bluuebunny/crossref_metadata_2025_split huggingface dataset:
Determining meaningful thresholds for evaluating treatment efficacy in patients with alopecia areata
Authors: Law Ernest H. , Williams Nicole J. , Korver Dane , Bender Randall H. , Mitra Debanjali , Schaefer Gregor , Nelson Lauren M. 
Published: May 2024

AbstractBackgroundThe Severity of Alopecia Tool (SALT) is a clinician‐reported outcome measure of scalp hair loss in alopecia areata (AA).ObjectivesTo characterise the magnitudes of change in SALT scores corresponding to meaningful treatment benefits from the patient's perspective.MethodsAnchor‐based methods for the estimation of meaningful within‐patient change thresholds were applied to pooled data from a randomised, double‐blind trial of ritlecitinib. Anchors included a patient‐reported measure of change in AA severity, the Patient Global Impression of Change (PGI‐C) and three items comprising the Patient Satisfaction with Hair Growth (P‐Sat) questionnaire. After reviewing Pearson correlations between change‐from‐baseline SALT scores and each anchor to confirm adequate association, potential thresholds were computed as mean change‐from‐baseline SALT scores among patients who reported moderate improvement on the PGI‐C and/or moderate satisfaction on each of three P‐Sat items at week 24.ResultsSix hundred and fifty participants (86% adults, 14% adolescents) had mean (standard deviation) SALT scores of 90.6 (14.3) at baseline, suggesting a sample with primarily severe AA. Correlations between SALT change‐from‐baseline scores and the patient‐reported items supported their use as anchors. Estimates based on patients reporting moderate improvement in AA (n = 102) on the PGI‐C and those reporting moderate satisfaction on the P‐Sat item related to the amount of hair growth at week 24 (n = 122) were −42.2 (26.1) and −43.1 (26.8), respectively. Supportive estimates based on the remaining P‐Sat items were similar in magnitude.ConclusionsAmong patients with severe AA, SALT change‐from‐baseline scores of 42 or 43 represent meaningful improvements. While the achievement of low SALT scores of ≤10–≤20 have been used to characterise efficacy in clinical trials, the amount of change required to meet this endpoint far exceeds the estimates in this study. The treatment goals of individual patients must be considered when evaluating benefit in both clinical trials and clinical practice.
Improvement in clinical outcomes following arthroscopic all‐inside medial lateral ligament reconstruction for rotational ankle instability
Authors: Lewis T. L. , Ayathamattam J. , Vignaraja V. , Dalmau‐Pastor M. , Ferreira G. F. , Nunes G. A. , Ray R. 
Published: May 2024

AbstractPurposeRotational ankle instability can be diagnosed in up to 18% of cases of chronic lateral ankle instability. It is characterised by an abnormal increase of talar rotation within the tibiofibular mortise, due to an injury in the most anterior component of the deltoid ligament secondary to a chronic deficiency of the lateral collateral ligament. The aim of this prospective observational study was to investigate the clinical outcomes following arthroscopic all‐inside medial and lateral ligament reconstruction for rotational ankle instability.MethodsA prospective observational study of consecutive patients undergoing arthroscopic all‐inside medial and lateral ligament reconstruction for rotational ankle instability with minimum 6‐month follow‐up. The primary outcome was a validated patient‐reported outcome measure (PROM), the Manchester‐Oxford Foot Questionnaire. Secondary outcomes included the EQ‐5D, European Foot and Ankle Society score and complications.ResultsBetween 2020 and 2023, 12 patients underwent primary arthroscopic all‐inside medial and lateral ligament reconstruction for rotational ankle instability with pre‐ and post‐operative PROMs available for all 12 patients. The mean ± standard deviation age was 33.9 ± 7.2 years and the mean follow‐up was 1.9 ± 1.2 (range: 0.5–3.8, interquartile range: 0.9–3.0) years. There was a significant improvement in all Manchester‐Oxford Foot Questionnaire domain scores (p < 0.05): Index 53.1 ± 19.1 to 26.4 ± 27.6, Pain 46.7 ± 20.3 to 26.2 ± 26.8, Walking/Standing 58.7 ± 26.0 to 27.0 ± 30.0 and Social Interaction 51.2 ± 19.5 to 25.6 ± 30.1. There were improvements in EQ‐5D‐5L Index, VAS and VAS Pain; however, these were not statistically significant. There was one complication—a superficial peroneal nerve injury which resolved with a corticosteroid injection.ConclusionThe arthroscopic all‐inside medial and lateral ligament reconstruction technique is a reliable and safe method for treating rotational ankle instability, demonstrating significant improvement in PROMs at a mean 1.9‐year follow‐up.Level of EvidenceLevel IV.
The ISAKOS subclassification of Rockwood type III AC joint dislocations in a stable type A and an unstable type B is not clinically relevant
Authors: Haugaard Kristine B. , Bak K. , Ryberg D. , Muharemovic O. , Hölmich P. , Barfod K. W. 
Published: May 2024

AbstractPurposeThe treatment of Rockwood type III AC joint dislocations has been debated for decades. In 2014, the International Society of Arthroscopy, Knee Surgery and Orthopaedic Sports Medicine (ISAKOS) Upper Extremity Committee suggested a subclassification of the injury into type A, considered stable and best treated nonsurgically, and type B, considered unstable and best treated surgically. Type B is defined by the presence of scapular dyskinesis and overriding of the clavicle to the acromion on a modified lateral radiograph. The objective of the study was to investigate if this subclassification is clinically relevant.MethodsThis was a prospective cohort study. Inclusion criteria were patients aged 18–60 years with acute AC joint dislocation and a baseline Zanca radiograph with an increase in the CC distance of >25% compared to the uninjured side. All patients were treated nonsurgically with 3 months of home‐based training and with the option of delayed surgical intervention. Patients were assessed at baseline and at follow‐ups 6 weeks, 3 months, 6 months and 1 year after the injury. At the 6‐week follow‐up, patients were graded as stable and unstable according to the ISAKOS criteria. Outcomes were the Western Ontario Shoulder Instability Index (WOSI) and referral for surgery.ResultsAt 6 weeks of follow‐up, 20 patients were classified as stable type A and 69 were classified as unstable type B. The ISAKOS subclassification was not clinically relevant, but patients graded as stable had statistically significantly better WOSI scores at 6 months compared to the unstable group (p = 0.03) but not at 3 months or 1 year. Nine patients (9.5%), all from the unstable group, were referred for surgery. No patients from the stable group underwent surgery (n.s).ConclusionThe ISAKOS subclassification of Rockwood type III in a stable type A and an unstable type B is not clinically applicable.Level of EvidenceLevel II.
Adolescents with prior patellar dislocation report affected quality of life and function, as measured using the Banff Patella Instability Instrument, Kujala and EQ‐5D‐5L index scores
Authors: Eysturoy Niclas H. , Husum Hans‐Christen , Ingelsrud Lina H. , Danielsen Oddrún , Blønd Lars , Mortensen Elinborg , Hölmich Per , Barfod Kristoffer W. 
Published: May 2024

AbstractPurposeWe aimed to establish patient‐reported outcome measure (PROM) reference data for a cohort of patients with prior patellar dislocation without previous knee surgery.MethodsAll inhabitants of the Faroe Islands aged 15–19 years were sent an online survey via secure email to establish a national cohort. They were asked to answer questions regarding demographics, whether they had prior patellar dislocation and to complete the PROMs: the Banff Patella Instability Instrument (BPII), Kujala, Marx activity and EQ‐5D‐5L questionnaires. Participants who had undergone knee surgery were excluded. Participants who had prior patellar dislocation underwent radiographic examinations to diagnose trochlear dysplasia. The study included three cohorts: the general population, prior patellar dislocation and prior patellar dislocation and trochlear dysplasia cohorts.ResultsOf the 3749 individuals contacted, 1119 completed the survey and responded to at least one PROM. Of these, 102 reported a history of patellar dislocation and 57 of them had trochlear dysplasia. All PROMs, except the Marx score, reflected a worse quality of life and function after patellar dislocation than in the general population cohort; this was most pronounced in the BPII. The percentage of people experiencing problems in EQ‐5D‐5L dimensions was higher in the patellar dislocation and trochlear dysplasia cohorts than in the general population cohort in all EQ‐5D‐5L domains, except anxiety/depression.ConclusionAdolescents who had patellar dislocation reported reduced quality of life and function according to the BPII, Kujala and EQ‐5D‐5L index values, as well as all EQ‐5D‐5L domains, except for anxiety/depression. However, their activity levels remained high.Level of EvidenceLevel III.
High in‐vivo accuracy of a novel robotic‐arm‐assisted system for total knee arthroplasty
Authors: Zaidi Faseeh , Goplen Craig M. , Fitz‐Gerald Connor , Bolam Scott M. , Hanlon Michael , Munro Jacob T. , Monk Andrew P. 
Published: May 2024

AbstractPurposeRobotic‐assisted total knee arthroplasty (TKA) has been shown to improve the accuracy and precision of bony resections and implant position. However, the in vivo accuracy of the full surgical workflow has not been widely reported. The primary objective of this study is to determine the accuracy and precision of a robotic‐arm‐assisted system throughout the intraoperative workflow.MethodsThis was a retrospective cohort study of adult patients who underwent primary TKA with various workflows and alignment targets by three arthroplasty‐trained surgeons with previous experience using the ROSA® Knee System (Zimmer Biomet) over a 3‐month follow‐up period. Accuracy and precision were determined by measuring the difference between various workflow time points, including the final preoperative plan (PP), robot‐validated (RV) resection angle and postoperative radiographs (PR). The absolute mean difference between the measurements determined accuracy, and the standard deviation represented precision. The lateral distal femoral angle, medial proximal tibial angle, femoral flexion angle and tibial slope were measured on postoperative coronal long‐leg radiographs and true short‐leg lateral radiographs.ResultsA total of 77 patients were included in the final analyses. The accuracy for the coronal femoral angle was 1.62 ± 1.11°, 0.75 ± 0.79° and 1.96 ± 1.29° for the differences between PP and PR, PP and RV and RV and PR. The tibial coronal accuracy was 1.44 ± 1.03°, 0.81 ± 0.67° and 1.57 ± 1.14° for PP/PR, PP/RV and RV/PR, respectively. Femoral flexion accuracy was 1.39 ± 1.05°, 0.83 ± 0.59° and 1.81 ± 1.21° for PP/PR, PP/RV and RV/PR, respectively. Tibial slope accuracy was 0.99 ± 0.72°, 1.19 ± 0.87° and 1.63 ± 1.11°, respectively. The proportion of patients within 3° was 93.2%, 95.3%, 97.3% and 94.6% for the distal femur, proximal tibia, femoral flexion and tibial slope angles when the final intraoperative plan was compared to PRs. No patients had a postoperative complication at the final follow‐up.ConclusionsThe ROSA Knee System has acceptable accuracy and precision of coronal and sagittal plane resections with few outliers at various steps throughout the platform's entire workflow in vivo.Level of EvidenceLevel III.
Efficiency and greenness evaluation of urban land use change in the Yangtze River Economic Belt, China
Authors: Guo Changqing , Kuang Wenhui , Dou Yinyin , Dong Yulin 
Published: May 2024

AbstractImproving urban land use efficiency and greenness is essential for achieving sustainable urban development and improving the well‐being of urban settlements. Using satellite‐based land use data, socioeconomic data, and sustainable development goal (SDG) indicators, we quantified the changes in the urban land use efficiency and greenness under rapid urban expansion in provincial cities in the Yangtze River Economic Belt (YREB) from 1990 to 2020. Over this period, urban area increased significantly, by 254.57%, at a rate of 191.41 km2 per year in the YREB, as national macro‐policies shifted the center of urban expansion westward. Nevertheless, the urban land use efficiency and greenness have both increased. The ratio of land consumption rate to population growth rate increased from 0.55 in 1990–2000 to 0.83 in 2010–2020 in the YREB, accompanied by an increase in the investment output ratio of fixed assets. In addition, the population‐weighted greenspace exposure increased by 5.31%, due to an 8.16% increase in the urban greenspace coverage, which improved the urban living environment amidst substantial urban population growth. We emphasize the importance of fostering coordinated development between central and western cities in the YREB. The results provide an important reference for the rational allocation of land resources, improving land use efficiency, and building resilient cities within global urbanization hotspots under the SDG framework.
The effect of vorticity on the feeding of a freshwater grazer
Authors: Goulet Luc , Currie Warren Joseph Sproule , Ackerman Josef Daniel 
Published: May 2024

AbstractThe transfer of energy through zooplankton grazing on phytoplankton is one of the most important interactions in aquatic ecosystems, yet the role of hydrodynamic forces is not fully understood. Factors that influence these interactions include algal size and shape and the interactions between grazer and alga dictated by hydrodynamic forces. Hydrodynamic forcing lead to unimodal relationships in grazer clearance rates (CR) because water motion and turbulence increases encounters but interferes with feeding at high levels. We expect higher CR on small algae due to increased encounter rates caused by vorticity generated in a horizontally oriented rotating cylinder to model increasing turbulence, whereas longer cells, tumbling in the flow, may be more difficult to handle. Ultimately, we expect that increased vorticity will interfere with zooplankton swimming. The CR of Daphnia magna followed the unimodal trend, with higher CR on the small, spherical Chlorella vulgaris than on larger, elongated, and colonial Scenedesmus quadricauda. This was likely due to lower handling time and higher concentration of the smaller cells in the feeding radius around D. magna. The normal hop‐sink swimming behavior of the Daphnia was affected by increasing vorticity; hop frequency decreased, displacement increased, and there was a loss of vertical orientation. This pattern in feeding and swimming were predicted by vorticity. These results for Daphnia differ from those obtained for copepods, which do not respond to vorticity. Given the importance of vorticity in nature, it is relevant to examine grazer feeding interactions under ecologically relevant hydrodynamic conditions.
Operando Battery Monitoring: Lab‐on‐Fiber Electrochemical Sensing Technologies
Authors: Xue Xiaobin , Han Xile , Li Wanjun , Li Kaiwei , Liu Fu , Guo Tuan 
Published: May 2024

AbstractSuccess in the development of next‐generation rechargeable batteries is attained by achieving low cost, high energy density, and long cycling life. Battery optimization is challenging due to the complicated processes involving material selection and optimal utilization of cell components. Battery performance and status during the charging/discharging cycle depend on the complicated interdependence of battery design and operational parameters. Monitoring techniques must be able to detangle the hidden high‐value information, including states of charge, health estimations, and operational guidance, as well as provide non‐electrochemical early failure indicators. Fiber–optic battery monitoring methods, which are advantageous because of their low cost, compactness, remote sensing capabilities, and simple integration without interfering with internal chemistry, are recently reported. The convergence of fiber optic technology and smart battery platforms promises to revolutionize the industry. The introduction of electrochemical lab‐on‐fiber sensing technology to continuously operando monitor the performance, health, and safety status of batteries will promote more reliable energy storage systems. This review highlights recent advancements in, and associated benefits of, electrochemical fiber grating battery sensing. This powerful sensing technology's potential to make possible the next generation of sustainable energy storage, and discuss future directions for improving battery sustainability is showcased.
Design and Fabrication of Fibrous Spindle‐Like Constructs Using a Melt Electrohydrodynamic Writing Process
Authors: Zaeri Ahmadreza , Cao Kai , Zhang Fucheng , Zgeib Ralf , Chang Robert C. 
Published: May 2024

AbstractAdvanced manufacturing of 3D‐structured materials enables the production of biomimetic muscle tissues. While models of muscle tissue exist, current approaches possess a limited ability to capture essential elements of the muscle tissue microarchitecture. Therefore, this paper aims to engineer the intrinsically complex muscle spindle‐like ellipsoid geometry using a polymer melt‐based electrohydrodynamic (EHD) printing system. EHD systems have conventionally reported fiber deposition in a layerwise fashion. However, without mitigation, the observed fiber sagging and residual charge phenomena for the melt electrowriting (MEW) process limit the ability to produce layered fibrous 3D constructs with in‐plane fiber alignment. However, in this work, fiber sagging and residual charge phenomena are leveraged as part of the design intent to deposit nonoverlapping suspended fibers between two stationary walls toward spindle‐like construct fabrication. Specifically, herein the structural and mechanical properties of the MEW‐enabled spindle‐like constructs are analyzed as a function of the process and design parameters that govern control over fiber sagging and residual charge. The results indicate that the collector speed and wall‐to‐wall distance are the key parameters for tuning the spindle morphology. Moreover, cycle number and fiber diameter are identified as effective parameters for tuning the spindle mechanical properties.
Deep Learning Method for Rapid Simultaneous Multistructure Temporal Bone Segmentation
Authors: Neves Caio A. , Chemaly Trishia El. , Fu Fanrui , Blevins Nikolas H. 
Published: May 2024

AbstractObjectiveTo develop and validate a deep learning algorithm for the automated segmentation of key temporal bone structures from clinical computed tomography (CT) data sets.Study DesignCross‐sectional study.SettingA total of 325 CT scans from a clinical database.MethodA state‐of‐the‐art deep learning (DL) algorithm (SwinUNETR) was used to train a prediction model for rapid segmentation of 9 key temporal bone structures in a data set of 325 clinical CTs. The data set was manually annotated by a specialist to serve as the ground truth. The data set was randomly split into training (n = 260) and testing (n = 65) sets. The model's performance was objectively assessed through external validation on the test set using metrics including Dice, Balanced accuracy, Hausdorff distances, and processing time.ResultsThe model achieved an average Dice coefficient of 0.87 for all structures, an average balanced accuracy of 0.94, an average Hausdorff distance of 0.79 mm, and an average processing time of 9.1 seconds per CT.ConclusionThe present DL model for the automated simultaneous segmentation of multiple structures within the temporal bone from CTs achieved high accuracy according to currently commonly employed objective analysis. The results demonstrate the potential of the method to improve preoperative evaluation and intraoperative guidance in otologic surgery.
Health‐Related Quality of Life in Patients With a Stable or Growing Vestibular Schwannoma Managed by Wait and Scan or Stereotactic Radiosurgery
Authors: Pruijn Ineke M.J. , Parmaksiz Merve , Verheul Jeroen B. , Mulder Jef J.S. , Kievit Wietske , Kunst Henricus P.M. 
Published: May 2024

AbstractObjectiveTo assess the effect of wait and scan (W&S) and stereotactic radiosurgery (SRS) on health‐related quality of life (HRQoL) over time in patients with a stable vestibular schwannoma (VS) and growing VS.Study DesignLongitudinal, multicenter, observational study.SettingTertiary expert center for VS (Radboudumc Nijmegen) and Gamma‐Knife center ETZ Hospital Tilburg.MethodsChanges in HRQoL, measured with the Penn Acoustic Neuroma Quality‐of‐Life (PANQOL), and the physical and mental component summary scores (PCS and MCS, respectively) derived from the 36‐Item Short Form Health Survey (SF‐36), were compared among patients managed by W&S and SRS between 2017 and 2022. Second, HRQoL over time in patients with a growing VS was compared between W&S and SRS.ResultsDifferences in PANQOL total and subdomain scores, PCS and MCS scores over time in the W&S (n = 73) and SRS (n = 170) groups were nonsignificant and on average did not exceed the minimal clinically important differences (mean difference of −2.56 [PANQOL total], 1.22 [PCS], and −1.76 [MCS]; all P > .05). In growing VS, comparison of W&S (n = 29) and SRS (n = 154) also revealed no significant difference (mean difference of 1.19 (PANQOL total), 1.83 (PCS) and −0.12 (MCS); all P > .05).ConclusionDifferences in HRQoL in patients with VS are minor and not significantly different or clinically relevant between patients managed with W&S or SRS. Similarly, patients with a growing VS managed with W&S or SRS exhibit no significant or clinical relevant difference in HRQoL during follow‐up. This can aid clinicians in the counseling of patients regarding HRQoL when deciding on a management strategy after diagnosis or documented growth.
Over‐The‐Counter Hearing Aids: Are They Safe and Effective?
Authors: Shah Rema , Wilkins Sarah G. , Panth Neelima , Tyagi Sidharth , Dunn Hannah , Bell Moira D. , Norgaard Sophie , Guyer Elizabeth , Schwartz Nofrat 
Published: May 2024

AbstractObjectiveIn 2022, the Food and Drug Administration established a new regulatory category for over‐the‐counter (OTC) hearing aids for mild to moderate hearing loss. Herein, we aim to better compare the safety and efficacy of these devices to that of prescription hearing aids.Study DesignComparative‐effectiveness model.SettingAcademic Audiology Center.MethodsThe safety and efficacy of prescription and OTC hearing aids was compared using the AudioScan Verifit 2 Testbox software. Three types of hearing loss (downsloping, sharp downsloping, and reverse sloping) were analyzed. Efficacy was tested at 3 volume inputs and was measured by calculating the average difference in test points (produced by the devices) and target points (estimated by the software). Safety was assessed by calculating the average difference in test points and the maximally safe hearing level (produced by the software).ResultsPrescription hearing aids were found to have a better safety profile by being further from the safety threshold compared to OTC devices at the 8000 Hz frequency for the 2 types of downsloping hearing loss patterns studied (48 vs 30.5 dB, P = .04; 51 vs 32.5 dB, P = .03). Prescription hearing aids also carried a statistically significant advantage at 3 test points. OTC hearing aids generally had a greater difference between test and target points.ConclusionOTC and prescription hearing aids are comparably safe, though OTC hearing aids are slightly less efficacious. Further evaluation of the OTC hearing aid efficacy is warranted to ensure it provides the gain of benefit needed for different types of hearing loss.