bluuebunny/crossref_metadata_2025_split huggingface dataset:
Is Workload Associated With Internal Impingement in Professional Baseball Pitchers? An Analysis of Days of Rest, Innings Pitched, and Batters Faced
Authors: Chalmers Peter N. , Mcelheny Kathryn , D’Angelo John , Ma Kevin , Rowe Dana , Erickson Brandon J. 
Published: August 2023

Background: Internal impingement is a common cause of shoulder pain and dysfunction in baseball pitchers. Purpose/Hypothesis: The purpose of this study was to determine if the amount of rest days between outings, the number of innings pitched in each outing, and the number of batters faced in each outing are risk factors for internal impingement in professional baseball pitchers. It was hypothesized that a higher workload would significantly increase a pitcher’s risk of developing internal impingement. Study Design: Case-control study; Level of evidence, 3. Methods: All professional (Major and Minor League) baseball pitchers who were diagnosed with internal impingement between 2011 and 2017 were identified using the Major League Baseball’s Health and Injury Tracking System. A separate player usage data set was used to determine workload. The authors compared workload variables (days of rest, innings pitched, and batters faced per game) between each of 4 injury-exposure groups (pitchers with documented internal impingement <2, <6, <12, and >12 weeks after a game) and a control group of pitchers with no internal impingement using Student t tests or Mann-Whitney U tests. In a within-pitcher paired analysis of the injury groups, the workload variables during 3 acute periods (<2, <6, and <12 weeks preinjury) were compared with the baseline values (>12 weeks preinjury). Results: Overall, there were 624 professional baseball pitchers diagnosed with internal impingement during the study period. Compared with pitcher games (n = 213,964), pitchers in all 4 injury-exposure groups had significantly more innings pitched per game ( P ≤ .003 for all) and faced significantly more batters per game ( P < .001 for all). There were significantly more starting pitchers in each of the injury-exposure groups when compared with the controls ( P < .001 for all). However, when comparing acute and baseline workloads in the pitchers diagnosed with internal impingement, there were no significant differences in the number of innings pitched, batters faced, or days of rest. Conclusion: This analysis revealed significantly greater pitcher workload and percentage of starting pitchers in professional baseball players diagnosed with internal impingement when compared with healthy controls. However, this injury did not seem to be associated with an acute increase in workload.
Eustachian Tube Teratoma: A Rare Entity
Authors: Gheorghe Dan Cristian , Enculescu Augustina , Stanciu Adina Elena , Epure Veronica , Zamfir-Chiru-Anton Adina 
Published: August 2023

Introduction: Teratomas, tumors derived from all 3 fetal germ cell layers, are rarely located in the head and neck region and extremely rare in the Eustachian tube area. Case report: The authors present the case of a 2 years old child with chronic ear discharge. Referral diagnosis was tumor or cyst of the temporal bone. Intraoperatively, a solid, hairy tumor located inside the Eustachain tube, with extension into the middle ear space was discovered and removed. Histology revealed a mature teratoma. Review of the literature showed reports of rare similar cases of Eustachian tube teratomas, differentiating themfrom hairy polyps of the rhynopharynx. The imaging of our patient, the surgical techique for removal of the tumor and long term follow-up are detailed. Conclusions: Teratomas located inside the Eustachian tube are exceptional. Their removal should be carefully planned in view of their long term anatomical sequelae and in order to avoid long term postoperative morbidity.
Brentuximab vedotin plus AVD for Hodgkin lymphoma: incidence and management of peripheral neuropathy in a multisite cohort
Authors: Bowers Jackson T. , Anna Jacob , Bair Steven M. , Annunzio Kaitlin , Epperla Narendranath , Pullukkara Jerrin Joy , Gaballa Sameh , Spinner Michael A. , Li Shuning , Messmer Marcus R. , Nguyen Joseph , Ayers Emily C. , Wagner Charlotte B. , Hu Boyu , Di Mengyang , Huntington Scott F. , Furqan Fateeha , Shah Nirav N. , Chen Christina , Ballard Hatcher J. , Hughes Mitchell E. , Chong Elise A. , Nasta Sunita D. , Barta Stefan K. , Landsburg Daniel J. , Svoboda Jakub 
Published: August 2023

Abstract
Brentuximab vedotin (BV) in combination with doxorubicin, vinblastine, and dacarbazine (AVD) is increasingly used for frontline treatment of stage III/IV classical Hodgkin lymphoma (cHL). Peripheral neuropathy (PN) was the most common and treatment-limiting side effect seen in clinical trials but has not been studied in a nontrial setting, in which clinicians may have different strategies for managing it. We conducted a multisite retrospective study to characterize PN in patients who received BV + AVD for newly diagnosed cHL. One hundred fifty-three patients from 10 US institutions were eligible. Thirty-four patients (22%) had at least 1 ineligibility criteria for ECHELON-1, including stage, performance status, and comorbidities. PN was reported by 80% of patients during treatment; 39% experienced grade (G) 1, 31% G2, and 10% G3. In total, BV was modified in 44% of patients because of PN leading to BV discontinuation in 23%, dose reduction in 17%, and temporary hold in 4%. With a median follow-up of 24 months, PN resolution was documented in 36% and improvement in 33% at the last follow-up. Two-year progression-free survival (PFS) for the advanced-stage patients was 82.7% (95% confidence interval [CI], 0.76-0.90) and overall survival was 97.4% (95% CI, 0.94-1.00). Patients who discontinued BV because of PN did not have inferior PFS. In the nontrial setting, BV + AVD was associated with a high incidence of PN. In our cohort, which includes patients who would not have been eligible for the pivotal ECHELON-1 trial, BV discontinuation rates were higher than previously reported, but 2-year outcomes remain comparable.
A feasibility randomized controlled trial of an mHealth app vs booklets for patient-facing guidelines in adults with SCD
Authors: Cronin Robert M. , Quaye Nives , Liu Xin , Landes Kristina , Crosby Lori E. , Kassim Adetola A. , Volanakis Emmanuel J. , Schnell Patrick M. , DeBaun Michael R. 
Published: August 2023

AbstractDespite the increased number of evidence-based guidelines for sickle cell disease (SCD), dissemination of evidence-based guidelines in lay language for individuals or families with SCD has not been evaluated. We conducted a feasibility randomized controlled trial to determine the acceptability of a mobile health (mHealth) app with patient-facing guidelines to improve the knowledge of individuals with SCD about SCD-specific knowledge and reduce hospitalizations. Primary outcome measures include recruitment, retention, and adherence rates. Adults with SCD were enrolled at 2 sickle cell centers between 2018 and 2022. Participants were randomized to receive either an mHealth app + booklet with patient-facing guidelines or a booklet with the guidelines alone. Participants completed surveys at baseline and a final 6-month visit. Approximately 67 of 74 (91%) agreed to participate and were randomized, with 50 of 67 (75%) completing all the study components. All participants who completed the study in the treatment arm used the app. Our results demonstrated high recruitment, retention, and adherence rate for the first randomized trial for an mHealth app with patient-facing guidelines in adults with SCD. This clinical trial was registered at https://www.clinicaltrials.gov/ as #NCT03629678.
Cutting Force Fluctuation Suppression and Error Homogenization of Noncircular Gear Hobbing Based on the Tool Shifting Method
Authors: Li Dazhu , Han Jiang , Tian Xiaoqing , Xia Lian 
Published: August 2023

AbstractThe current research on noncircular hobbing mainly focuses on the linkage model and motion realization. However, the intermittent cutting characteristics of hobbing would increase uncertainties in the manufacturing process. In this paper, a hobbing machining model with tool-shifting characteristics was proposed to solve the problems of cutting force fluctuation and inconsistency of tooth profile envelope accuracy at different positions of the pitch curve in noncircular gear hobbing. Based on the unit cutting force coefficient method, the undeformed chip volume generated by interrupted cutting was used to characterize the fluctuation trend of the hobbing force. The fluctuation characteristics of the cutting force generated by different hobbing models were compared and analyzed. Using the equivalent gear tooth and hob slotting numbers, an analysis model of the tooth profile envelope error of the noncircular gear was constructed. Subsequently, the tooth profile envelope errors at different positions of the pitch curve were compared and analyzed based on the constructed model. The transmission structure of the electronic gearbox was constructed based on the proposed hobbing model, and the hobbing experiment was conducted based on the self-developed noncircular gear CNC hobbing system. This paper proposes a hobbing method that can effectively suppress the fluctuation of the peak and whole circumference cutting force and reduce the maximum envelope error of the whole circumference gear teeth.
Estimation of joint value in mobility as a service ecosystems under different orchestrator settings
Authors: Kraus Lisa , Proff Heike , Jeppe Arne 
Published: August 2023

Abstract
Background
Ecosystems aim to create joint value that is higher than the sum of the value added of the single companies combined. However, for Mobility as a Service (MaaS) ecosystems, the economic potential is not yet proven. This concurs with the definition of MaaS ecosystems and the debate about who should be the orchestrator – a private or a public entity.

Purpose
This article therefore delivers a first approach to quantify the joint value of publicly and privately orchestrated MaaS ecosystems.

Methodology
The value estimationations are based on potential user preference analysis combined with market simulation and different volume discounts granted to a private orchestrator in the agency.

Findings
The results show that due to the high costs of all ecosystem actors in this asset-heavy industry, no profits are made in all constellations. The least value is destroyed when a private orchestrator receives 2% discount. Thus, added value must be created, for example through data analysis and advertising. Cities and governments must hence reallocate subsidies and support all MaaS actors to build a viable ecosystem.
Variables associated to intensive care unit (ICU)-mortality among patients admitted to surgical intensive care unit in Ethiopia: a retrospective observational study
Authors: Zewudie Misgan Mulatie , Melesse Debas Yaregal , Filatie Tesera Dereje , Zeleke Mulualem Endeshaw 
Published: August 2023

Abstract
Background
The present study aimed to assess variables associated to ICU-mortality among patients admitted to surgical intensive care unit in Ethiopia.

Methods
A Hospital-based retrospective follow-up study was conducted on all patients who were admitted to the surgical intensive care unit. Data were extracted from patients’ charts with a pretested data extraction tool, entered into Epi-data 4.6.0, and analyzed with STATA- 14. Bivariate and multivariate Cox proportional hazards regression models were fitted.

Results
Of the total study participants (388), 148 (38.1%) patients admitted to the surgical intensive care unit died during the follow-up period with a median survival time of 11 days. Potassium level < 3.5 mmol/L (adjusted hazard ratio ( AHR): 3.46, 95% CI (1.83 6.55), potassium level > 5.0 mmol/L (AHR:2.41, 95% CI (1.29–4.51), hypoxia (AHR:1.66, 95% CI (1.10–2.48), Glasgow Coma Scale (GCS) score < 9 (AHR: 4.06, 95% CI (1.51–10.89), mechanical ventilation (AHR:12, 95%CI (3–45), absence of thromboprophylaxis (AHR:10.8,95% CI (6.04–19.29), absence of enteral feeding (AHR:3.56, 95% CI (2.20–5.78) were variables associated with ICU-mortality among patients admitted to surgical intensive care unit.

Conclusions
The overall ICU-mortality of patients admitted to our surgical intensive care unit was higher compared to patients admitted to similar intensive care unit in developed countries. The variables associated to ICU-mortality among patients admitted to surgical intensive care unit were abnormal serum potassium level, lower GCS score, mechanical support, hypoxia, absence of thromboprophylaxis, and enteral feeding.
Acute hyperglycemia, a rabble-rouser or innocent bystander? A prospective analysis of clinical implications of acute hyperglycemia in STE-ACS patients
Authors: Kumar Rajesh , Ammar Ali , Kumar Ashok , Ali Ahsan , Talpur Mir Fahad Hussain , Rahooja Kubbra , Chachar Kalsoom , Wadhwa Anesh , Sial Jawaid Akbar , Saghir Tahir , Khan Sohail , Hakeem Abdul , Qamar Nadeem , Karim Musa 
Published: August 2023

Abstract
Background
Acute hyperglycemia is considered an independent prognosticator of both in-hospital and long-term outcomes in patients with acute coronary syndrome (ACS). This study aimed To analyze the incidence of acute hyperglycemia and its impact on the adverse in-hospital outcome in patients with STE-ACS undergoing primary percutaneous coronary intervention (PCI).

Methods
In this study, we enrolled patients presenting with STE-ACS and undergoing primary PCI at a tertiary care cardiac center. Acute hyperglycemia was defined as random plasma glucose (RBS) > 200 mg/dl at the time of presentation to the emergency room.

Results
Of the 4470 patients, 78.8% were males, and the mean age was 55.52 ± 11 years. In total, 39.4% (1759) were found to have acute hyperglycemia, and of these, 59% (1037) were already diagnosed with diabetes. Patients with acute hyperglycemia were observed to have a higher incidence of heart failure (8.2% vs. 5.5%; p < 0.001), contrast-induced nephropathy (10.9% vs. 7.4%; p < 0.001), and in-hospital mortality (5.7% vs. 2.5%; p < 0.001). On multivariable analysis, acute hyperglycemia was found to be an independent predictor of mortality with an adjusted odds ratio of 1.81 [1.28–2.55]. Multi-vessel disease (1.73 [1.17–2.56]), pre-procedure left ventricular end-diastolic pressure (LVEDP) (1.02 [1.0-1.03]), and Killip class III/IV (4.55 [3.09–6.71]) were found to be the additional independent predictors of in-hospital mortality.

Conclusions
Acute hyperglycemia, regardless of diabetic status, is an independent predictor of in-hospital mortality among patients with STE-ACS undergoing primary PCI. Acute hyperglycemia, along with other significant predictors such as multi-vessel involvement, LVEDP, and Killip class III/IV, can be considered for the risk stratification of these patients.
Effects of Mindfulness-Based Elder Care (MBEC) on symptoms of depression and anxiety and spiritual well-being of institutionalized seniors with disabilities: a randomized controlled trial
Authors: Hsiung Yvonne , Chen Yi-Heng , Lin Li-Chan , Wang Yu-Han 
Published: August 2023

Abstract
Background
Despite the need to incorporate seniors from various settings into mindfulness-based empirical research, issues of geriatric frailties and non-compliance remain. This study aimed to evaluate the effects of a mindfulness-based elder care (MBEC) program on mental health and spiritual well-being among seniors with disabilities in long-term care residential settings.

Methods
This single-blind, randomized controlled trial (RCT) randomly assigned seventy-seven participants into an MBEC group or control group of an eight-week MBEC program. Participants were assessed every four weeks at baseline (T0), mid-intervention (T1), post-intervention (T2) and follow-up (T3) using the Geriatric Depression Scale Short Form (GDS-SF), the State-Trait Anxiety Inventory (STAI) and the Spiritual Well-Being Scale (SWBS), respectively.

Results
Linear mixed model (LMM) showed that MBEC participants’ mental health improved significantly after completing the intervention; compared with controls, the MBEC group exhibited significantly lower anxiety (state-anxiety at T2; trait-anxiety at T2 and T3) and fewer depressive symptoms. Spiritual well-being was also significantly enhanced compared to that in the control group.

Conclusions
MBEC has positive effects on both mental health and spiritual well-being outcomes among seniors with disabilities. In long-term care facilities, seniors with abilities have the potential to adhere to and engage in activities of a mindfulness-based intervention. This low risk, easily accessible, and effective 8-week program is recommended to be integrated into regular long-term care institutional routines.

Trial registration
This study was registered with Clinical Trial Registry (ClinicalTrials.gov – U.S. National Library of Medicine #NCT05123261. Retrospectively registered on 07/04/2021.). The CONSORT 2010 guidelines were used in this study for properly reporting how the randomized trial was conducted.
SARS CoV-2 IgG seropositivity post-vaccination among dental professionals: a prospective study
Authors: Duś-Ilnicka Irena , Mazur Marta , Rybińska Anna , Radwan-Oczko Małgorzata , Jurczyszyn Kamil , Paradowska-Stolarz Anna 
Published: August 2023

Abstract
Background
The COVID-19 pandemic has spread very rapidly around the world. Various regional and national lockdowns were imposed to control the spread. Meanwhile, vaccine development and population vaccination were the next steps for pandemic control. Workers in the dental field, both dentists and dental assistants, however, were close to the sources of aerosol generated during dental procedures and thus were the group of workers the most exposed to COVID-19 infection. The aim of our study was to monitor the immune response before and after the vaccine in a high-risk population, composed by dental professionals.

Methods
A clinical prospective study was carried out among dental professionals at the Academic Dental Polyclinic, Wroclaw Medical University (Wrocław, Lower Silesia region, Poland). Blood samples were collected at an interval of one year – March/April 2020, before the vaccination against COVID-19, and April 2021, after the vaccination. The analysis was performed on serum with four different methods: qualitative, semi-quantitative, and quantitative IgG count for SARS-CoV-2, and SARS-CoV-2 neutralizing antibodies.

Results
A total of 42 healthy adult volunteers participated in the study. The results showed a statistically significant difference (p < 0.05) in antibody levels before and after vaccination (1st and 2nd measurement) for each test method. The tests that were used affected the results and the test that showed the strongest relationship with the result was the Qualitative test.

Conclusions
Dental professionals are the adult working population most at risk for COVID-19. Monitoring SARS-CoV-2-status-related seropositivity can provide useful information occupational risk factors for dental professionals.
The efficacy of adjuvant chemotherapy for older adults with stage II/III gastric cancer: a retrospective cohort study
Authors: Shih Yu-Hsuan , Lin Hsin-Chen , Liao Po-Wei , Chou Cheng-Wei , Lin Cheng-Hsien , Hsu Chiann-Yi , Teng Chieh-Lin Jerry , Wu Feng-Hsu , Luo Shao-Ciao , Kao Shao-Hsuan 
Published: August 2023

Abstract
Background
Adjuvant chemotherapy is recommended as the standard treatment for patients with stage II/III resected gastric cancer. However, it is unclear whether older patients also benefit from an adjuvant chemotherapy strategy. This study aimed to investigate the clinical impact of adjuvant chemotherapy in older patients with stage II/III gastric cancer.

Methods
This retrospective, real-world study analyzed 404 patients with stage II/III gastric cancer visited at our institute between January 2009 and December 2019. The clinical characteristics and outcomes of patients aged 70 years or older who received adjuvant chemotherapy were compared with those who did not receive this type of treatment. Propensity score analysis was performed to mitigate selection bias.

Results
Of the 404 patients analyzed, 179 were aged 70 years or older. Fewer older patients received adjuvant chemotherapy than did younger patients (60.9% vs. 94.7%, respectively; P < 0.001). Among patients aged 70 years or older, those who received adjuvant chemotherapy had improved disease-free survival (DFS) (5-year DFS rate, 53.1% vs. 30.4%; P < 0.001) and overall survival (OS) (5-year OS rate, 68.7% vs. 52.1%; P = 0.002) compared to those who did not receive adjuvant chemotherapy. A similar survival benefit was observed in the propensity-matched cohort. Multivariate analysis showed that more advanced stage was associated with poorer OS. Receipt of adjuvant chemotherapy was independently associated with a decreased hazard of death (hazard ratio (HR), 0.37; 95% confidence intervals (CI), 0.20–0.68; P = 0.002).

Conclusions
Adjuvant chemotherapy may benefit older stage II/III gastric cancer patients aged ≥ 70 years. Further prospective studies are needed to confirm these findings.
Dexmedetomidine improves the outcomes for pediatric severe sepsis with mechanical ventilation
Authors: Zhao Chun , Yin Yi , Zhang Tianxin , Li Jing , Zhou Xiaoming , Wang Yujuan , Wang Wei , Wang Qiwei , Jin Youpeng 
Published: August 2023

Abstract
Background
The sedative dexmedetomidine has been shown to reduce mortality in adult patients with severe sepsis, but it is not known whether children benefit. This study explored the effects of dexmedetomidine on the outcomes of children with severe sepsis with mechanical ventilation.

Methods
In this retrospective cohort study, children with severe sepsis requiring mechanical ventilation from 2016 to 2020 were categorized as dexmedetomidine and non-dexmedetomidine group. The propensity score matching was performed to match cases in both groups. The primary outcome was 28-day mortality, and the secondary outcomes were acute kidney injury, ventilator-free days, lengths of PICU and hospital stays. The Kaplan-Meier method and was the log-rank test used to estimate the 28-day mortality rate and assess between-group differences.

Results
In total, 250 patients were eligible patients: 138 in the dexmedetomidine group and 112 in the non-dexmedetomidine group. After 1:1 propensity score matching, 61 children in each group. dexmedetomidine group showed more lower 28-day mortality (9.84% vs. 26.23%, P = 0.008). During the 7-day observation period after PICU admission, the dexmedetomidine group showed significantly lower neurological and renal sub-scores at day 7 and serum creatinine level at day 3 and day 7. There were no statistical differences in the incidence of acute kidney injury, ventilator-free days, lengths of PICU and hospital stays between the two groups.

Conclusions
dexmedetomidine treatment in children with severe sepsis is associated with better outcomes and should therefore be considered for the sedation strategy.