bluuebunny/crossref_metadata_2025_split huggingface dataset:
Carotid Endarterectomy in Octogenerians
Authors: Ting Albert C. W. , Taylor David C. , Salvian Anthony J. , Chen Jerry C. L. , Strandberg Sandy , Hsiang York N. H. 
Published: September 2024

Purpose: The purpose of this study was to determine the safety and efficacy of carotid endarterectomy (CEA) in octogenerians. Methods: The records of 59 CEA performed in 57 patients who were 80 yr or older between April 1993 and September 1998 were reviewed. There were 33 males and 24 females with a mean age of 82. Forty-nine procedures (83%) were performed for symptomatic carotid stenosis. The perioperative mortality and morbidity including neurological events were recorded. Long term follow-up data was also obtained. Results: There were three perioperative deaths (5.1%) and three perioperative neurological events, including one stroke (1.7%) and two transient ischemic attacks (3.4%). The combined mortality and stroke rate was 6.8%. With a mean follow-up of 25 ± 21 months, Kaplan-Meier estimates of the 4-yr survival rate, freedom from stroke, and stroke free survival were 78. 94 and 75% respectively. For comparison, during the same time period, the same group of surgeons performed 597 CEA in patients less than 80 yr of age. The perioperative mortality and stroke rate was 0.3 and 2.5% respectively, with a combined mortality and stroke rate of 2.7%. Perioperative mortality was significantly higher in patients over 80 yr of age ( P < 0.01). Conclusions: CEA in octogenerians is associated with a higher mortality rate than in younger patients. However, good long term survival and freedom from stroke make CEA beneficial in octogenerians. With careful patient selection and perioperative management. CEA in octogenerians is worthwhile and should be advised in selected patients.
Carotid Endarterectomy Outcomes Research: Reduced Resource Utilization Using a Clinical Protocol
Authors: Hobart Dona C. , Nicholas Gary G. , Reed James F. , Nastasee Susan A. 
Published: September 2024

Background and purpose: The purpose of this study was to examine the necessity of intensive care unit (ICU) utilization following carotid endarterectomy (CEA) and to identify patients who can be managed postoperatively on a vascular unit using a clinical protocol. Methods: Medical records of 50 patients admitted to the ICU following elective CEA were reviewed retrospectively for patient characteristics, morbidity, mortality, length of stay (LOS), and ICU intervention. Prospectively, the next 200 patients were routed to either a vascular unit or ICU, based on a clinical protocol. Endpoints were mortality, stroke, myocardial infarction, total hospital LOS. ICU LOS. and ICU intervention. Results: There were no significant differences in morbidity or mortality between patients admitted to the vascular unit and those admitted to the ICU. Of patients evaluated prospectively, 129 (63%) were admitted directly to the vascular unit. Of the 73 patients admitted to the ICU, 63% required direct intervention compared with only 54% of patients in the retrospective series ( P = 0.001). In addition, after institution of the protocol, ICU LOS decreased significantly from 1.4 to 0.6 days (P < 0.001). The hospital cost savings using this protocol averaged $1043 per patient. Conclusions: A clinical protocol can select patients for admission to the ICU or the vascular unit following CEA without increase in morbidity or mortality. Selective use of the ICU conserved resources, decreased ICU LOS. and provided substantial cost savings.
Routine Minimally Invasive Aortic Valve Procedures
Authors: Lee Jae-Won , Lee Sang-Kwon , Choo Suk-Joong , Song Hyun , Song Meung-Gun 
Published: September 2024

Background: Due to the lack of objective evidence supporting the advantages and early technical difficulties, minimally invasive aortic valve procedures were performed on a highly selective rather than routine basis. Methods: From September 1997 to February 1999, one surgeon routinely used upper or transverse minimally invasive sternotomy to perform 46 consecutive cases of aortic valve procedures (M), whereas two other surgeons performed 40 aortic valve procedures through a conventional sternotomy (C). Results: More time consuming and technically demanding surgeries were done in M. There was one death in each group. Aortic clamp time was longer in M (93 ± 40 vs 59 ± 24 min, P = 0.001). There were no differences in operating time, pump time, intubation duration, bleeding and intensive care unit stay. The advantages of minimally invasive aortic valve operation included better postoperative ejection fraction (58 ± 17 vs 51 ± 10%, P = 0.04), decreased pain score (3 ± 2 vs 5 ± 2, P = 0.004), less transfusion (19 vs 55%, P = 0.02), shorter duration of chest tube drainage, and cosmetically more acceptable surgical wound (6.8 ± 2.2 vs 5.2 ± 2.0. P= 0.018). From our series, we could not find any negative effects of minimal access surgery. Conclusions: Our study demonstrated that aortic valve surgeries could be performed routinely by the minimally invasive approach with a high degree of effectiveness and safety.
Diagnosis of Limbs and Neck Arterial Trauma Using Duplex Ultrasonography
Authors: Kuzniec S. , Kauffman P. , Molnár L. J. , Aun R. , Puech-Leão P. 
Published: September 2024

Objective: To evaluate duplex ultrasonography for diagnosis of arterial trauma in limbs and neck. Method: Fifty-one wounds in 47 patients, with indication for arteriography, were prospectively studied and grouped according to the presence (PCS group: 21 wounds, 41.2%) or absence (ACS group: 30 wounds, 58.8%) of clinical signs of arterial injury. All underwent duplex ultrasonography and arteriography. Results: Arteriography disclosed arterial injury in 21 wounds, of which 19 were visualized by duplex ultrasonography. In the other 30 wounds neither methods disclosed any arterial injury. The sensitivity of duplex ultrasonography was 90.5%, the specificity was 100% and the accuracy was 96.1 %. In PCS group duplex ultrasonography showed 14 injuries (93.3%) and one false-negative result, and in ACS group, five injuries (83.3%) and one false-negative result in the ACS group. Conclusions: Duplex ultrasonography reproduces the results of arteriography as a non-invasive diagnostic method in trauma of the limbs and neck.
Cytocompatibility and Physico-Chemical Characterization of Polyester Tapes, Surface Treated for Periodontal, Orthodontic and Prosthodontic Applications
Authors: Poddevin Nicolas , Marois Yves , King Martin W. , Laroche Gaétan , Pageau Jean-François , Guidoin Robert 
Published: September 2024

Woven polyester tape has been suggested as a possible alternative biomaterial to metallic wires and braces used in periodontal, orthodontic and prosthodontic surgery. Two innovative technologies, namely cleaning by supercritical fluid extraction (SFE) and surface modification using cold oxygen plasma, were performed on dental polyester tapes in order to improve their physico-chemical characteristics and biocompatibility. The physical, dimensional, and chemical properties of the tapes were measured before and after SFE and plasma treatments using various textile test methods, contact angle, ESCA, FTIR, DSC, and SEM techniques. The cytocompatibility of the tapes was evaluated before and after SFE and plasma treatments in terms of cell adhesion and proliferation in an in vitro direct contact assay with human gingival fibroblasts. The SFE cleaning method was successful in removing most surface contaminants and bringing the residual amounts to levels similar to those observed on commercial polyester arterial prostheses. The oxygen plasma treatment induced chemical modifications, characterized by a 9% increase in surface oxygen in the form of C-0 and C=0 bonds. This modified surface was more hydrophilic, as indicated by contact angle measurements. Cell adhesion was surprisingly greater on the hydrophilic SFE treated tapes than on the hydrophilic plasma treated ones, and cell proliferation was improved significantly by both the SFE and plasma treatment processes. In conclusion, the cytocompatibility of the tapes improved with both SFE and oxygen plasma treatments. The combination of both treatments, however, had no synergistic effect on cell growth and adhesion.
ESG Disclosure and Cost of Equity: Do Big 4 Audit Firms Matter?
Authors: Mathath Nidhin , Kumar Vinod , Balasubramanian G. 
Published: September 2024

Efficiency in the financial market helps firms and the economy through efficient capital allocation and improved capital productivity. ESG (environmental, social, and governance) disclosure provides nonfinancial information that reduces informational inefficiency in the financial market. India saw a major shift in ESG regulation in 2013–2014. This study examines the impact of ESG disclosure on the cost of equity after new regulation. Analyzing panel data from 586 firms (2015–2022), the key findings are: (a) superior ESG disclosure lowers the cost of equity mainly due to the governance component of ESG; (b) the presence of Big 4 auditors do not have a significant differential impact on the ESG-cost of equity relationship. JEL Codes: G30, M14, Q56
A call for multi-agency collaboration in the Pacific Island countries’ mental health – The World Federation for Mental Health viewpoint
Authors: Gill Neeraj 
Published: September 2024

Objective To introduce the World Federation for Mental Health (WFMH) viewpoint on the Pacific Island countries’ mental health capacity building. Conclusion Multi-agency collaboration guided by a nuanced understanding of the local context can enable a public health model of mental health service delivery in the Pacific Island countries.
Outcomes of Charcot-Marie-Tooth Disease Cavovarus Surgical Reconstruction
Authors: Haupt Edward Thomas , Porter Giselle Moriah , Blough Christian , Michalski Max P. , Pfeffer Glenn B. 
Published: September 2024

Background: Charcot-Marie-Tooth (CMT) disease is a progressive inherited neurologic disorder causing muscle weakness and lower extremity deformity. The goal of foot and ankle surgical treatment is to create a stable, plantigrade foot, with the potential elimination of brace-wear for ambulation. The aim of this study was to report baseline CMT patient function and subsequent outcome improvement from surgical treatment, as determined by PROMIS physical function (PF), pain interference (PI), and mental health/depression (D) scores. Methods: Retrospective data were collected on consecutive CMT patients older than 18 years receiving surgical treatment by the senior surgeon at Cedars-Sinai Medical Center from 2018 to 2022 with minimum 1-year follow-up. Each patient prospectively completed PROMIS preoperatively and postoperatively after all planned surgical treatment was completed. Prospective clinical and radiographic data were collected to describe complications and correlation to outcome. Results: Ninety-five feet in 64 patients older than 18 years were included for analysis. Mean follow-up was 21 months (range, 12-31) with 100% minimum 1-year follow-up. CMT patients had worse preoperative and baseline scores in all domains except PROMIS-D compared with population normal PROMIS scores. Significant improvements were identified in all PROMIS domains following surgical treatment. The mean PROMIS-PF score increased (40 to 45, delta = 4.9, P < .001), the mean PROMIS-PI score decreased (59 to 52, delta = 7.1, P < .001), and the mean PROMIS-D score decreased (50 to 47, delta = 3.0, P = .004). Subgroup analysis was performed for patients with severe radiographic deformity and those treated with arthrodesis in an attempt to demonstrate the impact of disease severity on outcome. Subgroup analysis demonstrated that arthrodesis led to worse overall PROMIS-PF outcome with the same change score. Conclusion: Surgical treatment for CMT patients provides significant clinical improvement in all measured outcome domains. CMT patients can be restored to normal population physical function and pain interference outcome scores. Patients with more severe deformity have similar improvement from surgical treatment, although their ultimate functional improvement is blunted due to a lower baseline.
Influencing Factors on Independent Walking in Children With Lumbosacral Lipomas: A Retrospective Cohort Study Based on a 5-Year Untethering Series
Authors: Takeuchi Chiaki , Sugiura Shiro , Fujita Remi , Tatematsu Noriatsu , Sugiura Hideshi 
Published: September 2024

Background: Caregivers are deeply concerned about children achieving independent walking, and evidence-based rehabilitation support is beneficial. However, current research is confined to a single study on spina bifida aperta, leaving a gap in understanding the timing of independent walking for lumbosacral lipomas. Objectives: This study aimed to examine the factors influencing independent walking in children with lumbosacral lipomas. Design: Retrospective cohort study. Methods: This retrospective cohort study included 124 children who underwent untethering surgery for lumbosacral lipomas. The age (in months) at which the children walked independently was used as the primary endpoint, and potential influencing factors, including the type of spinal lipoma, extent of lipoma removal, magnetic resonance imaging features, congenital anomaly complications, urinary/defecation management requirements, foot/toe symptoms, and orthotic device fabrications were analyzed. Results: Multiple logistic regression analysis showed that the most significant influencing factor for delayed independent walking was the presence of systemic combined anomalies (adjusted odds ratio = 15.5, P  <  .001), while non-systemic malformations, such as suburethral cleft, had limited effects. A subgroup analysis of 94 patients without systemic combined anomalies showed that the presence of a malformed conus medullaris was significantly associated with delayed independent walking ( P  =  .014). The median age of independent walking in children with Morota’s classification type 2 was 14 months, which is 1 month later compared to other types, although this difference was not significant ( P  =  .055). Conclusion: Our findings suggest that complications arising from systemic combined anomalies and the presence of malformed conus medullaris are influencing factors in delays in independent walking in children with untethered lumbosacral lipomas.
Getting help early: An online mental health self-assessment tool for young people
Authors: Fischer Afra , Smith Oliver J , Gómez Álvarez Paula , Wolstein Jörg , Schall Ulrich 
Published: September 2024

Background Online self-assessments are becoming more popular. They can serve as a screening tool for specific conditions or assess mental health more broadly but often lack in depth evaluation. Methods This study presents preliminary data from an online self-assessment tool for young people within the age range of 12–30 years (Link: redcap.hmri.org.au/surveys/?s = MK7RCELJ79 ). It covers key symptoms of mood and psychotic disorders and risk factors, such as eating issues, substance use, suicidality, and deliberate self-harming behaviours. Participants self-assessed their level of functioning, access to ongoing interventions, and satisfaction with the help received. Based on the severity of mental health problems and the level of risk, different recommendations of how to seek help were provided. Results Out of 303, 114 participants gave permission to analyse their data. A high-risk profile was defined by anxiety symptoms, panic attacks, suicidal ideation, and urges to self-harm. These individuals were more likely to report psychotic or depression symptoms, recreational substance use and low day-to-day functioning. Ongoing treatment and the satisfaction with it were not determined by the severity of symptoms. Conclusions These preliminary results suggest that the online self-assessment tool reaches the intended young audience, particularly those with some degree of mental health problems.
Seismic behavior of I-steel reinforced concrete-filled GFRP tubular columns
Authors: Zhang Maoyu , Wang Yanru , Zheng Zezhong , Zhang Jicheng 
Published: September 2024

To better understand the seismic performance of the steel reinforced concrete-filled GFRP tubular (SRCFGT) columns, this paper presents a low-cycle repeated loading test on twelve I-SRCFGT columns with different parameters including axial compression ratio, diameter-thickness ratio and fiber winding angle. The failure mode, hysteresis curve, skeleton curve, ductility, stiffness degradation, strength degradation and energy dissipation capacity of each specimen are analyzed and discussed. The tests demonstrate the favorable seismic performance of the I-SRCFGT columns. The failure mode consists mainly of fiber fracture and matrix cracking. Besides, results show that an increase in the axial compression ratio from 0.7 to 0.9 leads to greater initial stiffness, but accelerates the stiffness degradation during the loading process, and the ductility index (DI) of the specimen decreases by 3.2 %. Specimens with larger wall thickness of the GFRP tube have higher ultimate bearing capacity, but excessively increasing the wall thickness of the GFRP tube can reduce the ductility of the specimen. The overall displacement ductility of the specimen with a wall thickness of the GFRP tube of 6 mm increased by 3.1 % compared to the specimen with a 4 mm wall thickness of the GFRP tube. However, when the wall thickness of the GFRP tube continued to increase, the DI decreased by 2.6 %. Furthermore, specimens with a fiber winding angle of ±45° perform better in terms of the ultimate bearing capacity and ductility as well as overall seismic performance.
A national survey of current practice in pre-alveolar bone graft orthodontics in the United Kingdom
Authors: Kane Georgina , Good Sarah 
Published: September 2024

Objective: To obtain an overview of current practice for pre-alveolar bone graft (pre-ABG) orthodontics at cleft centres across the United Kingdom. Design: Cross-sectional survey. Setting: Web-based. Methods: The survey was distributed online to UK orthodontic consultants undertaking cleft care and was piloted before use. The domains explored included level of experience, perceived benefits and concerns with undertaking pre-ABG orthodontics, types of appliances used and ABG outcomes. Results: A total of 38 consultant orthodontists responded, with a response rate of 56%. Pre-ABG orthodontics was performed most commonly (81.6%) in patients with a bilateral cleft lip and palate; however, 21.1% never performed it in any cleft phenotypes. The most common types of appliances used were fixed slow expanders and fixed appliances. No respondents reported poor ABG outcomes. Conclusion: There was no clear protocol for providing pre-ABG orthodontic treatment, with wide variation across the UK. A variety of orthodontic treatment approaches are being undertaken, and the outcomes of ABGs remain successful. Multidisciplinary teams should have a holistic approach to patient care when deciding to perform pre-ABG orthodontics and involve patients in decision making. Future UK research should focus on additional secondary outcomes and determining a standardised approach to ensure best possible care is delivered.
Key stakeholder perspectives on delivery of vaccination services in Quebec community pharmacies
Authors: Chadi Alexandre , Thirion Daniel J. G. , Waite Nancy M. , David Pierre-Marie 
Published: September 2024

Background: Undervaccination is a public health issue that disproportionately affects underserved populations. Pharmacists are accessible health care professionals who have the potential to better reach communities. The aim of this study is to understand how organizational obstacles influence the pharmacist’s ability to meet underserved clients’ vaccination needs in community pharmacy. Methods: We conducted semi-structured interviews with key stakeholders in Quebec. Results were codified according to domains of the Consolidated Framework for Implementation Research. Results: Fourteen interviews were carried out with representatives from pharmacy associations, pharmacy chains and banners, integrated health and social service centres, and local Quebec Public Health departments. Barriers to promoting vaccination were identified in four areas: 1) vaccine service logistics, 2) the pharmacy setting, 3) external influences and 4) pharmacist’s knowledge and beliefs. Discussion: Technological tools accessible to pharmacists are sufficient but not user-friendly due to the lack of integration between the pharmacy software, the vaccine registry and the provincial appointment system. Technology limits access to vaccination for certain underserved populations. Moreover, the incentives linked to vaccination do not favour the vaccination of difficult-to-reach clients and they limit pharmacists’ ability to be proactive with vaccine recommendations. Pharmacists are more inclined to participate in mass vaccination campaigns, and delegating vaccine administration to nurses and technicians allows pharmacies to financially break even. Certain services such as travel health vaccination require an extended set of knowledge, which creates resistance for some pharmacists to integrate the role. Conclusion: Pharmacists are well-placed to improve vaccination uptake, but several technological and organizational barriers limit their ability to provide vaccination services and reach underserved communities. A better alignment between incentives and proactive promotion should be put forward to encourage pharmacists to actively identify and reach underserved populations.
Comparative effect of different types of physical exercise and intensity levels on low birth weight: A systematic review and network meta-analysis
Authors: Díaz-Goñi Valentina , Cavero-Redondo Iván , Bizzozero-Peroni Bruno , Rodríguez-Gutiérrez Eva , Pascual-Morena Carlos , Sequí-Domínguez Irene , Lucas-Torres Maribel Lucerón , Arenas-Arroyo Sergio Núñez de , Saz-Lara Alicia 
Published: September 2024

Background: Low birth weight (LBW) has been established as a major determinant of neonatal mortality and morbidity. However, there is no evidence of the effectiveness of different types of physical exercise (PE) at different intensities during pregnancy to prevent LBW. Objectives: To compare the effectiveness of different types of PE at different levels of intensity in pregnant women to prevent LBW. Design: A systematic review and network meta-analysis was performed according to the guidelines of the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols for Network Meta-Analysis extension statement. Data Sources and Methods: We searched the PubMed, Cochrane Central Register of Controlled Trials, Scopus, and Web of Science databases from inception to November 2023. We included randomized controlled trials (RCTs). A random effects method was used to calculate the pooled mean difference (MD). The effect of each intervention was calculated using a network meta-analysis with a frequentist perspective. Results: Forty-three RCTs were included in the systematic review, and 38 RCTs were included in the network meta-analysis. In the general population, although no significant results, the MDs for light-moderate strength, moderate-vigorous strength, and moderate-vigorous Pilates exercises were favorable for preventing LBW. Furthermore, moderate-vigorous strength exercise was effective to prevent LBW, reporting significant MD compared to control groups in the healthy population (310.00, 95% confidence interval: 78.40, 541.60; I2 = 81.3%). Conclusion: Strength exercises at a moderate-vigorous intensity could be a potential strategy for the prevention of LBW in the healthy population. However, our findings should be interpreted with caution because the overall risk of bias was between “some concerns” and “high,” and the overall certainty of the evidence was low. Registration: PROSPERO CRD42023401770.