bluuebunny/crossref_metadata_2025_split huggingface dataset:
Association of arbitrary prescribing behavior to costly drug expenditures: a pharmacoeconomic study in primary care
Authors: Kirmizi Sonmez N Ipek , Aydin Volkan , Atac Omer , Akici Ahmet 
Published: October 2023

Abstract

Background
We aimed to examine the cost-related prescribing performance of primary care physicians who had a higher versus lower tendency of arbitrary prescribing.

Methods
In this cross-sectional study, we evaluated the prescriptions of primary care physicians in Istanbul, collected with 3:1 systematic sampling. We determined higher versus lower arbitrary prescribing by the physician’s degree of writing the solo diagnosis of “Z00- General examination without diagnosis/complaint”: those for whom such prescriptions constituted &gt;5% were classified as Group A and those with them at &lt;0.5% as Group B. We compared these two groups by the total and disease-specific drug costs per prescription they produced for 10 frequently encountered indications.

Results
The median cost of disease-specific medication for all diagnoses in Group A and Group B, except anemia, was equal. In upper respiratory tract infections (URTIs), hypertension, anemia, diabetes, and conjunctivitis, the mean prescription costs of Group A were significantly higher than those of Group B (P &lt; .001, P &lt; .001, P = .009, P = .007, and P &lt; .001, respectively), whereas disease-specific drug costs per prescription were similar (P &gt; .05 in all diagnoses). In myalgia, Group A had lower cost per prescription (P &lt; .001) and higher analgesic costs per prescription (P &lt; .001) compared to those in Group B. We found significantly higher disease-specific drug cost share in Group B for URTIs (antibiotic), gastroesophageal reflux disease (gastric acid–suppressant), hypertension (antihypertensive), anemia (iron preparations), diabetes (antidiabetic), depression (antidepressant), and conjunctivitis (corticosteroid) than those in Group A (P &lt; .001 for each).

Conclusions
Our study showed that physicians who had a higher tendency of prescribing for no clear indication are also more likely to produce costly prescriptions.
Postoperative Psychological Predictors for Chronic Postsurgical Pain After a Knee Arthroplasty: A Prospective Observational Study
Authors: Terradas-Monllor Marc , Ruiz Miguel A , Ochandorena-Acha Mirari 
Published: October 2023

Abstract

Objective
Chronic postsurgical pain (CPSP) is a significant adverse effect shown in around 20% of people who had undergone a knee arthroplasty (KA). Psychological risk factors have emerged as significant and potentially modifiable risk factors for its development. However, there is still little evidence when assessing these factors during the acute postoperative period. This study aimed to assess the predictive value of postoperative pain catastrophizing, pain-related fear of movement, anxiety, depression, and pain attitudes in developing CPSP after KA.

Methods
A 6-month follow-up prospective observational study design was used. The study sample comprised 115 people who underwent a KA due to painful primary osteoarthritis. Measures of pain catastrophizing, pain-related fear of movement, anxiety, depression, and pain attitudes were obtained 1 week after surgery. CPSP was set at an intensity of ≥30 using a 100-mm visual analog scale at 3 and 6 months after surgery.

Results
Analysis revealed that baseline pain intensity, pain catastrophizing, pain-related fear of movement, anxiety, depression, and maladaptive pain attitudes were significant predictors of chronic pain at 3 and 6 months after surgery in a univariate analysis. However, at 3 months after surgery, only pain intensity and pain catastrophizing were predictors in the final multivariate model forecasting disturbing pain. Moreover, 6 months after surgery, pain intensity and distrust in medical procedures remained independent predictors. Most of the psychological factors can be grouped into a single dimension defined as pain-related psychological distress.

Conclusion
The results suggest that postoperative pain intensity, pain catastrophizing, and pain attitudes are independent predictors for CPSP after KA.

Impact
Postoperative cognitive and emotional factors should be considered alongside pain intensity during postoperative rehabilitation after KA because they could influence the development of CPSP.
VEGF combined with DAPT promotes tissue regeneration and remodeling in vascular grafts
Authors: Yang Tao , Li Guangxu , Li Xifeng , Wei Boyang , Su Hengxian , Liu Wenchao , Guo Shenquan , Yang Nan , Xu Tao , Duan Chuanzhi 
Published: October 2023

Abstract
Previous research on tissue-engineered blood vessels (TEBVs) has mainly focused on the intima or adventitia unilaterally, neglecting the equal importance of both layers. Meanwhile, the efficacy of grafts modified with vascular endothelial growth factor (VEGF) merely has been limited. Here, we developed a small-diameter graft that can gradually release VEGF and γ secretase inhibitor IX (DAPT) to enhance tissue regeneration and remodeling in both the intima and adventitia. In vitro, experiments revealed that the combination of VEGF and DAPT had superior pro-proliferation and pro-migration effects on endothelial cells. In vivo, the sustained release of VEGF and DAPT from the grafts resulted in improved regeneration and remodeling. Specifically, in the intima, faster endothelialization and regeneration of smooth muscle cells led to higher patency rates and better remodeling. In the adventitia, a higher density of neovascularization, M2 macrophages and fibroblasts promoted cellular ingrowth and replacement of the implant with autologous neo-tissue. Furthermore, western blot analysis confirmed that the regenerated ECs were functional and the effect of DAPT was associated with increased expression of vascular endothelial growth factor receptor 2. Our study demonstrated that the sustained release of VEGF and DAPT from the graft can effectively promote tissue regeneration and remodeling in both the intima and adventitia. This development has the potential to significantly accelerate the clinical application of small-diameter TEBVs.
Curly Top Viruses and Phytoplasmas in Sugar Beets, Common Beans, and Beet Leafhoppers Along with Vector Population Dynamics in Southern Idaho
Authors: Strausbaugh Carl A. , Wenninger Erik J. , Jackson Laurie , Vincill Eric 
Published: October 2023

Beet curly top in sugar beet and common bean is a major yield-limiting factor that is caused by beet curly top virus (BCTV) and is vectored by the beet leafhopper (BLH; Circulifer tenellus). BLH populations in southern Idaho were tracked during the 2020 and 2021 growing seasons in desert areas and sugar beet and common bean fields with yellow sticky cards to assess BLH population levels and identify the curly top virus species/strains and phytoplasmas present. Plants from monitored crop fields were also assessed for the same pathogens. In one desert area (Elmore Co.), BLH populations began increasing in May and were present in double-digit numbers per card through the summer at all sites in both years. However, the BLH numbers at other desert sites were at or near zero. Local weed populations and not desert areas appeared to be the primary source of BLH in crop fields. Based on cytochrome oxidase gene sequence, two haplotypes dominated the BLH population. In both years, BCTV strains Worland and Colorado were the primary strains in BLH and plant samples. The California/Logan, pepper curly top (PeCT), and severe strains of BCTV were also detected in BLH, along with spinach curly top Arizona virus (SpCTAV). Phytoplasmas were detected in 1% of BLH samples in both years. Phytoplasmas, SpCTAV, and PeCT were not detected in plant samples. This project established the curly top species/strains for which host plant resistance is needed, as well as the time and areas when crops are at the highest risk for infection. [Formula: see text] The author(s) have dedicated the work to the public domain under the Creative Commons CC0 “No Rights Reserved” license by waiving all of his or her rights to the work worldwide under copyright law, including all related and neighboring rights, to the extent allowed by law, 2024.
Use of 3D Fluoroscopy to Assist in the Reduction and Fixation of Pelvic and Acetabular Fractures: A Safety and Quality Case Series
Authors: Warner Stephen J. , Haase Douglas R. , Chip Routt Milton L. , Eastman Jonathan G. , Achor Timothy S. 
Published: October 2023

Summary:
Multidimensional fluoroscopy has been increasingly used in orthopaedic trauma to improve the intraoperative assessment of articular reductions and implant placement. Owing to the complex osteology of the pelvis, cross-sectional imaging is imperative for accurate evaluation of pelvic ring and acetabular injuries both preoperatively and intraoperatively. The continued development of fluoroscopic technology over the past decade has resulted in improved ease of intraoperative multidimensional fluoroscopy use in pelvic and acetabular surgery. This has provided orthopaedic trauma surgeons with a valuable tool to better evaluate reduction and fixation at different stages during operative treatment of these injuries. Specifically, intraoperative 3D fluoroscopy during treatment of acetabulum and pelvis injuries assists with guiding intraoperative decisions, assessing reductions, ensuring implant safety, and confirming appropriate fixation. We outline the useful aspects of this technology during pelvic and acetabular surgery and report its utility with a consecutive case series at a single institution. The added benefits of this technology have improved the ability to effectively manage patients with pelvis and acetabulum injuries.
Stabilization of Tibial Fractures at Risk of Complications With the Bactiguard Intramedullary Nail: Early to Medium Results With a Novel Metal-Coated Device
Authors: Kotsarinis Georgios , Wakefield Sophia M. , Kanakaris Nikolaos K. , Giannoudis Peter V. 
Published: October 2023

Objectives:
The purpose of this study was to investigate the safety and early clinical results from the use of a novel, noble metal-coated titanium tibial nail for the definite stabilization of tibial shaft fractures at risk of developing complications.

Design:
This is a retrospective case series with prospectively collected data.

Setting:
Level I Trauma Centre in the United Kingdom.

Patients and Intervention:
Thirty-one patients who were managed with the Bactiguard-coated Natural Nail and achieved a minimum of a 12-month follow-up.

Main Outcome Measurements:
The main outcomes of this study were the incidence of adverse events (related to implant safety), complications (particularly infection), and reinterventions.

Results:
Thirty-one patients with a mean age of 41.6 years were included in this study. Active heavy smokers or intravenous drug users were 25.8% and 9.7% of them were diabetic. Five fractures were open while 13 had concomitant soft-tissue involvement (Tscherne grade 1 or 2). Twenty-seven patients healed with no further intervention in a mean time of 3.3 months. Three patients developed nonunion and required further intervention. The overall union rate was 96.7%. One patient developed deep infection after union (infection incidence 3.2%). Six patients (6/31; [19.3%]) required reinterventions [2 for the treatment of nonunion, 3 for removal of screws soft-tissue irritation, and 1 for the management of infection).

Conclusions:
The management of tibial shaft fractures with a noble metal-coated titanium tibial nail demonstrates encouraging outcomes. Further studies are desirable to gather more evidence in the performance of this innovative implant.

Level of Evidence:
Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
The Use of a Robotic Arm for Fixation of Pelvic Fractures
Authors: Gilani Syed , Mohamed Mustafa , Hartley Brandi , Zamora Rodolfo , Zou Jiyao , Daccarett Miguel , Carlson Jon B. 
Published: October 2023

Objectives:
The objective of this study was to evaluate unplanned cortical or neuroforaminal violation of iliosacral and transsacral screw placement using fluoroscopy versus screw placement using a robotic arm.

Design:
This is a prospective cohort study.

Setting:
Single surgeon, single North American level 1 trauma center.

Patients:
Radiographic and clinical data for 21 consecutive adult trauma patients with pelvic ring fractures undergoing surgical treatment were prospectively collected. Treatment consisted of iliosacral and/or transsacral screws with or without anterior fixation.

Intervention:
Ten patients were treated with the assistance of a robotic arm. Eleven patients were treated with standard fluoroscopic techniques.

Main Outcome Measurements:
Thirty-two screws were placed and evaluated with postoperative computed tomography or O-arm spins to assess unplanned cortical or neuroforaminal violation. Violations were graded according to the Gertzbein and Robbins system for pedicle screw violation, categorizing screw violation in 2-mm increments. The postoperative images were blindly reviewed by 5 fellowship-trained orthopaedic traumatologists. The treating surgeon was excluded from review.

Results:
The Mann–Whitney U test on the Gertzbein and Robbins system results demonstrated significantly (P = 0.02) fewer violations with robotic assistance. χ2 analysis of whether there was a cortical violation of any distance demonstrated significantly (P = 0.003) fewer cortical violations with robotic assistance. There were no neurovascular injuries in either group.

Conclusion:
Robotic assistance demonstrated significantly fewer unplanned cortical or neuroforaminal violations. Further research is needed with additional surgeons and sites to evaluate the accuracy of iliosacral and transsacral screw placement with robotic assistance.

Level of Evidence:
Therapeutic, level II.
Preclinical Study on a Novel Fluoroderivative of Dabigatran Etexilate in Animal Models
Authors: Ren Yujie , Li Chunlei , Zhang Yujia 
Published: October 2023

Abstract:
Here, the fluorinated derivative, R1, was synthesized from the fluorinated dabigatran derivative (R0). The in vivo pharmacokinetic characteristics of orally administered R1, R0 injection, and dabigatran etexilate in rats were compared. Safety evaluation results showed no significant changes in the QRS wave or PR and QT intervals in rat lead II electrocardiograms. The possible toxicity of R1 was studied using the limit test method, and no obvious toxicity occurred in mice after the acute oral administration of R1. R1 inhibited thrombin-induced platelet aggregation in a dose-dependent manner, had an inhibitory effect on platelet aggregation induced by arachidonic acid and adenosine diphosphate, could significantly prolong prothrombin time and activated partial thromboplastin time, and increased fibrinogen levels. R1 is the optimal candidate compound from among more than 100 candidate compounds designed and synthesized by our research group. It was first selected through preliminary in vitro anticoagulant activity screening and further through in vivo mouse activity testing. A systematic pharmacodynamic study showed that R1 was superior to the raw material drug dabigatran ester; particularly, the absolute bioavailability of R1 increased by 206%, and this can overcome the low bioavailability defect associated with the marketed drug dabigatran ester. Another safety assessment of R1 indicated that there were no risks of acute poisoning in rats and cardiac toxicity in mice or rats. Therefore, R1 can be considered a new candidate anticoagulant compound with great potential and significance for further clinical research.
The value of the International Association for the Study of Pain to developing countries
Authors: Soyannwo Olaitan , Chaudakshetrin Pongparadee , Garcia João Batista 
Published: October 2023

Abstract
Since it was founded, the International Association for the Study of Pain (IASP) has been at the forefront of improving pain research, education, and effective pain management in both developed and developing countries. As IASP activities progressed, major differences between the practice of pain management, education, and research in developed countries compared with developing countries were identified. This led to areas of focus by IASP that included pain education to address poor knowledge of pain assessment and treatment, prioritization of pain management by governments and official national legislation and programs, and availability of pain treatments (especially potent analgesics). A few pioneering IASP members from developing countries in the early years encouraged more multidisciplinary professionals to join IASP and attend conferences. Inauguration of national and regional chapters was also encouraged, and regular continuing medical education programs were held, especially on topics from IASP conferences and global pain events. Many IASP chapters in developing countries have established collaborations with groups from developed countries, whereas IASP also implemented other innovative approaches including the developing countries working group, educational grants, pain camps, and multidisciplinary pain hubs with toolkits to develop pain experts for regions in the developing world. Thus, the influence of IASP in many developing countries has had a multiplier effect on the progress made in effective pain management, education, and research. Nonetheless, challenges remain and include better integration of pain management, education, and research in national health systems and academic programs for health professionals.
Diagnostic test accuracy of preoperative nutritional screening tools in adults for malnutrition: A systematic review and network meta-analysis
Authors: Cheung Helen Hoi Ting , Joynt Gavin Matthew , Lee Anna 
Published: October 2023

Background:
Good nutritional screening tests can triage malnourished patients for further assessment and management by dietitians before surgery to reduce the risk of postoperative complications. We assessed the diagnostic test accuracy of common nutritional screening tools for preoperative malnutrition in adults undergoing surgery and determined which test had the highest accuracy.

Methods:
MEDLINE, EMBASE, CINAHL and Web of Science were searched for relevant titles with no language restriction from inception till January 1, 2023. Studies reporting on the diagnostic test accuracy of preoperative malnutrition in adults using one or more of the following index nutritional screening tools were included: Malnutrition Screening Tool (MST), Malnutrition Universal Screening Tool (MUST), Mini Nutritional Assessment (MNA), short-form Mini Nutritional Assessment (MNA-SF), Nutritional Risk Index (NRI), Nutrition Risk Screening Tool 2002 (NRS-2002), and Preoperative Nutrition Screening (PONS). The reference standard was the Subjective Global Assessment (SGA) before surgery. Random-effects bivariate binomial model meta-analyses, meta-regressions and a network meta-analysis were used to estimate the pooled and relative sensitivities and specificities.

Results:
Of 16 included studies (5695 participants with 11,957 index and 11,957 SGA tests), all were conducted after hospital admission before surgery. Eleven studies (n=3,896) were at high risk of bias using the Quality Assessment of Diagnostic Accuracy Studies tool due to a lack of blinded assessments. MUST had the highest overall test accuracy performance (sensitivity 86%, 95% CI 75% to 93%; specificity 89%, 95% CI 83% to 93%). Network meta-analysis showed NRI had similar relative sensitivity (0.93, 95% CI 0.77 to 1.13) but lower relative specificity (0.75, 95% CI 0.61 to 0.92) than MUST.

Conclusions:
Of all easy-to-use tests applicable at the bedside, MUST had the highest test accuracy performance for screening preoperative malnutrition. However its predictive accuracy is likely insufficient to justify the application of nutritional optimization interventions without additional assessments.
The impact of Pilates exercise for depression symptoms in female patients: A systematic review and meta-analysis
Authors: Ju Mingxiao , Zhang Zhennan , Tao Xiaojie , Lin Yong , Gao Lili , Yu Wenbing 
Published: October 2023

Background:
The Pilates exercise has recently become an increasingly popular way of exercise in female patients since it is an attractive and low-cost physical exercise modality. Pilates may be a beneficial method of exercise for female patients with depression and anxiety symptoms. However, to date, there has been no attempt to collate this literature. This review aims to systematically assess and meta-analyze the efficacy of Pilates exercise for female patients with depression and anxiety symptoms and inform evidence-based guidelines for exercise prescription.

Methods:
Five electronic databases (Scopus, MEDLINE/PubMed, Embase, Web of Science, and the Cochrane Library) were systematically searched up to January 2023 to examine randomized controlled trials (RCTs) focused on the effects of Pilates exercise for female patients with depressive disorders and individuals with elevated levels of depression were included. The primary outcomes were the severity of depression, and the secondary outcomes were anxiety. Statistical analyses were performed using Stata version 15.1 software with a 95% confidence interval (Registration number: CRD42023426522), and the PEDRO Scale was used to evaluate the risk of bias for RCT.

Results:
18 RCTs with 827 female patients were included. The methodological quality of the RCTs was considered an A level in 4 studies, B level in 13, studies, and C level in 1 study investigation. The meta-analysis showed that there was moderate evidence for the Pilates exercise significantly improved the severity of depression symptoms (SMD = –0.73; 95% CI –0.86 to –0.59; P < .01) and anxiety symptoms (SMD = –0.62; 95% CI –0.79 to –0.46; P < .01).

Conclusions:
Pilates exercise could reduce levels of depression and anxiety in female patients with depression and anxiety symptoms. Pilates exercise can be used as a potential ancillary program to improve depression and anxiety symptoms for female patients.