bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cost Analysis of Outpatient Colectomy in a Tertiary Center: A Projected Medico-Economic Evaluation
Authors: Agri Fabio , Möller William , Deslarzes Philip , Vogel Charles André , Hahnloser Dieter , Hubner Martin , Demartines Nicolas , Grass Fabian 
Published: September 2024

Aim of the study:Short stay processes are incentives to unburden chronically stressed healthcare systems. The aim of this study is to analyze financial implications of day admission (DAS) and outpatient strategies for colon resections in a prospective payment system (PPS) using Diagnosis Related Group (DRG) coding.Methods:Consecutive patients undergoing left and right colonic resections between January 1, 2019 and December 31, 2020 were included. Medico-economic evaluations of the virtual outpatient and day admission surgery groups based on predefined criteria were compared to the identical group of patients who underwent surgery in the actual traditional inpatient setting. In a second step, postoperative complications of the virtual outpatient group were assessed. Cost-revenue analysis was performed using a micro-costing approach including direct medical costs.Results:Overall (N = 257), 97 (37.7%) colectomies would have been potentially eligible for an outpatient strategy. The global costs of the actual inpatient strategy totaled USD 3 634 392 with a global revenue of USD 3 571 069, corresponding to a cost coverage rate of 98%. The result of the virtual DAS strategy would have been a net loss of USD 15 800 (coverage rate of 99%) due to 4 low length of stay outliers triggering a reimbursement reduction and preventing a positive net result of USD 16 208. The pilot reference outpatient case’s revenue and cost amounted to respectively USD 7479 and USD 6911 (cost coverage of 108%).Conclusion:From both any given hospital and healthcare system point of view, elective outpatient colectomy for selected patients is the most cost-saving option. However, in a prospective payment system implemented to avoid bad incentives, the latter can unintentionally disadvantage best performing hospitals and impede widespread adoption of high-value strategies.
Arthrodesis as Salvage for Failed Metacarpophalangeal Arthroplasty
Authors: Rode Matthew M. , Wu Kitty Y. , Welling Benjamin D. , Rizzo Marco 
Published: September 2024

Background: Surgical management of failed metacarpophalangeal (MCP) arthroplasties includes revision arthroplasty and arthrodesis. The purpose of this study was to review the indications and outcomes of arthrodesis as a salvage procedure for failed MCP arthroplasties. Methods: This was a retrospective cohort study of all patients undergoing salvage MCP arthrodesis at a single institution from 1990 to 2020. Patient charts were reviewed for patient demographics, indication for salvage, surgical technique, revision rate, and time to radiographic union. Patient-reported outcomes, including the Michigan Hand Outcomes Questionnaire and an MCP-specific questionnaire detailing pain, functional, appearance, and patient satisfaction, were also collected. Results: Eleven digits in 9 patients (6 women, 3 men, median age of 66) with median 36-month follow-up were included. The majority (91%) of patients also had concomitant soft tissue deformities, including joint contractures, extension lag, and collateral ligament insufficiency. The overall revision rate following arthrodesis was 45% with 3 digits requiring one revision each, and 2 digits undergoing 3 revisions. The overall union rate was 91% with median time to union of 4 months from most recent arthrodesis. Patient-reported outcomes obtained from 4 patients demonstrated improvements in pain and function. Conclusion: Despite a high revision rate of 45%, salvage MCP arthrodesis following arthroplasty has a high eventual union rate of 91% and is associated with improved pain and function based on 4 patients’ experiences. Arthrodesis as a salvage procedure for failed MCP arthroplasties should be considered in patients with persistent joint instability and functionally limiting soft tissue deformities.
Radiographic predictors of neurologic outcomes in patients with basilar artery occlusion: A single-center experience
Authors: Goldman Daryl , Al-Kawaz Mais , Reddi Preethi , Mehta Amol , Belani Puneet , Shafizadeh Milad , Matsoukas Stavrous , Kellner Christopher P , Mocco J , Fifi Johanna T , Majidi Shahram 
Published: September 2024

Background Randomized controlled trials indicate functional and mortality benefits in endovascular therapy for basilar artery occlusion (BAO). However, these studies only include patients who meet specific prognostic scores. This study investigates radiographic predictors of posterior circulation territory infarcts that may predict neurologic outcome at 90-day post-intervention. Methods This is a retrospective cohort study of a prospectively maintained thrombectomy database of all patients who underwent mechanical thrombectomy for BAO. Baseline demographics, comorbidities, baseline functional status (mRS), and severity of presenting neurologic deficits (NIHSS) were collected. Pc-ASPECTS, posterior circulation collateral score (PCCS), and basilar artery on computed tomography angiography (BATMAN) measured radiographic characteristics. Core infarct territory was identified. Primary outcomes were good neurologic outcome (mRS 0–3) and poor neurologic outcome (mRS 4–6) at 90-day post-thrombectomy. 90-day mortality was a secondary outcome. Results About 21.5% of patients achieved a good neurologic outcome. About 32.3% of patients were deceased at 90 days. Receiver operating characteristic analysis shows PCCS collateral scores (AUC = 0.74, SE = 0.03, CI = 0.62–0.74) and BATMAN (AUC = 0.72, SE = 0.04, CI = 0.35–0.49) have potential to differentiate between those with good neurologic outcome from those with poor neurologic outcome. Although there was no statistically significant difference in AUC between the three curves, pc-ASPECTS score trended toward being weaker predictor of neurologic outcome (AUC = 0.49, SE = 0.04, CI = 0.35–0.49). There were significant associations between 90-day poor neurologic outcome and established infarcts within the pons ( p = 0.01), left cerebellum ( p = 0.01), and left occipital lobe ( p = 0.03) on pre-thrombectomy CT. Conclusion Low BATMAN and PCCS collateral scores can be predictors of poor neurologic outcomes at 90-day post-thrombectomy for BAO while pc-ASPECTS score may be a weaker predictor of outcome.
Estimating Breakfast Characteristics Using Continuous Glucose Monitoring and Machine Learning in Adults With or at Risk of Type 2 Diabetes
Authors: Pai Ryan , Barua Souptik , Kim Bo Sung , McDonald Maya , Wierzchowska-McNew Raven A. , Pai Amruta , Deutz Nicolaas E. P. , Kerr David , Sabharwal Ashutosh 
Published: September 2024

Background: Continuous glucose monitoring (CGM) systems allow detailed assessment of postprandial glucose responses (PPGR), offering new insights into food choices’ impact on dysglycemia. However, current approaches to analyze PPGR using a CGM require manual meal logging, limiting the scalability of CGM-driven applications like personalized nutrition and at-home diabetes risk assessment. Objective: We propose a machine learning (ML) framework to automatically identify and characterize breakfast-related PPGRs from CGM profiles in adults at risk of or living with noninsulin-treated type 2 diabetes (T2D). Methods: Our PPGR estimation framework uses a random forest ML algorithm trained on 15 adults without diabetes who wore a CGM for up to four weeks. The algorithm performance was evaluated on a held-out subset of the participants’ CGM data as well as on an external validation data set of 36 individuals at risk for or with noninsulin-treated T2D. Results: Our algorithm’s estimations of breakfast PPGRs displayed no statistically significant differences to annotated PPGRs, in terms of incremental area under the curve and glucose rise ( P > .05 for both data sets), while a small difference in prebreakfast glucose was found in the nondiabetes data set ( P = .005) but not in the validation T2D data set ( P = .18). Conclusions: We designed an ML framework to automatically estimate the timing of meal events from CGM data in individuals without diabetes and in individuals at risk or with T2D. This could provide a more scalable approach for analyzing postprandial glycemia, increasing the feasibility of CGM-based precision nutrition and diabetes risk assessment applications.
Angelica sinensis Polysaccharide Suppresses Pyroptosis in Myocardial Ischemia/Reperfusion Injury via the FN1/NF-κB/NLRP3 Pathway
Authors: Niu Xiaowei , Zhang Wen Jun , Zhao Fei , Zhang Jingjing , Hu Shuwen , Bai Xue , Zhang Zheng , Bai Ming 
Published: September 2024

Background Pyroptosis, a form of inflammatory programmed cell death, has recently emerged as a pivotal factor in the pathogenesis of myocardial ischemia/reperfusion (MI/R) injury. Despite its significance, effective therapeutic strategies targeting MI/R-induced pyroptosis remain elusive in current clinical practice. Previous studies have demonstrated the promising anti-inflammatory effects of Angelica sinensis polysaccharide (ASP) in the context of certain inflammatory disorders. Objectives We aimed to investigate the effects of ASP on pyroptosis in MI/R injury and elucidate the potential molecular mechanisms by combining transcriptomic analysis with complementary in vivo and in vitro experiments. Materials and methods H9c2 cells were used to establish a hypoxia/reoxygenation (H/R) model, and MI/R injury was induced in rats by ligating and releasing the left anterior coronary artery. Myocardial tissue samples were harvested for transcriptomic sequencing and bioinformatic analyses. Cardioprotective effects were evaluated through electrocardiography, echocardiography, and histological examination. Enzyme-linked immunosorbent assay (ELISA) was employed to quantify levels of inflammatory mediators. Biochemical assays were conducted to assess myocardial injury biomarkers and Caspase-1 activity. Western blotting was performed to analyze the protein expression levels of Fibronectin 1 (FN1), Nuclear factor kappa B (NF-κB) p65, phosphorylated NF-κB p65 (p-NF-κB p65), Nod-like receptor protein 3 (NLRP3), and Gasdermin-D (GSDMD). Results Pretreatment with ASP conferred potent cardioprotective effects in a rat model of MI/R injury, as evidenced by significant attenuation of infarct size, myocardial enzyme levels, and ST-segment elevation on electrocardiography, alongside notable improvements in cardiac function. Transcriptomic profiling unveiled that differentially expressed genes modulated by ASP treatment were predominantly implicated in the pyroptosis-elicited inflammatory response. Concordantly, both in vivo and in vitro experiments substantiated that ASP treatment effectively attenuated MI/R-induced pyroptosis, as manifested by diminished levels of pyroptosis-related indicators, encompassing the proportion of TUNEL-positive cells, Caspase-1 activation, GSDMD cleavage, and the liberation of pro-inflammatory cytokines. Further mechanistic investigations revealed ASP inhibition of the FN1/NF-κB/NLRP3 signaling pathway. Conclusions Our investigation, leveraging system-level transcriptomic profiling, demonstrates that ASP confers cardioprotective effects against MI/R injury through the suppression of cardiomyocyte pyroptosis, culminating from downregulation of the FN1/NF-κB/NLRP3 pathway.
Imaging and Surgical Procedures After Surface-Related Collegiate Football Injuries on Artificial Turf Versus Natural Grass: Prevalence and Trends Over 15 Seasons
Authors: Meyers Michael C. , Sterling James C. , Robinson Shad K. 
Published: September 2024

Background: Few longitudinal studies exist comparing medical procedures after football injuries on artificial and natural grass surfaces. Purpose/Hypothesis: The purpose of this study was to specifically compare imaging and surgical procedures after surface-related collegiate football injuries on artificial turf versus natural grass. It was hypothesized that there would be no difference in the incidence of imaging and surgical procedures, combined medical procedures, or combined substantial and severe injuries over time between these surfaces. Study Design: Cohort study; Level of evidence, 2. Methods: A total of 39 universities across all Football Bowl Subdivision conferences were evaluated over 15 seasons (2006-2020). Playing surfaces evaluated were either a heavyweight artificial turf infill system (≥9.0 lb infill/ft2) or natural grass. Outcomes of interest included medical procedures across injury category, primary injury type, injury location, and specific procedures. Data involved multivariate analyses of variance (MANOVA) and Wilks λ criteria using general linear model procedures and were expressed as medical procedure incidence rates (IRs) per 10-game season. Results: Overall, 2224 games were documented: 1106 (49.7%) on artificial turf and 1118 (50.3%) on natural grass. Of the 9137 total injuries reported, 4010 (44%) were surface-related cases. MANOVA indicated significant main effects between surfaces according to imaging procedure ( F2,1738 = 4.718; P = .009), surgical procedure ( F1,539 = 5.974; P = .003), and medical diagnosis ( F2,456 = 2.643; P = .040). Post hoc analyses indicated significantly lower ( P < .05) incidences on artificial turf versus natural grass, respectively, for the following outcomes: imaging procedures ordered after player-to-surface impact trauma (IR [95% CI], 1.5 [1.3-1.8] vs 2.1 [1.9-2.4]), shoe-to-surface trauma during physical contact (4.4 [4.1-4.7] vs 5.2 [4.9-5.5]), foot injuries (0.6 [0.5-0.7] vs 1.1 [0.9-1.2]), ligament sprains/tears (4.6 [4.3-4.9] vs 5.3 [5.0-5.6]), muscle strains/tears (0.2 [0.2-0.3] vs 0.7 [0.6-0.9]), surgeries performed after shoe-to-surface trauma during physical contact (1.1 [0.9-1.3] vs 1.6 [1.4-1.8]), lower body surgeries (1.8 [1.6-2.0] vs 2.3 [2.1-2.6]), and surgeries involving ligament tears (1.0 [0.9-1.2] vs 1.5 [1.3-1.7]), as well as fewer diagnoses of syndesmosis sprains/tears (0.7 [0.5-0.8] vs 1.0 [0.8-1.2]) and Lisfranc trauma (0.3 [0.2-0.4] vs 0.5 [0.4-0.7]). Trends over the 15 seasons indicated a significant rise in combined medical procedures ( P = .005) and combined substantial and severe injuries ( P = .0007) irrespective of surface. Conclusion: Results indicated that collegiate football competition on heavyweight artificial turf resulted in lower incidences of imaging and surgical procedures and medical diagnoses compared with natural grass.
The Differences in Content of Health Care Plans of Medical and Nursing Students in Interprofessional and Uniprofessional Education
Authors: Teuwen Carolyn , Scheffer Hanke , Sekmen-Algin Suheda , Kusurkar Rashmi A. , Schreurs Hermien , Daelmans Hester , Peerdeman Saskia 
Published: September 2024

Background With a growing population of older people in all Western countries, interprofessional education (IPE) can help to prepare students for the complex care for these patients. Which aspects of this complex care could benefit from IPE? In this study we evaluated the differences in content of health care plans made by students who participated in IPE. Methods Undergraduate nursing and medical students were included and attended four sessions in which they wrote a health care plan for a paper-based geriatric patient case. Approximately half of the students were included in the IPE-group. To evaluate the content of interprofessional collaboration between the students, the other half of the students were included in a ‘uniprofessional education’ (UPE) group. UPE-students made the health care plan alone. In the IPE-group a medical and a nursing students compiled the health care plan together. All health care plans were assessed by comparing them with a validated health care plan. We zoomed into the differences in the content of the health care plans, and calculated a score ratio, proportion of correct items. Results The health care plans made by IPE-students had an average score ratio of 0.31. The health care plans made by UPE-students had an average score ratio of 0.22. Most differences were found in the subcategories medication, nursing actions and aftercare. Specific items within these categories were more frequently thought of in the IPE-group than in the UPE-group, for example delirium interventions and consultation with a transfer nurse. Conclusion This study gives insights into which health care actions are more often considered by interprofessional couples in IPE than by students in UPE. Awareness of these items in clinical practice could make a difference in the care for older patients.
Sustained benefit of zanubrutinib vs ibrutinib in patients with R/R CLL/SLL: final comparative analysis of ALPINE
Authors: Brown Jennifer R. , Eichhorst Barbara , Lamanna Nicole , O’Brien Susan M. , Tam Constantine S. , Qiu Lugui , Jurczak Wojciech , Zhou Keshu , Šimkovič Martin , Mayer Jiří , Gillespie-Twardy Amanda , Ferrajoli Alessandra , Ganly Peter S. , Weinkove Robert , Grosicki Sebastian , Mital Andrzej , Robak Tadeusz , Osterborg Anders , Yimer Habte A. , Wang Megan , Salmi Tommi , Wang Liping , Li Jessica , Wu Kenneth , Cohen Aileen , Shadman Mazyar 
Published: September 2024

Abstract
The ALPINE trial established the superiority of zanubrutinib over ibrutinib in patients with relapsed/refractory chronic lymphocytic leukemia and small lymphocytic lymphoma; here, we present data from the final comparative analysis with extended follow-up. Overall, 652 patients received zanubrutinib (n = 327) or ibrutinib (n = 325). At an overall median follow-up of 42.5 months, progression-free survival benefit with zanubrutinib vs ibrutinib was sustained (hazard ratio [HR], 0.68; 95% confidence interval [CI], 0.54-0.84), including in patients with del(17p)/TP53 mutation (HR, 0.51; 95% CI, 0.33-0.78) and across multiple sensitivity analyses. Overall response rate remained higher with zanubrutinib compared with ibrutinib (85.6% vs 75.4%); responses deepened over time with complete response/complete response with incomplete bone marrow recovery rates of 11.6% (zanubrutinib) and 7.7% (ibrutinib). Although median overall survival has not been reached in either treatment group, fewer zanubrutinib patients have died than ibrutinib patients (HR, 0.77 [95% CI, 0.55-1.06]). With median exposure time of 41.2 and 37.8 months in zanubrutinib and ibrutinib arms, respectively, the most common nonhematologic adverse events included COVID-19–related infection (46.0% vs 33.3%), diarrhea (18.8% vs 25.6%), upper respiratory tract infection (29.3% vs 19.8%), and hypertension (27.2% vs 25.3%). Cardiac events were lower with zanubrutinib (25.9% vs 35.5%) despite similar rates of hypertension. Incidence of atrial fibrillation/flutter was lower with zanubrutinib vs ibrutinib (7.1% vs 17.0%); no cardiac deaths were reported with zanubrutinib vs 6 cardiac deaths with ibrutinib. This analysis, at 42.5 months median follow-up, demonstrates that zanubrutinib remains more efficacious than ibrutinib with an improved overall safety/tolerability profile. This trial was registered at www.ClinicalTrials.gov as #NCT03734016.
Neighborhood social cohesion and physical disorder in relation to social isolation in older adults: racial and ethnic differences
Authors: Qin Weidi , Nicklett Emily J. , Yu Jiao , Nguyen Ann W. 
Published: September 2024

Abstract
Background
Neighborhood factors of social isolation have been understudied, hindering efforts to reduce social isolation at the neighborhood level. This study aims to investigate the longitudinal effects of neighborhood social cohesion and physical disorder on social isolation in community-dwelling older adults, as well as to examine whether race/ethnicity moderates the neighborhood-isolation relationship.

Methods
We used 11-year data from the National Health and Aging Trend Study, a longitudinal national study of Medicare beneficiaries aged 65 and older. Social isolation was measured through a summary score across four domains: marital/partner status, family and friend contact, religious attendance, and club participation. A series of weighted mixed-effects logistic regression models were performed to test the study aims. Sample sizes ranged from 7,303 to 7,291 across individual domains of social isolation.

Results
Approximately 20% of participants reported social isolation. Findings indicated a negative association between neighborhood social cohesion and social isolation. Higher levels of neighborhood social cohesion were longitudinally associated with lower odds of social isolation (odds ratio [OR] = 0.52, 95% CI: 0.47–0.58). Yet, the presence of neighborhood physical disorder was associated with an increased risk of overall social isolation ([OR] = 1.2, 95% CI: 1.00, 1.44). Race/ethnicity significantly moderated the effects of neighborhood social cohesion and physical disorder on social isolation. The odds of no in-person visits associated with neighborhood social cohesion are smaller among Black adults compared to White adults. Black adults had constantly lower odds of isolation from religious attendance compared to White adults regardless of the level of neighborhood social cohesion. Hispanic adults had decreased odds of having no friends associated with signs of physical disorder, while no associations were found among older White adults. White adults had higher odds of isolation from in-person visits when living in neighborhoods with signs of physical disorder, whereas no association was observed among older Black and Hispanic adults.

Conclusions
This study elucidates the role of neighborhood characteristics in shaping social isolation dynamics among older adults. Furthermore, the observed moderation effects of race/ethnicity suggest the need for culturally sensitive interventions tailored to address social isolation within specific neighborhood and racial contexts.
Determining the predictors of preventive behaviors adopted by pregnant women against COVID-19 based on the Health Belief Model constructs: a cross sectional study
Authors: Bayrami Roghieh , Masudi Sima , Didarloo Alireza , Nournezhad Homeira 
Published: September 2024

Abstract
Background
Pregnant women face great challenges during the coronavirus disease 2019(COVID-19) pandemic. The purpose of this study was to explain the main dimensions of adoption of self-care behaviors against COVID-19 based on the health belief model(HBM) in pregnant women.

Methods
This cross-sectional and analytical study was conducted in Iran, at the end of the third wave of the COVID-19 pandemic, between January and April 2021. Two hundred and thirty pregnant women who referred to Urmia health centers were selected using multi-stage random sampling. The data were collected using an online questionnaire including items that measured the participants’ demographic characteristics, the knowledge questionnaire, the HBM items, and questions assessing the adoption of self-care behaviors against COVID-19. The data were analyzed using SPSS software version 20. Descriptive statistics, bivariate Pearson’s correlation test, and multiple linear regression were used to analyze the data.

Results
The results of this study showed that the rate of self-care behaviors against COVID-19 in the pregnant women participating in the present study was not very favorable. It was also shown that among the constructs of the HBM, knowledge, self-efficacy, and perceived barriers were the most important predictors of adopting self-care behaviors with a variance of 24% change among the pregnant women.

Conclusion
Knowledge, self-efficacy, and perceived barriers were found in this study as the strongest predictors of self-care behaviors among pregnant women. Thus, it is suggested to implement interventions commensurate with the results of this study.