bluuebunny/crossref_metadata_2025_split huggingface dataset:
Statistical fragility analysis of reported outcomes associated with surgical management of acetabular labral pathology
Authors: Bhale Rahul , Kain Michael 
Published: November 2023

Introduction: The purpose of this study was to analyse the robustness of comparative research that evaluated arthroscopic labral reconstruction versus other surgical management of labral pathology. Key measures of statistical fragility include the fragility index and fragility quotient.ß Methods: 12 comparative studies that evaluated the use of arthroscopic labral reconstruction were included in this study. Particular attention was placed on evaluating trends, either statistically significant or not, of functional improvement, complication rates, need for total hip arthroplasty (THA) and revision rates with associated p-values. The analysis involved in this study was the Fragility Index, which is the median number of events required to change the statistical significance of a particular outcome, thus changing the study conclusions. Fragility quotient was calculated for each study as the fragility index divided by sample size. Results: Of the 12 studies that were included for analysis, there were a total of 25 reported outcomes, 8 of which were statistically significant ( p < 0.05). The statistical fragility for the significant outcomes were 2.5 (interquartile range [IQR]: 1.5–3.5), whereas the median statistical fragility for insignificant results was 6 (IQR 4–9). The overall fragility index was 4 (IQR 3–7). The median of fragility quotients was 0.04 (IQR 0.01–0.07). Conclusions: This study demonstrated that comparative research regarding arthroscopic techniques of labral reconstruction may not be as statistically stable as previously hoped. In many of the reported outcomes, particularly the ones that were statistically significant, only a small percentage of event changes was required to change the significance of the study conclusions. This fragility is worrisome, since clinical decisions that rely on these reported outcomes may have a significant impact on long-term patient outcomes. It is, therefore, crucial to optimise patient outcomes by incorporating past literature and reported outcomes.
Increasing femoral head size from 32 mm to 36 mm does not increase the revision risk for total hip replacement: a New Zealand joint registry study
Authors: English Robert TR , Munro Jacob T , Monk Andrew P 
Published: November 2023

Background: The use of larger femoral heads in total hip replacement (THR) has increased over the last decade. While the relationship between increasing head size and increased stability is well known, the risk of revision with increasing head size remains poorly understood. The aim of this study was to compare the outcome of total hip joint replacement with 32-mm and 36-mm heads. Methods: We carried out a 20-year retrospective analysis of prospective data from the New Zealand Joint Registry (NZJR). All primary total hip replacements registered between January 1999 and December 2018 were included. We compared the rate of revision of 32-mm and 36-mm heads in THR. Sub-group analysis included comparisons of bearing type and all-cause revision. Results: 60,051 primary THRs met our inclusion criteria. The revision rate per 100 component years was significantly higher with a 36-mm head than with a 32-mm head (0.649 vs. 0.534, p  < 0.001). Subgroup analysis of bearing type showed no significant differences in revision rates for all combinations of 36-mm heads when compared to 32-mm ( p  = 0.074–0.92), with the exception of metal-on-metal (MoM); p  = 0.038. When MoM was removed there was no significant difference in revision rates per 100 component years between 32-mm and 36-mm heads, 0.528 versus 0.578 ( p  = 0.099). Conclusions: Increasing head size from 32 mm to 36 mm results in no significant increase in revision in all bearing combinations except MoM.
Fracture of femoral neck in modular total hip arthroplasty: a systematic review of the literature
Authors: Solou Konstantina , Panagopoulos Andreas , Tatani Irini , Megas Panagiotis 
Published: November 2023

Background: Modular femoral stems have the advantage of anatomic hip reconstruction by restoring the femoral offset thus minimising the bearing surface wear, implant loosening and dislocation. Aim: This study aims to investigate the existing literature on modular neck fractures, to identify predisposing factors and guide the decision-making process in the management of these difficult cases. Methods: A systematic literature review was conducted until July 2022. PRISMA guidelines were followed, eligibility criteria were set, and methodology assessment of included studies was conducted based on MINORS criteria, size and primary outcome. Data were extracted and analysed thoroughly. Results: 5657 studies were initially screened; the full texts of 124 records were assessed and finally, 32 reports were included. There were 7 clinical studies and 25 case reports. A total of 4825 patients (5204 hips) with a mean age 62.38 years and a mean BMI 29.06 kg/m2 were analysed in the 7 clinical studies. The reported overall weighted revision rate was 0.86%, while the weighted mean modular neck fracture rate was 0.26%. The usual history was sudden experience of hip pain and instability. The average time interval to neck fracture was 4.57 (range 3–4.7) years and a long modular neck was identified in 91.17% of them. Data from case reports showed a mean age and average BMI of 55.85 and 31.63 kg/m2. 82.35% of the patients were male. Necks were fractured after an average time interval of 64.5 ± 8.8 months. Conclusions: The incidence of modular neck fracture is significant. The profile of a male, obese patient with a long modular neck increased risk of neck fracture. Microstructural investigation of the retrieved implants demonstrated a higher incidence of fracture line in the base of the neck junction and at its anterolateral distal part. Surgeons should be aware of this complication while using or revising such protheses.
The Associations of Adverse Childhood Experiences (ACEs) With Substance Use in Young Adults: A Systematic Review
Authors: Sebalo Ivan , Königová Michaela Poslt , Sebalo Vňuková Martina , Anders Martin , Ptáček Radek 
Published: November 2023

Introduction: Young adulthood is a transitional period between adolescence and adulthood. Due to the unique pressures of taking on a new social role and associated uncertainties, young adults are at heightened risk for drug and alcohol use. Furthermore, adverse childhood experiences (ACEs) increases the likelihood of using maladaptive coping strategies such as using substances to avoid or soothe negative emotions. The current review aimed to summarize the associations between exposure to ACEs before the age of 18 years and subsequent drug or alcohol use between the ages of 18 and 25 years. Methods: The review was performed in accordance with the 2020 Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The literature search of the Web of Science, PubMed, and PsycINFO databases was conducted in February 2022. Results: The initial search yielded 7178 articles, with 777 duplicates. Consequently, 6401 titles were inspected for relevance. After reading the full text, 88 articles were included in the review. Conclusion: This review provides clear evidence that exposure to multiple ACEs is a robust risk factor for the use of alcohol, cannabis and other drugs by young adults. Poor self-regulation and maladaptive coping strategies were identified as mechanisms explaining this link; however, further detailed research is needed.
Foodservice mobile application quality determinants’ impact on customer satisfaction and repeat usage intentions: The role of perceived risk
Authors: Ahn Joo , Slevitch Lisa , Sung Kyong Sik 
Published: November 2023

The current study aims to examine foodservice mobile commerce (MC) success model and investigate the relationships among its quality components, customer satisfaction, and repeat usage intentions in the restaurant context. The target population of the study was customers who had previous food delivery mobile application experience within the 12 months period. An online survey was conducted to collect the data and analyzed by the means of structural equation modeling. Ubiquitous connectivity, contextual offer, transaction accuracy, and content quality had significant positive impacts on customer satisfaction with food delivery mobile commerce application (MCA). The results also supported moderating effect of perceived risk on the relationship between customer satisfaction and repeat usage intentions. The study adds empirial evidence on the relationships between MCA quality components customer satisfaction. In addition, this study exaines the moderating role of perceived risk in the relationship between customer satisfaction and repeat usage intentions for food delivery mobile applications. The study can assist practitioners and MCA providers involved in the restaurant industry by showing how to configure quality components to satisfy customers and make them more willing to use food delivery mobile applications in casual dining restaurants.
Mentoring Programs: Characteristics Within HRD and Higher Education Contexts
Authors: Patterson Clinton A. 
Published: November 2023

Problem Mentorship directly and indirectly impacts an organization. Therefore, human resource development and higher education professionals often become responsible for mentoring program design, implementation, and assessment. Solution Mentoring literature for HRD and higher education contexts describes the complexity and benefits for individuals and organizations. Workplace themes associated with HRD are present in higher education mentoring ecosystems. This practitioner contribution reviews relevant mentoring research and evidence-based practices, prior to a descriptive and thematic analysis of current mentoring program design frameworks, two rooted in HRD and two associated with higher education. An aspirational goal for higher education professionals engaging in applied HRD efforts and HRD academic programs and their participants to span the institutional silos and learn more about each other. Stakeholders Mentorship practitioners and scholars, regardless of workplace affinity, will be able to easily identify actionable ways to incorporate evidence-based practices and recommendations into their mentoring ecosystem, program, and organization.
Comparing Predictors Influencing Restenosis Following High-Dose Drug-Coated Balloon Angioplasty and Fluoropolymer-Based Drug-Eluting Stenting in Femoropopliteal Artery Lesions
Authors: Kurata Naoya , Iida Osamu , Takahara Mitusyoshi , Asai Mitsutoshi , Okamoto Shin , Ishihara Takayuki , Nanto Kiyonori , Tsujimura Takuya , Hata Yousuke , Toyoshima Taku , Higashino Naoko , Nakao Sho , Mano Toshiaki 
Published: November 2023

Purpose: Despite widespread use of anti-restenosis devices, drug-coated balloons (DCBs) and drug-eluting stents (DESs), their appropriate use for femoropopliteal (FP) lesions has not been well investigated and the risk factors for restenosis have not been compared. To investigate risk factors associated with restenosis after endovascular therapy using DCB and DES for contemporary FP lesions. Materials and methods: This single-center, retrospective, observational study evaluated 378 FP lesions in 273 patients treated with DCB (278 lesions in 193 patients) or DES (120 lesions in 106 patients). The DCB used was high-dose DCB (IN.PACT, Admiral. Medtronic, Inc.) and DES was fluoropolymer-based DES (ELUVIA, Boston Scientific). Vessel preparation failure was defined as a residual stenosis of ≥50% and a dissection grade of D or greater on pre-dilatation angiography. The outcome measure was restenosis, and factors associated with restenosis in the DCB and DES groups were assessed using a Cox proportional hazards model. Results: The 2-year restenosis rate was not significantly different between the DCB and DES groups (29%±4% vs. 24%±5%, p=0.42). Interaction analysis demonstrated that popliteal lesions and plaque burden of ≥50% were restenosis-related factors for DES but not for DCB, whereas vessel preparation failure was a factor for DCB but not for DES (p<0.05). Vessel diameter of <6 mm and nodular calcification were risk factors in both groups (p<0.05). Conclusion: In contemporary FP lesions, smaller vessels and nodular calcification were shared restenosis-related factors for high-dose DCB and fluoropolymer-based DES. Popliteal lesions and plaque burden of ≥50% were restenosis-related factors for fluoropolymer-based DES and vessel preparation failure for high-dose DCB. Clinical Impact Shared and differential restenosis-related factors after endovascular therapy using high-dose drug-coated balloons (DCBs) and fluoropolymer-based drug-eluting stents (DESs) in contemporary femoropopliteal (FP) lesions are unclear. This single-center retrospective study included 378 FP lesions in 273 patients with lower-extremity arterial disease (high-dose DCB, 278 lesions in 193 patients; fluoropolymer-based DES, 120 lesions in 106 patients). Smaller vessels and calcified nodules were shared restenosis-related factors for both high-dose DCB and fluoropolymer-based DES, whereas popliteal lesions and plaque burden of ≥50% were restenosis-related factors for fluoropolymer-based DES and vessel preparation failure for high-dose DCB.
Rheumatoid arthritis disease activity and adverse events in patients receiving tofacitinib or tumor necrosis factor inhibitors: a post hoc analysis of ORAL Surveillance
Authors: Karpouzas George A. , Szekanecz Zoltán , Baecklund Eva , Mikuls Ted R. , Bhatt Deepak L. , Wang Cunshan , Sawyerr Gosford A. , Chen Yan , Menon Sujatha , Connell Carol A. , Ytterberg Steven R. , Mortezavi Mahta 
Published: November 2023

Background: In patients with rheumatoid arthritis (RA), persistent inflammation and increasing disease activity are associated with increased risk of adverse events (AEs). Objectives: To assess relationships between RA disease activity and AEs of interest in patients treated with tofacitinib or tumor necrosis factor inhibitors (TNFi). Design: This was a post hoc analysis of a long-term, postauthorization safety endpoint trial of tofacitinib versus TNFi. Methods: In ORAL Surveillance, 4362 patients aged ⩾50 years with active RA despite methotrexate, and ⩾1 additional cardiovascular (CV) risk factor, were randomized 1:1:1 to tofacitinib 5 or 10 mg twice daily or TNFi for up to 72 months. Post hoc time-dependent multivariable Cox analysis evaluated the relationships between disease activity [Clinical Disease Activity Index (CDAI)], inflammation [C-reactive protein (CRP)], and AEs of interest. The AEs included major adverse CV events (MACE), malignancies excluding nonmelanoma skin cancer (NMSC), venous thromboembolism (VTE), serious infections, herpes zoster (HZ), nonserious infections excluding HZ (NSI), and death. Results: Across treatments, risk for NSI was higher when patients had CDAI-defined active disease versus remission; MACE and VTE risks trended higher, but did not reach significance. Hazard ratios for MACE, malignancies excluding NMSC, VTE, infections, and death rose by 2–9% for each 5-mg/L increment in serum CRP. The interaction terms evaluating the impact of treatment assignment on the relationship between disease activity and AEs were all p > 0.05. Conclusion: In ORAL Surveillance, higher NSI risk was observed in the presence of active RA versus remission. The risk of MACE and VTE directionally increased in active disease versus remission, although statistical power was limited due to small event numbers in these categories. The relationship between active disease and AEs was not impacted by treatment with tofacitinib versus TNFi. Registration: NCT02092467.
The effect of educational intervention in the prevention of cardiovascular diseases in patients with hypertension with application of health belief model: A quasi-experimental study
Authors: Mohammadkhah Fatemeh , Shamsalinia Abbas , Rajabi Fatemeh , Afzali Hasirini Pooyan , Khani Jeihooni Ali 
Published: November 2023

Background The best methods for preventing and controlling cardiovascular diseases are preventive behaviours. Aim The purpose of the current study is to ascertain how educational intervention affects cardiovascular disease prevention. Methods The current investigation is a quasi-experimental study conducted in Shiraz, Iran, in the year 2022, focusing on 200 hypertension patients (by sample random sampling) that were divided into two groups: a control group consisting of 100 participants (63 males and 37 females) and an intervention group also consisting of 100 participants (58 males and 42 females). The data collection instrument comprises inquiries pertaining to demographic factors as well as constructs of the health belief model (HBM) and preventive behaviours for cardiovascular diseases. The participants in both groups completed the questionnaire prior to and three months after the intervention. The intervention group underwent a total of six training sessions, each lasting 55 min. Results The results showed that after the intervention, the intervention group showed a significant increase in all cues of the HBM model except for the perceived barriers. Following a period of three months subsequent to the educational intervention, the experimental group also exhibited a notable reduction in blood pressure in comparison to the control group. Conclusion The findings of the study indicate that the utilisation of the HBM demonstrated positive outcomes in facilitating the promotion of cardiovascular disease prevention among patients diagnosed with hypertension. The promotion of health among individuals with high blood pressure can be both beneficial and feasible. Moreover, this particular model can be utilised as a comprehensive framework for the development, execution, and evaluation of advantageous and effective healthcare initiatives.
Treated versus self-reported prevalence of chronic pain and costs of patients’ health services utilization: a population-based study of health administrative databases
Authors: Thanh Nguyen Xuan , Lopatina Elena , Montgomery Lori S , Robert Magali , Tanguay Robert L , Wasylak Tracy 
Published: November 2023

Objectives To compare treated to self-reported prevalence of chronic pain (CP) and to estimate health services utilization (HSU) costs of patients treated for CP in Alberta, Canada. Methods Patients treated for CP were identified by the physician billing codes of health services for CP from the practitioner claims database in fiscal year 2021/22. The treated prevalence of CP (number of these patients divided by the population) was compared to the self-reported prevalence of CP previously estimated (doi:10.1371/journal.pone.0272638). Costs of patients’ HSU included costs for general practitioner (GP), specialist, inpatient, emergency department, outpatient clinic services, and prescription drugs. Results The treated prevalence of CP was 6.0% (4.4% among males and 7.8% among females) which was 30% to 41% of the self-reported prevalence. The highest treated prevalence (7.2%) was found in the age group of 18–64 years, followed by age groups of >64 years (7.0%) and <18 years (2.1%). The average cost per patient per year was $5096 ($5878 for males and $4652 for females), of which hospitalizations accounted for 65.0%, outpatient clinic visits 16.4%, ED visits 9.5%, prescription drugs 4.7%, GP visits 3.9%, and specialist visits 0.4%. The total cost of patients with CP for the health system was $1.37 billion (∼7% of total health expenditure), of which males accounted for 41.7% and females for 58.3%. Discussion Our findings suggest that the economic burden of CP is considerable and that many people with self-reported CP do not use the public healthcare services. This can be multifactorial, including lack of availability and accessibility of publicly funded services, people’s lack of awareness of available services, lower utilization due to COVID-19 pandemic, and reliance on self-management, private services, and alternative treatments. Further studies are warranted to inform future policies and health system initiatives aiming to reduce the burden of CP and improve lives of people living with it.
Mask R-CNN based multiclass segmentation model for endotracheal intubation using video laryngoscope
Authors: Choi Seung Jae , Kim Dae Kon , Kim Byeong Soo , Cho Minwoo , Jeong Joo , Jo You Hwan , Song Kyoung Jun , Kim Yu Jin , Kim Sungwan 
Published: November 2023

Objective Endotracheal intubation (ETI) is critical to secure the airway in emergent situations. Although artificial intelligence algorithms are frequently used to analyze medical images, their application to evaluating intraoral structures based on images captured during emergent ETI remains limited. The aim of this study is to develop an artificial intelligence model for segmenting structures in the oral cavity using video laryngoscope (VL) images. Methods From 54 VL videos, clinicians manually labeled images that include motion blur, foggy vision, blood, mucus, and vomitus. Anatomical structures of interest included the tongue, epiglottis, vocal cord, and corniculate cartilage. EfficientNet-B5 with DeepLabv3+, EffecientNet-B5 with U-Net, and Configured Mask R-Convolution Neural Network (CNN) were used; EffecientNet-B5 was pretrained on ImageNet. Dice similarity coefficient (DSC) was used to measure the segmentation performance of the model. Accuracy, recall, specificity, and F1 score were used to evaluate the model's performance in targeting the structure from the value of the intersection over union between the ground truth and prediction mask. Results The DSC of tongue, epiglottis, vocal cord, and corniculate cartilage obtained from the EfficientNet-B5 with DeepLabv3+, EfficientNet-B5 with U-Net, and Configured Mask R-CNN model were 0.3351/0.7675/0.766/0.6539, 0.0/0.7581/0.7395/0.6906, and 0.1167/0.7677/0.7207/0.57, respectively. Furthermore, the processing speeds (frames per second) of the three models stood at 3, 24, and 32, respectively. Conclusions The algorithm developed in this study can assist medical providers performing ETI in emergent situations.
Organizational readiness and rehabilitation professionals’ views on integrating telerehabilitation into service delivery and students’ clinical training: A qualitative study
Authors: Nizeyimana Eugene , Joseph Conran , Louw Quinette A 
Published: November 2023

Objective To assess the readiness of healthcare institutions that serve as clinical platforms for Stellenbosch University’ rehabilitation students, and to explore the opinions of rehabilitation professionals regarding the integration of telerehabilitation (TR) into service delivery and students clinical training. Methods This study employed a qualitative research design and involved the participation of fourteen rehabilitation managers. Semi-structured interviews were conducted using both face-to-face and online platforms. Thematic analysis was employed to analyse the collected data. Results The readiness for implementing TR services varies across different dimensions. Facilities faced challenges related to funding for TR equipment and the absence of policies and guidelines, indicating a lack of financial and governance readiness. Rehabilitation professionals demonstrated high attitudinal readiness but low technical readiness due to a lack of knowledge and skills. Rehabilitation students particularly lacked practical experience, confidence, clinical reasoning and decision-making skills further contributing to low technical readiness. Conclusion Health care institutions are generally not ready for a successful implementation of TR. To improve the readiness, senior management should actively participate and provide financial support, develop policies, guidelines and training programs for rehabilitation professionals. Educational institutions should incorporate TR program into curricula to prepare students to gain practical experience and familiarity with the use of TR technology for their future clinical practice.