bluuebunny/crossref_metadata_2025_split huggingface dataset:
Risk Factors for Adverse In-Hospital Outcomes in Patients With Traumatic Blunt Thoracic Aortic Injuries Undergoing Thoracic Endovascular Aortic Repair (TEVAR): An Analysis of the US Nationwide Inpatient Sample
Authors: Chen Po-Sung , Lo Kuo-Jen , Yu Chi-Hsiu , Wang Chi-Feng , Lee Chuin-I 
Published: August 2024

Purpose: Thoracic endovascular aortic repair (TEVAR) is a treatment for traumatic blunt thoracic aortic injury (BTAI) with good survival rates and safety. However, there is limited study on the risk factors for in-hospital mortality and complications. This study aimed to identify risk factors associated with poor in-hospital outcomes after TEVAR. Materials and Methods: This is a population-based, retrospective observational study. Data of adults ≥20 years admitted for BTAI who received TEVAR were extracted from the Nationwide Inpatient Sample (NIS) database 2005 to 2018. The primary outcome was in-hospital mortality, and the secondary outcomes were length of stay (LOS) and unfavorable discharge (ie, non-routine discharge, including nursing homes or long-term care facilities). Associations between study variables and in-hospital outcomes were determined using univariate and multivariable logistic and linear regression analyses. Results: Data of 1095 participants (representing 5360 hospitalized patients in the United States) were analyzed. Multivariable analysis revealed that older age (adjusted odds ratio [aOR]=1.02) and having at least 1 perioperative complication (aOR=4.01) were significantly associated with increased risk for in-hospital mortality. Patients with at least 1 perioperative complication (aOR=11.19) had significantly increased odds for prolonged LOS. Risk for unfavorable discharge was significantly increased by older age (aOR=1.02), household income at quartile 2 (aOR=1.58), Charlson Comorbidity Index (CCI) 2 to 3 (aOR=1.66), and having at least 1 complication (aOR=3.94). Complications including perioperative cerebrovascular accident (CVA) (aOR=2.75), venous thromboembolism (VTE) (aOR=2.87), pneumonia (aOR=3.93), sepsis (aOR=4.69), infection (aOR=4.49), respiratory failure (aOR=4.55), mechanical ventilation (aOR=3.27), and acute kidney injury (AKI) (aOR=3.09) significantly predicted prolonged LOS. Conclusions: In adults with traumatic BTAI undergoing TEVAR, advanced age and perioperative complications are risk factors for poor in-hospital outcomes. Acute kidney injury, CVA, respiratory failure, and sepsis are strong predictors of prolonged LOS, unfavorable discharge, and in-hospital mortality. Clinical Impact The study identifies advanced age and perioperative complications as key risk factors for poor in-hospital outcomes in patients undergoing TEVAR for BTAI. Clinicians should be vigilant in managing these patients, particularly those with comorbidities, to mitigate risks. The findings suggest a need for tailored perioperative care strategies to improve survival rates and reduce complications. This research highlights the critical importance of early identification and intervention in high-risk patients, offering an innovative approach to refining TEVAR protocols and enhancing patient outcomes in trauma care.
Minimally Invasive Surgical Repair of Simple Congenital Heart Defects Using the Right Vertical Infra-Axillary Thoracotomy Approach
Authors: Tran Dien Minh , Tran Vinh Quang , Nguyen Mai Tuan , Mai Duyen Dinh , Doan Anh Vuong , Hoang Son Thanh , Kotani Yasuhiro , Nguyen Truong Ly-Thinh 
Published: August 2024

Objective: To evaluate the safety and efficacy of surgical repair for patients diagnosed with simple congenital heart defects (CHD) using the minimally invasive right vertical infra-axillary minithoracotomy (RVIAT) approach. Methods: We retrospectively reviewed the clinical data of consecutive patients who underwent minimally invasive RVIAT for repair of CHD between August 2019 and August 2022. There were 382 patients who underwent 8 primary procedures and were included in this study. Results: The median age of the patients was 16.2 (interquartile range [IQR], 7.2 to 41.9) months, and the median weight of the patients was 8.8 (IQR, 6.5 to 14) kg. The preoperative diagnoses were as follows: ventricular septal defect, atrial septal defect, partial anomalous pulmonary venous return, partial atrioventricular septal defect, cor triatriatum, complete atrioventricular septal defect, and myxoma. The mean aortic cross-clamp time, bypass time, and operation time were 45.4 ± 19.3 min, 65.6 ± 23.1 min, and 154.5 ± 29.7 min, respectively. There was no in-hospital mortality or conversion to median sternotomy. Two patients (0.5%) required early reoperation; 1 due to postoperative bleeding and 1 for permanent pacemaker implantation. Other complications included trivial residual shunts (23 of 382, 6%), pleural effusion (3 of 382, 0.8%), pneumothorax (0.8%), and wound infection (4 of 382, 1%). There were 2 late noncardiac deaths. Late reoperation was performed on 1 patient with progressive aortic valve regurgitation who required aortic valvuloplasty. Conclusions: RVIAT is a minimally invasive approach that can be safely performed on patients with simple CHDs. RVIAT may be a good alternative approach for median sternotomy and cardiac intervention.
Safety and efficacy of endovenous microwave ablation for treatment of varicose veins of the lower limbs in China: A prospective registered clinical trial
Authors: Zhang Lifeng , Lin Yao , Geng Caijuan , Huang Wei , Yang Qifan , He Chunshui , Zeng Wei 
Published: August 2024

Objective This study aimed to investigate the safety and efficacy of a new Chinese device using microwave ablation for treating symptomatic great saphenous vein (GSV) varicose veins (VVs). Methods This prospective, single-arm, single-center, cohort study investigated the safety and efficacy of endovenous microwave ablation for the treatment of symptomatic VVs. A total of 50 patients with lower limb varicose veins were enrolled from the Hospital of Chengdu University of Traditional Chinese Medicine. The clinical outcomes and complications were assessed at 1, 6, and 12 months after the procedure. The primary outcome was the occlusion rate of GSV immediately and at 1, 6, and 12 months after the treatment. The secondary outcomes included the venous clinical severity score (VCSS), the chronic venous insufficiency questionnaire 14 items (CIVIQ-14) score, the Aberdeen varicose vein questionnaire (AVVQ) score, and the pain visual analog scale (VAS) score. This study protocol was registered at ClinicalTrials.gov (ID: NCT04645771). Results In total, 50 limbs from 50 patients (26 female; mean age: 53.45 ± 9.78 years) were treated. A technical success rate of 100% was achieved and no serious adverse events were recorded. During the follow-up period, the occlusion rate of the major/minor saphenous vein trunk remained 100% at 1, 6, and 12 months after surgery except one patient fell off. The median 24-h VAS value was 2 (2,3). The VCSS score, CIVIQ-14 score, and AVVQ score ( p < .05) at 1, 6, and 12 months improved significantly compared with the value preoperative ( p < .05). Conclusion EMA was safe and effective for treating varicose veins in the lower limbs, with a high rate of venous trunk occlusion and few complications, thus improving patients’ postoperative quality of life.
Effectiveness of dry needling to treat lateral epicondylosis: A case report
Authors: Short Nathan , Linder Jill , Stump Ethan 
Published: August 2024

Purpose This study presents the use of dry needling (DN) as an intervention to support functional rehabilitation for an adult diagnosed with lateral epicondylosis. Methods A retrospective, single subject, AB design was implemented. A 50-year-old male with a six-month history of dominant left lateral epicondylosis received traditional interventions for 4 weeks (baseline phase; A) followed by the same interventions with the addition of DN (intervention phase; B). The QuickDASH assessment, numeric rating scale (NRS) for pain, grip strength (elbow flexed and neutral), and Maudsley’s test were used as measures of effectiveness along with patient self-report of ability to perform activities of daily living (ADLS), instrumental ADLs, work, and leisure occupations. Results The patient made minimal progress for the initial 4 weeks of traditional treatment. There were no changes to his initial pain rating of 7/10 on the NRS, left hand grip strength (67 lbs.), or initial QuickDASH score. DN was initiated at week five with a reduction in pain from 7/10 to 2/10 from weeks six to eight. He was discharged at week 12 with no pain, a score of 0/100 on the QuickDASH, non-painful grip of 83 lbs., and a self-report of the ability to perform all ADLs, instrumental ADLs, work, and leisure occupations independently. Conclusions Dry needling appears to have been an effective intervention when integrated with a holistic approach for an individual with chronic lateral epicondylosis. More research is needed to evaluate dry needling as an intervention to support functional rehabilitation with a larger sample size and randomization.
Behavioral marker-based predictive modeling of functional status for older adults with subjective cognitive decline and mild cognitive impairment: Study protocol
Authors: Kang Bada , Ma Jinkyoung , Jeong Innhee , Yoon Seolah , Kim Jennifer Ivy , Heo Seok-jae , Oh Sarah Soyeon 
Published: August 2024

Objective This study describes a research protocol for a behavioral marker-based predictive model that examines the functional status of older adults with subjective cognitive decline and mild cognitive impairment. Methods A total of 130 older adults aged ≥65 years with subjective cognitive decline or mild cognitive impairment will be recruited from the Dementia Relief Centers or the Community Service Centers. Data on behavioral and psychosocial markers (e.g. physical activity, mobility, sleep/wake patterns, social interaction, and mild behavioral impairment) will be collected using passive wearable actigraphy, in-person questionnaires, and smartphone-based ecological momentary assessments. Two follow-up assessments will be performed at 12 and 24 months after baseline. Mixed-effect machine learning models: MErf, MEgbm, MEmod, and MEctree, and standard machine learning models without random effects [random forest, gradient boosting machine] will be employed in our analyses to predict functional status over time. Results The results of this study will be fundamental for developing tailored digital interventions that apply deep learning techniques to behavioral data to predict, identify, and aid in the management of functional decline in older adults with subjective cognitive decline and mild cognitive impairment. These older adults are considered the optimal target population for preventive interventions and will benefit from such tailored strategies. Conclusions Our study will contribute to the development of self-care interventions that utilize behavioral data and machine learning techniques to provide automated analyses of the functional decline of older adults who are at risk for dementia.
Community Health Centers Uptake of Telemedicine During the COVID-19 Pandemic: Trends, Barriers, and Successful Strategies
Authors: Holderness Heather , Baron Andrea , Hodes Tahlia , Marino Miguel , O’Malley Jean , Danna Maria , Cohen Deborah J. , Huguet Nathalie 
Published: August 2024

Objective: To describe telemedicine use patterns and understand clinic’s approaches to shifting care delivery during the COVID-19 pandemic. Methods: We used electronic health record data from 203 community health centers across 13 states between 01/01/2019 and 6/31/2021 to describe trends in telemedicine visit rates over time. Qualitative data were collected from 13 of those community health centers to understand factors influencing adoption and implementation of telemedicine. Results: Most clinics in our sample were in urban areas (n = 176) and served a majority of uninsured and publicly insured patients (12.8% and 44.4%, respectively) across racial and ethnic minority groups (16.6% Black and 29.3% Hispanic). During our analysis period there was a 791% increase in telemedicine visits from before the pandemic (.06% pre- vs 47.5% during). A latent class growth analysis was used to examine differences in patterns of adoption of telemedicine across the 203 CHCs. The model resulted in 6 clusters representing various levels of telemedicine adoption. A mixed methods approach streamlined these clusters into 4 final groups. Clinics that reported rapid adoption of telemedicine attributed this change to leadership prioritization of telemedicine, robust quality improvement processes (eg, using PDSA processes), and emphasis on training and technology support. Conclusions: In response to the COVID-19 pandemic, telemedicine adoption rates varied across clinics. Our study highlight that organizational factors contributed to the clinic’s ability to rapidly uptake and use telemedicine services throughout the pandemic. These approaches could inform future non-pandemic practice change and care delivery.
Exploring the Experience of Student Researchers and Family Partners Working as an Interdisciplinary Team
Authors: Berg Karsten , dos Santos Ribeiro Mariana , Huijer Hadiya , Whitford Sandi , Sattar Schroder , Compton Roslyn M. 
Published: August 2024

IntroductionMany institutions seek to engage postsecondary students in research to grow future researchers. Despite this common goal, the means to achieve that end is often unknown creating difficulties for students as they seek out research opportunities.ObjectiveThis article will share first-hand reports on the experiences of graduate students, undergraduate students, and family partners following their engagement as an interdisciplinary research team.MethodsThis is a qualitative study using individual open-ended interviews with undergraduate students, graduate students, and patient family partners. The research was conducted using a Patient-Oriented Research approach. The transcripts were analyzed inductively by using Braun and Clarke's six phases of reflexive thematic analysis.ResultsTwo themes were developed from the analysis. The theme of Benefits & Facilitators was developed based on the many positive thoughts, feelings, resiliency, and learning expressed by the students and family partners. The undergraduate students found the experience of “doing” research fulfilling and a great tool for learning how to better use research in practice. Within the second theme Perceived Hierarchy, undergraduate students described themselves as helpers, not responsible, and they did not have the power to make decisions.ConclusionGiven the challenges identified in this study, future efforts in this approach should carefully consider the culture and how to best engage graduate students, undergraduate students, and family partners in research teams.
Medical complications during interhospital transfer for thrombectomy in patients with acute ischemic stroke
Authors: Mirkov Damjan , Jenetzky Ekkehart , Thieme Andrea S. , Qabalan Adeeb , Gumbinger Christoph , Wick Wolfgang , Ringleb Peter A. , Rizos Timolaos 
Published: August 2024

Introduction: Patients with acute ischemic stroke (AIS) and large-vessel occlusion are frequently transferred by emergency physicians (EPs) from primary to comprehensive stroke centers (CSC) for thrombectomy, particular when thrombolysed. Data on complications during such transfers are highly limited. Patients and methods: Consecutive AIS patients transferred between 01/2015 and 10/2021 to our CSC were included. Associations of major (MACO) and minor (MICO) complications with clinical and imaging data were assessed. Results: In total, 985 patients were included in the analysis (58.5% thrombolysed). MACO developed in 1.6%, MICO in 14.6%. Compared to patients without complications (NOCO), patients with MACO did not differ in terms of demographics, cerebrovascular risk factors, or site of vessel occlusion. They had more severe strokes ( p = 0.026), neurological worsening was more severe ( p = 0.008), and transport duration was longer ( p = 0.050) but geographical distances did not differ. Thrombolysed patients had any complication more often than patients without thrombolysis (20.3% vs 10.5%; p  < 0.001); however, this finding was driven by patients with MICO ( p  < 0.001) only (MACO: p = 0.804). No associations were observed between stroke severity and complications in either thrombolysed or nonthrombolysed patients. Neurological deterioration during transfer was observed in 21.2%, but multivariate analysis revealed no association with thrombolysis (OR 0.962; 95%CI 0.670–1.380, p = 0.832). Asymptomatic intracerebral hemorrhage was present in 1.1%, symptomatic in 0.1%. Discussion and conclusion: In this large cohort, no patient-specific factor increasing the risk of complications during interhospital transfer was identified. Specifically, our results do not indicate that thrombolysis increases MACO. Hence, interhospital transfer without EPs appears reasonable in most patients.
Preload Control Method of Threaded Fasteners: A Review
Authors: Yan Xing , Liu Zhifeng , Zheng Mingpo , Li Ying , Wang Yuezhen , Chen Wentao 
Published: August 2024

AbstractThreaded fasteners are one of the most commonly used connection methods for mechanical structures. Its primary function is to generate appropriate clamping forces and fasten the connected parts. An inappropriate preload can cause loosening, fatigue fracture, and other problems. This will affect the safety and reliability of mechanical equipment. The precise control of the preload has become a critical issue in mechanical assembly processes. Over the past few decades, various tightening measures and methods have been proposed to address this issue. However, many problems continue to exist with practical applications that have not been reviewed comprehensively and systematically. First, various control methods were summarized systematically, and their advantages and disadvantages in engineering applications were analyzed. Torque control is the most widely used tightening method owing to its simple operation and low cost. Therefore, the research on the torque control method was summarized systematically from three aspects: the torque–preload correlation formula, effective friction radius, and friction characteristics during tightening. In addition, the special circumstances that may increase preload uncertainty were discussed. Finally, based on a summary of the current research status, the prospects for future research were discussed. This study would aid researchers in extensively understanding the problems in preload control.
Altered individual-level morphological similarity network in children with growth hormone deficiency
Authors: Cheng Yanglei , Lin Liping , Hou Weifeng , Qiu Huaqiong , Deng Chengfen , Yan Zi , Qian Long , Cui Wei , Li Yanbing , Yang Zhiyun , Chen Qiuli , Su Shu 
Published: August 2024

Abstract
Background
Accumulating evidences indicate regional grey matter (GM) morphology alterations in pediatric growth hormone deficiency (GHD); however, large-scale morphological brain networks (MBNs) undergo these patients remains unclear.

Objective
To investigate the topological organization of individual-level MBNs in pediatric GHD.

Methods
Sixty-one GHD and 42 typically developing controls (TDs) were enrolled. Inter-regional morphological similarity of GM was taken to construct individual-level MBNs. Between-group differences of topological parameters and network-based statistics analysis were compared. Finally, association relationship between network properties and clinical variables was analyzed.

Results
Compared to TDs, GHD indicated a disturbance in the normal small-world organization, reflected by increased Lp, γ, λ, σ and decreased Cp, Eglob (all PFDR < 0.017). Regarding nodal properties, GHD exhibited increased nodal profiles at cerebellum 4-5, central executive network-related left inferior frontal gyrus, limbic regions-related right posterior cingulate gyrus, left hippocampus, and bilateral pallidum, thalamus (all PFDR < 0.05). Meanwhile, GHD exhibited decreased nodal profiles at sensorimotor network -related bilateral paracentral lobule, default-mode network-related left superior frontal gyrus, visual network -related right lingual gyrus, auditory network-related right superior temporal gyrus and bilateral amygdala, right cerebellum 3, bilateral cerebellum 10, vermis 1-2, 3, 4-5, 6 (all PFDR < 0.05). Furthermore, serum markers and behavior scores in GHD group were correlated with altered nodal profiles (P ≤ 0.046, uncorrected).

Conclusion
GHD undergo an extensive reorganization in large-scale individual-level MBNs, probably due to abnormal cortico-striatal-thalamo-cerebellum loops, cortico-limbic-cerebellum, dorsal visual-sensorimotor-striatal, and auditory-cerebellum circuitry. This study highlights the crucial role of abnormal morphological connectivity underlying GHD, which might result in their relatively slower development in motor, cognitive, and linguistic functional within behavior problem performance.
Deep vein thrombosis in patients with stroke or transient ischemic attack presenting with patent foramen ovale: a retrospective observational study
Authors: Huber Charlotte , Stöbe Stephan , Hagendorff Andreas , Mühlberg Katja Sibylle , Hoffmann Karl-Titus , Isermann Berend , Wachter Rolf , von Dercks Nikolaus , Schmidt Richard , Pelz Johann Otto , Michalski Dominik 
Published: August 2024

Abstract
Objective
Deep vein thrombosis (DVT) is discussed as a source of embolism for cerebral ischemia in the presence of patent foramen ovale (PFO). However, previous studies reported varying rates of DVT in stroke patients, and recommendations for screening are lacking. This study aimed to characterize patients with stroke or transient ischemic attack (TIA) and concomitant PFO and explore the rate of DVT and associated parameters.

Methods
Medical records were screened for patients with stroke or TIA and echocardiographic evidence of PFO. Concomitant DVT was identified according to compression ultrasonography of the lower limbs. A variety of demographic, clinical, and laboratory parameters, the RoPE and Wells scores were compared between patients with and without DVT.

Results
Three-hundred-thirty-nine patients (mean age 61.2 ± 15.4 years, 61.1% male) with stroke or TIA and PFO, treated between 01/2015 and 12/2020, were identified. Stroke and TIA patients did not differ for demographic and vascular risk factors. DVT was found in 17 cases out of 217 (7.8%) with compression ultrasonography. DVT was associated with a history of DVT, cancer, previous immobilization, calf compression pain, calf circumference difference, and a few laboratory abnormalities, e.g., increased D-dimer. A multivariate regression model with stepwise backward selection identified the Wells score (odds ratio 35.46, 95%-confidence interval 4.71–519.92) as a significant predictor for DVT.

Conclusion
DVT is present in a relevant proportion of patients with cerebral ischemia and PFO, which needs to be considered for the individual diagnostic workup. The Wells score seems suitable for guiding additional examinations, i.e., compression ultrasonography.