bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Efficacy of Local Antibiotic Delivery Systems Therapy in the Management of Diabetic Foot Osteomyelitis: A Systematic Review and Meta-Analysis
Authors: Shen Di , Huang Kai , Guo Qiaofeng , Ma Gouping , Ding Liqing 
Published: July 2024

Purpose We aim to evaluate the efficacy of local antibiotic delivery systems in patients with diabetic foot osteomyelitis (DFO). Methods The Web of Science, PubMed, and Embase databases were searched for relevant publications until March 2024. All studies evaluating the efficacy of local antibiotic delivery systems in patients with DFO were included. We calculated pooled risk ratio (RR) with 95% CIs for binary outcomes and mean difference (MD) for continuous outcomes. The Cochrane's risk of bias tool and methodological index for non-randomized studies (MINORS) assessment were used to evaluate the quality of studies. Results A total of 9 studies with 491 patients were included in this analysis. The overall healing rate in antibiotic group was 0.85 (95% CI: 0.67, 0.97). Healing rates were significantly higher in the antibiotic group compared to the control group (RR: 1.18, 95% CI: 1.01, 1.38). Furthermore, recurrence rates and amputation rates have no significantly difference between the antibiotic group and the control group (RR: 0.30, 95% CI: 0.04, 2.12 and RR: 0.22, 95% CI:0.03, 1.91), along with no significantly difference in healing time and hospital stays(MD: −7.87, 95% CI: −20.81, 5.07 and MD:−2.33, 95% CI:−5.17, 0.50). No obvious publication bias was observed in the funnel plot (Egger's test, P = .99). Conclusions Our meta-analysis found that diabetic foot osteomyelitis patients treated with local antibiotic delivery systems had better healing rates than the control group. However, no significant differences were found in healing time, recurrence, hospital stays, or amputation rates. Larger randomized controlled trials are necessary in the future.
Smart Glasses in Surgery: The Theatre and Beyond
Authors: Gollapalli Syama , Sharma Vidushi , Al Ghazwi Adel , Heskin Leonie 
Published: July 2024

Aims & Objectives The primary aim of this paper is to determine whether smart glasses or head-mounted displays improve efficiency in a procedural or theatre setting without compromising the quality of the procedure performed. Additionally, this paper aims to qualitatively explore applications in surgical education, whilst on-call, consulting and patient observation. Design This paper is a systematic review of the literature available on the topic of smart glasses or head-mounted displays in surgical or procedural settings. Methods A search of Pubmed, Cochrane and the Wiley Online Library was performed in accordance with the PRISMA guidelines. Procedural times and adverse outcomes were compared between the smart glass and non-smart glass groups in each of the quantitative studies. A literature review of studies, including those not satisfying the primary aim was conducted and is included in this paper. Results 32 studies were identified that complied with the inclusion criteria of this paper. 8 of these studies focused on procedural times and adverse outcomes, with and without smart glass usage. Procedural time was reduced when smart glass technology was used, without an increase in adverse patient outcomes. Conclusions Surgeons should consider whether the relatively short reduction in procedural time is worth the high cost, privacy issues, battery complaints and user discomfort involved with these devices. There are promising applications of this technology in the areas of surgical education and consultation. However, more trials are necessary to assess the value of using smart glasses in these settings.
In vitro quantification of stent-graft behaviour during chimney thoracic endovascular aortic repair
Authors: Kwiecinski Jakub , Uberoi Raman , Hadi Mohammed , Cheng Christopher P , You Zhong 
Published: July 2024

Objective To quantify dynamic gutter phenomena and endograft deformations during double chimney thoracic endovascular aortic repair (ch-TEVAR) in a physiological model of the thoracic aorta subjected to pulsatile haemodynamic conditions. Methods Two in vitro procedures revascularizing the brachiocephalic trunk and left common carotid artery were performed representing both balloon-expandable (BE, Ankura-BeGraft) and self-expandable (SE, Ankura-Viabahn) double ch-TEVAR configurations. Retrospectively gated computed tomography (CT) was used to evaluate endograft behaviour. Device interactions were characterised according to gutter volume, gutter surface deviation, and endograft deformation (D-ratio) at end-diastolic and peak-systolic aortic pressure. Results Use of BE chimney grafts resulted in three times total gutter volume compared to SE chimney grafts. Gutter volumes were observed to vary dynamically between the end-diastolic and peak-systolic phases of the cardiac cycle, with the most substantial change associated with the BE configuration. Chimney graft deformations were dependent on device type, with SE devices exhibiting up to twice the deformation as BE devices. When adjacent, SE chimney grafts were observed to support each other, and thus tended towards a more consistently circular shape. Conclusion Gutter and chimney graft behaviour were dependent on device type, and exhibited both spatial and temporal variability. This study emphasises notable differences between BE and SE double ch-TEVAR configurations which should be considered when evaluating risk of endoleak. The findings reported here also support the use of gated CT to better identify device-related complications with ch-TEVAR, and can be used in the design of next generation devices.
Aiming for zero: Success of the hysterectomy surgical site infection prevention bundle
Authors: Patel Ushma J , Al-Niaimi Ahmed A , Parrette Kelly M , Zerbel Sara A , Barman Stephanie M , Gill Tressa , Heisler Christine A 
Published: July 2024

Background The Center for Disease Control’s National Healthcare Safety Network (NHSN) reported increased Standardized Infection Ratios (SIRs) for hysterectomy at a large community hospital. Objective To promote a surgical site infection (SSI) prevention bundle implemented to reduce hysterectomy-associated SSI. Methods A multidisciplinary Workgroup implemented the Hysterectomy SSI Prevention Bundle in 2020 to enforce standardization of perioperative techniques. This study included all benign hysterectomies pre-implementation ( n = 857) and post-implementation ( n = 772). Per NHSN categorization guidelines, “abdominal hysterectomy” includes both open and laparoscopic routes. “Inpatient surgery” is date of discharge different from date of surgery; “outpatient surgery” is same date of discharge. “SSI” includes superficial, deep, and organ/space; “complex SSI” includes deep and organ/space. Patient demographics were categorized and evaluated for statistical significance. Results After implementation of the SSI bundle, SIRs for hysterectomy were reduced to <1.0, indicating infection prevention. Reductions in SIR were significant for outpatient abdominal hysterectomy (0.868 [ p = .007]), inpatient vaginal hysterectomy (0 [ p < .001]), inpatient complex abdominal hysterectomy (0 [ p = .040]), and inpatient complex vaginal hysterectomy (0 [ p < .001]). Differences between groups were significant for increased laparoscopic and decreased vaginal hysterectomies ( p < .001), increased outpatient surgeries ( p < .001), and longer procedure duration ( p < .001). Conclusion Implementation of an SSI prevention bundle at a large community hospital has significantly reduced SIR for inpatient vaginal hysterectomies, outpatient abdominal hysterectomies, and all inpatient complex hysterectomies.
Pipeline versus non-pipeline flow diverter treatment for M1 aneurysms: A systematic review and meta-analysis
Authors: Senol Yigit Can , Orscelik Atakan , Bilgin Cem , Kobeissi Hassan , Ghozy Sherief , Arul Santhosh , Kallmes David F , Kadirvel Ramanathan 
Published: July 2024

Background The flow diversion treatment of aneurysms located distal to the Circle of Willis has recently increased in frequency. We conducted a systematic review and meta-analysis of the clinical and radiological outcomes of flow diverter (FD) embolization in treating M1 aneurysms. Methods PubMed, Web of Science, Ovid Medline, Ovid Embase, and Scopus were searched up to May 2024 using the Nested Knowledge platform. We included studies assessing the long-term clinical and radiological outcomes for M1 aneurysms. Results of FDs classified as Pipeline Embolization Devices (PED) versus other types of FDs. Angiographic occlusion rates, ischemic and hemorrhagic complications, and favorable clinic outcomes were included. All data were analyzed using R software version 4.2.2. Results Thirteen studies with 112 total patients (58 patients for PED and 54 patients for other FD devices) were included in our meta-analysis. The overall adequate (complete + near-complete) occlusion rates were 85.1%. The complete occlusion rate was higher with PED than with other FD devices (72.9% PED and 41.6% for non-PED FDs, respectively, p-value <.01). The ischemic complications were 9.9% and 9.0% for the PED and non-PED groups, respectively ( p-value = .89). The overall modified Rankin Scale 0–2 was 100% for the non-PED and 97.1% for the PED group ( p-value = .51). In-stent stenosis rate was 7.5% for PED devices compared to 2.6% in the non-PED group ( p-value = .35). Conclusions This relatively small meta-analysis showed high rates of adequate and complete occlusion in FD treatment of M1 segment aneurysms, with favorable safety profiles. PEDs were associated with higher rates of complete aneurysm occlusion compared to other types of FDs.
A rapid review protocol of physiotherapy and occupational therapy telerehabilitation to inform ethical and equity concerns
Authors: Veras Mirella , Sigouin Jennifer , Auger Claudine , Auger Louis-Pierre , Ahmed Sara , Boychuck Zachary , Cavallo Sabrina , Lévesque Martine , Lovo Stacey , Miller William C , Nelson Michelle , Norouzi-Gheidari Nahid , O’Neil Jennifer , Perreault Kadija , Urbanowski Reg , Sheehy Lisa , Singh Hardeep , Vincent Claude , Wang Rosali , Zidarov Diana , Hudon Anne , Kairy Dahlia 
Published: July 2024

Background Telerehabilitation (TR) has emerged as a feasible and promising approach for delivering rehabilitation services remotely, utilizing technology to bridge the gap between healthcare providers and patients. As new modalities of virtual care and health technologies continue to emerge, it is crucial to stay informed about the growing landscape of virtual care to ensure that telehealth service delivery is ethical and equitable, and improves the quality of services and patient outcomes. Objective The primary objective of this article is to present the protocol of a rapid review to examine the equity-related aspects surrounding the implementation of TR. This includes a comprehensive analysis of the ethical dimensions and fairness concerns linked to this practice. Methods A rapid review protocol was developed in accordance with Cochrane Rapid Reviews Methods Guidance. Medline and EMBASE databases were searched between January 2010 and March 2023. Study selection and data extraction will be conducted in two phases (Phase I) by two independent reviewers and subsequently (Phase II) by a single reviewer. Our study will utilize the PROGRESS-Plus and Equitable virtual rehabilitation in the metaverse era framework to identify dimensions where potential inequities may exist within TR interventions. Results This rapid review is anticipated to enhance our knowledge of TR in the fields of physiotherapy and occupational therapy, with a specific focus on its influence on ethical and equitable practices and providing a foundation for informed decision-making and improved patient care. Conclusion This rapid review will contribute to the advancement of our understanding of TR within physiotherapy and occupational therapy. Through synthesizing existing evidence, this study not only addresses current gaps in knowledge but also offers valuable insights for future research and clinical practice in TR services.
Epidemic exposure risk assessment in digital contact tracing: A fuzzy logic approach
Authors: Rashidian Mohsen , Malek Mohammad Reza , Sadeghi-Niaraki Abolghasem , Choi Soo-Mi 
Published: July 2024

BackgroundBluetooth low energy (BLE)-based contact-tracing applications were widely used during the COVID-19 pandemic. However, the use of only the received signal strength feature for proximity calculations may not be adaptable to different virus variants or scalable for other potential epidemic diseases.ObjectiveThis study presents a novel framework in regard to evaluating and classifying personal exposure risk that considers both contact features, which include distance and length of contact, and environment features, which include crowd size and the number of recently infected cases in the environment. The framework utilizes a fuzzy expert system that is adaptable to different virus variants.MethodsThe proposed method was tested on two viruses with different close contact features, which used four membership functions and 256 fuzzy rule sets.ResultsThe proposed framework classified personal exposure risks into four classes, which include low, medium, high, and too high risk. The empirical results showed that the fuzzy logic-based approach reduced the number of false positive cases and demonstrated better accuracy and precision than the current BLE-only approaches.ConclusionsThe proposed framework provides a more practical and adaptable method in regard to assessing exposure risks in real-world scenarios. It has the potential to be scalable and adaptable to different virus variants and other potential epidemic diseases by considering both contact and environment features. These findings may be useful in order to develop more effective digital contact-tracing applications and policies.
Acceptance of mobile application-based clinical guidelines among health professionals in Northwestern Ethiopia: A mixed-methods study
Authors: Baykemagn Nebebe Demis , Nigatu Araya Mesfin , Fikadie Berhanu , Tilahun Binyam 
Published: July 2024

Background Globally, healthcare providers have faced significant difficulties in adhering to clinical guidelines. Applying mobile health systems is a crucial strategy for enhancing the dissemination and accessibility of clinical guidelines. This study aimed to assess the acceptance of mobile app-based primary healthcare clinical guidelines and associated factors among health professionals in central Gondar health centers. Methods A cross-sectional study supplemented with qualitative data was conducted on 403 health workers. Data were collected using a pre-test structured printed questionnaire and entered into EpiData version 4.6. Analysis was conducted using Stata version 14, which included bivariable and multivariable logistic regression analyses. For qualitative data, thematic analysis was conducted using Open Code v.4.2. Results Approximately 28% (95% confidence interval (CI): 23%–32%) of health professionals had utilized mobile app-based clinical guidelines. The availability of IT support (adjusted odds ratio (AOR)  = 3.51, 95% CI: 1.82–6.78), good knowledge (AOR = 3.46, 95% CI: 1.5–6.78), perceived usefulness (AOR = 2.21, 95% CI: 1.00–4.99), m-Health app exposure (AOR = 2.34, 95% CI: 1.2–4.50), and ease of use (AOR = 5.77, 95% CI: 2.50–13.32) were significantly associated with the acceptance of the mobile app-based clinical guideline. In qualitative data, lack of training and supervision and access to smartphones were barriers to acceptance of the mobile app-based clinical guideline. Conclusion In summary, acceptance of the app is currently low. However, it can be increased by improving the availability of IT support in the workplace, offering training and supervision, and enhancing access to smartphones.
Acceptability and usability of a WeChat-based intervention for depression in China: A mixed-methods study
Authors: Tan Yuxi , Lattie Emily G , Xiang Hui , Tang Hui , Teng Ziwei , Qiu Yan , Chen Jindong , Wu Haishan 
Published: July 2024

Background As research on the use of mobile technology to deliver mental health support grows, the research from China is still very limited. How to design an acceptable and usable mobile mental health service model suitable for China's social and cultural environment remains to be studied. Objective To understand the acceptability and usability of a WeChat-based intervention among Chinese patients with depression, and to provide insights to promote future development of user-centered mobile mental health services design. Methods The research team developed a multi-theoretical intervention that includes seven modules: recovery lessons, recovery journal, coaching sessions, mindfulness, personalized support, regular assessments and feedback collection. Forty-two patients diagnosed with depressive disorder were recruited, with a mixed sample of patients who were using an antidepressant medication ( n = 29) and patients who were not using an antidepressant medication ( n = 13). A single-arm mixed-methods study was conducted to understand engagement, satisfaction, usability and potential clinical effectiveness of the intervention. Results There was a retention rate of 83.33% — 22 participants who used an antidepressant medication and 13 participants who did not use an antidepressant medication completed the final assessments. The median (upper quartile–lower quartile) of the completed 60 recovery journals and 7 coaching sessions was 56 (59–46) and 6 (7–4) times, respectively. Participants' satisfaction regarding their recovery progress, and on perceived helpfulness on different modules were high. The overall score of the user version of the Mobile Application Rating Scale was 4.23 (SD 0.44, range 1–5), indicating high acceptability and usability. Qualitative feedback identified three key themes: an efficient access to professional help, a personalized source of social support, and a facilitator of cognitive and behavioral change. Conclusions This study demonstrated that a WeChat-based intervention for depression was acceptable, and has the potential to promote personal recovery. More studies are needed to understand the efficacy and implementation of this model in real world.
Comparison between clinical and computerized methods for assessing gingival pigmentation
Authors: Nik Azis Nik Madihah , Abdul Shukor Siti Nuramanina , Razali Masfueh , Zakaria Hanis Yasreena , Zabarulla Nur Zafira 
Published: July 2024

Background and Objective Digital computerized assessment can provide objective values for the measurement of gingival pigmentation. This study aims to compare the Commission Internationale de l’Eclairage Lab color space (CIELAB) values and the computerized intensity values (CIVs) from digital imaging with clinical evaluations using the Dummett–Gupta Oral Pigmentation Index (DOPI) for assessing gingival pigmentation in a multi-ethnic population. Methodology Digital photographs of 188 participants were taken using standardized parameters. The buccal gingival pigmentation was evaluated using three methods (a) a clinical evaluation by two independent assessors using the DOPI, (b) the CIELAB values using the Adobe Photoshop® software (Version 23.1.1) and (c) the CIV calculated using the ImageJ software (Version 1.53k). A hierarchical clustering analysis was used to identify colour groups that clustered together. Agreement between the clinical and digital categorization of the pigmentation was carried out using weighted kappa analysis. Agreements between CIELAB and CIV were compared using intra-class correlation coefficient. Results There was a statistically significant difference in the DOPI, the L*, a*, and b* coordinates, and the CIV between the different ethnic groups of the participants. Cluster analysis for the CIELAB and CIV both identified four clusters. The gingival pigmentation categorization using the L*, a*, and b* values moderately agreed with the clinical evaluation using the DOPI index while the categorization with the CIV was in slight agreement with the clinical evaluations. Conclusion This study identified four clusters of gingival pigmentation in 188 multi-ethnic participants. The clusters, determined by CIELAB values, align with the clinical assessment of gingival pigmentation. Digital measurements derived from clinical photographs can serve as an effective means of pigmentation measurement in dental clinics.
A 10-year retrospective cohort of diabetic patients in a large medical institution: Utilizing multiple machine learning models for diabetic kidney disease prediction
Authors: Li Guangpu , Li Jia , Tian Fei , Ren Jingjing , Guo Zuishuang , Pan Shaokang , Liu Dongwei , Duan Jiayu , Liu Zhangsuo 
Published: July 2024

Objective As the prevalence of diabetes steadily increases, the burden of diabetic kidney disease (DKD) is also intensifying. In response, we have utilized a 10-year diabetes cohort from our medical center to train machine learning-based models for predicting DKD and interpreting relevant factors. Methods Employing a large dataset from 73,101 hospitalized type 2 diabetes patients at The First Affiliated Hospital of Zhengzhou University, we analyzed demographic and medication data. Machine learning models, including XGBoost, CatBoost, LightGBM, Random Forest, AdaBoost, GBDT (gradient boosting decision tree), and SGD (stochastic gradient descent), were trained on these data, focusing on interpretability by SHAP. SHAP explains the output of the models by assigning an importance value to each feature for a particular prediction, enabling a clear understanding of how individual features influence the prediction outcomes. Results The XGBoost model achieved an area under the curve (AUC) of 0.95 and an area under the precision-recall curve (AUPR) of 0.76, while CatBoost recorded an AUC of 0.97 and an AUPR of 0.84. These results underscore the effectiveness of these models in predicting DKD in patients with type 2 diabetes. Conclusions This study provides a comprehensive approach for predicting DKD in patients with type 2 diabetes, employing machine learning techniques. The findings are crucial for the early detection and intervention of DKD, offering a roadmap for future research and healthcare strategies in diabetes management. Additionally, the presence of non-diabetic kidney diseases and diabetes with complications was identified as significant factors in the development of DKD.
Association between fitness technology use and physical activity mediated by communication behaviors on social media
Authors: Zheng Xia , Li Wenbo 
Published: July 2024

Objective Fitness technologies, such as smartphone applications and wearable tracking devices, have gained widespread popularity. This study had two main objectives: 1) to examine whether fitness technology use is associated with increased physical activity (PA) levels and 2) to investigate whether communication behaviors on social media mediated the association between fitness technology use and PA. Methods Data were from the U.S. Health Information National Trends Survey 2022 ( N = 6,252, weighted N = 258,418,467). Weighted linear regressions were conducted to examine the associations between fitness technology usage, physical activities, and communication behaviors on social media. Mediations were tested using PROCESS macro, a path-analysis based tool. Results Controlling for demographic and other known influences on PA, the findings revealed that users of fitness technology reported higher levels of both moderate PA ( β = .41, p < 0.001) and strength training ( β = .29, p < 0.001). Additionally, communication behaviors (i.e., sharing personal health information on social media and watching health-related videos on social media) mediated the relationship between fitness technology use and frequencies of strength training. Conclusion The results underscored the potential of fitness technologies in enhancing PA levels through promoting communication behaviors on social media.