bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of verbal and written information on the perception of pain and analgesic consumption, in adolescent orthodontic patients: A randomised controlled trial
Authors: Pavlić Andrej , Blagec Tadeja , Meštrović Senka 
Published: July 2024

Objective: To investigate the impact of written instructions, about post-bonding pain, on patients’ pain perception and analgesic consumption and to evaluate the correlation of pain with personality types. Design: Two-arm parallel randomised controlled trial. Setting: University Hospital Centre Zagreb, Zagreb, Croatia. Methods: Participants included adolescents in the permanent dentition with mild or moderate crowding. Randomisation: The participants were randomly allocated, using computer-generated random list, into two groups. Interventions: After bonding and archwire insertion, all participants received oral instructions on potential pain occurrence and pain control. Participants in the study group also received written information on post-bonding pain. Outcomes: Pain intensity was evaluated using the Numerical Rating Scale immediately after (T0), 2 days (T1) and 7 days (T2) after the placement of the fixed orthodontic appliance. Analgesic consumption was assessed as yes or no, and personality traits were assessed using the Big Five Inventory. Operators who scored pain intensity and recorded analgesic consumption and personality traits were blinded to the group allocation. Statistical analyses included the t-test, Mann-Whitney U-test, Spearman correlations and stepwise regression analysis. Results: The highest rate of pain was recorded at T1 ( P < 0.001). No statistically significant difference in pain perception between groups was observed. There was no statistically significant difference in analgesic consumption between the two groups ( P = 0.81). The correlations between personality traits and pain perception were not significant. Conclusion: The additional written information had little impact on pain perception, and it had no relationship to personality types. The perception of pain and analgesic consumption were not affected by the provision of additional written information ( P = 0.81). Participants’ personality types did not affect the impact of the information given.
A Preliminary Study of Post-Market Bridge-Enhanced ACL Restoration (BEAR) Suggests Non-Inferior Short-Term Outcomes and Low Complications
Authors: Shah Aakash K. , Rizy Morgan E. , Neijna Ava G. , Uppstrom Tyler J. , Gomoll Andreas H. , Strickland Sabrina M. 
Published: July 2024

Background: To improve outcomes following anterior cruciate ligament (ACL) reconstruction, bridge-enhanced ACL restoration (BEAR) was introduced. Bridge-enhanced ACL restoration uses a collagen-based implant saturated with infused autologous blood to bridge the torn proximal and distal ACL fibers. Purpose: We sought to analyze the short-term complications, clinical outcomes, and patient-reported outcome measures (PROMs) in patients undergoing BEAR outside of the initial clinical trials. Methods: We conducted a retrospective cohort study of all skeletally mature patients who had a midsubstance or proximal ACL tear treated with BEAR by 2 surgeons at a single institution and had a minimum follow-up of 6 weeks. A total of 58 patients were included (average age was 38 years, average time from injury to surgery was 45 days). Data on demographic factors, functional outcomes, and complications were collected from electronic medical records. Patient-reported outcome measures and a descriptive return-to-activity survey were analyzed utilizing paired t-tests and Wilcoxon signed-rank tests. Results: All 58 patients demonstrated a grade of 1A on the Lachman test at 6 weeks postoperatively. At 6 months postoperatively, the mean active flexion was 135° ± 5°, and all patients achieved 0° extension. Although not all patients completed PROM questionnaires, among those who did we observed a significant increase in PROMs between preoperative and postoperative measurements; more than half achieved the minimal clinically important difference in all PROMs, and 26 patients (87%) had a 1-level decrease in function. There were no cases of retear or instability. Three patients (5%) had postoperative arthrofibrosis. Conclusion: Early results of this preliminary post-market approval study suggest that BEAR may provide a safe and non-inferior approach to ACL reconstruction in selected patients. Studies are needed to investigate the long-term outcomes of this novel technique.
Impact of Pleural Integrity Preservation After Minimally Invasive Aortic Valve Surgery
Authors: Bacchi Beatrice , Cabrucci Francesco , Chiarello Bruno , Dokollari Aleksander , Bonacchi Massimo 
Published: July 2024

Objective: While the benefits of minimally invasive aortic valve surgery compared with standard sternotomy have been widely described, the impact of preservation of pleural integrity (PPI) in minimally invasive surgery is still widely discussed. This study aims to define the role of PPI on postoperative and long-term outcomes after minimally invasive aortic valve replacement (MIAVR). Methods: All 2,430 consecutive patients undergoing MIAVR (ministernotomy or right anterior minithoracotomy) between 1997 and 2022 were included in the study. Patients were divided into 2 groups: patients with and without PPI. PPI was considered the maintenance of the pleura closed without the need for a chest tube insertion at the end of the surgical procedure. A propensity-matched analysis was used to compare the PPI and not-PPI groups. Results: After propensity matching, 848 patients were included in each group (PPI and not-PPI). The mean age was 70.21 versus 71.42 years, and the mean Society of Thoracic Surgeons predicted risk of mortality was 0.31% versus 0.30% in not-PPI versus PPI, respectively. The mean follow-up time was 147.4 months. Postoperatively, not-PPI versus PPI patients had a longer intensive care unit stay (9.7 vs 17.3 h, P < 0.001) and hospital length of stay (5.2 vs 8.9 days, P < 0.001). The rate of respiratory complications including the incidence of pneumothorax or subcutaneous emphysema, pulmonary atelectasis, and pleural effusion events requiring thoracentesis/drainage was significantly higher in not-PPI versus PPI. The 30-day all-cause mortality was higher in not-PPI versus PPI (0.029 vs 0.010, P = 0.003). Perioperative, short-term, and long-term all-cause mortality was significantly higher in the not-PPI group. Conclusions: PPI after MIAVR is associated with reduced incidence of postoperative complications, reduced lengths of stay, and improved overall survival compared with not-PPI. Therefore, a MIAVR tailored patient-procedure approach to maintaining the pleura integrity positively impacts short-term and long-term outcomes.
Inter-Rater and Intrarater Reliability of Radiographs in the Diagnosis of Pediatric Scaphoid Fractures
Authors: Padeanu Stefan , Tang Ken , Highmore Kerri , Koujok Khaldoun , Carsen Sasha , Smit Kevin , Cheung Kevin 
Published: July 2024

Background: Pediatric scaphoid fractures can be challenging to diagnose on plain radiograph. Rates of missed scaphoid fractures can be as high as 30% to 37% on initial imaging and overall sensitivity ranging from 21% to 97%. Few studies, however, have examined the reliability of radiographs in the diagnosis of scaphoid fractures, and none are specific to the pediatric population. Reliability, both between different specialists and for individual raters, may elucidate some of the diagnostic challenges. Methods: We conducted a 2-iteration survey of pediatric orthopedic surgeons, plastic surgeons, radiologists, and emergency physicians at a tertiary children’s hospital. Participants were asked to assess 10 series of pediatric wrist radiographs for evidence of scaphoid fracture. Inter-rater and intrarater reliability was calculated using the intraclass correlation coefficient of 2.1. Results: Forty-two respondents were included in the first iteration analysis. Inter-rater reliability between surgeons (0.66; 95% confidence interval, 0.43-0.87), radiologists (0.76; 0.55-0.92), and emergency physicians (0.65; 0.46-0.86) was “good” to “excellent.” Twenty-six respondents participated in the second iteration for intrarater reliability (0.73; 0.67-0.78). Sensitivity (0.75; 0.69-0.81) and specificity (0.78; 0.71-0.83) of wrist radiographs for diagnosing scaphoid fractures were consistent with results in other studies. Conclusions: Both inter-rater and intrarater reliability for diagnosing pediatric scaphoid fractures on radiographs was good to excellent. No significant difference was found between specialists. Plain radiographs, while useful for obvious scaphoid fractures, are unable to reliably rule out subtle fractures routinely. Our study demonstrates that poor sensitivity stems from the test itself, and not rater variability.
Preferred lifestyle intervention characteristics and behaviour change needs of postpartum women following cardiometabolic pregnancy complications
Authors: Osei-Safo Elaine K , Lim Siew , Makama Maureen , Chen Mingling , Skouteris Helen , Taylor Frances , Harrison Cheryce L , Hutchesson Melinda , Bennett Christie J , Teede Helena , Melder Angela , Moran Lisa J 
Published: July 2024

Background: Women with cardiometabolic pregnancy complications are at increased risk of future diabetes and heart disease which can be reduced through lifestyle management postpartum. Objectives: This study aimed to explore preferred intervention characteristics and behaviour change needs of women with or without prior cardiometabolic pregnancy complications for engaging in postpartum lifestyle interventions. Design: Quantitative cross-sectional study. Methods: Online survey. Results: Overall, 473 women were included, 207 (gestational diabetes (n = 105), gestational hypertension (n = 39), preeclampsia (n = 35), preterm birth (n = 65) and small for gestational age (n = 23)) with and 266 without prior cardiometabolic pregnancy complications. Women with and without complications had similar intervention preferences, with delivery ideally by a healthcare professional with expertise in women’s health, occurring during maternal child health nurse visits or online, commencing 7 weeks to 3 months post birth, with 15- to 30-min monthly sessions, lasting 1 year and including monitoring of progress and social support. Women with prior complications preferred intervention content on women’s health, mental health, exercise, mother’s diet and their children’s health and needed to know more about how to change behaviour, have more time to do it and feel they want to do it enough to participate. There were significant differences between groups, with more women with prior cardiometabolic pregnancy complications wanting content on women’s health (87.9% vs 80.8%, p = 0.037), mother’s diet (72.5% vs 60.5%, p = 0.007), preventing diabetes or heart disease (43.5% vs 27.4%, p < 0.001) and exercise after birth (78.3% vs 68.0%, p = 0.014), having someone to monitor their progress (69.6% vs 58.6%, p = 0.014), needing the necessary materials (47.3% vs 37.6%, p = 0.033), triggers to prompt them (44.0% vs 31.6%, p = 0.006) and feeling they want to do it enough (73.4%, 63.2%, p = 0.018). Conclusion: These unique preferences should be considered in future postpartum lifestyle interventions to enhance engagement, improve health and reduce risk of future cardiometabolic disease in these high-risk women.
Fatigue in patients with metastatic breast cancer undergoing single-agent taxane-based chemotherapy: a real-world data global network
Authors: Fabi Alessandra , Gavioli Elizabeth M. , Wakade Renuka , Spera Maria C. , Miracle Santiago , Valveny Neus , Butler Elizabeth , DePizzol Maria , Ruffini Pier Adelchi , Allegretti Marcello 
Published: July 2024

Background: Cancer-related fatigue (CRF) occurs in nearly all patients with metastatic breast cancer (MBC). Objectives: This real-world analysis aimed to describe the prevalence and importance of fatigue in patients with MBC within 3 months of treatment with single-agent taxane-based chemotherapy during the timeframe of 2020–2022 in the United States and Europe. It was also conducted to assess whether there was a difference in relapsed patients compared to patients diagnosed de novo. Design: Electronic health records were analyzed from approximately 150 million patients to identify patients with MBC who underwent taxane treatment. Results: In 2021, 50,490 patients had MBC, of whom 16,170 were diagnosed de novo and 34,330 experienced relapse. The proportion of patients undergoing taxane-based chemotherapy was 7.5% ( n = 1220) and 13.4% ( n = 4590), respectively, and the prevalence of any fatigue and CRF was similar between the groups (24.6% versus 25.7% and 6.6% versus 5.4%, respectively). Conclusion: At least one in four patients with MBC undergoing taxane-based treatment will experience fatigue. This highlights the importance of validating screening tools to identify CRF, which is necessary to advance clinical trials aimed at investigating treatment strategies to improve patient-centered outcomes for fatigue.
Three-dimensional-printing-guided preoperative planning of upper and lower extremity pediatric orthopedic surgeries: A systematic review of surgical outcomes
Authors: Mounsef Peter Joseph , Aita Rachad , Skaik Khaled , Addab Sofia , Hamdy Reggie Charles 
Published: July 2024

Purpose: Three-dimensional printing has evolved into a cost-effective and accessible tool. In orthopedic surgery, creating patient-specific anatomical models and instrumentation improves visualization and surgical accuracy. In pediatric orthopedics, three-dimensional printing reduces operating time, radiation exposure, and blood loss by enhancing surgical efficacy. This review compares outcomes of three-dimensional printing–assisted surgeries with conventional surgeries for upper and lower extremity pediatric surgeries. Methods: A complete search of medical literature up to August 2023, using Ovid Medline, EMBASE, Scopus, Web of Science, and Cochrane Library was conducted in compliance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Broad search terms included “pediatrics,” “orthopedic,” and “3D-printing.” Eligible studies were assessed for intraoperative time, blood loss, and fluoroscopy exposure. Results: Out of 3299 initially identified articles, 14 articles met inclusion criteria. These studies included 409 pediatric patients, with ages averaging 9.51 years. The majority were retrospective studies (nine), with four prospective and one experimental study. Studies primarily utilized three-dimensional printing for navigation templates and implants. Results showed significant reductions in operative time, blood loss, and radiation exposure with three-dimensional printing. Complication occurrences were generally lower in three-dimensional printing surgeries, but there was no statistical significance. Conclusions: Three-dimensional printing is an emerging technology in the field of orthopedics, and it is primarily used for preoperative planning. For pediatric upper and lower extremity surgeries, three-dimensional printing leads to decreased operating room time, decreased intraoperative blood loss, and reduced radiation exposure. Other uses for three-dimensional printing include education, patient communication, the creation of patient-specific instrumentation and implants. Level of evidence: Level III
Perianeurysmal vasogenic oedema (PAVO): A single centre 10-year retrospective review
Authors: Verma Yatharth , Pringle Catherine , Emsley Hedley , Sonwalkar Hemant , Alalade Andrew F , Roberts Gareth A 
Published: July 2024

Introduction Perianeurysmal Vasogenic Oedema (PAVO) is a rare but important complication of endovascular treatment of intracranial aneurysms. Many potential risk factors have been identified including age, aneurysm size, aneurysm location, immunological profile, type of coil used, diabetes, hypertension, and smoking. PAVO can cause persistent post-procedural symptoms, subsequently increasing post-embolization morbidity. Methods A 10-year retrospective review was conducted between 2011 and 2021 at Royal Preston Hospital, Preston, UK. Results We identified 8 patients that fit our inclusion criteria. This included 6 (75%) females and 2 (25%) males. The mean age was 64. All patients had anterior circulation aneurysms with the middle cerebral artery (MCA) being the most common site. The mean aneurysm size was 12 mm. Our patients were managed with a range of endovascular techniques. One patient had pre-treatment PAVO while 7 patients had post-embolization PAVO. Five patients were symptomatic, and 3 cases were asymptomatic with only radiological evidence of PAVO. Five patients were managed with varying courses of dexamethasone. PAVO resolution was achieved in 4 cases. The oedema significantly improved in 3 cases, but transiently progressed in 1 case. Conclusions PAVO is a rare but important complication of endovascular management of intracranial aneurysms. We have shown that patients can be effectively managed with steroids with resultant oedema regression and symptomatic improvement. Many risk factors have been associated with PAVO, but further research is needed to better understand their role in PAVO development and help develop other therapeutic options.
Assessment of radiation exposure among pediatric patients referred for CT imaging at three government hospitals in Addis Ababa, Ethiopia
Authors: Tesfaw Ambaye Fisehaw , Dellie Seife Teferi , Legesse Tesfaye Kebede , Gebremedhin Yocabel Gorfu , Seid Abdhjelil Nijamu 
Published: July 2024

Background: Due to the high sensitivity of their growing tissues to ionizing radiation, pediatric patients are at a greater risk of cancer development. Objective: This study aimed to evaluate the level of radiation exposure experienced by pediatric patients undergoing a common CT examination at the three government hospitals in Addis Ababa, Ethiopia. Materials and methods: Structured formats were designed for data collection at three government hospitals, and then information about pediatric patients’ demography, CT protocols, and CT systems was retrieved and recorded from March 2018 up to July 2018. CT dose indicators: CTDIvol (mGy) and DLP (mGy.cm) values for abdomen, chest, and head CT scans were recorded based on pediatric patients’ age ⩽1, (1–5], (5–10], and (10–15] years old. The data were analyzed through SPSS version 25 software. Finally, the third quartile values of CTDIvol and DLP were determined and compared with other international DRLs. Results: The third quartile values of radiation dose descriptors for abdomen, chest, and head CT scans, respectively, in terms of CTDIvol (mGy): 58, 10, 17, 51; 23, 23, 34, 51; 62, 41, 50, 51; and in terms of DLP (mGy.cm), 377, 314, 624, 664; 523, 571, 406, 739; 927, 806, 929, and 1197 corresponded to pediatric patients of age ⩽1, (1–5], (5–10], and (10–15] years old, respectively. Conclusion: There were significant differences in the radiation dosage of some CT examinations between the same age groups, indicating a need for dose optimization. Therefore, this study recommends the need for enhancing radiation safety, ensuring appropriate imaging practices, and prioritizing the well-being of pediatric patients who visit CT examinations in Addis Ababa, Ethiopia.
Cystolitholapaxy for large-volume bladder stones using Swiss LithoClast TrilogyⓇ: Initial clinical experience
Authors: Sturgess George , Beckley Ian , Downey Alison , Phillips Rebecca , Sara Xenia , Wilcox George , Young Matthew , Symons Stephanie 
Published: July 2024

Objective: Large bladder calculi can be managed with open cystolithotomy, or endoscopically through cystolitholapaxy. The Swiss LithoClast Trilogy is a single-probe dual-energy lithotripter, widely used in percutaneous nephrolithotomy (PCNL). We report our clinical experience including the safety and efficacy of using Trilogy for cystolitholapaxy. Patients and Methods: Patients undergoing cystolitholapaxy using Trilogy since 2020 were identified, and data collected included stone profile, operative details, complications and stone-free status. Radiological stone characterisation was performed for all patients undergoing computed tomography (CT) imaging pre-operatively. Results: There were 41 cystolitholapaxy procedures performed using Trilogy. Average age was 65 years, and 85.4% were male. Average total stone volume was 13.7 cm3 (SD ±14.6 cm3). The largest stone cleared had a maximal diameter of 4.9 cm and volume of 46.1 cm3. Transurethral access via a nephroscope was used in 38 of 41 (92.7%) cases. Average total operating time was 89 minutes (SD ± 40 minutes), and average length of stay was 1.35 days (SD ±2.41 days). Two complications not directly attributable to the use of Trilogy occurred. Conclusion: Cystolitholapaxy using Trilogy is both safe and effective in treating large-volume bladder stones with high complete clearance rates and an excellent safety profile. It should be considered as an alternative to open cystolithotomy. Level of evidence: 4
From Banks or Venture Capitals? The Financing Choices of Chinese High-Tech Enterprises During the Start-Up Period
Authors: Fang Yongmei , Guan Bo , Yang Guiying 
Published: July 2024

The purpose of this research is financing options for high-tech enterprises in China during their early-stage. This study develops a three-phase model to analyze the financing choices of Chinese high-tech firms between banking and venture capital while considering information asymmetry. The findings reveal that opaque information disclosure favors venture capital financing, while transparent disclosure leads to bank loans for equally qualified high-tech enterprises. Data analysis further confirms that both bank loans and venture capital are viable options for early-stage Chinese high-tech enterprises. These findings offer valuable guidance for high-tech firms and investors navigating China’s financial landscape. Moreover, policy management departments can leverage these insights to make informed decisions and facilitate the financing of high-tech enterprises. JEL Classification: C70, C23, D22, G24.
Current Clinical Evidence for Magnetic Sphincter Augmentation: A Scoping Review
Authors: Andreae Thomas , Elshafei Moustafa , Gossage James A. , Kersting Thomas , Bell Reginald 
Published: July 2024

Background: Magnetic sphincter augmentation (MSA) is an alternative treatment option to laparoscopic fundoplication (LF) for patients with gastroesophageal reflux disease. To date, over 40,000 devices have been implanted worldwide since first approval in Europe in 2010 and the USA in 2012. Despite this clinical reality, the long-term safety and effectiveness of the procedure continues to be questioned. This study aims to systematically summarize and appraise the currently available evidence for MSA relative to effectiveness, safety, and healthcare resource use. Methods: A systematic literature search was carried out to identify all clinical studies published in English, as of February 15, 2023. Required endpoints were safety, effectiveness, and cost effectiveness. Results: The systematic search identified 212 publications and 14 entries in study registries. After screening and full text analysis, 82 publications were included in qualitative synthesis. One RCT established superiority of MSA compared to twice daily proton-pump inhibitors with respect to the elimination of moderate to severe regurgitation (89% vs 10%, RR 0.11, 95% CI 0.06-0.20, P < 0.001). Eleven cohort studies comparing MSA to LF showed no statistical difference in safety profile and effectiveness measured by post-operative GERD-HRQL score. In addition, patients undergoing MSA significantly retained the ability to belch and vomit when compared to LF. These results were consistent in follow-up out to 7 years. Conclusions: LINX has been shown to provide long lasting relief to patients suffering from persistent GERD while maintaining an acceptable safety profile. As an outpatient day-procedure, MSA is cost effective with short recovery.