bluuebunny/crossref_metadata_2025_split huggingface dataset:
Slowdown of the Indian Economy During 2019–2020: Deconstructing the Anomaly
Authors: Gupta Poonam 
Published: October 2024

In this paper, we analyse the deep and anomalous economic slowdown in 2019–2020, when the Indian economy grew at a rate of 4 per cent, the lowest in a decade. We argue that the slowdown was largely confined to one year, 2019–2020. The growth rate in the prior years averaged 7 per cent a year, and in none of the other years was it significantly below this average rate of growth. In contrast to some of the prevailing narratives, the slowdown did not permeate widely across sectors and activities. It was concentrated primarily in the manufacturing sector. The agriculture sector grew faster than before, and the services sector experienced only a mild deceleration, that too in the last two quarters of the year. On the demand side, the slowdown was reflected in a sharp contraction in exports; while the deceleration in consumption was milder, investment growth was flat and government expenditure grew at a faster pace than in the previous decade. The slowdown can be accounted for by three factors. First, about a 50 basis points worth of the slowdown was due to the COVID-induced lockdown in the last week of March 2020. Second, more than 100 basis points worth of the slowdown was due to the collapse in exports, attributed both to a large global slowdown in trade and to the fact that India lost ground to other countries in maintaining its market share in a slowing market. Finally, the credit collapse from banks, non-banking financial companies and housing finance companies impacted economic growth. JEL Codes: E65, F40, O11, O47, O53
Factors associated with severe diabetic ketoacidosis in patients diagnosed with type 1 diabetes: a decade-long cross-sectional analysis
Authors: Taieb Ach , Hela Ghali , Salsabil Achour , Asma Gorchane , Koussay Ach 
Published: October 2024

Objective The aim of this study was to identify factors associated with severe diabetic ketoacidosis (DKA) at the onset of type 1 diabetes mellitus (T1DM) in adult patients. Methods We conducted a retrospective analysis over a 10-year period including adults newly diagnosed with T1DM. Eligible participants were diagnosed with DKA at the time of T1DM diagnosis. DKA severity was categorized as mild, moderate, or severe. Data were collected on age, body mass index, family history of diabetes and autoimmune disorders, lifestyle habits, delayed diagnosis, and preceding factors. Results A total of 305 participants (69.8% men) with T1DM were included. Overall, 63 patients were admitted with severe DKA (Group 1) and 242 with non-severe DKA (Group 2). Factors associated with severe DKA at diagnosis of T1DM were a long period between symptom onset and first hospitalization, preceding infection, tachypnea, thrombocytopenia, anemia, hepatic cytolysis, polyuria, and tachycardia. Conclusions The present findings highlight the need for improving awareness about diabetes symptoms among physicians and the public to reduce the occurrence and severity of DKA at the onset of T1DM.
Healthcare Utilization in Pediatric Cancer Patients Near the End-of-Life
Authors: Kelly James P. , Runco Daniel V. , Slaven James E. , Niehaus Jason Z. 
Published: October 2024

Objective: Describe the healthcare utilization in the last 60 days of life in pediatric patients with cancer who died at home under hospice care and those that died in the hospital. Methods: Retrospective chart review of the medical records of those children with cancer diagnosis with palliative care consult and died either under hospice care at home or in the hospital. Results: Patients dying under hospice care spent a median of 44 days at home. Patients dying in the hospital spent a median of 30.5 days in the hospital, 10.5 days in the intensive care unit, and underwent 3.5 procedures requiring anesthesia. 45% of those that died in the hospital were compassionately extubated. Conclusion: For those dying with a cancer diagnosis, hospice care can allow for significant time at home with minimal healthcare while those dying in the hospital do spend a significant time in the hospital. This provides more information to both providers and families about end-of-life healthcare utilization.
Neuro-modelling and fuzzy logic control of a two-wheeled wheelchair system
Authors: Nasir NIzaruddin M. , Ghani Nor Maniha Abdul , Nasir Ahmad Nor Kasruddin , Ahmad Mohd Ashraf , Tokhi Mohammad Osman 
Published: October 2024

Two-wheeled wheelchairs have been used as alternatives for the elderly and disabled people to perform physical activities due to their restriction of movement. Significant challenges posed by two-wheeled wheelchairs control due to their inherent instability, resembling that inverted pendulum system. This research addresses these challenges by developing a dynamic non-linear model and stability control using computational algorithms. A neural network-based Nonlinear Autoregressive model with Exogenous Inputs (NARX) was developed, capturing and behaving similar to the complex dynamics of the wheelchair system with the identification on the experimental input–output data. Ensuring stable and responsive control, design of optimized PD-type and PID-type fuzzy logic controllers using Particle Swarm Optimization (PSO) were established and were tested under a simulation environment. The performance was evaluated across various metrics, including Integral Squared Error (ISE), Integral Absolute Error (IAE), Mean Squared (MSE), and Integral Time Absolute Error (ITAE). The result demonstrates that the PSO Optimized PID-type fuzzy logic controller with scaling factor from MSE index performance come out as best overall, significantly outperforms PD-type fuzzy logic controller, reducing its settling time by 12.5% to 35 s, minimizing overshoot to 0.81°, and achieving a negligible steady-state error of 0.046%. These results highlight the significant of integrating fuzzy logic control and PSO to the neural network model in enhancing the stability and performance of two-wheeled wheelchair systems, offering user safety and comfort.
Early and Midterm Outcomes of Chimney Endovascular Aortic Repair for Ruptured Abdominal Aortic Aneurysms
Authors: Takeuchi Yuriko , Morikage Noriyasu , Sakamoto Ryunosuke , Otsuka Ryo , Ike Soichi , Mizoguchi Takahiro , Samura Makoto , Harada Takasuke , Kurazumi Hiroshi , Suzuki Ryo , Suehiro Kotaro , Hamano Kimikazu 
Published: October 2024

Purpose: To compare the outcomes of endovascular aortic aneurysm repair using a chimney technique (ch-EVAR) with those of the standard EVAR (st-EVAR) for ruptured abdominal aortic aneurysms (RAAA). Materials and Methods: We implemented ch-EVAR for juxtarenal RAAA based on obvious anatomical indications after converting the strategy for RAAA from open repair to EVAR. A retrospective, cohort-based study was conducted on patients with RAAA who were treated using EVAR in our hospital between July 2011 and March 2022. EVAR cases were extracted, and outcomes were compared between ch-EVAR and st-EVAR. Patient clinical status, anatomical variables, treatment, and follow-up data were evaluated. Results: A total of 56 (82%) and 12 (18%) patients were treated by st-EVAR and ch-EVAR, respectively. Thirty-day mortality rates were comparable between the 2 groups [8.9% in st-EVAR vs 8.3% in ch-EVAR ( p= 0.95)]. Short-term outcomes showed that no type Ia endoleak occurred in either group. Midterm outcomes, including sac enlargement [7.5% in st-EVAR vs 0% in ch-EVAR (p= 0.37)], shrinkage [77.5% in st-EVAR vs 80.0% in ch-EVAR (p= 0.86)], and overall survival and freedom from aneurysm-related reintervention at 3 years [64.7% and 96.4% in the EVAR group vs 91.7% and 100% in the ch-EVAR group, respectively (p= 0.30 and 0.52)], were not significantly different between the 2 groups. Conclusion: Ch-EVAR for RAAA showed remarkably excellent outcomes, comparable to those of st-EVAR. Ch-EVAR is considered technically feasible in experienced centers. The indications for EVAR for RAAA may be further expanded using the chimney technique, resulting in overall improved outcomes for RAAA. Clinical Impact This is a retrospective, single-center analysis of 68 patients with ruptured abdominal aortic aneurysms (RAAAs) treated by endovascular repair (EVAR) to investigate the efficacy of the chimney technique for juxtarenal RAAA. Thirty-day mortality rate was 8.3% for the chimney EVAR group, which was equivalent to that in the standard EVAR group. Mid-term outcomes including sac enlargement/shrinkage, overall survival, and freedom from aneurysm-related reintervention were comparable between the two groups. This report suggests the possibility of broadening the selection criteria of the current endovascular strategy using the chimney technique.
Most Carpal Tunnel Releases Address Moderate or Severe Median Neuropathy
Authors: Brinkman Niels , Chandler Calvin , Ring David , Vagner Gregg , Reichel Lee 
Published: October 2024

Background: The role of surgery in normal or very mild median neuropathy can be questioned given that surgery in the absence of pathophysiology may offer only nonspecific effects that can be achieved without surgery, which raises ethical concerns. It’s also important to avoid misdiagnosis: given that mild median neuropathy is prevalent and generally well-accommodated, notable symptoms from mild median neuropathy can signal unhelpful thoughts and feelings of distress that are a more pressing health priority. Methods: We identified 38 studies that categorized electrodiagnostic (EDX) measured median neuropathy severity among people being evaluated for carpal tunnel syndrome. We converted the different EDX grades used into one general grading classification. The Kruskal–Wallis test was used to compare the ratio of moderate/severe to mild/normal EDX findings between tests ordered by a surgeon or a nonoperative clinician. Results: The median (interquartile range) ratio of moderate/severe to mild/normal EDX findings of median neuropathy at the carpal tunnel was 1.2 (0.91 to 1.8) among tests ordered by nonoperative clinicians and 3.3 (1.5 to 5.3) among tests ordered by surgeons ( P = .0023). Only 4.1% of the patients who had EDX testing ordered by a surgeon had no measurable neuropathy. There were zero patients with normal EDX findings in 10 of the 17 (59%) studies in surgeon practices and in 10 of the 21 (48%) in the practices of nonoperative clinicians. Conclusions: The observation that in case series documenting EDX severities of median neuropathy, surgeons are mostly treating and operating on moderate to severe pathophysiology, emphasizes that while mild median neuropathy is highly prevalent it is uncommonly considered for surgery. Level of evidence: Level II, Prognostic study.
Utilization and Effectiveness of Pectoralis Minor Tenotomy in the Surgical Management of Neurogenic Thoracic Outlet Syndrome
Authors: De Silva Gayan , Ohman J. Westley , Henderson Karen M. , Goestenkors Danita M. , Meyer Richard D. , Thompson Robert W. 
Published: October 2024

Background: Uncertainty exists concerning the optimal utilization and effectiveness of pectoralis minor tenotomy (PMT) in neurogenic thoracic outlet syndrome (NTOS). Methods: Between January 2020 and July 2023, 355 patients with NTOS underwent primary surgical treatment. Prospectively collected data were analyzed retrospectively. Results: Overall mean patient age was 35.9 ± 1.9 years, 76% were female, and the Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) score at presentation was 60.3 ± 3.2, reflecting substantial disability. Surgical treatment was based on localized tenderness/symptoms to palpation, with 322 (91%) undergoing combined supraclavicular decompression and PMT (SCD + PMT) and 33 (9%) selected for isolated PMT when findings were solely confined to the subcoracoid space. Mean operative time (29 ± 5 vs 164 ± 9 min, P < .01) and hospital stay (0.3 ± 0.1 vs 4.0 ± 0.2 days, P < .01) were both lower after isolated PMT, with no significant differences in postoperative complications or rehospitalization. During follow-up of 26.7 ± 1.5 months, QuickDASH scores declined by 41.2% ± 2.3% ( P < .0001) and patient-rated outcomes were excellent in 34%, good in 41%, fair in 22%, and poor in 4%. Fewer patients had poor-rated outcomes after SCD + PMT (2%) than after isolated PMT (19%) ( P < .01). Recurrent symptoms requiring supraclavicular reoperation occurred in 16 patients after SCD + PMT (5%) and in 5 patients after isolated PMT (15%) ( P < .05). Conclusions: Pectoralis minor tenotomy (PMT) has an important role in surgical treatment of NTOS, mainly as an adjunct in combination with SCD. While highly selected patients can do well after isolated PMT as a short outpatient procedure with rapid recovery, there is a greater potential for poor outcomes and supraclavicular reoperation than after SCD + PMT.
Hepatocellular carcinoma in HBsAg seroclearance: clinical features, recurrence, and prognosis following curative hepatectomy
Authors: Xu Wei , Gong Huai , Li Bolun , Yin Xinmin 
Published: October 2024

Aim: To explore clinical features and prognosis of hepatocellular carcinoma (HCC) in hepatitis B virus surface antigen (HBsAg)-serocleared patients and identify risk factors associated with postoperative recurrence after curative hepatectomy. Methods: Patients who had undergone initial hepatectomy for HCC from January 2010 through December 2022. Clinicopathological data were compared between HBsAg-seropositive and HBsAg-serocleared patients. Furthermore, risk factors associated with early and late postoperative HCC recurrence (early and late recurrences (ER and LR), respectively) were analyzed for HBsAg-serocleared HCC patients treated by curative hepatectomy. Results: A total of 2184 consecutive patients undergoing initial hepatectomy for HCC were enrolled, including 339 (15.5%) HBsAg-serocleared and 1845 (84.5%) HBsAg-seropositive cases. Tumor characteristics were comparable between the two groups. After curative hepatectomy, the ER rate was lower in the HBsAg-serocleared group than in the HBsAg-seropositive group (16.2% vs 26.3%; p = 0.000). LR rates in the HBsAg-seropositive and HBsAg-serocleared groups were similar (8.3% vs 6.9%, respectively, p = 0.418). Multivariate analysis showed that among HBsAg-serocleared patients, Hong Kong Liver Cancer stage and microvascular invasion were risk factors associated with postoperative ER, while γ-glutamyl transferase level and neutrophil-to-lymphocyte ratio were associated with LR. Conclusion: HBsAg-serocleared and HBsAg-seropositive HCC patients exhibited similar tumor characteristics. Curative hepatectomy-treated HBsAg-serocleared HCC patients experienced a lower ER rate and better short-term (⩽3 years) overall survival (OS) rates than their HBsAg-seropositive counterparts. LR, very late recurrence, and long-term (4-, and 5-year) OS rates were similar between the two groups.
Exploring Trends and Gaps in Osteoarthritis Biomarker Research (1999-2024): A Citation Analysis of Top 50 Cited Articles
Authors: Hu Wenjin , Yang Jiyong , Liu Li , Li Dongchao , Zhao Yun , Wang Aiguo 
Published: October 2024

Purpose This study aimed to comprehensively analyze the landscape of osteoarthritis (OA) biomarker research through the citation analysis of top-cited articles, identifying trends and gaps in this field. Methods The Web of Science Core Collection was utilized to retrieve the top 50 cited articles on OA biomarkers. Data extraction included publication characteristics, citation metrics, and biomarker categorization. Statistical analyses were conducted to discern correlations and assess significance. Results The top 50 cited articles spanned the years 1999 to 2020, and collectively cited 4849 articles, accumulating a total of 6177 citations, resulting in an average of 123.5 citations per document. Citations per article varied between 78 and 359, with a citation density ranging from 3.9 to 23.93. Analysis of the top 50 cited articles revealed comparable impact between recent and older publications. Predominant trends included cartilage-related and blood-based biomarkers, while inflammation-related, radiomics, and multi-omics emerged as potential future research directions. In BIPEDS classification, gaps were identified in biomarkers evaluating intervention efficacy and safety. Conclusion Despite significant advancements, there is no universally acknowledged biomarker for OA. Addressing gaps in biomarker exploration is crucial for enhancing OA management strategies. This study provides insights into prevailing trends and future research directions in OA biomarkers, guiding future investigations and therapeutic development.
Association between serum pyridoxal 5′-phosphate levels and all-cause, cardiovascular mortality, and cardiovascular disease in adults: a population-based cohort study
Authors: Xuan Chao , Liu Ru-Hua , Zhao Cong , Li Jing , Zhou Ting-Ting , Tian Qing-Wu , He Guo-Wei 
Published: October 2024

Background: The association between pyridoxal 5′-phosphate (PLP) and cardiovascular disease (CVD) remains a topic of discussion. Objectives: This study aimed to explore the relationship between serum PLP levels and the incidence of all-cause mortality, cardiovascular mortality, and the risk of CVD among the US population. Design: A population-based cohort study. Methods: This study analyzed data from the National Health and Nutrition Examination Survey. Adjusted hazard ratios (HRs) and their corresponding 95% confidence intervals (CIs) were calculated using weighted Cox proportional hazards regression models to assess the risk associated with all-cause and cardiovascular mortality. Weighted binary logistic regression was utilized to assess the relationship between serum PLP levels and the risk of CVD. Nonlinear associations were evaluated using multivariable-adjusted restricted cubic splines. Results: There were 2546 cases of all-cause mortality and 867 cases of cardiovascular mortality over a mean follow-up of 11.36 years. In the fully adjusted model, the adjusted HRs with 95% CIs for all-cause mortality associated with increases in serum PLP levels corresponding to the interquartile ranges were 0.83 (0.74–0.93), 0.71 (0.63–0.80), and 0.64 (0.56–0.74), respectively. Similarly, cardiovascular mortality decreased by 0.78 (0.62–0.97), 0.63 (0.49–0.81), and 0.62 (0.50–0.77) with each quartile increase in serum PLP levels. Higher serum PLP levels confer protection against CVD risk (odds ratio: 0.87, 95% CI: 0.79–0.96). Serum PLP levels showed nonlinear relationships with risk of all-cause mortality, cardiovascular mortality, and CVD. Conclusion: The results of this study provide evidence that serum PLP serves as a protective factor against all-cause mortality, cardiovascular mortality, and CVD in US adults, with dose–response relationships.
Data protection concerns are a statistically significant reason for refusal: Exploratory study of the patient perspective on telemedicine services based on 735 gynecological surgery patients
Authors: Hoffmann Sascha , Ott Marina , Bobbert Franziska , Jacoby Johann , Henes Melanie 
Published: October 2024

Objective Internet-based healthcare is a crucial facet of telemedicine. Here, we examine telemedicine methods in perioperative care for gynecological surgery from a patient's perspective. We aim to understand the patients’ needs during perioperative gynecological care and suggest how to optimize telemedicine services based on these insights. Methods The data were gathered via self-report questionnaires from patients who came in for preparatory consultations for gynecological surgery from May to November 2022. This process involved questioning 735 women about their past usage of internet-based services, personal information, and their views on telemedicine services. The study, which assured full anonymity, had voluntary participation. Results This participant pool consisted of 735 females. Around half ( n = 365, 49.66%) were preparing for outpatient surgery, while a significant number ( n = 322, 43.81%) were slated for inpatient surgery. Statistically, data protection concerns were the only significant factor influencing consent to telemedicine. While nonsignificant results were found for individuals with minimal concerns ( b = 0.08; odds ratio [OR] = 1.09, p = 0.791), markedly significant results ( p < 0.001) emerged for those expressing more concerns with b = 1.45 and OR = 4.28. This suggests that the likelihood of refusing consent to telemedicine is 4.28 times higher for those with significant data protection concerns compared with those with no concerns. Conclusion The patient's perspective on telemedicine services for gynecological surgery is influenced by several factors. These include the patient's age, computer skills, travel distance, occupation, education level, severity of the disease, satisfaction with previous treatments, treatment location, and referral method. Of these, concerns about data security significantly impact patient satisfaction. Hence, it is critical to prioritize this factor when offering telemedical services to meet patients’ needs.
Efficient patient care in the digital age: Online appointment scheduling in an ophthalmology practice
Authors: Betancor Paola Kammrath , Jordan Jens , Boehringer Daniel , Lüchtenberg Charlotte , Lambeck Marcus , Ketterer Manuel Christoph , Reinhard Thomas , Reich Michael 
Published: October 2024

Background Despite its potential to improve patient access, streamline administration, and enhance healthcare efficiency, systematic data on online appointment scheduling (OAS) in medical practices is lacking. Method Prospective, single center study conducted at an ophthalmology practice. Over a period of 12 weeks, all booked appointments, both online made via the OAS system, and offline made by practice staff via phone, email, or in-person, were recorded across four doctor consultations. Patient demographics, booking type (new appointment/rescheduled/cancelled), date and time of the booking, and the next available appointment slot were documented. Results 1080 interactions (new booking 76.8%, rescheduling 13.1%, cancellation 10.1%) were made by 880 patients via OAS and 2427 appointments offline by 1902 patients. Patients booking offline were older than those booking online (mean 50.3 ± 28.1 years vs. 41.7 ± 22.2, p < 0.0001). No difference between the groups was found regarding sex distribution (both, female around 59%, male around 41%, p = 0.81). New patients showed a preference for booking online (p < 0.0001). 63.1% of online bookings occurred on weekdays during practice hours. 36.8% of cancellations/reschedulings were made one to two days before the appointment. These vacant slots were promptly filled again, as OAS was primarily used for near-term bookings (booking time to appointment ≤7 days in 47.7%; selection of the earliest available appointment in 44.1%). Compared to appointments made offline the no-show rate was reduced by OAS (6.8%, n = 164, vs. 1.6%, n = 13, p < 0.0001). Conclusion OAS contributes to patient-centered and efficient resource utilization in healthcare by reducing no-show rates and promptly filling vacant slots.