bluuebunny/crossref_metadata_2025_split huggingface dataset:
Assessment of degradability and endothelialization of modified poly L-lactic acid (PLLA) atrial septal defect (ASD) occluders over time in vivo
Authors: Chen Jun , Xie Yumei , Li Yifan , Chen Xianmiao , Fu Mingjuan , Liu Yanfen , Zhang Zhiwei 
Published: October 2023

Abstract
Objective
To evaluate the fiber-degradation and endothelialization of a modified poly L-lactic acid (PLLA) atrial septal defect (ASD) occluder for a long time in vivo.

Methods
A total of 57 New Zealand rabbits were selected to establish the vasculature implantation model, which would be used to characterize the mechanical properties and pathological reaction of PLLA filaments (a raw polymer of ASD occluder). In total, 27 Experimental piglets were used to create the ASD model for the catheter implantation of PLLA ASD occluders. Then, X-ray imaging, transthoracic echocardiography, histopathology, and scanning electron microscope (SEM) were performed in the experimental animals at 3, 6, 12, and 24 months after implantation.

Results
In the rabbit models, the fibrocystic grade was 0 and the inflammatory response was grade 2 at 6 months after vasculature implantation of the PLLA filaments. The mass loss of PLLA filaments increased appreciably with the increasing duration of implantation, but their mechanical strength was decreased without broken. In the porcine models, the cardiac gross anatomy showed that all PLLA ASD occluders were stable in the interatrial septum without any vegetation or thrombus formation. At 24 months, the occluders had been embedded into endogenous host tissue nearly. Pathological observations suggested that the occluders degraded gradually without complications at different periods. SEM showed that the occluders were endothelialized completely and essentially became an integral part of the body over time.

Conclusion
In the animal model, the modified PLLA ASD occluders exhibited good degradability and endothelialization in this long-term follow-up study.
Effects of COVID-19 on diabetes care among dutch diabetes outpatients
Authors: Bak Jessica C.G. , Serné Erik H. , Groenwold Rolf H.H. , de Valk Harold W. , Kramer Mark H.H. , Nieuwdorp Max , Verheugt Carianne L. 
Published: October 2023

Abstract
Aims
The COVID-19 pandemic impacted diabetes care by reducing diabetes outpatient visits and diabetes-related screening due to allocation of healthcare resources. Yet the impact of COVID-19 on diabetes outpatients has not been extensively evaluated. This study aimed to assess the effect of the COVID-19 pandemic on diagnostics and intermediate outcomes of outpatient diabetes care pre- and during COVID.

Methods
This observational cohort study included 8,442 diabetes patients in the Dutch Pediatric and Adult Registry of Diabetes (DPARD) visiting diabetes outpatient clinics in 2019 and 2021. A mixed-effects regression analysis was used to examine differences in target achievement of HbA1c, BMI, blood pressure, LDL-cholesterol, eGFR, and the difference in mean HbA1c between 2019 and 2020 among n = 1,426 outpatients who visited in both years. Analyses were adjusted for age, sex, and BMI.

Results
A 22.7% (21.6–23.8%, p < 0.001) decline in outpatient volume was observed during the pandemic (2020). BMI, lipid spectrum, kidney function, and HbA1c were assessed less frequently in 2020 than in 2019. In 2020, compared to 2019, the median HbA1c level increased by 2.2% (1.0 mmol/mol, p = 0.035) and the percentages of patients with known HbA1C meeting targets below 10, 8, 7% (86, 64, and 53 mmol/mol) decreased by 0.5%, 1.7% and 1.4%, respectively. Target blood pressure ≤ 130/80 mmHg was achieved more often in 2020 (15.0% versus 18.3%, p = 0.018), while HbA1c ≤ 86 mmol/mol was achieved less (89.3% versus 87.1%, p = 0.001), among diabetes outpatients seen in both 2019 and 2020. In patients visiting both years, HbA1c was 2.3% (1.9 mmol/l, 95% CI 1.2–2.5, p < 0.001) lower during the pandemic than in the prepandemic (2019).

Conclusions
The COVID pandemic was associated with a marked reduction in patient volume in diabetes outpatient care among five hospitals. Among patients who received outpatient care both before and during the pandemic period, HbA1c control and blood pressure control enhanced during the pandemic. Re-evaluation of current diabetes outpatient care organization is warranted to ensure optimal diabetes care in future times.
Change in quality of life and return to work and sports after isolated closing-wedge distal femoral osteotomy
Authors: Fang Qian , Wang Dong , Liu Wenzheng , Lin Wei , Wang Guanglin 
Published: October 2023

Abstract
Purpose
To analyze return to work and sports, and health-related quality of life (HRQoL) after closing-wedge distal femoral osteotomy (CWDFO) for valgus deformity and lateral compartmental osteoarthritis.

Methods
Thirty-three patients underwent isolated CWDFO in our center between January 2018 and June 2020 were enrolled, of whom 32 and 23 patients were included in the return-to-work and return-to-sports analyses, respectively. Short Form-36 (SF-36), Tegner score, Knee injury and Osteoarthritis Outcome Score (KOOS) and visual analog scale (VAS) pain score were compared preoperatively and postoperatively. And postoperative complications were recorded.

Results
Overall, 33 patients were contacted at a mean follow-up of 37.94 ± 6.68 months, with a median age of 35 years (range: 26–63 years) at the surgery time. The physical component summary of SF-36 (p < 0.001) increased significantly at 1 year postoperatively. All patients returned to work, including 96.86% who returned to the same level of work in 1.89 ± 0.98 months, and to sports, including 78.26% who returned to the same sport level in 6.50 ± 2.05 months. Rates of returning to work (p = 0.215) and sports (p = 0.165) did not differ with work/sports intensity. Tegner scores (p = 0.025) and VAS pain scores (p < 0.001) decreased, and KOOS (p < 0.001) increased at 1 year postoperatively. Revision/conversion surgery was not required. In all, 30.43% patients reported a subjective decrease in sports ability; 82.61% patients considered their sports ability acceptable.

Conclusion
Patients returned to work/sports after isolated CWDFO, and had increased HRQoL. Patients playing high-impact sports had lower rates of returning to the same sport level, and may require preoperative counseling.

Level of evidence
IV, Case series.
MRI feature-based radiomics models to predict treatment outcome after stereotactic body radiotherapy for spinal metastases
Authors: Chen Yongye , Qin Siyuan , Zhao Weili , Wang Qizheng , Liu Ke , Xin Peijin , Yuan Huishu , Zhuang Hongqing , Lang Ning 
Published: October 2023

Abstract
Objective
This study aimed to extract radiomics features from MRI using machine learning (ML) algorithms and integrate them with clinical features to build response prediction models for patients with spinal metastases undergoing stereotactic body radiotherapy (SBRT).

Methods
Patients with spinal metastases who were treated using SBRT at our hospital between July 2018 and April 2023 were recruited. We assessed their response to treatment using the revised Response Evaluation Criteria in Solid Tumors (version 1.1). The lesions were categorized into progressive disease (PD) and non-PD groups. Radiomics features were extracted from T1-weighted image (T1WI), T2-weighted image (T2WI), and fat-suppression T2WI sequences. Feature selection involved intraclass correlation coefficients, minimal-redundancy-maximal-relevance, and least absolute shrinkage and selection operator methods. Thirteen ML algorithms were employed to construct the radiomics prediction models. Clinical, conventional imaging, and radiomics features were integrated to develop combined models. Model performance was evaluated using receiver operating characteristic (ROC) curve analysis, and the clinical value was assessed using decision curve analysis.

Results
We included 194 patients with 142 (73.2%) lesions in the non-PD group and 52 (26.8%) in the PD group. Each region of interest generated 2264 features. The clinical model exhibited a moderate predictive value (area under the ROC curve, AUC = 0.733), while the radiomics models demonstrated better performance (AUC = 0.745–0.825). The combined model achieved the best performance (AUC = 0.828).

Conclusion
The MRI-based radiomics models exhibited valuable predictive capability for treatment outcomes in patients with spinal metastases undergoing SBRT.

Critical relevance statement
Radiomics prediction models have the potential to contribute to clinical decision-making and improve the prognosis of patients with spinal metastases undergoing SBRT.

Key points
• Stereotactic body radiotherapy effectively delivers high doses of radiation to treat spinal metastases.
• Accurate prediction of treatment outcomes has crucial clinical significance.
• MRI-based radiomics models demonstrated good performance to predict treatment outcomes.

Graphical Abstract
Vascular organoids: unveiling advantages, applications, challenges, and disease modelling strategies
Authors: Naderi-Meshkin Hojjat , Cornelius Victoria A. , Eleftheriadou Magdalini , Potel Koray Niels , Setyaningsih Wiwit Ananda Wahyu , Margariti Andriana 
Published: October 2023

AbstractUnderstanding mechanisms and manifestations of cardiovascular risk factors, including diabetes, on vascular cells such as endothelial cells, pericytes, and vascular smooth muscle cells, remains elusive partly due to the lack of appropriate disease models. Therefore, here we explore different aspects for the development of advanced 3D in vitro disease models that recapitulate human blood vessel complications using patient-derived induced pluripotent stem cells, which retain the epigenetic, transcriptomic, and metabolic memory of their patient-of-origin. In this review, we highlight the superiority of 3D blood vessel organoids over conventional 2D cell culture systems for vascular research. We outline the key benefits of vascular organoids in both health and disease contexts and discuss the current challenges associated with organoid technology, providing potential solutions. Furthermore, we discuss the diverse applications of vascular organoids and emphasize the importance of incorporating all relevant cellular components in a 3D model to accurately recapitulate vascular pathophysiology. As a specific example, we present a comprehensive overview of diabetic vasculopathy, demonstrating how the interplay of different vascular cell types is critical for the successful modelling of complex disease processes in vitro. Finally, we propose a strategy for creating an organ-specific diabetic vasculopathy model, serving as a valuable template for modelling other types of vascular complications in cardiovascular diseases by incorporating disease-specific stressors and organotypic modifications.
Graphical abstract
A Simple 3D Printed Model for Intracranial Vascular Anastomosis Practice and the Rochester Bypass Training Score
Authors: Rahmani Redi , Santangelo Gabrielle , Jalal Muhammad I. , Catanzaro Michael , Samodal Joshua , Bender Matthew T. , Stone Jonathan J. 
Published: October 2023

BACKGROUND AND OBJECTIVES:
Surgical simulation models in cranial neurosurgery are needed to allow affordable, accessible, and validated practice in resident education. Current bypass anastomosis practice models revolve around basic tube tying or complex animal and 3-dimensional models. This study sought to design and validate a 3-dimensional printed model for intracranial anastomosis training.

METHODS:
A computer-aided design (CAD) generic skull was uploaded into Meshmixer (v.3.5), and a 55-mm opening was created on the right side, mimicking a standard orbitozygomatic craniotomy. The model was rotated 15° upward and 35° left, before a 10-mm square frame was added 80-mm deep to the right orbit. The CAD model was uploaded to GrabCAD and printed using a J750 PolyJet 3D printer before being paired with a vascular anastomosis kit. The model was validated with standardized assessments of residents and attendings by simulating an “M2 to P2” bypass. The Rochester Bypass Training Score (RBTS) was created to assess bypass patency, back wall suturing, and suture quality. Postsimulation survey data regarding the realism and usefulness of the simulation were collected.

RESULTS:
Five junior residents (Postgraduate Year 1-4), 3 senior residents (Postgraduate Year 5-7), and 2 attendings were participated. The mean operative time in minutes was as follows: junior residents 78, senior residents 33, and attendings 50. The RBTS means were as follows: junior residents 2.4, senior residents 4.0, and attendings 5.0. Participants agreed that the model was realistic, useful for improving operative technique, and would increase comfort in bypass procedures. There are a few different printing options, varying in model infill and printing material used. For this experiment, a mix of Vero plastics were used totaling $309.09 per model; however, using the more common printing material polylactic acid brings the cost to $17.27 for a comparable model.

CONCLUSION:
This study presents an affordable, realistic, and educational intracranial vascular anastomosis simulator and introduces the RBTS for assessment.
Distributionally Robust Optimization Under Distorted Expectations
Authors: Cai Jun , Li Jonathan Yu-Meng , Mao Tiantian 
Published: October 2023

Optimal Decision Making Under Distorted Expectation with Partial Distribution Information Decision makers who are not risk neutral may evaluate expected values by distorting objective probabilities to reflect their risk attitudes, a phenomenon known as distorted expectations. This concept is widely applied in behavioral economics, insurance, finance, and other business domains. In “Distributionally Robust Optimization Under Distorted Expectations,” Cai, Li, and Mao study how decision makers using distorted expectations can optimize their decisions when only partial information about objective probabilities is available. They show that decision makers who are ambiguity averse can optimize their decisions as if they are risk averse with their risk attitudes characterized by a convex distortion function. This finding demonstrates why even non–risk-averse decision makers, such as those studied in the celebrated cumulative prospect theory, may consider it optimal to take risk-averse decisions when facing uncertainty about objective probabilities. Leveraging this finding, the authors show that a large class of distributionally robust optimization problems involving the use of distorted expectations can be tractably solved as convex programs.
Allergic rhinitis and asthma – one airway, one approach
Authors: Bostock Beverley 
Published: October 2023

It is crucial for practice nurses to understand how to determine the severity of symptoms of allergic rhinitis. In this article, Beverley Bostock discusses how nurses can identify the relationship between asthma and allergic rhinitis. Allergic rhinitis (AR) is a condition which presents with symptoms such as a runny, itchy or blocked nose. It is also associated with ocular symptoms such as watering and itchy eyes. The symptoms of AR can significantly affect quality of life and the ability to take part in day-to-day activities. The impact can be felt from the condition alone or through the effect it can have on other conditions, most notably asthma.
Management of vitamin B12 deficiency in primary care
Authors: Arganda Mary-Jane 
Published: October 2023

Vitamin deficiencies are a major global health concern, and are a particular risk to infants, children and pregnant women. This article discusses what primary care nurses need to know when consulting a patient with a suspected deficiency Vitamin B12 is an essential water-soluble vitamin, which is vital in the production of red blood cells, nervous system function, and DNA synthesis during cell division. Vitamin B12 deficiency is a condition resulted from inadequate intake or malabsorption of vitamin B12. Severe B12 deficiency could lead to pernicious anaemia, mental impairment, and neurological disorders. Therefore, careful management and treatment are pivotal. This deficiency is commonly treated with B12 injections in Primary Care. However, review of literature showed that oral B12 supplementation was as effective as parenteral treatment. To minimise ambiguity in administering B12 injections, several clinical guidelines were highlighted. Nevertheless, further research is needed to evaluate the effectiveness of oral B12 therapy.
ARE GOOD OUTCOMES IN TOTAL KNEE ARTHROPLASTY PREDICTIVE OF SUCCESS IN SEQUENTIAL CONTRALATERAL TKA SURGERY?
Authors: Haque S.Z. , Downie S. , Ridley D. , Dalgleish S. , Nicol G. 
Published: October 2023

There is little published literature to support the claim that a successful total knee replacement (TKR) is predictive of future good outcomes on the contralateral side. The objective was to identify whether outcome from the first of staged TKRs could be used to predict the outcome of the contralateral TKR.This was a retrospective cohort study of 1687 patients over a 25-year period undergoing staged bilateral TKRs in a UK arthroplasty centre. A control group of 1687 patients undergoing unilateral TKR with matched characteristics was identified. Primary outcomes were satisfaction and Knee Society Score (KSS) at one year.Preoperative status was comparable for pain, ROM and KSS (mean 41, 45, 43±14). At one year follow up, dissatisfaction was similar for all groups (4% first of staged TKR, 4% second of staged TKR, 5% controls). If the first TKR had a good outcome, the relative risk of a contralateral bad outcome was 20% less than controls (95% CI 0.6–1.2). If the first TKR had a poor outcome, the risk of a second poor outcome was 4 times higher (95% CI 2.8–6.1), increasing from 6% to 27% (absolute risk).Patients undergoing the second of staged TKRs with a previous good outcome are likely to do well in their second procedure (94 in 100 will go on to have a second good outcome). Of those with a previous poor outcome, 27 in 100 will have a second poor outcome. The trend was persistent despite correcting for gender, age, BMI, and diagnosis.
INCIDENCE OF FEMORAL OSTEOLYSIS IN THE TITANIUM ALLOY THOMPSON PROSTHESIS
Authors: Russell H. , Tinning C. , Raza A. , Duff S. , Preiss R. A. 
Published: October 2023

The Thompson hemiarthroplasty is a common treatment option for acute neck of femur fractures in the elderly population. Our department noted a significant number of patients returning with thigh pain, radiographic loosening and femoral osteolysis following cemented implantation of the titanium alloy version of the Thompson hemiarthroplasty. We are not aware of any previous reports documenting complications specific to the titanium Thompson implant and a retrospective cohort study was therefore initiated following clinical governance approval.366 titanium alloy Thompson prostheses were implanted for hip fracture treatment between 2017 and 2020. As of February 2023, 6 of these have been revised at our hospital. 5 were revised for symptomatic femoral osteolysis and 1 presented with an acute periprosthetic fracture. All revised cases were determined to be aseptic. 32 living patients were excluded from recall on compassionate grounds due to permanent nursing home residence. 47 living patients were identified of which 33 attended for xray. 28 deceased and/or nursing home resident patients who had pelvis x-rays in the previous 12 months were also included in the analysis. Including the 6 index hips already revised, a total of 61 hip xrays were analysed, of which 19 hips (31.1%) showed radiographic evidence of femoral osteolysis or loosening.We conclude that there is a concerning incidence of femoral osteolysis and implant loosening associated with the titanium Thompson implant. We have discontinued use of the implant and reported our experience to the MHRA. We encourage other Scottish Health-Boards who use this implant to consider enhanced follow-up.
THE EFFECT OF HOSPITAL CASE VOLUME ON RE-REVISION FOLLOWING REVISION TOTAL HIP ARTHROPLASTY: A NATIONAL STUDY USING THE SCOTTISH ARTHROPLASTY PROJECT DATASET
Authors: Burt J. , Jabbal M. , Moran M , Jenkins P.J. , Walmsley P. , Clarke J.V. 
Published: October 2023

The aim of this study was to measure the effect of hospital case volume on the survival of revision total hip arthroplasty (RTHA).This is a retrospective analysis of Scottish Arthroplasty Project data, a nationwide audit which prospectively collects data on all arthroplasty procedures performed in Scotland. The primary outcome was RTHA survival at ten years. The primary explanatory variable was the effect of hospital case volume per year on RTHA survival. Kaplan-Meier survival curves were plotted with 95% confidence intervals (CIs) to determine the lifespan of RTHA. Multivariate Cox proportional hazards were used to estimate relative revision risks over time. Hazard ratios (HRs) were reported with 95% CI, and p-value < 0.05 was considered statistically significant.From 1999 to 2019, 13,020 patients underwent RTHA surgery in Scotland (median age at RTHA 70 years (interquartile range (IQR) 62 to 77)). In all, 5,721 (43.9%) were female, and 1065 (8.2%) were treated for infection. 714 (5.5%) underwent a second revision procedure. Co-morbidity, younger age at index revision, and positive infection status were associated with need for re-revision (p<0.001). The ten-year survival estimate for RTHA was 93.3% (95% CI 92.8 to 93.8). Adjusting for sex, age, surgeon volume, and indication for revision, high hospital case volume was not significantly associated with lower risk of re-revision (HR1, 95% CI 1.00 to 1.00, p 0.073)).The majority of RTHA in Scotland survive up to ten years. Increasing yearly hospital case volume cases is not independently associated with a significant risk reduction of re-revision.
Association between psychological vulnerability and glaucoma progression: Protocol for a multicenter prospective cohort study in South Korea
Authors: Baek Sung Uk , Kim Jin-Soo , Kim Dai Woo , Ha Ahnul , Kim Young Kook 
Published: October 2023

Introduction
Mental health is a significant concern for patients diagnosed with glaucoma, as visual impairment can have a profound impact on psychological well-being. Conversely, psychological vulnerability in glaucoma patients can negatively influence treatment adherence to ocular hypotensive therapy, thereby potentially exacerbating disease progression in a vicious cycle. The study protocol proposed herein aims to explore the impact of psychological states such as anxiety, depression, and stress on both medication adherence and progression of glaucoma.

Materials and methods
This study is to be a prospective multicenter study conducted at four tertiary medical centers. Patients recently diagnosed with glaucoma and not yet treated will be enrolled. Anxiety, depression, and stress scales will be administered at baseline, one year, and two years, along with glaucomatous assessments to be performed every six months. Validated questionnaires (Generalized Anxiety Disorder Assessment [GAD-7], Patient Health Questionnaire [PHQ-9], and Perceived Stress Scale-10 [PSS-10]) will assess anxiety, depression, and stress, respectively. The primary objective is to correlate post-diagnosis psychological status with medication adherence and disease progression. The effects of pre- and post-diagnosis changes in anxiety, depression, and stress on disease progression will be analyzed. Kaplan-Meier survival analysis and logistic regression will be performed to identify clinical characteristics associated with increased risk of developing anxiety, depression, and stress in glaucoma patients.