bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of process parameters on tensile properties of 3D printed continuous aramid fiber reinforced nylon 12 composites
Authors: Jiang Xibin , Shan Zhongde , Zang Yong , Liu Feng , Wu Xiaochuan , Zou Ailing 
Published: December 2023

Continuous fiber reinforced thermoplastic composites (CFRTP) have been increasingly used in aerospace and rail transport in recent years because of their high strength and light weight. In this paper, the effects of nozzle temperature, printing speed, substrate temperature and layer thickness on the tensile properties and macro/microscopic damage modes of CAF/PA12 printed specimens was systematically investigated. The fiber volume fraction(FVF) of CAF/PA12 filaments was 25.62%. The maximum average tensile strength and tensile modulus of CAF/PA12 printed specimens reached 572.60 MPa and 18.49 GPa, respectively. The results of the cross-sectional analysis indicated that filament toothed fractures and transverse cracks were the main macroscopic failure modes of CAF/PA12 composites. In SEM images, the main microscopic failure modes of CAF/PA12 composite are fiber fracture, fiber pull-out pores and unimpregnated fibers.
Dynamic characterization and damage analysis for the thermoplastic fiber-reinforced epoxy composites exposed to repeated low velocity impact
Authors: Sozen Betul , Coskun Taner , Sahin Omer Sinan 
Published: December 2023

In the current study, contrary to conventional fiber-reinforced composites, polyamide fiber was used as reinforcement material, and the effects of thermoplastic fiber reinforcement on repeated low velocity impact (LVI) responses of composites were examined. In this regard, polyamide fiber-reinforced composites were fabricated using the vacuum-assisted hand lay-up method (VAHLM) and then exposed to repeated LVI loadings. Experimental tests were performed on the specimens for 100 impacts with a constant velocity of 3 m/s, which is equivalent to 25.2 J, and the impacts of repeated LVI loadings on the dynamic responses such as peak force, energy absorbing/rebounding, total impulse, bending stiffness and contact stiffness were examined. Moreover, the damage mechanisms resulting from the relative damage accumulation depending on the impact numbers were examined. According to the findings, the thermoplastic polyamide fibers absorbed more than 60% of the applied energy, and the absorbed energy increased with ascending impact number. Furthermore, the thermoplastic fiber-reinforced epoxy composites gained stiffness with increasing impact, which was linked to the thermoplastic chain structure. Despite quite a number of impact loadings, no serious damage mechanisms such as fiber breakage, perforation, or penetration were observed, and the specimens maintained their structural integrity. Due to the higher energy absorption of thermoplastics, the utilization of polyamide fibers in composites has been found to be well suited for applications subjected to repeated impacts.
Recasting the gold standard – part II of II: communicating healthcare options along a continuum of care
Authors: Englar Ryane E 
Published: December 2023

Series outline This is the second part of a two-part series on spectrum of care that encourages practitioners to tailor case management to the patient along a continuum of acceptable options. Part I defined the spectrum of care and broadened its approach beyond initial cost-of-care considerations. This second article introduces strategies for initiating conversations with clients about their needs, wants and expectations specific to healthcare options and case management decisions. It will explore how open inquiry, reflective listening, transparency and unconditional positive regard facilitate dialogue between providers and their clients as they collaborate on decision-making along a spectrum of care. Relevance Contextual case management prioritizes interventions that are appropriate for both the patient and the client. To identify and explore which healthcare options represent the best fit for those impacted most by medical decisions, veterinarians need to make space for clients to feel comfortable sharing their perspectives. Clients are more likely to be engaged in decision-making when their insight is actively solicited. They have much to share with us as experts about their cat’s overall health and wellness needs. Inviting clients to contribute to the consultation and being receptive to hearing what motivates their choices helps us to structure conversations around healthcare options. The ability to communicate healthcare options is as vital as the provision of healthcare, if not more so.
miR-133b Promotes Esophageal Squamous Cell Carcinoma Metastasis
Authors: Huang Cong-Gai , Liu Qing , Zheng Shu-Tao , Liu Tao , Tan Yi-Yi , Peng Tian-Yuan , Chen Jiao , Lu Xiao-Mei 
Published: December 2023

Background: Evaluation of biological changes at the molecular level has important clinical implications for improving the survival rate of esophageal squamous cell carcinoma (ESCC). Therefore, we plan to analyze and elucidate the expression of microRNA-133b (miR-133b), M2 pyruvate kinase (PKM2), and signal transducer and activator of transcription 3 (STAT3) in ESCC and their associated clinicopathological significance. Methods: The 72 patients with ESCC were selected as the experimental study group. Normal adjacent tissues (NAT) were matched as the control group. In this study, in situ hybridization was used to detect the expression of miR-133b in ESCC, and tissue expressions of PKM2 and STAT3 were detected by immunohistochemistry, and literature review was conducted. Results: Studies had shown that the positive expression of miR-133b in NAT was significantly higher than that in ESCC (χ2 = 9.007, P = .003). PKM2 and STAT3 in ESCC had a significantly higher positive expression levels than those of NAT (χ2 = 56.523, P = .000; χ2 = 72.939, P = .000). From correlation analysis, there was a negative correlation between miR-133b and PKM2( r = −0.515, P < .001), a negative correlation between miR-133b and STAT3( r = −0.314, P = .007), and a positive correlation between PKM2 and STAT3( r = 0.771, P < .001). Conclusions: In ESCC, our study demonstrated that downregulation of miR-133b and upregulation of PKM2 and STAT3. We predict that miR-133b may inhibit the STAT3 pathway by downregulating PKM2.
Robotic Microsurgery in Extremity Reconstruction - Experience With a Novel Robotic System
Authors: Besmens Inga S. , Politikou Olga , Giovanoli Pietro , Calcagni Maurizio , Lindenblatt Nicole 
Published: December 2023

Background: Robotic systems have successfully been introduced into other surgical fields in the past. First attempts with different setups are made in the field of microsurgery. The Symani® Surgical System, a flexible platform consisting of two robotic arms, features motion scaling with tremor filtration to address the demands and complexity of microsurgery. Symani’s NanoWrist Instruments are the world’s smallest, wristed surgical instruments, intended to improve a surgeon’s range of motion beyond the capability of the human hand. This combination allows surgeons to scale their hand movements while seamlessly articulating the robotic micro instruments. Purpose: We report on our experience in extremity reconstruction with this novel system. Research Design: The Symani Surgical System® was used for 6 cases of extremity reconstruction. The surgeon controlled the manipulators along with the footswitch while either sitting away from the operating table relying on 3D visualization with an exoscope or sitting at the operating table using a standard microscope. Data Collection: Microsurgical anastomoses were performed in 4 patients (3 end-to-end arterial anastomoses and one end-to-side arterial anastomosis) and nerve grafting was performed in 2 patients. Results: Microvascular anastomoses were slower vs conventional microsurgery, but all anastomoses were patent. Epineural coaptation showed proper fascicle alignment and tissue manipulation could be kept to a minimum. The platform’s motion scaling allows the surgeon to perform precise micro-movements with only minimal tissue manipulation and hard-to-reach anatomy becomes accessible more easily. Conclusions: Robotic microsurgery might gain importance in the nearer future but more data will need to be collected.
Clinical, Radiographic, and Patient-Reported Outcomes of First Metatarsophalangeal Interposition Arthrodesis Using Porous Titanium Wedges
Authors: Noble David M. , Sumpter Anna , Small Benjamin , Ruland Jeffrey R. , Cooper M. Truitt , Park Joseph S. , Perumal Venkat 
Published: December 2023

Background First metatarsophalangeal (MTP) arthrodesis is a common surgical procedure for addressing hallux MTP pathology. In the setting of revision procedures with significant bone loss, porous titanium wedges may provide an alternative to structural bone autograft or allograft. Objective The purpose of this study is to report the clinical and radiographic outcomes achieved in first MTP interposition arthrodesis using porous titanium wedges. Methods A retrospective analysis of 9 patients with a mean age 65.4 years (45-82 years) who underwent first MTP interposition arthrodesis with the use of porous titanium wedges from February 2014 to September 2017 was performed. Outcomes were assessed using both plain-film radiographs and computed tomography (CT) scans, as well as patient-reported outcome measures, including Foot and Ankle Ability Measure (FAAM) (Sports and Activities of Daily Living), pain Visual Analogue Scale (VAS), and 36-Item Short Form Survey (SF-36). Average follow-up time was 34.2 months (14-72 months). Results At final follow-up, the average FAAM score was 91.1 ± 14.7 (75.1 ± 5.3 FAAM Activities of Daily Living; 17.9 ± 9.9 FAAM Sports). Average pain VAS score was 1.9 ± 1.7. Postoperative computed tomography (CT) imaging was obtained for 5 patients, all of which demonstrated good bony apposition or osseous integration of the wedge. Four patients underwent subsequent surgical procedures, including 3 isolated dorsal fixation revisions, and 1 complete MTP arthrodesis revision. Conclusion To our knowledge, this study represents the first reported clinical and radiographic outcomes in patients undergoing first MTP interposition arthrodesis with use of porous titanium wedges. While we found this technique to be a viable alternative to bone grafting for this difficult problem, further research should focus on comparative data with other commonly performed operative techniques. Level of Evidence: Level IV: Case series
Validity and diagnostic performance of a virtual reality-based supermarket application “MEMOSHOP” for assessing episodic memory in normal and pathological aging
Authors: Sagaspe Patricia , Amieva Hélène , Dartigues Jean-François , Olive Jérôme , de la Rivière Jean-Baptiste , Chartier Christophe , Taillard Jacques , Philip Pierre 
Published: December 2023

Objective MEMOSHOP is a virtual reality (VR)-based supermarket application for assessing episodic memory in aging. The aim of this study was to examine its construct validity against the gold standard paper-and-pencil neuropsychological test for clinical memory assessment in mild cognitive impairment (MCI) in older adults. Methods Patients with isolated subjective cognitive complaints (SCCs) or MCI were recruited in the Bordeaux Memory Clinic (MEMENTO cohort). Cognitively normal elderly controls were also recruited. MEMOSHOP allows a near-ecological evaluation of episodic memory during a usual daily life activity, i.e. shopping at the supermarket. MEMOSHOP and the gold standard Free and Cued Selective Reminding Test (FCSRT: French adaptation) were administered to all participants to assess episodic memory. Non-parametric tests and receiver operating characteristic curves were computed to compare their performances. Results Twenty-nine patients (21 females, age = 71 years ±7) and 29 matched controls were evaluated. The performance trends observed with MEMOSHOP and FCSRT on free and cued recall were associated ( p < .01) and comparable ( p < .0001), without any participants' groups interaction. Although easier than FCSRT in free recall for participants, MEMOSHOP demonstrated better diagnostic performance based on cued recall in isolated SCCs/MCI patients ( p < .05). Conclusion MEMOSHOP demonstrated its reliability and validity for VR-based episodic memory assessment in the early stage of MCI and is potentially of interest for use in memory clinic settings.
Unresolved Palliative Care Needs of Elderly Non-Cancer Patients at Home: A Multicenter Prospective Study
Authors: Hamano Jun , Shinjo Takuya , Fukumoto Kazuhiko , Kodama Maiko , Kim Hongja , Otomo Sen , Masumoto Shoichi , Hashimoto Kotaro , Matsuki Takamichi , Hisajima Kazuhiro , Miyata Nobuyuki , Suzuki Riri , Yokoya Shoji , Miyake Keijiro , Takayanagi Ryo , Shimizu Masakatsu , Kataoka Yoshihiro , Taira Hiroshi , Ozone Sachiko , Takahashi Hiroki , Kizawa Yoshiyuki 
Published: December 2023

Introduction/Objectives: There is growing consensus on the benefits of initiating palliative care early in the disease trajectory; however, palliative care needs for non-cancer patients remain to be elucidated. We investigated the trajectory of unresolved palliative care needs of non-cancer patients at home and explored associated factors. Methods: We conducted a multicenter prospective cohort study of elderly non-cancer patients at home in Japan between Jan 2020 and Dec 2020. Physicians assessed their palliative care needs using the Integrated Palliative Care Outcome Scale (IPOS). Unresolved palliative care needs were defined as IPOS symptoms above 2 (moderate). Results: In total, 785 patients were enrolled. The most frequent unresolved palliative care needs at enrollment were poor mobility (n = 438, 55.8%), followed by weakness/lack of energy (n = 181, 23.1%) and poor appetite (n = 160, 20.4%). Multivariate logistic regression analysis revealed that female and musculoskeletal disease were significantly positively associated with pain at starting home visits (OR = 1.89, P = .015; OR = 2.69, P = .005). In addition, neurological diseases were significantly positively associated with constipation and poor mobility 3 months after starting home visits (OR = 3.75, P = .047; OR = 3.04, P = .009). Conclusions: The order of the prevalence of unresolved palliative care needs may remain relatively stable over time, even for those receiving home-based palliative care services. We identified several specific diseases and conditions that were significantly associated with unresolved palliative care needs.
Knowledge, Attitude and Associated Factors Toward Ethiopian Abortion Law Among Reproductive Age Women in Bule Hora Town, Southern Oromia, Ethiopia, 2022
Authors: Wayessa Zelalem Jabessa , Boneya Balela Areri , Hadona Elias Amaje 
Published: December 2023

Objectives A woman's health and wellbeing are impacted by illegal abortion since improper procedures can lead to consequences like extreme bleeding, infection, and damage to the reproductive organs and low awareness and attitude toward abortion law is one of the public health problems in Ethiopia. This study aimed to assess the knowledge, and attitude, and identify the effect of short birth interval and wealth index on the abortion law among reproductive-age women in Bule Hora town, Southern Oromia, Ethiopia. Methods A community-based cross-sectional study design was conducted from June 20 to July 20, 2022. A systematic random sampling technique was carried out to select 402 reproductive-age women. Data was collected by using a structured questionnaire with face-to-face interviews after the tools were pretested. The data was cleaned, coded, and entered into Epidata 3.1 and exported to STATA 14 for analysis. The model goodness of fit was checked using the Hosmer-Lemeshow test. Statistical significance is declared at P < .05 and a 95% confidence interval. Results The study revealed that 153 (38%) of respondents had good knowledge and 192 (47%) had a favorable attitude toward the Ethiopian abortion law, with a 100% response rate. Women's educational status, having information regarding the criteria of legal abortion services, and short birth intervals as a reason for induced abortion were significantly associated with knowledge. On the other hand, women who attended secondary education and above, have information regarding the criteria of legal abortion services, wealth index middle/average and richer, using the contraceptive method, and short birth interval as a reason for induced abortion were predictors of attitude toward Ethiopian abortion law. Conclusion This study shows that knowledge and attitude toward Ethiopian abortion law was not sufficient. So focusing on awareness creation and health education strategies by mobilization of the community to minimize the knowledge and attitude gap is essential.
Differential Utilization Patterns of Total Ankle Arthroplasty vs Arthrodesis: A United States National Ambulatory Database Analysis
Authors: Mercier Michael R. , Ratnasamy Philip P. , Yee Nicholas S. , Hall Brandon , Del Baso Christopher , Athar Mohammed , Daniels Timothy R. , Halai Mansur M. 
Published: December 2023

Background: End-stage ankle osteoarthritis is a condition that can be treated with ankle arthrodesis (AA) or total ankle arthroplasty (TAA). The goal of this study is to estimate the 2016-2017 United States’ utilization of TAA and AA in specific ambulatory settings and delineate patient and hospital factors associated with the selection of TAA vs AA for treatment of ankle osteoarthritis. Methods: TAA and AA procedures performed for ankle osteoarthritis were identified in the 2016-2017 Nationwide Ambulatory Surgery Sample (NASS) Database. Notably, the NASS database only examines instances of ambulatory surgery encounters at hospital-owned facilities. As such, instances of TAA and AA performed at privately owned or freestanding ambulatory surgical centers or those performed inpatient are excluded from this analysis. Cases were weighted using nationally representative discharge weights. Univariate analyses and a combined multiple logistic regression model were used to compare demographic, hospital-related, and socioeconomic factors associated with TAA vs AA. Results: In total, 6577 cases were identified, which represents 9072 cases after weighting. Of these, TAA was performed for 2233 (24.6%). Based on the logistic regression model, several factors were associated with increased utilization of TAA vs AA. With regard to patient factors, older patients were more likely to undergo TAA, as well as females. Conversely, patients with a higher comorbidity burden were less likely to receive TAA over AA. With regard to socioeconomic factors, urban teaching and urban nonteaching hospitals were significantly more likely to use TAA compared to rural hospitals. Similarly, privately insured patients and those with a median household income of $71 000 or more were also more likely to receive TAA over AA. Private hospitals (“not-for-profit” and “investor-owned”) were significantly more likely to offer TAA over AA. Conclusion: Using a large nationally representative cohort, the current data revealed that during 2016-2017, 24.6% of operatively treated cases of end-stage ankle osteoarthritis in the ambulatory setting are treated with TAA. Associations between socioeconomic and hospital-level factors with TAA utilization suggest that nonclinical factors may influence surgical treatment choice for ankle osteoarthritis. Level of Evidence: Level III, retrospective cohort study.
Achilles Tendon Rupture – The Essentials: A Bibliometric Study
Authors: Markel Jacob F. , Anciano Victor 
Published: December 2023

Category: Sports; Hindfoot Introduction/Purpose: Achilles tendon rupture and management are among the most prevalent topics in the Foot and Ankle Literature. As the scientific literature increases across all fields of medicine, so too does the literature regarding Achilles tendon rupture. A bibliometric analysis of the current literature will help guide Foot and Ankle surgeons and others interested in learning about or partaking in the treatment of Achilles tendon ruptures. The purpose of this study was to identify and analyze the most- cited and influential research articles regarding Achilles tendon rupture. Methods: Using the Web of Science Database, with the search terms Achilles Tendon Rupture OR Achilles Tendon Tear OR Achilles Tendon Surgery OR Achilles Tendon Repair OR Achilles Tendon Reconstruction, over 1500 publications were identified. The search was then refined to include only original articles, which resulted in 1341 articles (Figure 1). Co-Authorship between authors was analyzed and using a readily available online citation manager software. The 50 most-cited articles were exported from Web of Science into Microsoft Excel for further analysis of publication year, journal, authors, and institution of publication. Results: The 1341 articles were published between 1948 and 2023, a plurality of which were published in 2021 and 2022 (117 and 113 articles, respectively). The top 50 most-cited articles were published between 1974 and 2017, and were cited an average of 170 times, ranging from 79 to 672 citations. RG Young et al.’s article Use of Mesenchymal Stem Cells in a Collagen Matrix for Achilles Tendon Repair was the most-cited article overall and in the past 10 years with 672 and 64 citations overall and since 2013, respectively. The American Journal of Sports Medicine was the most prolific publication, having published 10 of the top 50 most-cited articles. Leppilahti, J., Nilsson-Helander, K., and Silbernagel, K. were the most prolific primary authors, with 2 publications each. Conclusion: There is an immense amount of Achilles tendon rupture research available on the Web of Science. This can make it difficult for Foot and Ankle surgeons and other practitioners interested in the topic to navigate the relevant literature. Bibliometric analyses such as this one can help provide a road map of the most-significant literature available. This study identified and sought to describe the characteristics of the 50 most-influential articles regarding Achilles Tendon Rupture.