bluuebunny/crossref_metadata_2025_split huggingface dataset:
Stapler Versus Manual Suturing for Pharyngeal Closure in Total Laryngectomy
Authors: Teaima Ahmed Abdelmoneim , Mostafa Badr Eldin , Nabil Khaled Mohamed , Mady Ossama Mustafa 
Published: December 2024

Background: Laryngeal carcinoma is not uncommon worldwide. We conducted this study to comprehensively compare the outcome of stapler versus conventional suturing in total laryngectomy primary or salvage. Patients and Methods: This is a retrospective study conducted in our tertiary institute from 2015 to 2022 involving patients diagnosed with laryngeal carcinoma who underwent total laryngectomy either primary or salvage. We divided patients into 4 groups: primary or salvage laryngectomy, closed with stapler or manual suturing. The reported outcomes included : operative time, length of hospital stay, start of oral feeding, incidence of pharyngocutaneous fistula, positivity of surgical margins, and surgical site infection. Patients with multiple comorbidities and those requiring a flap for pharyngeal closure were excluded . Results: A total of 91 patients were included in our study. Pharyngocutaneous fistula rate was 19% in conventional patient group in comparison to 6.7% in stapler group for primary total laryngectomy while it was 12.5% for salvage with stapler and 25% for salvage with conventional. Hospital stay was 6 ± 1.5 days for stapler and 11.4 ± 2.9 days for conventional suturing in primary laryngectomy. It was 8.8 ± 1.3 days for stapler and 13.1 ± 1.8 for conventional suturing in salvage laryngectomy. There was highly significant difference found as regard mean operative time, start of oral feeding and hospital stay in favor of stapler use. Conclusion: Stapler use in total laryngectomy is is a simple, fast, and effective technique with tension free watertight closure, better hemostasis, less contamination of surgical field than manual suturing
Optimization of CNT-carbon fabric composites for enhanced mechanical and thermal properties, and improved fracture toughness: Finite element simulation and experimental validation
Authors: Raju Benjamin , Kancherla Kishore Babu , Subbappa Dakshayini B , Roy Mahapatra Debiprosad 
Published: December 2024

An optimal dispersion of chemically functionalized Multi-Walled Carbon Nanotubes (CNTs) in Carbon Fiber Reinforced Polymer Composites (CFC) can enhance mechanical and thermal properties. Nano-composite fabrication involves precise processing steps and parameters supported by simulations to explain deformation and fracture mechanisms. Controlled dispersion and processing reveal a significant interplay between stiffening and strengthening in the CNT-matrix. Crack bridging optimizes nano-scale stiffening and strengthening by delaying micro-crack initiation and propagation, emphasizing the importance of CNT dispersion and entanglement disruption. The correlation between nano-scale stress, fracture energy, and optimal CNT spacing at the macro-fiber interface is critical. With dilute CNT dispersion, improvements of 8% in specific modulus and strength in the matrix lead to significant enhancements in the fabric system, mainly through CNT-fiber interfacial mechanisms. This optimization results in a 9%–13% increase in specific stiffness, a 5%–9% increase in specific strength, and improved fracture properties. Thermal stability improves with increased storage modulus, glass transition temperature, and thermal conductivity (18%–25%), while specific heat capacity increases by 30% with 0.3 wt % CNT in the composite. CNT nano-reinforcement enhances fracture toughness, transferring to the fabric-matrix interface with a transfer ratio greater than one. CNT-modified carbon fabric composites demonstrate the highest interlaminar fracture properties, with a Mode-II to Mode-I fracture toughness ratio greater than 9, compared to the base composite. These studies establish a normalization scheme for nano-composite design and evaluation, providing insights for developing damage-tolerant, lightweight, and durable structural designs through multi-objective optimization.
Application of machine learning for predicting adhesive damage used for joining structural steel with GFRP under hygrothermal effect
Authors: Boumaiza Dahou , Sadek Kaddour , Aour Benaoumeur , Poncet Sebastien 
Published: December 2024

Adhesively bonded composite-steel structures are widely used in civil engineering due to their excellent mechanical properties, particularly for strengthening and repairing damaged steel structures. This study investigates the adhesive damage behavior of Araldite 2015 used to join cracked S235JR steel structures. Finite element analysis (FEM) and machine learning (ML) techniques were employed to predict adhesive damage. Two types of composites, graphite and boron, were used, and the adhesive was aged in deionized water over a period of 7.5 months. Damage was evaluated at four intervals: before immersion, and after 1, 3, and 7.5 months, under different applied loads of F = 100 MPa, F = 200 MPa, and F = 300 MPa, at a constant temperature of 25°C. The damage ratio (Dr) was calculated using SolidWorks based on damage zone theory. Three regression models, linear regression, polynomial regression, and support vector regression (SVR) were employed to predict adhesive damage. The results demonstrate that the adhesive maintained its integrity under prolonged immersion and high loads, even after 7.5 months of exposure and at a load of 300 MPa. Among the ML models, SVR provided the most accurate predictions, achieving a determination coefficient of R2 = 0.999 and outperforming other models across all evaluation metrics (MAE, MSE, RMSE).
Integration of Community Health Workers into Palliative Care Teams: A Scoping Review
Authors: Kroeze Visser Angela , Pithan Anne , Kupershmidt Sabina , Kenyon DenYelle B. , Puumala Susan E. 
Published: December 2024

Background: Rural communities, like other places in the United States, face a growing need for palliative care. Community health workers (CHWs) are one potential way to expand the ability to provide palliative care. This scoping review explores what is known about CHWs involved in palliative care teams in the United States. Objective: This scoping review is intended to outline current evidence related to best practices and factors that lead to the integration of CHWs into palliative care teams. Methods: A scoping review was conducted between June 2022 and April 2023 using 3 databases (CIHAHL, ScienceDirect, and PubMed) to identify included studies. Studies included were published between 2000 and 2022; discussed CHWs, lay health navigators, or associated terms, and palliative care in the United States; and addressed CHWs’ integration with health care teams. Results: The 24 studies included in this review encompassed qualitative and quantitative reports of CHW interventions that successfully increased advanced care planning documentation, improved patient symptoms, and increased hospice use. Home visits and telephone visits allowed CHWs to provide education, advocate, make referrals, and serve as social support. Stakeholders generally support the role of CHWs in palliative care teams and understand the way they can support “cultural translation.” Conclusions: CHWs have the potential to be integrated into palliative care teams, but there is variability in the approach toward roles within palliative care teams, training for CHWs, and strategies for integration within clinical teams.
Effects of Visualized Health Education Based on Health Belief Model on Self-Management of Patients Undergoing Maintenance Hemodialysis
Authors: Peng Mingmei , Cai Xiaoyan , Wang Qingqing , Li Zhiying , Cao Rui , Guan Baozhang , Yang Yuli , Xu Shuting , Yang Yi , Yang Shuai , Yan Fengxia 
Published: December 2024

Background: Patients with end-stage renal disease often require maintenance hemodialysis (MHD). Effective self-management is crucial for the prognosis of patients undergoing MHD; however, their self-management practices remain suboptimal. Objective: This study aimed to explore the effects of visualized health education based on health belief model on self-management, self-efficacy, quality of life, and quality of dialysis in patients undergoing MHD. Methods: A total of 93 patients undergoing MHD from a tertiary hospital in Guangzhou were recruited between December 2021 and June 2022 and divided into control (n = 44) and intervention (n = 49) groups according to their dialysis time. The control group received standard health education, while the intervention group received visualized health education based on the Health Belief Model (3 months, 3 times a week, about 1 hour each time). The Hemodialysis Self-Management Instrument, Self-Efficacy Scale, Hemodialysis Knowledge Questionnaire, and 12-Item Short-Form Health Survey were used before and after intervention. Physiological indices related to hemodialysis (serum potassium, phosphorus, intact parathyroid hormone, albumin, and hemoglobin) were collected. Results: After intervention, the intervention group showed significantly higher scores in self-management ability (63.0 [57.0, 68.5]), self-management efficacy (29.0 [26.0, 31.0]), hemodialysis knowledge (21.0 [20.0, 22.0]), and quality of life (68.8 [56.3, 79.2]) than the control group ( P < .05). More individuals in the intervention group achieved normal ranges for hemoglobin, albumin, serum potassium, and serum phosphorus. Conclusion: The visualized health education intervention significantly enhanced self-management level, self-efficacy, and quality of life in patients undergoing maintenance hemodialysis. This approach is recommended for broader application.
Correlation between popliteal vein functional diameter and the severity of chronic venous disease
Authors: Liu Hao , Li Liheng , Wei Wenjiang , Tang Yinghong , Liu Lina , Xiao Chengjiang 
Published: December 2024

Objective This study measured the diameter change of the popliteal vein under a rated pressure gradient and evaluated the relationship between popliteal vein functional diameter and severity of chronic venous disease. Methods Ultrasound examination was performed on 173 lower limbs of 173 patients admitted from June 2023 to January 2024. The diameter of the popliteal vein was measured before and after compression with the thigh inflatable cuff. The correlation between popliteal vein functional diameter and venous clinical severity score ( VCSS ) was statistically analyzed. Results Venous clinical severity score values ranged from 1 to 28 (median 7). The Spearman correlation analysis between venous clinical severity score and functional diameter had an rs value of −0.222, p (double-tailed) < .001. The correlation between VCSS and popliteal vein diameter variation index yielded rs = −0.633, p (double-tailed) < .001. Conclusion This study found that popliteal vein functional diameter negatively correlated with the severity of chronic venous disease. Popliteal vein functional diameter and diameter variation index can be used as disease-specific indicators to quantify the severity of chronic venous disease. (Clinicaltrials.gov Identifier: NCT06175481).
Physician-Patient Communication about Novel Drugs and High-Risk Medical Devices
Authors: Dhruva Sanket S. , Kesselheim Aaron S. , Woloshin Steven , Ji Robin Z. , Lu Zhigang , Darrow Jonathan J. , Redberg Rita F. 
Published: December 2024

Background After a new drug or medical device is approved by the US Food and Drug Administration (FDA), physician-patient communication about benefits and risks is critical, including whether the product was approved through an expedited pathway based on limited evidence. In addition, physician reporting of drug- and device-related adverse events in real-world use is necessary to have a complete safety profile. We studied physician-reported communication and safety-reporting practices related to drugs and devices. Methods We surveyed a random national sample of American Board of Internal Medicine–certified internists, cardiologists, and oncologists between October 2021 and September 2022 about the sources of information used to prescribe a drug or medical device, details of communication with patients, and reporting of adverse events. Results Among 509 respondents (39% response rate), 387 (76%) reported that FDA approval influenced their decision “a lot” to prescribe a new drug or recommend use of a medical device. Half (122; 50%) of the 244 physicians randomized to receive a question about their own communication of trial endpoints reported “usually” telling patients when products were approved based on surrogate measures and 126 (52%) “usually” reported telling patients if a postapproval trial was required to evaluate safety and effectiveness. Two-thirds (165) said they were likely to report drug- or device-related adverse events to FDA. Conclusions Physician self-reporting of communication with patients about drugs and devices suggests that half include characteristics of the pivotal trials such as use of clinically meaningful endpoints or continued requirement for evidence generation. Implications More consistent discussions with patients about the quality of evidence supporting new drugs and devices and increased reporting of adverse events could ensure optimal use of these products in clinical practice. Highlights Among 509 board-certified internists, cardiologists, and oncologists, half reported telling patients when drugs or medical devices were approved based on surrogate measures and when there was an FDA-mandated postapproval trial to further evaluate safety and effectiveness. As drugs and medical devices are increasingly approved by the FDA through expedited pathways based on data with lingering uncertainties, discussion with patients about issues such as the nature of the endpoints assessed and existence of postapproval testing requirements can help inform patient decision making.
A Parsimonious Approach to Remediate Concerns about QALY-Based Discrimination
Authors: Braithwaite Ronald Scott 
Published: December 2024

US regulators and payers avoid using quality-adjusted life-years (QALYs) for reasons including concerns about disability and age discrimination. Various modifications of the QALY health utility function have been proposed to address discrimination concerns but are unintuitive to some and appear to alter the usual typical QALY tradeoffs between life expectancy and quality of life. I assert that it is unnecessary to further modify typical QALY tradeoffs to address discrimination concerns because, while discrimination and inequality are distinct concepts, aversion to them can be represented by the same mathematical formulation. Accordingly, formulating QALYs based on inequality aversion, as is sometimes done in distributional cost-effectiveness analyses, may be used to counter disability and/or age-based discrimination concerns. I illustrate using a hypothetical example of a lifesaving therapy, applied across varying ages and baseline disability levels, and adjusted for varying levels of the Atkinson inequality-aversion parameter epsilon (ε). I conclude that adjusting QALYs for inequality aversion using ε ranging from approximately 1 to 2 may remediate concerns about QALY-based disability and/or age discrimination in some cases. Highlights Important barriers to the use of QALYs in the United States include concerns about disability and age discrimination. Modifications to the utility function underlying QALYs have been proposed to mitigate these concerns, but some find them challenging to consider and/or to apply. Unrelated to these concerns, QALYs have been adapted within the framework of distributional cost-effectiveness analysis to allow consideration of inequality as well as efficiency. I outline how this framework can also remediate concerns about disability and age discrimination.
Systemic lupus erythematosus is a risk factor for having multiple subtypes of cutaneous lupus erythematosus
Authors: Lu Grace , Brown Larry Steven , Chong Benjamin F 
Published: December 2024

Background Patients with cutaneous lupus erythematosus (CLE) can present with one or multiple different subtypes of CLE. There is limited understanding of the prevalence and associated risk factors for having multiple CLE subtype diagnoses. Objective This study characterized the frequency and risk factors for having multiple CLE subtypes. Methods This was a cross-sectional study of 319 patients with CLE enrolled in the University of Texas Southwestern Cutaneous Lupus Registry seen in outpatient dermatology clinics at the University of Texas Southwestern Medical Center and Parkland Health from January 1, 2009 to December 31, 2021. Demographic and clinical information was collected from each subject and compared using univariate and multivariable logistic regression analyses. Results 59 subjects (18.5%) were diagnosed with two or more CLE subtypes. Univariate analyses identified statistically significant differences in rates of systemic lupus erythematosus (SLE) diagnosis, history of positive anti-nuclear antibody, arthritis, renal disorder, and serositis in patients with multiple CLE subtype diagnoses. In the multivariable analysis, SLE diagnosis was found to be statistically significant. Conclusions Our study showed that almost one out of five CLE patients have multiple CLE subtypes, with SLE diagnosis being a significant risk factor. Clinicians can monitor CLE patients for developing multiple subtypes and account for systemic manifestations and laboratory abnormalities associated with SLE.
When Platforms Go Public, Standards Drop
Authors: Lapierre-Berger Guillaume , Cohen Maxime C , Puyana-Bastin Juan 
Published: December 2024

Peer-to-peer (P2P) platforms facilitate the direct exchange of goods, services, or financial transactions between individuals without the involvement of intermediaries. To maintain trust among their user bases, these platforms must implement stringent access controls to determine which users are eligible to participate in their digital marketplace. We argue that when a platform transitions from private to public ownership, it may be incentivized to strategically lower its access standards and admit users who might otherwise have been deemed unqualified. Lowering standards before an initial public offering (IPO) can enable platforms to rapidly increase their user base—and, consequently, enhance their perceived valuation—which could appeal to stock investors and positively influence the IPO price. While this strategy may bolster short-term growth, it could be costly to the platform’s user base. We support this hypothesis using data from two major P2P lending platforms—one that went public and one that remained private. Using a difference-in-differences analysis, we find that the platform preparing for an IPO admitted borrowers who exhibited higher risk levels. Additionally, lenders, in some cases, did not effectively screen out these subpar borrowers and ended up issuing loans to them, leading to higher default rates and lower returns for the lenders. This effect was particularly evident for a specific segment of lenders—namely, those who brokered small-valued loans and loans for necessary purchases (e.g., health emergencies). By contrast, lenders who screened for large-valued loans or loans for discretionary expenditures (e.g., vacations or weddings) were more successful in screening out these subpar borrowers and not issuing loans to them. These results fill a gap in the operations management literature on platform governance by integrating capital-raising objectives into the discussion of access control and operational screening. Our study highlights the nuanced trade-off between quality control and user expansion during capital-raising events, emphasizing both the opportunities and potential inefficiencies that arise in this context.
Advancements in Inventory Management: Insights From INFORMS Franz Edelman Award Finalists
Authors: Gupta Shubham , Guha Samayita , Kumar Subodha 
Published: December 2024

This article provides a comprehensive overview of the advancements and applications of operations research (OR) and management science (MS) in inventory management described by the Franz Edelman Award finalists from 1985 to 2023. The research presents the transformative potential of OR/MS in addressing complex inventory management challenges across various industries. Through an in-depth examination of the methodologies and solutions employed by these studies, we highlight the strategic implementations of several OR/MS techniques, including simulation-optimization, deep learning and advanced forecasting, dynamic pricing and yield management, and stochastic modeling. The analysis reveals the tangible benefits realized, such as optimized inventory levels, reduced costs, improved profits and revenue, and improved customer satisfaction. This research underscores the critical role of inventory process optimization and risk mitigation in navigating uncertainties and demand fluctuations. The managerial insights derived from these initiatives provide a roadmap for practitioners seeking to implement advanced OR/MS methodologies in real-world inventory management. The findings also encourage the adoption of innovative methods to enhance the operational efficiency and competitiveness. Through this exploration, we aim to stimulate further innovation and research in the evolving field of inventory management and to celebrate the achievements in applied analytics brought forth by the Franz Edelman Award finalists.
Comparison of Pediatric- and Adult-Onset Mycosis Fungoides Patients in Terms of Clinical Features and Prognosis in a Large Series
Authors: Pehlivan Ulutas Gizem , Atci Tugba , Baykal Can 
Published: December 2024

Background: Studies comparing the clinical and prognostic differences between pediatric- and adult-onset mycosis fungoides (MF) are limited. Objectives: To determine the impact of childhood-onset MF on clinical features and disease course in a large series. Methods: Consecutive MF patients seen in a single centre between 2007 and 2021 were categorized into 3 groups: (i) MF patients diagnosed in the pediatric ages (≤18 years) (pediatric group), (ii) MF patients with disease onset in the pediatric period and diagnosis in adulthood (lately diagnosed pediatric-onset group), and (iii) MF patients with disease onset in the adulthood period (>18 years) (adult-onset group). Demographics, clinical features, stage at diagnosis, and progression to advanced stages during follow-up were recorded and compared. Results: Among 651 MF patients, 52 (8%) belonged to the pediatric group and 30 (4.6%) to the lately diagnosed pediatric-onset group. Pediatric MF presented with a combination of clinical variants in 48.1% of cases. While classical MF was the most common presentation in the 3 groups, hypopigmented (55.8%) and folliculotropic (17.3%) variants were more prevalent in the pediatric group compared to the others. Progression to the advanced stages was higher in the adult-onset MF group (12.1%) compared to the pediatric and lately diagnosed pediatric-onset MF groups (2.4%) ( P = .014). Conclusions: This study highlights a relatively high prevalence of pediatric MF (8%) and lately diagnosed pediatric-onset MF (4.6%), often presenting with multiple and non-classical clinical variants. The higher rate of progression to advanced stages in the adult-onset group supports the relatively benign nature of MF in the pediatric-onset group.