bluuebunny/crossref_metadata_2025_split huggingface dataset:
Monotropein Reduces Retinal Inflammation, Oxidative Stress, and Dyslipidemia in Streptozotocin-induced Diabetic Retinopathy in Rats
Authors: Jia Yuxi 
Published: October 2024

Background Diabetic retinopathy (DR) is a major cause of visual problems and ultimately results in vision loss. Nearly 25% of diabetic patients have suffered from DR. Objectives The present research has assess the salutary properties of monotropein against streptozotocin (STZ)-induced DR in rats. Materials and Methods The experimental rats were challenged with STZ, and after the initiation of diabetes, the animals were treated with monotropein for 60 days. An investigation was conducted to assess the glucose, food intake, and body weight levels of the experimental rats. The antioxidants, angiogenic protein levels, and inflammatory cytokines were assessed using assay kits. The apoptotic protein levels and lipid profiles were examined by kits. A morphometric analysis was performed on the retinal tissues. Results The treatment of monotropein successfully reduced the glucose level, food consumption, and glycosylated hemoglobin (HbA1c) while increasing the body weight of DR rats. The monotropein also enhanced antioxidant levels and significantly decreased inflammatory cytokines and angiogenic protein levels in the DR rats. The lipid profiles and proapoptotic protein levels were also decreased by the monotropein. Conclusion The present research shows that monotropein successfully reduced dyslipidemia, inflammatory responses, and oxidative stress in DR rats. These data demonstrate that monotropein has the potential to mitigate STZ-induced DR in rats.
Seismic performance assessment and retrofitted by buckling-restrained braces for half-through concrete-filled steel tubular arch bridge with the vertical suspended deck system
Authors: Zou Yuhe , Wang Dongsheng , Li Xiaoli , Tong Lei , Hui Yingxin , Ge Xiao 
Published: October 2024

Arch bridges with vertical suspended deck systems have been constructed during the last 30 years, different from the existing arch bridges with longitudinal beams or panel beams. The latter have better the seismic inertia forces can be transmitted to the piers or foundations through both the arch rib and the longitudinal beam. However, for arch bridges with vertical suspended deck systems, seismic inertia forces produced by deck systems are transmitted to arch ribs by the geometric nonlinearity of suspenders firstly, and then further transmitted through the arch ribs to the piers or foundations, resulting in greater seismic demands on the arch ribs. In this paper, the seismic performance and weak structural elements of the half-through concrete-filled steel tubular (CFST) arch bridge with a vertical suspension deck system under tri-directional ground motions were studied by numerical simulation, and the bridge model was primarily verified by a static loading test conducted in situ. Moreover, Buckling-Restrained Braces (BRBs) were strategically placed to optimize their seismic mitigation effects by systematically analyzing the bridge’s seismic response. The results identify the arch foot, the 1/8 point of the arch rib, the arch crown, and the transverse bracing as weak structural elements for seismic resistance of the half-through concrete-filled steel tubular (CFST) arch bridge with a vertical suspension deck system. Therefore, a thoughtfully designed arrangement of BRBs targeting the seismic weak structural elements can significantly increase the values of capacity demand ratio (CDR) for weak structural element, thereby strengthening the seismic safety margin of the bridge.
Safety and efficacy of newer liquid embolic agents Squid and PHIL in endovascular embolization of cerebral arteriovenous malformations and dural arteriovenous fistulas: A systematic review and meta-analysis
Authors: Günkan Ahmet , Ferreira Marcio Yuri , Vilardo Marina , Scarcia Luca , Bocanegra-Becerra Jhon E. , Alexandre Andrea , Ferreira Christian , Dmytriw Adam , Ciccio Gabriele , Clarençon Frédéric , Jabbour Pascal , Serulle Yafell 
Published: October 2024

Background A wide range of liquid embolic agents has been used in endovascular treatment (EVT) of dural arteriovenous fistulas (dAVFs) and cerebral arteriovenous malformations (cAVMs). Newer liquid embolics, Squid (Balt) and PHIL (MicroVention), aim to improve the safety and efficacy of EVT of dAVFs and cAVMs. Objective To assess the safety and efficacy of EVT of cAVMs and dAVFs using Squid or PHIL as an embolic agent. Methods We searched major databases following PRISMA guidelines and included studies with ≥ five patients reporting on EVT of dAVFs and/or cAVMs using Squid or PHIL as embolic agent. We analyzed efficacy outcomes including complete occlusion, incomplete occlusion, and recurrence at follow up, and safety outcomes including procedure-related complications, morbidity, and mortality with a random-effects meta-analysis. Separate analyses were performed for cAVMs and dAVFs. Subanalyses were conducted for studies exclusively utilizing PHIL and those exclusively utilizing Squid, for both cAVMs and dAVFs. Results Ten studies, comprising 214 patients (53.7% male), were found. Of these, 113 patients had 113 dAVFs, while 101 patients had 101 cAVMs. Complete occlusion rates following embolization were 91% for dAVFs and 32% for cAVMs. A subanalysis of dAVFs embolized solely with Squid and PHIL identified 93% and 86% complete occlusion rates, respectively. The overall procedure-related permanent morbidity rate was 3% for dAVFs and 7% for cAVMs. There was only one procedure-related mortality, which developed in a cAVM case, across 214 cases. Conclusion Squid and PHIL are safe and effective embolic agents for treatment of dAVFs and cAVMs.
Real-world antifibrotic treatment patterns in patients with idiopathic pulmonary fibrosis: retrospective analyses of two large healthcare administrative databases in the United States
Authors: Qiu Ying , Zhu Julia , Chopra Pooja , Elpers Brandon , Dieyi Christopher , Byrne Clare , Tang Jackson , Wang Ye , Govindaraj Kousalya , Fischer Aryeh 
Published: October 2024

Background: Real-world data on the use, healthcare resource utilization (HCRU), and associated costs of antifibrotic therapies in patients with idiopathic pulmonary fibrosis (IPF) are limited. Objectives: To assess the prevalence of antifibrotic treatment, characteristics of patients receiving treatment, discontinuation rates, and HCRU and costs associated with treatment. Design: This retrospective study analyzed de-identified longitudinal and cross-sectional data, respectively, from two US claims databases: Optum’s de-identified Clinformatics® Data Mart Database (CDM; commercial claims, Medicare Advantage) and the Veterans Health Administration (VHA) database. The study periods were October 1, 2013–March 31, 2019 and October 1, 2014–September 30, 2019, respectively. Eligible individuals were adults with ⩾1 diagnosis claim for IPF. Methods: Antifibrotic prevalence, patient demographics, treatment discontinuation rates, and HCRU and costs were determined separately for each cohort and described using summary statistics. Bivariate comparisons were analyzed using Chi-square and Student’s t-tests for categorical and continuous variables, respectively. Results: Overall, 4223 and 4459 eligible patients were identified in the CDM and VHA databases, respectively. Prevalence of antifibrotic uptake was 9.2% and 29.1% and the rate of index treatment discontinuation was 47% and 66% during follow-up in the CDM and VHA cohorts, respectively. Antifibrotic-treated patients were significantly younger ( p < 0.0001) with lower mean Charlson Comorbidity Index scores at baseline versus untreated patients in both cohorts. In the CDM cohort, the number of outpatient and pharmacy visits was significantly higher in treated versus untreated patients during follow-up (both p < 0.0001). A similar trend was observed for the VHA cohort. Total follow-up costs in both cohorts were significantly higher in treated versus untreated patients due to higher pharmacy costs (CDM; p < 0.0001) or higher outpatient and pharmacy costs (VHA; p < 0.0001). Conclusion: The low prevalence of antifibrotic usage in both cohorts, together with the high rate of antifibrotic discontinuation, and increased HCRU and costs in treated versus untreated patients, support the need for novel treatment options for IPF. Trial registration: Not applicable.
The Impact of Middle Ear Packing Material Containing Antibiotic Ointment on Postoperative Infection After Myringoplasty
Authors: Lou Zhengcai , Lou Zihan , Chen Zhengnong 
Published: October 2024

Objective The objective of this study was to compare the postoperative infection and graft success rates, and the hearing improvement, after endoscopic cartilage underlay myringoplasty with versus without antibiotic ointment coating. Materials and methods This was a retrospective case-control study. The clinical records of patients who underwent endoscopic cartilage underlay myringoplasty and who met the selection criteria were retrieved and divided based on middle ear packing status into groups with antibiotic ointment packing (AOP group) and with no antibiotic ointment packing (no-AOP group). The operation time, postoperative infection, graft success status, and hearing improvement were compared between the 2 groups. Results Patients with 166 perforations constituted the AOP group, and patients with 141 perforations comprised the no-AOP group. At 3 months postoperatively, middle ear infections had occurred in 24 (14.5%) ears in the AOP group and 4 (2.8%) ears in the no-AOP group ( P < .01). At 12 months postoperatively, the graft success rate was 81.3% in the AOP group and 97.9% in the no-AOP group ( P < .01). No significant group differences were observed, preoperatively ( P = .657) or postoperatively ( P = .578), in the air-bone gap (ABG) values or mean ABG gains ( P = .758). Conclusion Middle ear packing without antibiotic ointment coating does not increase the postoperative infection rate or reduce the graft success rate after endoscopic cartilage underlay myringoplasty compared to antibiotic ointment coating. On the contrary, coating with antibiotic ointment increases the risk of postoperative infection given the complexity of middle ear manipulation.
Opportunity Cost of Surgical Management of Craniomaxillofacial Trauma: A Longitudinal Study
Authors: Issa Khalil , Frisco Nicholas A. , Kilpatrick Kayla W. , Kuchibhatla Maragatha , Barrett Dane M. , Powers David B. , Woodard Charles R. 
Published: October 2024

Study Design Single-institution retrospective financial analysis. Objective Trauma care is consistently linked to inadequate reimbursement, posing a significant financial burden for large trauma centers. Data show that declining Medicare reimbursement rates have indirectly led to declining payment for all procedures covered by insurance. The goals of this study are to investigate the opportunity cost associated with contemporary surgical management of CMF trauma at our institution and to evaluate longitudinal financial trends. Methods Patients with operative facial fractures between 2015 and 2022 at Duke University Medical Center were included and compared to patients undergoing general otolaryngology, plastic surgery and oral surgery operations in the same period. Procedural codes, payor type, charges billed, collections, relative value units (RVUs) and other financial data were obtained and analyzed among the 2 patient populations. Comparative analysis was performed to assess the financial trends in data reported previously from 2007-2015. Results The collection rate at Duke University Medical Center for operatively managed CMF fractures remains significantly lower than non-CMF counterparts. Interestingly, the collection rate gap between CMF and non-CMF surgeries has narrowed when comparing to the data from 2007-2013. This is largely due to a decrease in collection rates for non-CMF procedures from 29.61% (2007-2013) to 26.57% (2015-2022) [ P = 0.0001] and an increase in collection rates for CMF procedures from 17.25% (2007-2013) to 18.05% (2015-2022) [ P = 0.0001]. Conclusions Despite a slight improvement of the gap in reimbursement rates for CMF and non-CMF surgeries over the last several years, trauma care continues to have a negative financial impact on health care institutions.
Patient Perceived Barriers and Enablers to Medication Adherence in the Treatment of Depression: A Qualitative Study
Authors: Meng Yuki , Chiu Christopher , Kapoor Mamta , Li Shelly-Anne , Kaur Navaldeep , Marr Patricia , Kwan Debbie , Leblanc Kori , Ji Catherine , Papoushek Christine 
Published: October 2024

Background: Depression affects approximately 280 million individuals globally and it is a leading cause of disability. Despite effective medication options, 50% of patients prematurely discontinue antidepressants within 6 months. We sought to understand patients’ perspectives regarding their needs and expectations related to antidepressants. Objectives: To identify and describe enablers and barriers that influence adult patients’ medication adherence in depression treatment and to explore patients’ educational needs on initiating or continuing antidepressant therapy. Methods: Qualitative descriptive study was conducted using individual, semi-structured interviews of adult patients with depression who were prescribed an antidepressant within 3 months of study recruitment at an urban primary care clinic in Toronto, Canada. Thirteen participants were interviewed. Interviews were recorded and transcribed verbatim for inductive thematic analysis. Results: Six themes emerged: safety and effectiveness of antidepressant, understanding of depression and its management, medication administration, healthcare experiences in the treatment of depression, and social influences and relationships. Barriers to adherence included adverse effects of antidepressants, preference for non-pharmacological therapies, uncertainty about therapeutic effects, and social stigma. In contrast, enablers were positive responses from antidepressants, fear of relapse, reminder aids, established routine, and a trusting patient-provider relationship. Participants desired access to reliable, evidence-based, and personalized educational information delivered through verbal, written, and digital formats to support antidepressant adherence. Conclusion: To overcome the identified barriers, educational strategies should involve both patients and their prescribers to identify patient-specific needs and treatment goals, engage in shared decision-making, and maintain consistent follow-up to support antidepressant adherence.
Effect of Handheld Finger-Grip Relaxation Technique on Post-Neurosurgery Patients’ Pain and Anxiety
Authors: Elnosary Asmaa Mohammad Ahmad , Mostafa Heba Abdel-Azeem , Tantawy Nayera , Hani Salam Bani , ALBashtawy Mohammed , Ayed Ahmad , Fathalla Mostafa Marwa 
Published: October 2024

Introduction Post-neurosurgery patients often experience pain and anxiety. Handheld finger-grip relaxation helps the body, mind, and spirit to achieve relaxation. Objective This study investigated the effect of a handheld finger-grip relaxation technique on pain and anxiety in post-neurosurgery patients. Method A quasi-experimental study of 160 patients was randomly assigned to either the intervention group (received the handheld finger-grip relaxation technique) or the control group (received standard care). The intervention group received the handheld finger-grip relaxation technique for 15 min twice daily for 3 days. The control group received standard care. Pain and anxiety were assessed using a visual analog scale and a Spielberger State-Trait Anxiety Inventory, respectively. Results The results showed that the intervention group had a highly statistically significant difference between pre and post-phase ( p < .0000) regarding the severity of pain and anxiety level. Meanwhile, there was a statistically significant difference ( p < .05) between pre and post-phase among the control group. Conclusion It is suggested that the handheld finger-grip relaxation technique may be an effective intervention for reducing pain and anxiety in post-neurosurgery patients.
The Treasures of Renal Isle: Evaluating a Gamified Module While Enhancing Student Learning
Authors: Joy Shinu , Rumsey Kimberly , Ford Meredith 
Published: October 2024

Introduction Nursing education continues to evolve with the integration of innovative technologies aimed at enhancing student engagement and understanding of complex medical concepts. Gamification, the application of game elements in nongame contexts, emerges as a promising tool in nursing education. Method Faculty members collaborated with instructional designers to develop, The Treasures of the Renal Isles, a gamified module for nursing education. Drawing upon their expertise, faculty provided content knowledge and identified key gaming elements, while designers crafted a virtual world and storyline to contextualize the learning experience. The module was implemented within the curriculum, and student feedback was solicited through the Gameful Experience Scale (GAMEX), a validated tool for assessing gamified learning experiences. Additionally, exam scores were analyzed to determine the gamified module's impact on learning outcomes. Results Analysis of student responses to the GAMEX tool revealed favorable perceptions of the gamified renal module. Specifically, 77.3% of students believed that the module facilitated their understanding of renal content, indicating its efficacy in knowledge acquisition. Moreover, 71% of students expressed a desire for additional gamified modules, highlighting their engagement and interest in this instructional approach. However, despite positive feedback, no significant differences in test scores were observed postimplementation. Conclusion The findings of this project highlight the potential of gamification as an interactive learning method in nursing education. While the gamified renal module received positive feedback from students regarding its effectiveness in facilitating understanding, the lack of significant improvement in test scores warrants further refinement. By incorporating student feedback and revising the module accordingly, nursing educators can utilize gamification to bridge the gap between theoretical knowledge and clinical judgment. The development of additional gamified modules holds promise for enriching the learning experience and preparing nursing students for the complexities of clinical practice.
Stemless Reverse Shoulder Arthroplasty Grants Satisfactory Clinical Scores at Minimum 5 Year Follow-up: Comparative Study
Authors: Quemener Alexandre , Dabert Alizé , Rochet Séverin , Antoine Adam , Pozet Astrid , Nourissat Geoffroy , Antoni Maxime , Harris Howard , Agu Chinyelum , van Rooij Floris , Obert Laurent 
Published: October 2024

Purpose To compare outcomes, between stemmed and stemless reverse shoulder arthroplasty (RSA) at a minimum follow-up of 5 years. Methods The authors retrospectively assessed a consecutive series of 45 patients that underwent RSA between September 2014 and October 2018 (23 stemless and 22 stemmed). All patients underwent plain anteroposterior and scapular Y-view radiographs for assessment immediately post-operatively and at final follow-up. At a minimum follow-up of 5 years, an independent observer assessed the clinical scores, including Constant score, QuickDASH score, and American Shoulder and Elbow Surgeons score. Results Of the 45 patients that underwent RSA, 5 patients died (11%), 2 were revised due to infection (4%), and 4 patients were lost to follow-up (9%). This left a final cohort of 34 patients (18 stemless and 16 stemmed). Significant differences between groups were found immediately post-operatively for lateralisation shoulder angle (LSA) (p = 0.021), but at 5 years post-operative for distalisation shoulder angle (DSA) (p = 0.017) and QuickDASH scores (p = 0.041) (Table 4), while the outcomes were comparable for absolute Constant scores, ASES score, and range of motion. Finally, stemless RSA had a 17% complication rate, while stemmed RSA had a 31% complication rate. Conclusion Stemless RSA had significantly more lateralisation, and significantly less distalisation, compared to stemmed RSA. Furthermore, at a 5-year follow-up, stemless RSA granted significantly greater QuickDASH scores. Finally, stemless RSA had comparable complication rates as stemmed RSA. The clinical relevance of this study is that stemless RSA is a safe alternative to stemmed RSA, while granting comparable or greater scores. Level of Evidence: III, Comparative Study
Cardiovascular toxicities associated with novel cellular immune therapies
Authors: Munir Malak , Sayed Ahmed , Addison Daniel , Epperla Narendranath 
Published: October 2024

Abstract
Over the past decade, T-cell–directed therapies, including chimeric antigen receptor T-cell (CAR-T) and bispecific T-cell engager (BTE) therapies, have reshaped the treatment of an expanding number of hematologic malignancies, whereas tumor-infiltrating lymphocytes, a recently approved cellular therapy, targets solid tumor malignancies. Emerging data suggest that these therapies may be associated with a high incidence of serious cardiovascular toxicities, including atrial fibrillation, heart failure, ventricular arrhythmias, and other cardiovascular toxicities. The development of these events is a major limitation to long-term survival after these treatments. This review examines the current state of evidence, including reported incidence rates, risk factors, mechanisms, and management strategies of cardiovascular toxicities after treatment with these novel therapies. We specifically focus on CAR-T and BTE therapies and their relation to arrhythmia, heart failure, myocarditis, bleeding, and other major cardiovascular events. Beyond the relationship between cytokine release syndrome and cardiotoxicity, we describe other potential mechanisms and highlight key unanswered questions and future directions of research.
A lifeline for COPD: prevention strategy
Authors: Percival I. 
Published: October 2024

Educational aimsTo provide an overview of the medical devices used in support of respiratory diagnosis and management. An outline of the National Clinical Stratergy in the UK.To provide an outline of the National Clinical Stratergy in the UK.SummaryThis review provides an overview of the new National Clinical Strategy in the UK, which is designed to work proactively in preventing the development of chronic obstructive pulmonary disease (COPD) while defining a clear pathway to healthcare for sufferers. The government initiative will aim to associate the education of target groups with the diagnosis and management of COPD. Easy-to-use tools for healthcare professionals are available from the medical technology industry in support of the initiative, for example pre-screening, smoking cessation, spirometry measurements and body plethysmography.
Achieving quality spirometry in the office
Authors: Garbe B. 
Published: October 2024

SummaryEver since pioneering technology brought objective lung function measurement out of the laboratory with the introduction of “office spirometers” nearly 50 yrs ago, there has been a debate on whether nonspecialist practitioners can reliably achieve accurate lung function measurements. This debate continues today, because although it is certain that some users can achieve excellent-quality lung function measurements in general practice, occupational medicine and other nonspecialist practices, it is equally certain that some very poor-quality spirometry measurements are being performed. Examples of these poor quality measurements are presented as evidence that respiratory measurements should only be performed in controlled conditions by expert operators. Whether this is true can only be speculated upon, unless it is possible for an expert to review every spirometry measurement. You may think that this would be impossibly time consuming and expensive, but the internet, expert software and other technological advances have made this achievable and inexpensive; much cheaper than inaccurate lung function measurements.