bluuebunny/crossref_metadata_2025 huggingface dataset:
Analysis of Conservative Treatment Trends for Lumbar Disc Herniation with Radiculopathy in Korea: A Population-Based Cross-Sectional Study
Authors: Cho Sohyun , Lim Yu-Cheol , Kim Eun-Jung , Park Yeoncheol , Ha In-Hyuk , Lee Ye-Seul , Lee Yoon Jae
Published: August 2023

This study aimed to analyze the trends in conservative treatment and associated medical costs for lumbar intervertebral disc disorders with radiculopathy in Korea. This population-based cross-sectional study included patients aged ≥ 20 years with at least one “intervertebral disc disorder with radiculopathy” claim (Korean Standard Classification of Diseases (KCD)-7 code: M511) who sought treatment from tertiary, general, or Korean Medicine hospitals or clinics between 2010 and 2019 and whose data were extracted from the Korean Health Insurance Review and Assessment Service National Patients Sample database. Intervention frequency, ratio, and medical costs, including medication, were analyzed. The number of patients with lumbar intervertebral disc disorders and radiculopathy undergoing conservative treatment increased by >30%, and medical costs increased from USD 3,342,907 to USD 5,600,456 during the 10-year period. The non-surgical treatments mainly used were medication and physiotherapy, and the most commonly prescribed medication was non-opioid analgesics. Meanwhile, the number of patients who used nerve plexus and root and ganglion nerve blocks showed the most significant increase. In conclusion, the number of patients with radiculopathy who received nerve blocks, particularly nerve plexus and root and ganglion nerve blocks, and related expenditure increased, implying a gradual shift in medical decisions from systemic pain reduction to specific and targeted pain treatments. Future studies and clinical practice guidelines may require further inspection of real-world practice to advise optimal treatment choices for an effective treatment plan.
A Systematic Literature Review of Gamification in/for Cultural Heritage: Leveling up, Going Beyond
Authors: Marques Célio Gonçalo , Pedro João Paulo , Araújo Inês
Published: August 2023

Because of the possibilities that it opens for a variety of fields and practices, gamification has increasingly garnered significant attention. This has put it at the forefront of many significant debates around its applicability and implications. In the case of its application to cultural heritage, although there is much trailblazing to do, the body of work has been growing and the field is gaining its maturity. As such, this paper aims to take stock of the directions the field has been moving towards—to provide orientation for future work and projects that are yet to be developed. To do this, the paper aims to map out the publications in the field of gamified cultural heritage, by conducting a broader and systematic literature review. The study has found that, with regards to who the main actors with publications in the field are, a prominence of European institutions and networks, namely from Italy, Greece and the United Kingdom, can be observed. Regarding what heritage is being gamified and for what purpose, the study found a prominence of focus on historical, architectural and archeological heritage values and a very significant focus on gamification being used for motivation/engagement and for creativity enhancement. When looking at the gamification design dimensions that are given prevalence, intrinsic motivation seems to be prioritized, and, with regards to the observed target publics, tourists and visitors and seem to prevail in gamified heritage projects, with children as a specific group coming in second. Regarding technologies and tools being used, Mobile Applications, Augmented Reality (AR) and Virtual Reality (VR) are particularly prevalent. Regarding mentioned future orientations, the study found that a vast majority of papers are self-contained, both in scope of work and discussion, with most of those that do mention future directions indicating continuation and/or expansion of their specific project.
Physiological and Structural Changes in Apple Tree Branches of Different Varieties during Dormancy
Authors: Xu Gongxun , He Meiqi , Zhao Deying , Lyu Deguo , Qin Sijun
Published: August 2023

Low temperature is an abiotic stress factor limiting the distribution of fruit tree cultivation areas. As temperate deciduous fruit trees, apple (Malus domestica) trees go dormant in the winter to adapt to or avoid damage caused by low temperatures. The capacity for cold resistance is closely linked to the physiological, biochemical, and structural characteristics of one-year-old branches. In this study, we investigated such changes in the branches of cold-resistant ‘Hanfu’ (HF) and cold-sensitive ‘Naganofuji 2’ (CF) apple varieties. The relative electrical conductivity, malondialdehyde content, and reactive oxygen species content of HF branches were lower than those of CF branches, while the antioxidant enzyme activity was higher in HF. The proline, soluble protein, and soluble sugar contents in both varieties showed an initial increase, followed by a subsequent decrease. Sucrose and sorbitol were the main sugar components, but sucrose and fructose were higher in HF than in CF. The periderm, phloem, and xylem of HF branches were also found to be thicker than those of CF branches, while the vessel diameter was smaller and the density greater. The results of this study provide a theoretical reference for further research on the low temperature adaptability of apple tree branches during dormancy.
Integrating Language Instruction into Pharmacy Education: Spanish and Arabic Languages as Examples
Authors: Valcarcel-Ares Marta Noa , Abdulrhim Sara Hamdi , Anders Karli , Ali Raja Mahamade , Mukhalalati Banan Abdulrzaq , Mraiche Fatima
Published: August 2023

Effective communication is key for healthcare providers to provide optimal care for patients. Pharmacists’ fluency in a patient’s native language is important for effective communication. Additionally, language concordance improves patients’ trust and ensures health equity. In the United States (US), Hispanics are the largest minority group, but only 36% of the pharmacy schools in the US offer Spanish courses in their curriculum. Conversely, Middle Eastern countries have implemented English as the language of instruction in pharmacy schools, though the native language of the patient population is Arabic. The discrepancy between the language of education and the language used by patients might lead to communication problems, thus limiting a pharmacist’s role in practice. This review aims to describe the efforts of pharmacy schools both in the US and Middle Eastern countries to incorporate a second language (Spanish and Arabic, respectively) in their curriculum. Spanish language content has scarcely been introduced into the pharmacy curriculum in the US, either as didactic elements (elective courses, lab sessions, modules within a course, or co-curricular programs) or as language immersion experiences (rotations and internships, nationally or abroad). In Arabic-speaking countries, an Arabic course was introduced to the pharmacy curriculum to enhance students’ communication skills. This review provides an overview of the steps taken in various pharmacy programs to prepare students for adequate multilingual speaking. The findings reveal the need for additional strategies to assess the impact of language courses on student performance and patient experience, as well as language competence in pharmacists and pharmacy students.
Synthesis of Polystyrene@TiO2 Core–Shell Particles and Their Photocatalytic Activity for the Decomposition of Methylene Blue
Authors: Toyama Naoki , Takahashi Tatsuya , Terui Norifumi , Furukawa Shigeki
Published: August 2023

In this study, we investigated the preparation conditions of polystyrene (PS)@TiO2 core–shell particles and their photocatalytic activity during the decomposition of methylene blue (MB). TiO2 shells were formed on the surfaces of PS particles using the sol–gel method. Homogeneous PS@TiO2 core–shell particles were obtained using an aqueous NH3 solution as the promoter of the sol–gel reaction and stirred at room temperature. This investigation revealed that the temperature and amount of the sol–gel reaction promoter influenced the morphology of the PS@TiO2 core–shell particles. The TiO2 shell thickness of the PS@TiO2 core–shell particles was approximately 5 nm, as observed using transmission electron microscopy. Additionally, Ti elements were detected on the surfaces of the PS@TiO2 core–shell particles using energy-dispersive X-ray spectroscopy analysis. The PS@TiO2 core–shell particles were used in MB decomposition to evaluate their photocatalytic activities. For comparison, we utilized commercial P25 and TiO2 particles prepared using the sol–gel method. The results showed that the PS@TiO2 core–shell particles exhibited higher activity than that of the compared samples.
ATG16L1 and ATG12 Gene Polymorphisms Are Involved in the Progression of Atrophic Gastritis
Authors: Yamaguchi Naoyuki , Sakaguchi Takuki , Isomoto Hajime , Inamine Tatsuo , Ueda Haruka , Fukuda Daisuke , Ohnita Ken , Kanda Tsutomu , Kurumi Hiroki , Matsushima Kayoko , Hirayama Tatsuro , Yashima Kazuo , Tsukamoto Kazuhiro
Published: August 2023

Helicobacter pylori (H. pylori) infection causes a progression to atrophic gastritis and results in gastric cancer. Cytotoxin-associated gene A (CagA), a major virulence factor of H. pylori, is injected into gastric epithelial cells using the type IV secretion system. On the other hand, gastric epithelial cells degrade CagA using an autophagy system, which is strictly regulated by the autophagy-related (ATG) genes. This study aimed to identify SNPs in ATG5, ATG10, ATG12, and ATG16L1 associated with gastric mucosal atrophy (GMA). Here, two-hundred H. pylori-positive participants without gastric cancer were included. The degree of GMA was evaluated via the pepsinogen method. Twenty-five SNPs located in the four candidate genes were selected as tag SNPs. The frequency of each SNP between the GMA and the non-GMA group was evaluated. The rs6431655, rs6431659, and rs4663136 in ATG16L1 and rs26537 in ATG12 were independently associated with GMA. Of these four SNPs, the G/G genotype of rs6431659 in ATG16L1 has the highest odd ratio (Odds ratio = 3.835, 95% confidence intervals = 1.337–1.005, p = 0.008). Further functional analyses and prospective analyses with a larger sample size are required.
Unicompartmental Knee Arthroplasty Provides Superior Clinical and Radiological Outcomes Compared to High Tibial Osteotomy at a Follow-Up of 5–8 Years
Authors: Neubauer Markus , Reinberger Eva-Maria , Dammerer Dietmar , Moser Lukas B. , Neugebauer Johannes , Gottsauner-Wolf Florian , Nehrer Stefan
Published: August 2023

Background: Knee Osteoarthritis (OA) is a debilitating disease. Initially, the medial compartments are affected in most cases. For this pathology, joint preservation is preferable. Two surgical procedures aim to meet this goal: high-tibial osteotomy (HTO) and unicompartmental knee arthroplasty (UKA). The aim was to compare clinical and radiological outcomes of HTO versus UKA in patients with unicompartmental, medial OA. Method: Retrospective case series. A total of 86 (61 UKA, 25 HTO) patients that received either treatment at a single, specialized center were assessed pre-operatively and at a single follow-up examination at 77.13 months (±8.170). The Knee Society Score (KSS), range of motion (ROM), SF36 questionnaire and the Tegner score were used. The Kellgren–Lawrence score was assessed pre- and post-surgically. Survivorship with the endpoint “revision” was assessed. Results: The UKA group showed significantly better improvements in KSS scores for pain (p < 0.006) and function (p < 0.001). OA progression (p < 0.02) and survivorship (p < 0.018) differed, significantly favoring UKA. ROM, SF36 and Tegner score did not differ significantly. Conclusions: The presented mid-to long-term data suggest that UKA provides superior results in selected outcomes. Nevertheless, significant differences in the demographics of treatments indicate the challenge of comparing these two treatments.
What Remains up to 7 Months after Severe and Moderate Pneumonia in Non-Vaccinated Patients with Long COVID? Results of a CT Study
Authors: Kurys-Denis Ewa , Grzywa-Celińska Anna , Podgórska Katarzyna , Kawa Miłosz Piotr
Published: August 2023

Background: There is a growing evidence of long-lasting lung changes after COVID-19. Our aim was to assess the degree of lung injury and evaluate the recovery process of 4–7-month-non-vaccinated convalescent patients discharged from hospital after moderate and severe COVID-19 pneumonia, who presented with symptoms of long-COVID. Methods: On control lung CT after mean 5-month recovery period, we classified and determined the prevalence of residual radiological abnormalities in 39 symptomatic patients. To assess the advancement of the persisting changes we used the total severity score (TSS) and the chest CT score and then correlated the results with clinical data. Results and conclusions: On follow-up CT images, 94.9% of patients showed persistent radiological abnormalities. The most frequent changes were ground-glass opacities (74.4%), reticular pattern (64.1%), fibrotic changes (53.8%), nodules (33.3%), bronchiectasis (15.4%), vascular enlargement (10.3%), and cavitation (5.1%). The median TSS score was 4.1 points (interquartile range 3), whereas the median of the chest CT score 5.4 points (interquartile range of 4.5). No significant differences were observed between sex subgroups and between the severe and moderate course groups. There were no association between both CT scores and the severity of the initial disease, indicating that, mean 5 months after the disease, pulmonary abnormalities reduced to a similar stage in both subgroups of severity.
Endometriosis and Adverse Pregnancy Outcomes: A Nationwide Population-Based Study
Authors: Lim Hee Jeung , Sun Jiyu , Min Banhyang , Song Myungeun , Kim Tae Hun , Kim Byoung Jae , Hwang Kyu Ri , Lee Taek Sang , Jeon Hye Won , Kim Sun Min
Published: August 2023

Endometriosis is a major cause of infertility, and considering its pathophysiology, it is expected to affect pregnancy outcomes as well. This study aimed to evaluate whether endometriosis is associated with adverse pregnancy outcomes after successful conception. Data from singleton pregnancy deliveries between January 2014 and October 2019 were obtained from the Korean Health Insurance Review and Assessment Service database. We compared the clinical characteristics and adverse pregnancy outcomes of women with and without endometriosis. A total of 1,251,597 pregnant women were enrolled; of these, 32,951 (2.6%) were assigned to the endometriosis group. Women with endometriosis had significantly more adverse pregnancy outcomes than those without endometriosis. Adverse pregnancy outcomes associated with endometriosis included preterm labor, preterm birth, preeclampsia, fetal growth restriction, placenta previa, placental abruption, antepartum and postpartum hemorrhage, and stillbirth. This study also showed an increased risk of postpartum hemorrhage, blood transfusion, uterine artery embolization, and cesarean hysterectomy in the endometriosis group compared to the non- endometriosis group. The cesarean delivery rate was significantly higher in the endometriosis group than in the non-endometriosis group, even after excluding cases of antenatal obstetric complications that could increase the risk of cesarean delivery. Women with endometriosis not only have difficulty conceiving, but also have a significantly higher risk of adverse pregnancy outcomes.
The Influence of Physical Activity during Pregnancy on Miscarriage—Systematic Review and Meta-Analysis
Authors: Barakat Rubén , Zhang Dingfeng , Silva-José Cristina , Sánchez-Polán Miguel , Franco Evelia , Mottola Michelle F.
Published: August 2023

Miscarriage is an inability to complete the normal process of pregnancy and childbirth and represents a major concern for pregnant women that can be an emotionally devastating event. While it has been suggested that engaging in strenuous physical activity might be associated with an elevated risk of miscarriage, there is a recent systematic review that suggested that prenatal exercise is not associated with fetal mortality. The aim of this systematic review and meta-analysis (SR + MA) was to assess the effects of physical activity during pregnancy on the likelihood of experiencing a miscarriage (Registration No.: CRD42022370629). Thirteen randomized clinical trials (3728 pregnant women) were included. Meta-analyses were conducted with the dependent variable being the miscarriage ratio in each study. The total risk ratio (RR) sum was calculated using a random effects model. The I2 statistic was utilized to quantify the heterogeneity observed in the results. No significant association between exercise during pregnancy and the occurrence of miscarriage was found (RR = 0.83 95% CI = 0.83 (0.49–1.41); z = 0.69, p = 0.49; I2 = 0.00%, Heterogeneity p = 0.91). Results of the present SR + MA showed no increase in miscarriage risk in those who engaged in low- to moderate-intensity exercise compared to those who did not.
Krukenberg Progression of Gastric Carcinoma in Pregnancy: Is Early Diagnosis Possible? Case Report and Review of the Literature
Authors: Eckel Fanny , Carlin Greta , Mayer Stefanie , Polterauer Stephan , Chalubinski Kinga
Published: August 2023

Krukenberg tumors are metastatic tumors of the ovaries, associated with poor outcomes. Most commonly, these tumors are of gastric origin. The diagnosis of Krukenberg tumors in pregnant patients is extremely rare and poses specific difficulties for clinicians. We report a case of a pregnant woman presenting with an unknown abdominal tumor. Through the use of magnetic resonance imaging, multiple differential diagnoses were proposed, including a malignant ovarian tumor. A cesarean section and explorative laparotomy were conducted, revealing Krukenberg metastases of a gastric tumor, discovered during intraoperative gastroscopy. Tumor resection with concomitant chemotherapy was conducted. The main aim of this paper was to evaluate whether earlier diagnosis seems possible in such cases. A thorough literature review was conducted, unfortunately revealing no reliable method for early detection. Furthermore, no consensus regarding diagnostics or therapy exists to date. Thus, more research should be conducted regarding this rare condition to offer recommendations regarding early detection, diagnostics, and therapeutic approaches.
Simplifying Forehead and Temple Reconstruction: A Narrative Review
Authors: Redondo Pedro
Published: August 2023

The forehead and temporal region are frequent areas of skin cancer development. After tumor removal, reconstruction must be performed, maintaining the frontal–temporal line of the scalp and symmetry of the eyebrows in an attempt to hide the scars within these marks or natural folds and wrinkles. Second wound healing and skin grafts generally do not produce an acceptable cosmetic result. When direct closure is not possible, the technique of choice is skin flaps. In the midfrontal line continuation of the glabella, there is a remnant of skin to be used as a donor area for local flaps; similarly, it occurs in the preauricular cheek, which can move toward the temple. In addition to the classic advancement and rotation flaps, the frontalis myocutaneous transposition flap is an excellent technique for closing defects which are wider than higher on the forehead. Its design is very versatile and can be performed between the two pupil lines at different heights depending on the location of the defect. On the other hand, the preauricular skin advancement flap with an infralobular Burow’s triangle is also an excellent option for reconstructing tumors in the temporal area.
Are Babies Born Preterm High-Risk Asthma Candidates?
Authors: Caffarelli Carlo , Gracci Serena , Giannì Giuliana , Bernardini Roberto
Published: August 2023

Among preterm infants, the risk of developing asthma is a matter of debate. This review discusses the state of the art of poorly understood prematurity-associated asthma. Impaired pulmonary function is common in children born prematurely. Preterm infants are prone to developing viral respiratory tract infections, bronchiolitis in the first year of life, and recurrent viral wheezing in preschool age. All of these conditions may precede asthma development. We also discuss the role of both atopic sensitization and intestinal microbiome and, consequently, immune maturation. Diet and pollution have been considered to better understand how prematurity could be associated with asthma. Understanding the effect of factors involved in asthma onset may pave the way to improve the prediction of this asthma phenotype.
Impact of Sarcopenia on Spinal Spondylosis: A Literature Review
Authors: Kitsuda Yuki , Wada Takashi , Tanishima Shinji , Osaki Mari , Nagashima Hideki , Hagino Hiroshi
Published: August 2023

Sarcopenia and spinal spondylosis (SS) are important health challenges among older individuals; however, data regarding the effect of sarcopenia on SS are lacking. Hence, we aimed to organize the existing knowledge on the impact of sarcopenia on SS and explore potential issues in the available literature. We examined the trends and interventions regarding sarcopenia and SS, searching five databases (PubMed, Embase, CINHAL, Web of Science, and Cochrane Library) from inception to January 2023. Sarcopenia-related events were screened, selected, and reviewed, ultimately identifying 19 relevant studies. The identified reports were predominantly retrospective observational studies addressing lumbar degenerative spine disease (LDSD). Sarcopenia could negatively impact the quality of life and postoperative outcomes in several diseases, including cervical spondylotic myelopathy (CSM) and LDSD. However, there was no consensus among the studies regarding the relationship between sarcopenia and pain. These discrepancies were attributed to gaps in the assessment of sarcopenia, which the current study identifies as important challenges. This review identified several problems in the literature, including the limited number of studies examining CSM, adult spinal deformity (ASD) and scoliosis, and the retrospective study design of most reports. The further accumulation of quality research is needed to clarify the relationship between SS and sarcopenia.
Apparently Resistant Hypertension in Polish Hemodialyzed Population: Prevalence and Risk Factors
Authors: Symonides Bartosz , Lewandowski Jacek , Marcinkowski Wojciech , Zawierucha Jacek , Prystacki Tomasz , Małyszko Jolanta
Published: August 2023

Background: The aim of this study was to assess the prevalence, characteristics, and determinants of apparent treatment-resistant hypertension (aTRH) in an unselected large population of patients with end-stage kidney disease (ESKD) treated with hemodialysis (HD) throughout the country. Methods: A database of 5879 patients (mean age 65.2 ± 14.2 years, 60% of males receiving hemodialysis) was obtained from the biggest provider of hemodialysis in the country. Hypertension and aTRH were defined using pre- or/and post-dialysis BP values. Patients with and without aTRH (non-aTRH) were compared. Results: Using pre- and post-dialysis criteria, hypertension was diagnosed in 90.7% and 89.1% of subjects, respectively. According to pre- and post-dialysis blood pressure criteria, aTRH incidences were 40.9% and 38.4%, respectively. The hypertensive patients with aTRH versus non-aTRH were younger, had a higher rate of cardiovascular disease, lower dialysis vintage, shorter time on dialysis, higher eKt/V, higher ultrafiltration, higher pre- and post-dialysis BP and HR, and higher use of antihypertensive drugs. Factors that increase the risk of aTRH according to both pre- and post-dialysis BP criteria were age—OR 0.99 [0.98–0.99] and 0.99 [0.98–0.99], the history of CVD 1.26 [1.08–1.46] and 1.30 [1.12–1.51], and diabetes 1.26 [1.08–1.47] and 1.28 [1.09–1.49], adjusted OR with 95% CI. Conclusions: In the real-life world, as much as 40% of HD patients may have aTRH. In ESKD HD patients, aTRH seems to be multifactorial, influenced by patient-related rather than dialysis-related factors. Various definitions of aTRH preclude easy comparisons between studies.
A Comparative Study of a Small Series of Patients (50 Patients) with Pelvic Varicose Veins Treated with Plugs Alone or Plugs and Polidocanol
Authors: De Gregorio Miguel Ángel , Yamamoto-Ramos Masao , Fredes Arturo , Serrano-Casorran Carolina , Sierre Sergio , Ciampi-Dopazo Juan José , Méndez Santiago , Abadal Jose Maria , Urtiaga Ignacio , Bonastre Cristina , Rodríguez Jose , Urbano Jose , Guirola José Andrés
Published: August 2023

Level of Evidence: Level 2. Purpose: To compare the safety and efficacy of vascular plug (VP) and vascular plug and polidocanol foam (VPPF) treatments for embolization in pelvic congestion syndrome (PCS). Materials and methods: A comparative, prospective, two-center study enrolled 50 women with PCS from January 2019 to January 2020. The patients were divided into two groups, and embolization was performed with VP (n = 25) and VPPF (n = 25) treatments. The mean age of the patients was 45.6 years ± 6.9. Three clinical parameters were assessed: abdominal pain, dyspareunia, and lower limb pain. The primary outcome (clinical success at 1 yr using a VAS), number of devices, procedure and fluoroscopy times, radiation doses, costs, and complications were compared. The participants were followed-up at 1, 3, 6, and 12 months. Results: At the 1-year follow-up, clinical success did not significantly differ between the two groups (VP vs. VPPF) regarding the improvement of the symptoms analyzed (pelvic pain, dyspareunia, lower extremity pain, and other symptoms (p < 0.05)). The mean number of devices per case was 4 ± 1.1 for the VP group and 2 ± 0.31 for the VPPF group (p < 0.001). No major complications were recorded in either group. The VPPF group had a significantly longer fluoroscopy time (42.8 min ± 14.2 vs. 25.4 min ± 7) and longer radiation dose (VPPF air kerma 839.4 ± 513 vs. VP air kerma 658.4 mGy ± 355 (all p < 0.001)). Conclusions: Embolization for PCS resulted in pain relief in 90% of patients; the use of polidocanol did not demonstrate changes in the clinical outcome. The use of a VP alone was associated with decreased fluoroscopy time and radiation dose.
Comparing Meta-Analyses with ChatGPT in the Evaluation of the Effectiveness and Tolerance of Systemic Therapies in Moderate-to-Severe Plaque Psoriasis
Authors: Lam Hoai Xuân-Lan , Simonart Thierry
Published: August 2023

Background: Meta-analyses (MAs) and network meta-analyses (NMAs) are high-quality studies for assessing drug efficacy, but they are time-consuming and may be affected by biases. The capacity of artificial intelligence to aggregate huge amounts of information is emerging as particularly interesting for processing the volume of information needed to generate MAs. In this study, we analyzed whether the chatbot ChatGPT is able to summarize information in a useful fashion for providers and patients in a way that matches up with the results of MAs/NMAs. Methods: We included 16 studies (13 NMAs and 3 MAs) that evaluate biologics (n = 6) and both biologic and systemic treatment (n = 10) for moderate-to-severe psoriasis, published between January 2021 and May 2023. Results: The conclusions of the MAs/NMAs were compared to ChatGPT’s answers to queries about the molecules evaluated in the selected MAs/NMAs. The reproducibility between the results of ChatGPT and the MAs/NMAs was random regarding drug safety. Regarding efficacy, ChatGPT reached the same conclusion as 5 out of the 16 studies (four out of four studies when three molecules were compared), gave acceptable answers in 7 out of 16 studies, and was inconclusive in 4 out of 16 studies. Conclusions: ChatGPT can generate conclusions that are similar to MAs when the efficacy of fewer drugs is compared but is still unable to summarize information in a way that matches up to the results of MAs/NMAs when more than three molecules are compared.
Adverse Outcome Following Mild Traumatic Brain Injury Is Associated with Microstructure Alterations at the Gray and White Matter Boundary
Authors: Pankatz Lara , Rojczyk Philine , Seitz-Holland Johanna , Bouix Sylvain , Jung Leonard B. , Wiegand Tim L. T. , Bonke Elena M. , Sollmann Nico , Kaufmann Elisabeth , Carrington Holly , Puri Twishi , Rathi Yogesh , Coleman Michael J. , Pasternak Ofer , George Mark S. , McAllister Thomas W. , Zafonte Ross , Stein Murray B. , Marx Christine E. , Shenton Martha E. , Koerte Inga K.
Published: August 2023

The gray matter/white matter (GM/WM) boundary of the brain is vulnerable to shear strain associated with mild traumatic brain injury (mTBI). It is, however, unknown whether GM/WM microstructure is associated with long-term outcomes following mTBI. The diffusion and structural MRI data of 278 participants between 18 and 65 years of age with and without military background from the Department of Defense INTRuST study were analyzed. Fractional anisotropy (FA) was extracted at the GM/WM boundary across the brain and for each lobe. Additionally, two conventional analytic approaches were used: whole-brain deep WM FA (TBSS) and whole-brain cortical thickness (FreeSurfer). ANCOVAs were applied to assess differences between the mTBI cohort (n = 147) and the comparison cohort (n = 131). Associations between imaging features and post-concussive symptom severity, and functional and cognitive impairment were investigated using partial correlations while controlling for mental health comorbidities that are particularly common among military cohorts and were present in both the mTBI and comparison group. Findings revealed significantly lower whole-brain and lobe-specific GM/WM boundary FA (p < 0.011), and deep WM FA (p = 0.001) in the mTBI cohort. Whole-brain and lobe-specific GM/WM boundary FA was significantly negatively correlated with post-concussive symptoms (p < 0.039), functional (p < 0.016), and cognitive impairment (p < 0.049). Deep WM FA was associated with functional impairment (p = 0.002). Finally, no significant difference was observed in cortical thickness, nor between cortical thickness and outcome (p > 0.05). Findings from this study suggest that microstructural alterations at the GM/WM boundary may be sensitive markers of adverse long-term outcomes following mTBI.
Robotic Surgery for Bladder Endometriosis: A Systematic Review and Approach
Authors: Oliveira Marco Aurelio Pinho , Raymundo Thiers Soares , Pereira Thiago Dantas , Souza Ricardo José de , Lima Felipe Vaz , De Wilde Rudy Leon , Brollo Leila Cristina
Published: August 2023

Introduction: Women with bladder endometriosis often present with more advanced stages of endometriosis. Robotic surgery has emerged as a promising approach to the management of bladder endometriosis. This systematic review aims to analyze the current literature on robotic surgery for bladder endometriosis and describe our systematic approach to surgical treatment. Methods: This review followed the PRISMA guidelines, which ensured a comprehensive and transparent approach to selecting and evaluating relevant studies. We conducted a thorough literature search to identify studies that investigated the use of robotic surgery for bladder endometriosis. Relevant databases were searched, and inclusion and exclusion criteria were applied to select eligible studies. Data extraction and analysis were performed to assess the outcomes and effectiveness of robotic surgery for the treatment of bladder endometriosis. Results: We did not find any randomized clinical trials with the use of robotics in the treatment of bladder endometriosis. We found only two retrospective studies comparing robotic surgery with laparoscopy, and another retrospective study comparing robotic surgery, laparoscopy, and laparotomy in the treatment of bladder endometriosis. All the other 12 studies were solely case reports. Despite the lack of robust evidence in the literature, the studies demonstrated that robotic surgery is feasible and is associated with reduced postoperative pain, shorter hospital stays, and faster recovery. Conclusions: The utilization of robotic technology is a promising option for the surgical management of bladder endometriosis. We advocate a surgical systematic approach for the robotic treatment of bladder endometriosis. Robotic technology, with its 3D vision, instrumental degrees of freedom, and precision, particularly in suturing, may provide potential benefits over traditional laparoscopy.
A Qualitative Study Exploring the Experiences and Perceptions of Patients with Hemophilia Regarding Their Health-Related Well-Being, in Salamanca
Authors: Ramos-Petersen Laura , Rodríguez-Sánchez Juan Antonio , Cortés-Martín Jonathan , Reinoso-Cobo Andrés , Sánchez-García Juan Carlos , Rodríguez-Blanque Raquel , Coca Juan R.
Published: August 2023

Hemophilia is a chronic, congenital/hereditary and X-linked disease, characterized by an insufficiency of factors VIII or IX, which are necessary for blood clotting. Those affected by hemophilia often suffer from particular psychosocial problems, both in the acceptance, coping, treatment and self-management of their disease and in their family and social relationships, which are often mediated by these circumstances. The aim of this study was to explore the experiences of people with hemophilia or their family members, of in a specific region of Spain, regarding the impact of having hemophilia. Structured interviews were conducted and developed, using the studies of the World Federation of Hemophilia and Osorio-Guzmán et al. as a guide, as well as a literature review of qualitative work on hemophilia. Data were analyzed using a six-step thematic analysis. A total of 34 interviews were thematically analyzed. The results showed that three key themes emerged from the data: (1) the daily impact of having hemophilia, (2) uncertainty about the disease, (3) the role of associations and (4) support from institutions. The results make it clear that the disease has a major impact on their lives (work, family, leisure and personal environment). The main conclusion is that hemophilia has a negative impact on the daily lives of patients, families and caregivers.
The Accuracy of Zygomatic Implant Placement Assisted by Dynamic Computer-Aided Surgery: A Systematic Review and Meta-Analysis
Authors: Fan Shengchi , Sáenz-Ravello Gustavo , Diaz Leonardo , Wu Yiqun , Davó Rubén , Wang Feng , Magic Marko , Al-Nawas Bilal , Kämmerer Peer W.
Published: August 2023

Purpose: The present systematic review aimed to investigate the accuracy of zygomatic implant (ZI) placement using dynamic computer-aided surgery (d-CAIS), static computer-aided surgery (s-CAIS), and a free-hand approach in patients with severe atrophic edentulous maxilla and/or deficient maxilla. Methods: Electronic and manual literature searches until May 2023 were performed in the PubMed/Medline, Scopus, Cochrane Library, and Web of Science databases. Clinical trials and cadaver studies were selected. The primary outcome was planned/placed deviation. Secondary outcomes were to evaluate the survival of ZI and surgical complications. Random-effects meta-analyses were conducted and meta-regression was utilized to compare fiducial registration amounts for d-CAIS and the different designs of s-CAIS. Results: A total of 14 studies with 511 ZIs were included (Nobel Biocare: 274, Southern Implant: 42, SIN Implant: 16, non-mentioned: 179). The pooled mean ZI deviations from the d-CAIS group were 1.81 mm (95% CI: 1.34–2.29) at the entry point and 2.95 mm (95% CI: 1.66–4.24) at the apex point, and angular deviations were 3.49 degrees (95% CI: 2.04–4.93). The pooled mean ZI deviations from the s-CAIS group were 1.19 mm (95% CI: 0.83–1.54) at the entry point and 1.80 mm (95% CI: 1.10–2.50) at the apex point, and angular deviations were 2.15 degrees (95% CI: 1.43–2.88). The pooled mean ZI deviations from the free-hand group were 2.04 mm (95% CI: 1.69–2.39) at the entry point and 3.23 mm (95% CI: 2.34–4.12) at the apex point, and angular deviations were 4.92 degrees (95% CI: 3.86–5.98). There was strong evidence of differences in the average entry, apex, and angular deviation between the navigation, surgical guide, and free-hand groups (p < 0.01). A significant inverse correlation was observed between the number of fiducial screws and the planned/placed deviation regarding entry, apex, and angular measurements. Conclusion: Using d-CAIS and modified s-CAIS for ZI surgery has shown clinically acceptable outcomes regarding average entry, apex, and angular deviations. The maximal deviation values were predominantly observed in the conventional s-CAIS. Surgeons should be mindful of potential deviations and complications regardless of the decision making in different guide approaches.
What Is the Correlation between Clinical and Radiographic Findings in Patients with Advanced Osteoarthritis of the Knee?
Authors: Innmann Moritz M. , Lunz Andre , Fröhlich Larissa , Bruckner Thomas , Merle Christian , Reiner Tobias , Schiltenwolf Marcus
Published: August 2023

Knee range of motion and patient-reported outcome measures (PROMs) are often used as screening tools to assess the severity of knee osteoarthritis and guide the decision to refer patients to an arthroplasty clinic. However, there is little understanding regarding the correlation between these factors. Thus, the purpose of this study was to determine the correlation between patient-reported clinical function measured with the Oxford Knee Score (OKS), pain assessed using the visual analog scale (VAS), knee range of motion (ROM), and characteristic radiographic features in patients with advanced osteoarthritis of the knee. A prospective analysis of a consecutive series of 138 patients with advanced unilateral osteoarthritis (OA) of the knee was performed. The severity of radiographic OA was classified according to the most commonly used Kellgren and Lawrence classification (K&L). Spearman’s rank correlation analysis and multiple linear regression analysis were performed. The OKS was used as a dependent variable and was adjusted for pain, ROM, and nine standardized radiographic parameters on multiple views of the tibiofemoral and patellofemoral joint. OKS and pain correlated weakly with the K&L grade (r = −0.289; p = 0.001; r = 0.258; p = 0.002). K&L grade and the degree of patellofemoral joint space narrowing were identified as independent factors being associated with a poorer OKS (coefficient −4.528, p = 0.021; coefficient −2.211, p = 0.038). Slightly worse results were identified for OKS and pain in patients with K&L grade 4 osteoarthritis compared to patients with K&L grade 3 osteoarthritis (∆OKS 5.5 points, p < 0.001; ∆VAS 1.7 points, p = 0.003). There was no significant difference for passive range of motion between patients with K&L grade 3 or 4. When counseling patients with advanced knee osteoarthritis who may be eligible for knee arthroplasty, it is essential to give primary consideration to pain levels and self-reported limitations experienced during daily activities. Relying solely on knee ROM and PROMs is not an effective screening method for guiding the decision to refer patients to an arthroplasty clinic.
Impact of Defined Risk Factors on Degree of Urinary Stress Incontinence and Sling Outcome: A Retrospective Cohort Analysis
Authors: Frey Janine N. , Zellweger Mélanie , Krebs Jörg , Christmann Corina
Published: August 2023

Urinary stress incontinence is a distressing condition that has a severe impact on quality of life for most affected women. The insertion of the suburethral tension-free vaginal tape (TVT) is regarded as the gold-standard surgical treatment option. It is unclear whether all women with severe SUI benefit equally from TVT. Thus, the aim of our study was to identify risk factors for severe SUI and determine whether successful the resolution of incontinence after a TVT procedure was different in women with a higher degree of SUI. In total, 168 women were included in this retrospective cohort study. Women with severe SUI showed a significantly lower maximum urethral closure pressure (MUCP) (median 53 cmH2O in moderate vs. 39 cmH2O in severe, p = 0.001) and higher BMI (median 26.1 kg/m2 in moderate vs. 28.5 kg/m2 in severe, p = 0.045). Sonographic bladder neck funneling was detected significantly more often in women with severe SUI (27% in moderate vs. 57% in severe, p = 0.004). Lower MUCP and higher BMI were identified as significant predictors of severe SUI (p < 0.032). There was no difference in parity, age, functional urethral length and negative urethral stress pressure. Overall postoperative continence after the insertion of TVT was 91.9%. We found no significant difference in postoperative continence between women with severe vs. moderate SUI, suggesting that in our cohort the success of TVT was not significantly affected by the severity of SUI. In our cohort, low MUCP and high BMI were shown to be significant predictors of SUI severity. Nevertheless, treatment success of SUI with TVT did not differ substantially in women with more severe SUI.
A Systematic Review of New Imaging Technologies for Robotic Prostatectomy: From Molecular Imaging to Augmented Reality
Authors: Rodler Severin , Kidess Marc Anwar , Westhofen Thilo , Kowalewski Karl-Friedrich , Belenchon Ines Rivero , Taratkin Mark , Puliatti Stefano , Gómez Rivas Juan , Veccia Alessandro , Piazza Pietro , Checcucci Enrico , Stief Christian Georg , Cacciamani Giovanni Enrico
Published: August 2023

New imaging technologies play a pivotal role in the current management of patients with prostate cancer. Robotic assisted radical prostatectomy (RARP) is a standard of care for localized disease and through the already imaging-based console subject of research towards combinations of imaging technologies and RARP as well as their impact on surgical outcomes. Therefore, we aimed to provide a comprehensive analysis of the currently available literature for new imaging technologies for RARP. On 24 January 2023, we performed a systematic review of the current literature on Pubmed, Scopus and Web of Science according to the PRISMA guidelines and Oxford levels of evidence. A total of 46 studies were identified of which 19 studies focus on imaging of the primary tumor, 12 studies on the intraoperative tumor detection of lymph nodes and 15 studies on the training of surgeons. While the feasibility of combined approaches using new imaging technologies including MRI, PSMA-PET CT or intraoperatively applied radioactive and fluorescent dyes has been demonstrated, the prospective confirmation of improvements in surgical outcomes is currently ongoing.
Evaluation of Water Sorption and Solubility of 3D-Printed, CAD/CAM Milled, and PMMA Denture Base Materials Subjected to Artificial Aging
Authors: Dimitrova Mariya , Vlahova Angelina , Hristov Ilian , Kazakova Rada , Chuchulska Bozhana , Kazakov Stoyan , Forte Marta , Granberg Vanja , Barile Giuseppe , Capodiferro Saverio , Corsalini Massimo
Published: August 2023

Background: This in vitro study aimed to investigate and evaluate the values of water sorption and water solubility of four types of denture base polymers—3D-printed NextDent 3D Denture + (NextDent, 3D Systems, Soesterberg, The Netherlands), CAD/CAM milled Ivotion Base (Ivotion Denture System, Ivoclar Vivadent, Schaan, Liechtenstein), PMMA conventional Vertex BasiQ 20 (Vertex Dental, 3D Systems, Soesterberg, The Netherlands), and conventional heat-cured BMS (BMS Dental Srl, Rome, Italy)—which were subjected to artificial aging. Materials and methods: 200 specimens were created (n = 50), dried, and weighed accurately. They were immersed in artificial saliva (T1 = 7 days, T2 = 14 days, T3 = 1 month) and re-weighed after water absorption. After desiccation at 37 °C for 24 h and then at 23 ± 1 °C for 1 h, samples were weighed again. Next, thermocycling (100 h, 5000 cycles, 5–55 °C) was performed, and the water sorption and solubility were re-measured. IBM SPSS Statistics 0.26 was used for data analysis, revealing a direct correlation between water sorption and material type. Thermocycling at 55 °C increased water sorption for BMS and Vertex BasiQ 20. In conclusion, NextDent’s 3D-printed resin had higher water sorption values throughout the study. Water solubility averages decreased over time, reaching the lowest in the 30-day period for CAD/CAM milled dental resin Ivotion Base. The artificial aging had no effect on Ivotion Base and NextDent’s water sorption. Thermocycling did not affect the solubility of the materials tested. The conducted study acknowledges the great possibilities of dental resins for additive and subtractive manufacturing for the purposes of removable prosthetics in daily dental practice.
Synthesis and Characterization of Silicon–Carbon Powder and Its Resistance to Electron Irradiation
Authors: Pavlenko Vyacheslav Ivanovich , Cherkashina Natalia Igorevna , Edamenko Oleg Dmitrievich , Yastrebinsky Roman Nikolaevich , Noskov Anton Valerievich , Prokhorenkov Dmitry Stanislavovich , Gorodov Andrey Ivanovich , Piskareva Anastasia Olegovna
Published: August 2023

The issue of crystallization of silicon oxide at low temperatures is a topical issue for the electronics of the future. Organosilicon oligomers and polymers are “ideal” sources for obtaining ultrapure silicon ceramics and silicon nanoparticles. This paper presents the results of the synthesis of highly dispersed silicon-carbon powder from an organohydrosiloxane oligomer and the method for increasing its crystallinity at low temperatures. The diffraction pattern of the resulting powder corresponds to the amorphous–crystalline state of the components in this material, as evidenced by two intense and broadened amorphous halos in the region of Bragg angles 2θ = 7–11° and 18–25°. The resulting silicon–carbon powder was subjected to electron irradiation (E = 10 MeV; D = 106–107 Gy). This paper presents the data on the changes in powder properties via IR-Fourier spectroscopy, X-ray phase analysis, and scanning electron microscopy. Irradiation with fast electrons with an absorbed dose of 106 Gy leads to a slight crystallization of the amorphous SiO2 phase. An increase in the absorbed dose of fast electrons from D = 106 to D = 107 Gy leads to the opposite effect. An amorphization of silica is observed. This study showed the possibility of the crystallization of a silicon–carbon powder without a significant increase in temperature, acting only with electron irradiation. It is necessary to continue further research on expanding the boundaries of the optimal doses of absorbed radiation from fast electrons in order to achieve the maximum effect of the crystallization of silicon–carbon powder.
Computational Investigation of the Mechanical Behavior of a Bone-Inspired Nanocomposite Material
Authors: Yang Xingzi , Maghsoudi-Ganjeh Mohammad , Zeng Xiaowei
Published: August 2023

Bioinspired nanocomposites aim to mimic the structure of natural materials. These materials exhibit excellent mechanical properties such as high strength, toughness, and stiffness. Using modeling and simulation, we can gain insight into the underlying mechanisms that control the properties of these materials, study the impact of various parameters on their performance, and design new materials with high performance. This study investigates a bone-inspired nanocomposite that consists of two subunits: Subunit-A (Mineralized Collagen Fibril) and Subunit-B (Extrafibrillar Matrix). Subunit-B provides the composite with stiffness before yielding. After yielding, Subunit-A stretches to accommodate the deformation up to the final failure. The adhesive material in the interface plays an important role in this nanocomposite’s failure. The composite’s toughness is enhanced by multiple mechanisms: diffuse damage in Subunit-B, strain relaxation around crack tips through horizontal interface delamination between the subunits, and the crack bridging role of Subunit-A. This study provides insight into the mechanical behavior of bone-inspired nanocomposites under tensile loading conditions, highlighting the importance of the adhesive phase in optimizing the material performance in various applications.