bluuebunny/crossref_metadata_2025_split huggingface dataset:
Which treatment strategy for irreparable rotator cuff tears is most cost‐effective? A Markov model‐based cost‐utility analysis comparing superior capsular reconstruction, lower trapezius tendon transfer, subacromial balloon spacer implantation and reverse shoulder arthroplasty
Authors: Oeding Jacob F. , Kunze Kyle N. , Pareek Ayoosh , Samuelsson Kristian 
Published: February 2025

AbstractPurposeTreatment options for irreparable rotator cuff tears (IRCTs) remain controversial and include superior capsular reconstruction (SCR), lower trapezius tendon transfer (LTTT), subacromial balloon spacer (SABS), and reverse shoulder arthroplasty (RSA). Despite reports of positive treatment responses with all approaches, the relative clinical benefit in the context of associated cost has not been well delineated. The purpose of this study was to determine the most cost‐effective treatment strategy among SCR, LTTT, SABS, and RSA for patients with massive IRCTs.MethodsA Markov Chain Monte Carlo probabilistic model was developed to evaluate the outcomes and costs of 1000 simulated patients undergoing either SCR, LTTT, SABS, or RSA for massive IRCTs. Upfront costs, health utility values, and reoperation rates including revisions and conversion to RSA were derived from the published literature. Outcome measures included costs, quality‐adjusted life years (QALYs), and the incremental cost‐effectiveness ratio (ICER).ResultsMean total costs of SCR, RSA, LTTT, and SABS were $30,540 ± 5,770, $26,896 ± 5,622, $25,819 ± 4,325, and $16,412 ± 2,583, respectively. On average, total QALYs from SCR, RSA, LTTT, and SABS were 6.17 ± 0.53, 3.78 ± 0.38, 5.33 ± 0.49, and 5.59 ± 0.48. Overall, SCR was determined the preferred, most cost‐effective strategy in 60% of patients included in the microsimulation model, with SABS the optimal strategy in 31% of cases and LTTT the optimal strategy in 9% of cases.ConclusionSCR was found to be the most cost‐effective treatment option for IRCTs based on the current microsimulation and probabilistic sensitivity analyses, although LTTT and SABS were also found to be cost‐effective in select patients. Given that this statistical model does not consider the unique experiences of individual patients, shared decision‐making remains an important component in determining the optimal treatment strategy for IRCTs.Level of EvidenceLevel III, economic decision model.
Integrated multi‐month dispensing for HIV and hypertension in South Africa: A model of epidemiological impact and cost‐effectiveness
Authors: Jo Youngji , Rosen Sydney , Nichols Brooke E. , Jamieson Lise , Lekodeba Nkgomeleng , Horsburgh Robert 
Published: February 2025

AbstractIntroductionIn the current era of universal antiretroviral treatment (ART), health systems have the dual challenge of a growing number of people living with HIV and on ART who are also receiving chronic, life‐long treatment for non‐communicable diseases. Current evidence suggests that 6‐month multi‐month dispensing (6MMD) can maintain at least equivalent clinical outcomes to conventional care and reduce costs, but little is known when integrating 6MMD for multiple conditions. We examined the cost‐effectiveness of integrated multi‐month drug dispensing for people living with HIV and hypertension.MethodsUsing an age‐ and sex‐specific hybrid decision tree and Markov state‐transition model, we constructed a 100,000‐person simulated population cohort who may develop HIV and hypertension and initiate treatment at clinics in South Africa over a 10‐year time horizon. We assessed the incremental costs and effectiveness of 6MMD versus conventional care from a health system perspective under different conditions of care‐seeking, eligibility and uptake of 6MMD for clinically stable patients. Model inputs were sourced from previously published literature. 6MMD was defined as reducing the frequency of clinic visits by increasing the number of medications dispensed to stable patients at each visit from 3 to 6 months. For the integrated 6MMD, we assumed that comorbid patients receive both HIV and hypertension drugs at the same facility on the same day.ResultsOur study demonstrates that integrated 6MMD for HIV and hypertension in South Africa can avert between 0.8 and 1 DALYs and increase health systems costs between $24 and $49 per patient per year, compared to the status quo. One‐way sensitivity analysis showed that HTN drug cost and prevalence of HIVHTN and HIV were key drivers in the cost per DALYs averted. Overall, integrated 6MMD with a greater proportion of well‐controlled patients and lower mortality rates led to greater cost savings or better cost‐effectiveness (less than $50 per DALY averted) across a wide range of loss‐to‐follow‐up (LTFU) factor variation.ConclusionsBy better controlling disease among patients already in care, integrated 6MMD can be more beneficial than the status quo treatment by resulting in fewer cases of LTFU and fewer deaths through high‐quality care.
Integrating hepatitis C testing and treatment into routine HIV care in Cameroon is feasible
Authors: Kowo Mathurin Pierre , Coyer Liza , Sini Victor , Kafack Carole Assontsa , Metomo Gabriella Yelheen , Wafeu Guy S. , Njouom Richard , Boers Alexander , Coutinho Roel , Njoya Oudou , Kouanfack Charles ,   the DHEPC project team
Published: February 2025

AbstractIntroductionHepatitis C virus (HCV) prevalence and adverse outcomes are higher among people with human immunodeficiency virus (HIV) than people without HIV. Yet, HCV prevalence among people with HIV in Cameroon remains unknown, with HCV diagnosis and treatment largely inaccessible due to care centralization by specialists with high out‐of‐pocket costs. Integration of HCV services into routine HIV care by general practitioners could improve diagnosis and treatment coverage. We aimed to examine HCV prevalence and treatment cure rate among people with HIV attending 11 HIV clinics in the Centre Region of Cameroon.MethodsWe offered HCV rapid antibody testing, and, if positive, RNA testing to all persons ≥21 years, on HIV ART for ≥6 months and with suppressed HIV RNA (<1000 copies) who attended HIV counselling and treatment appointments between 20 April 2021 and 31 May 2022. Participants with an HCV RNA positive test received 12 weeks of pangenotypic sofosbuvir/velpatasvir. We calculated the cure rate as the proportion of participants with a sustained virological response 12 weeks after treatment completion (SVR12) among all starting and completing treatment.ResultsWe tested 8266 persons for HCV antibodies, 316 (3.8%, 95% CI = 3.4−4.3%) of whom were anti‐HCV positive. Of these, 286 (90.5%) were sampled for HCV RNA, 20 (6.3%) ineligible, 5 (1.6%) declined, 4 (1.3%) left before sampling and 1 (0.3%) had an unknown reason. Among 286 sampled, 251 (87.8%) had detectable HCV RNA. Of these, 173 (68.9%) enrolled for treatment, 55 (21.9%) were eligible but not enrolled (49 lost‐to‐follow‐up, 6 denied) and 23 (9.2%) were ineligible. Of 173 enrolled, 165 completed treatment, 6 were lost‐to‐follow‐up and 2 were excluded due to treatment interruption. SVR12 was achieved in 93.6% (n = 162; 95% CI: 88.9–96.8%) of those enrolled and 98.2% (95% CI: 94.8–99.6%) of treatment completers. All three initially not achieving SVR12 were cured with second‐line treatment (sofosbuvir/velpatasvir/voxilaprevir).ConclusionsOur study demonstrates the viability of integrating HCV testing and treatment into routine HIV care in Cameroon, yielding new HCV diagnoses and high cure rates. Cameroon can use this strategy to achieve HCV elimination goals, although improvements in testing uptake, diagnosis and treatment access, and laboratory capacity are needed.
Implantable cardiac defibrillator outcomes in octogenarians
Authors: Stringer Bryan , MacLeod Luke , Kaldas Fady , Krishnasamy Gayuni , Khan Habib Rehman 
Published: February 2025

AbstractBackgroundImplantable cardiac defibrillators (ICDs) are essential for preventing sudden cardiac death. Despite inclusion in national guidelines, older adults are often underrepresented in trials. Evaluating ICD use in the aging population, particularly with advancements in heart failure treatment, is crucial.ObjectiveThis study examines outcomes in octogenarians undergoing ICD implantation for primary and secondary prevention, focusing on ICD therapies and mortality timing.MethodsA retrospective observational study at a single Canadian academic center included patients ≥80 years old at ICD implantation, excluding those with <30 days follow‐up. Data on demographics, comorbidities, mortality, and ICD therapies were collected from electronic medical records. Clinical frailty was assessed using the Dalhousie Clinical Frailty Scale.ResultsWe identified 143 patients (mean age 82.6 ± 2.2 years, 14% female) from May 2015 to October 2023. ICDs were implanted for primary prevention in 63 patients (44%) and secondary prevention in 80 patients (56%). Thirty‐seven patients were excluded due to insufficient follow‐up. ICD therapies occurred in 30 patients (25%) through anti‐tachycardia pacing (ATP) and in 19 patients (18%) through shocks. The mean time to first ATP was 16.9 ± 21.0 months, and to first shock, 21.2 ± 23.6 months. Among 66 patients with mortality data, 19 (24%) died at 31.3 ± 30.4 months. Patients with non‐ischemic cardiomyopathy experienced earlier shocks (7.7 vs. 32.2 months, p < 0.05).ConclusionElderly patients undergoing ICD implantation have multiple comorbidities and competing causes of mortality. Device use is overall infrequent but occurs well before observed mortality. Prospective clinical trials are needed to determine ICD benefits in this age cohort.
Prenatal Diagnosis and Classification of Type I Persistent Left Superior Vena Cava
Authors: Li Tian‐gang , Wei Chuan‐min , Wu Wen‐rui , Sheng Yu‐Wu 
Published: February 2025

ObjectiveThis study aimed to assess the utility of two‐dimensional (2D) ultrasonography in diagnosing and classifying fetal type I persistent left superior vena cava (PLSVC).MethodsThe diameter (D1) of the coronary sinus (CS) was measured in the four‐chamber view and the diameter (D2) of the PLSVC was measured in the three‐vessel trachea view; the ratio of the diameter of CS to PLSVC (D1/D2) and the ratio of gestational week (GA)/D1 and GA/D2 were calculated to analyze the correlation between measurement and classification of type I PLSVC.ResultsCompared the parameter of Ia and Ib Group, the differences in D1, D2, GA/D1, and GA/D2 were statistically significant (P < .05). D1 and D2 are independent factors for the differential diagnosis of type I PLSVC, with odds ratios (OR) of 5.397 and 2.661, respectively, and both are statistically significant (P < .05). The nomogram model exhibited superior performance in diagnosing type I PLSVC, with the highest AUC value of 0.853, a sensitivity of 96.55%, and a specificity of 66.25%.ConclusionThe combination of D1, D2, GA/D1, and GA/D2 is valuable for diagnosing and classifying fetal type I PLSVC, demonstrating significant clinical application value.
Partial Hölder regularity for asymptotically convex functionals with borderline double‐phase growth
Authors: Chang Wenrui , Zheng Shenzhou 
Published: February 2025

AbstractWe study partial Hölder regularity of the local minimizers with to the integral functional in a bounded domain for . Under the assumption of asymptotically convex to the borderline double‐phase functional
where satisfies VMO in and is continuous in , respectively, and is a strongly log‐Hölder continuous function, we prove that the local minimizer of such a functional is locally Hölder continuous with an explicit Hölder exponent in an open set with for some small , where denotes ‐dimensional Hausdorff measure.
The Genetics of 241 Fetuses With Talipes Equinovarus: A 8‐Year Monocentric Retrospective Study
Authors: Pan Pingshan , Huang Dongbing , Wei Jiangxuan , He Wei , Huang Peng , Yi Sheng , Huang Jing , Meng Dahua , Tan Shuyin , Li Xinyan , Wei Hongwei , Wang Linlin 
Published: February 2025

ABSTRACTObjectiveThis study aims to investigate the utility of chromosomal microarray analysis (CMA) and whole exome sequencing (WES) in fetuses diagnosed with talipes equinovarus (TE), as well as to explore the genetic factors contributing to TE.MethodsThe study reviewed a total of 241 fetuses with TE between January 2015 and December 2023, categorizing them into two groups based on the absence or presence of additional ultrasound anomalies: 163 cases (67.6%) in the isolated TE group and 78 cases (32.4%) in the syndromic TE group. Karyotyping and CMA were performed for all cases, with WES being performed for 18 cases that had normal karyotype and CMA results.ResultsThe results indicated a total detection rate of 16.2% (39/241) using karyotyping and CMA. Furthermore, the detection rates of karyotyping and CMA in the isolated TE group and syndromic TE group were 10.4% (17/163) and 28.2% (22/78) respectively, showing a statistically significant difference (p < 0.05). WES was conducted on 18 fetuses with normal karyotyping and CMA results. A total of six cases, consisting of five cases with pathogenic single nucleotide variant (SNV) and one case of variants of uncertain significance (VUS), were identified, resulting in a detection rate of 33.3% (6/18). The identified SNVs was associated with the RIT1, GNPNAT1, PEX1, RYR1, ASCC1, and GDAP1 genes. The detection rates of WES in the isolated TE group and syndromic TE group were 25% (1/4) and 35.7% (5/14) respectively, with no statistically significant difference (p > 0.05). The overall diagnostic yield of genetic testing was 18.7% (45/241) in fetuses with TE.ConclusionWhen prenatal ultrasound identifies fetal TE, chromosome karyotyping and CMA should be considered as the first‐line diagnostic tests. Unlike previous studies, this study recommended WES in cases of normal CMA results for both isolated and syndromic fetal TE.
Lesion segmentation method for multiple types of liver cancer based on balanced dice loss
Authors: Xie Jun , Zhou Jiajun , Yang Meiyi , Xu Lifeng , Li Tongtong , Jia Haoyang , Gong Yu , Li Xiansong , Song Bin , Wei Yi , Liu Ming 
Published: February 2025

AbstractBackgroundObtaining accurate segmentation regions for liver cancer is of paramount importance for the clinical diagnosis and treatment of the disease. In recent years, a large number of variants of deep learning based liver cancer segmentation methods have been proposed to assist radiologists. Due to the differences in characteristics between different types of liver tumors and data imbalance, it is difficult to train a deep model that can achieve accurate segmentation for multiple types of liver cancer.PurposeIn this paper, We propose a balance Dice Loss(BD Loss) function for balanced learning of multiple categories segmentation features. We also introduce a comprehensive method based on BD Loss to achieve accurate segmentation of multiple categories of liver cancer.Materials and methodsWe retrospectively collected computed tomography (CT) screening images and tumor segmentation of 591 patients with malignant liver tumors from West China Hospital of Sichuan University. We use the proposed BD Loss to train a deep model that can segment multiple types of liver tumors and, through a greedy parameter averaging algorithm (GPA algorithm) obtain a more generalized segmentation model. Finally, we employ model integration and our proposed post‐processing method, which leverages inter‐slice information, to achieve more accurate segmentation of liver cancer lesions.ResultsWe evaluated the performance of our proposed automatic liver cancer segmentation method on the dataset we collected. The BD loss we proposed can effectively mitigate the adverse effects of data imbalance on the segmentation model. Our proposed method can achieve a dice per case (DPC) of 0.819 (95%CI 0.798–0.841), significantly higher than baseline which achieve a DPC of 0.768(95%CI 0.740–0.796).ConclusionsThe differences in CT images between different types of liver cancer necessitate deep learning models to learn distinct features. Our method addresses this challenge, enabling balanced and accurate segmentation performance across multiple types of liver cancer.
Patient and clinician satisfaction with home parenteral nutrition intestinal failure telemedicine consultations: A survey of clinicians and patients
Authors: Sasegbon Ayodele , Woods Amy , Vourloitis Francesca , Barrett Maria , Cuerda Cristina , Jeppesen Palle B. , Joly Francisca , Lamprecht Georg , Mundi Manpreet , Szczepanek Kinga , Van Gossum Andre , Vanuytsel Tim , Wanten Geert , Pironi Loris , Lal Simon 
Published: February 2025

AbstractIntroductionDespite the widespread use of telemedicine to assess patients with intestinal failure (IF) receiving home parenteral nutrition (HPN), satisfaction with remote consultation methods has not been comprehensively assessed. Here, we assessed patient and clinician attitudes to telephone and video IF consultations.MethodsTelemedicine questionnaires were designed and distributed in paper form to patients with IF receiving HPN under the care of a UK national IF reference center and electronically to IF clinicians in Europe, North America, Australia, and New Zealand.ResultsSeventy‐eight patients (53 women and 25 men) and 110 clinicians agreed to complete the questionnaires. Sixty seven percent of patients who had telephone consultations and 50% of patients who had video consultations were satisfied with their consultations. Forty nine percent and 83% of patients who had telephone and video consultations, respectively, felt they were of the same standard as their face‐to‐face consultations. Despite 60% of clinicians feeling telemedicine training would be useful, 55% of clinicians stated they mostly or always met all of the needs of their patients via telephone consultations, whereas 96% of clinicians felt similarly for video consultations (P = 0.002). A total of 33% and 57% of clinicians felt telephone and video consultations, respectively, were of the same standard as face‐to‐face consultations (P = 0.004).ConclusionThis study comprehensively assesses attitudes to IF telemedicine consultations. Our data show that a large proportion of patients and clinicians are satisfied with IF telephone and video consultations. However, there is an unmet need amongst clinicians for telemedicine training.
Tall Tales or Success Stories? A Scrutiny of the Business Incubation Policy and Landscape in India
Authors: Gupta Sonali , Sunder D. L. 
Published: February 2025

ABSTRACTBusiness incubators (BIs) have been in existence since the 1950s, and they claim to assist early‐stage entrepreneurs to convert ideas into sustainable enterprises by providing resources like space, mentoring, business services, networks, and capital. Governments across the world promote BI as a policy tool, but a deep dive into the literature shows limited empirical evidence about their effectiveness. With increasing investment of public funds into incubators, it is necessary to assess their performance and success in meeting the objective of enabling new ventures. Informational roadblocks in understanding the state of business incubation can lead to convenient assumptions that all is well with the policy and practice of business incubation. This article reviews the evolution of policy, practice, and literature on Business Incubation in India and finds a vacuum with respect to systematic studies and understanding of business incubation as a process. The paper concludes by advocating for an evidence‐based approach to policy formulation and emphasizes the need for rigorous evaluation and research to ascertain the true impact of BIs on India's entrepreneurial ecosystem.
Effect of different UV absorbers on the aging performance of poly (butylene adipate‐co‐terephthalate)/poly (propylene carbonate) degradable mulch films
Authors: Lin Jun , Meng Yaming , Chai Xicun , He Chunxia 
Published: February 2025

AbstractBiodegradable agricultural mulch films composed of poly (butylene adipate‐co‐terephthalate) (PBAT) and poly (propylene carbonate) (PPC) were manufactured using the extrusion technique. Integrated three types of UV absorbers C81, UV‐944, and UV‐326. The PBAT and PBAT/PPC mulch films acted as control samples. Preliminary performance assessments indicated that incorporating PPC significantly enhances the tensile strength of the PBAT mulch film. Notably, C81 increased the absorbance capacity of the PBAT/PPC mulch film within the 315~350 nm spectrum, whereas both C81 and UV‐944 improved the light transmittance characteristics of the mulch film. After 21‐day UV aging text, the tensile strength of the mulch films containing C81 and UV‐944 surpassed 15 MPa, with elongation at break exceeding 300%. This suggests that C81 and UV‐944 enhance the ultraviolet resistance of the mulch films. Furthermore, following 21‐day artificial climate aging test, the tensile strength of the PBAT/PPC mulch film with C81 also exceeded 15 MPa, showcasing not only exceptional UV resistance but also the ability to mitigate effects from artificial climate aging. SEM indicated that the ultraviolet absorbers hinder the aging process of the mulch films by minimizing the generation of flaky materials, thus safeguarding the mechanical integrity of the PBAT/PPC film.Highlights
UV absorbers enhance the mechanical properties of the PBAT/PPC mulch films after aging.
C81 increased the absorbance capacity of the PBAT/PPC mulch film.
The PBAT/PPC mulch film containing C81 exhibits the best performance.
Development of sustainable polymer composite with agro‐industrial residue for biomedical applications
Authors: Ali Shafahat , Deiab Ibrahim , Pervaiz Salman , Eltaggaz Abdelkrem 
Published: February 2025

AbstractThe excessive use of plastics has raised significant environmental concerns, including harm to marine ecosystems and pollution. PLA, a widely used bioplastic, suffers from low toughness and thermal stability, limiting its industrial applications. This study addresses these limitations by incorporating soybean hulls, a biodegradable agricultural waste, as a filler in PLA/PBAT blends to develop sustainable composites for 3D printing. Advanced optimization techniques, including grey relational analysis (GRA) and Taguchi design of experiments (TGRA), were used to optimize printing parameters. Results showed that the raster angle had the most significant influence on mechanical properties (70%). Validation tests using optimized parameters demonstrated a 23% decrease in tensile strength with 10 wt% soybean hulls but a 35% increase in flexural strength and only a 3% reduction in impact strength. These properties make the composite suitable for biomedical and rigid packaging applications. Scanning electron microscopy revealed voids, pullouts, and reduced interlayer adhesion, providing insights into the material's microstructure. This study highlights the innovative use of agricultural waste in 3D printing, combining eco‐friendly composites with advanced optimization techniques to improve sustainability and mechanical performance.Highlights
Biodegradable PLA/PBAT composites with soybean hull made via FDM were studied.
Raster angle influences 70% of mechanical property variations in composites.
Adding 10% soybean hull increased flexural strength by 35% and reduced tensile by 23%.
Grey relational analysis optimized printing improves composite properties.
Eco‐friendly composites could replace petroleum plastics for biomedical purposes.