J. , Rosenberg Shoshana M. , Snow Craig , Stover Daniel G. , Ruddy Kathryn J. , Peppercorn Jeffrey M. , Schapira Lidia , Borges Virginia F. , Come Steven E. , Warner Ellen , Frank Elizabeth , Neuberg Donna S. , Ebert Benjamin L. , Partridge Ann H. 
Published: September 2022

Abstract
Clonal hematopoiesis of indeterminate potential (CHIP), an emerging biomarker for personalized risk-directed interventions, is increased in cancer survivors. However, little is known about patient preferences for CHIP testing. We surveyed participants in a prospective cohort study of young women with breast cancer (BC). The emailed survey included an introduction to CHIP and a vignette eliciting participants’ preferences for CHIP testing, considering sequentially: population-based 10-year risk of BC recurrence, hematologic malignancy, and heart disease; increased CHIP-associated risks; current CHIP management; dedicated CHIP clinic; and hypothetical CHIP treatment. Preference changes were evaluated using the McNemar test. The survey response rate was 82.2% (528/642). Median age at time of survey was 46 years and median time from diagnosis was 108 months. Only 5.9% had prior knowledge of CHIP. After vignette presentation, most survivors (87.1%) recommended CHIP testing for the vignette patient. Presented next with CHIP-independent, population-based risks, 11.1% shifted their preference from testing to not testing. After receiving information about CHIP-associated risks, an additional 10.1% shifted their preference to testing. Preference for testing increased if vignette patient was offered a CHIP clinic or hypothetical CHIP treatment, with 7.2% and 14.1% switching preferences toward testing, respectively. Finally, 75.8% of participants desired CHIP testing for themselves. Among participants, 28.2% reported that learning about CHIP caused at least moderate anxiety. Most young survivors favored CHIP testing, with preferences influenced by risk presentation and potential management strategies. Our findings highlight the importance of risk communication and psychosocial support when considering biomarkers for future risk in cancer survivors. This trial has been registered at www.clinicaltrials.gov as #NCT01468246.
Perinatal depression and its impact on infant outcomes and maternal-nurse SMS communication in a cohort of Kenyan women
Authors: Hummel Alyssa D. , Ronen Keshet , Bhat Amritha , Wandika Brenda , Choo Esther M. , Osborn Lusi , Batra Maneesh , Kinuthia John , Kumar Manasi , Unger Jennifer A. 
Published: September 2022

Abstract
Background
Perinatal depression is broadly defined as depressive symptoms during pregnancy or within the 12 months following delivery, affecting approximately 20–25% of pregnant and postpartum women in low- and middle-income countries. The wide accessibility of mobile phones allows mobile health (mHealth) interventions to be considered a solution to identify perinatal depression and provide appropriate referrals for treatment. This study, nested in a larger SMS communication project, examined the prevalence and correlates of perinatal depression, determined the association between antenatal depression and infant morbidity and mortality, and compared SMS communication patterns between women with and without perinatal depression.

Methods
This was a prospective longitudinal cohort study of pregnant women seeking antenatal services at two public sector health clinics in Kenya. SMS messages were sent to participants with educational content related to their pregnancy and infant health and two-way SMS communication occurred with a nurse. Sociodemographic and obstetric characteristics, SMS messaging behaviors, infant health status, and depressive symptoms were assessed by a standardized questionnaire administered at enrollment (30–36 weeks gestation) and follow-up (14 weeks postpartum). Generalized estimating equation (GEE) with Poisson link was used to evaluate correlates of perinatal depressive symptoms, infant outcomes, and frequency of SMS messaging.

Results
Of the 572 women with complete follow-up information, 188 (32.9%) screened positive for elevated depressive symptoms (≥10 by EPDS scale) at some time point during pregnancy or postpartum. The strongest predictors of any depressive symptoms included interpersonal abuse during pregnancy, fewer years of schooling, and maternal unemployment. Antenatal depressive symptoms were associated with an increased risk of infant illness or hospitalization (RR = 1.12, 95% CI: 1.11, 1.13). Women with antenatal or persistent perinatal depressive symptoms sent fewer SMS messages during the study period than their counterparts without depression.

Conclusions
Prevalence of elevated perinatal depressive symptoms was high in this cohort of Kenyan women. Our findings highlight the importance of screening perinatal women for experiences of symptoms of depression as well as abuse. Differences in messaging frequency between women with vs. without depressive symptoms presents an opportunity to provide more tailored support for those perinatal depression.
Analysis of the dental care queries in the “Mouth-Nose” discussion forum of the French association of patients with Gougerot-Sjögren’s syndromes and dryness
Authors: Danvers P. , Saide J. , Decup F. , Seror R. , Belkhir R. , Gosset M. 
Published: September 2022

Abstract
Background
Primary Sjögren Syndrome is a rare autoimmune systemic disease characterized by impaired secretory functions of the exocrine gland. One of the main clinical features is dry mouth and subsequent oral diseases, which are also found in patients with Sicca. This leads to a marked deterioration in the quality of life and the patient’s search for information and solutions. Many patients turn to patients’ associations that offer moments of sharing to their members, especially through online discussion forums. Today, these forums represent quality material for a sociological or biomedical analysis of patients' concerns, as close as possible to their daily lives. Our objective is to analyze the concerns of patients with SS or Sicca regarding their dry mouth especially dental care.

Methods
In this cross-sectional observation study, a quantitative analysis of the Mouth-Nose online forum discussion of the French Association of Patients with Gougerot-Sjögren’s Syndromes and Dryness have been performed. After reading and re-reading, initial request themes, topics, and subtopics were established and coding was performed. Then, the 885 threads were classified depending the initial request, pragma-linguistic indices and the main topic discussed in the thread. After identifying the threads dealing with dental care, we looked at which types of care were most discussed and classified the discussions according to whether or not the patient was satisfied with their care at the dentist.

Results
The majority of the initial requests are posts for experiences sharing and/or advice. The topic of “dental care” is one of the main concerns of the forum users. Among the threads that concern dental care, requests to share experience with implants are in the majority. Finally, the majority of the posts on dental care relate to care in private dental practice, deals with dental implants and prevention and resulted mainly in patient satisfaction.

Conclusions
Analysis of the forum reveals importance of patient concerns about prevention, and care costs due to implant treatment, which add to disease burden. Most of messages relate favorable experiences with their dentists, which is in line with the approach of sharing experiences and support characteristic of a forum.
Perceptions and attitudes of dental practitioners towards impacts of Covid 19 pandemic on clinical dentistry: a cross-sectional study
Authors: Zhou Xiaoyan , Gao Jinlong , Holden Alexander C. L. , Nanayakkara Shanika 
Published: September 2022

Abstract
Background
The COVID-19 pandemic challenged all healthcare providers including dental practitioners. This cross-sectional study aimed to investigate the dental practitioners’ perceptions and attitudes towards the impacts of COVID-19 on their professional practice, career decision and patient care.

Methods
Data was collected from dental practitioners registered in New South Wales (NSW), Australia using an online survey.

Results and conclusion
Responses received from 206 dental practitioners revealed their perceptions and attitudes towards COVID-19 infection risk, clinical guidelines, and measures adopted to deliver patient care. Majority of participants perceived the risk of infection in dentistry was higher compared with other health professionals. Most dental practices have followed guidelines received from professional associations and adopted multiple measures such as providing hand sanitizer, social distancing, and risk screen, to ensure safe delivery of oral health care. Over 80% of dental practitioners raised concerns on patients’ accessibility to dental care during the pandemic. Despite tele-dentistry was introduced, almost half of the participants did not recognize tele-dentistry as an effective alternative. Moreover, negative impacts of COVID-19 pandemic on dental practitioner’s professional career have been reported, including lower practice safety, reduction in working hours and income. Noteworthy, one quarter of participants even considered changing their practice environment, moving sectors or even leaving their career in dentistry. However, majority of the dental practitioners are willing to stay in their current practice environment and continue their career in dentistry. Our observations demonstrate the systematic disruption to dental practice faced in Australia due to the COVID-19 pandemic. Providing dental practitioners with timely educational training and support is important to minimise negative impacts of the challenges and to optimise dental care.
The experiences of clinical nurses coping with patient death in the context of rising hospital deaths in China: a qualitative study
Authors: Zhang Jinxin , Cao Yingjuan , Su Mingzhu , Cheng Joyce , Yao Nengliang 
Published: September 2022

Abstract
Background
Chinese clinical nurses are increasingly confronting patient death, as the proportion of hospital deaths is growing. Witnessing patient suffering and death is stressful, and failure to cope with this challenge may result in decreased well-being of nurses and impediment of the provision of “good death” care for patients and their families. To our knowledge, few studies have specifically explored clinical nurses’ experiences coping with patient death in mainland China.

Objective
We aimed to explore nurses’ experiences coping with patient death in China in order to support frontline clinical nurses effectively and guide the government in improving hospice care policy.

Methods
Clinical nurses were recruited using purposive and snowball sampling between June 2020 and August 2020. We gathered experiences of clinical nurses who have coped with patient death using face-to-face, semi-structured, in-depth interviews. Audio recordings were transcribed verbatim and analyzed using thematic analysis.

Results
Three thematic categories were generated from data analysis. The first was “negative emotions from contextual challenges.” This category involved grief over deaths of younger persons, pity for deaths without family, and dread related to coping with patient death on night duty. The second category was “awareness of mortality on its own.” Subthemes included the ideas that death means that everything stops being and good living is important because we all die and disappear. The third category was “coping style.” This category included focusing on treating dying patients, recording the signs and symptoms, and responding to changes in the patient’s condition. It also involved subthemes such as avoiding talk about death due to the grief associated with dying and death, and seeking help from colleagues.

Conclusions
Clinical nurses’ emotional experiences are shaped by intense Chinese filial love, charity, and cultural attitudes towards death. Reasonable nurse scheduling to ensure patient and staff safety is a major priority. “Good death” decisions based on Chinese ethical and moral beliefs must be embedded throughout hospital care.
Cost-effectiveness of a whole-area testing pilot of asymptomatic SARS-CoV-2 infections with lateral flow devices: a modelling and economic analysis study
Authors: Drakesmith Mark , Collins Brendan , Jones Angela , Nnoaham Kelechi , Thomas Daniel Rhys 
Published: September 2022

Abstract
Background
Mass community testing for SARS-CoV-2 by lateral flow devices (LFDs) aims to reduce prevalence in the community. However its effectiveness as a public heath intervention is disputed.

Method
Data from a mass testing pilot in the Borough of Merthyr Tydfil in late 2020 was used to model cases, hospitalisations, ICU admissions and deaths prevented. Further economic analysis with a healthcare perspective assessed cost-effectiveness in terms of healthcare costs avoided and QALYs gained.

Results
An initial conservative estimate of 360 (95% CI: 311–418) cases were prevented by the mass testing, representing a would-be reduction of 11% of all cases diagnosed in Merthyr Tydfil residents during the same period. Modelling healthcare burden estimates that 24 (16—36) hospitalizations, 5 (3–6) ICU admissions and 15 (11–20) deaths were prevented, representing 6.37%, 11.1% and 8.2%, respectively of the actual counts during the same period. A less conservative, best-case scenario predicts 2333 (1764–3115) cases prevented, representing 80% reduction in would-be cases. Cost -effectiveness analysis indicates 108 (80–143) QALYs gained, an incremental cost-effectiveness ratio of £2,143 (£860-£4,175) per QALY gained and net monetary benefit of £6.2 m (£4.5 m-£8.4 m). In the best-case scenario, this increases to £15.9 m (£12.3 m-£20.5 m).

Conclusions
A non-negligible number of cases, hospitalisations and deaths were prevented by the mass testing pilot. Considering QALYs gained and healthcare costs avoided, the pilot was cost-effective. These findings suggest mass testing with LFDs in areas of high prevalence (> 2%) is likely to provide significant public health benefit. It is not yet clear whether similar benefits will be obtained in low prevalence settings or with vaccination rollout.
Guidelines and clinical priority setting during the COVID-19 pandemic – Norwegian doctors’ experiences
Authors: Bringedal Berit H. , Rø Karin Isaksson , Bååthe Fredrik , Miljeteig Ingrid , Magelssen Morten 
Published: September 2022

Abstract
Background
In the first phase of the COVID-19 pandemic, strong measures were taken to avoid anticipated pressure on health care, and this involved new priorities between patient groups and changing working conditions for clinical personnel. We studied how doctors experienced this situation. Our focus was their knowledge about and adherence to general and COVID-19 specific guidelines and regulations on priority setting, and whether actual priorities were considered acceptable.

Methods
In December 2020, 2 316 members of a representative panel of doctors practicing in Norway received a questionnaire. The questions were designed to consider a set of hypotheses about priority setting and guidelines. The focus was on the period between March and December 2020. Responses were analyzed with descriptive statistics and regression analyses.

Results
In total, 1 617 (70%) responded. A majority were familiar with the priority criteria, though not the legislation on priority setting. A majority had not used guidelines for priority setting in the first period of the pandemic. 60.5% reported that some of their patients were deprioritized for treatment. Of these, 47.5% considered it medically indefensible to some/a large extent. Although general practitioners (GPs) and hospital doctors experienced deprioritizations equally often, more GPs considered it medically indefensible. More doctors in managerial positions were familiar with the guidelines.

Conclusions
Most doctors did not use priority guidelines in this period. They experienced, however, that some of their patients were deprioritized, which was considered medically indefensible by many. This might be explained by a negative reaction to the externally imposed requirements for rationing, while observing that vulnerable patients were deprioritized. Another interpretation is that they judged the rationing to have gone too far, or that they found it hard to accept rationing of care in general. Priority guidelines can be useful measures for securing fair and reasonable priorities. However, if the priority setting in clinical practice is to proceed in accordance with priority-setting principles and guidelines, the guidelines must be translated into a clinically relevant context and doctors’ familiarity with them must improve.
LncRNA MRF drives the regulatory function on monocyte recruitment and polarization through HNRNPD-MCP1 axis in mesenchymal stem cells
Authors: Lin Jiajie , Xie Zhongyu , Zhang Zhaoqiang , Li Ming , Ye Guiwen , Yu Wenhui , Li Jinteng , Ye Feng , Su Zepeng , Che Yunshu , Xu Peitao , Zeng Chenying , Wang Peng , Wu Yanfeng , Shen Huiyong 
Published: September 2022

Abstract
Background
Mesenchymal stem cells (MSCs) exhibit two bidirectional immunomodulatory abilities: proinflammatory and anti-inflammatory regulatory effects. Long noncoding RNAs (lncRNAs) have important functions in the immune system. Previously, we performed high-throughput sequencing comparing lncRNA expression profiles between MSCs cocultured with or without CD14+ monocytes and screened out a new lncRNA termed lncRNA MCP1 regulatory factor (MRF). However, the mechanism of MRF in MSCs is still unknown.

Methods
MRF expression was quantified via qRT–PCR. RNA interference and lentiviruses were used to regulate MRF expression. The immunomodulatory effects of MSCs on monocytes were evaluated via monocyte migration and macrophage polarization assays. RNA pull-down and mass spectrometry were utilized to identify downstream factors of MRF. A dual-luciferase reporter assay was applied to analyze the transcription factors regulating MRF. qRT–PCR, western blotting and ELISAs were used to assess MCP1 expression. A human monocyte adoptive transfer mouse model was applied to verify the function of MRF in vivo.

Results
MRF was upregulated in MSCs during coculture with CD14+ monocytes. MRF increased monocyte recruitment by upregulating the expression of monocyte chemotactic protein (MCP1). Knockdown of MRF enhanced the regulatory effect of MSCs on restraining M1 polarization and facilitating M2 polarization. Mechanistically, MRF bound to the downstream protein heterogeneous nuclear ribonucleoprotein D (HNRNPD) to upregulate MCP1 expression, and the transcription factor interferon regulatory factor 1 (IRF1) activated MRF transcription early during coculture. The human monocyte adoptive transfer model showed that MRF downregulation in MSCs inhibited monocyte chemotaxis and enhanced the effects of MSCs to inhibit M1 macrophage polarization and promote M2 polarization in vivo.

Conclusion
We identified the new lncRNA MRF, which exhibits proinflammatory characteristics. MRF regulates the ability of MSCs to accelerate monocyte recruitment and modulate macrophage polarization through the HNRNPD-MCP1 axis and initiates the proinflammatory regulatory process in MSCs, suggesting that MRF is a potential target to improve the clinical effect of MSC-based therapy or correct MSC-related immunomodulatory dysfunction under pathological conditions.