bluuebunny/crossref_metadata_2025_split huggingface dataset:
Segmenting the Population and Estimating Transition Probabilities Using Data on Health and Health-Related Social Service Needs from the US Health and Retirement Study
Authors: Duminy Lize 
Published: February 2025

Background Simulation modeling is a promising tool to help policy makers and providers make evidence-based decisions when evaluating integrated care programs. The functionality of such models, however, depends on 2 prerequisites: 1) the analytical segmentation of populations to capture both health and health-related social service (HASS) needs and 2) the precise estimation of transition probabilities among the various states of need. Methods We took a validated instrument for segmenting the population by HASS needs and adapted it to the Health and Retirement Study, a nationally representative survey dataset from the US population older than 50 y. We then estimated the transition probabilities across all 10 need states and death using multistate modeling. A need state was defined as a combination of any of the 5 ordinal global impression segments and a complicating factor status. Results Kaplan-Meier survival curves, log-rank tests, and c-indices were used to assess predictive validity in relation to mortality. The Markov traces, using the estimated transition probability to replicate 2 closed cohorts, resembled the proportion of individuals per health state across subsequent waves well enough to indicate adequate fit of the estimated transition probabilities. Conclusions This article provides a population segmentation approach that incorporates HASS needs for the US population and 1-y transition probabilities across HASS need states and death. This is the first application of HASS segmentation that can estimate transitions between all 10 HASS need states, facilitating novel analysis of policy decisions related to integrated care. Implications Our results will be used as input for a simulation model that performs scenario analysis on the long-term effects of various integrated care policies on population health. Highlights We took a validated tool for segmenting the population according to health and health-related social service (HASS) needs and adapted it to the Health and Retirement Study, a nationally representative survey dataset from the US population over the age of 50 y. We estimated the 1-y transition probabilities across all 10 HASS segments and death. This is the first application of a version of this HASS segmentation tool that includes HASSs in the various need states when estimating transition probabilities. Our results will be used as input for a simulation model that performs scenario analysis on the long-term effects of various integrated care policies on population health.
Complications, Reoperations, and Readmissions After Common Arthroscopic Sports Medicine Procedures of the Knee: An Analysis of the ABOS Part II Oral Examination Case List Database
Authors: Bragg Jack T. , McIntyre J. Alex , Puzzitiello Richard N. , Salzler Matthew J. 
Published: February 2025

Background: Arthroscopic knee surgeries are among the most commonly performed orthopaedic surgeries, yet complications of these procedures are relatively understudied. Purpose: To determine the rate of complications, reoperations, and readmissions for arthroscopic knee surgeries by procedure, patient characteristics, and physician fellowship training status using a large national database. Study Design: Cross-sectional study; Level of evidence, 3. Methods: Data were collected from the American Board of Orthopaedic Surgery (ABOS) database for early-career orthopaedic surgeons taking the ABOS Part II Oral Examination between 2003 and 2022. We queried the type and frequency of complications, unexpected 90-day reoperations, and readmissions for patients undergoing sports medicine knee arthroscopy. Chi-square test and analysis of variance were used to determine the effect of fellowship training status, geographic region of practice, patient age, and patient sex on outcomes of interest. Results: Of 138,823 knee arthroscopic procedures, 10,450 complications were self-reported, making for an overall complication rate of 7.53%. Unexpected 90-day reoperation and readmission rates were calculated to be 1.16% and 0.91%, respectively. Posterior cruciate ligament reconstruction had the highest complication rate (26.38%). Sports medicine fellowship–trained physicians had a significantly higher rate of complications ( P < .001) compared with their non–sports medicine fellowship–trained peers (8.43% and 7.06%, respectively). Female patients had a higher complication rate (7.72%) than males (7.40%) ( P = .02). Patients aged 20 to 29 had the highest rate of complications and reoperations (10.29% and 1.56%, respectively), whereas patients aged 70 to 79 had the highest rate of readmission (1.47%). Geographic regions of practice had significantly different complication and reoperation rates ( P < .01). The rate of deep venous thrombus was 0.57%, and the rate of pulmonary embolism was 0.12%. Forty-two patients died, for an overall 0.03% mortality rate. Conclusion: The overall rate of self-reported complications was 7.53%, and the 90-day rate of unexpected reoperation and unexpected readmission was 1.16% and 0.91%, respectively. Patient sex, patient age, sports medicine fellowship training status, and geographic region of practice all affected rates of complications, reoperations, and readmissions. Knee arthroscopy carries many risks of which patients should be aware before undergoing these procedures.
Antithrombotic Potential of Cynanchum radians Acetone Extracts: Comparative Study with Heparin and Aspirin in a Murine Model
Authors: Alghamdi Ahmad A. 
Published: February 2025

Background Cynanchum radians ( C. radians) is a small herb from the Asclepiadoid genera, found in both the Old and New Worlds. The plant has potential medicinal properties, but its effects on coagulation have yet to be fully explored. Purpose This study aims to evaluate the antithrombotic properties of C. radians acetone extracts by comparing their effects on coagulation markers with those of standard anticoagulants, such as heparin and aspirin. Methods Forty mice were divided into four groups: control, acetonic extracts C. radians treatment group, aspirin treatment group, and heparin treatment group. Blood samples were drawn from each mouse in the four groups using ethylenediaminetetraacetic acid, sodium citrate, and heparin tubes. Blood tests, including complete blood count, renal function and liver enzymes tests, activated partial thromboplastin time (aPTT), prothrombin time (PT), international normalized ratio (INR), fibrinogen, and D-dimer concentrations were evaluated for each mouse. Results There were no significant variations in the levels of chloride, potassium, sodium, blood urea nitrogen, creatinine, aspartate aminotransferase, and alanine aminotransferase across all groups. The C. radians acetone extracts caused a significant prolongation of PT, aPTT, and INR in mice compared to the heparin- and aspirin-treated groups ( p < 0.05). However, no statistically significant differences were observed in D-dimer and fibrinogen levels among the groups. Conclusion The present investigation determines that the acetone extracts of C. radians have a more significant effect on prolonging aPTT, PT, and bleeding time in mice compared to heparin and aspirin. These findings suggest that C. radians extracts possess significant antithrombotic properties and may serve as potential precursors for developing thrombosis treatments. However, further research is needed to fully understand the underlying mechanisms, optimize dosing, and assess long-term safety and efficacy before clinical applications can be considered.
Medications Not Dosed Within Recommended Range for Renal Function in Patients With Chronic Kidney Disease Identified upon Hospice Admission; a Retrospective Chart Review
Authors: Latuga Natalie M. , Levy Kathryn 
Published: February 2025

Background Hospice-eligible patients are vulnerable to adverse medication effects given their advanced illnesses and general older age. It is not known how often medications are not renal dose adjusted in hospice-eligible patients and which are frequently problematic. This study aims to identify commonly prescribed medications with significant renal clearance that are dosed too high and patient characteristics that increase the likelihood of occurrence. Methods This is a retrospective chart review of adult patients admitted to hospice care. Data collected included clinical/demographic data, renally cleared medications taken at time of hospice admission, and calculated renal function using several formulas. Descriptive statistics and binomial logistic regression were used to analyze data. Results Of 283 included charts, 27% had ≥1 medication dosed too high for renal function. The most common medications prescribed and not renal dose adjusted included tramadol, gabapentin, duloxetine, loratadine, cetirizine, famotidine, apixaban, rivaroxaban, metformin, trospium, and most antimicrobials. Increasing serum creatinine values and increasing number of renally cleared medications were associated with a higher likelihood of a medication dosed too high [OR, 1.702, 95% CI (1.257, 2.305), P < 0.001] and [OR, 1.856, 95% CI (1.517, 2.271), P < 0.001] respectively. Residing at home vs a facility was associated with a reduced likelihood of having a medication dosed too high [OR, 0.30, 95% CI (0.134, 0.673), P = 0.003.]. Conclusions Hospice-eligible patients frequently have renally cleared medications prescribed and at doses too high for their renal function. Analgesics, over-the-counter antihistamines, anticoagulants, anticholinergics have potential for significant adverse effects and higher vigilance is needed.
A Review of Studies That Measured the Mental Health Outcomes of Spouse Caregivers Caring for a Spouse with Disabling Health Conditions
Authors: Oduche Margaret , Ruppar Todd 
Published: February 2025

Background: Spouse caregivers play a vital role in the long-term care of chronically ill and dependent partners. They frequently experience caregiver burden with negative health outcomes. Caregiver burden is associated with poor mental health outcomes such as depression and anxiety among spouse caregivers. A caregiver’s mental health is essential to the well-being of the caregiver and care recipient; thus, it needs to be accounted for in patient management and in caregiver studies. Objective: The purpose of this integrative review was to examine studies that explored relationships between caregiver burden and spouse caregivers’ mental health. Methods: Searches in PubMed, Scopus, and CINAHL identified 18 studies that met the inclusion criteria. Twelve of the studies focused on spouse caregivers alone while six included family caregivers with spouse caregivers making up 50% or more of the sample. Results: Anxiety and depression were common among spouse caregivers but were often not measured or discussed. Most samples lacked racial and ethnic diversity. Mediating factors such as socioeconomic/income status which can influence mental health outcomes were rarely analyzed or reported. Functional and cognitive decline were the most common mediators of anxiety and depression. The heterogeneity of the methods and measures used in the studies could limit the generalization of findings. Conclusion: More studies are needed that include historically underrepresented spouse caregivers. Accounting for confounders such as level of education, income status, and elements of social determinants of health is essential in caregiver studies because of their strong influence on health and mental outcomes.
Doctor when can I drive? A systematic review and meta-analysis of brake reaction time in patients returning to driving after hip arthroscopy for femoroacetabular impingement (FAI)
Authors: Patel Ravi , Sokhal Balamrit Singh , Fenton Carl , Omonbude Daniel , Banerjee Robin , Nandra Rajpal 
Published: February 2025

Background: A common question from patients undergoing hip arthroscopy for femoroacetabular impingement (FAI) is when they may return to driving. Purpose: We aimed to perform a formal systematic review and meta-analysis to address this issue. Methods: A systematic review and meta-analysis followed PRISMA guidelines. Databases searched included OVID, EMBASE, and COCHRANE through July 2024 for articles with keywords and MeSH terms like “Hip arthroscopy,” “Femoroacetabular Impingement,” “total brake response time,” and “reaction time” related to driving. Titles and full articles were reviewed for quality and relevance. Statistical analysis was done using Review Manager Version 5.4. A total of 39 articles were reviewed, with 5 meeting inclusion criteria. All selected articles used brake reaction time (BRT) as an outcome measure. A meta-analysis compared pre- and postoperative BRT values. Data were analysed for the right and left hips combined, followed by a subgroup analysis by laterality. BRT values were divided into preoperative and 2, 4, 6, and 8 weeks postoperative periods. Results: The studies assessed 160 patients, with 142 undergoing hip arthroscopy for FAI. The mean age was 32.75 ± 9.4 years, with a male-to-female ratio of 73:69. The right hip was affected in 68% of patients. Preoperative BRT ranged from 566 to 1960 milliseconds, while postoperative BRT ranged from 567 to 1860 milliseconds between week 2 and week 12. Conclusions: BRTs returned to baseline or control values and continued to improve 4 weeks post-surgery for FAI. It is safe to recommend a return to driving at 4 weeks after hip arthroscopy for FAI.
An Immunogenic Cell Death-Related Gene Signature Predicts the Prognosis and Immune Infiltration of Cervical Cancer
Authors: Sun Fangfang , Sun Yuanyuan , Tian Hui 
Published: February 2025

Objectives: Immunogenic cell death (ICD) has been demonstrated to play a critical role in the development and progression of malignant tumors by modulating the anti-tumor immune response. However, its function in cervical cancer (CC) remains largely unexplored. In this study, we aimed to construct an ICD-related gene signature to predict patient prognosis and immune cell infiltration in CC. Methods: The gene expression profiles and clinical data of CC were downloaded from The Cancer Genome Alas (TCGA) and Gene Expression Omnibus (GEO) datasets, serving as the training and testing groups, respectively. An ICD-related gene signature was developed using the LASSO-Cox model. The expression levels of the associated ICD-related genes were evaluated using single-cell data, CC cell lines, and clinical samples in vitro. Results: Two ICD-associated subtypes (cluster 1 and cluster 2) were identified through consensus clustering. Patients classified into cluster 2 demonstrated higher levels of immune cell infiltration and exhibited a more favorable prognosis. Subsequently, an ICD-related gene signature comprising 3 genes (IL1B, IFNG, and FOXP3) was established for CC. Based on the median risk score, patients in both training and testing cohorts were segregated into high-risk and low-risk groups. Further analyses indicated that the estimated risk score functioned as an independent prognostic factor for CC and influenced immune cell abundance within the tumor microenvironment. The up-regulation of the identified ICD-related genes was further validated in CC cell lines and collected clinical samples. Conclusion: In summary, the stratification based on ICD-related genes demonstrated strong efficacy in predicting patient prognosis and immune cell infiltration, which also provides valuable new perspectives for the diagnosis and prognosis of CC.
Long Term Outcomes After Flexor Tendon Tenotomy of the Diabetic Foot
Authors: Andersen Jonas Askø , Rasmussen Anne , Frimodt-Møller Marie , Kirketerp-Møller Klaus , Rossing Peter 
Published: February 2025

Background: Hammertoes is one if not the most common deformity that afflicts the diabetic foot and leads to increased risk of diabetic foot ulcers. Flexor tendon tenotomy treatment of the diabetic hammertoe has gained increased interest and is now recommended in international guidelines as a treatment of hammertoes to prevent diabetic foot ulcers. There is however no published data on the long term outcomes following tenotomy treatment. Introduction: The objectives of this study was to describe the demographics and long-term outcomes following tenotomy treatment of individuals with diabetes who had flexor tendon tenotomies of hammertoes performed between 2006 and 2009. Methods: This was an observational study of a cohort from a prior study. The study was performed at Steno Diabetes Center Copenhagen between 1st of January 2020 and 31st of June 2020. Participants from the prior study were invited to join the study, consisting of one visit where foot examination was performed by orthopedic surgeon. Information on medical history was obtained from medical records. Results: Of the original 38 operated participants, 21 (55.3%) had died during the follow-up period, one (2.6%) had moved away, and one (2.6%) had incorrect procedure performed originally. At follow-up (mean 149.7 months (±17)), age of the remaining 15 participants (86.7% male) was 66.6 years (±11.4), diabetes duration was 32.2 years (±13.3), all had neuropathy and 14 (93.3%) had palpable foot pulses. The 15 Included participants had 22 toes tenotomized in the original study, of which five toes (22.7%) in four participants (26.7%) had recurrent hammertoe deformities. Of the 15 participants, 14 (93.3%) had incurred at least one ulcer during the observation period, and eight (53.3%) had incurred an amputation. Conclusion: This study reports an undescribed risk of recurrence of deformities after tenotomies and supports that this population is at high risk of new ulcers, amputations, and have a high mortality rate.
Pronation angle changes with progression of trapeziometacarpal joint osteoarthritis
Authors: Tsukamoto Kazuya , Kuroiwa Tomoyuki , Ibara Takuya , Fujita Koji 
Published: February 2025

We evaluated thumb pronation angles in patients with trapeziometacarpal joint osteoarthritis. Patients with a significantly decreased pronation angle showed a moderate correlation with the Eaton–Littler classification. Weakness of opponens pollicis function is associated with the development of trapeziometacarpal joint osteoarthritis. Level of evidence: III
The Effects of Naturally Occurring Phenols on Amyloid Fibrils from Insulin in the Liquid Phase Using Atomic Force Microscopy
Authors: Dasani Divya B. , Nghiem Tyler P. , Facteau Katherine A. , Pollock Casey A. , Strain Monica L. , Zuchowski Grace E. , Moriarty Daniel F. 
Published: February 2025

Objectives Amyloid fibrils are misfolded proteins that self-assemble to form insoluble, elongated, β-sheet structures. These fibrils are linked with the progression of neurodegenerative diseases like Alzheimer's Disease and metabolic disorders such as Type II diabetes. A range of molecules have shown the ability to impede the formation of these fibrils, often by acting on the monomeric and oligomeric forms of the protein. Our work focuses on the inhibitory effect of curcumin, gallic acid and mangiferin on the formation of amyloid fibrils. Materials and methods Bovine insulin was used as a model system for amyloid formation by lowering the pH at 60 °C, and several different small molecules were used to test inhibition. Samples were analyzed using Atomic Force Microscopy (AFM) in a liquid environment, as well as Congo Red and Thioflavin T assays. Results We have been able to observe significant inhibition of amyloid fibril formed from insulin by these compounds as well as observe beginning stages and the morphology of fibrils. Mangiferin, gallic acid, and curcumin were all shown to slow down fibril formation, though by 5 days fibrils have started to form in the gallic acid solution. After 7 days, solutions containing curcumin or mangiferin still show no strong evidence of structured fibrils. Conclusion Gallic acid, curcumin and mangiferin are all molecules that have inhibitory effects on amyloid formation using insulin as a model system, with gallic acid being somewhat less effective than the other two. The AFM technique used to image fibrils was performed in an environment that more closely resembles in vivo conditions than air dried samples.
Development and Optimisation of a red ginseng Beverage from Codonopsis javanica in Vietnam: Sensory and Microbial Safety Evaluation
Authors: Ho Tram Thi Ngoc , Pham Loan Thi Hong , Nguyen Hoan Thai 
Published: February 2025

Objectives The study aimed to develop a protocol for producing a beverage from Codonopsis javanica ( C. javanica) (red ginseng) root extract, incorporating additives to enhance its overall sensory appeal. Key parameters, including triterpenoid saponin content, °Brix, pH, suspended solids, and moisture, were analyzed. Sensory evaluations were conducted to optimize the formulation, and the microbial safety of the final product was assessed. Methods Dried C. javanica roots were ground into powder and extracted using enzyme-assisted extraction with viscozyme® L. The extract was analyzed for triterpenoid saponin content, °Brix and pH, and the powder was measured for moisture content. Optimal heating conditions for suspended solid content were determined at three heating temperatures (70 °C, 75 °C and 80 °C) for 8 and 12 min, respectively. Different ratios of red ginseng extract to water (7:3, 8:2, 9:1 and 10:0), as well as varying concentrations of citric acid (0.0% and 0.1%), sucrose (8%, 10%, 12% and 14%), and honey (1% and 1.5%), were surveyed for sensory evaluation by a panel of testers. Product pasteurization (at 100 °C for 15 min) was performed to ensure microbial safety and microbiological standards were assessed after 28 days of storage. Results The optimal extraction method yielded a high °Brix (9.20), low pH (3.62), and a triterpenoid saponin content of 53.66 mg/100 g. Heating red ginseng extract at 80 °C for 8 min resulted in optimal suspended solid content. The most favourable sensory results were achieved with a dilution ratio of 8:2 (ginseng extract:water). The addition of 12% sucrose alone or 12% sucrose combined with 1.5% honey provided the best taste scores. Pasteurization ensured the absence of microorganisms, meeting national standards for non-alcoholic beverages. Conclusion The study successfully developed a red ginseng beverage with optimal sensory qualities and ensured microbial safety. The findings provide a foundation for further commercialization of red ginseng beverages, highlighting the importance of balanced formulations and proper processing techniques.