bluuebunny/crossref_metadata_2025_split huggingface dataset:
Analysis of Aortic Arch Hemodynamics With Simulated Bird’s Beak Effects
Authors: Gonzalez-Urquijo Mauricio , Fumagal González Gerardo Alejandro , Cárdenas Castro Héctor Manuel , Morales Guzman Arnulfo Alejandro , Guzman Valladares Alan Alejandro , MacDonald Danielle Catherine , Moya Bencomo Marcos David , Botello Arredondo Israel , Fabiani Mario Alejandro 
Published: April 2024

Objective The objective of this study was to investigate the flow effects in different degrees of thoracic aortic stent graft protrusion extension by creating bird beak effect simulations using accurate 3D geometry and a realistic, nonlinear, elastic biomechanical model using computer-aided software SolidWorks. Methods Segmentation in 3D of an aortic arch from a computed tomography (CT) scan of a real-life patient was performed using SolidWorks. A parametric analysis of three models was performed: (A) Aortic arch with no stent, (B) 3 mm bird-beak configuration, and (C) 6.5 mm bird-beak configuration. Flow velocity, pressure, vorticity, wall shear stress (WSS), and time average WSS were assessed. Results The flow velocity in Model A remained relatively constant and low in the area of the ostium of the brachiocephalic artery and doubled in the left subclavian artery. On the contrary, Models B and C showed a decrease in velocity of 52.3 % in the left subclavian artery. Furthermore, Model B showed a drop in velocity of 82.7% below the bird-beak area, whereas Model C showed a decline of 80.9% in this area. The pressure inside the supra-aortic branches was higher in Model B and C compared with Model A. In Model A, vorticity only appeared at the level of the descending aorta, with low to non-vorticity in the aortic arch. In contrast, Models B and C had an average vorticity of 241.4 Hz within the bird beak area. Regarding WSS, Model A, and Model B shared similar WSS in the peak systolic phase, in the aortic arch, and the bird beak area, whereas Model C had an increased WSS by 5 Pa on average at these zones. Conclusion In the present simulations’ lower velocities, higher pressures, vortices, and WSS were observed around the bird beak zone, the aortic arch, and the supra-aortic vessels.
Routine External Iliac Artery Cannulation in Robotic Cardiac Surgery: Role of the Corona “Vitae” in Distal Limb Perfusion
Authors: AlJamal Yazan N. , Kitahara Hiroto , Johnson Blaine , Grady Kaitlin , Balkhy Husam H. 
Published: April 2024

Objective: Femoral artery cannulation is the most commonly used approach for cardiopulmonary bypass (CPB) in robotic cardiac procedures. However, without adding a distal perfusion cannula, leg ischemia can occur in up to 11.5% of patients. There is a well-described 2 to 4 mm size arterial branch that originates from the medial side of the external iliac artery or inferior epigastric artery, immediately above the inguinal ligament, and connects to the obturator artery. Therefore, it was historically named the corona mortis, which means “crown of death” in Latin. When peripheral cannulation is performed above this branch in the external iliac artery, we consider it a corona “vitae” because of its role as a limb-saving collateral. We report herein our standard technique of peripheral cannulation without the need of a distal perfusion cannula and preventing limb ischemia. Methods: We included all patients who underwent robotic cardiac surgery with peripheral cannulation over a 16-month period at our institution. We cannulated just above the level of the inguinal ligament through a 2 to 3 cm transverse skin incision. The incidence of limb ischemia and vascular complications was recorded and analyzed. Results: During the study period, 133 patients underwent robotic cardiac procedures with peripheral “external iliac” CPB. The size of the cannula was 21F or larger in 73% and 23F in 54% of the patients. No leg ischemia or femoral artery complications requiring additional intervention occurred. Conclusions: External iliac cannulation can be successfully performed in robot-assisted cardiac surgery using relatively large cannulas without the need of a distal limb perfusion catheter, with good results. In our view, given the importance of the corona mortis (“crown of death” in Latin) in perfusing the limb during CPB, we propose a new name for this artery in robotic cardiac surgery, namely, the corona vitae (“crown of life” in Latin).
Evaluation of Patient Expectations and Outcomes after Distal Radius Fractures
Authors: Green Anna H. , Alter Todd H. , Varghese Bobby B. , Ferrera Fernando , Doss Thomas , Hawes Joseph , Frias Giulia C. , Guerrero Kevin D. , Tawfik Amr M. , Katt Brian M. , Monica James T. 
Published: April 2024

Background: Patient expectations influence patient-reported outcomes after musculoskeletal injuries. The goal of this study is to determine how pretreatment expectations correlate with outcomes in patients with distal radius fractures. Methods: Seventy-five patients with an isolated distal radius fracture were prospectively enrolled into nonoperative and operative cohorts. The Trauma Expectation Factor–Trauma Outcome Measure (TEF-TOM) score was the primary outcome measure. Trauma Expectation Factor scores were recorded at the time of enrollment, and TOM scores were recorded at 3, 6, and 12 months. Quick Disabilities of the Arm, Shoulder, and Hand (qDASH) and Patient-Rated Wrist Evaluation (PRWE) scores were also recorded. Results: Trauma Outcome Measure scores at all time points were worse than expected ( P < .01). Expectations were higher for patients younger than 65 years than for the 65+ group ( P = .02). In patients aged 65+ years, mean TOM at 3 months was not significantly different than expected ( P = .11) but decreased by 6 ( P = .04) and 12 months ( P < .01). Baseline TEF and TEF-TOM scores were not significantly different between operative and nonoperative groups ( P = .37). Quick Disabilities of the Arm, Shoulder, and Hand and PRWE scores were not significantly different between age or treatment groups at the final follow-up. Conclusions: The overall treatment of distal radial injuries in our study did not meet patient expectations. Patients aged 65 years or older had lower expectations but were not able to predict their outcomes better than patients aged <65 years. There were no differences in TEF or TOM by treatment method. Patients demonstrated improved functional outcomes (qDASH/PRWE) at all time points regardless of age and treatment method.
The Utility of I-Poems to Explore Subjective Well-Being in Children and Adolescents with ADHD
Authors: Nicolaou Andrea Marisa , Eloff Irma 
Published: April 2024

This study explores the utility of the I-poem methodology to investigate subjective well-being in children and adolescents with ADHD in South Africa during the COVID-19 pandemic. Subjective well-being in this population has been studied extensively via quantitative methodologies. In addition, narrative studies, discourse and theme analysis, participatory and visual method studies have also contributed to deeper understandings in the field. The current study seeks to contribute to knowledge creation within this field of non-numerical studies in an attempt to decentralise the voice of researchers and highlight the voices of participants. In the I-poem methodology, self-report ratings of children and adolescents with ADHD between the ages of 10 and 18 years old ( n = 376) during the COVID-19 pandemic in South Africa was captured in an open-ended question. Data was analysed through the researcher’s creation of themed I-poems. The findings delineate broad categories of positive, negative and neutral feelings of subjective well-being during the pandemic. Notions of subjective well-being are related to themes of home, school, social life, self-growth and reflection, experiences of change, rules, extra-curricular activities, concerns, loss, finances, the new normal, and emotions. The study illustrates the utility of the I-poem methodology to illuminate dimensions of well-being that may otherwise remain invisible. The study also amplifies the potential of the I-poem methodology to be used in conjunction with, and complementary to, other research methodologies.
Can HALP score predict post-contrast acute kidney injury and 6-year mortality in patients undergoing endovascular abdominal aneurysm repair?
Authors: Özderya Ahmet , Şahin Sinan , Koşmaz Tolga , Maz Mehmet Ali , Yerlikaya Murat Gökhan , Akyüz Ali Rıza , Sayın Muhammet Raşit , Erkan Hakan 
Published: April 2024

Background The aim of this study is to investigate the relationship between HALP score and post-contrast acute kidney injury (PC-AKI) and average 6-year mortality in patients undergoing endovascular abdominal aortic aneurysm repair (EVAR). Methods 125 patients who underwent EVAR between January 2015 and December 2020 were included in our study. HALP score was calculated with the formula “hemoglobin × albumin × lymphocyte count/platelet count.” In the first phase of the study, two groups were developed: those who developed PC-AKI and those who did not. In the second stage, statistical analysis was performed by creating two groups: average 6-year mortality and survivors group. Results HALP score was found to be lower in the PC-AKI group [26.12 (14–61.54) versus 40.53 (7.22–103.61); p < .001]. Low HALP score was found to be both a dependent and independent predictor of the development of PC-AKI ( p = .019). HALP score was also found to be lower in the mortality group compared to the survivors [28.97 (12.6–103.61) versus 40.81 (7.22-99) p = .004]. Low HALP score was found to be only a dependent predictor of mortality. The development of PC-AKI was found to be an independent predictor of mortality ( p = .042). Conclusions The HALP score, which can be calculated with a simple formula, can be used to predict PC-AKI and medium-long-term mortality in EVAR patients.
Managing incisional wounds with Prevena VAC therapy in lower-extremity vascular surgery: A comparative study
Authors: Kasten Kody , Yang Andrew , Shaffer Lynn , Kociola Samuel , Holland Conor , Roche Faith Anne , Pilbeam Calvin 
Published: April 2024

Background Vascular surgical site infections have been reported with an overall incidence of 5–10% for patients undergoing arterial interventions and as high as 10–20% for lower-limb bypass grafting procedures. Given that vascular surgery patients are known to be at a higher risk of postoperative wound infections and other complications, our objective was to evaluate a potential method to reduce such complications. This study compares the rate of wound healing complications between incisional negative pressure wound therapy (NPWT) and conventional dressings in vascular surgery patients with infra-inguinal incisions. The primary endpoint is complete closure of the wound at the 2-week follow-up appointment. Secondary endpoints include frequency infections requiring antibiotics, need for wound revision, and wound dehiscence. Methods A prospective cohort study with retrospective control group was performed following infra-inguinal vascular surgeries for peripheral arterial disease at the Mount Carmel Health System. The patients included in this study were those who underwent a lower-extremity vascular procedure with primary closure of an incision distal to the groin between January 2014 and July 2018. Patients that had received an infra-inguinal incision with primary closure were included. Patients in the experimental group who had a Prevena Wound VAC were compared with a retrospectively obtained control arm treated with conventional dressings. Data regarding wound healing and complications, specifically infections and wound dehiscence, were obtained. Results A total of 201 patients were recruited in our study: 64 in the Prevena group and 137 in the control group. There was a significant reduction in the number of open wounds in the Prevena group compared to the control group at the 2-week follow-up (10.9% Prevena vs 33.6% control; p = .0005). When evaluated in aggregate, there was a statistically significant reduction in the number of patients who succumbed to any complication in the Prevena arm compared with traditional dressings (13 (20.3%) Prevena vs 72 (52.6%) control; p < .0001). Conclusion The results of our study suggest there should be a significant consideration for the use of NPWT as a prophylactic measure to reduce the risk of wound complications of primarily closed infra-inguinal incisions in vascular surgery patients following common vascular procedures. Its use is particularly effective for patients at enhanced risk of infection, especially those with poor vascularization from BMI, smoking, and diabetes. This leads to decreased trends in antibiotic use, ED visits, readmissions, and surgical revisions, which translates to decreased utilization of hospital resources and economic burden.
Meta-analysis of perioperative outcomes and safety of percutaneous nephrostomy versus retrograde ureteral stenting in the treatment of acute obstructive upper urinary tract infection
Authors: Wang Xidong , Wu Gang , Wang Tianqi , Liu Shangjing , Ding Guixin , Mao Qiancheng , Chu Yongli , Cui Yuanshan , Wu Jitao 
Published: April 2024

Background: The debate regarding the optimal drainage method for acute obstructive upper urinary tract infection persists, focusing on the choice between percutaneous nephrostomy (PCN) and retrograde ureteral stenting (RUS). Aims: This study aims to systematically examine the perioperative outcomes and safety associated with PCN and RUS in treating acute obstructive upper urinary tract infections. Methods: A comprehensive investigation was conducted using the Medline, Embase, Web of Science, and Cochrane databases up to December 2022, following the guidelines of the Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) statement. The utilized keywords included ‘PCN’, ‘RUS’, ‘acute upper obstructive uropathy’, and ‘RCT’. Inclusion criteria encompassed studies providing accurate and analyzable data, which incorporated the total subject count, perioperative outcomes, and complication rates. The assessed perioperative outcomes included fluoroscopy time, normalization of temperature, normalization of serum creatinine, normalization of white blood cell (WBC) count, and operative time. Safety outcomes encompassed failure rate, intraoperative and postoperative hematuria, postoperative fever, postoperative pain, and postoperative nephrostomy tube or stent slippage rate. The study protocol was prospectively registered at PROSPERO (CRD42022352474). Results: The meta-analysis encompassed 7 trials involving 727 patients, with 412 assigned to the PCN group and 315 to the RUS group. The outcome of the meta-analysis unveiled a reduced occurrence of postoperative hematuria in the PCN group [odds ratio (OR) = 0.54, 95% confidence interval (CI) 0.30–0.99, p = 0.04], along with a decreased frequency of insertion failure (OR = 0.42, 95% CI 0.21–0.81, p = 0.01). In addition, the RUS group exhibited a shorter fluoroscopy time than the PCN group (mean difference = 0.31, 95% CI 0.14–0.48, p = 0.0004). Conclusion: Given the significant impact of hematuria and catheterization failure on postoperative quality of life, the preference for PCN appears more advantageous than RUS.
International Mobility and Knowledge Exchange Between China and the West: A Study of Chinese Humanities and Social Sciences Scholars
Authors: Shen (沈裕挺) Yuting 
Published: April 2024

Purpose This study examines the impact of international academic mobility on knowledge exchange between China and the West, including its potential benefits and risks, specifically in the humanities and social sciences (HSS) fields. Design/Approach/Methods This study employed qualitative research methods; specifically, data were collected through interviews and analyzed using thematic analysis. Findings With increasing knowledge flows in global academia, Chinese HSS scholars are benefiting from international academic mobility. They engage in various activities, such as international visits, conferences, and research collaborations, and praise the role of mobility in building an understanding of Western culture and knowledge, including research dynamics, embodied and encultured knowledge, and location-specific textual materials. However, international mobility has inadvertently exacerbated global knowledge asymmetries, with some Chinese scholars uncritically adopting Western paradigms. Nonetheless, pioneering Chinese HSS scholars aim to promote a two-way knowledge exchange between China and the West by fostering cultural reflexivity and enhancing their global visibility. Originality/Value Chinese HSS scholars serve as an illuminating example in the context of global knowledge asymmetries dominated by the Anglo-American West. These findings have theoretical and practical implications for fostering equitable and inclusive knowledge exchange between Western and non-Western societies through international academic mobility.
Impact of time to start of tranexamic acid treatment on rebleed risk and outcome in aneurysmal subarachnoid hemorrhage
Authors: Germans Menno R , Tjerkstra Maud A , Post René , Brenner Amy , Vergouwen Mervyn DI , Rinkel Gabriël JE , Roos Yvo BWEM , van den Berg René , Coert Bert A , Vandertop W Peter , Verbaan Dagmar ,   for the ULTRA Investigators
Published: April 2024

Introduction: The ULTRA-trial investigated effectiveness of ultra-early administration of tranexamic acid (TXA) in subarachnoid hemorrhage (SAH) and showed that TXA reduces the risk of rebleeding without concurrent improvement in clinical outcome. Previous trials in bleeding conditions, distinct from SAH, have shown that time to start of antifibrinolytic treatment influences outcome. This post-hoc analysis of the ULTRA-trial investigates whether the interval between hemorrhage and start of TXA impacts the effect of TXA on rebleeding and functional outcome following aneurysmal SAH. Patients and methods: A post-hoc comparative analysis was conducted between aneurysmal SAH patients of the ULTRA-trial, receiving TXA and usual care to those receiving usual care only. We assessed confounders, hazard ratio (HR) of rebleeding and odds ratio (OR) of good outcome (modified Rankin Scale 0–3) at 6 months, and investigated the impact of time between hemorrhage and start of TXA on the treatment effect, stratified into time categories (0–3, 3–6 and >6 h). Results: Sixty-four of 394 patients (16.2%) in the TXA group experienced a rebleeding, compared to 83 of 413 patients (19.9%) with usual care only (HR 0.86, 95% confidence interval (CI): 0.62–1.19). Time to start of TXA modifies the effect of TXA on rebleeding rate ( p < 0.001), with a clinically non-relevant reduction observed only when TXA was initiated after 6 h (absolute rate reduction 1.4%). Tranexamic acid treatment showed no effect on good outcome (OR 0.96, 95% CI: 0.72–1.27) with no evidence of effect modification on the time to start of TXA ( p = 0.53). Discussion and conclusions: This study suggests that the effect of TXA on rebleeding is modified by time to treatment, providing a protective, albeit clinically non-relevant, effect only when started after 6 h. No difference in functional outcome was seen. Routine TXA treatment in the aneurysmal SAH population, even within a specified time frame, is not recommended to improve functional outcome.
Percutaneous vs Open Zadek Osteotomy for Treatment of Insertional Achilles Tendinopathy and Haglund’s Deformity: A Systematic Review
Authors: Bakaes Yianni , Hall SarahRose , Jackson J. Benjamin , Johnson A. Holly , Schipper Oliver N. , Vulcano Ettore , Kaplan Jonathan R. M. , Gonzalez Tyler A. 
Published: April 2024

Background:Percutaneous Zadek osteotomy (ZO) has emerged as a surgical treatment of insertional Achilles tendinopathy (IAT) over the last decade. Existing literature is limited regarding the comparison of this approach with the more established, open ZO technique. This systematic review aims to evaluate and compare the current data on open vs percutaneous ZO approaches to help set evidence-based guidelines.Methods:A systematic literature search was performed using the keywords (Zadek osteotomy) OR (Keck and Kelly osteotomy) OR (dorsal closing wedge calcaneal osteotomy) OR (Haglund Deformity) OR (Haglund Syndrome) OR (Insertional Achilles Tendinopathy) and MeSH terms Osteotomy, Calcaneus, Syndrome, Insertional, Achilles tendon, and Tendinopathy. Our search included the following databases: PubMed, Embase, and the Cochrane Library. The PRISMA protocol and the Cochrane Handbook guidelines were followed. All studies included were published from 2009 to 2024 and included the use of open or percutaneous approaches of ZO for the treatment of IAT with at least a 12-month follow-up. The MINORS score criteria were used to evaluate the strength and quality of studies.Results:A total of 17 studies were reviewed, including 611 subjects and 625 ZO procedures. Of these procedures, 81 (11%) subjects had a percutaneous and 544 (89%) subjects had an open ZO. The mean follow-up time was 16.1 months for patients treated with percutaneous ZO and 36.1 months for patients treated with open ZO. Both open and percutaneous studies included in this review showed postoperative improvements in AOFAS, FFI, VISA-A, and VAS scores in patients with IAT. The reported complication rate was 5.8% among patients treated with percutaneous ZO and 10.2% among patients treated with open ZO.Conclusion:Percutaneous ZO is an emerging approach with substantially fewer documented cases compared with the open ZO. Both percutaneous and open ZO appear to be relatively effective treatments for insertional Achilles tendinopathy with Haglund’s deformity. The lower complication rates reported for percutaneous ZO is encouraging. Further investigation with more subjects undergoing percutaneous ZO is clearly needed.
Agreement Analysis on Postoperative Care Between ChatGPT and a High-Volume Foot and Ankle Surgeon
Authors: Efrima Ben , Barbero Agustin , Indino Cristian , Maccario Camilla , Usuelli Federico Giuseppe 
Published: April 2024

Introduction/Purpose: ChatGPT is an Artificial intelligence (AI) algorithm based on a user-friendly interface that does not requires advanced programming skills. Since its release to the public, it has made AI more accessible. As a result, the Patient refers to chat GTP for medical inquiries. This study compares the postoperative (PO) information provided by chatGPT to those of a high- volume foot and ankle orthopedics surgeon. Methods: The study includes 251 patients treated for end-stage osteoarthritis with total ankle arthroplasty. Postoperative emails containing inquiries about their PO status were uploaded to chatGTP. We then evaluated the agreement in simple (SA) and complex (CA) answers. The SA abbreviated the answer provided into "yes" or "no" Its agreement analysis was made using Cohens Kappa. In contrast, CA contained detailed information, and answers were classified into complete agreement, partial agreement, or complete disagreement. Additionally, in partial agreement answers, we calculated the percentage of agreement. Finally, we measured the cases where the surgeon added additional information unrelated to the inquiry. Results: There was only a slight agreement in the SA category (K=0.08). In the CA category, we found 27 percent of complete agreement; in 52 percent, we found complete disagreement; in 20 percent, we found only partial agreement. In 50 % of the cases, the surgeon added information unrelated to the question. Conclusion: We found limited agreement between chat GPT and the primary surgeon regarding postoperative information. Indicating that chat, GPT is currently an unreliable source for postoperative management. Table 2 Distribution of agreement percentage between a High-volume foot and ankle surgeon and ChatGPT response to postoperative inquiries from patients with total ankle arthroplasty in those with partial agreement