bluuebunny/crossref_metadata_2025_split huggingface dataset:
Complications and revision rates after total shoulder arthroplasty are similar between patients with and without diabetes mellitus
Authors: Sanii Ryan , Kasto Johnny , Castle Joshua P , Jay Jordan , Burdick Gabriel , Muh Stephanie J 
Published: September 2024

Purpose There is wide variability in the conclusions of studies examining the effects of diabetes mellitus (DM) on outcomes of shoulder arthroplasty (SA). The objective of this study was to determine if there are differences in complication profiles between patients with DM and those without undergoing anatomic and reverse total SA. Methods A retrospective review of patients undergoing SA in a single center from January 2014 to December 2019 was performed. Patients were then stratified into two cohorts, patients with controlled DM (mean hemoglobin A1C < 7%) and those without. Outcomes analyzed included intraoperative complications, postoperative complications, and revision surgery rates. Emergency department (ED) visits and hospital readmissions within 30 days were also recorded. Results A total of 595 patients underwent SA. No significant difference was found between the diabetes ( n = 151) and control group ( n = 444) with regard to length of stay ( P = .168), complications ( P = .286), infection rate ( P = .977), 30-day ED visits ( P = .789), and readmissions ( P = .230). The average time to revision was 26.8 months in the diabetes group and 26.6 months in the control group ( P = .989). Conclusions Following SA patients with controlled DM showed no increased risk of postoperative infection, ED visitation,hospital readmission, and revision surgery rate when compared to non-diabetics. Level of evidence Level III—retrospective cohort.
ChatGPT provides acceptable responses to patient questions regarding common shoulder pathology
Authors: Ghilzai Umar , Fiedler Benjamin , Ghali Abdullah , Singh Aaron , Cass Benjamin , Young Allan , Ahmed Adil Shahzad 
Published: September 2024

Background ChatGPT is rapidly becoming a source of medical knowledge for patients. This study aims to assess the completeness and accuracy of ChatGPT's answers to the most frequently asked patients’ questions about shoulder pathology. Methods ChatGPT (version 3.5) was queried to produce the five most common shoulder pathologies: biceps tendonitis, rotator cuff tears, shoulder arthritis, shoulder dislocation and adhesive capsulitis. Subsequently, it generated the five most common patient questions regarding these pathologies and was queried to respond. Responses were evaluated by three shoulder and elbow fellowship-trained orthopedic surgeons with a mean of 9 years of independent practice, on Likert scales for accuracy (1–6) and completeness (rated 1–3). Results For all questions, responses were deemed acceptable, rated at least “nearly all correct,” indicated by a score of 5 or greater for accuracy, and “adequately complete,” indicated by a minimum of 2 for completeness. The mean scores for accuracy and completeness, respectively, were 5.5 and 2.6 for rotator cuff tears, 5.8 and 2.7 for shoulder arthritis, 5.5 and 2.3 for shoulder dislocations, 5.1 and 2.4 for adhesive capsulitis, 5.8 and 2.9 for biceps tendonitis. Conclusion ChatGPT provides both accurate and complete responses to the most common patients’ questions about shoulder pathology. These findings suggest that Large Language Models might play a role as a patient resource; however, patients should always verify online information with their physician. Level of Evidence Level V Expert Opinion.
Reconstruction of Maxillary Bone Defects With Cellular Bone Matrix Allografts
Authors: Marschall Jeffrey S. , Davis Stephen S. , Rysavy Oscar , Kushner George M. 
Published: September 2024

Study Design Retrospective Cohort Study. Objective Reconstruction of maxillary bone defects can be completed with vascularized and non-vascularized autografts. Cellular bone matrix allografts (CBMs), which have lineage committed bone cells, has risen as an alternative. The purpose of this study was to describe our experience and to determine the success of CBM based maxillary reconstruction in a variety of clinical scenarios. Methods A retrospective cohort study was designed and implemented using data from subjects who presented to the University of Louisville and were treated with a CBM for maxillary reconstruction from 2019 to 2023. Subjects were excluded if they were not treated with a CBM, data were not complete, or postoperative follow-up time was less than 3 months. Descriptive statistics were calculated for each variable. To measure the associations between the risk factors and graft success, Fisher’s exact test was implemented. A P-value of <0.05 was considered significant. Results The sample included 48 subjects. The mean age of all subjects was 43 ± 24 years. Overall, 42 (87.5%) cases were successful. The perioperative antibiotic administered ( P = 0.02), etiology ( P = 0.021), and the addition of platelet rich fibrin or autograft as an adjunct influenced CBM success ( P = 0.039). Conclusions CBMs are a viable option for reconstruction of maxillary bone defects. CBMs may be an alternative to autografts.
Demographic and clinical associations of autoimmune diseases in rheumatoid arthritis patients: Insights from a tertiary care hospital in Saudi Arabia from 2019 to 2023
Authors: Alghofaili Nouf , Ismail Samaher , Aladnani Abdullah , Alfarsi Abdullah , Aqabawi Sally , Shahat Ghofran , Zakariyah Abeer , Alhazmi Ahmed , Albeshri Tariq 
Published: September 2024

Background: Rheumatoid arthritis is a severe inflammatory arthritis that causes irreversible damage to joints and bones, resulting in deformities and disabilities. Population-based studies on the co-occurrence in patients with rheumatoid arthritis are lacking despite shared mechanisms with other autoimmune diseases. Objectives: This study aimed to determine the prevalence and association of autoimmune diseases among patients with rheumatoid arthritis and explore the associations between autoimmune diseases and treatment options for rheumatoid arthritis. Method: This retrospective study was conducted from 2019 to 2023 at King Fahad Armed Forces Hospitals, Jeddah, Saudi Arabia. Data were cleaned in Excel and analyzed using IBM SPSS version 29. The activity of the disease was assessed through clinical manifestations, laboratory findings, and its associations with other autoimmune diseases. Results: Our study included 365 patients with rheumatoid arthritis, predominantly female (89%), and observed diverse demographics and comorbidities. Prevalent conditions included diabetes mellitus (28.2%), hypertension (27.3%), and dyslipidemia (14.7%). Other autoimmune diseases were present in 24.9% of patients, with notable associations with age at rheumatoid arthritis diagnosis and endocrine, rheumatology/dermatology, and pulmonary disorders ( p < 0.001). Treatment approaches varied, with prednisolone (24.4%) and methotrexate (55.1%) being predominant. No significant associations were observed between autoimmune disorders and specific treatment modalities ( p > 0.05). Conclusion: Our study provides a thorough overview of rheumatoid arthritis in a large cohort, revealing demographic trends, comorbidities, autoimmune disease prevalence, treatment preferences, and associations. Relationships with age at rheumatoid arthritis diagnosis and other autoimmune diseases were noted. Treatment approaches varied, with no significant associations between autoimmune disorders and specific modalities.
Present state and perceived future use of teledentistry in long-term care facilities in Japan: A cross-sectional study
Authors: Okumura Takuma , Nakagawa Kazuharu , Yoshimi Kanako , Saito Mitsuko , Ito Kayoko , Itoda Masataka , Takeuchi Kenji , Mizutani Shinsuke , Yoshida Mitsuyoshi , Watanabe Yutaka , Tohara Haruka 
Published: September 2024

Objectives Teledentistry could be effective in managing oral health through the provision of oral hygiene instruction and diagnostic services. This study aimed to assess the perception and usefulness of teledentistry in Japanese long-term care facilities. Methods We conducted a questionnaire survey to compare related factors of the usefulness of teledentistry and identify issues in its implementation. We chose 1000 facilities using a stratified random sampling method. The questionnaires were sent to the facilities in August 2021 and collected in December of the same year. Responses to the questionnaire items regarding the usefulness of teledentistry for oral management were divided into three groups according to the answer: perceiving teledentistry as “useful,” “not useful,” or “neither,” including facilities that do not currently use teledentistry. Results In total, 26.1% (261) responded to the questionnaire, and among these, 184 facilities answered the question regarding the usefulness of teledentistry. Only two of these facilities implemented teledentistry. Facilities with dental hygienists ( p = 0.040) and those that receive insured medical treatment: reimbursement for oral feeding maintenance II ( p = 0.040) tended to perceive teledentistry as useful in the management of patients with coronavirus disease. The higher the number of services that responded to the question “what kind of services do you think can be provided via teledentistry?” the higher the percentage of “useful” responses. Conclusions Although only a few facilities use teledentistry, many long-term care facilities perceive it as useful even without using it. The presence of dental hygienists and interprofessional work done with reimbursement for oral feeding maintenance II contributed to the perception of the usefulness of teledentistry in long-term care facilities.
Sleep well, worry less: A co-design study for the development of the SMILE app
Authors: Cormier Marcus , Orr Matt , Kaser Alanna , MacDonald Hannah , Chorney Jill , Meier Sandra 
Published: September 2024

Objective With the coronavirus disease 2019 pandemic exacerbating mental health concerns, the prevalence rates of anxiety and sleep problems have increased alarmingly among youth. Although 90% of patients with anxiety experience sleep problems, current interventions for anxiety often do not target sleep problems in youth. Given this lack, we designed the SMILE app, an intervention that addresses both anxiety and sleep problems simultaneously. Methods As users’ perspectives are essential to ensure app engagement and uptake, the features, designs, and functions of the SMILE app were evaluated using a participatory app design approach. Participants ( N = 17) were youth aged 15 to 25 who reported co-morbid anxiety and sleep issues above clinical thresholds. After completing an online screening survey assessing demographics, anxiety, and sleep problems, participants shared app feedback through group-based, semi-structured co-design sessions. Qualitative analyses were conducted to identify common themes from participants’ feedback. Results While participants expressed enthusiasm for the SMILE app's features, particularly the Visualization, Journaling, and Psychoeducation features, and their variety, they criticized the design aspects of the app, such as the font and text amount. Most participants stated they would use the SMILE app or recommend it to a friend. Conclusion By actively involving the target population in the design process, the SMILE app has the potential to notably improve the mental well-being of youth, though further research and development are required to realize this potential fully.
Transformation in marginal zone lymphoma: results from a prospective cohort and a meta-analysis of the literature
Authors: Bommier Côme , Link Brian K. , Gysbers Brianna J. , Maurer Matthew J. , Larson Melissa C. , Khurana Arushi , Wang Yucai , Thompson Carrie A. , Chihara Dai , Alderuccio Juan P. , Koff Jean L. , Epperla Narendranath , Conconi Annarita , Lossos Izidore S. , Nowakowski Grzegorz S. , Feldman Andrew L. , Habermann Thomas M. , King Rebecca L. , Cerhan James R. 
Published: September 2024

Abstract
Marginal zone lymphoma (MZL) includes extranodal MZL (EMZL), splenic MZL (SMZL), and nodal MZL (NMZL) subtypes. Histologic transformation (HT) to large B-cell lymphomas is well documented but with a large variability in published cumulative incidence rates. We report results from the Molecular Epidemiology Resource (MER) cohort on the cumulative incidence of HT (with death as competing risk) and the associated risk factors and outcomes. We also conducted a meta-analysis of available studies on the cumulative incidence of HT. From 2002 to 2015, 529 patients with MZL were enrolled in the MER study (69% EMZL, 16% SMZL, and 15% NMZL). The 10-year overall survival (OS) from diagnosis was 66%. HT occurred in 21 patients with a 5-year and 10-year cumulative incidence of 2.7% (95% confidence interval [CI], 0.02-0.05) and 3.6% (95% CI, 0.02-0.06), respectively. HT was associated with an increased risk for death (subdistribution hazard ratio [HR], 3.95; 95% CI, 2.06-7.55). Predictors of HT were ≥2 extranodal sites and mucosa-associated lymphoid tissue International Prognostic Index score ≥2. The OS was 79% at 5 years and 55% at 10 years after HT. In the meta-analysis of 12 studies (6161 patients), the 5- and 10-year cumulative incidence of HT across all subtypes were 5% (95% CI, 0.05-0.06) and 8% (95% CI, 0.07-0.09), respectively. These rates were lower in EMZL (3% and 5%) than in SMZL (7% and 13%) and NMZL (9% and 13%). Although HT is relatively uncommon in the first decade after MZL diagnosis, it is associated with an inferior outcome and needs new approaches for prevention and management.
Outcomes in children with provoked venous thrombosis and antiphospholipid antibodies: findings from the Kids-DOTT trial
Authors: Betensky Marisol , Mosha Maua , Tarango Cristina , Verma Anupam , Bhat Rukhmi , Kucine Nicole E. , Nakano Taizo , Nakar Charles , Woods Gary , Amankwah Ernest , Brandão Leonardo R. , Schulman Sam , Goldenberg Neil A. 
Published: September 2024

Abstract
Few studies have prospectively evaluated the incidence and outcomes in children with provoked venous thromboembolism (VTE) and transient or persistent antiphospholipid antibodies (aPLs). We compared outcomes of patients aged &lt;21 years with a first-episode acute provoked VTE and positive aPL at diagnosis, enrolled in the Multicenter Evaluation of the Duration of Therapy for Thrombosis in Children trial. aPLs were tested at enrollment and, when positive, repeated at 6 weeks after VTE diagnosis. Subsequent testing was performed at the discretion of the treating hematologist. Of 524 patients, 116 (22%) had positive aPLs at enrollment. At follow-up, 70 (60%) had transient (n = 66) or low-titer aPLs (n = 4), 11 (10%) had persistent aPLs meeting the criteria for antiphospholipid antibody syndrome (APS), and 35 (30%) had no repeat testing. Patients with APS were older (15.8 vs 9.9 years; P = .014) and had a statistically significant higher risk of symptomatic recurrent VTE (18% vs 1%; odds ratio [OR], 12.2; 95% confidence interval [CI], 1.4-108; P = .025) and a statistically nonsignificant but clinically meaningful difference in the risk of anticoagulant-related clinically relevant bleeding (9% vs 0%; OR, 20.1; 95% CI, 0.7-558; P = .077) compared with those in the transient or low-titer aPL group. In conclusion, aPLs are common in young patients with acute provoked VTE and are mostly transitory and clinically insignificant. Patients with APS and provoked VTE appear to have an increased risk of recurrent VTE compared with patients with transitory or low-titer aPLs. Future collaborative studies should investigate the optimal VTE management for children with provoked VTE who meet the criteria for APS. The trial was registered at www.ClinicalTrials.gov as #NCT00687882.
Pulsed Unipolar-Polarisation Plasma Electrolytic Polishing of Ni-Based Superalloys: A Proof of Conception
Authors: Zhou Chuanqiang , Qian Ning , Su Honghua , He Jingyuan , Ding Wenfeng , Xu Jiuhua 
Published: September 2024

AbstractThe enhanced performance of aerospace equipment drives parts development towards integration, complexity, and structural optimization. This advancement promotes metal near-net fabrication technologies like wire electrical discharge machining (WEDM) and 3D printing. However, the high initial surface roughness from WEDM or 3D printing poses significant challenges for the high-performance surface finishing required. To effectively reduce the surface roughness of the workpieces with high initial surface roughness, this paper proposes pulsed unipolar-polarisation plasma electrolytic polishing (PUP-PEP). The study examined the material removal mechanisms and surface polishing quality of PUP-PEP. This technique combines the high current density and material removal rate of the electrolytic polishing mode with the superior surface polishing quality of PEP through voltage waveform modulation. For an Inconel-718 superalloy part fabricated by WEDM, PUP-PEP reduced surface roughness from Ra 7.39 μm to Ra 0.27 μm in 6 min under optimal conditions. The roughness decreased from Ra 7.39 μm to Ra 0.78 μm in the first 3 min under pulsed unipolar-polarisation voltage, resulting in a remarkable 233% increase in efficiency compared to that with conventional PEP. Subsequently, the voltage output voltage is transformed into a constant voltage mode, and PEP is continued based on PUP-PEP to finally reduce the workpiece surface roughness value to Ra 0.27 μm. The proposed PUP-PEP technology marks the implementation of ‘polishing’ instead of conventional rough-finish machining processes, presenting a new approach to the surface post-processing of metal near-net fabrication technologies.
Assessment of prolonged safety and tolerability of erenumab in migraine patients in a long-term open-label study (APOLLON)
Authors: Göbel Hartmut , Schlegel Eugen , Jaeger Kathrin , Ortler Sonja , Leist Lea 
Published: September 2024

Abstract
Background
Efficacy and safety of human monoclonal antibody erenumab used for migraine prophylaxis have been shown in clinical studies. APOLLON is an open-label, multi-center, single arm study, which permits dose adjustments of erenumab and includes an option for a drug holiday. The findings contribute to the accumulating long-term evidence regarding erenumab’s tolerability and safety profile in individuals experiencing episodic and chronic migraines.

Methods
The study population consisted of adult patients with episodic or chronic migraine, who had successfully completed the HER-MES study (NCT03828539). Patients were treated with erenumab for 128 weeks at a flexible dose of either 70 mg or 140 mg. Treatment discontinuation attempts were allowed as voluntary single treatment interruption (‘drug holiday’) of up to 24 weeks.

Results
701 patients were enrolled in APOLLON. The exposure associated incidence rate (EAIR) of adverse events (AEs) (N = 601) per 100 subject years was 101.71 (95% CI [92.28; 111.14]) meaning a patient could expect having about one adverse event per each year of treatment. EAIR was higher in females (n = 524, EAIR: 104.40, 95% CI [93.93; 114.86]) than in males (n = 77, EAIR: 86.55, 95% CI [65.39; 107.71]) and increased with initial monthly migraine days (MMD) and prior prophylactic treatment failures. A total of 155 patients discontinued erenumab treatment during open-label treatment phase. Of these, 29 were due to AEs (4.1% of total cohort) and out of these 65.5% (N = 19) were considered treatment-related. Safety parameters were in line with HER-MES data and did not reveal new safety signals. Drug holidays were realized by 108 patients (15.4%), of which 64.8% (N = 70) returned to treatment. The mean number of monthly headache days (MHDs), MMDs, and days with acute headache medication significantly increased during drug holiday. After resumption of erenumab treatment, a rapid reduction of the migraine parameters was observed.

Conclusions
APOLLON provides long-term safety and tolerability data confirming the beneficial safety profile of erenumab over a period of 128 weeks. In addition, reversibility of migraine deterioration during drug holiday was shown and most patients returned to their treatment with similar response rates compared to initial treatment.

Trial registration
ClinicalTrials.gov ID: NCT04084314 (https://clinicaltrials.gov/study/NCT04084314), First submitted: 2019-09-06.
Empowering vision: the impact of nursing-led educational program on patients with dry eye syndrome
Authors: Rabie Emad Abd El Gawad Ali , ElRazkey Jehan Y. , Ahmed Heba Abdelmowla 
Published: September 2024

Abstract
Background
Dry eye syndrome (DES) is a widespread ocular condition affecting the general population. It is a complex disorder affecting the eye surface, characterized by a tear film imbalance and ocular symptoms such as eye ache, burning, irritation, dryness, blurred vision, and foreign body sensation. DES can reduce visual acuity, increase the risk of ocular infection, and significantly impact daily activities and quality of life.

Aim
Determine the impact of nursing-led educational program on the management of DES and patients’ health outcomes including the intensity of DES symptoms and their influence on visual-related functions.

Methods
The study was conducted with a quasi-experimental design. Sixty adult patients diagnosed with DES were selected using a convenience sampling method. Two tools were employed for the collection of data. Tool I: Precipitating factors of DES structured interview schedule. Tool II: Ocular surface disease index (OSDI) to assess ocular irritation symptoms associated with DES and their effect on functions related to vision.

Results
A statistically significant decrease in the mean scores of OSDI in the study group two weeks after the implementation of the educational program regarding the ocular symptoms, functions associated with vision, environmental triggers, and overall score of OSDI.

Conclusion
Implementing an educational program for DES is effective in relieving symptoms, boosting patients’ understanding of managing symptoms effectively, and maintaining eye health. Therefore, patients must be instructed on dry eye early detection and management to enhance health-related outcomes and self-care practices.

Registration
ClinicalTrials.gov: NCT06288945.