bluuebunny/crossref_metadata_2025_split huggingface dataset:
Finite Element Analysis of the Mechanical Strength of Phalangeal Osteosynthesis Using Kirschner Wires
Authors: HAYASHI Yukinori , AJIKI Takashi , TAKAHASHI Tsuneari , ENDO Teruaki , TAKESHITA Katsushi 
Published: April 2023

Background: Kirschner wire (K-wire) fixation is widely used to repair metacarpal and phalangeal fractures. In this study, we simulated K-wire osteosynthesis of a 3-dimensional (3D) phalangeal fracture model and investigated the fixation strength at various K-wire diameters and insertion angles to clarify the optimal K-wire fixation method for phalangeal fractures.Methods: The 3D phalangeal fracture models were created by using computed tomographic (CT) images of the proximal phalanx of the middle finger in five young healthy volunteers and five elderly osteoporotic patients. Two elongated cylinders representing K-wires were inserted according to various cross-pinning methods; the wire diameters were 1.0, 1.2, 1.5 and 1.8 mm, and the wire insertion angles (i.e. the angle between the fracture line and the K-wire) were 30°, 45° and 60°. The mechanical strength of the K-wire fixed fracture model was investigated by using finite element analysis (FEA).Results: The fixation strength increased with increasing wire diameter and insertion angle. Insertion of 1.8-mm wires at 60° achieved the strongest fixation force in this series. Fixation strength was generally stronger in the younger group than the elderly group. Dispersion of stress to cortical bone was a critical factor to increase fixation strength.Conclusions: We developed a 3D phalangeal fracture model into which we inserted K-wires; using FEA, we clarified the optimal crossed K-wire fixation method for phalangeal fractures.Level of Evidence: Level V (Therapeutic)
Persian Fixation – A Novel Surgical Method for Intra-articular Distal Radius Fractures
Authors: FALLAH Yousef , ZOHRABI Kian , SHARIYATE Mohammad Javad 
Published: April 2023

Background: Intra-articular distal radius fracture treatment options include Kirschner wires (K-wire) fixation, external fixation and plate fixation, however, fixation of small bone fragments in distal radius fractures in a secure and anatomical manner was a challenging issue with several limitations. In this study, we present a novel surgical method that we have called the Persian Fixation for intra-articular distal radius fracture and describe a short-term clinical result. Methods: We described the surgical procedure and clinical result of 15 patients between 2019 and 2020 in whom the Persian Fixation technique was utilised. Through clinical examination and questionnaires, objective and subjective clinical results were determined. Results: At the final follow-up, the mean Quick Disabilities of the Arm, Shoulder and Hand (Quick-DASH) score for our patients was 17.6 ± 12.1, the mean WOrk-Related Questionnaire for UPper extremity disorders (WORQ-UP) score was 20.7 ± 4.4 and the mean Visual Analogue Scale (VAS) score was 27.8 ± 16.5, indicating a good to excellent clinical result. Conclusions: We recommended the Persian Fixation technique for intra-articular distal radius fractures, which is a low-cost and readily accessible procedure that provides stable fixation of a tiny bone piece. Level of Evidence: Level IV (Therapeutic)
Knotless Tendon Repair with a Resorbable Barbed Suture: An In-vivo Comparison in the Turkey Foot
Authors: PELTZ Tim S. , MCMAHON James E. , SCOUGALL Peter J. , GIANOUTSOS Mark P. , OLIVER Rema , WALSH William R. 
Published: April 2023

Background: Un-knotted barbed suture constructs are postulated to decrease repair bulk and improve tension loading along the entire repair site resulting in beneficial biomechanical repair properties. Applying this repair technique to tendons has shown good results in ex-vivo experiments previously but thus far no in-vivo study could confirm these. Therefore, this current study was conducted to assess the value of un-knotted barbed suture repairs in the primary repair of flexor tendons in an in-vivo setting. Methods: Two groups of 10 turkeys (Meleagris gallapovos) were used. All turkeys underwent surgical zone II flexor tendon laceration repairs. In group one, tendons were repaired using a traditional four-strand cross-locked cruciate (Adelaide) repair, while in group two, a four-strand knotless barbed suture 3D repair was used. Postoperatively repaired digits were casted in functional position, and animals were left free to mobilise and full weight bear, resembling a high-tension post-op rehabilitation protocol. Surgeries and rehabilitations went uneventful and no major complications were noted. The turkeys were monitored for 6 weeks before the repairs were re-examined and assessed against several outcomes, such as failure rate, repair bulk, range of motion, adhesion formation and biomechanical stability. Results: In this high-tension in-vivo tendon repair experiment, traditionally repaired tendons performed significantly better when comparing absolute failure rates and repair stability after 6 weeks. Nevertheless, the knotless barbed suture repairs that remained intact demonstrated benefits in all other outcome measures, including repair bulk, range of motion, adhesion formation and operating time. Conclusions: Previously demonstrated ex-vivo benefits of flexor tendon repairs with resorbable barbed sutures may not be applicable in an in-vivo setting due to significant difference in repair stability and failure rates. Level of Evidence: Level IV (Therapeutic)
What even is a meandering river? A philosophy-enhanced synthesis of multilevel causes and systemic interactions contributing to river meandering
Authors: Kleinhans Maarten G. , McMahon William J. , Davies Neil S. 
Published: April 2023

Abstract
Despite creating one of Earth's most iconic landforms, and having been studied since antiquity, river meandering is currently explained by several alternative models that remain debated. This is partly because observers have deconstructed meanders to a set of properties thought to be fundamental or significant for meandering, but each of these underpinning properties is itself complex and in turn requires analysis of its causes and mechanisms. This philosophical contribution aims to provide a perspective on the state of the science that makes a rigorous interrogation into what ‘causation’ actually means, and explores what a systems perspective can elucidate about meandering phenomena. We approach the problem through a discussion of the variety of ways in which previous researchers have tackled the problem of meandering, from a channel and floodplain perspective, on Earth and Mars, in the field and laboratory, and at the present day through to the ancient stratigraphic record. It is evident that river meandering has numerous causal pathways rather than a single set of necessary and sufficient conditions. A systemic view on the evolution of plant species shows that their feedbacks on river pattern likewise have several pathways. Employing the conceptual apparatus of the philosophy of science will move us towards a more consensual synthesis of river meandering.
Modelling shear stress distribution in ice-covered streams
Authors: Koyuncu Berkay , Le Trung Bao 
Published: April 2023

Abstract
Distribution of bed shear stress is the critical factor in regulating the meandering of single-thread rivers. However, the impact of ice cover on bed shear stress is largely unknown. In this study, we develop a theoretical model of cross-stream momentum balance to examine the distribution of bed shear stresses in ice-covered meandering rivers. To validate the theoretical model, field surveys were carried out in a river reach of the Red River in Fargo, North Dakota. Data monitoring was completed using an Acoustic Doppler Current Profiler to obtain time-averaged velocity profiles. Our theoretical model indicates that an ice covering develops high-shear zones near both the inner and outer banks, which might exacerbate sediment transport and enhance bank erosion. Velocity measurements confirm the results of the proposed model and demonstrate a clear impact of meandering river banks on velocity profiles and secondary flow patterns under ice cover. Based on our results, we hypothesize that ice cover increases turbulent stresses near banks, which in turn lead to the enhancement of the bed shear stress. Our work provides new insights into the impact of ice cover on bed shear stress distribution, which could play an important role in driving sediment-transport processes and the long-term morphodynamic evolution of meandering rivers seasonally covered by ice.
Heparin Prowess: Favorable Vascular–Immune Reprogramming in Pancreatic Cancer
Authors: Korc Murray 
Published: April 2023

Summary
Several approaches for overcoming immunotherapy resistance in pancreatic and colorectal cancer syngeneic models were assessed using heparin and immunotherapy. Beneficial responses were attributed to heparin-induced vascular normalization, ensuing CD8+ T-cell infiltration, and M1 macrophage polarization, suggesting the potential for heparin-anchored therapies in cold tumors such as pancreatic cancer.
See related article by Wei et al., p. 2525
At the Crossroads: Multi-Stakeholder and Multi-Disciplinary Approaches in the Application of ihl
Authors: Durham Helen , Quintin Anne 
Published: April 2023

Abstract
The faithful application of ihl during armed conflicts requires working on a variety of systems, structures and institutions that exist within a society, to ensure that the environment is conducive to respect for the law. Accordingly, there are many different roads to travel down, from developing and interpreting international legal rules to building adequate domestic frameworks, and from training armed actors on the rules applicable in warfare to working with communities affected by violence to ensure their voices are heard. This article aims to recognize the value of bringing different actors together, fostering complementarity among them and joining their forces towards the common aim of ensuring better respect for the law. Based on recent examples and studies in the field of ihl training, application and implementation, the article also aims to help humanitarian practitioners, armed actors, diplomats, legal scholars and others identify ways to work together and cross-fertilize their work.
A critical evaluation of QIDS-SR-16 using data from a trial of psilocybin therapy versus escitalopram treatment for depression
Authors: Weiss Brandon , Erritzoe David , Giribaldi Bruna , Nutt David J , Carhart-Harris Robin L 
Published: April 2023

Background: In a recent clinical trial examining the comparative efficacy of psilocybin therapy (PT) versus escitalopram treatment (ET) for major depressive disorder, 14 of 16 major efficacy outcome measures yielded results that favored PT, but the Quick Inventory of Depressive Symptomatology, Self-Report, 16 items (QIDS-SR16) did not. Aims: The present study aims to (1) rationally and psychometrically account for discrepant results between outcome measures and (2) to overcome psychometric problems particular to individual measures by re-examining between-condition differences in depressive response using all outcome measures at item-, facet-, and factor-levels of analysis. Method: Four depression measures were compared on the basis of their validity for examining differences in depressive response between PT and ET conditions. Results/Outcomes: Possible reasons for discrepant findings on the QIDS-SR16 include its higher variance, imprecision due to compound items and whole-scale and unidimensional sum-scoring, vagueness in the phrasing of scoring options for items, and its lack of focus on a core depression factor. Reanalyzing the trial data at item-, facet-, and factor-levels yielded results suggestive of PT’s superior efficacy in reducing depressed mood, anhedonia, and a core depression factor, along with specific symptoms such as sexual dysfunction. Conclusion/Interpretation: Our results raise concerns about the adequacy of the QIDS-SR16 for measuring depression, as well as the practice of relying on individual scales that tend not to capture the multidimensional structure or core of depression. Using an alternative approach that captures depression more granularly and comprehensively yielded specific insight into areas where PT therapy may be particularly useful to patients and clinicians.
SAMe-TT2R2 to Predict Clinical Outcomes and Time in Therapeutic Range in Patients on Vitamin K Antagonists: A Systematic Review and Meta-Analysis
Authors: Incomenoy Supatcha , Saokaew Surasak , Poonchuay Natnicha 
Published: April 2023

Background: The SAMe-TT2R2 score identifies patients on vitamin K antagonists (VKAs) who are more likely to have poor time in therapeutic range (TTR); however, the association between SAMe-TT2R2 and clinical outcomes remains controversial. Objectives: The objective is to assess the association of SAMe-TT2R2 score with clinical outcomes and poor TTR in patients on VKAs. Methods: We searched using the term “SAMe-TT2R2.” Original articles reporting clinical outcomes and SAMe-TT2R2 scores before October 2021 were included. Odds ratios (ORs) of clinical outcomes, diagnostic accuracy parameters of poor TTR (<60%-70%), and mean TTR were extracted. Meta-analysis was performed using random-effects models. Results: Ten studies were included (N = 22 894); 4 showed pooled changes in TTR of −3.61% (95% CI:−4.88% to −2.35%) and −3.98% (95% CI: −6.08% to −1.87%) at SAMe-TT2R2 scores ≥2 and ≥3, respectively, compared with lower scores. The diagnostic accuracy parameters for poor TTR were too heterogeneous to conclude. SAMe-TT2R2 ≥3 significantly correlated with all adverse events (OR = 1.43 [95% CI: 1.29-1.54; P < 0.001]), composite thromboembolism (OR = 1.53 [95% CI: 1.19-1.97; P = 0.001]), and composite bleeding (OR = 1.33 [95% CI: 1.12-1.59; P = 0.001] regardless of the indication, while an SAMe-TT2R2 ≥2 significantly correlated with mortality (OR = 1.32 [95% CI: 1.02-1.70; P = 0.033]). We found no relationship between an SAMe-TT2R2 ≥3 and mortality or between a score ≥2 and clinical outcomes. Conclusions and Relevance: Patients on VKAs with SAMe-TT2R2 ≥3 experienced more adverse events, bleeding, and thromboembolism compared with patients who had an SAMe-TT2R2 <3. However, the score had limited and inconclusive predictability for poor TTR in the study.
Evaluation of oncology infusion pharmacy practices: A nationwide survey
Authors: Boyd AM , Sue C , Khandoobhai A , Vinson B , Shaikh H , Sorenson S , Patel V , Snyder B , Bondarenka C , Koukounas Y , Earl M , Jenkins M 
Published: April 2023

Purpose Oncology care continues to evolve at a rapid pace including provision of infusion-based care. There is currently a lack of robust metrics around oncology infusion centers and pharmacy practice. The workgroup completed a nationwide survey to learn about oncology-based infusion pharmacy services offered. The objective was to highlight consistent, measureable oncology-based infusion pharmacy metrics that will provide a foundation to describe overall productivity including emphasis on high patient-safety standards. Methods A nationwide survey was developed via a workgroup within the Vizient Pharmacy Cancer Care Group beginning in April 2019 and conducted electronically via the Vizient Pharmacy Network from September to November 2020. The survey was designed to capture a number of key metrics related to oncology-based infusion pharmacy services. Results Forty-one sites responded to the survey. Responses highlighted hours of operation (median = 11.5), number of infusion chairs (median = 45). Staffing metrics included 7.1 pharmacist full-time equivalent (FTE) and 7.6 technician FTE per week. 80.5% of sites had cleanrooms and 95.1% reported both hazardous and nonhazardous compounding hoods. 68.3% of sites reported using intravenous (IV) technology, 50.0% measured turnaround time, and 31.4% prepared treatment medications in advance. Conclusion There was variability among oncology infusion pharmacy practices in regard to survey responses among sites. The survey results highlight the need for standardization of established productivity metrics across oncology infusion pharmacies in order to improve efficiency and contain costs in the changing oncology landscape. The survey provides insight into oncology infusion pharmacy practices nationwide and provides information for pharmacy leaders to help guide their practices.
Journey to Diagnosis of Young-Onset Dementia: A Qualitative Study of People with Young-Onset Dementia and their Family Caregivers in Australia
Authors: Lai Michelle , Jeon Yun-Hee , McKenzie Heather , Withall Adrienne 
Published: April 2023

Objectives This study aims to explore the journey to dementia diagnosis and reaction to the diagnosis from the perspective of people with young-onset dementia living in the community from diverse areas in Australia (metropolitan, regional, rural) and their family caregivers. Methods Semi-structured interviews were conducted with community-dwelling people with early to moderate young-onset Alzheimer’s disease ( n = 8) or frontotemporal dementia ( n = 5) and one person with both Alzheimer’s disease and frontotemporal dementia, and family caregivers of community-dwelling people with young-onset Alzheimer’s disease and/or frontotemporal dementia ( n = 28). This study employed interpretive description. Thematic analysis was conducted for emergent themes, comparisons and interplay between themes. Findings The journey to the diagnosis is characterised as involving an extensive period of the gradual worsening of symptoms, drawn out investigations, and difficulties facing the prospect of a diagnosis of young-onset dementia. Participants with young-onset dementia struggled to manage their symptoms and the process of seeking a diagnosis was often slow due to difficulties during the course of their medical investigations and feeling reluctance to face the possibility of having dementia. Once participants finally received the diagnosis of young-onset dementia, participants with young-onset dementia and their family caregivers experienced feelings of devastation and shock, in some cases denial and avoidance, and even, confirmation and relief at having received a diagnosis. In some instances, participants experienced more than one of these reactions. There was a profound realisation by participants that a diagnosis of young-onset dementia had serious implications on their life and future. Conclusion The journey to diagnosis was found to be a drawn-out process and receiving the diagnosis was a shock for both people with young-onset dementia and their family caregivers. The findings highlight the significance of the role healthcare professionals play in both the diagnostic and post-diagnostic journey, particularly in terms of supporting patients with young-onset dementia and their family caregivers.
A microRNA-related single nucleotide polymorphism of the Dicer gene is associated with risk of dermatomyositis
Authors: Peng Chenxing , Zhang Jingjing , Zhang Shasha , Zhang Xiaoyun , Zhao Yufei 
Published: April 2023

To evaluate the correlation of miRNA-related single nucleotide polymorphisms (miR-SNPs) with the risk of dermatomyositis (DM) development. MicroRNAs (MiRNAs) are involved in a variety of activities such as cell differentiation, proliferation, apoptosis, tumorigenesis, and immunological response. MiR-SNPs alter the expression levels of miRNAs, leading to increased susceptibility to DM. We genotyped six miR-SNPs for miRNA processing machinery genes, including XPO5 (rs11077), RAN (rs14035), Dicer (rs3742330), TNRC6B (rs9623117), GEMIN3 (rs197412), and GEMIN4 (rs2740348), and two miR-SNPs for microRNA binding site, including SET8 (rs16917496), and KRT81 (rs3660), in a case-control study to assess the impact of these miR-SNPs on DM risk. Then we assessed cytokine expression and ROS levels in DM to determine the relationship between risk-related miR-SNPs and cytokines. We discovered that Dicer’s (rs3742330) AA genotype had a decreased chance of developing DM than the AG + GG type (odds ratio, 0.527; 95% confidence interval: 0.281–0.987; p = 0.045). The subsequent analysis showed that the AA genotype carrier had greater levels of IL-4 ( p = 0.034). The SNP of Dicer (rs3742330) maybe an attractive predictor of DM, moreover the cytokine of IL-4 may act as the factor that distinguishes SNP of Dicer (rs3742330) into AA and AG + GG.
Relative Efficacy of Cervical Total Disc Arthroplasty Devices and Anterior Cervical Discectomy and Fusion for Cervical Pathology: A Network Meta-Analysis
Authors: Zavras Athan G. , Federico Vincent P. , Butler Alexander J. , Nolte Michael T. , Dandu Navya , Phillips Frank M. , Colman Matthew W. 
Published: April 2023

Study Design Systematic Review and Meta Analysis Objective This study sought to compare patient-reported outcomes, success, complications, and radiographic outcomes directly and indirectly between different cervical total disc arthroplasty (TDA) devices and anterior cervical discectomy and fusion (ACDF). Methods Patients of prospective randomized controlled trials of 1-level cervical TDA with a minimum of 2 years follow up were identified in the literature. A frequentist network meta-analysis model was used to compare each outcome across the different TDA devices included and ACDF using the mixed effect sizes. Results 15 studies were included for quantitative analysis, reporting the outcomes of 2643 patients with an average follow-up was 67.3 months (range: 24-120 months), 1417 of whom underwent TDA and 1226 of whom underwent ACDF. Nine TDA devices were compared to ACDF, including the Bryan, Discover, Kineflex, M6, Mobi-C, PCM, Prestige ST, ProDisc-C, and Secure-C cervical prostheses. Several devices outperformed ACDF for certain outcomes, including Visual Analog Scale (VAS) Arm, Physical Component Score of the Short-Form Health Survey (SF PCS), neurological success, satisfaction, index-level secondary surgical interventions (SSI), and adjacent level surgeries. Cumulative ranking of each intervention assessed demonstrated the highest performance with the M6 prosthesis ( P = .70), followed by Secure-C ( P = .67), PCM ( P = .57), Prestige ST ( P = .57), ProDisc-C ( P = .54), Mobi-C ( P = .53), Bryan ( P = .49), Kineflex ( P = .49), Discover ( P = .39), and ACDF ( P = .14). Conclusion Cervical TDA was found to be superior on most outcomes assessed in the literature of high-quality clinical trials. While most devices demonstrated similar outcomes, certain prostheses such as the M6 were found to outperform others across several outcomes assessed. These findings suggest that the restoration of near-normal cervical kinematics may lead to improved outcomes.