bluuebunny/crossref_metadata_2025_split huggingface dataset:
Development and internal validation of an artificial intelligence-assisted bowel sounds auscultation system to predict early enteral nutrition-associated diarrhoea in acute pancreatitis: a prospective observational study
Authors: Liu Chengcheng , Wu Li , Xu Rui , Jiang Zhiwei , Xiao Xiaoping , Song Nian , Jin Qianhong , Dai Zhengxiang 
Published: August 2024

Aims/Background An artificial intelligence-assisted prediction model for enteral nutrition-associated diarrhoea (ENAD) in acute pancreatitis (AP) was developed utilising data obtained from bowel sounds auscultation. This model underwent validation through a single-centre, prospective observational study. The primary objective of the model was to enhance clinical decision-making by providing a more precise assessment of ENAD risk. Methods The study enrolled patients with AP who underwent early enteral nutrition (EN). Real-time collection and analysis of bowel sounds were conducted using an artificial intelligence bowel sounds auscultation system. Univariate analysis, multicollinearity analysis, and logistic regression analysis were employed to identify risk factors associated with ENAD. The random forest algorithm was utilised to establish the prediction model, and partial dependence plots were generated to analyse the impact of risk factors on ENAD risk. Validation of the model was performed using the optimal model Bootstrap resampling method. Predictive performance was assessed using accuracy, sensitivity, specificity, positive predictive value, negative predictive value, and an area under the receiver operating characteristic (ROC) curve. Results Among the 133 patients included in the study, the incidence of ENAD was 44.4%. Six risk factors were identified, and the model's accuracy was validated through Bootstrap iterations. The prediction accuracy of the model was 81.10%, with a sensitivity of 84.30% and a specificity of 77.80%. The positive predictive value was 82.60%, and the negative predictive value was 80.10%. The area under the ROC curve was 0.904 (95% confidence interval: 0.817–0.997). Conclusion The artificial intelligence bowel sounds auscultation system enhances the assessment of gastrointestinal function in AP patients undergoing EN and facilitates the construction of an ENAD predictive model. The model demonstrates good predictive efficacy, offering an objective basis for precise intervention timing in ENAD management.
PERIPROSTHETIC JOINT INFECTION AND HETEROTOPIC OSSIFICATION AFTER TOTAL HIP ARTHROPLASTY: A NARRATIVE REVIEW
Authors: Pulik Ł. , Łęgosz P. , Brzóska E. , Mierzejewski B. , Grabowska I. , Ciemerych M. A. , Hube R. 
Published: August 2024

This meta analysis address the relationship between infection developing after total hip arthroplasty (THA) and heterotopic ossification (HO). To identify the gaps in available knowledge, we screened for full-length peer-reviewed research articles listed in PubMed, Embase, and Web of Science over the past 20 years. The following search terms and Boolean operators were used: heterotopic ossification AND infection AND (hip replacement OR hip arthroplasty). The search resulted in the identification of as few as 14 articles describing periprosthetic joint infection (PJI) and HO after THA. Data summarized from 6 studies suitable for further meta-analysis yielded a cumulative sample size of 753 observations, with 186 recorded events of HO. The pooled RR was estimated at 2.22 (95% CI: 1.00 to 4.91, p = 0.0497), suggesting a more than twofold risk of HO compared to the group without PJI. In conclusion, there is a clear association between a higher risk of HO and PJI. Basic research findings support the hypothesis that bacterial pathogen-associated molecular patterns (PAMPs) can lead to osteogenesis through a toll-like receptor (TLR) and nuclear factor kappa B (NF-κB) pathway in the course of HO development. Together, these results suggest that HO prophylaxis should always be prescribed in PJI after THA. Moreover, during revisions following THA for presumed non-septic reasons, the presence of HO warrants consideration for infection, as there is a potential heightened risk of pathologic ossification induced by PAMPs.Keywords: heterotopic ossification; total hip arthroplasty; total hip replacement; periprosthetic joint infection; bacteriaAuthors Ł. Pulik and P. Łęgosz contributed equally to this work.
PRIMARY TOTAL HIP ARTHROPLASTY USING CUSTOM-MADE ACETABULAR IMPLANTS IN PATIENTS WITH CROWE IV DEVELOPMENTAL DYSPLASIA OF THE HIP
Authors: Tikhilov R. M. , Bilyk S. S. , Dzhavadov A. A. , Shubnyakov I. I. 
Published: August 2024

Literature data show varying rates of aseptic loosening of standard hemispherical cups after primary total hip arthroplasty (THA) in patients with Crowe IV developmental dysplasia of the hip (DDH). In order to improve the results regarding the frequency of aseptic loosening of the acetabular component, we decided to use custom-made acetabular implants (CMAI) in this category of patients. The aim of our study was to report outcomes after primary THA using CMAI in patients with Crowe IV DDH.We retrospectively analyzed the results of primary THA using the CMAI in 58 hips. The mean follow-up period was 5.2 years (range 4.2 – 6.3).Patients demonstrated improved functional outcomes according to the Oxford Hip Score: preoperatively 16.9 and postoperatively 38.5 (P < 0.05). Revisions were performed in 2 cases due to dislocations, in 1 case due to nonunion of the greater trochanter and in 1 case due to chronic pain syndrome caused by contact of the CMAI flange with the iliopsoas muscle. In a patient with chronic pain syndrome, during the revision, the pubic flange of the CMAI, which was in contact with the iliopsoas muscle, was removed. There were no radiological signs of loosening of the CMAI.The use of CMAI shows good results in patients with DDH. Extended capability for supplementary screw fixation is an excellent feature of such implants, allowing them to obtain reliable primary fixation. Further observation is required to assess CMAI in the long-term follow-up.
COST ANALYSIS OF DIRECT ANTERIOR VERSUS DIRECT LATERAL APPROACH FOR OUTPATIENT TOTAL HIP ARTHROPLASTY
Authors: MacDonald S. J. , Lanting B. , Marsh J. , Somerville L. , Zomar B. , Vasarhelyi E. , Howard J. L. , McCalden R. W. , Naudie D. 
Published: August 2024

The increased demand for total hip arthroplasty (THA) is having a significant impact on healthcare resources, resulting in increased interest in outpatient care pathways to reduce resource consumption. This study compared costs between patients who underwent outpatient THA using a Direct Anterior (DA) approach compared to a Direct Lateral (DL) approach to understand the effect of surgical approach on resource use.We conducted a prospective randomized controlled trial for DA patients undergoing primary THA. We compared patients in the outpatient arm of the trial to a prospective cohort of outpatient DL approach THAs. We recorded all costs including: equipment, length of stay in hospital, and laboratory or other medical tests. Following discharge, participants also completed a self-reported cost diary recording resource utilization such as emergency department visits or subsequent hospitalizations, tests and procedures, consultations or follow-up, healthcare professional services, rehabilitation, use of pain medications, informal care, productivity losses and out of pocket expenditures.We report costs from both Canadian public health care payer (HCP) and a societal perspective. The HCP perspective includes any direct health costs covered by the publicly funded system. In addition to the health care system costs, the societal perspective also includes additional costs to the patient (e.g. physiotherapy, medication, or assistive devices), as well as any indirect costs such as time off paid employment for patients or caregivers.We included 127 patients in the DA group (66.6 years old) and 51 patients in the DL group (59.4 years old) (p<0.01).There were no statistically significant differences in costs between groups from both the healthcare payer (DA= 7910.19, DL= 7847.17, p=0.80) and societal perspectives (DA= 14657.21, DL= 14581.21, p=0.96)In patients undergoing a successful outpatient hip replacement, surgical approach does not have an effect on cost from in hospital or societal perspectives.
THE EFFECT OF CEMENTED FEMORAL COMPONENT DESIGN AND PROPHYLACTIC WIRE PLACEMENT AGAINST EARLY PERIPROSTHETIC FEMORAL FRACTURE IN PRIMARY TOTAL HIP ARTHROPLASTY: A BIOMECHANICAL STUDY
Authors: Perez S. F. Guarin , Zhao G. , Tsukamoto I. , Labott J. R. , Restrepo D. J. , Hooke A. W. , Zhao C. , Sierra R. J. 
Published: August 2024

Previous studies have highlighted differences in the risk of periprosthetic fracture between tapered slip (TS) and composite beam (CB) stems. This biomechanical study explored periprosthetic fractures around these stems and the effect of adding a 16-gauge calcar or diaphyseal wire to TS stems on their resistance to torque.A power analysis determined a sample size of 7 specimens per group, assuming a standard deviation of 14.8 Nm in peak torque, to provide 90% power to detect a difference of at least 30 Nm between groups. Twenty-one TS stems (eight alone, six with calcar wiring, seven with diaphyseal wiring placed 2 cm distal to the lesser trochanter) and seven CB stems were cemented into standard Sawbones. A servo-hydraulic test machine applied a 1000 N load with a 1-degree rotation per second until failure. The peak torque at failure was measured, and the fracture location recorded. Comparisons were performed using two-sample t-tests.CB stems exhibited a significantly higher peak torque at failure (205.3 Nm) than TS stems (159.5 Nm, p=0.020). Calcar-wire-TS (148.2 Nm, p=0.036) and diaphyseal-wire-TS (164.9 Nm, p=0.036) were both weaker than CB stems. Wired-TS stems showed no significant difference from non-wired-TS stems. Additionally, the study could not conclude that calcar wiring is stronger than diaphyseal wiring. All TS fractures occurred at the mid-stem, simulating a B-type fracture, while the addition of the diaphyseal wire shifted the fracture location more distally in four of seven stems (p=0.0699).This biomechanical study supports the clinical evidence that CB stems have stronger resistance to torque than TS stems and may explain lower risk of periprosthetic fracture. The addition of calcar or diaphyseal wires to TS stems resulted in no significant changes in peak torque to fracture. In patients at high risk of periprosthetic fracture, CB cemented stems should be considered.
LOW RISK OF CUP FIXATION FAILURE AT TEN YEARS USING CONSTRAINED LINER AT THE SAME TIME OF ACETABULAR COMPONENT REVISION
Authors: AlFayyadh F. , Neufeld M. E. , Howard L. C. , Masri B. A. , Greidanus N. V. , Garbuz D. 
Published: August 2024

There remains concern with the use of constrained liners (CL) implanted at the time of acetabular cup revision in revision total hip replacement (rTHA). The aim of this study was to determine the implant survival in rTHA when a CL was implanted at the same time as acetabular cup revision.We reviewed our institutional database to identify all consecutive rTHAs where a CL was implanted simultaneously at the time acetabular cup revision from 2001 to 2021. One-hundred and seventy-four revisions (173 patients) were included in the study. Mean follow-up of 8.7 years (range two – 21.7). The most common indications for rTHA were instability (35%), second-stage periprosthetic joint infection (26.4%), and aseptic loosening (17.2%).Kaplan Meier Analysis was used to determine survival with all-cause re-revision and revision for cup aseptic loosening (fixation failure) as the endpoints.A total of 32 (18.3%) patients underwent re-revision at a mean time of 2.9 years (range 0.1 – 14.1). The most common reasons for re-revision were instability (14), periprosthetic joint infection (seven), and loosening of the femoral component (four). Three (1.7%) required re-revision due to aseptic loosening of the acetabular component (fixation failure) at a mean of two years (0.1 – 5.1). Acetabular component survival free from re-revision due to aseptic loosening was 98.9% (95% CI 97.3 – 100) at five-years and 98.1% (95% CI 95.8 – 100) at 10-years. There were no acetabular component fixation failures in modern highly porous shells.CLs implanted at the time acetabular cup revision in rTHA have a 98.1% 10-year survival free from acetabular cup aseptic loosening (fixation failure). There were no cup fixation failures in modern highly porous shells. Thus, when necessary, implanting a CL during revision of an acetabular component with stable screw fixation is safe with an extremely low risk of cup fixation failure.
DELAYED GADOLINIUM-ENHACED MAGNETIC RESONANCE IMAGING OF CARTILAGE IS A PREDICTOR OF PERIACETABULAR OSTEOTOMY FAILURE IN PATIENTS 40 YEARS AND OLDER
Authors: Kim Y.-J. , Kiapour A. , Millis M. , Novais E. 
Published: August 2024

Pelvic osteotomies for hip dysplasia results can be variable and depend on the amount of preexisting arthritis. Delayed gadolinium-enhanced magnetic resonance imaging of cartilage (dGEMRIC) is a technique designed to measure early arthritis, and could be used to select hips that would benefit from a joint-preserving reconstructive procedure. Our objective was to investigate the role of preoperative dGEMRIC in predicting the success of PAO in patients 40 and above. We hypothesized that patients who failed had lower preoperative dGEMRIC index compared to those who did not.Following IRB approval, patients 40 or older who underwent PAO between 1990–2013 and had preoperative dGEMRIC scan and minimum follow-up of 4 years were identified. Patients with prior hip surgeries or any pathologies were removed leading to a total of 70 patients (Age: 44.2 ± 2.9 years old, BMI: 25.7 ± 4.5 Kg/m2). We only included the first hip undergoing PAO for those with bilateral PAO. Out of 70, 19 had failure defined by the need for total hip replacement or WOMAC pain score of 10 and above within 10 years after index PAO surgery. Articular cartilage was segmented on the 3D pre-operative dGEMRIC scan. The average thickness and dGEMRIC index across the whole articular surface were analyzed.Failed hips had a lower dGEMRIC index by 115 ± 20 ms (P<0.001). All but one failed hips had a dGMERIC index of 400 or less (range: 313 – 479 ms), while all survived hips had a dGMERIC index of greater than 400 (range: 403 – 691 ms). Similar trends were observed when comparing the dGEMRIC index within the 6 subgroups (P<0.01). There were no differences in cartilage thickness (combined femoral head and acetabular cartilage) between the failed and survived hips (p>0.2).Patients with a high dGMERIC index (indicating high GAG content) may have a higher chance of successful outcomes following PAO. Current efforts are underway to develop a multi-modal predictive model to evaluate risk of failure after PAO.
Superfine multiresonant fiber grating sensors assisted with silica capillaries
Authors: Li Kaiwei , Xiao Yongguang , Liu Fu , Yang Zhiyong , Yan Xiangyu , Li Zhaohui , Guo Tuan , Xiao Gaozhi George , Albert Jacques 
Published: August 2024

We propose and demonstrate a superfine multiresonant fiber grating sensor characterized by superior spectral resolution and enhanced sensing capabilities. This sensor can be easily constructed by inserting a tilted fiber Bragg grating (TFBG) probe into a silica capillary filled with a refractive index (RI) matching oil. As the fiber cladding, the RI-matching oil, and the capillary all have the same RI, the cladding modes excited by the TFBG can extend into the RI-matching oil and capillary, facilitating surface sensing outside the capillary. Our study shows that the number of cladding modes increases, and the resonance spectrum becomes denser as the outer diameter of the capillary gets larger. As a result, the detection accuracy of RI based on mode cutoff wavelength identification can be improved. Particularly, with a capillary diameter of 1 mm, the heightened spectral density enhances refractometric accuracy by nearly an order of magnitude compared to the intrinsic TFBG. The superfine multiresonant fiber grating sensor proposed here is flexible in configuration and easy to fabricate, providing a new strategy for developing new fiber sensing devices.
Reported healthcare-seeking of loiasis patients and estimation of the associated monetary burden in Gabon: Data from a cross-sectional survey
Authors: Veletzky Luzia , Schlicker Veronika , Hergeth Jennifer , Stelzl Daniel R. , Zoleko Manego Rella , Mombo-Ngoma Ghyslain , Eberhardt Kirsten Alexandra , McCall Matthew B. B. , Adegnika Ayôla A. , Lell Bertrand , Mordmüller Benjamin , Adegnika Scherif , Ramharter Michael , Budke Christine 
Published: August 2024

Background
Loiasis is a disease of relevance in endemic populations and there has been advocacy for its inclusion on the World Health Organization’s neglected tropical diseases list. As loiasis-related healthcare-seeking behaviors and related costs are unknown, we aimed to evaluate these aspects in a population residing in an endemic region in Gabon.

Methods
Data were collected during a community-based, cross-sectional study assessing the disease burden due to loiasis. Diagnostics for microfilaremia were performed and a history of eyeworm was obtained. In addition, a standardized questionnaire about type of healthcare resources and frequency of use, as well as respective associated costs was administered to each participant. Loiasis related healthcare-seeking behaviors were evaluated, and the associated monetary burden was estimated as a secondary outcome of the study.

Findings
Individuals diagnosed with loiasis more frequently reported any healthcare-seeking (OR 1.52 (95%CI: 1.21–1.91)), self-medicating (OR 1.62 (1.26–2.08)), inability to work (OR 1.86 (1.47–2.35)), and consulting with traditional healers (logOdds 1.03 (0.52–1.53)), compared to loiasis negative individuals. The most frequently reported treatment for the eyeworm was traditional herbs. The estimated healthcare associated costs, per positive individual, was US-$ 58 (95% CI: 21–101) per year, which would correspond to 3.5% of the reported mean household income. Extrapolation to the rural population of Gabon (n = 204,000), resulted in an annual monetary burden estimate of US-$ 3,206,000 (1,150,000–5,577,000).

Interpretation
Loiasis patients have demonstrated healthcare needs, often consulted traditional healers, and used traditional treatments for disease specific symptoms. Further, loiasis seems to be associated with substantial direct and indirect costs for individuals and thus may cause a relevant economic burden for endemic populations and economies of affected countries.
Effects of calcium channel blockers in patients with heart failure with preserved ejection fraction: A protocol for systematic review and meta-analysis
Authors: Fukuta Hidekatsu , Goto Toshihiko , Kamiya Takeshi 
Published: August 2024

Background
Nearly half of patients with heart failure (HF) have preserved ejection fraction (EF) and the mortality and morbidity of patients with HF with preserved EF (HFpEF) are high. Patients with HFpEF are often elderly and their primary chronic symptom is severe exercise intolerance. Due to the frequent coexistence of hypertension in HFpEF patients, the use of anti-hypertensive medications is common in their treatment. While many cohort studies and several randomized controlled trials (RCTs) have examined the effectiveness of various anti-hypertensive drugs such as beta-blockers and renin-angiotensin system inhibitors in HFpEF, the role of calcium channel blockers (CCBs) remains uncertain. Despite several RCTs and cohort studies exploring the effects of CCBs on prognosis and exercise capacity in HFpEF patients, the findings have been inconsistent, likely due to limited statistical power and/or variations in study design. Therefore, our aim is to conduct a systematic review and meta-analysis of studies on the effects of CCBs in these patients.

Methods
This meta-analysis will include RCTs and cohort studies on the effect of CCBs in HFpEF patients. Information of studies will be collected from PubMed, Web of Science, and Scopus. The primary outcome of interest will be prognosis. The secondary outcome of interest will be exercise capacity.

Discussion
Synthesizing our meta-analytical results with expert consensus could contribute to the formulation of updated clinical guidelines. Our systematic review and meta-analysis will provide directions for future research on the use of CCBs in HFpEF patients.

Systematic review registration
INPLASY202430097.
Population immunity to varicella in Canada: A Canadian Immunization Research Network (CIRN) study
Authors: Wright James , Crowcroft Natasha , McLachlan Elizabeth , Perez-Iratxeta Carol , Joh Eugene , Osman Selma , Hatchette Todd , Deeks Shelley L. , Wilson Sarah E. , Hughes Stephanie L. , Halperin Scott A. , Buchan Sarah A. , Ward Brian J. , Gubbay Jonathan , Brisson Marc , Serhir Bouchra , Severini Alberto , Bolotin Shelly 
Published: August 2024

Introduction
The incidence of varicella in Canada has decreased by almost 99% since vaccination was introduced. However, variation in the timing and eligibility of vaccination programs across the country has resulted in some cohorts being under-vaccinated and therefore potentially susceptible to infection.

Methods
We used nationally representative specimens from the Biobank of Statistics Canada’s Canadian Health Measures Survey (CHMS) as well as residual specimens from Ontario collected between 2009–2014 to estimate population immunity across age-groups and geography, and identify any groups at increased risk of varicella infection.

Results
The weighted proportion of specimens with antibody levels above the threshold of protection was 93.6% (95% CI: 92.4, 95.0). Protection was lowest among those aged 3–5 years (54.3%; 95% CI: 47.3, 61.4), but increased with age. Individuals born outside Canada had more than twice the odds of varicella susceptibility than those born in Canada (aOR: 2.7; 95% CI: 1.4, 5.0; p = 0.004). There were no differences by sex or geography within Canada, and there were no statistically significant differences when Ontario CHMS sera were compared to Ontario residual sera, apart from in participants aged 12–19 year age-group, for whom the CHMS estimate (91.2%; 95% CI: 86.7, 95.7) was significantly higher (p = 0.03) than that from residual specimens (85.9%, 95% CI: 81.1, 90.8).

Discussion
Varicella immunity in Canada is changing. Children appear to have low population immunity, placing them at greater risk of infection and at increased risk of severe disease as they age. Our results underscore the importance of performing periodic serosurveys to monitor further population immunity changes as the proportion of vaccine-eligible birth-cohorts increases, and to continually assess the risk of outbreaks.