bluuebunny/crossref_metadata_2025_split huggingface dataset:
Bundle branch block and nonspecific intraventricular conduction delay prevalence using Chinese nationwide survey data
Authors: Qiao Qing , Lin Jing , Chen Ning , Xia Shijun , Du Jing , Du Xin , Bai Rong , Dong Jianzeng , Ma Changsheng 
Published: August 2022

Objective We aimed to determine the prevalence of and the factors associated with intraventricular conduction disturbance in the Chinese population. Methods Electrocardiographic data from 42,031 people were retrospectively analysed. The weighted prevalences of left bundle branch block (LBBB), right bundle branch block (RBBB), bifascicular block and nonspecific intraventricular conduction delay (NS-IVCD) were calculated. The independently associated factors were determined using logistic regression analysis. Results The weighted prevalence for Chinese people older than 45 years was 0.17% for LBBB, 2.16% for RBBB and 0.44% for NS-IVCD. The weighted prevalence for RBBB combined with left anterior fascicular block was 0.17%, and 0.05% for RBBB combined with left posterior fascicular block. There were significant differences in the weighted prevalences of RBBB and NS-IVCD between men and women. The weighted prevalence of LBBB and RBBB increased markedly with increasing age. Age and diabetes were independent factors associated with LBBB, compared with age and sex for RBBB and sex and coronary artery disease for NS-IVCD. Conclusions This study provided reliable data for the weighted prevalence of and factors associated with LBBB, RBBB and NS-IVCD in Chinese adults.
Application of 3D-printed osteotomy guides in periacetabular osteotomy: A short-term clinical study
Authors: Ma Shiqiang , Xiao Li , Guo Donghui , Shi Qiuling , Shen Runbin , Li Xiaoming 
Published: August 2022

Objective: To compare the clinical efficacy between personalised 3-dimensional (3D) printed osteotomy and traditional osteotomy in periacetabular osteotomy (PAO). Methods: Twenty-two patients with acetabular dysplasia were randomly divided into a personalised 3D-printed osteotomy group and a traditional osteotomy group without 3D printing assistance. The operation time, intraoperative blood loss, X-ray frequency, quantity of postoperative drainage, postoperative transfusion rate, hip angle and Harris hip score of 6 months postoperative were studied and compared to evaluate the surgical efficacy between personalised 3D-printed osteotomy and traditional osteotomy in periacetabular osteotomy. Results: The operation time, intraoperative blood loss, X-ray frequency, postoperative 24 h drainage volume in the personalised 3D-printed osteotomy group (114.70 ± 2.21 min, 639.70 ± 5.00 mL, 11.82 ± 0.42 times, 231.20 ± 3.86 mL) was superior to the traditional group (150.40 ± 2.45 min, 850.50 ± 5.34 mL, 17.09 ± 0.39 times, 324.30 ± 4.06 mL). There was a statistically significant difference between the 3D-printed osteotomy group and the traditional osteotomy group in terms of the operation time, intraoperative blood loss, X-ray frequency and postoperative 24 h drainage volume ( p < 0.05). And there were no substantial differences in the hip angle and the 6-month postoperative Harris hip score between the two groups ( p > 0.05). Conclusion: The 3D-printed osteotomy template for PAO is a valid method and its short-term clinical effect is superior to that of traditional osteotomy.
Meanings of troubled conscience in nursing homes: nurses’ lived experience
Authors: Munkeby Hilde , Bratberg Grete , Devik Siri A 
Published: August 2022

Background: Troubled conscience among nurses and other healthcare workers represents a significant contributor to healthcare worker moral distress, burnout and attrition. While research in this area has examined critical care in hospitals, less knowledge has been obtained from long-term care contexts such as nursing homes, despite widely recognised challenges with regard to vulnerable patients, increasing workload and maintaining workforce sustainability among nurses. Objective: The aim of this study was to illuminate and interpret the meaning of the lived experience of troubled conscience among registered nurses (RNs) working in nursing homes. Research design: This qualitative research employed narrative interviews with eight nurses to obtain essential meanings of their lived experiences of troubled conscience. The interview texts were analysed using a phenomenological hermeneutic approach. Ethical considerations: Participation was voluntary, informed and was conducted with written consent. The Norwegian Centre for Research Data approved the data processing of personal data. Findings: The analysis uncovered two themes: (1) troubled conscience means abandoning ideals, with the subthemes: failing dependent patients; being disloyal to colleagues; being inadequate in the performance of work tasks and (2) troubled conscience means facing realities, with the subthemes: accepting being part of the system; responding to barriers. Discussion: Troubled conscience meant experiencing continuous and simmering tension between one’s ideals and realities and feeling a drive to preserve accountability and one’s moral integrity. Endangered ideals were often under cross-pressure and included humanistic values, professional values, working life values and the values of the organisation. Conclusion: Nurses’ troubled conscience refers to a struggle, but also a force that plays out at various levels and arenas in long-term care. Openness and dialogue about how professional values and the welfare state’s intentions can be realised within the given framework are important for individual nurses’ occupational health as well as the quality of care provided to patients.
Two Orthogonal Nitinol Staples and Combined Nitinol Staple-Screw Constructs for a First Metatarsophalangeal Joint Arthrodesis: A Biomechanical Cadaver Study
Authors: Schafer Kevin A. , Baldini Todd , Hamati Mary , Backus Jonathon D. , Hunt Kenneth J. , McCormick Jeremy J. 
Published: August 2022

Background: End-stage hallux metatarsophalangeal (MTP) joint arthritis is commonly treated with arthrodesis using stainless steel or titanium implants. These implants provide static compression that is maximal at the time of implant insertion. Alternatively, nitinol staples are capable of dynamic compression. They have most frequently been used for midfoot arthrodesis procedures. However, their biomechanical performance during hallux MTP arthrodesis has not been described. Methods: 8 matched pairs of cadaveric feet (4 female, 4 male) were prepared for hallux MTP arthrodesis using cup and cone reamers. Cadaveric pairs were then instrumented with either (1) a transarticular lag screw and dorsal nitinol staple or (2) orthogonal nitinol staples placed dorsally and medially. Walking in a short leg cast for 6 weeks was simulated by applying 90-N forces at 3 Hz to the plantar proximal phalanx for up to 250 000 cycles. Failure was defined as catastrophic implant failure or plantar gapping beyond 7 mm. Results: 15 of 16 specimens failed cyclic loading. All 8 specimens fixed with orthogonal staples failed at an average of 37 ± 81 cycles. 7 of 8 specimens fixed with a dorsal staple and crossed screw failed at 14 900 ± 39 000 cycles. Collectively, 5 specimens failed because of bone fracture (1 in orthogonal staples, 4 in staple-screw group) and 10 failed because of excessive gap formation (7 in orthogonal staples, 3 in staple-screw group). The number of cycles to failure was significantly lower ( P = .0469) in the orthogonal staple constructs compared with the dorsal staple and crossed screw constructs. Conclusion: The tested constructs permit significant motion at the first MTP fusion surface during simulated protected weightbearing. Although multiple in vivo factors should be considered when extrapolating results from this cadaveric study, this motion may result in clinical failure with early postoperative weightbearing protocols. Clinical Relevance: We report the first biomechanical evaluation of hallux MTP arthrodesis using modern nitinol staples in 2 separate constructs.
Effects of Pregnant Fatigue on the Development of Offspring in Rats
Authors: Wu Fan , Bai Ting , Yan Shuhan , Zhang Feng 
Published: August 2022

Aim To explore the correlation between pregnant fatigue and intrauterine physical and neural development of offspring in rats. Methods Sprague-Dawley pregnant rats were randomly divided into a normal control group, a mild fatigue group (stand in water for 6 hours/day), and a severe fatigue group (stand in water for 15 h/day). The levels of lactic acid, 5-Hydroxytryptamine and Interleukin-6 in cardiac serum of rats were used to evaluate the fatigue. The expression of S100β in the telencephalon, Insulin-like growth factor-1 (IGF-1) in the liver and Cyclooxygenage-2 (COX-2) in the small intestine tissues of fetal rats were examined. Frozen sections were taken from the telencephalon of rat pups to observe morphological changes in the hippocampal primordium. Results Pregnant fatigue led to a decrease in food intake ( F = 37.586, p = 0.000) and water intake ( F = 23.608, p = 0.000) in rats. The IGF-1 mRNA expression of fetal rats in the severe fatigue group was lower than that in the control group ( p = 0.0003). The expression of S100β mRNA ( p = 0.000) and COX-2 mRNA ( p = 0.0002) of fetal rats were higher in the severe fatigue group than in the control group. HE staining of the telencephalon of fetal rats in the pregnant fatigue group revealed sparse and irregular cell arrangement and increased gaps in the hippocampal primordial site. Conclusion Pregnant fatigue rats had both physical fatigue and mental fatigue. Fatigue during pregnancy affects physical development and neurodevelopment of offspring. Further research should elucidate the mechanisms of pregnant fatigue and its effects on offspring.
Comparison of wound architecture in implantable collamer lens surgery: Self-sealing single-plane opposite clear corneal incision versus main surgical incision
Authors: González-Cruces Timoteo , Cano-Ortiz Antonio , Villarrubia Alberto , Sánchez-González María Carmen , Sánchez-González Jose María 
Published: August 2022

Purpose Incision architecture can play an important role in corneal astigmatism management through peripheral corneal relaxing incisions. The aim of this study was to compare the incision architecture of single-plane opposite clear corneal incisions (OCCIs) and main surgical incisions (MSIs) in patients undergoing implantable collamer lens (ICL) surgery. Methods A retrospective cross-sectional tomographic analysis of MSI and OCCI architectures was performed 6 months after ICL surgery. Image acquisition was performed using spectral-domain anterior segment optical coherence tomography. Results A total of 31 OCCIs and 24 MSIs were evaluated. The mean incision angle was 42.83 ± 5.69 degrees for MSIs and 48.26 ± 6.07 degrees for OCCIs (p < 0.01), and the mean MSI and OCCI length was 1146.70 ± 150.48 µm and 976.68 ± 140.19 µm, respectively (p < 0.01). The mean increase in epithelium depth in the wound was 37.63 ± 11.91 µm in the MSI group and 47.64 ± 15.45 µm in the OCCI group (p = 0.02). Endothelial misalignment was observed in both types of incisions. However, the misalignment with MSI was greater than with OCCI, 106.67 ± 31.84 µm versus 83.75 ± 23.39 µm (p = 0.01), respectively. Conclusion Both types of incisions, OCCI and MSI, were shown to be safe with complete wound sealing and healing 6 months postoperatively. The MSIs performed in the temporal position were more angled and longer, with greater endothelial retraction and minor epithelial thickening in the wound area compared with astigmatic incisions without manipulation.
Barriers and Facilitators to Substance Use Disorder Treatment: An Overview of Systematic Reviews
Authors: Farhoudian Ali , Razaghi Emran , Hooshyari Zahra , Noroozi Alireza , Pilevari Azam , Mokri Azarakhsh , Mohammadi Mohammad Reza , Malekinejad Mohsen 
Published: August 2022

objective: This investigation explored the barriers and facilitators to substance use disorder (SUD) treatment in the integrated paradigm. methods: A search technique for barriers and facilitators of SUD treatment was applied to the PubMed and Web of Science databases to identify relevant systematic reviews. The eligibility criteria included systematic review (SR) or SR plus meta-analysis (MA) articles published before the end of 2021, human research, and the English language. Each of the 12 relevant review articles met the inclusion criteria. AMSTAR was utilised to evaluate the methodological quality of the systematic reviews. results: Two authors analysed 12 SR/SR-MA articles to identify barriers or facilitators of SUD treatment. The cumulative summary results of these 12 evaluations revealed that barriers and facilitators may be classified into 3 levels: individual, social and structural. By analysing these review papers, 37 structural barriers, 21 individual barriers and 19 social barriers were uncovered, along with 15 structural facilitators, 9 social facilitators and 3 individual facilitators. conclusions: The majority of barriers indicated in the review articles included in this analysis are structural, as are the majority of facilitators. Consequently, the design of macro models for the treatment of substance use disorders may yield various outcomes and potentially affect society and individual levels.
Predictors of Hand-Washing Practices at Critical Times Among Mothers of Under-5 Years Old Children in Rural Setting of Gedeo Zone, Southern Ethiopia
Authors: Agaro Ashenafi , Hareru Habtamu Endashaw , Muche Temesgen , Sisay W/tsadik Daniel , Ashuro Zemachu , Negassa Belay , Legesse Mehret Tesfu , Kaso Abdene Weya , Alemu Wagaye , Alemayehu Gube Addisu , Aregu Mekonnen Birhanie , Soboksa Negasa Eshete 
Published: August 2022

Background: Various communicable and infectious diseases could be contained by proper hand washing leading to a reduction in mortality and morbidity of children. Objective: To assess predictors of hand-washing practices at critical times among mothers of under 5 years old children in rural setting of Gedeo zone, Southern Ethiopia. Method: An institutional-based cross-sectional survey was conducted among 422 women with children under the age of 5 attended the Dilla Zuria health facility and were chosen using a systematic sampling method. Data was gathered using pre-tested interview-administered structured questionnaires. Data was entered into EPI info version 17 and analyzed using SPSS version 25. Binary logistic regression was employed to identify the association between dependent and independent variables. Finally, for variables with a P < .05 in multivariable analysis, adjusted odds ratio (AOR) with a 95% confidence interval (CI) was determined and interpreted. Results: The hand washing practice of mothers at critical times was 44.9% [95% CI: 40.1, 49.7%]. The pertinent predictors were favorable attitude [AOR = 7.77, 95% CI: 4.56, 10.37], availability of water source near the household [AOR = 5.31, 95% CI: 3.56, 10.37], and constant availability of soaps at household [AOR = 2.32, 95% CI: 1.33, 6.70]. Conclusion: In our study, hand-washing practices at critical times was low. The pertinent predictors were attitude, the presence of a water source near the household, and the presence of soap. Therefore, it is advised to encourage domestic hygiene education to improve mothers’ attitudes and to increase the availability of water and soap close to the household to promote handwashing with soap and water at critical times.
Blind sports’ blind spot: The global epidemiology of visual impairment against participation trends in elite blind para sport
Authors: Stratton Catherine S M , Fagher Kristina , Li Xiang , Ottesen Taylor D , Tuakli-Wosornu Yetsa A 
Published: August 2022

Background: It remains unknown whether access to elite blind sports opportunities is globally balanced or matches the prevalence of blindness/visual impairment (VI). The primary objective of this study was to determine the rate of elite blind sports participation in each world region registered in the International Blind Sports Federation’s (IBSA) and to assess its association with the global and regional prevalence of blindness/VI. The secondary objective was to determine the association between other covariates, such as age, vision class, and sex, with the number of IBSA-registered athletes from each region. Methods: A baseline estimate of blindness/VI data was established and used when comparing participation rates to blindness/VI rates. Descriptive statistics were used to describe sports participation and associated co-variates. Results: Among 123 member countries registered in IBSA, 31 did not have any completed registrations in blind sports, of which 22 had a prevalence of blindness/VI higher than the global average. During the summer season 2019, 738 (29.52%) IBSA athletes were female and 1762 (70.48%) were male. Conclusions: These results suggest elite blind/VI sport participation is limited independently from blindness/VI prevalence. Increasing blind-friendly sport resources, especially in low-and-middle-income countries (LMICs), would improve the rate of elite sport participation among athletes with blindness/VI.
Preoperative Medial Tightness and Narrow Medial Joint Space Are Predictive Factors for Lower Extremity Alignment Change Toward Varus After Opening-Wedge High Tibial Osteotomy
Authors: Lee Sung-Sahn , Lee Young Keun , Kim Il Su , Ryu Dong Jin , Jung Eui Yub , Lee Do Kyung , Wang Joon Ho 
Published: August 2022

Background: Time-dependent changes in lower extremity alignment after an opening-wedge high tibial osteotomy (OWHTO) have been poorly investigated. Moreover, few studies have investigated risk factors of postoperative alignment change. Purposes: To investigate time-dependent alignment changes and identify predictive factors for postoperative alignment change after OWHTO. Study Design: Case-control study; Level of evidence, 3. Methods: This study included patients who underwent OWHTO between March 2010 and September 2018. A total of 142 knees with a mean follow-up of 42 months were included and classified as the change group when the amount of hip-knee-ankle (HKA) angle change was >1°; if otherwise, then as the no-change group. HKA angle was obtained at 6 time points: preoperatively and at 3 months, 6 months, 1 year, 2 years, and final follow-up postoperatively. Multiple regression analysis was performed to identify the factors that were correlated with the changes in the HKA angle from 3 months to the final follow-up. Results: Among the 142 knees, 59 (42%) were included in the change group. The overall postoperative HKA angles progressed serially toward varus after OWHTO. The mean angles of the 6 time points were 8.5°, –3.7°, –3.6°, –3.3°, –3.1°, and –2.7°, respectively. The mean HKA angles of the change and no-change groups were 9.1°, –4.3°, –3.4°, –2.8°, –2.0°, and –1.4° and 8.1°, –3.3°, –3.8°, –3.6°, –3.8°, and –3.7°, respectively. Greater change in the HKA angle was predicted by preoperatively greater valgus stress joint line convergence angles and less medial joint space width. Conclusion: Of the cases of OWHTO, 42% showed correction loss of >1° at a mean follow-up of 42 months. The overall postoperative HKA angles progressed serially to varus angles after OWHTO. Preoperative greater valgus stress joint line convergence angles and less medial joint space width were predictive factors for greater change in alignment toward varus after OWHTO.
Cross-Sectional Analysis of Foot and Ankle Questions on the Orthopaedic In-Training Examination: A Guide for Resident Preparation
Authors: Klein Brandon , Giordano Joshua , Barmann Jacob , White Peter B. , Cohn Randy M. , Bitterman Adam D. 
Published: August 2022

Background: The Orthopaedic In-Training Examination (OITE) is a standardized examination administered annually to orthopaedic surgery residents. The examination is designed to evaluate resident knowledge and academic performance of residency programs. Methods: All OITE foot and ankle questions from 2009 through 2012 and 2017 through 2020 were analyzed. Subtopics, taxonomy, references, and use of imaging modalities were recorded. Results: There were a total of 167 foot and ankle (F&A)–related questions across 8 years of OITE examinations. Trauma remained the most commonly tested subtopic of F&A across both subsets, followed by rehabilitation, tendon disorders, and arthritis. We found an increase in questions related to arthritis ( P = .05) and a decrease of questions related to the diabetic foot ( P = .02). Taxonomy 3 questions constituted 49.5% of F&A questions from 2009 through 2012 compared with 44.7% of questions from 2017 to 2020 ( P = .54). Radiography was the most commonly used imaging modality in both subsets. From 2009 to 2012, 63.6% of questions included a radiograph compared with 76.5% in 2017 through 2020 ( P = .13). FAI ( Foot & Ankle International), JAAOS ( Journal of the American Academy of Orthopaedic Surgeons), and JBJS ( The Journal of Bone and Joint Surgery) were the most commonly cited journals, making up more than 50% of total citations. Citations per question increased from 2.20 to 2.42 from 2009-2012 to 2017-2020 ( P = .01). The average lag time in the early subset was 8.2 years and 8.9 years in the later subset. Conclusion: This study provides a detailed analysis of the F&A section of the OITE. Use of this analysis can provide residents with a guide on how to better prepare for the OITE examination. Level of Evidence: Level IV, cross-sectional review of Orthopaedic In-Training Examination questions
Prolonged XPO1 inhibition is essential for optimal antileukemic activity in NPM1-mutated AML
Authors: Pianigiani Giulia , Gagliardi Andrea , Mezzasoma Federica , Rocchio Francesca , Tini Valentina , Bigerna Barbara , Sportoletti Paolo , Caruso Simona , Marra Andrea , Peruzzi Sara , Petito Eleonora , Spinozzi Giulio , Shacham Sharon , Landesman Yosef , Quintarelli Concetta , Gresele Paolo , Locatelli Franco , Martelli Maria Paola , Falini Brunangelo , Brunetti Lorenzo 
Published: August 2022

Abstract
NPM1 is the most frequently mutated gene in adults with acute myeloid leukemia (AML). The interaction between mutant NPM1 (NPM1c) and exportin-1 (XPO1) causes aberrant cytoplasmic dislocation of NPM1c and promotes the high expression of homeobox (HOX) genes, which is critical for maintaining the leukemic state of NPM1-mutated cells. Although there is a rationale for using XPO1 inhibitors in NPM1-mutated AML, selinexor administered once or twice per week did not translate into clinical benefit in patients with NPM1 mutations. Here, we show that this dosing strategy results in only a temporary disruption of the XPO1-NPM1c interaction, limiting the efficacy of selinexor. Because the second-generation XPO1 inhibitor eltanexor can be administered more frequently, we tested the antileukemic activity of prolonged XPO1 inhibition in NPM1-mutated AML models. Eltanexor caused irreversible HOX downregulation, induced terminal AML differentiation, and prolonged the survival of leukemic mice. This study provides essential information for the appropriate design of clinical trials with XPO1 inhibitors in NPM1-mutated AML.