bluuebunny/crossref_metadata_2025_split huggingface dataset:
Multi-Institutional Analysis of Insurance Denial Patterns Within Rhinology
Authors: Janz Tyler A. , Khan Najm S. , Dhanda Aatin K. , Takashima Masayoshi , Wu Arthur W. , Tang Dennis M. , Higgins Thomas S. , Ramanathan Murugappan , Ahmed Omar G. 
Published: March 2024

BackgroundObtaining insurance approval is a necessary component of healthcare in the United States and denials of these claims have been estimated to result in a loss of 3% to 5% of revenue.ObjectiveExamine the trends in insurance denials for rhinological procedures.MethodsA retrospective review of deidentified financial data of patients who were treated by participating physicians across 3 institutions from January 1, 2021, to June 30, 2023. The data was queried for rhinological and non-rhinological procedures via CPT codes. Cumulative insurance denials were calculated and stratified by procedure and insurance type. Write-offs were dollar amounts associated with final denials.ResultsA sample of 102,984 procedures and visits revealed a final denial rate between 2.2% and 2.9% across institutions ( p = .72). The top three rhinological procedures for final write-offs were: nasal endoscopy (16.24%, $111,836.87), nasal debridement or polypectomy (6.48%, $79,457.51), and destruction of intranasal lesion (2.11%, $56,932.20). The write-off percentage for each procedure was highest among commercial insurance payers as opposed to Medicare or Medicaid.ConclusionFinal denial rates of rhinology procedures ranged between 2% and 3%. Common procedures such as nasal endoscopy and nasal debridement are among the highest written-off procedures. Insurance denials can lead to notable revenue loss. Rhinology practices must continue to remain knowledgeable of the changes and effects of insurance reimbursement on their practice.
Treatment of basilar artery aneurysms with two braided stents: Two centers experience of low-profile visualized intraluminal support stents versus Pipeline flow diverters
Authors: Luo Bin , Wang Chao , Liu Jian , Zhang Yisen , Wang Kun , Li Wenqiang , Zhang Ying 
Published: March 2024

Background Both low-profile visualized intraluminal support (LVIS)stents and Pipeline flow diverters (FDs) are therapeutic strategies for basilar artery (BA) aneurysms, but they have not been directly compared. Methods A total of 132 consecutive patients with 139 BA aneurysms treated with either LVIS stent or Pipeline FDs were analyzed. Propensity score matching (PSM) was used to control for age, sex, hypertension, aneurysm size, shape, location, and duration of follow-up. The treatment results of these two braided stents were compared. Results LVIS stent was placed in 88 (63.3%) and Pipeline FDs in 51 (36.7%) procedures. Patients with Pipeline FDs tended to be younger and have less hypertension, whereas aneurysms had larger aneurysm size. After PSM, similar complete or near-complete occlusion rates (76.7% vs 73.3%, p = .766) and favorable functional outcomes (86.7% vs 90.0%, p = 1) were achieved in patients treated with LVIS stents and Pipeline FDs, respectively. Further comparisons were conducted at three different locations (basilar apex/basilar trunk/vertebrobasilar artery junction [VBJ]) separately, and the results showed a higher complete or near-complete aneurysm occlusion rate after Pipeline FD treatment than LVIS treatment (86.7% vs 59.2%, p = .012) only at VBJ, where a particularly high proportion of non-saccular shape (70.9%) and a male preponderance were noted. Conclusion Both braided stents were effective in the treatment of BA aneurysms, with good occlusion rates and favorable functional outcomes. Pipeline FD achieved a particularly higher aneurysm occlusion rate than LVIS stent at VBJ, where lesions often require reconstruction of the diseased vessel.
Extra-gastrointestinal stromal tumour of the lesser omentum presenting as a massive intra-abdominal swelling: A case report and literature review
Authors: Ashindoitiang John Adi , Nwagbara Victor Ikechukwu Canice , Ugbem Theophilus Ipeh , Enya Nkami Joseph , Aniebo Ikechimka Ogbugbanduchi , Ekong Joseph Christopher , Obinna Sidney Esotu , Asuquo Maurice Efana 
Published: March 2024

Extra gastrointestinal stromal tumour(EGIST) is rare and is regarded as gastrointestinal stromal tumour(GIST) that originates outside of the gastrointestinal tract. They originate from other intraabdominal tissues such as the omentum, mesentery and peritoneum. The cell of origin is the interstitial cell of Cajal(ICC), a pacemaker cell that controls gastrointestinal peristalsis and the tumor is characterized by the expression of KIT(CD117) a transmembrane tyrosine kinase receptor. Here, a 49-year-old female who presented with a 6 month history of abdominal pain, progressive abdominal swelling and the presence of an upper abdominal mass. She had surgical resection and adjuvant imatinib for the intraabdominal mass diagnosed on histology and immunohistochemistry as EGIST of the lesser omentum. Serial CT 14 months after surgery revealed no evidence of recurrence or metastasis. Clinicians should consider EGIST in the differential diagnosis of abdominal masses.
Trends in vacuum and forceps delivery in teaching hospitals and academic health systems in West Java, Indonesia: A retrospective study
Authors: Hayati Khishotul , Ritonga Mulyanusa Amarullah , Djuwantono Tono 
Published: March 2024

Objectives: Recently, there has been a decline in the use of vacuums and forceps. This is due to complications that occur in the mother and baby as well as the operator’s ability to operate the instruments. Concerning Professional Education Standards for Obstetrics and Gynecology Specialists, the minimum skill that must be achieved by vacuum extraction and forceps is a minimum of five cases. This is difficult to achieve with the number of obstetrics and gynecology residents in West Java. Methods: A retrospective study was conducted using medical records based on the International Classification of Disease 10th Revision from 1 to 28 February 2023 at teaching hospitals and Academic Health System in West Java, namely Hasan Sadikin Hospital, Al-Ihsan Hospital Bandung, and Cikalong Wetan Hospital West Bandung, in the period 1 January 2018 to 31 December 2022. The main outcome was vacuum and forceps extraction with consecutive sampling. The relationship between maternal characteristics such as maternal age, parity, gestational age, and indication for delivery with vaginal operative delivery was descriptive statistics analyzed using IBM SPSS Statistics 26. Results: Trends indicate that the percentage of vaginal operative deliveries tends to be low, below 5%. Vacuum deliveries decreased from 0.75% in 2018 to 0.68% in 2022, while forceps deliveries decreased from 2.77% to 0.98% over the same period. Conclusion: This study concludes that there was an insufficiency of vacuum extraction and forceps delivery cases at the teaching hospital and Academic Health System in West Java to achieve a minimum case of vacuum and forceps. Further research studying how educational interventions improve operative delivery skills might be considered.
RTC_TongueNet: An improved tongue image segmentation model based on DeepLabV3
Authors: Tang Yan , Tan Daiqing , Li Huixia , Zhu Muhua , Li Xiaohui , Wang Xuan , Wang JiaQi , Wang Zaijian , Gao Chenxi , Wang Ji , Han Aiqing 
Published: March 2024

Objective Tongue segmentation as a basis for automated tongue recognition studies in Chinese medicine, which has defects such as network degradation and inability to obtain global features, which seriously affects the segmentation effect. This article proposes an improved model RTC_TongueNet based on DeepLabV3, which combines the improved residual structure and transformer and integrates the ECA (Efficient Channel Attention Module) attention mechanism of multiscale atrous convolution to improve the effect of tongue image segmentation. Methods In this paper, we improve the backbone network based on DeepLabV3 by incorporating the transformer structure and an improved residual structure. The residual module is divided into two structures and uses different residual structures under different conditions to speed up the frequency of shallow information mapping to deep network, which can more effectively extract the underlying features of tongue image; introduces ECA attention mechanism after concat operation in ASPP (Atrous Spatial Pyramid Pooling) structure to strengthen information interaction and fusion, effectively extract local and global features, and enable the model to focus more on difficult-to-separate areas such as tongue edge, to obtain better segmentation effect. Results The RTC_TongueNet network model was compared with FCN (Fully Convolutional Networks), UNet, LRASPP (Lite Reduced ASPP), and DeepLabV3 models on two datasets. On the two datasets, the MIOU (Mean Intersection over Union) and MPA (Mean Pixel Accuracy) values of the classic model DeepLabV3 were higher than those of FCN, UNet, and LRASPP models, and the performance was better. Compared with the DeepLabV3 model, the RTC_TongueNet network model increased MIOU value by 0.9% and MPA value by 0.3% on the first dataset; MIOU increased by 1.0% and MPA increased by 1.1% on the second dataset. RTC_TongueNet model performed best on both datasets. Conclusion In this study, based on DeepLabV3, we apply the improved residual structure and transformer as a backbone to fully extract image features locally and globally. The ECA attention module is combined to enhance channel attention, strengthen useful information, and weaken the interference of useless information. RTC_TongueNet model can effectively segment tongue images. This study has practical application value and reference value for tongue image segmentation.
Perspective of Created Value in Consumer Choice: Comparison of Economic and Ecological Dimensions
Authors: Kubiczek Jakub , Hadasik Bartłomiej , Krawczyńska Dominika , Przedworska Kornelia , Madarász Erika Zsuzsanna , Ryczko Aleksandra 
Published: March 2024

This paper aims to identify and categorize the factors influencing consumer goods’ value into ecological and economic dimensions and subsequently compare them. The analysis employs the Allegro Reviews (AR) dataset, comprising post-purchase product reviews, with a focus on a sample of 1,400 randomly selected reviews from a pool of 10,615 comments. Through this examination, distinct influencing factors are identified, categorized as either ecological or economic, and their frequency of reference in online reviews was compared. The research findings show that consumers consistently address economic dimensions in their reviews. Notably, emphasis is placed on goods’ quality, pricing, and the price-quality relationship. On the other hand, ecological aspects receive limited attention in reviews, suggesting their lesser significance to consumers compared to economic considerations. This study’s implications for theory and practice indicate that companies should prioritize economic aspects in their value creation endeavors, relegating ecological factors to a secondary role. However, from a global standpoint, enterprises must incorporate ecological dimensions during the value creation process to avert environmental degradation, which could otherwise undermine overall societal quality of life. In terms of originality and value, this research diverges from typical consumer choice studies that rely on questionnaires. Instead, it analyzes actual post-purchase product reviews, providing insights into tangible elements contributing to goods’ value, thus bypassing reliance on mere declarations. JEL Classification: D11, D12, L25, L26.
Randomized controlled trial on analgesic effect of pre-operative fascia iliaca compartment block in geriatric patients with hip fracture
Authors: Tze-Kit Wan , Yung-Chak Hsu , Kwok-Hang Lam , Kwok-Keung Chu , Lok-Ming Leung , Chi-Chung Tse , Chun-Kwan Wong 
Published: March 2024

Objective While most geriatric patients with hip fracture benefit from definitive operative treatment, pre-operative pain management is often overlooked. Conventional oral analgesics may provide suboptimal pain control, resulting in poor morbidity outcomes. Fascia iliaca compartment block (FICB) provides a more consistent analgesic effect. This study aims to provide high level local evidence on the effect of FICB in pre-operative pain control for these patients in Hong Kong. Materials and Methods This study was a double-blinded randomized controlled trial. Mentally competent geriatric patients with acute fracture hip, admitted to United Christian Hospital, were recruited to receive pre-operative FICB. The procedure was carried out by landmark approach with addition of ultrasonography-guidance. They were randomized into intervention group (receiving 0.25% levobupivacaine), and control group (receiving normal saline as placebo). Numeric Rating Scale of pain score (at rest, and on gentle movement) at different time intervals, timing of injection, systemic analgesic use, complications, and demographics were compared. Results Total 80 patients were recruited from July 2019 to September 2021 and randomized into intervention and control groups. Two patients in intervention group and 1 in control group were withdrawn due to development of delirium. Demographics of both groups were comparable. Pain score at rest was significantly lower at 12 h after injection in intervention group (41.4% reduction, p = 0.03). Pain score upon gentle movement was significantly lower in intervention group at 1 h (p = 0.01), 12 h (28.9% reduction, p = 0.003) and 24 h after injection (p = 0.01). There was no complication from the procedure documented. Total systemic analgesic use was similar in both groups. Conclusion FICB is an effective choice of pre-operative analgesia for geriatric hip fracture patients with good safety profile, especially in controlling pain induced by movement. It shall be considered as a routine practice for suitable patients.
Implementation leadership and implementation climate in context: A single organization intrinsic case study for implementation of digital measurement-based care
Authors: Sklar Marisa , Ehrhart Mark G. , Ramirez Nallely , Carandang Kristine , Kuhn Nicolle , Day Ana , Aarons Gregory A. , Williams Nathaniel J. 
Published: March 2024

Background Although studies have demonstrated that implementation leadership and climate are important constructs in predicting evidence-based practice (EBP) implementation, concrete descriptions of how they operate during organizational implementation efforts are lacking. This case study fills that gap through an in-depth description of an organization with effective implementation leadership that successfully built a strong implementation climate. This case study provides an illustration of implementation leadership and climate in tangible, replicable terms to assist managers, practitioners, and researchers in addressing the organizational context in their own implementation projects. Method A single organization, intrinsic case study was employed to paint a multifaceted picture of how one organization leveraged implementation leadership to strengthen a climate for the successful implementation of digital measurement-based care. The case was drawn from a cluster-randomized trial designed to test the effects of a leadership-focused implementation strategy on youth-level fidelity and clinical outcomes of digital measurement-based care. Following the completion of the trial, case study activities commenced. Descriptive summaries of multiple data sources (including quantitative data on implementation leadership and climate, coaching call and organizational alignment meeting recordings and notes, and development plans) were produced and revised iteratively until consensus was reached. Leadership actions were analyzed for corresponding dimensions of implementation leadership and climate. Results Specific actions organizational leaders took, as well as the timing specific strategies were enacted, to create a climate for implementation are presented, along with lessons learned from this experience. Conclusion This case study offers concrete steps organizational leaders took to create a consistent and aligned message that the implementation of a specific EBP was a top priority in the agency. The general approach taken to create an implementation climate provides several lessons for leaders, especially for EBPs that have broad implications across an organization.
Method Study to Compare a CAAHEP Accredited Advanced Cardiac Sonography Program With Two Pilot Advanced Sonography Programs
Authors: Guthrie Joy D. 
Published: March 2024

Objective: The aim was to review the value of advanced sonography programs and to quantitatively evaluate the educational outcomes of two pilot advanced sonography programs (e.g., vascular and perinatal) with a well-established Commission on Accreditation of Allied Health Education Programs (CAAHEP) accredited Advanced Cardiac Sonography Program. Materials and Methods: The first phase of this sequential mixed-method study was to conduct a document analysis and extracting themes from published literature to highlight the content, benefits, and development of advanced sonography programs. The second phase was to implement a one-group pre-test post-test design to address the population, intervention, control, and outcomes (PICO) question: Among a sample of 12 participants (P), what are the effects of advanced programs (I) in cardiac, vascular, and perinatal sonography (C) on students’ composite knowledge, across 12 course levels and one clinical internship (O)? Results: The document analysis identified four latent themes: (1) the benefits of sonographer certification; (2) the need for sonographers to continuously develop their knowledge and skills; (3) the need to develop sonographers in diverse specialties of medicine; and (4) the need to develop new credentials for advanced practice sonographers. The effects of the three advanced sonography programs on the composite knowledge of the graduates were impressive, indicated by Hedges’ g = 2.02 (moderate) to 2.71 (large) effect size. Triangulation of data revealed that the four latent themes were consistent with the evaluation of the content and outcomes of the advanced cardiac, perinatal, and vascular sonography programs. Conclusion: Consistency between theory and practice and similar educational outcomes were achieved when comparing a well-established Advanced Cardiac Sonography Program with two pilot programs in advanced perinatal sonography and advanced vascular sonography. As this is the first comparison of this type, distinct conclusions that apply to all allied health programs cannot be drawn. The data collection in this study is a set of outcome measures that fits into a larger picture of academic success for these programs.
Machine learning to establish three sphingolipid metabolism genes signature to characterize the immune landscape and prognosis of patients with gastric cancer
Authors: Yan Jianing , Yu Xuan , Li Qier , Miao Min , Shao Yongfu 
Published: March 2024

Abstract
Background
Gastric cancer (GC) is one of the most common malignant tumors worldwide. Nevertheless, GC still lacks effective diagnosed and monitoring method and treating targets. This study used multi omics data to explore novel biomarkers and immune therapy targets around sphingolipids metabolism genes (SMGs).

Method
LASSO regression analysis was performed to filter prognostic and differently expression SMGs among TCGA and GTEx data. Risk score model and Kaplan-Meier were built to validate the prognostic SMG signature and prognostic nomogram was further constructed. The biological functions of SMG signature were annotated via multi omics. The heterogeneity landscape of immune microenvironment in GC was explored. qRT-PCR was performed to validate the expression level of SMG signature. Competing endogenous RNA regulatory network was established to explore the molecular regulatory mechanisms.

Result
3-SMGs prognostic signature (GLA, LAMC1, TRAF2) and related nomogram were constructed combing several clinical characterizes. The expression difference and diagnostic value were validated by PCR data. Multi omics data reveals 3-SMG signature affects cell cycle and death via several signaling pathways to regulate GC progression. Overexpression of 3-SMG signature influenced various immune cell infiltration in GC microenvironment. RBP-SMGs-miRNA-mRNAs/lncRNAs regulatory network was built to annotate regulatory system.

Conclusion
Upregulated 3-SMGs signature are excellent predictive diagnosed and prognostic biomarkers, providing a new perspective for future GC immunotherapy.
Prevention of postoperative nausea and vomiting after orthognathic surgery: a scoping review
Authors: Gao Peng-fei , Zhao Le , Li Shi-yue , Li Yue , Chen Ming-kai , Fu Jing , Ji Yang 
Published: March 2024

AbstractIntroductionPostoperative nausea and vomiting (PONV) is one of the most common adverse events following orthognathic surgery. It’s a distressing feeling for patients and continues to be the cause of postoperative complications such as bleeding, delayed healing, and wound infection. This scoping review aims to identify effective PONV prophylaxis strategies during orthognathic surgery that have emerged in the past 15 years.MethodsWe searched Pubmed, Cochrane Controlled Register of Trials, and Embase from 2008 to May 2023. Studies meeting the following criteria were eligible for inclusion: (1) recruited patients undergo any orthognathic surgery; (2) evaluated any pharmacologic or non-pharmacologic method to prevent PONV. Studies meeting the following criteria were excluded: (1) case series, review papers, or retrospective studies; (2) did not report our prespecified outcomes.ResultsTwenty-one studies were included in this review. Pharmacological methods for PONV prevention include ondansetron and dexamethasone (3 studies), peripheral nerve block technique (4 studies), dexmedetomidine (1 study), pregabalin (2 studies), nefopam (2 studies), remifentanil (1 study), propofol (2 studies), and penehyclidine (1 study). Non-pharmacologic methods include capsicum plaster (1 study), throat packs (2 studies) and gastric aspiration (2 studies).ConclusionsBased on current evidence, we conclude that prophylactic antiemetics like dexamethasone, ondansetron, and penehyclidine are the first defense against PONV. Multimodal analgesia with nerve block techniques and non-opioid analgesics should be considered due to their notable opioid-sparing and PONV preventive effect. For the non-pharmacological methods, throat packs are not recommended for routine use because of their poor effect and serious complications. More prospective RCTs are required to confirm whether gastric aspiration can prevent PONV effectively for patients undergoing orthognathic surgery.