bluuebunny/crossref_metadata_2025_split huggingface dataset:
Percutaneous Versus Surgical Femoral Cannulation in Minimally Invasive Cardiac Surgery: A Systematic Review and Meta-Analysis
Authors: Kirov Hristo , Caldonazo Tulio , Runkel Angelique , Fischer Johannes , Tasoudis Panagiotis , Mukharyamov Murat , Cancelli Gianmarco , Dell’Aquila Michele , Doenst Torsten 
Published: April 2024

Objective: Minimally invasive cardiac surgery (MICS) is increasing worldwide. In most cases, the surgical technique includes cannulation of the groin for the establishment of cardiopulmonary bypass, requiring a second surgical incision (SC) for exposure and cannulation of the femoral vessels. With the introduction of arterial closure devices, percutaneous cannulation (PC) of the groin has become a possible alternative. We performed a meta-analysis and systematic review to compare clinical endpoints between the patients who underwent PC and SC for MICS. Methods: Three databases were assessed. The primary outcome was any access site complication. Secondary outcomes were perioperative mortality, any wound complication, any vascular complication, lymphatic complications, femoral/iliac stenosis, stroke, procedural duration, and hospital length of stay (LOS). A random effects model was performed. Results: A total of 5 studies with 2,038 patients were included. When compared with PC, patients who underwent SC showed a higher incidence of any access site complication (odds ratio [OR] = 3.09, 95% confidence interval [CI]: 1.87 to 5.10, P < 0.01), any wound complication (OR = 10.10, 95% CI: 3.31 to 30.85, P < 0.01), lymphatic complication (OR = 9.37, 95% CI: 2.15 to 40.81, P < 0.01), and longer procedural duration (standardized mean difference = 0.31, 95% CI: 0.12 to 0.51, P < 0.01). There was no significant difference between the 2 groups regarding perioperative mortality, any vascular complication, femoral/iliac stenosis, stroke, or hospital LOS. Conclusions: The analysis suggests that surgical groin cannulation in MICS is associated with a higher incidence of any access site complication (especially wound complication and lymphatic fistula) and with a longer procedural time compared with PC. There was no difference in perioperative mortality.
Evaluating the clinical and cost-effectiveness of a conservative approach to oxygen therapy for invasively ventilated adults in intensive care: Protocol for the UK-ROX trial
Authors: Martin Daniel S , Shahid Tasnin , Gould Doug W , Richards-Belle Alvin , Doidge James C , Camsooksai Julie , Charles Walton N , Davey Miriam , Francis Johnson Amelia , Garrett Roger M , Grocott Michael PW , Jones Joanne , Lampro Lamprini , Miller Lorna , O’Driscoll B Ronan , Rostron Anthony J , Sadique Zia , Szakmany Tamas , Young Paul J , Rowan Kathryn M , Harrison David A , Mouncey Paul R 
Published: April 2024

Background: In the United Kingdom, around 184,000 adults are admitted to an intensive care unit (ICU) each year with over 30% receiving mechanical ventilation. Oxygen is the commonest therapeutic intervention provided to these patients but it is unclear how much oxygen should be administered for the best clinical outcomes. Methods: The UK-ROX trial will evaluate the clinical and cost-effectiveness of conservative oxygen therapy (the minimum oxygen concentration required to maintain an oxygen saturation of 90% ± 2%) versus usual oxygen therapy in critically ill adults receiving supplemental oxygen when invasively mechanically ventilated in ICUs in England, Wales and Northern Ireland. The trial will recruit 16,500 patients from approximately 100 UK adult ICUs. Using a deferred consent model, enrolled participants will be randomly allocated (1:1) to conservative or usual oxygen therapy until ICU discharge or 90 days after randomisation. Objectives: The primary clinical outcome is all cause mortality at 90 days following randomisation. Discussion: The UK-ROX trial has received ethical approval from the South Central – Oxford C Research Ethics Committee (Reference: 20/SC/0423) and the Confidentiality Advisory Group (Reference: 22/CAG/0154). The trial commenced in May 2021 and, at the time of publication, 95 sites had opened to recruitment.
Arthroscopic repair of proximal anterior cruciate ligament tears in children and adolescents: A systematic review
Authors: Turati Marco , Anghilieri Filippo Maria , Gatti Simone Daniel , Courvoisier Aurelien , Rigamonti Luca , Zatti Giovanni , Nicolaou Nicolas , Bigoni Marco 
Published: April 2024

Purpose: Anterior cruciate ligament repair techniques are of growing interest because they allow for minimally invasive surgery that avoids harvesting of the transplant, without risking growth deficiencies in young patients. The aim of this study is to summarize the published evidence about arthroscopic repair of anterior cruciate ligament proximal tears in skeletally immature patients. Methods: In total, four studies were included and processed for data extraction after screening for eligibility for this systematic review: one retrospective cohort study and three retrospective case series. Altogether, the four studies included in this review included 61 skeletally immature patients with a mean age of 12.1 years diagnosed with proximal anterior cruciate ligament tear who underwent arthroscopic repair with preservation of the native ligament. The mean follow-up period was 2.8 years. Results: The most relevant and objective outcome that we considered was re-rupture rate. One study reports a cumulative incidence of graft failure in the first 3 years after surgery of 48.8% while the others report a 0%, 0% and 21.5% re-rupture rate. No growth disturbances were reported in the included studies. Conclusion: Despite growing interest surrounding anterior cruciate ligament repair techniques, the presence of limited quality studies in the literature means repair cannot be strongly supported at present. Some encouraging data regarding the absence of growth disturbance and functional outcomes does exist, but studies with larger samples are required. Level of evidence: level IV.
Ballistic resistance analysis of hard ceramic combined with aluminum foam sandwich constructions
Authors: Pratomo Arief Nur , Ruhma Zaka , Rukmono Wawan , Martijanti Martijanti , Sutarno Sutarno , Tse Kwong Ming 
Published: April 2024

A ballistic resistance of hard ceramic combined with aluminum foam sandwich (CAFS) constructions was investigated in this paper. This combination plate is constructed by a front faceplate (FFP), ceramic plates, an aluminum foam (Al-foam) panel, and a rear faceplate (RFP). The material used for the FFP and RFP was heat-treated mild steel with the thicknesses are 5 mm and 3.5 mm, respectively. The ceramic materials to be evaluated are B4C, SiC, and Al2O3. Al-foams were fabricated by varying the stabilizer weight ratio of MgO and Al2O3. The Al-foams have a porosity of 79.93%–82.57%, a pore diameter of 2.51–2.82 mm, the relative density of 0.17–0.24, and plateau stress of 3.88–6.63 MPa. Ballistic tests were carried out only for aluminum foam sandwich (AFS) construction without ceramics to evaluate the manufacturing effect and to obtain a baseline ballistic plate to be improved. Ballistic tests are conducted by using 5.56 × 45 mm bullet with 50 m shooting range and bullet speed of 929–958 m/s. To validate the damage mode and energy absorption capability of the AFS, a numerical model is constructed. The numerical studies were conducted to investigate the damage mode and energy absorption capabilities of each part. The simulation has a good agreement with the experiment result on the damage mode. This model then to be used to study the effect of the additional hard ceramic layer. An interaction between hard ceramic and AFS is also investigated to get a new insight of the energy absorption mechanism during bullet penetration. A new finding shows that ceramic presses the Al-foam to solidify so that it can increase the energy absorbed by the Al-foam. The ceramic is impacted by a bullet pushing the Al-foam so that it undergoes solidification which leads to increasing absorbed energy.
Exploring the Impact of Artificial Intelligence on Global Health and Enhancing Healthcare in Developing Nations
Authors: Zuhair Varisha , Babar Areesha , Ali Rabbiya , Oduoye Malik Olatunde , Noor Zainab , Chris Kitumaini , Okon Inibehe Ime , Rehman Latif Ur 
Published: April 2024

Background: Artificial intelligence (AI), which combines computer science with extensive datasets, seeks to mimic human-like intelligence. Subsets of AI are being applied in almost all fields of medicine and surgery. Aim: This review focuses on the applications of AI in healthcare settings in developing countries, designed to underscore its significance by comprehensively outlining the advancements made thus far, the shortcomings encountered in AI applications, the present status of AI integration, persistent challenges, and innovative strategies to surmount them. Methodology: Articles from PubMed, Google Scholar, and Cochrane were searched from 2000 to 2023 with keywords including AI and healthcare, focusing on multiple medical specialties. Results: The increasing role of AI in diagnosis, prognosis prediction, and patient management, as well as hospital management and community healthcare, has made the overall healthcare system more efficient, especially in the high patient load setups and resource-limited areas of developing countries where patient care is often compromised. However, challenges, including low adoption rates and the absence of standardized guidelines, high installation and maintenance costs of equipment, poor transportation and connectivvity issues hinder AI’s full use in healthcare. Conclusion: Despite these challenges, AI holds a promising future in healthcare. Adequate knowledge and expertise of healthcare professionals for the use of AI technology in healthcare is imperative in developing nations.
The Complexity of Female Empowerment in India
Authors: Anderson Siwan 
Published: April 2024

On a global scale, India ranks very poorly in terms of gender equality. This overall indicator masks important heterogeneities across the separate measures of female empowerment. India scores very highly with regards to equality of civil liberties and the political participation of women. But the country falls well below the global average with respect to equal access to economic resources and protection from gender-based violence. These poorer empowerment indicators have persisted not only in the wake of strong economic progress, but also in the context of an impressive set of government led reforms and policies targeting women. These different initiatives have successfully augmented women’s agency in both the private and public spheres of life, but women and girls still face extreme discrimination and violence. The salience of restrictive local customs appears to be a core hindrance towards transformative change. This paper reviews the economics literature which examines this complexity across the different dimensions of female empowerment in India. It highlights the newly emerging research focused on ameliorating gender biased norms and discusses potential steps forward. JEL Classifications: J12, J16
Arthroscopic Chondral Ankle Treatment: A Multicenter Outcome Study
Authors: Yuro Matthew R. , Carreira Dominic S. , Acevedo Jorge I. , Harris Thomas G. 
Published: April 2024

Introduction/Purpose: Chondral injuries of the ankle are common, often requiring surgical intervention. The purpose of this multicenter study of ankle osteochondral injuries is to report minimum one year outcomes for patients undergoing arthroscopic surgical treatment. Methods: Thirty-nine patients undergoing arthroscopic surgery to treat chondral ankle injuries between December 2017 and January 2022 were enrolled in the present multicenter study. Intraoperative information including diagnoses and procedures performed were recorded. All patients completed the Visual Analog Scale for Pain (VAS), the Veteran RAND 12-Item Health Survey (VR-12) Physical and Mental component scales, and Foot and Ankle Ability Measure Sports subscale (FAAM-S). These measures were collected at the pre-operative visit within two weeks before surgery and at a minimum of one year post- operatively. Patient demographics and perioperative complications were also recorded. Paired T-test was used to determine statistical significance. Results: Of the thirty-nine patients with a minimum of 1 year follow-up, the average age was 46 years old and 51% were male. Average patient BMI was 29. Laterality was right in 54% of the patients, and 8% of surgeries were revisions. Relative to baseline, there was a significant decrease in VAS at minimum 1-year post-operatively (4.9 to 1.7, p< 0.001). Additionally, the VR-12 Physical was significantly higher at minimum 1-year post-operatively (35.4 to 46.8, p< 0.001). The VR-12 Mental was also significantly higher at minimum 1-year post-operatively (47.6 to 54.6, p=0.005). Finally, there was a significant increase in FAAM Sports (11.3 to 34.0, p< 0.001). There were no recorded complications. Conclusion: For patients undergoing arthroscopic surgery to treat chondral ankle injuries, our study found significant improvements in self-reported pain, overall physical health, overall mental health, and sport activities at minimum one-year follow- ups with no complications.
Evaluation of Surgical Costs in Acute Achilles Repairs
Authors: Wagers Kade , Nixon Devon , Ofori-Atta Blessing S. , Presson Angela , Tucker William 
Published: April 2024

Introduction/Purpose: Increasing attention is being paid to the costs associated with various orthopedic surgeries. Here, we studied the factors that influence costs associated with surgically treated acute Achilles tendon tears. Methods: We retrospectively identified patients with surgically repaired acute Achilles tendon tears, excluding insertional ruptures or chronic tendon issues. Using the Value Driven Outcome (VDO) tool from our institution, we assessed total direct costs as well as facility costs. Briefly, the VDO tool includes an item-level database that can capture granular-level cost data – costs are then reported as relative mean data. Cost variables were adjusted to 2022 US dollars, and total direct cost was compared with patient characteristics using gamma regressions to report cost ratios with 95% confidence intervals (CIs). Results: Our cohort consisted of 224 patients with Achilles tendon tears surgically repaired by one of four fellowship-trained orthopedic foot and ankle surgeons. There were no differences in demographics, total direct costs, or facility costs based on positioning (prone N =156, supine N =68). Total direct costs were 9% higher in males (N =182) compared to females (N =42) (p=0.023, 95% CI: 1.01-1.17) in an unadjusted analysis. Mini-open repairs (N =215), compared to percutaneous techniques (N =9), had 32% less total direct costs (p < 0.001; 95% CI: 0.60-0.78). Compared to surgery at a main academic hospital (N =15), procedures at an ambulatory care center (N =207) had 25% lower total direct costs (p < 0.001; 95% CI: 0.67-0.83) and 44% lower reduced facility costs (p < 0.001; 95% CI: 0.51-0.61). Significance was maintained in multivariable analysis except for sex. Conclusion: Improving cost-effective orthopedic care remains an increasingly important goal. Patient positioning for Achilles tendon repair does not appear to have meaningful effects on cost. Surgery at an ambulatory center was significantly less costly than repairs performed at an academic hospital. When clinically appropriate, considering surgery location at an ambulatory center appears to reduce surgical costs.
Gender Representation Among Foot & Ankle Conference Presenters and Research Authors: A 10-Year Analysis (2012-2022)
Authors: Mullen Marguerite Anne , Budis Emmanuel , Gianakos Arianna , Esfahani Soheil Ashkani , DiGiovanni Christopher W. , Guss Daniel 
Published: April 2024

Introduction/Purpose: Today women are over 50% of medical school matriculants but remain underrepresented in orthopaedic surgery (~15% of residents and < 6% of practicing surgeons). Moreover, despite different and sometimes controversial reports, the rate of female society memberships and national and international meeting speakers as well as their contribution to leadership positions including moderating sessions, podiums, and symposiums are believed to be low. The objective of this study was to assess whether there is a gap in female representation among invited speakers at American Orthopaedic Foot & Ankle Society (AOFAS) national meetings relative to research productivity as reflected by article authorship in Foot & Ankle International journal (FAI). Methods: Programs for AOFAS specialty days and annual meetings and FAI articles from January 2012 to December 2022 were obtained. Industry-hosted programs were excluded. Gender was identified through personal acquaintance or online search on the biographies of the authors. Presentations and articles were categorized as “technical” or “non-technical”, where technical was defined as relating to basic science or the clinical practice of orthopaedics. Comparisons were done using the Chi-Square Test (significance level= p< 0.05). Results: 1,020 AOFAS presentations and 2,230 FAI articles were analyzed. Gender was unavailable for 0.19% of AOFAS speakers, 4.48% of FAI first authors and 4.13% of FAI senior authors. 11.08% of AOFAS invited national meeting speakers, 15.18% of FAI first authors and 7.40% of FAI senior authors were female. Overall, the proportion of female speakers was significantly lower than female first authors (p= 0.0036), and significantly higher than female senior authors (p < 0.001). In 2018 and 2019, women were more likely to have given “non-technical” AOFAS presentations. There was no significant difference in other years or among FAI articles. The average annual change was +2.00% female AOFAS presenters, +0.31% FAI female first authors and -0.37% FAI female senior authors per year. Conclusion: Women represented 15.16% of first authors in FAI between 2012 and 2022 but 11.08% of invited speakers at AOFAS meetings. Meanwhile, the percentage of female AOFAS membership in the organization as a whole increased from 7.5% to 13%. Thus, despite historically low rates of representation, female Foot & Ankle surgeons were proportionally represented in 2021 and 2022 among invited national conference presentations and research compared to female society membership and female research publications in FAI. There is still room to increase representation of deserving historically under-represented groups, however the increase in female AOFAS presenters demonstrates a positive trend. Figure 1. Percentage of AOFAS Female Podium Speakers and FAI Female 1st Authors, 2012 - 2022
Glucose Lability and Complications in Diabetic Ankle Fractures
Authors: LeDuc Ryan , Shimizu Michelle , McGregor Patrick C. , Eikani Carlo , Hamid Kamran , Pinzur Michael , Schiff Adam 
Published: April 2024

Introduction/Purpose: Rotational ankle fractures in diabetics have long posed difficult clinical challenges, with several observational studies noting increased risk of complications and amputation following treatment of unstable ankle fractures in diabetics. Several treatment options exist, including non-operative management, external fixation, open reduction internal fixation, staged fixation, and fusion. Hemoglobin A1C produces a mean blood glucose level over a three-month period. There is mounting evidence that glucose variability may be an alternative predictor of complication profile in non-orthopedic procedures, as well as in the total joint arthroplasty literature. The purpose of this investigation is to retrospectively analyze complication rates for diabetics with rotational ankle fractures at a single institution and assess their association with both the hemoglobin A1C and glucose variability. Methods: After obtaining Institutional Review Board approval, all patients from 2015-2022 with a diagnosis of diabetes and ankle fracture were retrospectively identified based on ICD-9/ICD-10 codes. These charts were manually reviewed to determine fracture classification and treatment. For operatively and non-operatively managed ankle fractures, the patient’s hemoglobin A1C was recorded when available within 3 months of the date of injury. Glucose variability was calculated using a coefficient of variation. Results: Two-hundred patients were included for analysis, of which 29% (n=58) were treated non-operatively. The majority of surgically treated patients underwent acute ORIF (58%, n=116). 8.5% were treated with staged fixation, 3.5% with acute hindfoot fusion, and 1% with external fixation alone. The overall complication rate was 27.5% (n=55). There were no statistically significant differences in both A1C (7.81 +/- 1.89 vs 7.73 +/- 1.96) and glucose variability, as measured by the covariance of variation (0.23 +/- 0.15 vs 0.20 +/- 0.13) in patients who did and did not experience postoperative complications. Higher glucose variability did trend towards predicting complications, though not in a statistically significant fashion (OR=1.57, p=0.35). Conclusion: Ankle fractures in patients with diabetes pose a challenge for orthopedic surgeons, as evidenced by the high medical and surgical complication rate observed in this study and others. No statistical significance was found between higher A1C and complication rate or between glucose variability and complication rate. Further investigation on the impact of glucose variability on complication rates in a larger cohort of this patient population is warranted. Univariable logistic Regression Results for the association of the odds of post-operative complication with patient characteristics.
Amableite-(Ce), Na15[(Ce1.5Na1.5)Mn3]Mn2Zr3□Si[Si24O69(OH)3](OH)2⋅H2O, a new eudialyte-group mineral from Saint-Amable Sill, Québec, Canada
Authors: Chukanov Nikita V. , Zolotarev Andrey A. , Schäfer Christof , Varlamov Dmitry A. , Pekov Igor V. , Vigasina Marina F. , Belakovskiy Dmitry I. , Aksenov Sergey M. , Vozchikova Svetlana A. , Britvin Sergey N. 
Published: April 2024

AbstractThe new eudialyte-group mineral amableite-(Ce), ideally Na15[(Ce1.5Na1.5)Mn3]Mn2Zr3□Si[Si24O69(OH)3](OH)2⋅H2O, was discovered in a peralkaline pegmatite at Saint-Amable Sill, Montérégie, Québec, Canada. The associated minerals are albite, microcline, aegirine, serandite, natrolite, yofortierite, and an unidentified titanosilicate forming minute grains. Amableite-(Ce) occurs as yellow equant or thick tabular crystals up to 2 mm across. The observed crystal forms are {0001}; the subordinate forms are {11$\bar{2}$0}, {10$\bar{1}$1}, and {10$\bar{1}$0}. Amableite-(Ce) is brittle, with a Mohs hardness of 5. D(meas) = 2.89(1), D(calc) = 2.899 g⋅cm–3. Amableite-(Ce) is optically anomalously biaxial (+) with α ≈ β = 1.603(2) and γ = 1.608(2). The chemical composition is (wt.%, electron microprobe, H2O measured by means of a modified Penfield method): Na2O 14.20, K2O 0.41, CaO 1.89, MnO 8.25, Fe2O3 2.40, La2O3 3.10, Ce2O3 4.19, Pr2O3 0.16, Nd2O3 0.59, SiO2 49.41, ZrO2 11.17, HfO2 0.24, TiO2 0.68, Nb2О5 1.54, Cl 0.26, H2O 1.70, –O≡Cl –0.06, total 100.13. The crystal structure was determined using single-crystal X-ray diffraction data and refined to R1 = 0.0423. Amableite-(Ce) is trigonal, space group R3, with a = 14.1340(3) Å, c = 30.3780(11) Å and V = 5255.6(3) Å3. The crystal-chemical formula is (Na12.93K0.27Ce0.06)Σ13.26[(Mn2.49Ce0.30Ca0.21)Σ3.00(Ce1.14Na1.04Ca0.82)Σ3.00](Mn1.05Fe0.90□1.05)Σ3.00(Zr2.85Ti0.12Hf0.03)Σ3.00(□0.40Nb0.36Si0.24)Σ1.00(Si0.88□0.12)Σ1.00[Si24(O70.44(OH)1.56)Σ72.00][(OH)2.20(H2O)1.27]Σ3.47Cl0.22 (Z = 3). Infrared and Raman spectra are given. The strongest lines of the powder X-ray diffraction pattern [d, Å (I, %)(hkl)] are: 11.34 (51)(101), 7.06 (76)(110), 4.312 (63)(205), 3.783 (38)(033), 3.538 (43)(027, 220), 2.963 (84)($\bar{3}$45), 2.837 (100)(404). The mineral is named after the discovery locality.