bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Cost-Effectiveness of Computer-Assisted Compared with Conventional Total Knee Arthroplasty
Authors: Tian Yao , Ahmed Abdalrahman G. , Hiredesai Annika N. , Huang Lynn Wei , Patel Ankita M. , Ghomrawi Hassan M.K. 
Published: April 2024

Background:
Recent evidence showing that computer-assisted total knee arthroplasty (TKA) is associated with better outcomes compared with conventional TKA for patients with end-stage knee osteoarthritis has not been included in economic evaluations of computer-assisted TKA, which are needed to support coverage decisions. This study evaluated the cost-effectiveness of computer-assisted TKA from a payer’s perspective, incorporating recent evidence.

Methods:
We compared computer-assisted TKA with conventional TKA with regard to costs (in 2022 U.S. dollars) and quality-adjusted life-years (QALYs) using Markov models for elderly patients (≥65 years of age) and patients who were not elderly (55 to 64 years of age). Costs and QALYs were estimated in the lifetime for elderly patients and in the short term for patients who were not elderly, under a bundled payment program and a Fee-for-Service program. Transition probabilities, costs, and QALYs were retrieved from the literature, a national knee arthroplasty registry, and the National Center for Health Statistics. Threshold and probabilistic sensitivity analyses were conducted to examine the robustness of key estimates used in the base-case analysis. Using projected estimates of TKA utilization, the total cost savings of performing computer-assisted TKA rather than conventional TKA were estimated.

Results:
Compared with conventional TKA, computer-assisted TKA was associated with higher QALYs and lower costs for both elderly patients and patients who were not elderly, regardless of payment programs, making computer-assisted TKA a favorable treatment option. Widespread adoption of computer-assisted TKA in all U.S. patients would result in an estimated total cost saving of $1 billion for payers.

Conclusions:
Compared with conventional TKA, computer-assisted TKA reduces costs to payers while providing favorable outcomes. Payers may consider providing additional payment incentives to providers for performing computer-assisted TKA, to achieve outcome improvement and cost control by facilitating widespread adoption of computer-assisted TKA.

Level of Evidence:
Economic and Decision Analysis Level II. See Instructions for Authors for a complete description of levels of evidence.
Long-Term Outcomes of Arthroscopic Labral Treatment of Femoroacetabular Impingement in Adolescents
Authors: Domb Benjamin G. , Prabhavalkar Omkar N. , Maldonado David R. , Perez-Padilla Paulo A. 
Published: April 2024

Background:
Hip arthroscopy has demonstrated effectiveness as a treatment for femoroacetabular impingement (FAI) in adult patients, with promising long-term outcomes. However, there is a paucity of literature regarding the adolescent population. The purposes of our study were to report on survivorship and patient-reported outcomes (PROs) at a minimum 10-year follow-up in adolescent patients who underwent hip arthroscopy for FAI and labral tears and to compare the survivorship and outcomes of this population with those of a nested, propensity-matched adult control group.

Methods:
Data regarding adolescent patients who underwent primary hip arthroscopy between February 2008 and January 2012 were reviewed. Patients with a minimum 10-year follow-up for the modified Harris hip score (mHHS), Non-Arthritic Hip Score (NAHS), Hip Outcome Score Sport-Specific Subscale (HOS-SSS), International Hip Outcome Tool-12 (iHOT-12), and visual analog scale (VAS) for pain were eligible. The exclusion criteria were previous ipsilateral hip conditions or surgical procedures, a Tönnis grade of >1, or dysplasia. In the subanalysis, adolescent patients were matched to young adult patients with use of a 1:1 ratio on the basis of sex, body mass index, Tönnis grade, lateral center-edge angle (LCEA), labral treatment, capsular treatment, and additional procedures performed during the surgery.

Results:
A total of 74 patients (61 female and 13 male; 74 hips) with a mean (and standard deviation) age of 16.7 ± 1.4 years and a minimum follow-up of 10 years were included. The latest follow-up occurred at a mean of 125.4 ± 5.3 months (range, 120.0 to 144.1 months). Significant improvement in all PROs from baseline and 100% survivorship were demonstrated at the 10-year follow-up. In the subanalysis, 58 adolescent hips were propensity-matched to 58 young adult hips. The adolescent group had higher postoperative scores for the HOS-SSS (p = 0.021), NAHS (p = 0.021), and iHOT-12 (p = 0.042) than the young adult group. Patient satisfaction at the latest follow-up was also significantly higher in the adolescent group (p = 0.00061). The rate of survivorship free from conversion to THA was similar between the adolescent and control groups (100% versus 96.6%; p = 0.200).

Conclusions:
Adolescents undergoing hip arthroscopy for the treatment of FAI and labral tears demonstrated excellent outcomes and a high rate of survivorship. These outcomes were superior to those seen in a matched adult group. The results of this study indicate that hip arthroscopy in adolescents is a safe procedure that leads to improvement in outcomes at long-term follow-up.

Level of Evidence:
Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
Unveiling enigmatic phase transitions of water in the supercooled region and no man’s land
Authors: Kim Kwang , Pourasad Saeed 
Published: April 2024

Abstract

In the perplexing domain of supercooled water, scientists have dedicated decades to unraveling its mysteries. Using advanced sampling methods within the TIP4P/2005 water model, this study pinpoints the second critical point at temperature Tc= 238±2 K and pressure Pc= 288±30 bar, signifying an abrupt first-order to a gradual continuous phase transition. It also reveals a transition temperature Tt=172±1 K at which a pivotal transformation unfolds, marking the stability switching of a two-step nucleation process, unveiling a previously unnoticed mid-density state bridging high- and low-density liquid states. These findings redefine our understanding of liquid-liquid phase transition, contributing to a comprehensive phase diagram for supercooled water including the elusive "no man’s land, unravelling its intricate complexity.
Biohydrogen Production from Lignocellulosic Hydrolysate: Unveiling Synergistic Impact of Substrate Concentration and Furfural Inhibition
Authors: Haroun Basem , El-Qelish Mohamed , Akobi Chinaza , Hafez Hisham , Nasr Fayza , Kim Mingu , Nakhla George 
Published: April 2024

Abstract

The pulp and paper industry discharges large quantities of lignocellulosic wastewater which if not properly managed, will cause serious environmental pollution. The current study hereby examined the influence of lignocellulosic hydrolysate on biohydrogen production in the presence of furfural. Synthetic lignocellulosic hydrolysate, consisting primarily of 76% xylose, 10% glucose, 9% arabinose, and a mixture of other sugars such as galactose and mannose, was employed as the substrate. Various substrate concentrations ranging from 2 to 32 g/L were tested, along with furfural concentrations of 0, 1, and 2 g/L. The investigation aimed to assess the effects of initial substrate concentration, initial furfural concentration, furfural-to-biomass ratio (F/B), and furfural-to-substrate ratio (F/S) on biohydrogen production yields. The maximum specific substrate utilization rates at different substrate concentrations were effectively characterized using Haldane's substrate inhibition model. Among the tested concentrations, 16 g/L emerged as the optimal substrate concentration. The initial furfural concentration was identified as the most significant parameter impacting biohydrogen production, with complete inhibition observed at a furfural concentration of 2 g/L. Higher F/S ratios at substrate concentrations ranging from 2 to 16 g/L resulted in reduced maximum specific hydrogen production rates (MSHPR) and hydrogen yields. Substrate inhibition was observed at 24 g/L and 32 g/L. Lactate was the predominant volatile fatty acid (VFA) in all batches containing 2 g/L furfural, as well as in batches with 1 g/L furfural at substrate concentrations of 24 and 32 g/L. Furfural at a concentration of 1 g/L was not inhibitory in any of the batches.
Targeting PDS gene to establish a transgene-free genome editing system in sorghum
Authors: Zhang Yan , Cheng Ming , Massel Karen , Godwin Ian D. , Liu Guoquan 
Published: April 2024

Abstract

Genome editing in plants using CRISPR/Cas9 typically involves integrating transgenic constructs into plant genome. However, a challenge arises after the target gene is successfully edited, transgene elements such as Cas9, gRNA cassette, and selective marker genes remain integrated. This integration of transgenes causes regulatory and environmental concerns, particularly for commercialization. In addressing this issue, we present the establishment of a transgene-free genome editing system in sorghum, achieved through transient gene expression without selection. We selected the phytoene desaturase (PDS) gene as the target due to its capacity to induce a visible phenotypic change, namely albinism, upon mutation. Following microprojectile co-transformation with maize optimised Cas9 vector and a gRNA cassette with kanamycin resistance gene, immature embryo (IE) derived tissues were divided into two groups (selection and non-selection) and deployed as parallel experiments. Remarkably, 4 out of 18 homozygous/biallelic editing lines in the non-selection group were identified as transgene-free lines in the T0 generation, with no traceable transgenes. Conversely, no transgene-free editing line was achieved in the selection group. This strategy not only enables to regenerate transgene-free genome-edited lines more efficiently but also saves one generation of time by eliminating the need for self-crossing or out-crossing. Our results displayed the feasibility of achieving transgene-free genome-edited plants within a single generation in sorghum. Furthermore, this approach opens avenues for vegetatively propagated crops like pineapple, sugarcane, and banana to obtain transgene-free genome-edited lines, facilitating their commercialization.
Hypomagnesemia Is Associated with the Skull CT Black Hole Sign in Patients with Spontaneous Intracerebral Hemorrhage
Authors: Shen Zhengkui , Zhu Yan , Yan Xiaotong , Wu Guofeng 
Published: April 2024

Abstract

Objectives:Determining the value of hypomagnesemia in predicting the black hole sign in patients with intracranial hemorrhage(ICH) .
Methods: Two hundred sixty-one patients with cerebral hemorrhage who finished initial skull computed tomography(CT) were studied within 24 hours after admission . Sixty-nine patients (26.4%) demonstrated hypomagnesemia in initial laboratory tests. The black hole sign occurred in 123 patients, (named black hole sign group, including patients with and without hypomagnesemia) and the rest 138 patients(non-black hole sign group) did not show it. Multivariable logistic regression analyses were performed to assess the values of hypomagnesemia.
Results: The black hole sign occurred in 45 of the 69 (65.2%) patients with hypomagnesemia, and in 78 of the 192 (40.6%) patients without hypomagnesemia.In the black hole sign group, 45 patients (36.6%) were found to have hypomagnesemia. However, only 24 patients (19.5%) from the normal magnesium concentration group
had hypomagnesemia.The sensitivity, specificity, and positive and negative predictive values of hypomagnesemia for predicting the black hole sign were 69.9%, 82.5%, 36.6%, and 82.8%, respectively. The odd ratio for hypomagnesemia, smoking history, and hypokalemia for predicting the black hole sign were 2.74, 1.971, and 1.629, respectively.
Conclusions: Hypomagnesemia could predict the black hole sign in ICH patients and have a certain value in guiding clinical treatment.
Bioremediation of heavy metals by an unexplored bacterium, Pseudoxanthomonas mexicana strain GTZY, isolated from aerobic-biofilm wastewater system
Authors: Nelofer Abdul Raheem , Selvaraj Ganesh-Kumar , Karuppanan Kalimuthu , Ganesan Govindarajan , Soorangkattan Saravanan , Subramanian Balachandran , Baluraj Shivani Ramamurthy , Rajaiah Dhilip Kumar , Hasan Imran 
Published: April 2024

Abstract

We prompted first to characterize a wastewater bacterium, Pseudoxanthomonas mexicana GTZY, that efficiently transforms toxic mercury and arsenic and to explore its bioremediation capability and to reveal their relevant gene resistance operons. The Isolated strain was characterized for its phylogenetic, biochemical and phenotypic properties. The strain GTZY potentially removed 84.3% of mercury and their mercury volatilization (Hg(II) to Hg(0)) was confirmed using X-ray film method, and its respective merA gene was PCR amplified. In addition, strain GTZY was efficiently removed arsenate (68.5%) and arsenite (63.2%), and showed resistance up to >175 and >55 mM, respectively. Their genomic annotations were disclosed the linkage of Tn2-transposon and int1 in both ends of meroperon (merAPTR). The co-existence of arsP and arsH proteins in its intrinsic ars operon (arsCPRH) was extremely diverse from its ancestral species. We believe that mercury resistance-conferring meroperon of P. mexicana GTZY presumably derived horizontally from other species in the reactor, while arsenic resistance-conferring intrinsic ars operon was highly diversified and evolved from its ancestral species. By considering the potential of the strain GTZY to transform heavy metals, this can be used to recover contaminated sites.
The effects of glucose-containing dialysate during dialysis in maintenance haemodialysis patients with type 2 diabetes
Authors: He Li , Chen Hui , Chen Lin , Zhang Yingjun , Liu Mingming , Liu Li 
Published: April 2024

Abstract

Background：Type 2 diabetes mellitus (T2DM) is the leading cause of end-stage renal disease (ESRD), and approximately 26%～47% of haemodialysis patients have diabetes. At present, most haemodialysis treatments use glucose-free dialysate. Howerver, the use of glucose-free dialysate resulted in an increased incidence of asymptomatic hypoglycemia during dialysis treatment.The aim of this study was to investigate the effect of glucose-containing dialysate during dialysis in Maintenance haemodialysis (MHD) patients combined with type 2 diabetes.
Methods: A randomized controlled study was conducted to select 16 MHD patients with type 2 diabetes from March 2023 to April 2023. Patients were randomly divided into a glucose-containing dialysate group (n=8) and a glucose-free dialysate group (n=8). A Flash Continuous Glucose Monitoring System (CGMS) was used for blood glucose monitoring. The target time in range (TIR) of blood glucose levels, the frequency of dialysis hypoglycaemia and the changes in blood pressure and heart rate were compared between the two groups within 14 days.
Results: In the glucose-containing dialysate group, the blood glucose TIR was greater than that in the glucose-free dialysate group within 14 days (50.50% vs. 30.75%, P < 0.05), on dialysis days (75.70% vs. 57.76%, P < 0.05) and on nondialysis days (74.67% vs. 57.76%, P < 0.05). Hypoglycaemia occurred less frequently in the glucose-containing dialysate group than in the glucose-free dialysate group during 4 hours of dialysis treatment (43 vs. 205). The frequency of hypoglycaemia in the glucose-containing dialysate group was significantly lower than that in the glucose-free dialysate group at the second hour of dialysis (P < 0.05). There was no significant difference in blood pressure or heart rate fluctuation between the two groups.
Conclusion: Glucose-containing dialysate is beneficial for blood glucose management in MHD patients with type 2 diabetes, and the clinical application of glucose-containing dialysate in MHD patients with type 2 diabetes should be improved.
All-magnonic repeater based on bistability
Authors: Wang Qi , Verba Roman , Davídková Kristýna , Heinz Björn , Tian Shixian , Rao Yiheng , Guo Mengying , Guo Xueyu , Dubs Carsten , Pirro Philipp , Chumak Andrii 
Published: April 2024

Abstract

Bistability, a universal phenomenon found in diverse fields such as biology, chemistry, and physics, describes a scenario in which a system has two stable equilibrium states and resets to one of the two states. The ability to switch between these two states is the basis for a wide range of applications, particularly in memory and logic operations. Here, we present a universal approach to achieve bistable switching in magnonics, the field processing data using spin waves. As an exemplary application, we use magnonic bistability to experimentally demonstrate the still missing magnonic repeater. A pronounced bistable window is observed in a 1 μm wide magnonic conduit under an external rf drive characterized by two magnonic stable states defined as low and high spin-wave amplitudes. The switching between these two states is realized by another propagating spin wave sent into the rf driven region. This magnonic bistable switching is used to design the magnonic repeater, which receives the original decayed and distorted spin wave and regenerates a new spin wave with amplified amplitude and normalized phase. Our magnonic repeater is proposed to be installed at the inputs of each magnonic logic gate to overcome the spin-wave amplitude degradation and phase distortion during previous propagation and achieve integrated magnonic circuits or magnonic neuromorphic networks.
Oral carbohydrate 2 hours vs long fasting in risk of reflux and aspiration: a randomized controlled trial conducted on volunteers
Authors: Zhang Gang , Huang Xiaoyan , Feng Ji , Yang Guang , Yao Fu 
Published: April 2024

Abstract

Background: There is controversy over whether carbohydrate drinks should be allowed before surgery due to concerns about aspiration.
Methods: Volunteers were randomly assigned to either an experimental group (E) or control group (C). Group E drank less than 400ml of carbohydrate after 6 hours of fasting, while group C continued to fast without any beverage. They received ultrasound evaluation every hour. The primary outcome was the incidence of risk stomach.
Results: The total incidences of risk stomach in group E and C were 100% vs 13%, 70% vs 10%, 13.3% vs 6.6%, 10% vs 6.6% at T0, T1, T2, T3 respectively. There were no significant differences between the two groups at T2 and T3. The gastric volume of group E and C were 36.08 ± 16.90 vs 1.01 ± 16.89, 25.67 ± 20.67 vs 0.54 ± 18.10, 6.89 ± 18.32 vs -1.70 ± 15.32, 2.74 ± 16.48 vs -0.70 ± 17.57 at T0, T1, T2, T3 respectively. The VAS of hunger and thirst in the two groups were 0.60 ± 0.62 vs 1.00 ± 0.70, respectively.
Conclusion: Oral carbohydrate more than 2 hours before surgery did not increase the incidence of risk stomach and reduced preoperative hunger and thirst.
Trial registration: This was also registered prior to patient enrollment at Chinese Clinical Trial Registry. (http://www.chictr.org.cn; Registration date: 7/2/2021; Registration number: ChiCTR2100043166; Principal investigator: Gang Zhang).
A Biomimetic Multi-Component Subunit Vaccine via Ratiometric Loading of Hierarchical Hydrogels
Authors: Scott Evan , Du Fanfan , Yuk Simseok , Qian Yuan , Vincent Michael , Bobbala Sharan , Abbott Tirzah , Kim Hyeohn , Li Haoyu , Yi Sijia , Qiao Baofu , Li Yang 
Published: April 2024

Abstract

The development of subunit vaccines that mimic the molecular complexity of attenuated vaccines has been limited by the difficulty of intracellular co-delivery of multiple chemically diverse payloads at controllable concentrations. We report on hierarchical hydrogel depots employing simple poly(propylene sulfone) homopolymers to enable ratiometric loading of a protein antigen and four physicochemically distinct adjuvants in a hierarchical manner. The optimized vaccine consisted of immunostimulants either adsorbed to or encapsulated within nanogels, which were capable of noncovalent anchoring to subcutaneous tissues. These 5-component nanogel vaccines demonstrated enhanced humoral and cell-mediated immune responses compared to formulations with standard single adjuvant and antigen pairing. The use of a single simple homopolymer capable of rapid and stable loading and intracellular delivery of diverse molecular cargoes holds promise for facile development and optimization of scalable subunit vaccines and complex therapeutic formulations for a wide range of biomedical applications.
The Degradation Mechanism of Multi-Resonance Thermally Activated Delayed Fluorescence Materials
Authors: You Youngmin , Jhun Byung Hak , Kim Hwang Suk , Kim Joonghyuk , Park Yerin , Lee Eunji , Moon Hyejin , Oh Changjin , Jung Yongsik , Choi Seunghee , Baik Mu-Hyun 
Published: April 2024

Abstract

1,4-Azaborine-based arenes gained prominence as electroluminescent emitters that exhibit thermally activated delayed fluorescence (TADF). These materials display exceptionally narrow emission spectra and high photoluminescence quantum yields, benefits arising from the multi-resonance (MR) effect. The practical application of MR-TADF emitters is often constrained by their limited operational stability. In this study, we explore the mechanism responsible for the degradation of a series of MR-TADF molecules. Electroluminescent devices employing these compounds show varied operational lifetimes, which do not align with either the excitonic stability of the emitter molecules or the degree of roll-off in external quantum efficiency. Our bulk electrolysis study reveals a considerable instability of the radical cationic forms of the MR-TADF compounds. A direct correlation is observed between device lifetime and the Faradaic yield for oxidative degradation of the emitter molecules. Comprehensive chemical analyses suggest that the degradation byproducts originate from intramolecular cyclization in the radical cation, preceded by intermolecular hydrogen atom transfer. Quantum chemical calculations indicate that this intramolecular cyclization accelerates the overall reaction, implying that cyclization reactivity is crucial for the intrinsic stability of the MR-TADF compound upon hole trapping. Our study offers an explanation for the beneficial effects of deuteration on the intrinsic stability and lays the groundwork for developing mechanism-based strategies to design MR-TADF compounds with greater operational longevity.