bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Impact of COVID-19 and Socioeconomic Determinants on Appointment Non-Attendance in an Urban Otolaryngology Clinic: A Retrospective Analysis From a Safety Net Hospital
Authors: Puyo Elizabeth M. , Salvati Lindsay R. , Garg Neha , Bayly Henry , Kariveda Rohith R. , Carnino Jonathan M. , Nathan Ajay S. , Levi Jessica R. 
Published: November 2024

Objective: The objective of this study is to investigate various demographic, socioeconomic, COVID-related, and clinical factors associated with missed otolaryngology appointments in the outpatient setting at Boston Medical Center (BMC), an urban safety net hospital. Methods: A retrospective chart review was conducted on adults (≥18 years old) with scheduled appointments in the otolaryngology department at BMC from May 1, 2015, to May 1, 2022. Data were extracted from the electronic medical record and included appointment-related factors (eg, status and type), demographic variables (eg, age, sex, race, and ethnicity), and socioeconomic factors (eg, employment and insurance). Statistical analyses utilized a binary mixed-effects model to identify predictors of appointment non-attendance, with pre-COVID, during COVID, and post-COVID periods defined for comparative analysis. Results: Out of 14 050 patients, 5725 (40.8%) were classified as no-show. Older age decreased the likelihood of missing appointments (OR = 0.989, 95% CI = [0.986, 0.992]). Males (OR = 1.090, 95% CI = [1.022, 1.161]), Black/African American (OR = 2.047, 95% CI = [1.878, 2.231]), and Hispanic or Latino individuals (OR = 1.369, 95% CI = [1.232, 1.521]) were more likely to not show up. Retired participants (OR = 0.859, 95% CI = [0.753, 0.981]) and those with private insurance (OR = 0.698, 95% CI = [0.643, 0.758]) were less likely to miss appointments. During the COVID-19 pandemic, appointment attendance improved (OR = 0.865, 95% CI = [0.767, 0.976]). In-person appointments had a significantly higher non-attendance rate compared to telemedicine appointments (OR = 6.133, 95% CI = [5.248, 7.167]). Conclusions: Appointment non-attendance in otolaryngology is influenced by various demographic and socioeconomic factors, with significant disparities observed among racial and ethnic groups. The COVID-19 pandemic altered attendance patterns, highlighting the potential benefits of telemedicine. These findings underscore the need for targeted interventions to address healthcare disparities and improve appointment adherence, particularly among minority and socioeconomically disadvantaged populations. Future research should incorporate patient perspectives to better understand barriers to appointment attendance.
Outcomes of hand-made versus commercial stent grafts in frozen elephant trunk
Authors: Kanemitsu Shinji , Ishikawa Renta , Sakamoto Shunsuke , Mizumoto Toru 
Published: November 2024

Objectives The frozen elephant trunk (FET) technique is effective for treating extended aortic arch aneurysms. This study compares hand-made and factory-made devices in this context. Methods A retrospective case-control study was conducted on 68 patients who underwent FET for distal aortic arch aneurysm at our institution. We used two different types of devices: hand-made stent graft in group Z (17 cases, 25.0%) and a commercialized stent graft in group J (51 cases, 75.0%). The study compared demographic characteristics and the outcomes between the two groups. Results In-hospital mortality was equivalent in both groups (5.9%). Spinal cord injury rates were 5.9% in group Z and 3.9% in group J. Group Z had a higher rate of aortic events (55.9% vs 96.9%, p < 0.001) and more frequent stent migration. The number of cases with aneurysm diameter shrinkage was lower in group Z. The landing zone angle at insertion influenced aneurysm changes, being 17.6 degrees in shrink cases and 26.7 degrees in unchanged or enlarged cases ( p = 0.045). Conclusions FROZENIX device notably reduced incidences of postoperative complications compared to hand-made prostheses. Factors such as insertion angle and stent size, rather than changes in the landing zone angle, appeared to influence aneurysm shrinkage. The use of FROZENIX in TARFET procedures has shown benefits in reducing complications and improving long-term prognosis, taking into account the landing zone angle.
Total arterial revascularization with RIMA-LIMA-Y configuration in patients with left subclavian artery stenosis
Authors: Kumar Anit , Sundar Bharath , Khapli Swanand , Salim Ahmed Sayyed Azhar , Barman Dhiraj , Kapoor Lalit , Chakraborty Unmesh 
Published: November 2024

Background: Subclavian artery stenosis (SAS) occurs in 6% of patients undergoing coronary artery bypass grafting (CABG). Complications such as subclavian-coronary steal are common. Revascularization options in such cases remain debatable. Methods In this case series, all patients with angina, had severe triple vessel disease on angiography. All tests including computed tomography (CT) angiography of neck vessels, were done as part of routine workup for CABG. Results: The patients, all males, had a mean age of 66.5 years with three of them having hypertension and diabetes. All were ex-smokers with mean ejection fraction (EF) of 60.1%. CT angiography of neck vessels revealed that two patients had moderate to severe while one had severe left SAS and another had severe proximal left internal mammary artery (LIMA) stenosis. Total arterial revascularization was performed, with an average of 3.5 distal grafts. The LIMA graft was employed in a Y graft configuration, anastomosed to in-situ right internal mammary artery (RIMA). All patients had uneventful postoperative stay and were discharged with a mean hospital stay of 3.8 days. There were no postoperative strokes, myocardial infarction, neurological symptoms, or change in EF. At 6-month follow-up, they were asymptomatic and doing well. Conclusion: The RIMA-LIMA-Y configuration can be a safe, viable option in CABG for patients with left SAS. It is challenging, with re-entry and judicious utilization of the length of LIMA being of paramount importance. The importance of CT angiography of neck vessels to detect SAS cannot be under-emphasized.
Accidental finding of ALCAPA in a child with severe mitral regurgitation: A case study
Authors: Rahmat Budi , Prakoso Radityo , Simbolon Rafles PH. , Lopolisa Albert T. , Rayhan Muhammad , Marwali Eva M. 
Published: November 2024

Case report A six-year-old child who had undergone cardiac surgery five years ago presented to us with severe mitral valve regurgitation. During her current surgery, the coronary artery was injured during the attempt to release extensive epicardial adhesion, resulting in very poor contractility that prompted a delay in the intended valve repair. The injured coronary vessels were successfully repaired, yet low cardiac output syndrome persisted during perioperative care, necessitating further investigation of the coronary problem. It was later discovered that the patient had anomalous left coronary artery from pulmonary artery (ALCAPA) syndrome. Discussion The presence of severe mitral regurgitation, pulmonary hypertension, and anatomical factors may have contributed to the delayed presentation and diagnosis in this case. The severity of mitral regurgitation and the most likely underlying mechanism indicates a low possibility of recovery following coronary repair alone, warranting the need for concomitant mitral surgery. Coronary and mitral repair were performed in this patient, resulting in a favorable outcome. Conclusions The management of ALCAPA presents unique challenges, especially in cases with delayed diagnosis. Proper diagnosis and tailored surgical approaches are crucial for achieving favorable outcomes in patients with ALCAPA.
A Pharmacokinetic Model Determination of Time Activity Curves in Radiopharmaceutical Therapy
Authors: Steiner Joseph , Nguyen Brandon , Jafari Farhad 
Published: November 2024

Introduction and Purpose Radiopharmaceutical therapy (RPT) dosimetry can be challenging to perform due to sparse data measurements and variations in how the time activity curve (TAC) is determined. In this work, a single system of equations was theoretically derived to estimate the TAC. Methods A pharmacokinetic (PK) model was developed to estimate patient specific rate constants for a given set of body compartments. The PK model and an optimizer were numerically implemented to determine the rate constants and, using these physiologic data, to generate TACs and time integrated activities (TIAs) for 3 tissue systems from clinical data gathered in 5 patients. A fourth (aggregate) tissue compartment is added using conservation of activity considerations. Results Feasibility of the PK model was demonstrated by successfully generating TACs and TIAs for all patients in a manner comparable to existing methods in the literature. The data are compared to smaller sampling regimes. Differences between the 3- and 4-compartment models show that conservation of activity considerations should be part of TAC estimations. Conclusion The results here suggest a new paradigm in RPT in using the rate constants so identified as a diagnostic tool and as a vehicle to achieving individualized tumorcidal dose and/or the maximum tolerable dose to normal tissues.
What engagement strategies are useful in facilitating the implementation of electronic health records in health care settings? A rapid review of qualitative evidence synthesis using the normalization process theory
Authors: Zharima Campion , Mhlanga Samantha , Abdulla Saira , Goudge Jane , Griffiths Frances 
Published: November 2024

Objective The study aimed to identify and describe the engagement strategies used in implementing electronic health records in health care settings and to ascertain why they were successful or not, using normalization process theory. Methods In this rapid review, we searched PubMed and CINAHL for qualitative and mixed methods primary studies published from 2010 to 2023 (June). We identified 41 studies that explored the implementation of EHRs, involving clinicians as participants. For quality appraisal, we employed the standards for reporting qualitative research (SRQR) tool. For analysis, a qualitative comparative analysis, using the normalization process theory was conducted. This was followed by a narrative synthesis to compile and analyze key findings. Results About 56% ( n = 23) of the studies were conducted in hospitals, while the remaining were done in mental health, maternity, and ambulatory care settings. Participants included a range of clinicians such as nurses, physicians, doctors, dentists, pediatricians and other specialists. Evidence shows that prior to implementation, effective communication of the vision of EHRs and early user involvement in decision-making are useful engagement strategies in preparing users for implementation. Tailored training and on-demand technical support for users sustain system usage during the roll out. Lastly, ongoing engagement with users is essential for continuous user support and system improvements. Conclusion User engagement improves the chances of successful implementation, particularly if engagement strategies are effective for the specific stages of implementation. The success of these strategies is more evident when they ensure normalization process theory tenets, which include user coherence, cognitive participation, collective action and reflective monitoring.
The Giant Leap in the Development of Higher Engineering Education in China
Authors: Wu (邬正阳) Zhengyang 
Published: November 2024

Purpose This study discusses the development of higher engineering education and its future direction following the increased enrollment in higher education institutions in China. Design/Approach/Methods By compiling and analyzing corresponding policies and historical and statistical data, the large-scale expansion process and quality enhancement pathways of China's higher engineering education are summarized. Additionally, probable future development scenarios are identified based on the current situation. Findings Ever since the expansion of higher education enrollment in China, higher engineering education has experienced rapid expansion in scale and quality, leading China toward becoming a prolific global leader in this aspect. Through a series of national engineering educational reforms, such as “Engineering Program Accreditation,” “Outstanding Engineer Plan,” and “New Engineering Construction,” China has sought to improve the quality of engineering talent to “transition from a large state to a powerful state” in higher engineering education. Therefore, this development process can be considered a “golden age” of higher engineering education development in China. Going forward, China's higher engineering education should focus on continuous quality improvement, strengthen international exchanges and collaboration, and expansion into new engineering fields. Originality/Value This study systematically analyzes the large-scale expansion and quality enhancement routes of China's higher engineering education. By enhancing the understanding of such education, this study can serve as a reference for domestic and foreign engineering education researchers.
Research progress of MUC1 in genitourinary cancers
Authors: Mao Weipu , Zhang Houliang , Wang Keyi , Geng Jiang , Wu Jianping 
Published: November 2024

Abstract

MUC1 is a highly glycosylated transmembrane protein with a high molecular weight. It plays a role in lubricating and protecting mucosal epithelium, participates in epithelial cell renewal and differentiation, and regulates cell adhesion, signal transduction, and immune response. MUC1 is expressed in both normal and malignant epithelial cells, and plays an important role in the diagnosis, prognosis prediction and clinical monitoring of a variety of tumors and is expected to be a new therapeutic target. This article reviews the structural features, expression regulation mechanism, and research progress of MUC1 in the development of genitourinary cancers and its clinical applications.
The optimal timing of breast cancer surgery after COVID-19 infection: an observational study
Authors: Bi Zhao , Cheng Wei-Hao , Zheng Wen-Hao , Ren Tong-Yue , Chen Peng , Liu Yan-Bing , Qiu Peng-Fei , Wang Wei-Li , Wang Yong-Sheng 
Published: November 2024

Abstract
Purpose
It is controversial for the optimal time of breast cancer surgery after COVID-19 infection. Purpose was to assess the risk of postoperative complication in breast cancer patients with COVID-19 infection, in order to select optimal surgery timing after COVID-19 infection.

Methods
Breast cancer patients infected with COVID-19 and performed surgery between December 20th, 2022 to March 20th, 2023 were included in this prospective study (n = 577). Patients performed surgery between May 1, 2019 to October 1, 2019 were listed as control group (n = 329). They had not been infected with COVID-19 before surgery. Patients were grouped by time of surgery relative to COVID-19 infection. Database was evaluated using logistic regression.

Results
Patients infected with COVID-19 had a higher incidence of complications after surgery compared to that not-COVID-19 infection (6.59% vs. 3.04%). Multivariable logistic analysis demonstrated that timing of surgery was associated with complications (OR = 4.253; 95% CI: 0.855–21.153, P = 0.044). Patients performed surgery within 2 weeks after COVID-19 infection had the highest rates of complication (17.65%) when compared with other groups, while the incidence was decreased into 5.51% when surgery 2 weeks or more after COVID-19 infection. With a median follow-up was 10 months, all patients with complications were recovered without serious complications or death, which had no adverse effect on subsequent anti-tumor therapy.

Conclusions
It needs to be cautious when breast cancer surgery was performed within 2 weeks after COVID-19 infection. Although the incidence of complications in patients undergoing surgery 2 weeks after COVID-19 infection is still slightly high, surgery might be recommended considering urgency of treatment, good prognosis of complications and the lack of influence on subsequent adjuvant therapy.
Light curing infection control barriers: do some types jeopardize the concept of conventional bulk-fill composites?
Authors: Sherief Dalia I. , Kandil Mohamed M. , El-Refai Dina Ahmed 
Published: November 2024

Abstract
Background
Using infection control barriers (ICBs) on light curing units (LCUs) became mandatory to achieve proper infection control measures without jeopardizing the integrity of the restorations, especially at deeper layers. This study explored the effect of two ICBs on the irradiance of the LCU, as well as the degree of conversion (DC) and flexural strength (FS) of two types of bulk-fill composites. Water vapor permeability (WVP) of both barriers was also assessed to evaluate the capability of such barriers to prevent transmission of blood and saliva droplets and aerosols.

Methods
Two bulk-fill composites (X-tra fil and Tetric N- ceram) and two ICBs (Pinnacle Cure sleeve and Sanita wrapping film) were used in this study. Light irradiance was recorded per experimental condition using spectroradiometer. For DC and FS, specimens of 4 mm thickness were prepared. Each specimen was composed of two separable upper and lower layers of thickness 2 mm. DC and FS were measured using Infra-red spectroscopy and three-point loading test respectively. WVP was investigated using the cup method. Means and standard deviations were calculated, and the data were statistically analyzed using factorial analysis of variance test (α = 0.05).

Results
Light irradiance showed highest values using no ICBs and lowest values using Pinnacle curing sleeve. Both bulk-fill composites showed higher DC mean values without ICBs and when using Sanita wrapping film for both upper and lower layers of the specimens compared to Pinnacle curing sleeve. The upper layers of composite specimens showed higher DC compared to lower layers for all experimental conditions. Both ICBs had no adverse effect on FS of both composites’ upper layers. Pinnacle sleeve significantly reduced FS of both composites’ lower layers. X-tra fil showed higher DC and FS compared to Tetric N-Ceram for all experimental conditions. Regarding WVP; the wrapping film showed higher WVP compared to the curing sleeve.

Conclusions
Sanita wrapping film can be used as a successful ICB, without jeopardizing the concept of bulk-fill composites. Pinnacle cure sleeve can be considered an effective ICB, however its influence on properties and serviceability of bulk-fill composites remains questionable.
How and why do community stakeholders participate in the national stroke audit in England? Findings from a mixed-method online survey
Authors: Russell L , Chouliara N , Lewis S , James M , Fisher R 
Published: November 2024

Abstract
Background
National audit programmes are a recognised means of assessing quality of healthcare by collecting and reporting data in relation to evidence-based standards. The Sentinel Stroke National Audit Programme is a prospective audit of processes and outcomes for all stroke patients in England, Wales and Northern Ireland which has historically focused on hospital-based care. Evidence suggests it has been successful in driving quality improvement. What has yet to be explored is the influence of such a national audit programme on community-based healthcare. The aims of this study were to understand how community stakeholders perceive and participate in the audit.

Methods
The study used a realist approach, being theory driven and informed by collaborators including stroke clinicians and experts in realist and audit methodology. Contextual determinants and mechanisms were identified from the literature as having the potential to influence quality improvement. These were operationalised into 18 survey items, using a combination of 5-point scales and yes / no responses. Free text options offered the opportunity to expand upon responses.
The online survey was distributed using social media, clinical networks and professional bodies. Representation was sought from community stroke stakeholders across England and from roles throughout the audit process including administrative, clinical, management and commissioning.

Results
The survey achieved a national sample from a broad range of stakeholders (n=206). Participants reported being engaged in the audit, committing significant resources to participation. National audit feedback was described as being used to support a range of improvement activities, including funding for additional staff and service reorganisation. A number of factors influenced the ability of teams to participate in audit and utilise feedback for quality improvement. These included the online platform, the accuracy of data submitted and leadership support.

Conclusions
Findings highlight the work needed in terms of the data captured, organisational audit support and engagement with feedback if the potential of the audit as a tool for quality improvement in community rehabilitation (as highlighted in acute stroke care) is to be realised.
Robot-assisted technique can achieve accurate screw placement in four-corner fusion and reduce operative difficulty: a cadaver study
Authors: Wang Zhixin , Liu Bo , Yi Zhe , Xu Ke , Jia Shijie , Wang Qianqian , Yin Yaobin 
Published: November 2024

Abstract
Background
The purpose of this study is to explore the feasibility and accuracy of a robot-assisted technique in four-corner fusion compared with traditional freehand operation.

Methods
Twenty cadaver specimens were randomly assigned to the robot-assisted group and freehand groups. Three screws were placed percutaneously to fix the capitate-lunate joint, lunate-triquetrum joint, and triquetrum-hamate-capitate joint in each specimen by robot-assisted or freehand technique. The offset between the actual and planned screw positions was determined by merging the images of intraoperative and postoperative CT scans in the robot-assisted group. The centrality of the screw, time-consuming, drilling attempts, and radiation exposure were compared between the two groups.

Results
The mean offset between the actual and planned screw position was 1.09 (SD: 0.56) mm. The offset at the start point of the screw was significantly lower than that at the endpoint. There was no significant difference in the centrality of the screws, surgical time between the two groups. The number of drilling attempts and the radiation dose received by surgeons were significantly lower in the robot-assisted group.

Conclusions
Although there was no significant difference in screw centrality between the two groups, the slight offset between the actual and planned screw positions confirmed the feasibility of the robot-assisted technique in four-corner fusion. The robot-assisted technique has advantages in reducing the difficulty of surgery and protecting the surgeon from exposure to large doses of radiation.