bluuebunny/crossref_metadata_2025_split huggingface dataset:
Phosphoserine enhanced Cu-doped bioactive glass dynamic dual-network hydrogel for craniofacial bone defect repair
Authors: Liu Yuwei , Wang Gang , Luo Huitong , Zhao Bangjiao , Liao Muheng , Dai Qiyuan , Li Maocai , Li Qingtao , Cao Xiaodong 
Published: May 2023

Abstract
Flexible hydrogels containing various osteogenic inorganic constituents, which can accommodate complicated shape variations, are considered as ideal grafts for craniofacial bone defect reconstruction. However, in most hybrid hydrogels, poor interaction between the polymer network and particles has detrimental effects on hydrogel rheological and structural properties, clinical manipulation and repair efficacy. In this article, we designed and prepared a series of hyaluronic acid composite hydrogel containing Cu-doped bioactive glass (CuBG) and phosphoserine (PS), in which hyaluronic acid was modified by methacrylate groups and phenylboronic acid groups to form a double crosslinked network. PS acted as an interaction bridge of CuBG particles and HAMA-PBA network to improve the mechanical properties of the composite hydrogels. The CuBG/PS hydrogels exhibited suitable rheological properties (injectable, self-healing, shape-adaptable), bone tissue integrating ability and anti-bacterial property. Meanwhile, we found that CuBG and PS have synergistic effect on improving osteogenic efficiency both in vitro and in vivo, particularly when the ratio of CuBG to PS is lower than 3 (9CB/3PS). This work provided a versatile and scalable approach to enhanced the interaction within inorganic particles and polymer network in hydrogels without extra modification on components.
Effects of the windshield inclination angle on head/brain injuries in car-to-pedestrian collisions using computational biomechanics models
Authors: Wang Fang , Wang Mingliang , Hu Lin , Peng Ke , Yin Jiajie , Wang Danqi , Shi Liangliang , Zhou Zhou 
Published: May 2023

Abstract
Car-to-pedestrian collision (CPC) accidents occur frequently, and pedestrians often suffer serious head/brain injuries. One major cause is the primary impact with the windshield. Here, we use a numerical simulation method to study the influence of the windshield inclination angle of a passenger car on pedestrian head/brain injury due to CPC accidents. The range of the windshield inclination angle was set at 24°–50°, with an interval of 2°. The results show that the windshield angle significantly affects the pedestrian kinematics and exerts different effects on the head injury when evaluating with various head injury criteria. Regarding the head peak linear/rotational acceleration and acceleration-based head injury criterion (HIC)/rotational injury criterion (RIC), the predictions at the secondary impact stage have no clear relationship with the windshield angle (R2=0.04, 0.07, 0.03 and 0.26, respectively) and their distributions are scattered. In the primary impact, the peak linear acceleration and HIC show a weak trend of first decreasing and then increasing with the increasing of the windshield angle, and the rotational acceleration and RIC tend to remain relatively constant. Regarding the cumulative strain damage measure (CSDM) criterion, the predictions at the primary impact are slightly lower than those at the secondary impact, and the trend of first decreasing and then increasing with the increase in the windshield angle is observed at both impact stages. When the windshield inclination angle is approximately 32°–40°, the head injury severity in both impact phases is generally lower than that predicted at other windshield angles.
Bridging Access to Pediatric Pain Care
Authors: Sepsey Amber M. , Sokol Olivia E. , Huestis Samantha E. , Bhandari Rashmi P. 
Published: May 2023

Objectives:
To evaluate subsequent shifts to patient access to tertiary pain management care following shelter-in-place (SIP) and increased telehealth during the COVID-19 pandemic.

Materials and Methods:
Retrospective naturalistic design was used. Data for this study were extracted from a retrospective review of the Pediatric-Collaborative Health Outcomes Information Registry, with additional demographic information collected using chart review. Participants were 906 youth who received an initial evaluation either in-person (n=472) within the 18 months before SIP or through telehealth (n=434) within the 18 months after SIP during the COVID-19 pandemic. Patient variables to assess access included geographic distance from the clinic, ethnic and racial diversity, and patient’s insurance type. Descriptive characteristics for each group were analyzed using χ2 test, percentage change, and t-test analyses.

Results:
Data indicated that transitioning to telehealth resulted in maintained access rates between groups as measured by race and ethnic diversity as well as distance traveled from the clinic. A trend toward increase in government-funded insurance was found, though no statistically significant differences were identified between telehealth and in-person visits. Though the majority of participants (in-person: 52.75%; telehealth 55.81%) lived within 50 miles of the clinic, results indicated that telehealth allowed for a statistically significant increase in evaluation access for families living further from the clinic within a 50-mile radius.

Discussion:
Overall, accessibility to pediatric pain management through telehealth during SIP was maintained despite significant declines in overall access to health care, with some trends in increased accessibility for patients with government insurance.
Diagnosis of Developmental Dysplasia of the Hip by Ultrasound Imaging Using Deep Learning
Authors: Kinugasa Maki , Inui Atsuyuki , Satsuma Shinichi , Kobayashi Daisuke , Sakata Ryosuke , Morishita Masayuki , Komoto Izumi , Kuroda Ryosuke 
Published: May 2023

Background:
A timely diagnosis of developmental dysplasia of the hip (DDH) is important for satisfactory clinical outcomes. Ultrasonography is a useful tool for DDH screening; however, it is technically demanding. We hypothesized that deep learning could assist in the diagnosis of DDH. In this study, several deep-learning models were assessed to diagnose DDH on ultrasonograms. This study aimed to evaluate the accuracy of diagnoses made by artificial intelligence (AI) using deep learning on ultrasound images of DDH.

Methods:
Infants who were up to 6 months old with suspected DDH were included. DDH diagnosis using ultrasonography was performed according to the Graf classification. Data on 60 infants (64 hips) with DDH and 131 healthy infants (262 hips) obtained from 2016 to 2021 were retrospectively reviewed. For deep learning, a MATLAB deep learning toolbox (MathWorks, Natick, MA, US) was used, and 80% of the images were used as training data, with the rest as validation data. Training images were augmented to increase data variation. In addition, 214 ultrasound images were used as test data to evaluate the AI’s accuracy. Pre-trained models (SqueezeNet, MobileNet_v2, and EfficientNet) were used for transfer learning. Model accuracy was evaluated using a confusion matrix. The region of interest of each model was visualized using gradient-weighted class activation mapping (Grad-CAM), occlusion sensitivity, and image LIME.

Results:
The best scores for accuracy, precision, recall, and F-measure were all 1.0 in each model. In DDH hips, the region of interest for deep learning models was the area lateral to the femoral head, including the labrum and joint capsule. However, for normal hips, the models highlighted the medial and proximal areas where the lower margin of the os ilium and the normal femoral head exist.

Conclusions:
Ultrasound imaging with deep learning can assess DDH with high accuracy. This system could be refined for a convenient and accurate diagnosis of DDH.

Level of Evidence:
Level—Ⅳ.
Intracranial activity of first-line immune checkpoint inhibitors combined with chemotherapy in advanced non-small cell lung cancer
Authors: Huang Zhe , Wu Fang , Xu Qinqin , Song Lianxi , Zhang Xiangyu , Wang Zhan , Deng Li , Zhang Yongchang , Zeng Liang , Yang Nong 
Published: May 2023

Abstract

Background:
Immune checkpoint inhibitors (ICIs) are increasingly used as first-line therapy for patients with advanced non-small cell lung cancer (NSCLC) harboring no actionable mutations; however, data on their efficacy among patients presenting with intracranial lesions are limited. This study aimed to explore the efficacy and safety of ICIs combined with chemotherapy in advanced NSCLC patients with measurable brain metastasis at initial diagnosis.

Methods:
Our study retrospectively analyzed clinical data of a total of 211 patients diagnosed with driver gene mutation-negative advanced NSCLC with measurable, asymptomatic brain metastasis at baseline from Hunan Cancer Hospital between January 1, 2019 and September 30, 2021. The patients were stratified into two groups according to the first-line treatment regimen received: ICI combined with chemotherapy (n = 102) or chemotherapy (n = 109). Systemic and intracranial objective response rates (ORRs) and progression-free survival (PFS) were analyzed. Adverse events were also compared between the groups.

Results:
Compared with the chemotherapy-based regimen, the ICI-containing regimen was associated with a significantly higher intracranial (44.1% [45/102] vs. 28.4% [31/109], χ
2 = 5.620, P = 0.013) and systemic (49.0% [50/102] vs. 33.9% [37/109], χ
2 = 4.942, P = 0.019) ORRs and longer intracranial (11.0 months vs. 7.0 months, P <0.001) and systemic (9.0 months vs. 5.0 months, P <0.001) PFS. Multivariable analysis consistently revealed an independent association between receiving ICI plus platinum-based chemotherapy as a first-line regimen and prolonged intracranial PFS (hazard ratio [HR] = 0.52, 95% confidence interval [CI]: 0.37–0.73, P <0.001) and systemic PFS (HR = 0.48, 95% CI: 0.35–0.66, P <0.001). No unexpected serious adverse effects were observed.

Conclusion:
Our study provides real-world clinical evidence that ICI combined with chemotherapy is a promising first-line treatment option for driver gene mutation-negative advanced NSCLC patients who present with brain metastasis at initial diagnosis.

Clinical trial registration:

https://www.clinicaltrials.gov/, OMESIA, NCT05129202.
Association between weekend catch-up sleep and hyperuricemia with insufficient sleep in postmenopausal Korean women: a nationwide cross-sectional study
Authors: Son Soo Min , Park Eun-Ju , Kwon Ryuk Jun , Cho Young Hye , Lee Sang Yeoup , Choi Jung In , Lee Youngin , Lee Sae Rom , Kim Yun Jin , Lee Jeong Gyu , Yi Yu Hyeon , Tak Young Jin , Lee Seung Hun , Kim Gyu Lee , Ra Young Jin 
Published: May 2023

Abstract

Objective
Hyperuricemia is associated with metabolic and cardiovascular diseases and mortality. Efforts to lower the risk of hyperuricemia in various ways are needed as the prevalence of these diseases increases in postmenopausal women. Studies have shown that one of these methods is associated with adequate sleep duration, which is related to a low risk of hyperuricemia. Considering that it is difficult for people to get enough sleep in modern society, this study hypothesized that weekend catch-up sleep could be an alternative. To our knowledge, no past study has investigated the relation between weekend catch-up sleep and hyperuricemia in postmenopausal women. Hence, the aim of this research was to estimate the relation between weekend catch-up sleep and hyperuricemia with insufficient sleep in postmenopausal women during weekday or workday.

Methods
This study included 1,877 participants extracted from the Korea National Health and Nutrition Examination Survey VII. The study population was divided into weekend catch-up sleep and non–weekend catch-up sleep groups. Odds ratios with 95% confidence intervals were derived using multiple logistic regression analysis.

Results
Weekend catch-up sleep had a significantly lower prevalence of hyperuricemia after adjusting for confounders (odds ratio, 0.758 [95% confidence interval, 0.576-0.997]). In a subgroup analysis, weekend catch-up sleep of 1 to 2 hours was significantly correlated with a lower prevalence of hyperuricemia after adjusting for confounders (odds ratio: 0.522 [95% confidence interval, 0.323-0.845]).

Conclusions
Weekend catch-up sleep had a decreased prevalence of hyperuricemia in postmenopausal women with sleep deprivation.
Investigating the efficacy and feasibility of using a whole-of-diet approach to lower circulating levels of C-reactive protein in postmenopausal women: a mixed methods pilot study
Authors: Cowan Stephanie , Dordevic Aimee , Sinclair Andrew J. , Truby Helen , Sood Surbhi , Gibson Simone 
Published: May 2023

Abstract

Objective
Chronic inflammation is associated with obesity and is an underlying pathophysiology for cardiovascular disease (CVD) development in postmenopausal women. This study aims to determine feasibility and efficacy of an anti-inflammatory dietary intervention to lower levels of C-reactive protein in weight stable postmenopausal women with abdominal obesity.

Methods
This mixed-methods pilot study used a single arm pre-post design. Thirteen women followed a 4-week anti-inflammatory, dietary intervention, optimizing consumption of healthy fats, low glycemic index wholegrains, and dietary antioxidants. Quantitative outcomes included change in inflammatory and metabolic markers. Focus groups were undertaken and thematically analyzed to explore participants lived experience of following the diet.

Results
There was no significant change in plasma high-sensitivity C-reactive, protein. Despite discouraging weight loss, median (Q1–Q3) body weight decreased by −0.7 (−1.3 to 0 kg, P = 0.02). This was accompanied by reductions in plasma insulin (0.90 [−0.05 to 2.20] mmol/L), Homeostatic Model Assessment of Insulin Resistance (0.29 [−0.03 to 0.59]), and low-density lipoprotein:high-density lipoprotein ratio (0.18 [−0.01 to 0.40]) (P ≤ 0.023 for all). Thematic analysis revealed that postmenopausal women have a desire to improve meaningful markers of health status that do not focus on weight. Women were highly engaged with learning about emerging and innovative nutrition topics, favoring a detailed and comprehensive nutrition education style that challenged their proficient health literacy and cooking skills.

Conclusions
Weight-neutral dietary interventions targeting inflammation can improve metabolic markers and may be a viable strategy for CVD risk reduction in postmenopausal women. To determine effects on inflammatory status, a fully powered and longer-term randomized controlled trial is required.
Barriers to hormone therapy following prophylactic bilateral salpingo-oophorectomy in BRCA1/2 mutation carriers
Authors: DiSilvestro Jessica B. , Haddad Jessica , Robison Katina , Beffa Lindsey , Laprise Jessica , Scalia-Wilbur Jennifer , Raker Christina , Clark Melissa , Lokich Elizabeth , Hofstatter Erin , Dalela Disha , Brown Amy , Bradford Leslie , Toland Maris , Stuckey Ashley 
Published: May 2023

Abstract

Objective
This study aimed to identify barriers to hormone therapy (HT) use among women with BRCA1/2 mutations after prophylactic bilateral salpingo-oophorectomy (BSO).

Methods
A cross-sectional, electronic survey was conducted of BRCA1/2 mutation carriers at Women and Infants Hospital, Yale Medical Center, Hartford Healthcare, and Maine Medical Center. This study was a subanalysis of a subset of female BRCA1/2 mutation carriers who had undergone a prophylactic BSO. Data were analyzed using the Fisher's exact test or t test.

Results
We performed a subanalysis of 60 BRCA mutation carriers who underwent a prophylactic BSO. Only 24 women (40%) reported ever using HT. HT use was higher in women who underwent their prophylactic BSO at age younger than 45 years (51% vs. 25%, P = 0.06). Among all women who had a prophylactic BSO, the majority (73%) reported that a provider talked to them about using HT. Two thirds reported having seen contradictory information in the media about long-term consequences of HT. Seventy percent listed their provider as the primary influence in their decision to start HT. The most common reasons for not starting HT included it not being recommended by their physician (46%) and that it was not necessary (37%).

Conclusions

BRCA mutation carriers frequently undergo prophylactic BSO at young ages, and less than half report using HT. This study highlights barriers to HT use, such as patient fears and physician discouragement, and identifies potential areas to improve educational efforts.
Hysteroscopic alterations in women with infertility or recurrent spontaneous abortion in case of normal transvaginal ultrasonography
Authors: Zhang Ya-nan , Liu Peng , Qi Dan , Zhao Sheng-rui , Chen Zi-Jiang , Han Ting , Yan Lei 
Published: May 2023

Introduction:
Whether hysteroscopy should routinely be conducted before embryo transfer remains uncertain especially when transvaginal ultrasonography (TVS) is normal. We aimed to investigate the hysteroscopic findings for patients with infertility or recurrent spontaneous abortion and with normal TVS.

Methods:
Patients who underwent TVS and hysteroscopy in the hospital from January 2014 to May 2019 were enrolled. Propensity score matching (1:1) was carried out for TVS positive and negative result groups. The positive results of hysteroscopy in the primary and secondary infertility patients were further compared. The prevalence rates of various diseases in different age groups were summarized and analyzed.

Results:
A total of 1532 individuals were enrolled in the study group and 19,118 cases in the control group. A total of 1495 cases with TVS positive results were matched using propensity score matching (1:1). The prevalence of uterine diseases in the TVS positive group was significantly higher than that in the TVS negative group (P<0.001).The prevalence of endometrial polyps and endometrial hyperplasia in patients with primary infertility was significantly higher than that with secondary infertility (P<0.001). The diagnostic sensitivity of TVS for major uterine cavity diseases, confirmed by hysteroscopy was relatively low (12.7%; 11.9%–13.6%).

Conclusions:
Hysteroscopy can detect a considerable number of uterine lesions even after normal TVS results. The sensitivity of TVS for the diagnosis of intrauterine lesions is relatively low. We suggest that hysteroscopy be recommended for patients with infertility or recurrent spontaneous abortion.
Association Between Solid Fuel Use and the Risk of Hypertension in China
Authors: Fu Ziwei , Wang Shuang , Xie Hongwei , Xie Yuxin , Wen Xilin , Zheng Jing , Shi Yu , Li Yichong 
Published: May 2023

Objective
The aim of the study is to assess the association between solid fuel use for cooking or heating and the risk of hypertension among individuals older than 45 years.

Methods
Baseline questionnaires were used to collect self-reported primary cooking and heating fuel usage. Outcomes were defined as the time of first diagnosis of hypertension. Data were analyzed using Cox proportional hazards models.

Results
Solid fuel use for cooking was associated with a higher risk of hypertension. The association between solid fuel for cooking and hypertension remained significant among residents in north China, individuals aged 45 to 65 years, urban residents, and nonsmokers. Solid fuel for heating was associated with a higher risk of hypertension only in South China.

Conclusions
Solid fuel use may result in an increased risk of hypertension. Our findings further emphasize the health hazards of solid fuel for cooking and heating.
Career Development Needs of Physician Associates in the United Kingdom: A Qualitative Study
Authors: Carey Frances , Newton Philip M. 
Published: May 2023

Introduction
The physician associate (PA) profession is relatively new to the United Kingdom (UK) with the first UK-trained PAs graduating in 2008. Unlike other UK health professions, there is currently no well-established career framework after graduating as a PA. This pragmatic research aimed primarily to provide useful information for the future development of a PA career framework that will best support the career development needs of the PA profession.

Methods
The current study used qualitative 1:1 interviews to understand senior PAs' aspirations, postgraduate education, career progression, development opportunities, and perceptions for a career framework. Where are they now? What are they doing? What are their expectations for the future? What subsequent changes do senior PAs think a career framework might bring to the profession?

Results
Most PAs support a career framework and the opportunity to highlight and facilitate the PA's unique ability to transfer specialties; both generalist and specialized PA experience should be recognized. All participants supported a postgraduate standardization of PA practice citing patient safety and equal opportunities for the PA workforce. Furthermore, although the PA profession was introduced to the UK with lateral rather than vertical progression, the current study demonstrates the existence of hierarchical roles within the PA workforce.

Discussion
A postqualification framework is needed in the UK, one that supports the current flexibility of the PA workforce.
Three- versus two-rows circular staplers for left-sided colorectal anastomosis: a propensity score-matched analysis of the iCral 2 and 3 prospective cohorts
Authors: Catarci Marco , Guadagni Stefano , Masedu Francesco , Ruffo Giacomo , Viola Massimo Giuseppe , Borghi Felice , Baldazzi Gianandrea , Scatizzi Marco ,   on behalf of the the Italian ColoRectal Anastomotic Leakage (iCral) study group
Published: May 2023

Background:
Since most anastomoses after left-sided colorectal resections are performed with a circular stapler, any technological change in stapling devices may influence the incidence of anastomotic adverse events. The aim of the present study was to analyze the effect of a three-rows circular stapler on anastomotic leakage and related morbidity after left-sided colorectal resections.

Materials and Methods:
A circular stapled anastomosis was performed in 4,255 (50.9%) out of 8,359 patients enrolled in two prospective multicenter studies in Italy, and, after exclusion criteria to reduce heterogeneity, 2,799 (65.8%) cases were retrospectively analyzed through a 1:1 propensity score-matching model including 20 covariates relative to patient characteristics, to surgery and to perioperative management. Two well balanced groups of 425 patients each were obtained: group (A) – true population of interest, anastomosis performed with a 3-rows circular stapler; group (B), – control population, anastomosis performed with a 2-rows circular stapler. The target of inferences was the average treatment effect in the treated (ATT). The primary endpoints were overall and major anastomotic leakage, and overall anastomotic bleeding; the secondary endpoints were overall and major morbidity, and mortality rates. The results of multiple logistic regression analyses for the outcomes, including the 20 covariates selected for matching, were presented as odds ratios (OR) and 95% confidence intervals (95%CI).

Results:
Group A vs. group B showed a significantly lower risk of overall anastomotic leakage [2.1 vs. 6.1%; OR 0.33; 95%CI 0.15–0.73; P=.006], major anastomotic leakage [2.1 vs. 5.2%; OR 0.39; 95%CI 0.17–0.87; P=.022], and major morbidity [3.5 vs. 6.6% events; OR 0.47; 95%CI 0.24–0.91; P=.026].

Conclusion:
The use of 3-rows circular staplers independently reduced the risk of anastomotic leakage and related morbidity after left-sided colorectal resection. Twenty-five patients were required to avoid one leakage.