bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison of Bretschneider HTK cardioplegia solution and blood cardioplegia in terms of postoperative results in patients who underwent isolated supracoronary ascending aortic replacement
Authors: Tunca Nuri Utkan , Yesilkaya Nihan Karakas , Karaagac Erturk , Durmaz Huseyin , Besir Yuksel , Gokalp Orhan , Iner Hasan , Yılık Levent , Gurbuz Ali 
Published: June 2023

Introduction Cardiac arrest with cardioplegia is the most common and reliable method of myocardial protection in cardiac surgery, but there is no definite consensus on the use of different types of cardioplegia. Two of the commonly used types of cardioplegia are Bretschneider histidine-tryptophan-ketoglutarate solution (Custodiol) and conventional blood cardioplegia. In this study, Custodiol solution and conventional blood cardioplegia used in patients with type A aortic dissection who underwent supracoronary ascending aortic replacement were aimed to be compared in terms of postoperative results. Methods 70 patients with type A aortic dissection who underwent supracoronary ascending aortic replacement in our clinic between January 2011 – October 2020 were included. Patients were divided into two groups, blood cardioplegia group ( n = 48) and Custodiol group ( n = 22) and they were compared regarding preoperative, perioperative and postoperative variables. Results There was no significant difference between cardiopulmonary bypass time and cross-clamp time ( p = 0.17 and p = 0.16, respectively). Mechanical ventilator weaning time, intensive care unit stay and hospital stay were shorter in Custodiol group ( p = 0.04, p = 0.03 and p = 0.05, respectively). While inotropic support need was higher in the blood cardioplegia group ( p = 0.001), there was no significant difference in terms of mortality, arrhythmia, neurological complications and renal complications. Conclusions Our results show that Custodiol cardioplegia solution may be superior to blood cardioplegia in reducing mechanical ventilation weaning period, intensive care and hospital stay, and reducing the use of inotropic agents in patients with type A aortic dissection undergoing supracoronary ascending aorta replacement.
Comparison of endovenous laser ablation and cyanoacrylate embolization in the non-invasive treatment of superficial venous insufficiency in terms of patient satisfaction
Authors: ER Zafer Cengiz , Ikbali Afsar Ferhat , Atılgan Kıvanç , Onuk Burak Emre 
Published: June 2023

Objective Ablation with n-butyl cyanoacrylate is a clinically newer technique than endovenous laser ablation and other interventional techniques in the treatment of chronic venous insufficiency (CVI). The aim of this study was to compare the endovenous laser ablation (EVLA) and n-butyl cyanoacrylate (NBCA) interventional techniques in terms of benefit, effectiveness, and patient satisfaction. Materials and Methods The study was conducted at Yozgat City Hospital and Bozok University Research Hospital Cardiovascular Surgery clinics between November 2016 and February 2021. A total of 260 symptomatic patients with 130 randomized cases in each intervention group were included. NBCA patients constituted Group 1 and EVLA patients Group 2. The saphenous vein was evaluated by color Doppler ultrasonography (CDUS) of the lower extremity. Patients with saphenous veins over 5.5 mm in diameter and a saphenous-femoral reflux time of 2 s or longer were included in the study. The patients were asked about their satisfaction and symptoms in the first postoperative week during an outpatient clinic follow-up with CDUS investigation at the first and sixth months. Results Although vena saphenous magna (VSM) closure results were similar with the two methods, satisfaction rates were found to be higher with the NBCA procedure. Conclusion Comparison of the new methods used in the treatment of CVI revealed similar VSM closure rates in the two methods, but the satisfaction rate was higher with the NBCA technique in this study.
Ceiling Effect of the Combined Norwegian and Danish Knee Ligament Registers Limits Anterior Cruciate Ligament Reconstruction Outcome Prediction
Authors: Martin R. Kyle , Wastvedt Solvejg , Pareek Ayoosh , Persson Andreas , Visnes Håvard , Fenstad Anne Marie , Moatshe Gilbert , Wolfson Julian , Lind Martin , Engebretsen Lars 
Published: June 2023

Background: Clinical tools based on machine learning analysis now exist for outcome prediction after primary anterior cruciate ligament reconstruction (ACLR). Relying partly on data volume, the general principle is that more data may lead to improved model accuracy. Purpose/Hypothesis: The purpose was to apply machine learning to a combined data set from the Norwegian and Danish knee ligament registers (NKLR and DKRR, respectively), with the aim of producing an algorithm that can predict revision surgery with improved accuracy relative to a previously published model developed using only the NKLR. The hypothesis was that the additional patient data would result in an algorithm that is more accurate. Study Design: Cohort study; Level of evidence, 3. Methods: Machine learning analysis was performed on combined data from the NKLR and DKRR. The primary outcome was the probability of revision ACLR within 1, 2, and 5 years. Data were split randomly into training sets (75%) and test sets (25%). There were 4 machine learning models examined: Cox lasso, random survival forest, gradient boosting, and super learner. Concordance and calibration were calculated for all 4 models. Results: The data set included 62,955 patients in which 5% underwent a revision surgical procedure with a mean follow-up of 7.6 ± 4.5 years. The 3 nonparametric models (random survival forest, gradient boosting, and super learner) performed best, demonstrating moderate concordance (0.67 [95% CI, 0.64-0.70]), and were well calibrated at 1 and 2 years. Model performance was similar to that of the previously published model (NKLR-only model: concordance, 0.67-0.69; well calibrated). Conclusion: Machine learning analysis of the combined NKLR and DKRR enabled prediction of the revision ACLR risk with moderate accuracy. However, the resulting algorithms were less user-friendly and did not demonstrate superior accuracy in comparison with the previously developed model based on patients from the NKLR alone, despite the analysis of nearly 63,000 patients. This ceiling effect suggests that simply adding more patients to current national knee ligament registers is unlikely to improve predictive capability and may prompt future changes to increase variable inclusion.
Validity of the hydrogen ion mobilisation model during haemodialysis with time-dependent dialysate bicarbonate concentrations
Authors: Leypoldt John Kenneth , Pietribiasi Mauro , Debowska Malgorzata , Wieliczko Monika , Twardowska-Kawalec Malgorzata , Malyszko Jolanta , Waniewski Jacek 
Published: June 2023

Background: The hydrogen ion (H+) mobilisation model has been previously shown to accurately describe blood bicarbonate (HCO3) kinetics during haemodialysis (HD) when the dialysate bicarbonate concentration ([HCO3]) is constant throughout the treatment. This study evaluated the ability of the H+ mobilization model to describe blood HCO3 kinetics during HD treatments with a time-dependent dialysate [HCO3]. Methods: Data from a recent clinical study where blood [HCO3] was measured at the beginning of and every hour during 4-h treatments in 20 chronic, thrice-weekly HD patients with a constant (Treatment A), decreasing (Treatment B) and increasing (Treatment C) dialysate [HCO3] were evaluated. The H+ mobilization model was used to determine the model parameter (Hm) that provided the best fit of the model to the clinical data using nonlinear regression. A total of 114 HD treatments provided individual estimates of Hm. Results: Mean ± standard deviation estimates of Hm during Treatments A, B and C were 0.153 ± 0.069, 0.180 ± 0.109 and 0.205 ± 0.141 L/min (medians [interquartile ranges] were 0.145 [0.118,0.191], 0.159 [0.112,0.209], 0.169 [0.115,0.236] L/min), respectively; these estimates were not different from each other ( p = 0.26). The sum of squared differences between the measured blood [HCO3] and that predicted by the model were not different during Treatments A, B and C ( p = 0.50), suggesting a similar degree of model fit to the data. Conclusions: This study supports the validity of the H+ mobilization model to describe intradialysis blood HCO3 kinetics during HD with a constant Hm value when using a time-dependent dialysate [HCO3].
The Effect of Fluid Resuscitation Timing in Early Sepsis Resuscitation
Authors: Kuttab Hani I. , Evans Chad G. , Lykins Joseph D. , Hughes Michelle D. , Kopec Jason A. , Hernandez Michael A. , Ward Michael A. 
Published: June 2023

Purpose The dose and timing of early fluid resuscitation in sepsis remains a debated topic. The objective of this study is to evaluate the effect of fluid timing in early sepsis management on mortality and other clinical outcomes. Methods Single-center, retrospective cohort study of emergency-department-treated adults (>18 years, n = 1032) presenting with severe sepsis or septic shock. Logistic regression evaluating the impact of 30 mL/kg crystalloids timing and mortality-versus-time plot controlling for mortality in emergency department sepsis score, lactate, antibiotic timing, obesity, sex, systemic inflammatory response syndrome criteria, hypotension, and heart and renal failures. This study is a subanalysis of a previously published investigation. Results Mortality was 17.1% (n = 176) overall and 20.4% (n = 133 of 653) among those in septic shock. 30 mL/kg was given to 16.9%, 32.2%, 16.2%, 14.5%, and 20.3% of patients within ≤1, 1 ≤ 3, 3 ≤ 6, 6 ≤ 24, and not reached within 24 h, respectively. A 24-h plot of adjusted mortality versus time did not reach significance, but within the first 12 h, the linear function showed a per-hour mortality increase (odds ratio [OR] 1.29, 95% confidence interval [CI] 1.02-1.67) which peaks around 5h, although the quadratic function does not reach significance ( P = .09). When compared to patients receiving 30 mL/kg within 1 h, increased mortality was observed when not reached within 24 h (OR 2.69, 95% CI 1.37-5.37) but no difference when receiving this volume between 1 and 3 (OR 1.11, 95% CI 0.62-2.01), 3 and 6 (OR 1.83, 95% CI 0.97-3.52), or 6 and 24 h (OR 1.51, 95% CI 0.75-3.06). Receiving 30 mL/kg between 1 and 3 versus <1 h increased the incidence of delayed hypotension (OR 1.83, 95% CI 1.23-2.72) but did not impact need for intubation, intensive care unit admission, or vasopressors. Conclusions We observed weak evidence that supports that earlier is better for survival when reaching fluid goals of 30 mL/kg, but benefits may wane at later time points. These findings should be viewed as hypothesis generating.
STI testing, diagnoses and online chlamydia self-sampling among young people during the first year of the COVID-19 pandemic in England
Authors: Sonubi Tamilore , Sheik-Mohamud Dahir , Ratna Natasha , Bell James , Talebi Alireza , Mercer Catherine H , Sinka Katy , Migchelsen Stephanie J , Folkard Kate , Mohammed Hamish 
Published: June 2023

Purpose COVID-19 control measures reduced face-to-face appointments at sexual health services (SHSs). Remote access to SHSs through online self-sampling was increased. This analysis assesses how these changes affected service use and STI testing among 15–24 year olds (‘young people’) in England. Methods Data on all chlamydia, gonorrhoea and syphilis tests from 2019-2020, among English-resident young people were obtained from national STI surveillance datasets. We calculated proportional differences in tests and diagnoses for each STI, by demographic characteristics, including socioeconomic deprivation, between 2019–2020. Binary logistic regression was used to determine crude and adjusted odds ratios (OR) between demographic characteristics and being tested for chlamydia by an online service. Results Compared to 2019, there were declines in testing (chlamydia-30%; gonorrhoea-26%; syphilis-36%) and diagnoses (chlamydia-31%; gonorrhoea-25%; syphilis-23%) among young people in 2020. Reductions were greater amongst 15-19 year-olds vs. 20-24 year-olds. Amongst people tested for chlamydia, those living in the least deprived areas were more likely to be tested using an online self-sampling kit (males; OR = 1.24 [1.22–1.26], females; OR = 1.28 [1.27–1.30]). Conclusion The first year of the COVID-19 pandemic in England saw declines in STI testing and diagnoses in young people and disparities in the use of online chlamydia self-sampling which risk widening existing health inequalities.
Fabrication and swelling properties of a novel superabsorbent composite derived from waste coal gangue
Authors: Zhang Yan , Wei Jianxiong , Zhang Xingyu , Gao Pingqiang 
Published: June 2023

In this work, novel superabsorbent composites made of starch-grafted-polyacrylic acid/coal gangue were prepared via aqueous solution polymerization. The starch-g-polyacrylic acid/coal gangue (St-g-PAA/CG) composite with 10 wt.% CG showed the maximum water absorbency in distilled water (560 g·g−1) and a 0.9 wt.% NaCl solution (102 g·g−1). Moreover, this superabsorbent composite exhibited fine thermal stability and its swelling behavior was dependent on pH. In general, the swelling kinetics of the superabsorbent composites fitted with the Scott’s kinetic model. These composites not only showed excellent water absorption reversibility after five absorption/drying cycles, but also exhibited considerable environmental responsiveness after the swelling medium was changed from distilled water to the 0.9 wt.% NaCl solution. Based on these results, the prepared superabsorbent composites can be applied in several fields such as horticulture, agriculture, health care, and controlled drug delivery, while ensuring comprehensive utilization of solid wastes.
Economic Impact Analysis of a Mega Project on Petroleum Refinery: A Case Study of the Proposed Ratnagiri Refinery in Maharashtra
Authors: Bandyopadhyay Saurabh , Biswas Pradip Kumar , Pratap Devender , Joshi Laxmi , Sahu Ajaya K. 
Published: June 2023

An economic evaluation of mega projects is very important for taking into account important aspects connected with investment and operation costs, their possible overflows and the fulfilment of the time period intended for the project. But it is also needed for monitoring the impact of the projects on the overall economy and the regional surroundings. The main objective of the present article is the evaluation of a particular mega project, that is, Ratnagiri Refinery and Petrochemicals Limited, by examining the various aspects of economic evaluation using a new methodology for the estimation of the specific impact in the project evaluation. JEL Codes: C67, L71, L74
A Single Measure of Overall Export Performance
Authors: Chakrabartty Satyendra Nath , Sinha Deepankar 
Published: June 2023

Exports are a lifeline to a country’s growth, and an overall index can describe its export performance. However, there is little evidence of a single measure encompassing all the relevant aspects of exports. A composite and multi-dimensional measure can aid in assessing the relative position of a country in the world list and identifies necessary policy interventions. The article proposes an Overall Export Performance Index that satisfies the principles of index formation—monotonicity, time reversal, robustness and an unbiased approach. The proposed index avoids selecting weights and scaling variables. It facilitates the identification of crucial indicators requiring the attention of policymakers, tracking the progress of a country across time and the computing of mean and variance of the index for a group of countries at a given time. An empirical comparison of the USA and India reveals that India registered better overall export performance than the USA from 2015 to 2018. The results suggest India’s need for reforms in existing foreign trade policies. JEL Codes: F1, F10, F13
Clinical model of pulmonary metastasis in patients with osteosarcoma: A new multiple machine learning-based risk prediction
Authors: Su Zhiping , Huang Feihong , Yin Chunyue , Yu Yuezhao , Yu Chaojie 
Published: June 2023

Background Metastasis is one of the most significant prognostic factors in osteosarcoma (OS). The goal of this study was to construct a clinical prediction model for OS patients in a population cohort and to evaluate the factors influencing the occurrence of pulmonary metastasis. Methods We collected data from 612 patients with osteosarcoma (OS), and 103 clinical indicators were collected. After the data were filtered, the patients were randomly divided into training and validation cohorts by using random sampling. The training cohort included 191 patients with pulmonary metastasis in OS and 126 patients with non-pulmonary metastasis, and the validation cohort included 50 patients with pulmonary metastasis in OS and 57 patients with non-pulmonary metastasis. Univariate logistics regression analysis, LASSO regression analysis and multivariate logistic regression analysis were performed to identify potential risk factors for pulmonary metastasis in patients with osteosarcoma. A nomogram was developed that included risk influencing variables selected by multivariable analysis, and used the concordance index (C-index) and calibration curve to validate the model. Receiver operating characteristic curve (ROC), decision analysis curve (DCA) and clinical impact curve (CIC) were employed to assess the model. In addition, we used a predictive model on the validation cohort. Results Logistic regression analysis was used to identify independent predictors [N Stage + Alkaline phosphatase (ALP)+Thyroid stimulating hormone (TSH)+Free triiodothyronine (FT3)]. A nomogram was constructed to predict the risk of pulmonary metastasis in patients with osteosarcoma. The performance was evaluated by the concordance index (C-index) and calibration curve. The ROC curve provides the predictive power of the nomogram (AUC = 0.701 in the training cohort, AUC = 0.786 in the training cohort). Decision curve analysis (DCA) and clinical impact curve (CIC) demonstrated the clinical value of the nomogram and higher overall net benefits. Conclusions Our study can help clinicians effectively predict the risk of lung metastases in osteosarcoma with more readily available clinical indicators, provide more personalized diagnosis and treatment guidance, and improve the prognosis of patients. Mini Abstract A new risk model was constructed to predict the pulmonary metastasis in patients with osteosarcoma based on multiple machine learning.
Existential depression: A meaningful diagnostic entity?
Authors: Restifo Sam 
Published: June 2023

Objective To examine the construct of existential depression and whether it represents a distinct diagnostic entity. Method Descriptive psychopathology and phenomenology are used to define the characteristics of existential depression and for comparison with other presentations of low mood. Results Existential depression can be differentiated from other forms of depression by careful appraisal of symptomatology. Drawing attention to this, and likewise other distinguishable yet under-recognised forms of depression, may help stimulate interest in further research on the classification of mood disorders with the prospect of greater diagnostic specificity and more precise treatment matching. Conclusion Existential depression is a clinically discernible diagnostic entity.
Regional Disparities in Prescription Methamphetamine and Amphetamine Distribution Across the United States
Authors: Lopera Sarah D. , O’Kane Victoria M. , Goldhirsh Jessica L. , Piper Brian J. 
Published: June 2023

Objective: The objectives of this report were to characterize the regional and state differences in prescription methamphetamine and amphetamine distribution in the US. Methods: Prescription methamphetamine and amphetamine distribution was obtained from the Drug Enforcement Administration for 2019. Results: Total per capita drug weight distribution of amphetamine was 4,000 times higher than methamphetamine. Regionally, total per capita drug weight for methamphetamine was highest in the West (32.2% of total distribution) and lowest in the Northeast (17.4%). The total per capita drug weight for amphetamine was highest in the South (37.0% of total distribution) and lowest in the Northeast (19.4%). Distribution of methamphetamine was 16.1% while amphetamine was 54.0% of its production quota. Conclusion: Overall, prescription amphetamine distribution was common while prescription methamphetamine distribution was rare. The patterns observed in distribution are likely the result of stigmatization, differences in accessibility, and the efforts of initiatives such as the Montana Meth Project.
Feminizing hormone therapy in a Canadian cohort of transgender women with and without HIV
Authors: Armstrong Ian , Lacombe-Duncan Ashley , Shokoohi Mostafa , Persad Yasmeen , Tseng Alice , Fung Raymond , Underhill Angela , Côté Pierre , Machouf Nimâ , Saucier Adrien , Varriano Brenda , Brundage Monica , Jones Reilly , Weisdorf Thea , Goodhew John , MacLeod John , Loutfy Mona 
Published: June 2023

Background Potential bidirectional drug–drug interactions between feminizing hormone therapy (FHT) and antiretroviral therapy (ART) are of concern for trans women with HIV and their healthcare providers. This study aimed to characterize patterns of FHT and ART among trans women with HIV and to compare serum hormone levels to trans women without HIV. Methods Charts of trans women were reviewed at seven HIV primary care or endocrinology clinics in Toronto and Montreal from 2018 to 2019. ART regimens, FHT use, serum estradiol, and serum testosterone levels were compared on the basis of HIV status (positive, negative, missing/unknown). Results Of 1495 trans women, there were 86 trans women with HIV, of whom 79 (91.8%) were on ART. ART regimens were most commonly integrase inhibitor-based (67.4%), many boosted with ritonavir or cobicistat (45.3%). Fewer (71.8%) trans women with HIV were prescribed FHT, compared to those without HIV (88.4%) and those with missing/unknown status (90.2%, p < 0.001). Among trans women on FHT with recorded serum estradiol ( n = 1153), there was no statistical difference in serum estradiol between those with HIV (median: 203 pmol/L, IQR: 95.5, 417.5) and those with negative (200 mol/L [113, 407]) or missing/unknown HIV status (227 pmol/L [127.5, 384.5) ( p = 0.633). Serum testosterone concentrations were also similar between groups. Conclusions In this cohort, trans women with HIV were prescribed FHT less often than trans women with negative or unknown HIV status. There was no difference in serum estradiol or testosterone levels of trans women on FHT regardless of HIV status, providing reassurance regarding potential drug–drug interactions between FHT and ART.
Experimental noise reduction (aeroacoustical enhancement) of a large diameter axial flow cooling fan through a reduction in blade tip clearance
Authors: Swanepoel Pieter Coenraad , Biedermann Till M , van der Spuy Sybrand J 
Published: June 2023

Aerodynamic and aeroacoustic performance experiments were carried out on four- and eight bladed, 1.542 m diameter, axial flow cooling fans, with constant solidity and hub-to-tip ratio. Tests were conducted in an ISO5801, Type A Fan Test facility. The tip gap (TG) was reduced from 4 mm (0.26% fan diameter) to 2 mm (0.13% fan diameter), to 0 mm, for both fan configurations. The noise profile of each fan configuration at the same TG over the whole volumetric flow rate spectrum was compared to each other. The 4 mm (0.26%) TG is used as a baseline to measure the nett increase or decrease in sound levels. Noise emissions decreased as the TG was reduced. It is discovered that the four bladed fan configuration had lower noise emissions than the eight bladed fan configuration at all blade tip clearances at design flow rate. It is concluded that reducing the TG and number of blades, at constant solidity, reduces sound emissions. The 0 mm TG for the four bladed fan produced the greatest reduction in noise emissions. An increase in fan total-to-static performance is observed when reducing the TG for both fan configurations.