bluuebunny/crossref_metadata_2025_split huggingface dataset:
Efficacy and Validity of Percutaneous Transhepatic Gallbladder Drainage as a Bridge to Surgery for Octogenarian and Older Patients With Acute Cholecystitis: A Single-Center Retrospective Observational Study in Japan
Authors: Nishiwada Satoshi , Tanaka Tetsuya , Hidaka Teruyuki , Kirihataya Yuki , Takei Takeshi , Sadamitsu Tomomi , Morimoto Takuma , Hata Kengo , Enoki Masaru , Osaki Yui , Matsumoto Kazusuke , Horiuchi Hazuki , Okura Yasushi , Sawai Masayoshi , Yoshimura Atsushi 
Published: November 2024

Background Japan currently has a super-aged society, with a rapid increase in elderly patients in need of medical care. Determining treatment strategies for acute cholecystitis (AC) in very elderly patients with various comorbidities is often difficult. Although percutaneous cholecystostomy (PC) is a less-invasive treatment option, its impact on subsequent surgery remains debatable. This study investigated the validity of PC as a bridge to surgery in very elderly patients with AC. Methods Of 215 patients who underwent cholecystectomy for AC at our hospital, we retrospectively investigated 83 patients aged ≥80 years—53 and 30 who underwent upfront surgery (US) and PC before surgery, respectively—to assess the treatment strategies and clinical course. Results The PC group had a significantly worse systemic status at diagnosis than the US group, including age, severity grading, comorbidities, performance status, systemic inflammatory status, and blood coagulation abnormalities, which improved after PC. The elective surgery rate was significantly higher in the PC group than in the US group. Despite the high number of severe cases in the PC group, surgical quality indicators, including the conversion rate to open surgery, operative time, blood loss, and critical view of safety achievement rate, tended to be better in the PC group, without severe perioperative complications. Discussion PC followed by cholecystectomy improves preoperative conditions, including systemic inflammation status and blood coagulation abnormalities, in very elderly patients, allowing safe elective surgical treatment while securing the quality of surgery and clinical outcomes.
In the Gains from Trade as Firms Matter, So Do Their Sizes
Authors: Dash Sunil 
Published: November 2024

This article examines whether the gains from economic integration agreements (EIAs) vary across firm sizes. The empirical analysis makes use of a unique and unbalanced panel dataset with 1,520 country pairs, firm sizes and EIAs from 2007 to 2017. First, we decompose the aggregate export flows across firm sizes, that is, micro, small, medium and large. Second, we deconstruct the extensive and intensive export margins across firm sizes. The empirical model follows a panel estimator with structural gravity specification and estimates the EIA coefficients by employing three-way (exporter-time, importer-time and country-pair) fixed effects. The results indicate that EIAs positively affect overall export flows for firms of all sizes; however, for large and medium-sized firms, this positive effect is primarily through the intensive margin, whereas, for the small and micro-sized firms, it is exclusively through the extensive margin. JEL Codes: F1, F15
Female patients with acute aortic dissection type A (AADA): A gender-selective evaluation of the intensity of the surgical treatment
Authors: Arar Morsi , Martens Andreas , Rudolph Linda , Krueger Heike , Arar Victoria , Beckmann Erik , Shrestha Malakh , Kaufeld Tim 
Published: November 2024

Objective Acute aortic dissection type A (AADA) is a condition that affects both genders and requires urgent surgical intervention as non-operative treatment is often associated with a poor prognosis. Studies have proven that less aggressive surgical treatments influence the outcome for female patients in the fields of several diseases. The purpose of this study was to report and analyze our results in the selective cohort of female patients with AADA to detect differences in the treatment of this group of patients. Methods Between January 2000 and July 2018, 141 adult female patients with acute aortic dissection (AAD) underwent repair of the aorta in our department. A total of 75 patients received a proximal arch. replacement (group A), and 66 patients received a subtotal (replacement of the brachiocephalic trunk) and/or total arch. replacement with elephant trunk or frozen elephant trunk (group B). Results The median age in group A was 70.7 years (range 60.7–74.7 years) and in group B 66.3 years (range 55.6–71.3 years). Operation times were significantly longer in group B (total operation time: A = 286.9 min (range 225.0–341.0 min), B = 341 min (range 266.0–392 min), p = .003; cardiopulmonary bypass time: A = 189.0 min (range 139.0–138 min), B = 238 min (range 176.8–300.5 min), p < .001; circulatory arrest time: A = 27.0 min (range 21.0–37.0 min), B = 42.0 min (range 32.0–56.3 min), p < .001). There were no significant differences between the groups regarding 30-day mortality (A = 24% ( n = 18), B = 19.7% ( n = 13), p = .538) and rate of reoperation (A = 13.3% ( n = 10), B = 15.2% ( n = 10), p = .757) or the preoperative characteristics. Conclusion Our study showed no significant difference in mortality rate depending on the type of operation. Based on these results, a proximal arch. replacement should be considered as the first line of operation technique if the individual situation allows. For inexperienced clinics and surgeons in particular, we recommend limited aortic repair in patients with AADA. Finally, location of the intimal tear remains the essential factor for the evaluation of the surgical treat.
Accuracy of Combined High Tibial Slope Correction Osteotomy Using 3-Dimensional-Planned Patient-Specific Instrumentation
Authors: Zindel Christoph , Hodel Sandro , Jud Lukas , Zimmermann Stefan M. , Vlachopoulos Lazaros , Fucentese Sandro F. 
Published: November 2024

Background: If an increased posterior tibial slope (PTS) and concomitant unicompartmental osteoarthritis are present, a simultaneous sagittal (slope) and coronal correcting high tibial osteotomy has been recommended. However, no study has investigated the accuracy of such combined high tibial slope correction osteotomies. Purpose: (1) To report the accuracy of navigated high tibial slope correction osteotomies using patient-specific instruments (PSI) and (2) to analyze the influence of an open wedge osteotomy (OWO) versus a closed wedge osteotomy (CWO) and the hinge axis angle (HAA) on the accuracy of the PTS correction. Study Design: Cohort study; Level of evidence, 3. Methods: All PSI PTS-reducing osteotomies performed at 1 institution between 2019 and 2022 were reviewed. Three-dimensional (3D) accuracy was defined as the mean absolute 3D angular difference between the planned and achieved surgical correction (in degrees) in 3D models of computed tomography data. The influence of OWO versus CWO and the HAA on the reported accuracy was analyzed and a cutoff defined using receiver operating characteristic curve analysis. Results: Eighteen patients who underwent a slope-reducing CWO (n = 9) or OWO (n = 9) were included. The 3D accuracy for PTS was 2.3°± 1.1° (mean ± SD), with CWO being more accurate than OWO (1.4°± 0.9° vs 3.1°± 0.6°; P < .01). Accuracy strongly correlated with the HAA ( r = 0.788; P < .01). An HAA >38.9° predicted a PTS error >2° (odds ratio, 1.12 [95% CI, 1.04-1.20; P = .004]; area under the curve, 0.95 [95% CI, 0.89-1.00; P < .001]) corresponding to a coronal/sagittal correction of 0.8:1. Conclusion: Slope-reducing osteotomy can accurately be achieved using PSI. CWO demonstrated an increased accuracy when compared with OWO, which strongly depended on the HAA. With an aim of combined PTS and coronal correction, CWO should be considered the primary choice for accurate slope reduction with a coronal/sagittal correction cutoff of 0.8:1 (HAA, 38.9°).
Colleague Care – Implementing a staff peer support program
Authors: Michael Sarah , Vrklevski Lila Petar , Innes Lesley , Hallahan Andrew , Lyons Blaise , Campbell Sharon , Slade Graeme , Richards Bethan 
Published: November 2024

Objectives In line with the widespread acknowledgement of the harms which can be caused to healthcare staff through their role in adverse events and unexpected patient outcomes, so is there now acceptance of the role of staff peer support programs to support these ‘second victims’ in a non-clinical way. Here, we share reproduceable steps that any service might take in creating their own staff peer support program. Methods We outline the establishment of a program in a NSW health-service encompassing several hospitals and services, from initiation of the program, customising it to our local needs, engaging the broader health service, launching the program, and the ongoing maintenance required. Results Dedicated resourcing and strong executive support have been essential to launch and maintain the program. Reaching all staff in a large organisation and building trust in the program’s confidentiality have been the main challenges. Conclusions Staff peer support programs, whilst early in their evidence, offer a way to provide practical, non-clinical support to staff harmed through adverse events in healthcare. Here, we offer methodology and learnings for all services to consider when implementing a localised program.
Evaluation of Posterior Superior Alveolar Canal in Individuals With Cleft Lip and Palate Using Cone Beam Computed Tomography
Authors: Tannishtha Tannishtha , Babu G. Subhas , Shetty Vikram , Ajila Vidya 
Published: November 2024

Objective To evaluate the posterior superior alveolar canal (PSAC) in individuals with cleft lip and palate (CLP) by comparing them with individuals with no cleft lip and palate (NC) using cone beam computed tomography (CBCT). Setting This is a cross-sectional, analytical study with a prospective sample. Patients, Participants CBCT scans of 29 individuals with no cleft and palate (Group I) and 29 individuals with cleft lip and palate (Group II) were used. Interventions PSAC was evaluated and compared for its position, diameter, and distance between the individuals with CLP and NC using CBCT scans. Results The mean age of individuals in Group I and II were 12.93 and 11.82 years, respectively. The distribution of individuals based on gender comprised of 51.7% males and 48.3% females in both the study groups. PSAC was present in both right and left maxillary sinus in 100% of the study subjects of Group I and Group II. The most prevalent position of PSAC in Group I and Group II was on the lower third and middle third of lateral wall of maxillary sinus, respectively. The mean diameter was higher in Group II (1.2962 mm) when compared to Group I (1.0897 mm) which showed statistically significant value ( P = .008). Conclusion The promising results obtained from the present study demonstrates the importance of knowing the precise anatomical location of the PSAC in individuals with cleft lip and palate by using CBCT which is reliable, less time consuming and cost effective imaging tool.
Use of two general-purpose scales to assess clinical pharmacy activities in a cell transplantation unit
Authors: Quinet Florence , Gilliot Sixtine , Beauvais David , Vasseur Michele , Srour Micha , Magro Léonardo , Coiteux Valérie , Chauvet Paul , Yakoub-Agha Ibrahim , Odou Pascal , Décaudin Bertrand , Simon Nicolas 
Published: November 2024

Introduction The general-purpose rating scales used by clinical pharmacists to rate their activities have not been extensively studied in specialist care units. This study aims to describe drug-related problems (DRPs) and pharmacist interventions (PIs) in a French hematopoietic cell therapy (HCT) unit and to evaluate the PIs’ likely clinical, economic, and organizational impacts. Methods We retrospectively assessed all DRPs reported and all PIs issued between December 2018 and December 2021. The Act-IP scale was used to rate DRPs and PIs, and the ClEO scale was used to rate each PI's clinical, economic and organizational impacts. Fisher's exact test was used to assess the relationships between PIs and DRPs and between the three dimensions of the ClEO scale. Results The DRPs were most frequently related to drug-drug interactions (16.5%), physicochemical incompatibilities (15.5%), and drug monitoring problems (14.9%). 62.8% of the PIs had at least a moderate clinical impact. PIs that recommended drug monitoring were most frequent (26.8%), and most of these (75%) were likely to have prevented incidents that would have required patient monitoring or treatment. Conclusions The results of this study showed that after a slight adaptation, the Act-IP scale can be used to map clinical pharmacy activity in an HCT unit. More than 60% of the DRPs/PIs were likely to have had a positive impact on the patient's clinical outcome. All the PIs were rated with a positive organizational impact and PIs likely to lead to cost savings were balanced by those likely to increase costs.
Same same but different: Introduction of a classification system in calcar-guided short-stem total hip arthroplasty
Authors: Kutzner Karl P 
Published: November 2024

Background: The concept of calcar-guided short-stem THA (ssTHA) has largely emerged over the last decade, especially in Europe, and today modern calcar-guided short stems are among the most successful primary femoral implants in terms of complications and revision rates as indicated by multiple registry data. The philosophy originally comprised an individualised reconstruction of the hip anatomy by following the calcar of the femoral neck providing bone- and soft-tissue-sparing characteristics. However, as the stem design allows either metaphyseal fixation alone or additional diaphyseal anchoring, depending on the stem alignment and indication, distinct knowledge is required regarding the implantation technique, the broad variation of positioning and fixation and its potential clinical consequences. Aim: To report on and highlight the characteristics of different ways of performing calcar-guided ssTHA as well as to introduce a classification in order to systematically account for the variety of strategies and the respective implications on the type of fixation. Surgical technique: Already when templating preoperatively, surgeons need to weigh up the different fixation types taking into account a number of patient-related factors. Intraoperatively, by individually controlling the level of osteotomy, the intended type of anchorage can be implemented. Intraoperative radiography to confirm the result, is mandatory. Results: Despite numerous options of stem alignment, depending on the patient’s anatomy, the bone quality or the indication for operation, a total of 4 categories were identified to characterise different fixation strategies in calcar-guided ssTHA. Conclusions: The classification system should be used for the preoperative determination of the intended type of anchorage. Whenever a short-stem philosophy with metaphyseal fixation (Type I (M)) is possible, it should be pursued.
Methods to reduce fraudulent participation and highlight autistic voices in research
Authors: Carey Meghan E , McLean Kiley J , Chvasta Kyle , de Marchena Ashley , Roux Anne M 
Published: November 2024

Alongside the rise in online qualitative research, fraudulent representation of research participants is increasing, and current strategies to address this issue within studies of non-neurodiverse samples may exclude autistic voices. Seeking to reduce fraudulent or “scammer” participation in our focus group study, and increase data validity and expenditure efficiency, we implemented strategies suggested in the literature and tested additional strategies. This research adds to the growing conversation around best practices for reducing scammers in autism research using online methods by (1) providing data evaluating the utility of existing strategies; (2) testing emerging strategies; and (3) discussing ethical dilemmas involved in addressing scammers in studies. We received over 200 expressions of interest and the established strategies suggested in the literature plus emerging strategies proved critical for mitigating the enrollment of scammers in focus groups. Protecting the integrity of data about human subjects from fraud is essential for rigorous autism research; trustworthy conclusions cannot be otherwise drawn from analysis. However, the strategies inherently require subjective decision-making that could systematically exclude participants with more limited or atypical communication and result in unfair subject selection. Procedures we recommend incur resources and are time consuming but are beneficial to ensure data integrity and inclusivity. Lay abstract Over the last decade, especially since the pandemic, more research has been happening online. Conducting research online can create opportunities to include autistic people across the world and make our studies more diverse. However, conducting research online had led to scammers, or people pretending to be autistic, participating in autism research studies. Strategies to stop scammers may accidentally leave out autistic people who have difficulty with processing time and open-ended questions. We tried out documented strategies to stop scammers from participating in autism research. We also tested new strategies to understand how helpful they are. Using these strategies, we suspected over 100 people who wanted to participate were scammers and did not invite them to participate. As researchers, we must ensure we stop scammers from participating in our studies. It’s important to highlight autistic voices and guarantee we get accurate results. However, the strategies to identify scammers may also leave out autistic people who have communication differences. This is unfair and could also make our results less reliable. The existing and new strategies to stop scammers take a lot of time and resources but they’re worth it to make sure our data are reliable, and include only autistic voices.
Out-of-plane shear behavior of BFRP-reinforced geopolymer concrete one-way slabs: Experimental and numerical investigations
Authors: Huang Jun-Qi , Kumar Sushil , Guo Dong , Dai Jian-Guo 
Published: November 2024

Sustainability and durability in construction are vital considerations that involve using environmentally friendly materials and implementing efficient design and construction techniques to minimize the environmental impact. This research study investigated the structural behavior of one-way solid slabs incorporating basalt fiber-reinforced polymer (BFRP) reinforcement and geopolymer concrete to develop an environmentally sustainable and durable structural member. Six full-scale BFRP-reinforced geopolymer concrete one-way slab specimens were prepared and subjected to four-point loading tests to assess their out-of-plane shear performances. The considered experimental parameters were compressive strength of concrete (i.e., 30, 40 and 50 MPa) and longitudinal tensile reinforcement ratios (i.e., 1.20% and 2.18%). The structural performance of the slabs was carefully investigated in terms of crack patterns, failure modes, load-deflection relationships and load-strain relationships. The obtained shear resistances from tests were compared with predicted results from the Codes of Practice and design guidelines. A two-dimensional (2D) finite element (FE) analysis was conducted, considering the bond-slip relationship between BFRP rebar and geopolymer concrete. It was found that all tested specimens were governed by shear failure and had similar shear resistance for the chosen values of considered parameters. The JSCE shear design method provided the closest prediction of shear resistance of BFRP-reinforced geopolymer concrete one-way slab. The developed FE models predicted the out-of-plane shear performance with reasonable accuracy and revealed that the slip distribution of the BFRP rebar presents a sawtooth shape owing to concrete cracking.
A genetic programming Rician noise reduction and explainable deep learning model for Alzheimer's diseases severity prediction
Authors: Khan Sajid Ullah , Albanyan Abdullah , Bilal Mohsin , Ullah Shahid 
Published: November 2024

Background: Degradation of magnetic resonance imaging (MRI) remains a challenging issue, with noise being a key damaging component introduced due to a variety of environmental and mechanical factors. Objective: The aim of this research work is to addresses the issue of noise reduction and to predict Alzheimer's disease detection efficiently. Methods: First, we present a genetic programming (GP) technique for reducing Rician noise in MRI images to pre-process the dataset. To effectively reduce Rician noise, this GP approach combines a Feature Extraction component, GP Optimal Expression, and an Optimum Removal Estimation component. In the second phase, we design and develop an explainable Deep Learning framework. This framework uses a local data-driven interpretation technique based on SHAP values to investigate the relationship between the neural network's estimated AD diagnosis and the input MRI images. In addition, we handle class distribution by combining an oversampling strategy with a minority approach. Several assessment metrics are used to analyze the performance of our proposed model. Results: The proposed method is tested on a variety of medical samples, and the results are compared to those obtained using other comparable approaches. We also test and compare our model to three cutting-edge models: DenseNet169, VGGNet15, and Inceptionv3. Conclusions: The empirical results show that our proposed model outperforms others, particularly in handling basic structures with limited spectral features, lower computational complexity, and less overfitting. This research worked addressed Rician noise issue in MRI images and predict AD severity prediction using explainable deep learning framework.
Association between selective serotonin reuptake inhibitors and mortality following COVID-19 among patients with Alzheimer's disease
Authors: Gao Zhenxiang , Dorney Ian , Davis Pamela B , Kaelber David C , Xu Rong 
Published: November 2024

Background: Recent research suggests that selective serotonin reuptake inhibitors (SSRIs) may reduce mortality in COVID-19 patients; however, research into their benefits for elderly Alzheimer's disease (AD) patients remains limited. Objective: To investigate the relationship between SSRIs therapy and the mortality risk after COVID-19 infection in elderly patients with and without AD. Methods: This retrospective cohort study leveraged a large database containing over 100 million electronic health records in the US from the TriNetX platform to compare the hazard rates of mortality after COVID-19 infection in elderly AD patients prescribed SSRIs versus propensity-score matched individuals prescribed other antidepressants. This study was also conducted in separate cohorts of patients without AD to compare the findings. Results: When compared with non-SSRI antidepressants, SSRIs were associated with lower risk for mortality after COVID-19 infection in elderly patients without AD over early, middle, and later stages of the pandemic with HRs of 0.84 (95% CI: 0.75–0.93), 0.86 (95% CI: 0.79–0.93), and 0.77 (95% CI: 0.71–0.33), respectively. When comparing SSRIs with non-SSRI antidepressants for mortality risk following COVID-19 among patients with AD, HRs of 0.95 (95% CI: 0.71–1.27), 0.80 (95% CI: 0.61–1.06), and 0.99 (95% CI: 0.75–1.32), were found respectively. Conclusions: Our findings suggest that the use of SSRIs is significantly associated with reduced mortality risk following COVID-19 in elderly patients without AD compared to other antidepressants. While a lower mortality risk was also observed among AD patients, the association was not statistically significant.