bluuebunny/crossref_metadata_2025_split huggingface dataset:
Diagnostic performance of gadoxetic acid-enhanced abbreviated magnetic resonance imaging protocol in small hepatocellular carcinoma (≤2 cm) in high-risk patients
Authors: Wang Jia-Hui , Qiu Qian-Sai , Dong San-Yuan , Chen Xiao-Shan , Wang Wen-Tao , Yang Yu-Tao , Sun Wei , Rao Sheng-Xiang 
Published: September 2023

Background Biannual Ultrasound showed insufficient sensitivity in detecting small or early-stage hepatocellular carcinoma (HCC). Abbreviated magnetic resonance imaging (A-MRI) protocols with fewer sequences demonstrated higher HCC detection sensitivity than ultrasound with acceptable cost and examination time. Purpose To compare the diagnostic performance of gadoxetic acid-enhanced A-MRI with a full sequence MRI (F-MRI) protocol for small HCC (≤2 cm) in cirrhotic or hepatitis B virus-infected high-risk patients. Material and Methods Two hundred and four consecutive patients with 166 pathologically confirmed small HCC who underwent preoperative gadoxetic acid-enhanced MRI were retrospectively included. A-MRI set comprised T1-weighted hepatobiliary phase imaging, T2-weighted imaging, diffusion-weighted imaging and apparent diffusion coefficient mapping. Two independent radiologists blinded to clinical data assessed the A-MRI set and F-MRI set. Per-patient HCC and per-lesion HCC diagnostic performance were compared. Results Per-patient HCC detection sensitivity of A-MRI set was 93.8% and 91.2% for observer 1 and observer 2, and, for the F-MRI set, the per-patient HCC detection sensitivity was 96.6% and 95.2%, respectively. There was no significant difference in per-patient sensitivity, specificity and per-lesion HCC detection sensitivity between the two imaging sets for both readers. ( P = 0.06–0.25) The A-MRI set showed higher sensitivity on HCC without arterial phase hyperenhancement, and the F-MRI set demonstrated with higher sensitivity on HCC with arterial phase hyperenhancement ( P < 0.05). Conclusion A-MRI using diagnostic criteria including hypointensity on hepatobiliary phase plus mild to moderate hyperintensity on T2-weighted imaging or restricted diffusion demonstrated comparable sensitivity and specificity for small HCC compared to the F-MRI protocol in high-risk patients.
Effect of S-ketamine on the intraoperative Surgical Pleth Index in patients undergoing video-assisted thoracoscopic surgery: a single-center randomized controlled clinical trial
Authors: Chen Xian , Zhu Yumin , Peng Ke , Wang Qinyun , Feng Changdong 
Published: September 2023

Objective To investigate whether S-ketamine affects the Surgical Pleth Index (SPI) during video-assisted thoracoscopic surgery. Methods Eighty-four patients undergoing video-assisted thoracoscopic lung lobectomy were enrolled. They were randomly assigned to an S-ketamine group (group S) and an equivalent normal saline group (group N). SPI values were recorded; and pain score on a numerical rating scale (NRS), the consumption of opioids, rescue analgesia, and post-operative nausea and vomiting (PONV) were evaluated. Results The SPI and heart rate of the S-ketamine group were significantly lower 30 minutes after the start of surgery and at the end. The NRS score was lower in the S-ketamine group 6 and 12 hours postoperatively, but there were no differences in mean blood pressure or the NRS score 24 and 48 hours postoperatively. Rescue analgesia was required less frequently by the S-ketamine group, but the incidence of PONV did not differ between the groups. Conclusions S-ketamine was associated with lower intraoperative SPI 30 minutes after the start and at the end of surgery. It also reduced opioid use intraoperatively and the NRS scores 6 and 12 hours postoperatively. Trial registration: Chinese Clinical Trial Registry (ChiCTR2000040012), 18/11/2020.
Enhancing professional identity of first-year occupational therapy students with the community-academia student tutoring program
Authors: Tal-Saban Miri , Zaguri-Vittenberg Shahar , Weintraub Naomi 
Published: September 2023

Introduction:Delayed professional identity of occupational therapists inhibits successful transition from student to professional. One of the objectives of development of the Community–Academia Student Tutoring (CAST) program is to encourage professional identity formation among first-year undergraduate occupational therapy students. It focuses on developing competence in communication and professional knowledge through a learning-community setting while interacting with individuals with disabilities, thus enhancing students’ self-reflection abilities.Methods:Mixed-method design assessing change before and after participation among 193 students, in competence components essential for professional identity, and factors supporting its formation. Open-ended questions assessed the students’ perceived contribution of the CAST program.Results:Significantly higher competence in knowledge about people with disabilities and relating to them; increased sense of belonging to a learning community and self-reflection abilities compared to before. Relationship with a person with disability and belonging to a learning community predicted 25.4% of the variance in perceptions of program contribution. Central in the students’ experience were development of self-reflection abilities and interpersonal relationship skills, and learning occupational-therapy concepts through meeting people with disabilities.Conclusions:First-hand relationships with people with disability and self-reflection in a structured learning-community setting, may help develop first-year students’ communication skills and their professional identity as occupational therapists.
Study on mechanics and high temperature tribological properties of porous bearing cage material
Authors: Zhang Zhuangya , Zhang Hui , Wang Junhua , Qin Shikun , Duan Xinsheng , Duan Mingde 
Published: September 2023

To meet the self-lubricating performance requirements of aerospace bearing cages, poly-ether-ether-ketone (PEEK)-based self-lubricating bearing cage materials were prepared based on the Fused Deposition Molding (FDM) process. The mechanical and tribological properties under high temperature condition (200°C) of the porous self-lubricating materials were researched. The results of microstructure analysis of porous sample showed that under laboratory conditions, NaCl can exhibit excellent pore-forming effect and could be effectively removed. The mechanical test results showed that the mechanical properties of the samples showed a significant decrease with the increase in porosity, and were affected by the synergistic effect of pore creation. However, the mechanical properties of heat-treated samples can meet the performance requirements of the bearing cage. The results of the tribological performance tests under high temperature conditions showed that the wear process of the dense samples was more smoother. Further comparing with the tribological properties at room temperature, it was found that the wear resistance of PEEK samples decreased under high temperature conditions. The normalized results of the mechanical and tribological properties data show that the samples with 50 wt% of porogenic agent can express the most balanced and excellent overall performance.
Association of regulatory T cells with renal outcomes in patients with proliferative lupus nephritis
Authors: Wang Jingjing , Zhu Mengyue , Jiao Chenfeng , Xu Xiaodong , Xu Feng , Liang Dandan , Liu Zhengzhao , Chen Yinghua , Zhang Haitao 
Published: September 2023

Background Despite progress in the diagnosis and treatment of proliferative lupus nephritis (PLN), the prognosis remains unfavorable. Previous investigations have suggested that the deficiency of regulatory T cells (Tregs) is involved in the pathogenesis of systemic lupus erythematosus (SLE) and lupus nephritis (LN). But the prognostic value of Tregs in PLN remains controversial. This study aimed to investigate the association of Tregs with renal outcomes in patients with PLN. Methods The baseline and follow-up data of patients with biopsy-proven PLN were collected in this study. All patients were divided into two groups according to whether the renal endpoint event occurred. Clinicopathologic features and therapeutic responses were compared between the two groups. Cox regression analyses curve fitting and threshold effect analysis were implemented to investigate the relationship between Tregs level and the long-term renal outcomes. The renal endpoint was defined as end-stage kidney disease (ESKD) or doubling the SCr value. Results A total of 405 PLN patients were included. After a follow-up of 71.53 (53.13–97.47) months, 42 (10.4%) patients reached the renal endpoint. The Treg cell counts (16/μL) in the renal endpoint group were significantly decreased than that in the non-renal endpoint group ( p < 0.001). Univariate and multivariate Cox regression analyses showed that the high level of Tregs was an independent protective factor for the long-term renal prognosis of PLN. Smooth curve fitting of the generalized additive mixed model analysis indicated that the risk of renal endpoint first decreased with Tregs and then slightly increased along with Treg cell levels. The segmented linear model revealed that when Treg cell counts <46/μL, the risk of renal endpoint decreased by 6.8% for every 1 μL increase in Treg levels ( p = 0.0029). Conclusion Treg cell counts are closely related to the long-term renal outcomes of patients with PLN, and increasing Treg cell levels may play an important role in improving the prognosis of the kidney, but there may be a turning point (i.e., threshold effect) at the Treg cell counts that leads to directional changes in the renal outcomes.
Sociodemographic Disparities in Craniosynostosis: A Systematic Review
Authors: Blum Jessica D. , Ng Jinggang J. , Craig Jasmine , Smith Rachel , Kota Anchith , Moura Steven P. , Ford Avery D. , Kalluri Manasa H. , Garland Catharine , Cho Daniel Y. 
Published: September 2023

Objective Given the consequences of delayed treatment and diagnosis of craniosynostosis, this study reviews the literature on sociodemographic risk factors and disparities associated with delayed craniosynostosis treatment. Design A systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A literature search of PubMed/Medline and Embase was performed by two independent reviewers. Included studies discussed craniosynostosis health disparities. Demographic characteristics and outcomes were analyzed. Setting Not applicable. Patients Patients with craniosynostosis. Interventions Standard surgical intervention for craniosynostosis. Results Our literature search yielded 273 studies, of which 18 were included for analysis. Included studies represented data from 31 256 U.S. patients with craniosynostosis. Sixty percent of patients (n = 16 510) were White, 13.8% were Hispanic/Latino, 6.2% were Black/African American, 1.3% were Asian, 0.3% were American Indian or Alaska Native, and 0.1% were Native Hawaiian or Pacific Islander. Average age at surgery was 6.36 months for White patients, 10.63 months for Black patients, and 9.18 months for Hispanic patients. Minority racial and/or ethnic status was a risk factor for delayed presentation, and increased incidence of open surgery, complication rates, hospital charges, operative time, anesthesia duration, and hospital length of stay. Government-funded health insurance was associated with delayed intervention and increased complications. Conclusions Minority craniosynostosis patients experience delays in intervention and increased complication rates. Our findings highlight the importance of expedited and equitable referrals, screenings, and treatment, and the need for a standardized approach to investigating longitudinal demographic and outcomes data in this population.
The Effect of Adverse Childhood Experiences on ADHD Symptom Reporting, Psychological Symptoms, and Cognitive Performance Among Adult Neuropsychological Referrals
Authors: Alfonso Demy , Basurto Karen , Guilfoyle Janna , VanLandingham Hannah B. , Gonzalez Christopher , Ovsiew Gabriel P. , Rodriguez Violeta J. , Resch Zachary J. , Ulrich Devin M. , Soble Jason R. 
Published: September 2023

Objective: Adverse childhood experiences (ACEs) are early life experiences that influence mental health outcomes, though there are mixed findings reported in relation to attention deficit hyperactivity disorder (ADHD) symptoms. The current study compared adults who experienced ACEs on measures of ADHD symptom reporting, psychological symptoms, and neurocognitive test performance. Method: The sample ( n = 115) had mean age of 28.42 ( SD = 6.46); educational attainment of 16.47 years ( SD = 1.99); and was 35% male/65% female and racially/ethnically diverse. Participants completed measures of ACEs, ADHD symptoms, psychopathology, and perceived stress, as well as neuropsychological tests. Results: The high ACEs group endorsed higher levels of childhood/adulthood inattentive, impulsive, and hyperactive symptoms, and overall childhood symptoms when compared to the low ACEs group. Conclusions: This study provides a more comprehensive understanding of the association between ACEs and cognitive/mental health outcomes. Greater ACEs resulted in higher ADHD symptom reporting but not significantly greater psychological symptoms or worse neurocognitive performance.
Economic assessment of the impact of telecare on the use of social care resources using a zero-inflated, hierarchical linear statistical model
Authors: Moss Joe WE , Bracewell Josh , Waters Errol , Wright Dianne , Hex Nick 
Published: September 2023

Introduction There is an ever-increasing demand for social care in the UK, with expenditure predicted to double to £56 billion by 2038/39. Many councils are under budget restrictions putting pressure on the number of services provided and their quality. Telecare complements social care and involves the implementation of technology to keep individuals more independent. Methods This study utilised a retrospective time-series analysis of data provided by Lancashire County Council between the period January-2013 to March-2018. A generalised linear mixed model (GLMM) was used to control for potential confounders. Two groups were identified: those using telecare (telecare group, n = 699) and those who did not (control group, n = 839). Results The fixed effects data showed that telecare group start £75 per week lower in cost and as time progressed this reduced further by 9p per service user per week. In contrast, control group costs rose 5p per week per user. This effect was independent of age but was affected by measure of dependency. Analysis was then utilised to make predictions based on weighted averages. The scenario showed a total difference of £4,949 per service user over the whole year. A second scenario pro-rata’d costs for the full year showed a difference of £6,214, where telecare would avoid costs of £17 million per year. Discussion This analysis demonstrates that there is evident potential for the use of telecare to reduce social care resource use and costs. This study also highlights the use of a GLMM as a novel method of analysing observed data by controlling confounders.
Total wrist arthroplasty with the Freedom® prosthesis: a short-term follow-up
Authors: Brown Matthew , Wharton Rupert , Begum Rumina , Trail Ian , Hayton Mike , Talwalkar Sumedh 
Published: September 2023

We retrospectively reviewed our series of primary total wrist arthroplasty with the Freedom® prosthesis. The primary outcome measure was revision, and secondary measures included radiographic loosening, pain, complications, movement range, grip strength and patient-reported measures. We reviewed 12 implants in 11 patients (mean age 59 years, range 45–80) with a mean radiological and clinical follow-up of 2.7 and 3 years, respectively. One radial component failed to integrate and was revised at Day 84. Four carpal components demonstrated areas of lucency. There was a statistically significant reduction in pain, and total flexion–extension increased. Despite high patient satisfaction on a ten-point visual analogue scale score (mean 8.7 out of 10), the mean patient-rated wrist evaluation, Quick Disabilities of the Arm, Shoulder and Hand and Patient Evaluation Measure scores were 52, 55 and 53, respectively. The Freedom® implant reduced pain and preserved wrist movement in our patients; however, annual surveillance is recommended due to the high incidence of early carpal component lucency. Level of evidence: IV
An alternative treatment for degenerative triangular fibrocartilage complex injuries with distal radioulnar joint instability: first experience with 48 patients
Authors: Shaer Sanharib Al , van der Palen Job , Teunissen Joris , Fink Alexandra , van der Heijden Brigitte , Zöphel Oliver ,   The Hand Wrist Study Group
Published: September 2023

Treatment of ulnar impaction syndrome combined with distal radioulnar joint instability due to irreparable degenerative triangular fibrocartilage complex injuries can be complex. We describe the outcomes of a novel technique for restoring distal radioulnar stability due to ulnar impaction syndrome using a distally based extensor carpi ulnaris tendon strip combined with ulnar shortening osteotomy in 48 patients. Patients were assessed using standardized outcome measurements. The patient-rated wrist/hand evaluation total score improved from 66 (SD 15) at intake to 40 (SD 25) at 3 months, and 28 (SD 23) at 12 months postoperatively ( p < 0.001). Wrist extension and flexion improved significantly at 12 months from 53° (SD 11) to 65° (SD 8) ( p < 0.001) and from 45° (SD 10) to 56° (SD 12) ( p = 0.01), respectively. Adding a distally based longitudinal extensor carpi ulnaris strip to ulnar shortening osteotomy for restoring distal radioulnar joint stability seems to be an effective treatment in patients with irreparable degenerative triangular fibrocartilage complex injuries due to ulnar impaction syndrome.  Level of evidence: IV
Outcomes After Meniscal Root Repair in Patients With and Without Advanced Patellofemoral Chondromalacia: Comparison at 2-Year Follow-up
Authors: Murphy Sierra N. , Brinkman Joseph C. , Tummala Sailesh V. , Renfree Sean P. , Kemper Kacey J. , Economopoulos Kostas J. 
Published: September 2023

Background: Meniscal root repair can improve patient outcomes significantly; however, several contraindications exist, including arthritic change to the medial or lateral tibiofemoral compartments. Purpose/Hypothesis: The purpose of this study was to evaluate the outcomes of meniscal root repair in patients with advanced patellofemoral chondromalacia (PFC). It was hypothesized that the presence of advanced PFC would not significantly affect the postoperative outcomes. Study Design: Cohort study; Level of evidence, 3. Methods: A retrospective review was conducted of patients who underwent meniscal root repair with at least 2 years of follow-up data. Patients with chondromalacia as determined by arthroscopic visualization (defined as Outerbridge grade 3 or 4) were placed in the PFC group; patients with Outerbridge grade 0 to 2 chondromalacia were placed in the non-PFC group. Outcomes were measured by the Lysholm knee scoring scale and the International Knee Documentation Committee (IKDC) Subjective Knee Form. Clinical outcomes including complications were also recorded. Quantitative data between the groups were analyzed using the 2-tailed independent-samples t test. Results: Overall, this study included 81 patients (35 in the PFC group, 46 in the non-PFC group). The mean follow-up times were 25.1 months in the PFC group and 24.8 months in the non-PFC group. In both groups, Lysholm and IKDC scores improved significantly with 24-month Lysholm scores averaging 85.86 in the PFC group and 86.61 in the non-PFC group ( P = .62) and 24-month IKDC scores averaging 77.66 for the PFC group and 79.59 for the non-PFC group ( P = .45). The cohorts demonstrated similar rates of retear, arthrofibrosis, infection, and progression to total knee arthroplasty. Conclusion: The presence of advanced PFC was not associated with inferior outcomes in patients who underwent posterior meniscal root repair, and rates of recurrent tears, postoperative infection, arthrofibrosis, and conversion to total knee arthroplasty were similar between the study groups. These findings suggest that PFC may not significantly alter the results of meniscal root repair and should not be considered an absolute contraindication for this procedure.
Association of Medial Meniscus Root Tears and Nonroot Tears With Worsening of Radiographic Knee Osteoarthritis
Authors: Chambers Caitlin C. , Lynch John A. , Feeley Brian T. , Nevitt Michael C. 
Published: September 2023

Background: Medial meniscus root tears (RTs) are associated with the development and worsening of knee osteoarthritis (OA), but little is known about their progression when compared with meniscal tears that spare the root (nonroot tears; NRTs). Purpose: To compare radiographic worsening of OA in knees with RTs versus NRTs and to identify factors associated with radiographic worsening of OA in knees with RTs. Study Design: Cohort study; Level of evidence, 3. Methods: Using the Osteoarthritis Initiative database, we included knees with medial meniscus RTs and NRTs present at the baseline visit (baseline tears) and new RTs and NRTs observed at 12- to 48-month annual follow-up visits (incident tears). Worsening of radiographic OA was defined for baseline tears as an increase in Kellgren-Lawrence grade (KLG) during the subsequent 12 months of follow-up; for incident tears, worsening was defined as either concurrent (increase in KLG over the 12 months preceding tear appearance on magnetic resonance imaging) or subsequent (increase in KLG during the 12 months after tear appearance). Odds ratios (ORs), adjusted for covariates, were calculated for the association of worsening by type of tear. Results: Included were 39 knees with baseline RTs, 633 knees with baseline NRTs, 33 knees with incident RTs, and 234 knees with incident NRTs. Radiographic OA worsening subsequent to meniscal tear identification was no different for baseline RTs (15%) or baseline NRTs (14%; adjusted OR, 1.34; 95% CI, 0.52-3.47), nor did subsequent worsening differ for incident RTs (19%) versus incident NRTs (18%; adjusted OR, 0.52; 95% CI, 0.15-1.83). Concurrent radiographic OA worsening was seen at a significantly higher rate for incident RTs (64%) versus incident NRTs (21%; adjusted OR, 3.00; 95% CI, 1.21-7.47). Incident RTs in knees without radiographic OA (KLG 0-1) before the tear had a high rate of worsening (94%, n = 16) and were more likely to worsen than those in knees with radiographic OA (KLG ≥2) present before the tear. Conclusion: Compared with NRTs, incident RTs were associated with a significantly increased risk of worsening radiographic OA over a 12-month period concurrent with the appearance of the tear. Incident RTs in knees without radiographic OA at baseline had a high rate of worsening.