bluuebunny/crossref_metadata_2025_split huggingface dataset:
Long term outcomes and impact on renal function following radical cystectomy
Authors: Tilala Yash Manharla , Panda Sabyasachi , Tripathi Abhilekh , Sharma Sachin , Paul Amiya Shankar , Choudhuri Sanjay , Swain Samir 
Published: May 2024

Introduction: To assess clinical, oncological outcomes and impact on renal function in patients who underwent the radical cystectomy with pelvic lymphadenectomy for muscle invasive and high risk non-muscle invasive transitional cell carcinoma of urinary bladder without evidence of non-regional lymph nodes and distant metastasis. Materials and methods: With curative intent total 156 patients underwent radical cystectomy with pelvic lymphadenectomy from January 2015 to December 2022. Total 132/156 patients had primary transitional cell carcinoma of bladder. Thirty patients, presented with obstructive nephropathy, operated after stabilization of renal function. Pre-operatively and post-operatively eGFR calculated using modified diet in renal disease formula. Results: In present study 114 (86.36%) patients had high grade TCC, 70 (53.02%) patients had organ confined disease. Nodal extension seen in 74 (56.06%) patients. Perioperative mortality noted in 36 (27.2%) patients. The overall survival and recurrence free survival (RFS) over 5 years was 66.67 and 45.45%. RFS was significantly related to pathological stage, nodal status, histological-grade, positivity of surgical margin and time of surgery from diagnosis. Total 92/132 (69.7%) patients had recurrence. Pelvic recurrence in 10/92 (10.87%) whereas 82/92 (89.13%) patients had distant recurrence. Pre-operatively mean creatinine was 2.6 mg/dl and mean eGFR was 38.9 ml/h in patients who presented with obstructive nephropathy after stabilization of renal function. Post-operatively in 46/132 (34.8%) patients had improvement in eGFR while 86/132 (65.2%) patients had deterioration of eGFR over 62 months of median follow up. Conclusion: Radical cystectomy provides good overall survival outcomes. Pre-operative eGFR has significant impact on post-operative renal function in long term.
The efficacy and safety of retrograde ureteral stenting in the management of complicated cases of ureteral obstruction caused by urolithiasis
Authors: Mustafa Mahmoud , Aghbar Amir , Alami Ibraheem , Khalil Nabil 
Published: May 2024

Purpose: To investigate the efficacy and safety of retrograde double J stent (RDJS) placement in the management of complicated obstructive uropathy caused by urolithiasis. Patients and Methods: An observational study done at a tertiary center was implemented in which a total of 27 patients (10 males, 17 females) with average age of 48.74 years (range: 15–88) who underwent RDJS or percutaneous nephrostomy (PCN) between 2017 and 2021 due to complicated obstruction caused by urolithiasis were included. Results: A total of 27 patients (10 males, 17 females) with average age of 48.74 years (range: 15–88) who underwent kidney decompression between 2017 and 2021 due to complicated unilateral or bilateral kidney obstruction caused by ureteral stones were included. Twenty-two patients (81.48%) underwent successful RDJS placement, two patients had RDJS placement then PCN was also placed, and two patients underwent PCN placement. Three patients needed an intensive care unit “ICU” after intervention, two of them were in the ICU before intervention. All septic parameters were normalized within a short period postoperatively. Two patients with failed previous ureteroscopy had a successful RDJS placement. Conclusion: Retrograde DJS placement is a feasible option in the management of complicated cases of obstructive uropathy caused by urolithiasis. Short hospitalization period, low rate of complications and better quality of life are the most prominent advantages of RDJS placement. In the hands of experienced surgeons, RDJS should be offered as the first choice of decompression for obstructive uropathy caused by urolithiasis.
Role of stacking sequence, metal sheets, and nano particle on strength and toughness of FMLs
Authors: Hussain Syed Hameed , Khurram Aqeel Ahsan , Munir Adnan , Khan Muhammad Salman , Mubashar Aamir 
Published: May 2024

The effect of nano particle inclusion and the stacking sequence/metal volume fraction on the tensile strength and energy absorption properties of Fiber Metal Laminates (FML) is investigated. The FML structure is composed of lightweight thin sheets of aerospace grade aluminum alloy 7075 and unidirectional glass fiber composite sheets with Araldite LY5052 thermoset epoxy system as the matrix. The volume fraction of aluminum sheets in the FML structure was varied by increasing the number of aluminum sheets from 2 to maximum 4. In the second batch, the epoxy matrix is reinforced with of multi-walled carbon nano tubes and nano diamond particles together, each with 0.15 wt%. The purpose is to enhance the properties of the epoxy matrix to facilitate higher inter-laminate adhesion (FRP and aluminum). The results of the tensile testing show that with the increase of the metal volume fraction, the tensile strength as well energy absorbing capability (toughness) both are increased. The inclusion of the nano-reinforcements has increased the tensile strength and the toughness of the FML structure as compared to that of the FMLs without nano particles. The strength-to-weight ratio of FML structures is also increased after the inclusion of nano reinforced as desired for aerospace applications.
Study on the characteristics of Napier grass fibre reinforced porcelain filler particulates poly lactic acid matrix biocomposite
Authors: Thandavamoorthy Raja , Devarajan Yuvarajan 
Published: May 2024

This study investigates the complex properties of a novel biocomposite by a conventional process, which is composed of poly (lactic acid) (PLA) as the matrix, porcelain particles as fillers, and Napier grass fibre as reinforcement. The primary objective was to evaluate the mechanical, crystalline, water absorption, morphological, and antibacterial properties of the biocomposites in relation to the individual components and their synergistic impacts. When 25 g porcelain particles were added to PLA with Napier grass fibre, mechanical tests demonstrated a 25% increase in tensile strength (maximum tensile strength of 39.76 MPa) and a 30% increase in flexural strength (maximum flexural strength of 41.29 MPa). Scanning electron microscopy (SEM) revealed a strong interfacial bond between the fibre and matrix, with porcelain particles serving as bridges to facilitate stress transmission. The biocomposite exhibited reduced water absorption due to the inherent hydrophobic nature of porcelain, which enhances its resistance to bacterial growth. The study demonstrates that combining Napier grass fibre with porcelain filler particles synergistically enhances the properties of PLA, creating a viable biocomposite material suitable for use in packaging, automotive, and sustainable building industries.
Emotion Regulation and Organizational Skills in Children With ADHD Symptoms Are Associated With Behavioral Parent Training Adherence
Authors: Hawkey Elizabeth J. , Williams Aya I. , Chung Sara , Owens Elizabeth B. , Pfiffner Linda J. 
Published: May 2024

Objective: Behavioral parent training (BPT) is a well-established treatment for ADHD; however, treatment response is variable. Consistency in parent skill use during BPT is known to influence child outcomes post-treatment, while less research has focused on specific child factors that may be impacting parent skill utilization during treatment. The current study examined associations between child organizational skills and emotion dysregulation (ED) with parent treatment adherence during BPT and post-treatment child impairment. Method: Parents of 72 children ( Mage = 8.31) with ADHD symptoms and impairment participated in BPT which was embedded in a 12-week, multicomponent, school-based intervention for children delivered by school mental health clinicians. Outcomes included parent treatment adherence and child improvements in global impairment post-treatment. Results: Greater pre-treatment child organizational problems were associated with less parent treatment adherence regardless of ADHD symptom severity. Worse pre-treatment child ED was associated with more impairment post-treatment regardless of ADHD symptom severity whereas the effects of child ED on parent treatment adherence were moderated by child ADHD symptom severity. Conclusion: The current study suggests that pre-treatment child ED and organizational difficulties impact parent treatment adherence to behavioral interventions targeting ADHD symptoms, potentially in unique ways, and should be considered in future BPT treatment studies.
Identifying potentially low value surgical care: A national ecological study in England
Authors: Jones Tim , McNair Angus , McLeod Hugh , Morley Josie , Rooshenas Leila , Hollingworth William 
Published: May 2024

Objectives High variation in clinical practice may indicate uncertainty and potentially low-value care. Methods to identify low value care are often not well defined or transparent and can be time intensive. In this paper we explore the usefulness of variation analysis of routinely-collected data about surgical procedures in England to identify potentially low-value surgical care. Methods This is a national ecological study using Hospital Episode Statistics linked to mid-year population estimates and indices of multiple deprivation in England, 2014/15-2018/19. We identified the top 5% of surgical procedures in terms of growth in standardised procedure rates for 2014/15 to 2018/19 and variation in procedure rates between clinical commissioning groups as measured by the systematic component of variance (SCV). A targeted literature review was conducted to explore the evidence for each of the identified techniques. Procedures without evidence of cost-effectiveness were viewed as of potentially low value. Results We identified six surgical procedures that had a high growth rate of 37% or more over 5 years, and four with higher geographical variation (SCV >1.6). There was evidence for two of the 10 procedures that surgery was more cost-effective than non-surgical treatment albeit with uncertainty around optimal surgical technique. The evidence base for eight procedures was less clear cut, with uncertainty around clinical- and/or cost-effectiveness. These were: deep brain stimulation; removing the prostate; surgical spine procedures; a procedure to alleviate pain in the spine; surgery for dislocated joints due to trauma and associated surgery for traumatic fractures; hip joint replacement with cemented pelvic component or cemented femoral component; and shoulder joint replacement. Conclusions This study demonstrates that variation analysis could be regularly used to identify potentially low-value procedures. This can provide important insights into optimising services and the potential de-adoption of costly interventions and treatments that do not benefit patients and the health system more widely. Early identification of potentially low value care can inform prioritisation of clinical trials to generate evidence on effectiveness and cost-effectiveness before treatments become established in clinical practice.
‘You never know when you will need an antibiotic’: A qualitative study of structural barriers and cultural assumptions in antibiotic misuse among immigrants in the United States
Authors: Imanpour Sara , McMaughan Darcy Jones 
Published: May 2024

Objectives The use of nonprescribed antibiotics increases the risk of antibiotic resistance, which is a primary public health concern of the 21st century. This study explores structural and cultural determinants of antibiotic misuse among immigrants living in the United States who arrived from home countries with easier access to antibiotics. Methods Adopting a qualitative approach, we interviewed 34 immigrants living in the United States and who had traveled back to their home countries within 1 year of the interview. We followed the steps of constructive grounded theory to analyze the data. Results We found two primary influences of immigrants’ use of nonprescribed antibiotics. The first was structural barriers to health care access in the host country, including insurance coverage, cost of an emergency department visit, cost of missing a paid day of work, complexity of the healthcare system, and communication issues with health care providers. The second was participants’ cultural assumptions, including their experiences of antibiotics use, beliefs about antibiotics, a habit of self-medication, and uncertainty about future medical needs. Conclusions This study informs policymakers concerned with combating antibiotic resistance. Promoting antibiotic stewardship among immigrants from countries with lax antibiotic-prescribing practices and improving access to appropriate channels for preventative and same-day care may reduce the inappropriate use of antibiotics.
Predictive models for lymph node metastasis in endometrial cancer: A systematic review and bibliometric analysis
Authors: Li He , Wang Junzhu , Zhang Guo , Li Liwei , Shen Zhihui , Zhai Zhuoyu , Wang Zhiqi , Wang Jianliu 
Published: May 2024

Background: Lymph node metastasis is associated with a poorer prognosis in endometrial cancer. Objective: The objective was to synthesize and critically appraise existing predictive models for lymph node metastasis risk stratification in endometrial cancer. Design: This study is a systematic review. Data Sources and Methods: We searched the Web of Science for articles reporting models predicting lymph node metastasis in endometrial cancer, with a systematic review and bibliometric analysis conducted based upon which. Risk of bias was assessed by the Prediction model Risk Of BiAS assessment Tool (PROBAST). Results: A total of 64 articles were included in the systematic review, published between 2010 and 2023. The most common articles were “development only.” Traditional clinicopathological parameters remained the mainstream in models, for example, serum tumor marker, myometrial invasion and tumor grade. Also, models based upon gene-signatures, radiomics and digital histopathological images exhibited an acceptable self-reported performance. The most frequently validated models were the Mayo criteria, which reached a negative predictive value of 97.1%–98.2%. Substantial variability and inconsistency were observed through PROBAST, indicating significant between-study heterogeneity. A further bibliometric analysis revealed a relatively weak link between authors and organizations on models predicting lymph node metastasis in endometrial cancer. Conclusion: A number of predictive models for lymph node metastasis in endometrial cancer have been developed. Although some exhibited promising performance as they demonstrated adequate to good discrimination, few models can currently be recommended for clinical practice due to lack of independent validation, high risk of bias and low consistency in measured predictors. Collaborations between authors, organizations and countries were weak. Model updating, external validation and collaborative research are urgently needed. Registration: None.
Comparison of limited driving pressure ventilation and low tidal volume strategies in adults with acute respiratory failure on mechanical ventilation: a randomized controlled trial
Authors: Tongyoo Surat , Viarasilpa Tanuwong , Deawtrakulchai Phitphiboon , Subpinyo Santi , Suppasilp Chaiyawat , Permpikul Chairat 
Published: May 2024

Background: Ventilator-induced lung injury (VILI) presents a grave risk to acute respiratory failure patients undergoing mechanical ventilation. Low tidal volume (LTV) ventilation has been advocated as a protective strategy against VILI. However, the effectiveness of limited driving pressure (plateau pressure minus positive end-expiratory pressure) remains unclear. Objectives: This study evaluated the efficacy of LTV against limited driving pressure in preventing VILI in adults with respiratory failure. Design: A single-centre, prospective, open-labelled, randomized controlled trial. Methods: This study was executed in medical intensive care units at Siriraj Hospital, Mahidol University, Bangkok, Thailand. We enrolled acute respiratory failure patients undergoing intubation and mechanical ventilation. They were randomized in a 1:1 allocation to limited driving pressure (LDP; ⩽15 cmH2O) or LTV (⩽8 mL/kg of predicted body weight). The primary outcome was the acute lung injury (ALI) score 7 days post-enrolment. Results: From July 2019 to December 2020, 126 patients participated, with 63 each in the LDP and LTV groups. The cohorts had the mean (standard deviation) ages of 60.5 (17.6) and 60.9 (17.9) years, respectively, and they exhibited comparable baseline characteristics. The primary reasons for intubation were acute hypoxic respiratory failure (LDP 49.2%, LTV 63.5%) and shock-related respiratory failure (LDP 39.7%, LTV 30.2%). No significant difference emerged in the primary outcome: the median (interquartile range) ALI scores for LDP and LTV were 1.75 (1.00–2.67) and 1.75 (1.25–2.25), respectively ( p = 0.713). Twenty-eight-day mortality rates were comparable: LDP 34.9% (22/63), LTV 31.7% (20/63), relative risk (RR) 1.08, 95% confidence interval (CI) 0.74–1.57, p = 0.705. Incidences of newly developed acute respiratory distress syndrome also aligned: LDP 14.3% (9/63), LTV 20.6% (13/63), RR 0.81, 95% CI 0.55–1.22, p = 0.348. Conclusions: In adults with acute respiratory failure, the efficacy of LDP and LTV in averting lung injury 7 days post-mechanical ventilation was indistinguishable. Clinical trial registration: The study was registered with the ClinicalTrials.gov database (identification number NCT04035915).
Explorative cost-effectiveness analysis of colorectal cancer recurrence detection with next-generation sequencing liquid biopsy in Spain, France, and Germany
Authors: Schramm Wendelin , Hollenbenders Yasmin , Kurscheidt Maximilian 
Published: May 2024

Background: Next-generation sequencing liquid biopsy (NGS-LB) for colorectal cancer (CRC) detection and surveillance remains an expensive technology as economies of scale have not yet been realized. Nevertheless, the cost of sequencing has decreased while sensitivity has increased, raising the question of whether cost-effectiveness (CE) has already been achieved from the perspective of European healthcare systems. Objectives: This health economic (HE) modeling study explores the CE of NGS-LB for CRC based on direct treatment costs compared to standard care without liquid biopsy in Spain, France, and Germany. Methods: A structured literature search was used to collect evidence from 2009 to 2020 on the stage-dependent quality of life (quality-adjusted life-years, QALY), efficacy, and total direct treatment costs (TDC) of NGS-LB. A decision-analytic Markov model was developed. Over the remaining lifetime, cumulative life expectancy (LE), TDC, and QALYs were calculated for 60-year-old men and women in CRC stage III with different assumed effects of NGS-LB of 1% or 3% on improved survival and reduced stage progression, respectively. Results: The use of NGS-LB increases LE by 0.19 years in Spanish men (France: 0.19 years, Germany: 0.13 years) and by 0.21 years in Spanish women (France: 0.21 years, Germany: 0.14 years), respectively. The 3% discounted cost per QALY gained was 35,571.95 € for Spanish men (France: 31,705.15 €, Germany: 37,537.68 €) and 35,435.71 € for Spanish women (France: 31,295.57 €, Germany: 38,137.08 €) in the scenario with 3% improved survival and reduced disease progression. Compared to the other two countries, Germany has by far the highest TDC, which can amount to >80k euros in the last treatment year. Conclusion: In this explorative HE modeling study, NGS-LB achieves generally accepted CE levels in CRC treatment from the health system perspective in three major European economies under assumptions of small improvements in cancer recurrence and survival. Confirmation of these findings through clinical trials is encouraged.
Association Between Statin Use and the Incidence of Clinically Diagnosed Osteoarthritis: A Nationwide Retrospective Cohort Study in Taiwan
Authors: Lin Guan-Ling , Keller Joseph Jordan , Wang Li-Hsuan 
Published: May 2024

Objective To investigate the effect of higher cumulative defined daily dose per year (cDDD/y) compared with lower cDDD/y of statin use in the incidence of any joint osteoarthritis (OA). Design In this population-based retrospective cohort study, patients who were aged ≥40 years were newly initiated on statin therapy between 2002 and 2011, and had a statin prescription for ≥90 days in the first year of treatment were identified from the 2000 Longitudinal Generation Tracking Database. All patients were separated into groups with higher cDDD/y (>120 cDDD/y) and lower cDDD/y (≤120 cDDD/y; as an active comparator) values. Propensity score matching was performed to balance potential confounders. All recruited patients were followed up for 8 years. Marginal Cox proportional hazard models were used to estimate time-to-event outcomes of OA. Results Compared with lower cDDD/y use, higher cDDD/y use did not reduce the risk of any joint OA (adjusted hazard ratio, 1.07; 95% confidence interval, 0.99-1.14). Dose-related analysis did not reveal any dose-dependent association. A series of sensitivity analyses showed similar results. Joint-specific analyses revealed that statin did not reduce the incidence of knee, hand, hip, and weight-bearing (knee or hip) OA. Conclusions Higher cDDD/y statin use did not reduce the risk of OA in this Taiwanese nationwide cohort study. The complexity of OA pathogenesis might contribute to the ineffectiveness of statin. Repurposing statin with its anti-inflammation properties might be ineffective for OA development, and balancing the catabolism and anabolism of cartilage might be a major strategy for OA prevention.
The impact of digital social capital on the health of older adults: A moderated mediation effect test
Authors: Cui Yupeng , He Youshi , Xu Xinglong , Zhou Lulin , Nutakor Jonathan Aseye 
Published: May 2024

Purpose Older adults are struggling in the digital age due to lower digital literacy and other reasons. The purpose of this study was to explore the relationship between digital social capital, digital divide, learning ability, and health of older adults. Methods This study used data from the China General Social Survey (CGSS) to systematically analyze effects of digital social capital on the health of older adults using the moderated mediated effect test. Results Digital social capital has a significant positive effect on the health of older adults and significant household and regional heterogeneity. Internet usage has a mediating impact between social capital and the health of older adults. Learning ability positively moderates the effect of internet usage on the health of older adults, but negatively moderates the impact of digital social capital on internet usage. Learning ability moderates the mediating effect of internet usage between social capital and the health of older adults. The stronger the learning ability, the stronger the mediating effect of internet usage between social capital and health of older adults. Conclusion Digital social capital can promote the health of older adults, and internet usage and learning ability can play mediating and moderating roles in the process of digital social capital affecting the health of older adults, revealing that we should cultivate the digital social capital of older adults and improve the digital ability of older adults to improve their health.