bluuebunny/crossref_metadata_2025_split huggingface dataset:
The effects of applying a novel cleaner on the bonding strength of zirconia surfaces
Authors: Recen Duygu , Yildirim Bengisu , Çeliksöz Özge 
Published: February 2023

This study evaluates how pre-treatment with an MDP-containing cleaning agent (Katana Cleaner, Kuraray) influences the micro-shear bond strength (µSBS) of saliva-contaminated zirconia when used with universal adhesive (UA) systems. Rectangular specimens (2 mm × 12 mm × 15 mm) were obtained (IPS, e.max ZirCAD, MO, B65L17, Ivoclar Vivadent) and divided into three groups; a non-contaminated group (control group)(CON), a contaminated and cleaned with isopropyl alcohol group(ISP), and lastly, a group contaminated and cleaned with an MDP-containing cleaning agent(KAC). Each group was then subdivided into three subgroups according to the UAs used ( n = 12). Composite cylinders were prepared and bonded to each surface with Panavia V5 (Kuraray, Noritake Dental). A µSBS test was performed and the data were evaluated with the two-way analysis of variance (two-way ANOVA) and multiple comparisons test (α = 0.05). The highest µSBS values were obtained in the non-contaminated group ( p < 0.001), regardless of UAs. All subgroups showed lower µSBS values after saliva contamination, but KAC resulted in significantly higher µSBS values than 99% isopropanol ( p < 0.001). Overall, the lowest µSBS value was obtained with 99% isopropanol. The KAC-Clearfil UA subgroup resulted in statistically significantly higher µSBS values than the other UAs ( p = 0.035 and 0.007), although all three UAs resulted in sufficient µSBS values. This study revealed that applying KAC followed by a UA containing phosphate monomers produces promising results for improving µSBS values of zirconia, greater than results using 99% isopropanol. Clinical relevance: An MDP-containing cleaning agent followed by a phosphate monomer containing a universal adhesive is a promising method to obtain acceptable bonds with saliva-contaminated zirconia ceramics.
In vitro Antioxidant and Anti-inflammatory Effects of Erythroxylum cuneatum Leaf Extract on Oxidized Low-density Lipoprotein-stimulated Human Aortic Endothelial Cells
Authors: Adam Siti Khadijah , Shanmugam Nitya , Mohamad Sharlina , Rahman Shamima Abd , Moklas Mohamad Aris Mohd 
Published: February 2023

Background The oxidation of low-density lipoprotein (LDL) by reactive oxygen species (ROS) causes inflammation, which results in the expression of adhesion molecules and monocyte adhesion and migration. This eventually leads to the progression of atherosclerosis. Erythroxylum cuneatum (EC), locally known as “Chinta mula,” is used as traditional medicine in certain countries. However, the scientific evidence of its medicinal properties, particularly related to cardiovascular disease (CVD) is still limited. Objectives This study was designed to evaluate the antioxidant and anti-inflammatory properties of EC leaf extract in protecting against atherosclerosis in vitro. Materials and Methods Human aortic endothelial cells (HAoECs) induced by oxidized LDL (oxLDL) were treated with comparable concentrations (40 and 80 µg/ml) of EC ethanol and acetone leaf extracts. The antioxidant activities were determined by thiobarbituric acid reactive substances (TBARS), ROS, and nitric oxide (NO) production assays. The anti-inflammatory effects of EC leaf extract were evaluated using monocyte adhesion and migration assays and the expression of adhesion molecules, namely, intracellular adhesion molecule-1 (ICAM-1) and human vascular cell adhesion molecule-1 (VCAM-1). Results Both EC extracts possess antioxidant and anti-inflammatory activities against oxLDL-induced HAoECs, which were concentration-dependent. Acetone extract showed significant reduced TBARS levels and increased NO production compared to ethanol extract. It also caused a significant decrease in monocyte adhesion and expression of ICAM-1 as compared to ethanol extract. Conclusion These findings suggest that EC leaf extract is valuable in preventing atherogenesis. The superior effect of EC acetone extract warrants future studies to elucidate its mechanisms in the prevention of CVDs, particularly atherosclerosis.
Impact of pterygium on central corneal thickness measured by optical coherence tomography in older adults
Authors: Dotto Pedro Gabriel , Salomão Solange Rios , Fernandes Arthur Gustavo , Mitsuhiro Marcia Regina Kimie Higashi , Ferraz Nívea Nunes , Furtado João Marcello , Watanabe Sung Song , Cypel Marcela , Sacai Paula Yuri , Cunha Cristina Coimbra , Vasconcelos Galton Carvalho , Morales Paulo Henrique , Cohen Marcos Jacob , Cohen Jacob Moysés , Campos Mauro , Muñoz Sergio , Belfort Rubens , Berezovsky Adriana 
Published: February 2023

Purpose To measure the central corneal thickness (CCT) using anterior segment optical coherence tomography (AS-OCT) in older adults with and without pterygium from the Brazilian Amazon Region Eye Survey (BARES). Methods BARES is a population-based epidemiological cross-sectional study conducted in Parintins city. Participants were residents ≥45 years of age identified through a door-to-door interview. Eligible participants were invited for a comprehensive eye exam. Pterygium occurrence and severity were assessed by ophthalmologists through slit-lamp examination considering its location (nasal or/and temporal) and severity (lesion with extension <3 mm, ≥3 mm not reaching the pupillary margin or ≥3 mm reaching the pupillary margin). CCTs were obtained and measurements from the more severely affected eye were included. Images were analyzed offline by masked observers. Results A total of 671 subjects, 533 (79.4%) with pterygium in at least one eye and 138 (20.6%) without pterygium in either eye, were examined. The mean CCT evaluated by multiple linear regression and adjusted for demographic variables and pterygium severity was 521 ± 34 μm (median = 521; range = 304–665). Decreased CCT was significantly associated with age and pterygium severity. Individuals aged 65–74 years had CCT 7 μm thinner than those aged 45–54 years ( p = 0.044), individuals aged 75 years and older had CCT 15 μm thinner than those aged 45–54 years ( p = 0.001), and eyes with severe pterygium had CCT 33 μm thinner than eyes without pterygium ( p < 0.001). Conclusions The CCT analysis in this population-based sample shows that a thinner cornea is associated with pterygium severity and older age.
A decision-making algorithm proposal for PICCs and midlines insertion in patients with advanced kidney disease: A pilot study
Authors: Bartoli Arianna , Gallieni Maurizio , Cogliati Chiara , Casella Francesco , Calloni Maria , Melchionda Chiara , Heidempergher Marco , Foschi Antonella , Luca Brucato Antonio , Rizzi Giulia , Quici Massimiliano , Gidaro Antonio 
Published: February 2023

Introduction: Kidney Disease Outcomes Quality Initiative clinical practice guidelines recommend avoiding placement of peripherally inserted vascular access devices in patients with an estimated glomerular filtration rate (eGFR) <45 ml/min. On the other hand, many patients with severe chronic kidney disease (CKD) have poor prognosis. This study carried out a global assessment of mortality at 2 years through Charlson Comorbidity Index (CCI) and Beclap score in patients with PICCs or Midlines, assuming that in those with an estimated high mortality rate at 2 years, it could be acceptable to implant a peripheral vascular access device (PVAD) despite the presence of CKD. Methods: We analyzed data on patients with PICCs or Midlines inserted from October 2018 to November 2019. CCI, Beclap score, and eGFR were calculated for each patient at the time of the catheter insertion. We then followed patients for 2 years to assess 2-year mortality for each. Results: One hundred and thirty-one patients were enrolled, 49 (37.4%) had eGFR<45 ml. The 2-year mortality rate was 57.3%. The cut off derived from ROC curve analysis of 15 for Beclap score and 5 for CCI, showed good sensitivity and specificity in predicting mortality of the total population, patients without an oncological disease and patients with eGFR<45 ml/min. Conclusion: CCI and Beclap score are good predictors of mortality at 2 years. Physicians and nurses can use these tools in the evaluation of patients at risk for future dialysis, instead of relying exclusively on renal function to decide whether implanting PICCs, Midlines, or other vascular access devices.
Helping the Helpers: Adaptation and Evaluation of Stress First Aid for Healthcare Workers in the Veterans Health Administration During the COVID-19 Pandemic
Authors: McLean Carmen P. , Betsworth Deborah , Bihday Christine , Daman Megan C. , Davis C. Adrian , Kaysen Debra , Rosen Craig S. , Saxby Dyani , Smith Ann E. , Spinelli Sam , Watson Patricia 
Published: February 2023

Background: Early interventions are needed to support the behavioral health of healthcare staff in the context of the COVID-19 pandemic. Stress First Aid (SFA) is a self-care and peer support model for reducing burnout and stress that is designed for use in high-stress occupations. Methods: We conducted a mixed-methods evaluation of an SFA program in the Veterans Health Administration (VHA). This brief, multi-session, didactic program was adapted for hospital workgroups. Program attendees completed a survey assessing implementation outcomes, burnout, stress, mood, and SFA skills at the beginning ( N = 246) and end ( n = 94) of the SFA program and a subgroup ( n = 11) completed qualitative feedback interviews. Findings: Program acceptability, appropriateness, and feasibility were rated highly. From pre- to post-SFA, the impact of the pandemic on stress and anxiety, as well as proficiency in supporting peers increased. Qualitative findings suggest the program provided a shared language to discuss stress, normalized stress reactions, met a need for stress management tools, and helped staff feel valued, empowered, connected with each other. Staff reported being more aware of their stress, but SFA was insufficient to address many of the systemic sources of burnout and stress. Conclusions and Applications to Practice: While the SFA program was well received, the impact of brief programs is likely to be modest when implemented in the middle of an ongoing pandemic and when burnout arises from chiefly from systemic sources. Lessons learned during the program implementation that may guide future efforts are discussed.
Radial Extracorporeal Shock Wave Therapy Enhances Graft Maturation at 2-Year Follow-up After ACL Reconstruction: A Randomized Controlled Trial
Authors: Zhang Shurong , Wen Aizhen , Li Shengkun , Yao Wei , Liu Chang , Lin Zifan , Jin Zhengbiao , Chen Jiwu , Hua Yinghui , Chen Shiyi , Li Yunxia 
Published: February 2023

Background: Graft maturation is an important prognostic factor for hamstring autograft anterior cruciate ligament reconstruction (ACLR). It remains unclear whether extracorporeal shock wave therapy (ESWT) can promote graft healing after ACLR. Purpose: To evaluate the therapeutic and graft maturation effects of ESWT in hamstring autograft ACLR. Study Design: Randomized controlled trial; Level of evidence, 1. Methods: Between May 18, 2019, and September 20, 2019, we randomly assigned 30 patients who met study inclusion criteria to 2 groups. Patients in the control group followed a 5-week advanced rehabilitation training program (30 minutes/session, 5 times/week) starting at 3 months postoperatively. In the ESWT group, together with the 5-week advanced rehabilitation training, radial ESWT was applied once a week for 5 weeks. Functional scores (Lysholm, International Knee Documentation Committee, and Tegner scores), KT-1000 arthrometer knee laxity measurement, and magnetic resonance imaging scans were assessed at 3 months (baseline), 6 months, and 24 months postoperatively. To evaluate graft maturation, we assessed the graft signal-to-noise quotients (SNQs) of the tibial, intra-articular, and femoral sides on magnetic resonance imaging scans. Data were compared between the ESWT and control groups. Results: In total, 26 patients (13 with ESWT, 13 controls) were assessed. There were no significant between-group differences on any assessment at baseline, and no significant within-group or between-group differences were found in knee laxity at any point. At 24-month follow-up, the ESWT group had significantly higher Lysholm and Tegner scores compared with the controls ( P = .012 and .017, respectively). Regarding graft maturation, at 6-month follow-up, the SNQ of the tibial intraosseous graft was significantly lower in the ESWT group versus controls ( P = .006), but no differences were detected at the femoral intraosseous graft ( P = .321) or the intra-articular graft ( P = .314). At 24-month follow-up, the SNQs of the femoral intraosseous graft and intra-articular graft were significantly lower in the ESWT group versus controls ( P = .020 and .044, respectively) but no difference was found at the tibial intraosseous graft ( P = .579). Conclusion: Both enhanced graft maturation and improved functional scores at 24-month follow-up were seen in patients who received radial ESWT during rehabilitation after hamstring autograft ACLR. Registration: ChiCTR1900022853 (Chinese Clinical Trial Registry).
Patient Decision Making in Anterior Cruciate Ligament Reconstruction: A Discrete Choice Experiment Examining Graft Preference
Authors: Sonnier John Hayden , Paul Ryan W. , Sando Hayden E. , Hall Anya T. , Tjoumakaris Fotios P. , Cohen Steven B. , Freedman Kevin B. 
Published: February 2023

Background: Bone–patellar tendon–bone (BTB) and hamstring autografts are the most common grafts used for anterior cruciate ligament (ACL) reconstruction. Patient preferences should be accounted for as a part of shared decision making. Purpose/Hypothesis: The purpose of this study was to perform a discrete choice experiment that evaluated patient preferences toward ACL autografts. We hypothesized that there would be no difference in patient preferences between groups. Study Design: Cross-sectional study. Methods: Patients aged 18 to 25 years who underwent shoulder arthroscopy at a single institution between 2013 and 2019 were included in the study as a proxy for healthy controls. Patients with a history of ACL tear were excluded. A discrete choice experiment was developed from a literature search and used the following data points as they pertain to BTB or hamstring autograft: risk of developing a significant complication, return-to-play rate, risk of anterior knee pain with kneeling, and risk of additional surgery due to graft failure. Included patients completed a custom survey in which they were asked to choose between “surgery A” (hamstring) and “surgery B” (BTB). Results: A total of 107 participants were included in the analysis. Of these participants, 39 (36.5%) chose surgery A (hamstring) and 68 (63.6%) chose surgery B (BTB). When comparing the hamstring group with the BTB group, there was no significant difference in age, sex, body mass index, race, level of education, or employment status. However, 80.5% of self-reported athletes preferred BTB ( P = .008). When controlling for age, sex, and body mass index, patients in the BTB group were more likely to rate return to sport (risk ratio [RR] = 1.49 [95% CI, 1.18-1.98]; P = .001) and the risk of requiring additional surgery due to graft failure (RR = 1.26 [95% CI, 1.02-1.58]; P = .037) as highly important. Conversely, they were less likely than patients in the hamstring group to rate pain while kneeling (RR = 0.65 [95% CI, 0.98-1.05]; P < .001) and complication risk (RR = 0.75 [95% CI, 0.59-0.94]; P = .013) as important. Conclusion: The study hypothesis was rejected, as patient values did affect ACL graft choice preference. Utilizing patient-selected values in a quantifiable way can benefit the shared decision-making process before ACL reconstruction.
Longitudinal outcomes of employment, income and housing for Flemish care leavers
Authors: Gypen Laura , Stas Lara , West Delphine , Van Holen Frank , Vanderfaeillie Johan 
Published: February 2023

Care leavers are more often unemployed, have lower annual earnings and live in inferior housing circumstances than their peers in the general population. International research has extensively studied and discussed these outcomes. However, in Flanders (the Dutch speaking part of Belgium), no previous quantitative studies are known. This study therefore explores and predicts outcomes on employment, income and housing circumstances of care leavers in Flanders and investigates if these outcomes improve in the years after leaving care. Associations with placement factors are explored to support recommendations to the clinical field. The current study involves 175 care-leavers (both family foster care ( n = 105) and residential care ( n = 70)). Data was collected using a self-reporting questionnaire touching multiple domains. The participants of the study (49 male, 126 female) are between 18 and 27 years old. Care leavers are employed at younger ages but are also more often unemployed than their peers from the general population, they earn significantly less than peers and are more often homeless. On all domains, no significant differences were found between foster- and residential care leavers. Placement characteristics are more declaratory than only the type of care. In the current study, most outcomes improve during the years after leaving care, this supports the theory of emerging adulthood. Although we cannot infer causal effects, care leavers who experienced fewer placement changes and received individual therapy during their time in care tend to have better outcomes in the current study. The same applies for care leavers who were prepared for leaving care and supported after leaving care. Policy makers should focus on increased support regarding breakdown prevention and individual mental health support during the time in care. Preparation for placement ending and aftercare should be provided.
Arthroscopic Anatomic Glenoid Reconstruction in the Unstable Shoulder: Technique, Pearls, and Pitfalls
Authors: Joannette-Bourguignon Maude , Wong Ivan 
Published: February 2023

Background: Anterior shoulder instability with glenoid bone loss is a complex condition. Bankart repairs have higher failure rate in this population and the Latarjet procedure is associated with a high complication rate (15%-30%). A recent technique, the arthroscopic anatomic glenoid reconstruction, safely uses distal tibial allograft to augment the glenoid. Indications: Glenoid or bipolar bone loss in the setting of shoulder instability. Technique Description: A diagnostic shoulder arthroscopy is performed to assess bone loss and capsulolabral tissue. After the preparation of the anterior glenoid, a bone block harvested from a distal tibial allograft is prepared. This technique uses the Halifax portal, a safe, far medial portal to insert the graft, and compress it onto the anterior glenoid using screws. A Bankart repair is then performed, to reduce the capsulolabral complex onto the glenoid. Results: Results at 2 years show a 92% to 100% union of the graft, no recurrence of instability, and improved patient-reported outcome scores. Graft remodeling is regularly observed on postoperative imaging. This procedure may be faster to learn and to perform compared to an arthroscopic Latarjet. Discussion/Conclusion: Arthroscopic anatomic glenoid reconstruction is a safe, minimally invasive procedure to address shoulder instability. It has low complication rate and is associated with improved patient-reported outcomes. Patient Consent Disclosure Statement: The author(s) attest that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form of approval from the patient(s) with this submission for publication.
A validated composite comorbidity index predicts outcomes of CAR T-cell therapy in patients with diffuse large B-cell lymphoma
Authors: Shouse Geoffrey , Kaempf Andy , Gordon Max J. , Artz Andy , Yashar David , Sigmund Audrey M. , Smilnak Gordon , Bair Steven M. , Mian Agrima , Fitzgerald Lindsey A. , Bajwa Amneet , Jaglowski Samantha , Bailey Neil , Shadman Mazyar , Patel Krish , Stephens Deborah M. , Kamdar Manali , Hill Brian T. , Gauthier Jordan , Karmali Reem , Nastoupil Loretta J. , Kittai Adam S. , Danilov Alexey V. 
Published: February 2023

Abstract
Chimeric antigen receptor T-cell therapy (CART) has extended survival of patients with relapsed/refractory diffuse large B-cell lymphoma (DLBCL). However, limited durability of response and prevalent toxicities remain problematic. Identifying patients who are at high risk of disease progression, toxicity, and death would inform treatment decisions. Although the cumulative illness rating scale (CIRS) has been shown to correlate with survival in B-cell malignancies, no prognostic score has been independently validated in CART recipients. We retrospectively identified 577 patients with relapsed/refractory DLBCL indicated for CART at 9 academic centers to form a learning cohort (LC). Random survival forest modeling of overall survival (OS) and progression-free survival (PFS) was performed to determine the most influential CIRS organ systems and severity grades. The presence of a severe comorbidity (CIRS score ≥ 3) in the respiratory, upper gastrointestinal, hepatic, or renal system, herein termed “Severe4,” had the greatest impact on post-CART survival. Controlling for other prognostic factors (number of prior therapies, Eastern Cooperative Oncology Group performance status, BCL6 translocation, and molecular subtype), Severe4 was strongly associated with shorter PFS and OS in the LC and in an independent single-center validation cohort (VC). Severe4 was also a significant predictor of grade ≥3 cytokine release syndrome in the LC, while maintaining this trend in the VC. Thus, our results indicate that adverse outcomes for patients with DLBCL meant to receive CART can be predicted using a simplified CIRS-derived comorbidity index.
What is the optimal management of potentially resectable stage III-N2 NSCLC? Results of a fixed-effects network meta-analysis and economic modelling
Authors: Evison Matthew , Maconachie Ross , Mercer Toby , Daly Caitlin H. , Welton Nicky J. , Aslam Shahzeena , West Doug , Navani Neal 
Published: February 2023

IntroductionThere is a critical need to understand the optimal treatment regimen in patients with potentially resectable stage III-N2 nonsmall cell lung cancer (NSCLC).MethodsA systematic review of randomised controlled trials was carried out using a literature search including the CDSR, CENTRAL, DARE, HTA, EMBASE and MEDLINE bibliographic databases. Selected trials were used to perform a Bayesian fixed-effects network meta-analysis and economic modelling of treatment regimens relevant to current-day treatment options: chemotherapy plus surgery (CS), chemotherapy plus radiotherapy (CR) and chemoradiotherapy followed by surgery (CRS).FindingsSix trials were prioritised for evidence synthesis. The fixed-effects network meta-analyses demonstrated an improvement in disease-free survival (DFS) for CRSversusCS and CRSversusCR of 0.34 years (95% CI 0.02–0.65) and 0.32 years (95% CI 0.05–0.58) respectively, over a 5-year period. No evidence of effect was observed in overall survival although point estimates favoured CRS. The probabilities that CRS had a greater mean survival time and greater probability of being alive than the reference treatment of CR at 5 years were 89% and 86% respectively. Survival outcomes for CR and CS were essentially equivalent. The economic model calculated that CRS and CS had incremental cost-effectiveness ratios of £19 000/quality-adjusted life-year (QALY) and £78 000/QALY compared to CR. The probability that CRS generated more QALYs than CR and CS was 94%.InterpretationCRS provides an extended time in a disease-free state leading to improved cost-effectiveness over CR and CS in potentially resectable stage III-N2 NSCLC.