bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluation of the long-term patient-reported outcomes after hip arthroplasty or joint preserving with Sugioka femoral osteotomy in patients with femoral head osteonecrosis
Authors: Shoji Takeshi , Shozen Hideki , Ueki Shinichi , Kaneta Hiroki , Yaunaga Yuji , Adachi Nobuo 
Published: February 2024

Abstract
Purpose
This study retrospectively evaluated long-term clinical outcomes and patient-reported outcome measures (PROMs) in patients with osteonecrosis of the femoral head (ONFH) who underwent transtrochanteric rotational osteotomy (TRO), curved varus osteotomy (CVO), and total hip arthroplasty (THA).

Methods
We retrospectively reviewed the 109 hips in 96 patients (46 men, 50 women) who underwent CVO, TRO, or THA for ONFH treatment. The mean follow-up period for the TRO, CVO, and THA groups was 14.8, 11.5, and 13.3 years, respectively.

Results
The THA conversion rate of the TRO patients was significantly higher than that of the patients with CVO, and the final clinical scores in the patients with TRO did not improve compared with preoperative scores. Postoperative PROMs showed that the total and pain scores of the patients with THA were significantly higher than those of patients with TRO and CVO, while the PROM score did not change between patients with TRO and CVO. The analysis further showed that the preoperative type C2, stage 3A, or postoperative type C1 and C2 were significant predictors of decreased final PROM scores.

Conclusion
This study found that CVO and THA are clinically effective treatments for ONFH, with significant improvements compared with preoperative scores. However, THA was associated with significantly higher PROMs and pain scores than those of CVO and TRO in long-term follow-up. Furthermore, our results suggest that postoperative PROMs depend mainly on the preoperative level of collapse and postoperative transposed intact ratio of the articular surface of the femoral head.
Influence of chromium oxide nanoparticles and fiber fillers on silicone rubber nanocomposite
Authors: Naguib Hamdy M. , Taha Eman O. , El-Deeb Asmaa S. , Kader Marwa M. Abdel , Ahmed Mona A. 
Published: February 2024

AbstractThe development of polymer composites, considering the environmental issues, is aimed for minimizing the industrial content. New environmental-friendly nanocomposites, based on silicone rubber matrix and different concentrations of natural fiber/chromium oxide fillers, are prepared for the first time. The microstructural analysis confirms the successful obtaining of microfibers after treatment and chromium oxide nanoparticles and the formation of the final composite. The nanocomposites achieved improved physical and mechanical properties due to the dual effect of both fillers and attachment to the matrix. The 1% optimized nanocomposite achieved the highest modulus, dielectric properties, hydrophobicity, and surface stability. The effect of exposure to weathering conditions was studied. The characterization sentence asserts the preparation of a novel silicone rubber nanocomposite with improved properties, along with the environmental impact, regarding the dual effect of natural fiber waste and chromium oxide nanoparticles.
Investigating the effects of tilting the postural drainage lithotripsy system on cerebral blood flow, intracranial pressure, heart rate, and blood pressure
Authors: Dai Liangliang , Li Shihui , Yang Tao , Wei Hanping , Song Rijin , Meng Xianghu , Yuan Xiaoliang , Jiao Zhimin , Wu Tingchun , Shi Honglei 
Published: February 2024

Abstract
Purpose
To investigate the effect of the postural drainage lithotripsy system developed by our experimental team on the vital signs of patient with urinary stones during the stone removal process.

Methods
Four groups of 15 subjects (0°, 10°, 40°, and 70°) were subjected to different angles of head-down tilt to measure middle cerebral artery blood flow velocity (MCAv), cerebrovascular conductance coefficient (CVCi), intracranial pressure (nICP), heart rate (HR), and mean arterial blood pressure (MAP).

Results
As the angle of HDT changed, MCAv values, nICP values, CVCi values, HR values, and MAP values changed significantly (all P ≤ 0.001), and the difference was statistically significant. During 10°HDT, despite a slight increase in nICP, the other measurements remained stable. During 40°HDT, only the MCAv values did not change significantly, whereas the rest of the measures were significantly altered. During 70°HDT, all indicators changed significantly.

Conclusions
The significant alterations in cerebral blood flow, intracranial pressure, and hemodynamics induced during the treatment of renal residual fragments with postural drainage should be used with caution in individuals with cerebrovascular accidents.

China Clinical Trials Registry
ChiCTR2300070671; Registration date: 2023-04-18.
Hirnstimulation: NIBS, THS und Optogenetik
Authors: Freise Johannes 
Published: February 2024

ZusammenfassungUnterschiedliche Formen von Hirnstimulation werden sowohl zur Therapie verschiedener neurologischer und psychiatrischer Krankheiten als auch zu Forschungszwecken verwendet. Im rechtswissenschaftlichen Diskurs fand bisher überwiegend die Tiefe-Hirnstimulation Beachtung. Dagegen mangelt es an Ausführungen zu Methoden der nicht-invasiven Hirnstimulation. Der Beitrag nimmt, vor dem Hintergrund des durch die Verordnung (EU) 2017/745 veränderten Rechtsrahmens, zunächst eine medizinprodukterechtliche Einordnung vor. Anschließend werden Fragen von Aufklärung und Einwilligung erläutert. Darüber hinaus werden rechtliche Aspekte der Verwendung von KI im Kontext von nicht-invasiver Hirnstimulation und Tiefer-Hirnstimulation dargestellt. Zum Abschluss erfolgt ein Ausblick auf die noch in der Entwicklung befindlichen Methoden der neuronalen Optogenetik.
Brain stem tumors in children less than 3 months: Clinical and radiologic findings of a rare disease
Authors: Papangelopoulou Danai , Bison Brigitte , Behrens Lars , Bailey Simon , Ansari Marc , Ehlert Karoline , Martinez Ofelia Cruz , Kramm Christof M. , Morales La Madrid Andres , von Bueren Andre O. 
Published: February 2024

Abstract
Purpose
Brain stem tumors in children < 3 months at diagnosis are extremely rare. Our aim is to study a retrospective cohort to improve the understanding of the disease course and guide patient management.

Methods
This is a multicenter retrospective analysis across the European Society for Pediatric Oncology SIOP-E HGG/DIPG Working Group linked centers, including patients with a brainstem tumor diagnosed between 2009 and 2020 and aged < 3 months at diagnosis. Clinical data were collected, and imaging characteristics were analyzed blindly and independently by two neuroradiologists.

Results
Five cases were identified. No patient received any therapy. The epicenter of two tumors was in the medulla oblongata alone and in the medulla oblongata and the pons in three. For patients with tumor in equal parts in the medulla oblongata and the pons (n = 3), the extension at diagnosis involved the spinal cord; for the two patients with the tumor epicenter in the medulla oblongata alone (n = 2), the extension at diagnosis included the pons (n = 2) and the spinal cord (n = 1). Biopsy was performed in one patient identifying a pilocytic astrocytoma. Two patients died. In one patient, autopsy revealed a high-grade glioma (case 3). Three survivors showed either spontaneous tumor regression (n = 2) or stable disease (n = 1). Survivors were followed up for 10, 7, and 0.6 years, respectively. One case had the typical imaging characteristics of a dorsal exophytic low-grade glioma.

Conclusions
No patient fulfilled the radiologic criteria defining a high-grade glioma. Central neuroradiological review and biopsy may provide useful information regarding the patient management.
Is survival after transanal total mesorectal excision (taTME) worse than that after traditional total mesorectal excision? A retrospective propensity score-adjusted cohort study
Authors: Ammann Yanic , Warschkow Rene , Schmied Bruno , De Lorenzi Diego , Reißfelder Christoph , Bischofberger Stephan , Marti Lukas , Brunner Walter 
Published: February 2024

Abstract
Purpose
Transanal total mesorectal excision (taTME) was developed to provide better vision during resection of the mesorectum. Conflicting results have shown an increase in local recurrence and shorter survival after taTME. This study compared the outcomes of taTME and abdominal (open, laparoscopic, robotic) total mesorectal excision (abTME).

Methods
Patients who underwent taTME or abTME for stages I–III rectal cancer and who received an anastomosis were included. A retrospective analysis of a prospectively conducted database was performed. The primary endpoints were overall survival (OS), cancer-specific survival (CSS), and disease-free survival (DFS). Risk factors were adjusted by propensity score matching (PSM). The secondary endpoints were local recurrence rates and combined poor pathological outcomes.

Results
From 2012 to 2020, a total of 189 patients underwent taTME, and 119 underwent abTME; patients were followed up for a mean of 54.7 (SD 24.2) and 78.4 (SD 34.8) months, respectively (p < 0.001). The 5-year survival rates after taTME and abTME were not significantly different after PSM: OS: 78.2% vs. 88.6% (p = 0.073), CSS: 87.4% vs. 92.1% (p = 0.359), and DFS: 69.3% vs. 80.9% (p = 0.104), respectively. No difference in the local recurrence rate was observed (taTME, n = 10 (5.3%); abTME, n = 10 (8.4%); p = 0.280). Combined poor pathological outcomes were more frequent after abTME (n = 36, 34.3%) than after taTME (n = 35, 19.6%) (p = 0.006); this difference was nonsignificant according to multivariate analysis (p = 0.404).

Conclusion
taTME seems to be a good treatment option for patients with rectal cancer and is unlikely to significantly affect local recurrence or survival. However, further investigations concerning the latter are warranted.

Trial registration
ClinicalTrials.gov (NCT0496910).
Dietary protein and blood pressure: an umbrella review of systematic reviews and evaluation of the evidence
Authors: Boeing Heiner , Amini Anna M. , Haardt Julia , Schmidt Annemarie , Bischoff-Ferrari Heike A. , Buyken Anette E. , Egert Sarah , Ellinger Sabine , Kroke Anja , Lorkowski Stefan , Louis Sandrine , Nimptsch Katharina , Schulze Matthias B. , Schutkowski Alexandra , Schwingshackl Lukas , Siener Roswitha , Zittermann Armin , Watzl Bernhard , Stangl Gabriele I. ,   the German Nutrition Society
Published: February 2024

Abstract
Introduction
This umbrella review aimed to investigate the evidence of an effect of dietary intake of total protein, animal and plant protein on blood pressure (BP), and hypertension (PROSPERO: CRD42018082395).

Methods
PubMed, Embase and Cochrane Database were systematically searched for systematic reviews (SRs) of prospective studies with or without meta-analysis published between 05/2007 and 10/2022. The methodological quality and outcome-specific certainty of evidence were assessed by the AMSTAR 2 and NutriGrade tools, followed by an assessment of the overall certainty of evidence. SRs investigating specific protein sources are described in this review, but not included in the assessment of the overall certainty of evidence.

Results
Sixteen SRs were considered eligible for the umbrella review. Ten of the SRs investigated total protein intake, six animal protein, six plant protein and four animal vs. plant protein. The majority of the SRs reported no associations or effects of total, animal and plant protein on BP (all “possible” evidence), whereby the uncertainty regarding the effects on BP was particularly high for plant protein. Two SRs addressing milk-derived protein showed a reduction in BP; in contrast, SRs investigating soy protein found no effect on BP. The outcome-specific certainty of evidence of the SRs was mostly rated as low.

Discussion/conclusion
This umbrella review showed uncertainties whether there are any effects on BP from the intake of total protein, or animal or plant proteins, specifically. Based on data from two SRs with milk protein, it cannot be excluded that certain types of protein could favourably influence BP.
Seawater nasal wash to reduce symptom duration and viral load in COVID-19 and upper respiratory tract infections: a randomized controlled multicenter trial
Authors: de Gabory Ludovic , Vallet Sophie , Naelten Gaëlle , Raherison-Semjen Chantal 
Published: February 2024

Abstract
Purpose
The objective was to assess the efficacy of seawater nasal wash on symptom duration, intranasal viral load, household transmission in COVID-19 and URTIs.

Methods
This prospective, randomized, controlled, multicentric, parallel study included 355 mild/moderate COVID-19 and URTI adults with rhinologic symptoms ≤ 48h. Active group performed 4-daily nasal washes with undiluted isotonic seawater versus control group (without nasal wash). Symptoms were self-assessed daily using the WURSS-21 questionnaire for 3 weeks. Viral load was measured by RT-PCR on nasopharyngeal swabs collected on Day 0, Day 5, Day 14 and Day 21. Digital droplet PCR was additionally performed for SARS-CoV-2.

Results
Overall COVID-19 subjects recovered earlier the ability to accomplish daily activities in the active group (– 1.6 day, p = 0.0487) with earlier improvement of taste (– 2 days, p = 0.0404). COVID-19 subjects with severe nasal symptoms at D0 showed the earliest resolution of anosmia (– 5.2 days, p = 0.0281), post-nasal drip (– 4.1 days, p = 0.0102), face pain/heaviness (– 4.5 days, p = 0.0078), headache (– 3.1 days, p = 0.0195), sore throat (– 3.3 days, p = 0.0319), dyspnea (– 3.1 days, p = 0.0195), chest congestion (– 2.8 days, p = 0.0386) and loss of appetite (– 4.5 days, p = 0.0186) with nasal wash. In URTIs subjects, an earlier resolution of rhinorrhea (– 3.5 days, p = 0.0370), post-nasal drip (– 3.7 days, p = 0.0378), and overall sickness (– 4.3 days, p = 0.0248) was reported with nasal wash.
Evolution towards more severe COVID-19 was lower in active vs control, with earlier viral load reduction in youngest subjects (≥ 1.5log10 copies/10000 cells at Day 5: 88.9% vs 62.5%, p = 0.0456). In the active group, a lower percentage of SARS-CoV-2 positive household contacts (0–10.7%) was reported vs controls (3.2–16.1%) among subjects with Delta variant (p = 0.0413).

Conclusion
This trial showed the efficacy and safety of seawater nasal wash in COVID-19 and URTIs.

Trial registration
Trial registry ClinicalTrials.gov: NCT04916639. Registration date: 04.06.2021.
Hypothermic sepsis in time since death estimation – a case report
Authors: Potente Stefan , Hanser Victoria , Heinbuch Sara , Wrede Arne , Schäfer Nadine , Schmidt Peter 
Published: February 2024

AbstractBoth hyper- and hypothermia are problematic in temperature based forensic time since death estimation. Hyperthermia may occur in infection, traumatic brain injury, and intoxication. Hypothermia is encountered predominantly in exposure. Sepsis may present itself clinically as hypothermic. Sepsis is not uncommon in the forensic setting and mostly occurs in the context of malpractice accusations. There is usually little overlap between sepsis and typical forensic time since death estimation scenarios of violent or otherwise suspicious deaths. In the presented case, hypothermia and time since death estimations did collide. An inmate was found dead in his jail cell. Wardens claimed they had visually approached him alive relatively shortly prior. Rectal temperature measurements, using two separate crime scene thermometers as well as temperature loggers, revealed low rectal temperature at relatively high ambient temperature. These findings suggested a much longer postmortem interval and consequently raised doubts about the stated timeline. The wardens’ claims were however confirmed by camera recordings, which also allowed a reasonable estimate of the true time of death. The cause of death was confirmed as septic organ failure at autopsy, which explained low rectal temperature. The presence of Wischnewski-spots was noted. When the Prism-method was applied to the temperature recordings, low rectal temperature at the time of death was detected successfully. However, adaptation of the underlying equation for lower “starting temperature” did not produce satisfactory results. It is concluded that even though hypothermia at the time of death may possibly be detected from temperature data, attempts at time since death estimation for cases of hypothermia by adaptation of the equation should be avoided.
A Delphi consensus to identify the key screening tests/questions for a digital neurological examination for epidemiological research
Authors: Ferreira Vasco Ribeiro , Brayne Carol , Ragonese Paolo , Ketzoian Carlos , Piccioli Marta , Tinti Lorenzo , Casali Carlo , di Lorenzo Cherubino , Ramos Claudia , Azevedo João , Gomes Adriana , Stewart Roderick , Haas Hein , Hoppenbrouwer Stan , Metting Esther , Gallo Valentina 
Published: February 2024

Abstract
Background
Most neurological diseases have no curative treatment; therefore, focusing on prevention is key. Continuous research to uncover the protective and risk factors associated with different neurological diseases is crucial to successfully inform prevention strategies. eHealth has been showing promising advantages in healthcare and public health and may therefore be relevant to facilitate epidemiological studies.

Objective
In this study, we performed a Delphi consensus exercise to identify the key screening tests to inform the development of a digital neurological examination tool for epidemiological research.

Methods
Twelve panellists (six experts in neurological examination, five experts in data collection—two were also experts in the neurological examination, and three experts in participant experience) of different nationalities joined the Delphi exercise. Experts in the neurological examination provided a selection of items that allow ruling out neurological impairment and can be performed by trained health workers. The items were then rated by them and other experts in terms of their feasibility and acceptability.

Results
Ten tests and seven anamnestic questions were included in the final set of screening items for the digital neurological examination. Three tests and five anamnestic questions were excluded from the final selection due to their low ratings on feasibility.

Conclusion
This work identifies the key feasible and acceptable screening tests and anamnestic questions to build an electronic tool for performing the neurological examination, in the absence of a neurologist.
A spectral finite element Reissner–Mindlin shell formulation with NURBS-based geometry definition
Authors: Azizi Nima , Dornisch Wolfgang 
Published: February 2024

AbstractA curved non-isoparametric Reissner–Mindlin shell element is developed for analyzing thin-walled structures. The standard kinematic description of the element requires the calculation of the director vector. To address this demand accurately, similar to isogeometric analysis (IGA), the geometry is defined by utilization of the non-uniform rational B-splines (NURBS) imported directly from computer-aided design (CAD) files. Then, shape functions of the Legendre spectral element method (SEM) are used to interpolate the displacements. Consequently, the shell director vector and Jacobian of the transformation are calculated properly according to the presented formulation. On the other hand, in Legendre SEM combined with Gauss–Lobatto–Legendre quadrature, the integration points and the element nodes coincide. Thus, the easily computable local coordinate systems at the integration points can be used directly as nodal basis systems. A separate calculation of nodal basis systems at control points, which is the source of either complexity or error in IGA shells, is not required. Given the condition number of the stiffness matrix in the developed method, super high-order elements can also be used. Very high order p-refined elements are used in addition to h-refinement of the mesh to show the capability of higher order elements to analyze problems without mesh refinement. The validity and convergence rate of the method are investigated and verified through various cases of h- and p-refinement in challenging obstacle course problems.
Thermal stress and comfort assessment in urban areas using Copernicus Climate Change Service Era 5 reanalysis and collected microclimatic data
Authors: Silva Tiago , Lopes António , Vasconcelos João , Chokhachian Ata , Wagenfeld Malte , Santucci Daniele 
Published: February 2024

AbstractIn this initial study of a research project, this paper seeks to understand the thermal conditions in the cities of Lisbon and Munich, specifically focusing on Urban Heat Island intensity and on thermal comfort using the Universal Thermal Climate Index modeling data at the Local Climate Zone scale. Based on these datasets, Munich has exhibited more unfavourable thermal conditions than Lisbon. In terms of UHII, both cities have shown that low, medium, and high rise compact urban areas and bare rock or paved areas have the highest values, while sparsely built areas have the lowest. These results differ from the UTCI, which indicates that in Lisbon and Munich, these sparsely built areas as well as areas with low plants and vegetation are the most uncomfortable. In Munich, the population was exposed to very strong heat stress, while Lisbon experienced strong heat stress conditions. Conversely, low, medium, and high rise compact urban areas and densely wooded areas in Munich, and scattered trees areas and large low-rise urban areas in Lisbon, have demonstrated the lowest monthly mean and average maximum values. These results will be further explored in future studies in the city of Lisbon and cross-checked with data obtained from roving missions. This will enable a more detailed temporal and local analysis.
Equity of travel to access surgery and radiation therapy for lung cancer in New Zealand
Authors: Gurney Jason , Davies Anna , Stanley James , Whitehead Jesse , Costello Shaun , Dawkins Paul , Henare Kimiora , Jackson Christopher G. C. A. , Lawrenson Ross , Scott Nina , Koea Jonathan 
Published: February 2024

Abstract
Purpose
Centralisation of lung cancer treatment can improve outcomes, but may result in differential access to care for those who do not reside within treatment centres.

Methods
We used national-level cancer registration and health care access data and used Geographic Information Systems (GIS) methods to determine the distance and time to access first relevant surgery and first radiation therapy among all New Zealanders diagnosed with lung cancer (2007–2019; N = 27,869), and compared these outcomes between ethnic groups. We also explored the likelihood of being treated at a high-, medium-, or low-volume hospital. Analysis involved both descriptive and adjusted logistic regression modelling.

Results
We found that Māori tend to need to travel further (with longer travel times) to access both surgery (median travel distance: Māori 57 km, European 34 km) and radiation therapy (Māori 75 km, European 35 km) than Europeans. Māori have greater odds of living more than 200 km away from both surgery (adjusted odds ratio [aOR] 1.83, 95% CI 1.49–2.25) and radiation therapy (aOR 1.41, 95% CI 1.25–1.60).

Conclusions
Centralisation of care may often improve treatment outcomes, but it also makes accessing treatment even more difficult for populations who are more likely to live rurally and in deprivation, such as Māori.