bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison of Bioprosthesis and Mechanical Valves, a Meta-Analysis of Randomised Clinical trials
Authors: Kassaï B. , Gueyffier F. , Cucherat M. , Boissel J.-P. 
Published: September 2024

The main purpose of this meta-analysis was to compare the outcomes of patients who randomly received mechanical valves or bioprosthesis, over a long-term clinical follow-up. We found only three trials meeting our selection criteria with a total of 1229 patients (8069.5 patient-yr). Bleeding was more frequent in patients with mechanical prostheses both after Syr (RR = 2.6; IC = [1.9;3.5]; P <0.0001) and 11 yr (RR = 1.6; IC = [1.2:2.2]; P < 0.001) of follow-up. However, the increased risk of bleeding at 11 yr was only statistically significant with mechanical prostheses in the aortic position (RR = 1.93; IC = [1.36:2.74]; P = 0.0002). Reoperation was significantly more frequent in patients with bioprosthesis after 11 yr follow-up (RR = 0.4; IC = [0.3;0.6]: P < 0.001). Endocarditis was more frequent after 11 yr (RR = 0.6; IC = [0.3;0.95]; P < 0.05) in patients with mechanical prostheses but these results were heterogeneous between mitral and aortic valves. The choice of valve type does not significantly influence survival.
Radical Debridement and Omental Transposition for Post Sternotomy Mediastinitis
Authors: d'Udekem Y. , Lengele B. , Noirhomme P. , El Khoury G. , Vanwijck R. , Rubay J. E. , Dion R. 
Published: September 2024

Objective: Reported mortality for postoperative mediastinitis treated by debridement alone can reach 40%. The authors' experience with radical debridement and omental transposition is reviewed. Methods: Between May 1990 and August 1996, 14 patients with untractable mediastinitis had a transfer of the greater omentum: 11 after coronary artery bypass grafting (CABG) (6 bilateral internal thoracic arteries ITA grafts), one after a heart transplant, one after an aortic valve replacement and CABG, and one after a repair of the aortic isthmus related to a motor vehicle accident. The mean age was 63 ± 8 years. Infection was proven in all patients by cultures of intraoperative specimens. Two patients had such a large sternal defect that no primary closure could be attempted. The remaining 12 patients had a mean of 1.4 ± 0.7 previous debridement. Five patients had a total sternectomy. After radical debridement, the omentum was transferred over the entirety of the wound and covered with a meshed thin skin graft. All patients had a minimum of 4 weeks of i.v. antibiotic therapy. Results: There was no operative death. Apart from one focal necrosis and one traumatic dehiscence of the omentum, there was no hospital complication. Sepsis was controlled in all patients. The median hospital stay was 31 days (range 20–154 days). At a median follow-up of 20 months (range: 6–44 months), there were two late deaths: one sudden and unexpected death and one after a re-do CABG. The remaining patients had resumed their previous activities. One patient had developed an incisional hernia and another underwent further surgery for cosmetic reasons. Conclusion: Radical debridement and omental transposition may achieve a cure for postoperative mediastinitis with good mid-term results.
Minimally Invasive vs Open First Ray Dorsiflexion Osteotomy: Radiographic Outcomes and Early Complications Report
Authors: Raza Marium , Ranganathan Noopur , Ashkani-Esfahani Soheil , Miller Christopher P. 
Published: September 2024

Background: There is limited literature comparing open and minimally invasive surgical (MIS) techniques for first ray dorsiflexion osteotomy (DFO). This study is the first of its kind to report early healing and complication rates of patients undergoing MIS vs open first ray DFO. Methods: A retrospective cohort review of 28 patients who underwent a first ray DFO procedure at an academic medical center between 2015 and 2024 was conducted. Demographic factors and medical comorbidities were recorded. Radiologic parameters were measured along with healing. Postoperative healing and outcomes were identified through medical record review. Results: Thirteen open and 15 MIS DFO procedures were performed. At follow-up, all osteotomies were healed with no wound or infection complications. There was no significant difference in hardware removal rates, 7.7% for open and 6.7% for MIS. The change in lateral Meary angle was 10.5 ± 3.9 and 9.7 ± 4.3 for the open and MIS groups, respectively ( P = .61). The calculated dorsal closing wedge resection was 3.5 mm and 4.1 mm for open and MIS, respectively ( P = .26). Conclusion: This study showed no significant differences in healing or complication rates in the short term between MIS and open surgery, with comparable magnitude of correction, suggesting similar ability for the MIS technique to correct first ray alignment. Further studies are needed to determine long-term outcomes.
Goal Concordant Care: A Cross-Sectional Study Evaluating Correlates of Concordant Care and Association With Satisfaction and Outcomes
Authors: Julian Kaitlyn R. , Kwong Jeffrey W. , Leversedge Chelsea , Zhuang Thompson , Schroeder Nicole , Kamal Robin N. , Shapiro Lauren M. 
Published: September 2024

Background: The concordance between patient and physician goals has been associated with improved outcomes in many chronic diseases. The purpose of this study was to evaluate the association between goal concordant care, patient satisfaction, and patient experience and to analyze factors associated with goal concordant care in hand and upper extremity surgery. Methods: New patients who were 18 years or older were invited to participate. Goal concordant care was defined as the patient’s previsit treatment goal matching the primary treatment received. The χ2 tests were used to evaluate the association between goal concordant care and patient satisfaction and patient experience. We conducted univariable logistic regression to evaluate variables for their association with concordance and multivariable logistic regression for variables that were significantly associated in the initial analyses to evaluate their aggregate influence on concordance. Results: In total, 169 patients enrolled. The rate of goal concordant care was 62%; concordance was not associated with patient satisfaction or experience. Age, sex, English proficiency, health literacy, education level, employment and relationship status, pain self-efficacy, symptom duration, functional disability, and patient-centered decision-making were not associated with concordant care. Patients with annual income less than $50,000 had significantly higher odds of goal discordant care. Conclusion: Patients with lower income had more than 3 times the odds of receiving discordant care. However, discordant care was not associated with patient satisfaction or experience. Further studies on other pertinent outcomes are needed in orthopedic surgery (eg, treatment adherence). Known care disparities based on socioeconomic status may be mediated through care discordance and should be investigated.
The Comparative Performance of Large Language Models on the Hand Surgery Self-Assessment Examination
Authors: Chen Clark J. , Sobol Keenan , Hickey Connor , Raphael James 
Published: September 2024

Background: Generative artificial intelligence (AI) models have emerged as capable of producing human-like responses and have showcased their potential in general medical specialties. This study explores the performance of AI systems on the American Society for Surgery of the Hand (ASSH) Self-Assessment Exams (SAE). Methods: ChatGPT 4.0 and Bing AI were evaluated on a set of multiple-choice questions drawn from the ASSH SAE online question bank spanning 5 years (2019-2023). Each system was evaluated with 999 questions. Images and video links were inserted into question prompts to allow for complete AI interpretation. The performance of both systems was standardized using the May 2023 version of ChatGPT 4.0 and Microsoft Bing AI, both of which had web browsing and image capabilities. Results: ChatGPT 4.0 scored an average of 66.5% on the ASSH questions. Bing AI scored higher, with an average of 75.3%. Bing AI outperformed ChatGPT 4.0 by an average of 8.8%. As a benchmark, a minimum passing score of 50% was required for continuing medical education credit. Both ChatGPT 4.0 and Bing AI had poorer performance on video-type and image-type questions on analysis of variance testing. Responses from both models contained elements from sources such as PubMed, Journal of Hand Surgery, and American Academy of Orthopedic Surgeons. Conclusions: ChatGPT 4.0 with browsing and Bing AI can both be anticipated to achieve passing scores on the ASSH SAE. Generative AI, with its ability to provide logical responses and literature citations, presents a convincing argument for use as an interactive learning aid and educational tool.
Risk of major adverse cardiovascular events and all-cause mortality under treatment with GLP-1 RAs or the dual GIP/GLP-1 receptor agonist tirzepatide in overweight or obese adults without diabetes: a systematic review and meta-analysis
Authors: Stefanou Maria-Ioanna , Palaiodimou Lina , Theodorou Aikaterini , Safouris Apostolos , Fischer Urs , Kelly Peter J. , Dawson Jesse , Katan Mira , Katsanos Aristeidis H. , Lambadiari Vaia , Giannopoulos Sotirios , Alexandrov Andrei V. , Siasos Gerasimos , Tsivgoulis Georgios 
Published: September 2024

Background: Among the currently approved antiobesity medications, the glucagon-like-peptide-1 receptor-agonists (GLP-1 RAs) liraglutide and semaglutide, and the dual glucose-dependent-insulinotropic-polypeptide (GIP)/GLP-1 RA tirzepatide have been suggested to reduce cardiovascular-risk in overweight or obesity without diabetes. Objectives: The objective of this study was to evaluate the cardio- and neuroprotective potential of these novel agents in the nondiabetic overweight/obese adult population. Data sources and methods: A systematic review and meta-analysis of randomized-controlled clinical trials (RCTs) was performed to estimate the risk of major adverse cardiovascular events (MACE), all-cause and cardiovascular mortality in overweight or obese adults without diabetes treated with GLP-1 or GIP/GLP-1 RAs (vs placebo). Secondary outcomes included the risk of myocardial infarction (MI) and stroke. Results: Sixteen RCTs (13 and 3 on GLP-1 RAs and tirzepatide, respectively) comprising 28,168 participants were included. GLP-1 or GIP/GLP-1 RAs reduced MACE (odds ratio (OR): 0.79; 95% confidence interval (CI): 0.71–0.89; p < 0.01; I2 = 0) and all-cause mortality (OR: 0.80; 95% CI: 0.70–0.92; p < 0.01; I2 = 0), while there was a trend toward lower cardiovascular-mortality (OR: 0.84; 95% CI: 0.71–1.01; p = 0.06; I2 = 0%) compared to placebo. Additionally, GLP-1 or GIP/GLP-1 RAs reduced the odds of MI (OR: 0.72; 95% CI: 0.61–0.86; p < 0.01; I2 = 0%) and nonfatal-MI (OR: 0.72; 95% CI: 0.61–0.85; p < 0.01; I2 = 0%); while no associations between antiobesity treatment and fatal-MI, stroke, nonfatal, or fatal stroke were uncovered. Conclusion: GLP-1 and GIP/GLP-1 RAs reduce cardiovascular-risk and all-cause mortality in overweight or obese adults without diabetes. Additionally, GLP-1 RAs and GIP/GLP-1 RAs attenuate the risk of MI. Since data on stroke are still limited, future RCTs are warranted to evaluate the neuroprotective potential of these novel antiobesity agents. Trial registration: PROSPERO CRD42024515966.
Landscape of C-MET overexpression in non-small cell lung cancer: a large-scale study of clinicomolecular features and prognosis based on Chinese data
Authors: Zhan Shuting , Li Jianfu , Cheng Bo , Li Caichen , Feng Yi , Fan Lei , Xiong Shan , Zeng Wenchuang , Cai Qi , Xiang Yang , Wang Huiting , Li Chunyan , Chen Peiling , Zheng Xin , Fu Wenhai , Hao Zhexue , He Jianxing , Liang Wenhua 
Published: September 2024

Background: Real-world data on C-MET protein overexpression in non-small cell lung cancer (NSCLC) patients, particularly among the Asian Chinese population, are limited. Objectives: This study aimed to evaluate the clinicomolecular characteristics and prognosis of C-MET overexpression in Chinese NSCLC patients, focusing on those with positive C-MET overexpression (immunohistochemistry (IHC) 3+). Design: A retrospective and observational study. Methods: Data were collected from NSCLC patients diagnosed at the First Affiliated Hospital of Guangzhou Medical University between November 2006 and April 2021. We identified C-MET overexpression using IHC and C-MET overexpression positivity was defined as IHC 3+ with ⩾50% tumor cells. Additionally, patient genotypes were collected for subgroup analysis. Results: Data from 9785 NSCLC patients were collected. C-MET (−) accounted for 5% (503/9785), C-MET (+) for 27% (2654/9785), C-MET (++) for 36% (3464/9785), and C-MET (+++) for 32% (3164/9785). Genetic testing was available for 4326 patients. Wild-type was observed in 37% (1591 cases), with epidermal growth factor receptor ( EGFR) abnormalities being the most common at 49% (2127 cases). Positive C-MET overexpression correlated significantly with women ( p < 0.001), early-stage ( p = 0.003), adenocarcinoma ( p < 0.001), and driver mutations ( p < 0.001). Patients with anaplastic lymphoma kinase ( ALK) alterations had a higher occurrence of C-MET overexpression positivity (57.1%). Positive C-MET overexpression was significantly associated with EGFR ( p < 0.001), ALK ( p < 0.001), and KRAS alterations ( p = 0.024). Compared to C-MET overexpression (IHC 0), C-MET overexpression (IHC 2+) (hazard ratio (HR) = 0.455, p < 0.001) and C-MET overexpression (IHC 3+) (HR = 0.569, p < 0.001) were correlated with better overall survival in overall NSCLC patients, especially for C-MET overexpression (IHC 2+). Conclusion: Our study elucidates the clinicomolecular characteristics and prognosis of C-MET overexpression in NSCLC patients, particularly those with positive C-MET overexpression (IHC 3+). This provides insight into the prevalence of C-MET overexpression in Chinese NSCLC patients and offers a basis for considering C-MET overexpression as a prognostic and predictive marker in NSCLC.
Production time and practicability of 3D-Printed wrist orthoses versus low temperature thermoplastic wrist orthoses
Authors: von Haller Marianne , Couchman Louise , Honigmann Philipp 
Published: September 2024

Introduction In recent years, three-dimensional (3D) printing has emerged as a new manufacturing technique for orthoses, showing comparable stability and wearing comfort to traditional orthoses. However, the lengthy designing and printing process is assumed to take more time than the common practice of manufacturing low-temperature thermoplastic orthoses (LTTOs). The aim of this prospective cross-sectional study was to compare the production time of 3D-printed orthoses (3DPO) to LTTOs. Methods The active and passive time needed to manufacture the orthoses was measured in a clinical setting. 17 orthoses (8 3DPOs and 9 LTTOs) were included in the data analysis. Results The mean total production time of a 3DPO (12:14:50h total time; 0:44:35h active production time) was significantly longer than in LTTOs (0:14:14h; p < 0.001). Discussion The longer production time might be a hurdle regarding the implementation of 3DPOs in hand therapy. Although 3D-printing might become more cost- and time-efficient due to future developments in technology and growing experience, some practical advantages of LTTOs prevail, such as the fast and efficient provision of orthoses and the adaptability of the material if subsequent changes are needed. A combination of both manufacturing techniques may be a feasible solution to provide patient-centred orthosis provision in future hand therapy practice.
Global research on wearable technology applications in healthcare: A data-driven bibliometric analysis
Authors: Meng Fanyu , Cui Zhiying , Guo Haoxin , Zhang Ye , Gu Zhengmin , Wang Zhongqing 
Published: September 2024

Background In recent years, with the advancement of technological innovation and the widespread application of semiconductor materials, wearable technology has emerged as a significant branch in healthcare, demonstrating considerable potential for further development. This analysis aims to explore the global scientific trends on wearable technology applications in healthcare. Methods Scientific publications on wearable technology applications in healthcare from 1 January 2003 to 31 December 2022 were retrieved from the Web of Science Core Collection. A total of 19,426 publications were included in the bibliometric analysis. VOSviewer and CiteSpace were used to conduct bibliometric and visualized analysis. Key metrics such as country, institution, author co-authorships, cited references, journal citations, and keyword co-occurrences were selected for analytical emphasis. Results The United States of America and China emerged as the top two contributing countries, with significantly higher publication compared to other countries/regions. Chinese Acad Sci and Sensors are the institution and journal with the largest number of publications, respectively. Najafi, Bijan is the most active author. Research hotspots of wearable technology were divided into four clusters based on the co-occurrence analysis of keywords: (1) Wearable Technology for Detecting and Monitoring Human Physiological Parameters; (2) Wearable Technology for Human Chronic Disease Detection and Management; (3) Wearable Technology Exercise Health and Sports Rehabilitation Therapy under Intervention; and (4) The Technical Realization of Accuracy Enhancement in Wearable Technology. Conclusions The number of annual publications on wearable technology applications in healthcare has increased over the past 20 years. This analysis identified the status, trends, hot topics, and frontiers of wearable technology applications in healthcare. These findings will help researchers quickly identify emerging themes and offer new insights into the future development of wearable technology in healthcare.
The Influence of Wait Time on Surgical Outcomes in Elective Lumbar Degenerative Spine Conditions: A Retrospective Multicentre Cohort Study
Authors: Bond Michael , Charest-Morin Raphaële , Street John , Fisher Charles , Dea Nicolas , Singh Supriya , Paquet Jerome , Abraham Edward , Bailey Christopher , Weber Michael , Nataraj Andrew , Attabib Najmedden , Kelly Adrienne , Rampersaud Raja , Manson Neil , Phan Phillippe , Thomas Ken , Soroceanu Alex , LaRue Bernard , Ahn Henry , Marion Travis , Christie Sean , Glennie Andrew , Zhi Wang , Hall Hamilton , Sutherland Jason M. 
Published: September 2024

Study Design Retrospective cohort study. Objectives The impact of delayed access to operative treatment on patient reported outcomes (PROs) for lumbar degenerative conditions remains unclear. The goal of this study is to evaluate the association between wait times for elective lumbar spine surgery and post-operative PROs. Methods This study is a retrospective analysis of patients surgically treated for a degenerative lumbar conditions. Wait times were calculated from primary care referral to surgery, termed the cumulative wait time (CWT). CWT benchmarks were created at 3, 6 and 12 months. A multivariable logistic regression model was used to measure the associations between CWT and meeting the minimally clinically important difference (MCID) for the Oswestry Disability Index (ODI) score at 12 months post-operatively. Results A total of 2281 patients were included in the study cohort. The average age was 59.4 years (SD 14.8). The median CWT was 43.1 weeks (IQR 17.8 – 60.6) and only 30.9% had treatment within 6 months. Patients were more likely achieve the MCID for the ODI at 12 months post-operatively if they had surgery within 6 months of referral from primary care (OR 1.22; 95% CI 1.11 – 1.34). This relationship was also found at a benchmark CWT time of 3 months (OR 1.33; 95% CI 1.15 – 1.54) though not at 12 months (OR 1.08; 95% CI 0.97 – 1.20). Conclusions Patients who received operative treatment within a 3- and 6-month benchmark between referral and surgery were more likely to experience noticeable improvement in post-operative function.
An Evidence-Based Measure to Assess Self-Efficacy Among Adolescents With Type 1 Diabetes Mellitus in Jordan
Authors: Atiyeh Huda M. , AlOsta Mohammad R. , Othman Elham H. , Khirfan Randa Y. , Hamdan Falastine R. 
Published: September 2024

Purpose The purpose of the study was to assess self-efficacy among adolescents with type 1 diabetes mellitus and to identify its contributing factors using a new measure based on the International Society for Pediatric and Adolescent Diabetes Guidelines: the Type 1 Diabetes Mellitus Self-Efficacy Scale (T1DM-SES). Method A descriptive, cross-sectional design was used to collect data from 161 adolescents ages between 12 and 18 via an online questionnaire survey, including demographic and management-related variables and the 21 items of T1DM-SES. Results Results demonstrated that adolescents had high self-efficacy levels regarding the basic needs to manage their diabetes and relatively moderate and low levels regarding more sophisticated needs, such as adjusting insulin dose to correct fluctuated glucose levels, covering carbohydrates, and managing ketoacidosis at home. Adolescent females and adolescents who have working mothers or caregivers demonstrated higher levels of self-efficacy, whereas adolescents who have another family member with T1DM reported lower levels. Conclusion Assessing adolescents’ self-efficacy using evidence-based measures is crucial for informing health education plans. There should be a greater focus on acquiring the advanced knowledge and skills necessary for adolescents to manage the constantly evolving challenges of diabetes management. Access to health care and sufficient health insurance coverage that encompasses modern technology are fundamental for the effective management of T1DM.
Efficacy and safety of selexipag in patients with inoperable or persistent/recurrent CTEPH (SELECT randomised trial)
Authors: Kim Nick H. , Channick Richard , Delcroix Marion , Madani Michael , Pepke-Zaba Joanna , Borissoff Julian I. , Easton Valerie , Gesang Sophie , Richard Dominik , Ghofrani Hossein-Ardeschir 
Published: September 2024

BackgroundSELECT was the first global randomised controlled trial of selexipag with standard of care in patients with inoperable or persistent/recurrent chronic thromboembolic pulmonary hypertension.MethodsSELECT was a multicentre, randomised, double-blind, placebo-controlled, parallel-group, group-sequential, phase 3 study (ClinicalTrials.gov:NCT03689244). Adults aged ≤85 years in World Health Organization Functional Class I–IV, with a 6-min walk distance of 100–450 m, were randomised (1:1) to receive selexipag (200–1600 µg twice daily titration until individual maximum tolerated dose)+standard of care or placebo+standard of care. Patients were recruited into the haemodynamic set (first 91 randomised patients to undergo right heart catheterisation (RHC); week 20) or non-haemodynamic cohort (remaining patients, no RHC required). The primary end-point was percent of baseline pulmonary vascular resistance (PVR; week 20). Safety was also assessed.ResultsOf 321 patients screened, 128 were randomised (haemodynamic set n=91 (selexipag n=47; placebo n=44)). In the haemodynamic set, 29 (31.9%) patients had previous pulmonary endarterectomy (PEA), 20 (22.0%) balloon pulmonary angioplasty (BPA), and 14 (15.4%) both PEA and BPA; 28 (30.8%) were inoperable. The independent data monitoring committee recommended to stop the study for futility as no statistically significant difference was observed for the primary end-point (between-treatment geometric least squares mean ratio of PVR: 0.95, 95% CI 0.84–1.07; p=0.412). Adverse events were reported in 63 (98.4%) and 53 (82.8%) patients for selexipag and placebo, respectively.ConclusionsSELECT was discontinued for futility, as no treatment effect on the primary end-point (PVR) was observed. Safety data were consistent with the established safety profile of selexipag, with no new safety signals identified.