bluuebunny/crossref_metadata_2025_split huggingface dataset:
Preparation and dielectric properties of polyimide-based composites with Al-Nb co-doped SiO2
Authors: Zhang Wenchao , Fu Qiang , Yuan Qixin , Li Han , Yue Dong , Feng Yu , Chen Qingguo , Yin Jinghua 
Published: December 2023

Polyimide (PI) film have been synthesized and used extensively in energy transmission, wind power generation, new energy vehicles, lidar, and high-power weapons, et al. Nevertheless, it is still challenge to further improve the breakdown strength and dielectric constant of PI film. After the powders of Al0.5xNb0.5xSi1-xO2 (NASO (x mol%)) have been fabricated, it was analyzed that the effect of doping elements Al3+ and Nb5+ on the surface chemistry and microstructure of the NASO powder. And then a small amount of NASO powder was polymerized in situ with PI matrix material, and the effects of NASO on dielectric properties and breakdown strength of the NASO/PI composites were analyzed. The results showed that the introduction of the doping elements Al3+ and Nb5+ favors could be conductive to the formation of oxygen vacancies on the surface of the NASO particle, which improved the surface activity and chemical reactivity of the NASO particle. The PI matrix can efficiently capture additional charges and enhance the insulating characteristics of the NASO/PI composite by properly doping NASO fillers with specific defect concentrations. In the results the breakdown strength of 1 vol% NASO (1 mol%)/PI composites reaches 334.38 kV/mm, which is a 19.6% higher than that of PI. Because the traps in the fillers capture and suppress the carrier transport to enhance the insulating properties of the composites. This work offers a novel synthesis method to simultaneously produce polymer dielectrics with high insulation and high polarization.
Awareness and usage of mobile applications as an orthodontic diagnostic tool among Croatian orthodontic clinicians
Authors: Markusi Matea , Blagec Tadeja , Šimunović Luka , Lapter Varga Marina , Meštrović Senka 
Published: December 2023

Objective: To assess the impact of gender and orthodontic qualification length on the awareness, knowledge and usage of orthodontic diagnostic mobile applications, non-diagnostic mobile applications and social media platforms among orthodontic clinicians. Design: Cross-sectional questionnaire-based study. Setting: The Republic of Croatia. Participants: A total of 92 orthodontic specialists, members of the Croatian Dental Chamber. Methods: This study was conducted using a questionnaire distributed via email to orthodontic clinicians between May and July 2022. Results: In total, 92 respondents were divided into groups according to sex and median orthodontic qualification length: more recently qualified (MRQ) with ⩽12 years; and longer qualified (LQ) with >12 years. Nearly one-third of respondents did not have any prior knowledge of mobile applications used as an orthodontic diagnostic tool. MRQ respondents were more interested in using mobile apps as opposed to computer software for digital analysis ( P < 0.05). This interest was in a negative correlation with orthodontic qualification length ( P < 0.01) and was more prevalent among female respondents ( P < 0.001). About one-third (32.6%) of respondents did not use non-diagnostic mobile applications and 44.6% did not use social media platforms. Nearly two-thirds (62%) of the respondents did not promote their work through social media. Male respondents and LQ promoted their work more frequently than others ( P < 0.05). The usage of other mobile applications was in a positive correlation with the knowledge and awareness of orthodontic mobile applications ( P < 0.05). Conclusion: Orthodontic clinicians lacked knowledge, awareness and the usage of orthodontic diagnostic mobile applications according to sex and orthodontic qualification length. One-third used non-diagnostic mobile applications and less than half used social platforms in daily clinical work.
Rescue Strategy for Hemorrhagic Complication During Mechanical Thrombectomy and the Clinical Outcome
Authors: Wang Chao , Shi Mingchao , Li Chao , Wang Shouchun , Yang Yi 
Published: December 2023

Purpose: Hemorrhagic complications occasionally occur during mechanical thrombectomy and may lead to catastrophic outcomes. Therefore, remedial strategies require careful investigation. Herein, we aimed to evaluate a cohort of patients who experienced hemorrhage during endovascular procedures, the rescue methods used, and outcomes observed. Method: This prospective study included patients who had hemorrhagic complications observed on digital subtraction angiography (DSA) during mechanical thrombectomy, between October 2017 and October 2022, at a high-volume stroke center. Functional outcomes were assessed using the modified Rankin scale (mRS) score at a 90-day follow-up. The primary outcomes were favorable outcomes (mRS score: 0–2 points) and mortality rates. The secondary outcomes were rescue therapy success rates, according to extravasation observed on the final DSA, recanalization status, and causes of hemorrhage. Results: From October 2017 to October 2022, 1537 patients with stroke received emergency endovascular therapy, and 1147 patients completed a 90-day follow-up. Hemorrhage was observed in 33 (2.1%) patients in the process of endovascular interventions. Eighteen (54.5%) cases of hemorrhage were caused by microwire or microcatheter perforation. Mechanical stretching of the vessel during stent retriever withdrawal resulted in 8 (24.2%) cases of hemorrhage. Nine (27.3%) instances of hemorrhage stopped after the reversal of heparin administration and introduction of blood pressure control measures. Further endovascular rescue treatment was performed in 11 patients. Intracranial inflation of the balloon for tamponade stopped 10 hemorrhages, and 1 patient underwent additional coil embolization. Fifteen (45.5%) patients died within 90 days after the procedure. Three (9.1%) patients recovered functional independence (mRS score: 0–2 points) within 90 days. Conclusion: Hemorrhage during mechanical thrombectomy is a rare but severe complication of acute ischemic stroke with high mortality and disability rates. Intracranial inflation of a balloon for tamponade can effectively stop extravasation. Clinical Impact This paper described haemorrhagic events characterised by contrast extravasation in the procedure of mechanical thrombectomy due to various causes. Although this complication is rare, patients showed a high mortality and disability rate. There are limited reports available. We found self-limiting haemorrhage had a rather benign prognosis and balloon tamponade could effectively stop the extravasation and might reduce the death rate within 90d. The methods we adopted could be applied in the clinical practice and help neuro-interventionist cope with this complication more promptly and effectively
Endovascular Treatment of TASC C and D Femoropopliteal Arterial Disease With Heparin-Bonded Covered Stents: The Impact of Distal Run-Off Vessels
Authors: Barabino Emanuele , Nivolli Arianna , Pittaluga Giulia , Arnò Matteo , Gazzo Paolo , Tosques Michele , Ivaldi Diego 
Published: December 2023

Introduction: In the last 2 decades, several studies in the literature evaluated the possible role of covered stents in the treatment of TransAtlantic Inter-Society Consensus (TASC) C and D femoropopliteal lesions but, despite the encouraging results, the employment of these devices was never included in clinical guidelines. The aim of this study is to evaluate the role of the technical aspects in patients with TASC C or D lesions that were treated with the GORE VIABAHN endoprosthesis and to elaborate a computerized method to objectively estimate the post-stent run-off and predict stent-graft failure. Materials and Methods: In this monocentric retrospective study, we collected the patients who were treated in our department from December 2014 to May 2021. Inclusion criteria comprised: (1) patients who underwent endovascular treatment of a TASC C or D femoropopliteal lesions using one or more heparin-bonded covered stent(s) and (2) clinical follow-up >2 years. Exclusion criteria were clinical follow-up <2 years or missing. An in-house computerized analysis to estimate the post-stent run-off, CEVERO (Computerized Estimation of VEssel Run-Off), was elaborated. Results: Sixty-six patients were enrolled in the study. Eleven patients had a TASC type C lesion, and 55 patients presented a type D lesion. The median follow-up time was 2.6 years. Twenty-nine patients (43.9%) experienced a major adverse limb event. Primary patency after 6, 12 and 24 months was 74.2%, 60.6%, and 57.6%; primary-assisted patency was 78.8%, 65.2%, and 59.1%. The presence of <2 run-off vessels (p<0.001) was correlated with stent-graft failure. The CEVERO analysis demonstrated an accuracy of 90.0% in predicting stent-graft failure. Conclusions: The treatment of TASC C and D femoropopliteal lesions remains technically challenging. Our study supported the hypothesis that run-off is the most critical factor in determining the outcome of the procedure and that concomitant angioplasty of the tibial vessels might improve the patency of the covered stent. The CEVERO analysis could permit a real-time, objective estimation of the distal run-off using conventional angiographic images, and it might be employed as a tool in the intraprocedural decision-making process, but its clinical applicability should be evaluated on external validation cohorts. Clinical Impact The endovascular treatment of TASC C and D femoropopliteal lesions is technically challenging and run-off seems to be the most critical factor in determining the outcome. Concurrent angioplasty of the tibial vessels can create adequate run-off to avoid stent failure. The CEVERO analysis is a computerized estimation of run-off that might be a useful tool in the decision-making process.
Embolization of cerebellar pial arteriovenous fistula presented with congestive edema of the brainstem and cervical cord
Authors: Zhou Zibo , Yu Jinlu 
Published: December 2023

Cerebellar pial arteriovenous fistula (PAVF) in adults presenting with congestive edema of the brainstem and cervical cord has rarely been reported. Here, we report such a case. A 59-year-old man presented with progressive weakness and numbness of the limbs and hiccups for 6 months. On physical examination, his limbs had grade III muscle strength, and he was unable to stand or walk. He also had occasional incontinence and retention. There was a positive Babinski sign in both lower limbs. Below the neck, he had hypoesthesia of the skin. Magnetic resonance imaging (MRI) showed edema of the brainstem and upper cervical cord. Digital subtraction angiography (DSA) confirmed there was a cerebellar nongalenic-type PAVF lesion; the feeding arteries were the branches of the posterior inferior cerebellar artery (PICA); and the draining vein was a single cortical vein that ultimately entered the venous systems of the brainstem and upper cervical cord. Casting Onyx-18 via the PICA obliterated the PAVF. Postoperatively, the patient recovered gradually. Two and a half months later, he could walk using a crutch and had no incontinence. Six-month follow-up MRI and DSA revealed recession of the edema of the brainstem and cervical cord and no recurrence of this PAVF. One year later, he was nearly normal. In conclusion and extremely rarely, cerebellar nongalenic-type PAVF can present with congestive edema of the brainstem and high cervical cord. This treatment by Onyx-18 embolization can resolve PAVF.
Public relations, activism, and the culture of assertion: The case of Blackrock’s Larry Fink and the letter to the CEOs
Authors: Foust Joshua , St John Burton 
Published: December 2023

This study argues that public relations scholarship on activism needs to better contextualize the ascendancy of non-dialogic, raw assertions in today’s public sphere. Analyzing 10 years of corporate communication by Blackrock CEO Larry Fink, we show how his corporate activist rhetoric suggests a growing disregard for dialogic communication, which is typically articulated within American public relations scholarship as a vital component in, for example, Grunig’s Excellence Theory and Heath’s rhetorical perspectives. This analysis of Fink’s communication further suggests the need for American public relations scholarship to move beyond a false binary between external and internal approaches to activism, which is further complicated by Fink’s seeming lack of interest in dialogic communication. Relatedly, we note that the mainstream conception of public relations as a consensus-oriented, good faith exchange seems at odds with the emerging reality of a societal disposition for mere assertions. We end with discussing theoretical implications regarding public relations’ ability to engage with stakeholder groups.
2023 Roger A. Mann Award Winner: Younger Patients Undergoing Total Ankle Arthroplasty Experience Higher Complication Rates and Worse Functional Outcomes Scores
Authors: Anastasio Albert T. , Kim Billy I. , Wixted Colleen M. , DeOrio James K. , Nunley James A. , Easley Mark , Adams Samuel 
Published: December 2023

Category: Ankle Arthritis; Ankle Introduction/Purpose: Although many patients with postraumatic ankle arthritis are of a younger age, studies evaluating the impact of age on outcomes of primary total ankle arthroplasty (TAA) reveal heterogenous results. The purpose of this study is to determine the effect of age on complication rates and patient reported outcomes after TAA. Methods: This was a retrospective study of 1,185 primary TAA divided into 3 age cohorts (Age < 55, n=219; Age55-70, n=688; Age>70, n=278). Patient demographics, intraoperative variables, postoperative complications, and patient reported outcome measures were compared among groups using univariable analyses. Multivariable Cox regression was performed to assess risk for implant failure by age group. Mean follow-up was 5.7 years. Results: Compared to Age55-70 and Age>70 groups, Age < 55 patients had the lowest mean ASA score (2.2 vs 2.4 vs 2.5; p< 0.001) and highest rates of all complications (33.8% vs 23.1% vs 19.8%; p=0.001), implant failure (9.1% vs 6.0% vs 3.2%; p=0.022), and component removal (5.0% vs 2.8% vs 1.1%; p=0.030). Univariable and multivariable cox regression analysis revealed decreased risk for implant failure for Age>70 compared to Age < 55 patients (HR: 0.43 [95%CI: 0.19-0.94], p=0.034; and HR: 0.42 [95%CI: 0.18-0.95], p=0.038, respectively). Across the AOFAS Hindfoot and all FAOS subscales, Age < 55 group reported the lowest (worst) mean pre and postoperative scores (p < 0.001). The age < 55 group had the highest mean VAS score at final follow-up (22 vs 14 vs 14; p< 0.001). Conclusion: Studies involving large sample sizes with mid-to long-term follow up are critical to reveal age-related impacts on outcomes after TAA. Younger patients had higher rates of complications and implant failure and fared worse on patient reported outcome measures in the largest single-institution series to date evaluating the effect of age on outcomes in TAA.
Altered Gait in Charcot Neuropathic Mice: A Kinematic Analysis
Authors: Alwine Shelby , Fye Nicole M. , Milne Indigo G. , Koroneos Zachary A. , Stauch Christopher , Saloky Kaitlin L. , Aynardi Michael 
Published: December 2023

Category: Diabetes; Hindfoot Introduction/Purpose: Charcot arthropathy is known to cause neurodegenerative as well as physical skeletal changes that can affect gait. A verified model of inducing Charcot arthropathy in mouse hindlegs exists, but clinical data has yet to be gathered from this model. This is a pilot study with the purpose of gathering clinical data on mouse gait and joint reactive forces that occur over time as a result of Charcot arthropathy utilizing MatLab software. Methods: Eleven wild-type 25-week-old C57BL/6J were included in this study. Group A (n= 6) was fed a high-fat 60% kcal diet starting at the age of 6 weeks and underwent a verified running protocol to induce microtrauma leading to hind-paw Charcot-type arthropathy. Sensory testing and fasting blood glucose levels confirmed the presence of hyperglycemia and neuropathy in Group A. Group B (n= 5) was fed a normal diet and did not complete a running protocol. At week 0 and week 16 of the study, brightly colored dots were placed on mice hindlimbs to mark the hip, knee, ankle, and tarsal joints. The mice were placed on the treadmill at a constant speed of 10 m/sec and were recorded in slow motion for 2-3 full gait cycles. MATLAB was used to measure gait angles and coordinates in space by following the corresponding colored dot for each joint on the mouse (Figure 1). Results: The control mice did not have significant changes in range of motion of the knee, ankle, or midfoot while walking between weeks 0 and 16. In contrast, the mice fed a high-fat diet had statistically significant differences in ankle range of motion (p=0.0275), nearly significant differences in knee range of motion (p=0.0991), and insignificant differences in midfoot range of motion between weeks 0 and 16. In addition, the differences between range of motion of the knee of the control vs. C57BL/6J mice were significantly different between groups at both weeks 0 (p=0.0016) and 16 (p=0.0201). In the ankle, the difference was statistically significant at week 0 (p=0.0275) but not week 16 (p=0.7066), presumably due to a large standard deviation in ankle range of motion. Conclusion: Results of this gait analysis indicate that mice with Charcot-like arthropathic changes demonstrated gait differences that affected the range of motion of the knees and ankles of the mice, but not the midfoot. These changes could be due to the neuropathic abnormalities induced in mouse feet that would cause gait changes. Future studies will include a larger sample size of mice with gait analysis done at intermediate time points to further quantify how gait changes over time with Charcot arthropathy.
The Impact of Surgical Timing After Ankle Fracture on Clinical and Long-Term Patient Reported Outcomes
Authors: McCrosson Matthew J. , Scheinberg Mila , Sanchez Thomas , Shah Ashish 
Published: December 2023

Category: Trauma; Ankle Introduction/Purpose: The goal of this study is to evaluate the effect of time-to-surgery following closed ankle fractures on long- term patient reported outcomes, fracture healing, and wound complications. To date, little research has been done focusing on the impact “time to definitive fixation” has on patient reported outcomes. Methods: We performed a retrospective analysis of 215 patient records who underwent open reduction and internal fixation (ORIF) for an ankle fracture from July 2011 to July 2018. A total of 86 patients completed the patient reported outcome measurement information systems (PROMIS) survey at long term follow up. Primary outcomes were the rate of delayed union, postoperative wound complications, Patient Reported Outcome Measurement Information System (PROMIS) Pain Interference (PI), and Physical Function (PF) scores. Results: No differences were found when comparing time to surgery on a continuous scale with rates of delayed union, nonunion, or wound complications (p=0.84, 0.47, and 0.63, respectively). PROMIS scores were collected at a median of 4.5 years (2.0 interquartile range (IQR), Range 2.5 to 12.3) postoperatively. The time from ankle fracture to surgery was independently associated with worse PROMIS PI scores (Unstandardized β .38, 95% CI 0.07 to 0.68) but not PROMIS PF scores. Severe Lauge- Hansen injuries were independently associated with decreased PROMIS PF scores (Unstandardized β -7.02, 95% CI -12.0 to -2.04). Increased time to surgical intervention and severe Lauge Hansen injuries were independently associated with worse long-term patient reported outcomes. Surgical timing did not impact union rates or wound complications. Conclusion: Surgeons should be aware that delaying ankle fracture repair beyond 12 days after injury may negatively affect long- term patient reported pain scores.
Wear Rates of Highly Cross-Linked Polyethylene in Total Ankle Arthroplasty at Mean 7-Year Follow- up
Authors: McCahon Joseph , Thalody Hope , Radack Tyler , Bridges Tiffany N. , Lencer Adam , Parekh Selene G. , Daniel Joe 
Published: December 2023

Category: Ankle Arthritis; Ankle Introduction/Purpose: Polyethylene (PE) wear particles have been shown to be a contributing factor of osteolysis and aseptic loosening. The use of highly cross-linked polyethylene (HXLPE) liners has been proven to reduce wear rates in hip and knee arthroplasty. To date, no clinical study has investigated the in vivo wear rates of HXLPE in total ankle arthroplasty (TAA). Therefore, the purpose of our study was to evaluate mid- and long-term outcomes and HXLPE wear rates in primary TAA. Methods: We retrospectively identified 49 patients who underwent primary TAA with HXLPE liners at a minimum of 5-year follow up. The average age was 65 years, 57.1% female, and average body mass index was 28.7 kg/m2. Polyethylene wear rates at final follow up were assessed using anteroposterior ankle radiographs and a validated computer assisted software. In addition, overall implant survivorship and complications were recorded. Results: The average polyethylene linear wear rate was 0.073 mm/year (SD, +/- 0.027) at mean 7.6 year (range, 5.1 to 12.2) follow up. Further analysis of patients with greater than 10 year follow up (n=8) demonstrated a linear wear rate of 0.06 mm/year (SD, +/- 0.02) at mean 11.1 year (range, 10.0 to 12.2). There were no instances of linear fracture or dissociation. Survivorship was 98.0% with 1 patient requiring removal of hardware and revision TAA secondary to failure of distal tibial osteotomy which was performed at index procedure. The rate of reoperation was 12.2% (n=6) with the most common indication being symptomatic ankle impingement treated with peri-implant cyst excision, exostectomy, and debridement (n=4). Conclusion: Highly crosslinked polyethylene liners in primary TAA demonstrated low in vivo wear rates and no cases of liner mechanical failures. In addition, our cohort demonstrated low complication and reoperation rates and exceptional survivorship at mid to long-term follow up. Therefore, the use of HXLPE liners is a viable option for surgeons performing TAA.