bluuebunny/crossref_metadata_2025_split huggingface dataset:
Orthognathic Surgery Rates in Furlow Double-Opposing Z-Plasty Versus Straight-Line Repair: A Review of Three Decades of Experience
Authors: Lasky Sasha , Moshal Tayla , Jolibois Marah , Roohani Idean , Manasyan Artur , Husain Fatemah , Harris Samuel , Nagengast Eric S. , Urata Mark M. , Magee William P. , Hammoudeh Jeffrey A. 
Published: August 2024

Objective The influence of different surgical techniques on maxillary growth remains unclear. This study investigates the long-term impact of Furlow double-opposing Z-plasty versus straight-line repair (SLR) techniques on midface growth and subsequent orthognathic surgery. Design Retrospective cohort study. Setting Tertiary children's hospital. Patients/participants This study evaluated patients who underwent primary palatoplasty with Furlow or SLR techniques from 1994–2023. Patients were >14 years old at their most recent follow-up. Interventions No interventions were performed. Main Outcome Measure(s) Primary outcomes were orthognathic surgery and orthognathic surgery recommendation rates to correct midface hypoplasia (MFH). Cephalometrics at the time of orthognathic surgery recommendation were traced to validate MFH. Results In total, 1857 patients underwent palatoplasty, of which 335 met inclusion criteria (49 SLR, 286 Furlow). Average age at last follow-up was 18.5±2.6 years. Patients who underwent Furlow versus SLR showed no significant difference in orthognathic surgery rates (p=0.428) or recommendation for orthognathic surgery rates (p=0.900). Patients recommended to undergo orthognathic surgery had more negative ANB angles (p<0.001) and smaller SNA angles (p<0.001) than patients not recommended for orthognathic surgery, demonstrating maxillary hypoplasia. Upon multivariate regression, patients with Veau III and IV clefts had an increased need for orthognathic surgery, p=0.047 and p=0.008, respectively. Conclusions Our findings suggest that higher cleft severity contributes to future orthognathic surgery. However, palatoplasty technique did not influence orthognathic surgery rates. Our results provide valuable data when surgeons are considering the impact of palatoplasty technique on sagittal growth restriction.
Predictive Role of Elevated Neutrophil-Lymphocyte Ratio for Bone Metastasis in Esophageal Cancer
Authors: Wang Xuan , Gao Ying , Wang Junyang , Chen Ling , Zhang Xin , Chen Min , Lan Ning , Li Wenyang , Wu Fang , Ren Juan 
Published: August 2024

Purpose Research on bone metastasis in esophageal cancer (EC) is relatively limited. Once bone metastasis occurs in patients, their prognosis is poor, and it severely affects their quality of life. Currently, there is a lack of convenient tumor markers for early identification of bone metastasis in EC. Our research aims to explore whether neutrophil-lymphocyte ratio (NLR) can predict bone metastasis in patients with EC. Methods Retrospective analysis of clinical indicators was performed on 604 patients with EC. They were divided into groups based on whether or not there was bone metastasis, and the patients’ coagulation-related tests, blood routine, tumor markers and other indicators were collected. The receiver operating characteristic curve (ROC) were used to determine the predictive ability of parameters such as NLR for bone metastasis in EC, and univariate and multivariate logistic regression analyses were conducted to determine the impact of each indicator on bone metastasis. Using binary logistic regression to obtain the predictive probability of NLR combined with tumor markers. Results ROC curves analysis suggested that the area under the curve (AUC) of the NLR was 0.681, with a sensitivity of 79.2% and a specificity of 52.6%, which can be used as a predictive factor for bone metastasis in EC. Multivariate logistic regression analysis showed that high NLR (odds ratio [OR]: 2.608, 95% confidence interval [CI]: 1.395-4.874, P = 0.003) can function as an independent risk factor for bone metastasis in patients with EC. Additionally, high PT, high APTT, high FDP, high CEA, high CA724, low hemoglobin, and low platelet levels can also predict bone metastasis in EC. When NLR was combined with tumor markers, the area under the curve was 0.760 (95% CI: 0.713-0.807, P < 0.001), significantly enhancing the predictability of bone metastasis in EC. Conclusion NLR, as a convenient, non-invasive, and cost-effective inflammatory indicator, could predict bone metastasis in EC. Combining NLR with tumor markers can significantly improve the diagnostic accuracy of bone metastasis in EC.
LncRNA NONHSAT227443.1 Confers Esophageal Squamous Cell Carcinoma Chemotherapy Resistance by Activating PI3K/AKT Signaling via Targeting MRTFB
Authors: Wang Yuchen , Wang Yingying , Zhang Jinze , Shi Zhihua , Liu Junfeng 
Published: August 2024

Introduction Esophageal cancer presents significant challenges due to limited treatment options and poor prognosis, particularly in advanced stages. Dysregulated long non-coding RNAs (lncRNAs) are implicated in cancer progression and treatment resistance. This study investigated the roles of dysregulated lncRNA NONHSAT227443.1, identified through lncRNA-seq, and its downstream target gene MRTFB in esophageal squamous cell carcinoma (ESCC). Methods Dysregulated lncRNAs were identified through lncRNA-seq in esophageal cancer tissues with varying chemotherapy response. The regulatory interaction of overexpressed NONHSAT227443.1 was assessed using quantitative real-time polymerase chain reaction (qRT-PCR) and western blotting. Functional assays, including cell viability, cell proliferation, and flow cytometry analyses, were performed to comprehensively investigate the influence of NONHSAT227443.1 and its downstream molecules on ESCC. Results NONHSAT227443.1 was significantly overexpressed in paclitaxel plus platinum chemotherapy non-responders and esophageal cancer cell lines. Chemotherapy exposure led to diminished NONHSAT227443.1 expression. NONHSAT227443.1 negatively regulated MRTFB expression, and their combined dysregulation correlated with increased cancer activity, proliferation, and suppressed apoptosis. Diminished MRTFB expression was associated with PI3K/AKT pathway activation. Conclusion Our study provides insights into NONHSAT227443.1 and MRTFB roles in esophageal cancer, contributing to aggressive traits and treatment resistance. NONHSAT227443.1 and MRTFB may serve as potential therapeutic targets to enhance the response to paclitaxel plus platinum chemotherapy in non-responsive cases.
Intraluminal crossing of infrainguinal SFA chronic total occlusions may offer patency superiority compared to subintimal crossing
Authors: Camazine Maraya , Coorts Jack , Christian Terrell , Schlesselman Chase , Kruse Robin L. , Bath Jonathan , Vogel Todd R. 
Published: August 2024

Objectives Patency for chronic total occlusions (CTO) of the superficial femoral artery (SFA) after endovascular interventions traditionally demonstrate a low 1-year patency ranging from 40%–60%. The optical coherence tomography (OCT) catheter (Avinger Inc., Redwood City, CA) uses light-based technology imaging to cross Trans-Atlantic Inter-Society Consensus D (TASC D) lesions intraluminally with direct intra-arterial visualization. Insufficient data exist evaluating intraluminal crossing with OCT imaging compared with traditional subintimal techniques. We evaluated outcomes for TASC D lesions crossed intraluminally. Methods A retrospective analysis of patients with SFA TASC D lesions crossed intra-arterially with the OCT catheter imaging. Descriptive statistics evaluated patient characteristics which included patient demographics, Rutherford scores, ABIs, CTA information, lesion categorization, as well as runoff score. Patency at baseline, 30-day, 6-month, and 1-year outcomes were compared using t-tests. Cumulative patency rates were evaluated using Kaplan–Meier analysis. Results 101 patients underwent elective intervention for SFA TASC D lesions with the OCT catheter. The crossing rate was 78.2%, mean lesion length was 16.2 cm, and runoff at the tibial level was 2.2 patent vessels. Mean age and BMI were 64 years and 29 kg/m2, respectively. Patient characteristics are male (57%); Caucasian (90%); ever smoking (85%); hypertension (82%), hyperlipidemia (70%), and diabetes (46%). Pre-operative computed tomography demonstrated SFA lesions were predominantly eccentric (91%) with mild to moderate calcification (90%). All underwent PTA, 87% were stented (mean stent length: 186.1 mm), mean crossing time was 13.4 min. Pre-operative, 30-day, 6-month, and 1-year post-operative mean Rutherford–Becker scores were 4, 1, 1, and 1, respectively ( p < 0.0001). Mean pre-operative ABI was 0.49, compared to 0.84 at 30 days, 0.64 at 6 months, and 0.67 at 1 year ( p < .0001). Duplex demonstrated 6- and 12-month primary patency of 89% and 75%; primary-assisted patency was 94% and 84%. Conclusions The OCT imaging catheter successfully crossed long chronic total occlusions of the SFA using direct intra-arterial imaging. Compared to subintimal techniques, patients had high 1-year primary patency and prolonged symptom improvement with intraluminal crossing. These data suggest that intraluminal crossing of TASC D lesions may be superior to traditional subintimal crossing techniques.
Investigation of the effect of adhesive type for ballistic armor applications
Authors: Tekin Başer Tuğçe , Karataş Çetin , Karadağlı Emirhan , Toksoy Ahmet Kaan 
Published: August 2024

Functional optimization is necessary in ballistic armor applications to overcome threat penetration. Multi-layer armor systems have been developed by combining several types of material to achieve high-performance protection. One of the most effective ways of building layered structures is application of adhesive in between intermediate layers. In this present study, five different commonly used adhesives have been used for determination of effect of the mechanical properties on ballistic protection. Tensile and bending test samples were prepared and tested to characterize their mechanical properties. Furthermore, armor plates were prepared by bonding 99.7% pure hexagonal alumina ceramic tiles together with the Al6061 backing plate. Prepared armor plates were ballistically tested by using STANAG 4569 Level three threat 7.62 mmx54R B32 (854 ± 20 m/s) ammunition. The tensile stress and impedance ratio of the adhesive layer are directly correlated. In the polyurethane-based adhesive, the mechanical impedance ratio was calculated as the highest value. In addition, higher back plate deformation was caused by low toughness and flexural stress. The ratio of adhesive flexural stress to tensile stress affected ballistic efficiency, so when the ratio was less than 2.5, partial penetration was observed. Tensile and flexural stress values are found associated with impedance ratio, playing a crucial role in elastic energy absorption during the impact. Also, ballistic impact-induced damage mechanisms were observed and correlated with adhesive toughness and flexural stress. Furthermore, damage area of each type of armor plates was associated with ratio between tensile and flexural stresses of adhesives.
Predicting dementia in Parkinson's disease on a small tabular dataset using hybrid LightGBM–TabPFN and SHAP
Authors: Tran Vinh Quang , Byeon Haewon 
Published: August 2024

Objective This study aims to create a robust and interpretable method for predicting dementia in Parkinson's disease (PD), especially in resource-limited settings. The model aims to be accurate even with small datasets and missing values, ultimately promoting its use in clinical practice to benefit patients and medical professionals. Methods Our study introduces LightGBM–TabPFN, a novel hybrid model for predicting dementia conversion in PD. Combining LightGBM's strength in handling missing values with TabPFN's ability to exploit small datasets, LightGBM–TabPFN outperforms seven existing methods, achieving outstanding accuracy and interpretability thanks to SHAP analysis. This analysis leverages data from 242 PD patients across 17 variables. Results Our LightGBM–TabPFN model significantly outperformed seven existing methods. Achieving an accuracy of 0.9592 and an area under the ROC curve of 0.9737. Conclusions The interpretable LightGBM–TabPFN with SHAP signifies a significant advancement in predictive modeling for neurodegenerative diseases. This study not only improves dementia prediction in PD but also provides clinical professionals with insights into model predictions, offering opportunities for application in clinical settings.
A Panel Analysis of the Impact of EBITDA, Equity Book Values, Growth, Risk and Negative Earnings on Share Price Variations
Authors: Nhleko Ronald , Schutte Daniel 
Published: August 2024

This study was motivated by the recent prevalence of valuation professionals utilizing EBITDA measures as part of their equity valuation strategies. To examine the impact of such valuation measures on share price variations, we developed a variant of the Ohlson valuation model that relates EBITDA, equity book values, growth, risk and negative earnings to share prices. We validated this relationship by utilizing the complete time-series data of the largest companies listed on the Johannesburg Stock Exchange from 1994 to 2017. We found that our model specification accounted for over 87% of the variance in the logarithmic-transformed share prices. Furthermore, the response coefficients for each explanatory variable were statistically significant, regardless of whether companies or sectors were incorporated as cross-sections. These findings have several significant empirical implications. Firstly, they demonstrate that EBITDA and equity book value variables significantly impact share price variations. Secondly, they lend credence to the hypotheses that growth and risk factors impact share price variations, and that negative earnings are value relevant. Ultimately, these findings constitute conclusive evidence of the empirical validity of the model specification we posit. JEL classification codes: G10, G12, G14, G11, G32, M41.
Aging With Grace: The Quest for Integrated, Compassionate Care for Older Adults
Authors: Romem Anat , Zalcman Beth G. , Katz Emilia , Prager Tal 
Published: August 2024

Introduction This Practice Update discusses the potential for implementation of the 4M model for care of older adults in Israel, to complement the medical-centric model that exists today. The older adult population in Israel is increasing. However, efficient and sufficient care that takes patient's wishes into consideration is lacking. Purpose Care of older adults, particularly palliative patients, is complex and requires multidisciplinary efforts. There are numerous challenges to caring for older adults. These include fragmentation of care, unclear boundaries between palliative and geriatric care, and the preservation of patient autonomy, indicating a need to adopt new care frameworks. Conclusion The authors suggest implementing the 4M model as a new care framework in addition to the current medical-centric model. This framework considers important care aspects during discussions of care: what matters to the patient, medication, mentation, and mobility. Implementation of this model can promote better-integrated care, thus improving the quality of life for older adults.
Sleep Disorders’ Prevalence and Impact on Academic Performance among Undergraduate Nursing Students in a Selected University, United Arab Emirates
Authors: Ibrahim Fatma M , Salmi Rahma Nemer , Saif Malak Anes , Mohammed Amani 
Published: August 2024

Introduction Throughout their academic pursuits, students may encounter various sleep-related issues, including insomnia, sleep apnea, hypersomnia, or sleep terror disorder. These disorders can profoundly impact their well-being, emotional state, and academic achievements. Objective This study, of significant relevance to the field of nursing and sleep disorders, aimed to investigate the prevalence of sleep disorders and their impact on academic performance among undergraduate nursing students in the United Arab Emirates. Methods A cross-sectional research method was implemented among 177 undergraduate nursing students. Two tools were used: Too I consisted of two parts: sociodemographic and academic performance classifications, whereas Tool II comprised the SLEEP-50 questionnaire. Results Our findings revealed that 30.6% of nursing students had one or more sleep disorders. Insomnia was the most prevalent among the nursing students (37.5%), followed by circadian rhythm (33.3%), narcolepsy (26.6%), sleep apnea and restless leg syndrome (25%), nightmares (22.2%), and sleepwalking (11.11%). There was a significant relation between restless leg syndrome and academic performance, while in linear regression analysis, it was found that the variable that most affects sleep is gender. Conclusion The implications of this study's findings are clear-nursing schools must intensify their efforts to raise awareness about the detrimental effects of sleep problems on academic performance. Furthermore, subsequent research is crucial to evaluate the execution of interventions aimed at preventing such disorders.
Bridge to Practice: A Qualitative Evaluation of Joint Medical Program (JMP) International Medical Graduates Perceived Preparedness for Professional Practice
Authors: Foot Michelle , Vashum Khanrin , Ballal Pavana , Lampe Lisa 
Published: August 2024

OBJECTIVES This study sought to examine the views of international graduates regarding how they perceived the Joint Medical Program Bachelor of Medicine (JMP BMed) undergraduate training prepared them to practice in a health system different from that in which they had studied. Eighteen international graduates of the JMP between 2010 and 2017 inclusive agreed to be interviewed face-to-face. METHODS JMP BMed international graduates were interviewed using 18 standardized questions to elicit perceptions of their preparedness to practice and reflections on their training experience. The interview data were qualitatively analyzed, and the main themes were identified and categorized. RESULTS Overall, the international graduates of the JMP BMed curriculum felt well-prepared for tasks associated with communication, self-directed learning, and approaching mental health issues. Conversely, they perceived the level of clinical exposure and experience as inadequate in preparing them for the expected level of medical knowledge and responsibility. They also felt underprepared for navigating a different health system. CONCLUSIONS The strengths and weaknesses identified in the JMP BMed program in its preparation of international graduates, particularly those who chose to practice in their country of origin, are of relevance for all medical schools that enrol international students. Greater awareness of the needs of international medical students returning home to practice may be of value for future curriculum planning purposes to ensure that medical schools optimally prepare their graduates to practice with confidence in a range of healthcare systems.
Locked Stem Reverse Total Shoulder Arthroplasty for Complex Proximal Humerus Fracture in the Elderly: Clinical and Radiological Short-Term Results
Authors: Rivera Alberto R. , Cardona Victor 
Published: August 2024

Purpose To evaluate both the short-term clinical and radiological results of reverse shoulder arthroplasty (RSA) with uncemented locked stem in the management of a proximal humerus fracture (PHFs) in the elderly. Methods Retrospective study including 40 consecutive 3–4 part proximal humerus fractures treated with reverse shoulder arthroplasty with a minimum of 24 months follow-up. In all the cases, the greater tuberosity (GT) was reattached with a standardized suture technique and a local horseshoe bone graft. All the patients were assessed at the 24-month follow-up with Constant-Murley Score (CMS) and Visual Analog Score (VAS). Radiographic healing of the greater tuberosity was noted in addition to stem locking screws radiographic changes. Complications and revision rates were reported. Results Mean final CMS for this cohort was 80 points. The greater tuberosity healed in the anatomic position in 90% of the cases (N = 36), obtaining an average CMS of 80 in these patients. Healing of the greater tuberosity did not occur in 10% of the cases (N = 4), obtaining an average CMS of 60. All patients scored above 100° in forward elevation with a mean of 140°. Mean active external rotation was 30°. Low-grade scapular notching was reported in <1% of the cases. Major complications were reported in one patient with an acromial fracture. No complications or loosening of stem locking screws were noted. There were no reoperations. Conclusion In the elderly population, reverse shoulder arthroplasty utilizing a fracture-specific locking stem, low-profile metaphysis, suture-friendly groove, meticulous suture technique, and local bone grafting allows adequate fixation, variable prosthesis height adjustment, and enhances greater tuberosity healing. This approach yields positive short-term clinical outcomes without complications related to the stem's locking screws. Level of Evidence Level IV Retrospective Case Series
A Randomized Controlled Trial of a Culturally Adapted, Community-Based, Remotely Delivered Mindfulness Program for Latinx Patients With Breast Cancer is Acceptable and Feasible While Reducing Anxiety
Authors: Juarez-Reyes Maria , Martinez Erica , Xiao Lan , Goldman Rosas Lisa 
Published: August 2024

Background/ObjectiveFew Spanish mindfulness interventions have been evaluated in Latinx patients with cancer. We culturally adapted a mindfulness intervention for Spanish speaking Latinx patients. The objective was to measure feasibility and acceptability as primary outcomes, with changes in anxiety, depression, and sleep as secondary outcomes.MethodSpanish-speaking Latinx patients with breast cancer (n = 31) were randomized, between April 2021 and May 2022 to either intervention or wait-list control groups. The mindfulness intervention consisted of 6-weekly 1.5-hour sessions remotely delivered by a novice facilitator. Cultural adaptations included language, metaphor, goal, concept, trauma informed, and acknowledgement of spirituality. Feasibility was benchmarked as 75% of participants attending their first session, 75% of participants completing 4 of 6 sessions, and scoring ≥ 4 on a 5-point Likert feasability scale measuring ability to implement changes after 6-weeks. Acceptability was measured as scoring ≥ 4 on a 5-point Likert scale measuring usefulness and relevance of the mindfulness intervention for each session. An intention-to-treat, linear mixed model with repeated measures analysis examined changes in anxiety, depression, and sleep at week 6 and 18 (3 months post intervention).ResultsAll three feasibility benchmarks were met with 75% of first session attendance, 96% of participants completing 4 of 6 sessions, and 94% scoring ≥ 4, on the feasibility scale (Mean (SD) = 4.3 (0.6)). Acceptability scores for both usefulness and relevance questions were ≥ 4 across all 6 sessions. Anxiety was significantly reduced at 3 months (−3.6 (CI -6.9, −0.2), P = .04), but is of unclear clinical significance given the small change. Depression scores declined, but not significantly, and there were no changes in sleep.ConclusionThis culturally adapted, remotely delivered mindfulness intervention using a novice facilitator was acceptable and feasible and demonstrated associated reductions in anxiety amongst Spanish speaking Latinx patients with breast cancer.Trial RegistrationClinicalTrials.gov ID# NCT04834154.