bluuebunny/crossref_metadata_2025_split huggingface dataset:
Patient satisfaction after elective implant removal of the lower extremity — a retrospective cohort study
Authors: Hambrecht Jan , Canal Claudio , Klingebiel Felix Karl-Ludwig , Köhli Paul , Neuhaus Valentin , Pape Hans-Christoph , Kalbas Yannik , Hierholzer Christian 
Published: February 2024

Abstract
Purpose
The topic of elective implant removal (IR) in healed fractures of the lower extremity remains controversial, particularly when unspecific symptoms of discomfort, which cannot be quantified, are the primary indication. This study aims to assess indications and outcomes of elective IR of the lower extremity, focusing on unspecific symptoms of discomfort and patient satisfaction postoperatively.

Materials and methods
The retrospective cohort study was conducted at a single level I academic trauma center. We included patients who underwent elective IR for healed fractures of the ankle, foot, patella, and proximal tibia from 2016 to 2021. All patients were followed-up for a minimum of 6 weeks after IR. Our outcomes of interest were patient satisfaction, complications, and alleviation of complaints.

Results
A total of 167 patients were included in the study. Unspecific symptoms of discomfort were the most common reason for IR in all investigated anatomical regions of the lower extremity (47.9%), followed by pain (43.1%) and limited range of motion (4.2%). 4.8% of patients experienced a combination of pain and range of motion limitation. Among all patients, 47.9% reported subjective improvement after IR. IRs based on unspecific symptoms of discomfort were significantly less likely to show alleviation of complaints after IR (27.5%, OR 0.19, p ≤ 0.01). Patients who reported limited range of motion (OR 1.7, p = 0.41) or pain (OR 6.0, p = 0) were significantly more likely to be satisfied after IR. Patients who reported sensitivity to cold weather also showed a decrease of complaints after IR (OR 3.6, p = 0.03). Major complications occurred in 2.1% of cases. The minor complication rate was 8.4% (predominantly impaired wound healing). Smoking patients showed a significantly higher risk of complications after IR (OR 5.2, p = 0.006). Persistent pain postoperatively was detected in 14.7%.

Conclusion
When elective IR for consolidated fractures of the lower extremity is primarily motivated by patients’ subjective symptoms of discomfort, the risk for postoperative dissatisfaction significantly increases. Objective symptoms on the other hand are associated with higher satisfaction after IR. While the procedure is generally safe, minor complications such as wound healing disorders can occur, especially in smokers. Patient education and well-documented informed consent are critical.
General practitioner consultations for mental health reasons prior to and following bereavement by suicide
Authors: Bélanger Sissel Marguerite , Hauge Lars Johan , Reneflot Anne , Øien-Ødegaard Carine , Christiansen Solveig Glestad , Magnus Per , Stene-Larsen Kim 
Published: February 2024

Abstract
Purpose
Prior research has shown that the majority of those bereaved by suicide express a need for mental health care services. However, there is a lack of knowledge about these individuals’ use of primary health care. The objective of our study was to estimate the association between suicide bereavement and general practitioner (GP) consultations for mental health reasons.

Methods
A population-wide, register-based cohort study identifying 25,580 individuals bereaved by suicide. Estimations of increases in consultation rate were modeled through individual fixed-effects linear analyses adjusted for age and time-period.

Results
Overall, 35% of those bereaved by suicide had a GP consultation for mental health reasons during the first 1–2 months, and 53% after two years. In the month immediately after bereavement by suicide, there was a large increase in the consultation rate with a GP for mental health reasons. In the months that followed, the consultation rate gradually decreased. One year after bereavement, the consultation rate stabilized at a somewhat higher level than before the death. The increase in consultation rate was evident across all kinship groups, and the increase was greatest for partners and smallest for siblings. Women had more contact with the GP before the suicide and a greater increase in contact than men.

Conclusion
Our findings suggest that many of those bereaved by suicide seek assistance from primary health care, and that some are in need of prolonged follow-up from the GP. Health governments should be aware of this and seek to strengthen the GPs knowledge of the needs and challenges associated with this patient group. Measures should also be taken to remove barriers to contact the health care system, especially for men and bereaved siblings.
Mechanical and microstructural characterization of Ti6Al4V lattice structures with and without solid shell manufactured via electron beam powder bed fusion
Authors: Cantaboni Francesco , Battini Davide , Hauber Keren Z. , Ginestra Paola S. , Tocci Marialaura , Avanzini Andrea , Ceretti Elisabetta , Pola Annalisa 
Published: February 2024

AbstractThe topological optimization of components by means of lattice structures allows to reduce their weight avoiding a loss in the mechanical performance. Often the lattice parts are integrated in a more complex geometry, and they present an interface with a solid part.In the present paper, the mechanical and microstructural characterization of Ti6Al4V lattice structures with body-centered cubic unit cell was carried out. Samples with and without an external solid shell were designed and produced with electron beam powder bed fusion in order to investigate the behavior of these complex structures, especially at the interface between the solid and lattice parts. The microstructure and defects were analyzed, and compression tests were performed on the samples with and without solid shell to understand the influence of the solid part and its interaction with the lattice structure. After the fracture and detachment of the shell, the same behavior for both set of samples was observed.Finally, a finite element model was defined to better understand the mechanical behavior of the investigated structures. The nominal sample stiffness was significantly higher than the experimental one. This discrepancy can be attributed to local defects, both in terms of porosities and deviations from ideal geometry.
Comparing AGS Beers 2019, STOPP version 2, and EU(7)-PIM list in Portuguese older adults in primary health care
Authors: Rodrigues Daniela A. , Herdeiro Maria Teresa , Mateos-Campos Ramona , Figueiras Adolfo , Roque Fátima 
Published: February 2024

Abstract
Purpose
This study aims to identify PIM prevalence in older adults according to the 2019 Beers criteria, Screening Tool of Older Person’s Prescriptions version 2 (STOPP v2) criteria, and the Portuguese EU(7)-PIM list and also to analyze the concordance between these criteria.

Methods
A retrospective study was conducted among 1200 Portuguese older adults (≥ 65 years old), users of primary health care. Demographic, clinical, and pharmacological data were collected concerning the period between April 2021 and August 2022. A comparative analysis was performed between the three PIM identification criteria, and the concordance was determined according to the Lin concordance correlation coefficient.

Results
The mean age was 76.3 (SD 7.7) years old and 57.6% of the older adults were females. Our findings indicate varying prevalence rates among these criteria with 63.8% (95% CI 61.0–66.6%), 66.8% (95% CI 64.1–69.5%), and 50.1% (95% CI 47.2–53.0%) of the older adults take at least one PIM according to the EU(7)-PIM list, Beers 2019, and STOPP v2 criteria, respectively. The highest prevalence observed was for proton pump inhibitors according to EU(7)-PIM list (30.1%, 95% CI 27.6–32.9) and Beers criteria (30.1%, 95% CI 27.6–32.9) and alprazolam according to STOPP v2 criteria (10.1%, 95% CI 8.4–11.9%). A poor concordance between criteria was observed (< 0.834). The highest concordance coefficient was found between the EU(7)-PIM list and the Beers criteria (0.833), and the lowest between the EU(7)-PIM list and STOPP criteria (0.735).

Conclusion
This study reveals varying prevalence rates of PIM in older adults, as assessed by different criteria, and highlights the need for targeted interventions and improved prescribing practices. In the future, studies should focus on the occurrence of negative outcomes in older adults associated with PIM consumption.
Surgical revascularization as a procedure to prevent neurological complications in children with moyamoya syndrome associated with neurofibromatosis I: a single institution case series
Authors: Morello Alberto , Scala Marcello , Schiavetti Irene , Diana Maria Cristina , Severino Mariasavina , Tortora Domenico , Piatelli Gianluca , Pavanello Marco 
Published: February 2024

Abstract
Background
The optimal timing and surgical approach for surgical revascularization in patients with moyamoya syndrome (MMS) associated with neurofibromatosis type I (NF1) remain so far elusive. We aimed to compare the long-term clinical, radiological, and cognitive effects of different revascularization procedures in a pediatric cohort of NF1-associated MMS.

Methods
We reviewed the clinical, radiological, and surgical data of 26 patients with NF1-associated MMS diagnosed at our institution between 2012 and 2022, at the clinical onset and last follow-up.

Results
Indirect bypasses were performed in 12/26 patients (57.1%), while combined direct and indirect procedures in 9/26 subjects (42.9%); 5 patients did not undergo surgery. Through logistic regression analysis, pathological Wechsler Intelligence Scale for Children (WISC) at onset was found to be associated with symptom improvement at 1-year follow up (p = 0.006). No significant differences were found in long-term neurocognitive outcome and stroke rate in patients receiving combined or indirect bypass (p > 0.05).

Conclusions
Currently, whether combined or indirect bypass should be considered the treatment of choice in pediatric patients with NF1-associated MMS remains unclear, as well as the optimal time approach. In our series, no significant differences were found in long-term neurocognitive outcome and stroke rate between patients treated with either of these two approaches. Clinical evidence supports the crucial role of early diagnosis and surgical revascularization in subjects with MMS-associated NF1, even in case of mildly symptomatic vasculopathy. This allows to achieve a good long-term outcome with improved intellectual function and prevention of stroke and seizure in these patients.
Forensic investigation on a combined death by food aspiration and acute escitalopram intoxication occurred to a psychiatric subject in a nursing home
Authors: Zuccarello P. , Carnazza G. , Salerno M. , Esposito M. , Cosentino S. , Giorlandino A. , Sessa F. , Pomara C. , Barbera N. 
Published: February 2024

AbstractFood aspiration is one of the major health risks for elderly people in nursing homes which could lead to death. Moreover, misconducts in pharmacotherapy may represent a potential risk of adverse drug reactions. It is reported here the toxicological evaluation of a combined death by food aspiration and acute escitalopram intoxication of a psychiatric subject, occurred in a nursing home. An 89-year-old man, suffering from dysphagia and Alzheimer’s, was resident in a nursing home. He was fed with a liquid diet administered directly in mouth using a syringe. The man was also being treated with escitalopram 10 mg tablet. One evening, after receiving the meal in the usual way, the man complained of sudden illness. Carried to the emergency room, the man died about 3 h later with a diagnosis of cardiogenic shock subsequentially to ab ingestis. The histological findings revealed the presence of exogenous material, probably food, up to the finest bronchial branches. The toxicological examination revealed the presence of escitalopram and its main metabolite, desmethylcitalopram: in the blood 1972 ng/ml and 285 ng/ml, in the brain 4657 ng/g and 1025 ng/g, in the gastric content 2317 ng/g and 423 ng/g, in the lung 21,771 ng/g and 468 ng/g, respectively. The bad practice of the nurses to dissolve the escitalopram tablet in the liquefied food and to administer the therapy with a syringe directly into the mouth emerged thanks this investigation. Following food aspiration, escitalopram was absorbed by inhalation route, reaching high concentrations in blood and tissues. The death occurred due to a combined mechanism between food aspiration and the escitalopram toxic action.
Effects of cardiovascular risk factors and pre-existing diseases on the short-term outcome of Takotsubo syndrome
Authors: Mousavi Roya Anahita , Schober Andreas , Kronberger Christina , Han Emilie , Litschauer Brigitte , Pichler Gernot , Badr Eslam Roza 
Published: February 2024

Summary
Background
The effects of cardiovascular risk factors (CVRF) on the development of most acute cardiac conditions are well established; however, little is known about the frequency and effects of CVRF in Takotsubo syndrome (TTS) patients.

Objective
The aim of our study was to compare the frequency of CVRF and pre-existing diseases (PD) of TTS patients to ST-elevation myocardial infarction (STEMI) patients and analyze their effects on short-term outcome.

Methods
We analyzed the frequency of CVRF (hypertension, hyperlipidemia, type II diabetes mellitus, smoking, chronic kidney disease, family history) as well as somatic and psychiatric PD at admission in TTS patients and compared them with STEMI patients. Their effect on short-term outcome was calculated using a combined endpoint of cardiogenic shock, cardiopulmonary resuscitation, mechanical ventilation, and/or in-hospital death.

Results
In total, 150 TTS and 155 STEMI patients were included in our study. We observed a higher frequency of psychiatric (30% vs. 7%, p < 0.001), neurological (5% vs. 0%, p = 0.01), and pulmonary (18% vs. 5%, p < 0.001) PD in TTS patients as compared to STEMI patients. There were less smokers (47% vs. 61%, p = 0.03) and patients with hyperlipidemia (24% vs. 51%, p < 0.001) in the TTS cohort than in the STEMI cohort. None of the CVRF or PD behaved as an independent predictor for adverse short-term outcome in TTS patients.

Conclusion
Psychiatric, neurological, and pulmonary pre-existing diseases are more common in TTS than in STEMI patients. Interestingly, PD and CVRF do not seem to have any impact on the short-term outcome of TTS patients.
The fusion rates at different times of cortical iliac crest autograft or allograft compared with cages after anterior cervical discectomy and fusion: a meta-analysis
Authors: Li Yongai , Su Tong , Meng Tong , Song Dianwen , Yin Huabin 
Published: February 2024

Abstract
Objective
The cortical iliac crest autograft (CICA)/structural allograft (SA) has still been recognized as the gold standard for the ACDF technique for its high degree of histocompatibility and osteoinduction ability though the flourishing and evolving cage development. However, there was no further indication for using CICA/SA in ACDF based on basic information of inpatients. Our operative experience implied that applying CICA/SA has an advantage on faster fusion but not the long-term fusion rate. Therefore, our study aimed to compare the fusion rates between CICA and cage, between SA and cage, and between CICA/CA and cage.

Methods
Based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), a comprehensive literature search of electronic databases including PubMed, Embase, Cochrane Library and Web of Science was conducted to identify these clinical trials that investigated the postoperative 3, 6, 12 and 24 months fusion rates of CICA/structural SA versus cage. Assessment of risk of bias, data extraction and statistical analysis were then carried out by two independent authors with the resolve-by-consensus method. The primary outcome was fusion rate at 3, 6, 12 and 24 months postoperatively. The secondary outcomes were also meta-analyzed such as hardware complications, operative duration and hospitalization time. Our meta-analysis was registered with PROSPERO (Identifier: CRD42022345247).

Result
A total of 3451 segments (2398 patients) derived from 34 studies were included after the screening of 3366 articles. The segmental fusion rates of CICA were higher than cages at 3 (P = 0.184, I2 = 40.9%) and 6 (P = 0.147, I2 = 38.8%) months postoperatively, but not 12 (P = 0.988, I2 = 0.0%) and 24 (P = 0.055, I2 = 65.6%) months postoperatively. And there was no significant difference in segmental fusion rates between SA and cage at none of 3 (P = 0.047, I2 = 62.2%), 6 (P = 0.179, I2 = 41.9%) and 12 (P = 0.049, I2 = 58.0%) months after operations. As for secondary outcomes, the CICA was inferior to cages in terms of hardware complications, operative time, blood loss, hospitalization time, interbody height, disk height and Odom rating. The hardware complication of using SA was significantly higher than the cage, but not the hospitalization time, disk height, NDI and Odom rating.

Conclusion
Applying CICA has an advantage on faster fusion than using a cage but not the long-term fusion rate in ACDF. Future high-quality RCTs regarding the hardware complications between CICA and cage in younger patients are warranted for the deduced indication.
Does the angle of trocar insertion affect the fascial defect caused? A porcine model
Authors: Paasch C. , Meyer J. , Hunger R. , Krollmann N. , Heisler S. , Mantke R. 
Published: February 2024

Abstract
Introduction
With an incidence of 0–5.2%, trocar site hernias frequently occur following laparoscopy. It is unclear to what extent the angle of trocar insertion affects the size of the fascial defect caused. Hence, we performed a porcine model.

Methods
In October 2022, a total of five female pigs were euthanized. In alternating order, three bladeless and two bladed conical 12-mm trocars were inserted at an angle of 45° on each side for 60 min twice each pig. For this purpose, an epoxy resin handmade cuboid with a central channel that runs at an angle of 45° was used. Subsequently, photo imaging and defect size measurement took place. The results were compared with those of our previously conducted and published porcine model, in which the trocars were inserted at an angle of 90°. Effects of trocar type (bladed vs. bladeless) and angle on defect size were analyzed using a mixed model regression analysis.

Results
The bladeless trocars caused statistically significant smaller defects at the fascia than the bladed (23.4 (SD = 16.9) mm2 vs. 41.3 (SD = 14.8) mm2, p < 0.001). The bladeless VersaOne trocar caused the smallest defect of 16.0 (SD = 6.1) mm2. The bladed VersaOne trocar caused the largest defect of 47.7 (SD = 10.5) mm2. The defect size of the trocars used at a 45° angle averaged 30.5 (SD = 18.3) mm2. The defect size of trocars used at a 90° angle was significantly larger, averaging 58.3 (SD = 20.2) mm2 (p = 0.007).

Conclusion
When conical 12-mm trocars are inserted at a 45° angle, especially bladeless ones, they appear to cause small fascial defects compared with insertion at a 90° angle. This might lead also to a lower rate of trocar hernias. Bladeless trocars might cause smaller fascial defects than bladed trocars.
Host finding and probing behavior by Philaenus spumarius on olive varieties with a different degree of susceptibility to Xylella fastidiosa
Authors: Cornara Daniele , Zaffaroni-Caorsi Valentina , Hamouche Zeinab , Avosani Sabina , Cavallo Giuseppe , Verrastro Vincenzo , Lago Clara , Trani Antonio , De Stradis Angelo , Almeida Rodrigo P. P. , Fereres Alberto 
Published: February 2024

AbstractAbundance on and access time to the host plant are the pivotal factors in Xylella fastidiosa transmission to olive by the meadow spittlebug Philaenus spumarius. Therefore, olive varieties suitable for the vectors, i.e., plants providing all the necessary cues to the insect for their location, settling and acceptance, and devoid of antixenotic defenses, could be more susceptible to infection than varieties non- or less suitable for the vector. Here we evaluated whether a bacterium-susceptible olive variety, Ogliarola Salentina, could be a more suitable host for P. spumarius than the two resistant varieties Leccino and FS-17. We carried out: (i) an evaluation of between-hosts and within-host preference; (ii) an insect survival analysis; (iii) an Electrical Penetration Graph (EPG)-assisted analysis of the probing behavior; (iv) light microscopy of the tissues the spittlebugs had access to; (v) an analysis of the xylem sap primary metabolites. In choice tests, the insect exhibited a significant preference for Ogliarola Salentina. In addition, spittlebugs displayed longer xylem sap ingestion bouts on the bacterium-susceptible variety compared to resistant genotypes, possibly because of differences in the xylem sap chemical profile rather than xylem anatomy. Spittlebugs preference for Ogliarola over both Leccino and FS-17 could be a relevant and so far overlooked component of the low disease prevalence in these two olive varieties reported in Southern Italian olive orchards. Overall, our data point toward the importance of incorporating studies on vector-plant interaction and host traits of resistance to the vector in research on genotypes resistant to X. fastidiosa.
Three-way decisions in generalized intuitionistic fuzzy environments: survey and challenges
Authors: Ding Juanjuan , Zhang Chao , Li Deyu , Zhan Jianming , Li Wentao , Yao Yiyu 
Published: February 2024

AbstractEnhancing decision-making under risks is crucial in various fields, and three-way decision (3WD) methods have been extensively utilized and proven to be effective in numerous scenarios. However, traditional methods may not be sufficient when addressing intricate decision-making scenarios characterized by uncertain and ambiguous information. In response to this challenge, the generalized intuitionistic fuzzy set (IFS) theory extends the conventional fuzzy set theory by introducing two pivotal concepts, i.e., membership degrees and non-membership degrees. These concepts offer a more comprehensive means of portraying the relationship between elements and fuzzy concepts, thereby boosting the ability to model complex problems. The generalized IFS theory brings about heightened flexibility and precision in problem-solving, allowing for a more thorough and accurate description of intricate phenomena. Consequently, the generalized IFS theory emerges as a more refined tool for articulating fuzzy phenomena. The paper offers a thorough review of the research advancements made in 3WD methods within the context of generalized intuitionistic fuzzy (IF) environments. First, the paper summarizes fundamental aspects of 3WD methods and the IFS theory. Second, the paper discusses the latest development trends, including the application of these methods in new fields and the development of new hybrid methods. Furthermore, the paper analyzes the strengths and weaknesses of research methods employed in recent years. While these methods have yielded impressive outcomes in decision-making, there are still some limitations and challenges that need to be addressed. Finally, the paper proposes key challenges and future research directions. Overall, the paper offers a comprehensive and insightful review of the latest research progress on 3WD methods in generalized IF environments, which can provide guidance for scholars and engineers in the intelligent decision-making field with situations characterized by various uncertainties.