bluuebunny/crossref_metadata_2025_split huggingface dataset:
Antithrombin restriction in extracorporeal membrane oxygenation support (ARES): A multidisciplinary approach
Authors: Lam Jade C , Lam Erwin H , Pidathala Sai , Padiyar Josna P 
Published: June 2024

Background: Antithrombin (AT) replacement is occasionally utilized in the setting of extracorporeal membrane oxygenation (ECMO)-associated heparin resistance. Although past studies emphasized the high costs and limited clinical benefit of AT supplementation, guidance on strategies to prevent unnecessary use remain lacking. Methods: In this retrospective study, we evaluated the cost, efficacy, and safety outcomes three years pre- and post-implementation of an AT restriction protocol in adult ECMO patients. The primary endpoint was the cost spent on anticoagulation and AT normalized to ECMO duration. Secondary endpoints included thromboembolic and bleeding outcomes. Results: 175 patients were included for analysis (pre-restriction protocol n = 87; post-restriction protocol n = 88). Implementation of the restriction resulted in complete elimination of AT use and significantly reduced the primary cost endpoint from $1009.20 to $42.99 per ECMO day ( p < .001). There was no significant change in occurrence of new Venous Thromboembolism (VTE) ( p = .099). Those in the pre-implementation group had significantly higher rates of transfusions ( p < .001) and ISTH major bleeding ( p < .001). Outcomes remained significant after exclusion of patients with coronavirus infections. Conclusion: Results of this study exemplify how AT restriction can be successfully implemented to decrease anticoagulation-associated costs without jeopardizing the risk of bleeding and thrombosis in ECMO patients.
Dr Bhagwan Din Chaurasia: A Guiding Light and a Pillar of Anatomy Education in India
Authors: Vaishya Raju 
Published: June 2024

Introduction: Dr Bhagwan Din Chaurasia is a legend in Indian Anatomy education. Being his student in 1977–78, I saw him closely and was inspired immensely to write his biography to pay my homage and tribute to this great ‘guru’. Methods: Apart from my first-hand information and experience with Dr Chaurasia, I did extensive research on PubMed, Scopus and Google Scholar databases to extract his research publications. I also extracted his personal information from his old students at Gajra Raja Medical College, Gwalior (India), some of the main ones have been acknowledged in this paper. Results: Despite a shortened life, Dr Chaurasia’s influence on the field remains immense. His book, Human Anatomy has been an essential guide for countless medical students around the world. He was not only a gifted teacher but also, a dedicated researcher, actively publishing in prestigious journals. Conclusion: Dr Chaurasia’s legacy is a testament to the power of clear explanations, innovative teaching methods, and unwavering passion for Anatomy. The name Dr B. D. Chaurasia is synonymous with excellence in Anatomy education. His work will continue to inspire generations of medical professionals to come.
Refined dynamic analysis of three slab tracks on bridge structures under various high-speed train loads
Authors: Liu Hanlin , Wang Yi , Zhou Rui , Xu Jingmang , Sheng Xi , Xu Fei 
Published: June 2024

The dynamic performance of three slab ballastless tracks in the China Railway Track System (CRTS), which is supported by a simply supported box girder under various train loads, were comprehensively investigated with refined rigid-flexible coupled models. A refined rigid-flexible coupled model of vehicle-multi layer track-bridge system was developed to investigate the dynamic performance of three various CRTS slab tracks (i.e., CRTS I, II, III) under various conditions of train models, speeds and loads, respectively. The numerical analysis was conducted by using the combination of ANSYS and Universal Mechanism. It shows that the developed refined model has the capability of simulating the vehicle-slab track-bridge interaction with consideration multi-layer track structures, and the model predictions agree reasonably well with the experimentally measured wheel load reduction rate, lateral displacement and lateral acceleration of the bridge under different train speeds. The parameters of derailment system, vertical and lateral acceleration, the wheel-rail contact force, and Sperling index gradually become larger with the increase of the train speed, especially when the speed increases to 350 km/h. In addition, there is a significant increase in vertical wheel-rail contact force while a decrease in Sperling index when the train with full load capacity. Furthermore, the CRTS III slab track has demonstrated a better dynamic performance of track and bridge structures in comparison to CRTS I and CRTS II slab ballastless tracks.
The effect of thermo-oxidative ageing on the mechanical properties of unsaturated polyester/wood composites
Authors: Mousa Ahmad 
Published: June 2024

Thermo-oxidative aging (TOA) is a crucial factor that judges the serviceability of a composite material. Therefore, olive husk wastes (OHWs) was subjected to mechanical and chemical treatments in the first and second stages to check its potential as a reinforcement for unsaturated polyester (UPE) to produce PWC. The mechanical treatment involved milling using a ball mill, followed by mechanical sifting to obtain the smallest particle size. Raw OHW (R-OHW) was progressively increased from 0 to 50 phr and incorporated into the UPE resin. The prepared composites were subjected to TOA process using an air-circulating furnace. The unaged and aged samples were characterized with respect to mechanical properties. The highest retention% was displayed by the sample with 30 phr OHW. The sample with 10 and 30 phr content was subjected to hydrogen peroxide (P-OHW) and di-octylphalate (DOP) treatments (D-OHW) under ambient conditions for 24 h, followed by incorporation into the UPE resin. The prepared composites were undergone TOA process, as before. It has been found that the composition with 10 phr OHW displayed the highest retention% in terms of mechanical performance. Thus, the chemical treatment decreased the OHW amount to be incorporated into the UPE.
Cross-Frequency Coupling as a Biomarker for Early Stroke Recovery
Authors: Mark Jasper I. , Riddle Justin , Gangwani Rachana , Huang Benjamin , Fröhlich Flavio , Cassidy Jessica M. 
Published: June 2024

Background The application of neuroimaging-based biomarkers in stroke has enriched our understanding of post-stroke recovery mechanisms, including alterations in functional connectivity based on synchronous oscillatory activity across various cortical regions. Phase-amplitude coupling, a type of cross-frequency coupling, may provide additional mechanistic insight. Objective To determine how the phase of prefrontal cortex delta (1-3 Hz) oscillatory activity mediates the amplitude of motor cortex beta (13-20 Hz) oscillations in individual’s early post-stroke. Methods Participants admitted to an inpatient rehabilitation facility completed resting and task-based EEG recordings and motor assessments around the time of admission and discharge along with structural neuroimaging. Unimpaired controls completed EEG procedures during a single visit. Mixed-effects linear models were performed to assess within- and between-group differences in delta-beta prefrontomotor coupling. Associations between coupling and motor status and injury were also determined. Results Thirty individuals with stroke and 17 unimpaired controls participated. Coupling was greater during task versus rest conditions for all participants. Though coupling during affected extremity task performance decreased during hospitalization, coupling remained elevated at discharge compared to controls. Greater baseline coupling was associated with better motor status at admission and discharge and positively related to motor recovery. Coupling demonstrated both positive and negative associations with injury involving measures of lesion volume and overlap injury to anterior thalamic radiation, respectively. Conclusions This work highlights the utility of prefrontomotor cross-frequency coupling as a potential motor status and recovery biomarker in stroke. The frequency- and region-specific neurocircuitry featured in this work may also facilitate novel treatment strategies in stroke.
Relationships between symptoms and lung function in asthma and/or chronic obstructive pulmonary disease in a real-life setting: the NOVEL observational longiTudinal studY
Authors: Papi Alberto , Hughes Rod , del Olmo Ricardo , Agusti Alvar , Chipps Bradley E. , Make Barry , Tomaszewski Erin , Peres Da Costa Keith , Srivastava Divyansh , Vestbo Jørgen , Janson Christer , Burgel Pierre-Régis , Price David 
Published: June 2024

Background: The relationships between spirometric assessment of lung function and symptoms (including exacerbations) in patients with asthma and/or chronic obstructive pulmonary disease (COPD) in a real-life setting are uncertain. Objectives: To assess the relationships between baseline post-bronchodilator (post-BD) spirometry measures of lung function and symptoms and exacerbations in patients with a physician-assigned diagnosis of asthma and/or COPD. Design: The NOVEL observational longiTudinal studY (NOVELTY) is a global, prospective, 3-year observational study. Methods: Logistic regression analysis was used to evaluate relationships. Spirometry measures were assessed as percent predicted (%pred). Symptoms were assessed at baseline, and exacerbations were assessed at baseline and Year 1. Results: A total of 11,181 patients in NOVELTY had spirometry data (asthma, n = 5903; COPD, n = 3881; asthma + COPD, n = 1397). A 10% lower post-BD %pred forced expiratory volume in 1 s (FEV1) and forced vital capacity (FVC) – adjusted for age and sex – were significantly associated with dyspnea (modified Medical Research Council ⩾ grade 2), frequent breathlessness [St George’s Respiratory Questionnaire (SGRQ)], frequent wheeze attacks (SGRQ), nocturnal awakening (Respiratory Symptoms Questionnaire; ⩾1 night/week), and frequent productive cough (SGRQ). Lower post-BD %pred FEV1 and, to a lesser extent, lower post-BD %pred FVC were significantly associated with ⩾1 physician-reported exacerbation at baseline or Year 1. This association was stronger in patients with COPD than in those with asthma. Conclusion: In a real-life setting, reduced lung function is consistently associated with symptoms in patients with asthma, COPD, or asthma + COPD. The relationship with exacerbations is stronger in COPD only than in asthma. Trail registration: clinicaltrials.gov identifier: NCT02760329 ( www.clinicaltrials.gov ).
Lactobacillus reuteri compared with placebo as an adjuvant in Helicobacter pylori eradication therapy: a meta-analysis of randomized controlled trials
Authors: Li Meng , Wang Xiaolei , Dong Xinhong , Teng Guigen , Dai Yun , Wang Weihong 
Published: June 2024

Background: Given the growing problem of antibiotic resistance, it is crucial to improve Helicobacter pylori ( H. pylori) treatment interventions or provide adjunctive therapy. The objective of this meta-analysis was to evaluate whether Lactobacillus reuteri ( L. reuteri) could improve H. pylori eradication rate, reduce the incidence of adverse events (AEs), and alleviate gastrointestinal symptoms. Design: A meta-analysis of randomized controlled trials (RCTs) comparing L. reuteri supplementation therapy with placebo was conducted. Sources and methods: We retrieved relevant studies from PubMed, Embase, and the Cochrane Library. The primary outcome was H. pylori eradication rate, and the scores on the Gastrointestinal Symptom Rating Scale and AEs were secondary outcomes. Results: Eight RCTs including 1087 patients were included in this analysis. The L. reuteri supplementation group showed significantly higher H. pylori eradication rates in both intention-to-treat (ITT) and per-protocol (PP) analysis [ITT: 80.0% versus 72.6%; p = 0.005, relative risk (RR): 1.10; 95% confidence interval (CI): 1.03–1.17; number needed to treat (NNT) = 14; PP: 81.8% versus 75.0%; p = 0.006, RR: 1.09; 95% CI: 1.03–1.16; NNT = 15]. Patients treated with L. reuteri showed greater improvements in gastrointestinal symptoms (pooled mean difference: −2.43, 95% CI: −4.56 to −0.29, p = 0.03). The incidence of AEs was significantly reduced in the L. reuteri supplementation group based on ITT and PP analysis (ITT: p < 0.00001, RR: 0.72, 95% CI: 0.67–0.78; PP: p < 0.00001, RR: 0.70, 95% CI: 0.65–0.77). Conclusion: The present meta-analysis demonstrated that supplementation with L. reuteri was beneficial for improving the eradication rate of H. pylori, reducing the overall incidence of side effects, and relieving gastrointestinal symptoms in patients during treatment. The findings provide new insights into clinical decision-making. Trial registration (PROSPERO): CRD42023424052.
Management of Atrophic Edentulous Mandible Fractures Utilizing Virtual Surgical Planning and Patient-Specific Implants
Authors: Caruso Daniel P. , Aquino Vincent M. , Hajibandeh Jeffrey T. 
Published: June 2024

Study Design This paper presents a case series analysis of 5 patients with Luhr class III mandible fractures treated using virtual surgical planning (VSP) and patient-specific implants (PSI) between October 2020 and February 2023. The study focuses on evaluating the effectiveness of VSP and PSI in managing complex mandibular fractures, particularly in edentulous patients. Objective The primary objective is to assess the outcomes of using VSP and PSI for reconstructive surgery in patients with Luhr class III mandible fractures. The study aims to determine the accuracy of these techniques in fracture reduction and their impact on surgical complications and overall patient outcomes. Methods The methodology involves a detailed preoperative planning process using VSP to design customized implants tailored to the specific anatomical needs of each patient. The study tracks the surgical procedures, implant placements, and postoperative outcomes, comparing the preoperative plans with the actual surgical results to evaluate accuracy and effectiveness. Results The results indicate successful fracture reduction in all 5 patients, with a high degree of accuracy in implant placement and alignment compared to the preoperative virtual plans. The study highlights the benefits of VSP and PSI, including precise screw placement and enhanced potential for prosthetic rehabilitation. Despite the higher costs, the outcomes suggest significant advantages in terms of surgical precision and patient recovery. Conclusions The use of VSP and PSI in the treatment of Luhr class III mandible fractures provides a tailored approach that enhances surgical accuracy and patient outcomes. While acknowledging the increased costs, the findings support the value of these advanced techniques in managing complex edentulous mandible fractures, advocating for their consideration in similar cases to improve surgical results and patient care. The study adds to the growing evidence of the benefits of VSP and PSI in reconstructive maxillofacial surgery.
Patients’ needs and experiences of telerehabilitation after total hip and knee arthroplasty: A qualitative systematic review and meta-synthesis
Authors: Zhang Wenzhong , Ji Hong , Wu Yan , Xu Zhenzhen , Li Jing , Sun Qingxiang , Wang Chunlei , Zhao Fengyi 
Published: June 2024

Background The number of patients undergoing joint replacement procedures is continuously increasing. Tele-equipment is progressively being employed for postrehabilitation of total hip and knee replacements. Gaining a comprehensive understanding of the experiences and requirements of patients undergoing total hip and knee arthroplasty who participate in telerehabilitation can contribute to the enhancement of telerehabilitation programs and the overall rehabilitation and care provided to this specific population. Objective To explore the needs and experiences of total hip and knee arthroplasty patients with telerehabilitation. Design Systematic review and qualitative synthesis. Methods Electronic databases PubMed, Web of Science, The Cochrane Library, Embase, CINAHL, Scopus, ProQuest, CNKI, Wanfang Data, VIP, and SinoMed were systematically searched for information on the needs and experiences of telerehabilitation for patients with total hip arthroplasty and total knee arthroplasty in qualitative studies. The search period was from the creation of the database to March 2024. Literature quality was assessed using the 2016 edition of the Australian Joanna Briggs Institute Centre for Evidence-Based Health Care Quality Assessment Criteria for Qualitative Research. A pooled integration approach was used to integrate the findings inductively. Results A total of 11 studies were included and 4 themes were identified: the desire to communicate and the need to acquire knowledge; accessible, high-quality rehabilitation services; positive psychological experiences; the dilemmas of participating in telerehabilitation. Conclusions This study's findings emphasize that the practical needs and challenges of total hip and knee arthroplasty patients’ participation in telerehabilitation should be continuously focused on, and the advantages of telerehabilitation should be continuously strengthened to guarantee the continuity of patients’ postoperative rehabilitation and to promote their postoperative recovery.
Factors influencing telemedicine adoption among physicians in the Malaysian healthcare system: A revisit
Authors: Tan Siow-Hooi , Wong Chee-Kuan , Yap Yee-Yann , Tan Siow-Kian 
Published: June 2024

Background The Malaysian healthcare system is under strain due to an aging population, the rising prevalence of chronic diseases, and heavy workloads among physicians. As costs and requirements continue to rise, telemedicine is critical for bridging gaps in supply and demand. However, there are limited studies on telemedicine adoption among Malaysian physicians. Furthermore, the existing literature on telemedicine adoption does not contain a comprehensive framework that integrates the multidimensional social influence, and technological, clinical, and individual factors. Objective This research investigates the adoption of telemedicine among Malaysian physicians. It draws from the Technology Acceptance Model (TAM) and Kelman's Social Influence Theory. Methods A survey was conducted among 230 participants in hospitals located in Kuala Lumpur and Selangor. The data were analyzed using Partial Least Squares Structural Equation Modeling (PLS-SEM). Results The study identified crucial factors influencing telemedicine adoption, including informational influences, rewards, perceived ease of use, and usefulness. Meanwhile, the Importance-performance Map Analysis (IPMA) identified perceived ease of use as the most important factor for physicians, but the highest performance was patient’s records. Conclusions The proposed integrated model enhances the understanding of telemedicine adoption and highlights the differential effects of individual, technological, clinical, and multidimensional social influence factors from the physicians’ perspective. The findings can guide future studies and influence implementation strategies for telemedicine promotion in the Malaysian healthcare context. Hospitals should prioritize user-friendly technology and information provision, while telemedicine providers should enhance the accessibility of patient records to facilitate telemedicine adoption. Policymakers should consider supporting training programs that will boost physicians’ confidence in effectively utilizing telemedicine.
Exploring social media adoption for marketing purpose among healthcare professionals in Gondar town, central Gondar zone: A facility-based cross-sectional survey
Authors: Atsbeha Berhanemeskel Weldegerima , Wodaje Mulugeta Negash 
Published: June 2024

Background Social media has become an integral platform for global information exchange and business interactions, emerging as a crucial tool for promoting products and services in the digital age. Despite its worldwide significance, local businesses, especially in Ethiopia, lag behind in leveraging social media for healthcare marketing. The scarcity of studies on social media adoption among healthcare providers in Ethiopia highlights the imperative for comprehensive research. Objective This study, conducted in Gondar Town, focused on private healthcare professionals, aiming to identify the determinants of their behavioral intention and usage behavior in adopting social media marketing. Method A facility-based cross-sectional survey involving 238 health professionals from private healthcare facilities in Gondar Town was conducted between March and June 2023. The study analyzed data using SPSS Version 26 and AMOS Structural Equation Modeling Version 23. Results All participants reported using social media platforms, with Facebook, Telegram, and YouTube being popular choices. Performance expectancy, social influence, facilitation condition, and behavioral intention significantly influenced healthcare professionals’ adoption of social media marketing. Performance expectancy and social influence exhibited the strongest impact on behavioral intention, acting as mediators influencing usage behavior. However, effort expectancy did not significantly influence behavioral intention. Age, gender, experience, and voluntariness showed no significant moderating effects. Conclusion This study contributes valuable insights into social media marketing adoption in the healthcare sector, emphasizing the critical role of various factors in shaping behavioral intention and usage behavior. The findings offer practical implications for private healthcare providers, policymakers, and marketers, guiding strategies to enhance patient communication and engagement through social media in Gondar Town.