bluuebunny/crossref_metadata_2025_split huggingface dataset:
The ROWAN study: Safety and efficacy of transarterial radioembolization with Y-90 glass microspheres and the STRIDE regimen in hepatocellular carcinoma.
Authors: He Aiwu Ruth , Toskich Beau 
Published: February 2023

TPS622 Background: In patients with early and intermediate hepatocellular carcinoma (HCC) who are ineligible for resection, thermal ablation, or liver transplant, transarterial radioembolization (TARE) with yttrium-90 glass microspheres has shown superior efficacy compared to transarterial chemoembolization; a subset of patients progress despite effective local therapy. Immunotherapy using the single tremelimumab regular interval durvalumab (STRIDE) regimen has demonstrated superior overall survival to sorafenib in advanced HCC. Recent work showed that TARE upregulates both the innate and adaptive immune systems. The possibility for TARE and STRIDE to have additive or synergistic effects when combined is of current scientific and clinical interest. The primary objective of the Phase II ROWAN Study is to assess the objective response rate and durability of local tumor control with TARE followed by STRIDE vs. TARE alone. Methods: ROWAN is a global, open-label, prospective, multicenter randomized controlled trial comparing treatment with TARE using glass microspheres followed by the STRIDE regimen (a single dose of 300 mg tremelimumab combined with 1500 mg monthly dose of durvalumab for 18 months) to TARE alone in HCC. ROWAN will include 150 patients across approximately 20 study sites in North America and Europe. Key inclusion criteria: HCC, diagnosed by radiographic imaging or histology; ineligible for or declined liver resection, thermal ablation, or transplantation; Child-Pugh A; ECOG 0; life expectancy ≥6 months; treatment naïve; unilobar tumor; measurable by mRECIST; tumor volume ≤25% of whole liver volume; and untreated future liver remnant volume ≥30% of whole liver volume. Key exclusion criteria: extrahepatic metastases; shunt fraction with a lung dose of >30 Gy; macrovascular invasion; infiltrative disease not evaluable by mRECIST; history of any organ allograph; autoimmune or inflammatory disorder; current use of immunosuppressive medication; history of malignancy other than HCC within past 3 years; and active infection. Patients will be randomized in a 1:1 ratio to two study arms (TARE followed by STRIDE or TARE alone) using two stratification factors (TARE treatment goal [ablative vs. non-ablative] and alpha fetoprotein level [>400 vs. ≤400 ng/mL]). Tumor and blood samples will be collected for correlative studies. Co-primary efficacy endpoints are objective response rate and duration of response (localized mRECIST). The primary safety endpoint is the number of adverse events (AEs) and serious AEs. Interim statistical analyses will be conducted after 25 patients have been randomized to each arm and completed the second imaging assessment 6 months post-randomization; final analysis will be after the last evaluable patient has completed the 18 months follow-up visit post-randomization or discontinued treatment. Clinical trial information: 05063565 .
Augmented Reality–Assisted Percutaneous Rhizotomy for Trigeminal Neuralgia
Authors: Berger Assaf , Choudhry Osamah J. , Kondziolka Douglas 
Published: February 2023

BACKGROUND:
Percutaneous rhizotomy of the trigeminal nerve is a common surgery to manage medically refractory trigeminal neuralgia. Traditionally, these procedures have been performed based on anatomic landmarks with fluoroscopic guidance. Augmented reality (AR) relays virtual content on the real world and has the potential to improve localization of surgical targets based on preoperative imaging.

OBJECTIVE:
To study the potential application and benefits of AR as an adjunct to traditional fluoroscopy-guided glycerol rhizotomy (GR).

METHODS:
We used traditional fluoroscopy-guided percutaneous GR technique as previously described, performed under general anesthesia. Anatomic registration to the Medivis SurgicalAR system was performed based on the patient's preoperative computerized tomography, and the surgeon was equipped with the system's AR goggles. AR was used as an adjunct to fluoroscopy for trajectory planning to place a spinal needle into the medial aspect of the foramen ovale.

RESULTS:
A 50-year-old woman with multiple sclerosis–related right-sided classical trigeminal neuralgia had persistent pain, refractory to medications, previous gamma knife stereotactic radiosurgery, and percutaneous radiofrequency rhizotomy performed elsewhere. The patient underwent AR-assisted fluoroscopy-guided percutaneous GR. The needle was placed into the right trigeminal cistern within seconds. She was discharged home after a few hours of observation with no complications and reported pain relief.

CONCLUSION:
AR-assisted percutaneous rhizotomy may enhance the learning curve of these types of procedures and decrease surgery duration and radiation exposure. This allowed rapid and correct placement of a spinal needle through the foramen ovale.
Ontogenetic changes in the concentration of serum proteins in chick and mammalian embryos
Authors: Grabowski Casimer T. 
Published: February 2023

ABSTRACT
It is generally recognized, on the basis of electrophoretic studies, that the serum proteins of individuals in the perinatal period of development are somewhat different than those of the adult (Kekwick, 1959; Lehrer & Toben, 1965). It is also known that the protein content of the serum of perinatal mammals is low, and gradually rises to the adult level over a period of weeks or months (McMurray, Roe & Sweet, 1948; Knapp & Routh, 1949; Ewerbeck & Levens, 1950; Potter, 1952; Halliday & Kekwick, 1957). Virtually nothing, however, is known about the serum proteins of very young vertebrate embryos, presumably because of technical difficulties involved in obtaining samples suitable for quantitative study.
The knowledge, attitude and practice level of dental auxiliaries regarding oral health care for pregnant patients in the eastern province of Saudi Arabia
Authors: Alibrahim Daneah , El. Mahalli Azza 
Published: February 2023

Background:The purpose of this research was to assess the knowledge, attitude, and practice of dental auxiliaries related to oral health care for pregnant patientsin the Eastern Province of Saudi Arabia. Methods: A cross-sectional study using a questionnaire survey was conducted. The knowledge, attitude, and practice were rated using the Likert scale out of 5. Knowledge and practice were categorized using bloom’s cut off point methods (80% and above isgood, and less than 80% is bad).Concerningattitude, (80% and above is positive, and less than 80% is negative) The questionnaires were sent to all dental hygienists and assistants (N=358), and responses were collected from 218. Statistical Package for the Social Sciences (SPSS) software was utilised to conduct statistical analysis. Results: Out of the 358, 218 responded (response rate = 61%). More than half of the respondents showed relatively good knowledge (57.3%). Most respondents had a positive attitude (89.4%). Regarding practice, approximately two-thirds had a good practice (67.4%). The knowledge score of hygienists was significantly higher than dental assistants, and respondents with experience in treating pregnant patients had significantly higher knowledge scores than others who did not have experience in treating pregnant patients. There is a statistically significant positive correlation between practice scores and education. Conclusions: The findings suggest the need to establish continuous education programs and for dental hygienists and dental assistants to adopt the best practice guidelines on perinatal oral health.
Integrated secure distance bounding and hardware-based security: A case study for the insurance claim verification of farmers during COVID-19
Authors: Kanak Alper , Ergün Salih , Arif İbrahim , Tanrıseven Sercan , Uğur Niyazi , van Schaik Gert-Jan , Badii Atta 
Published: February 2023

Given the rapidly evolving developments in Fintech, Insurtech, Open Banking, and Mobile Money business models in recent years, the capability for ensuring strong authentication remains the most pressing need for the protection of security and privacy of data in this sector as in many other areas. The security-integrity of insurance and financial transactions and workflows is vitally dependent on access control mechanisms to deliver strong multi-factor authentication (MFA) with operationally acceptable latency and throughput to support real-time response, particularly as demanded by the increasing online and mobile financial service models. The Critical-Chains Project was motivated by the above objectives as underpinned by the overarching commitment to accountability engineering as required by the operational logic. This must be crucially supported by real-time hardware-enabled services comprising authentication (including Distance Bounding and Prover’s Proximal Location Presence Verification), hardware security and cryptography (AUTH-as-a-Service, Hardware-Security-as-a-Service, Cryptography-as-a-Service) as delivered through the Critical-Chains main framework. This paper reports on the development and evaluation of the innovative Hardware-enabled authentication and security capabilities of the Critical-Chains framework which is successfully validated in the context of financial services, specifically the insurance claim settlement application domain, and can also be deployed in any other domains where trusted authentication and specific location-time bound prover’s presence verification is required.
Sales-Based Rebate Design
Authors: Ajorlou Amir , Jadbabaie Ali 
Published: February 2023

In this paper, we study a family of sales-based rebate mechanisms as an effective tool to implement price discrimination across a population of buyers with correlated heterogeneous valuations on indivisible goods and services. In order to implement such sales-based rebate mechanisms, the seller charges each buyer a fixed price at the time of purchase contingent on a rebate that is a function of the ex post sales volume to be realized at the end of the sales period. The seller declares both a price and a menu of rebates as a function of sales. We show that, when there is a common component of uncertainty in consumers’ valuations (to which we refer as the quality of the product), such rebates enable a seller to effectively induce different expected net prices at different valuations. Importantly, this effective price discrimination over valuations is achieved keeping both the base price and the rebate uniform across all buyers. This uniformity of price and rebate across buyers is a key advantage of our proposed rebate mechanism, thereby providing a new mechanism for price discrimination in crowd-based markets. We use tools and techniques from game theory and variational optimization to provide insight into the economics of such mechanisms. In particular, we identify two mechanisms that are monotone functions of the sales volume that are easy to implement in practice and perform well when compared with the much more complex optimal mechanism. We provide a rigorous analysis of the optimal mechanism and discuss practical limitations in implementing the globally optimal design, further demonstrating the efficacy of our proposed monotone mechanisms. This paper was accepted by Gabriel Weintraub, revenue management and market analytics. Funding: This research was supported by a Vannevar Bush Fellowship from the Office of Secretary of State and Army Research Office [MURI Project W911NF-19-1-0217]. Supplemental Material: The data files are available at https://doi.org/10.1287/mnsc.2023.4691 .
The impact of brain tissue oxygenation monitoring on mortality in adult patients with severe traumatic brain injuries: a systematic review
Authors: Ennis Carlyn , Avsar Pinar , Moore Zena , Patton Declan , O'Connor Tom , Varley Jarlath 
Published: February 2023

Background: Intracranial pressure (ICP) monitoring and cerebral perfusion pressure (CPP) monitoring are long established adjuncts in the management of traumatic brain injuries (TBIs). However, brain tissue oxygenation (PbtO2) monitoring, used in conjunction with ICP or CPP monitoring, is an additional element that could be used in directing the management of TBIs. Aims: To determine the impact of PbtO2 monitoring on mortality in adult patients with severe TBIs. Methods: A systematic review of electronic databases was performed in October 2021. A total of six articles were identified for inclusion. Data were extracted using a pre-designed extraction tool. Analysis was undertaken using RevMan for the mortality rates and a narrative analysis for the secondary outcomes. Findings: A total of 926 participants were evaluated. Of these, 269 received PbtO2 monitoring. There was no significant difference in mortality rates between the groups, with the PbtO2 and ICP/CPP groups having a mortality rate of 25% (72/284) and 26% (171/662), respectively. The odds ratio was calculated as 0.88 (0.63–1.23, P=0.45) suggesting a 37% reduction in the odds of mortality when PbtO2 is used. However, the 95% confidence intervals do indicate a non-statistical finding. Morbidity rates between the two groups were also similar, with some limited evidence (one study) demonstrating a higher fiscal cost associated with PbtO2 monitoring. Conclusions: There was no significant difference in mortality or morbidity rates between the two groups. Based on these results, this systematic review cannot support the addition of PbtO2 monitoring to guide the treatment of adult patients with severe TBIs.
TWO-YEAR RESULTS OF THE KNEEFIX STUDY: AN RCT COMPARING CEMENTED VERSUS UNCEMENTED TKA
Authors: Grant M.J. , Zeng N. , Lin M. , Farrington W. , Walker M. , Bayan A. , Elliot R. , Van Rooyen R. , Sharp R. , Young S. 
Published: February 2023

Joint registries suggest a downward trend in the use of uncemented Total Knee Replacements (TKR) since 2003, largely related to reports of early failures of uncemented tibial and patella components. Advancements in uncemented design such as trabecular metal may improve outcomes, but there is a scarcity of high-quality data from randomised trials.319 patients <75 years of age were randomised to either cemented or uncemented TKR implanted using computer navigation. Patellae were resurfaced in all patients. Patient outcome scores, re-operations and radiographic analysis of radiolucent lines were compared.Two year follow up was available for 287 patients (144 cemented vs 143 uncemented). There was no difference in operative time between groups, 73.7 v 71.1 mins (p= 0.08). There were no statistical differences in outcome scores at 2 years, Oxford knee score 42.5 vs 41.8 (p=0.35), International Knee Society 84.6 vs 84.0 (p=0.76), Forgotten Joint Score 66.7 vs 66.4 (p=0.91). There were two revisions, both for infection one in each group (0.33%). 13 cemented and 8 uncemented knees underwent re-operation, the majority of these being manipulation under anaesthetic (85.7%), with no difference (8.3% vs 5.3%, 95% CI −2.81% to 8.89%, p = 0.31). No difference was found in radiographic analysis at 2 years, 1 lucent line was seen in the cemented group and 3 in the uncemented group (0.67% v 2.09%, 95%CI −4.1% to 1.24%, p = 0.29).We found no difference in clinical or radiographic outcomes between cemented and uncemented TKR including routine patella resurfacing at two years.Early results suggest there is no difference between cemented and uncemented TKR at 2 years with reference to survivorship, patient outcomes and radiological parameters.
POSTOPERATIVE USE OF GAME READYTM CRYOCOMPRESSION SYSTEM FOLLOWING TOTAL KNEE ARTHROPLASTY: A PROSPECTIVE RANDOMIZED CONTROLLED TRIAL
Authors: Marinova M. , Sundaram A. , Holtham K. , Ebert J. , Wysocki D. , Meyerkort D. , Radic R. 
Published: February 2023

Cryocompression therapy is a non-invasive and non-pharmacological modality used in managing acute post-operative inflammation and pain. A prospective, randomised controlled trial (RCT) was undertaken to evaluate the effectiveness of a post-operative cryocompression protocol using the Game ReadyTM (GR) device versus usual care on recovery following total knee arthroplasty (TKA).A single centre RCT was conducted with 70 TKAs (68 patients) randomised to a 2-week intervention period consisting of treatment with GR cryocompression (n=33, 33.3% males) or a usual care protocol of ice with static compression using tubigrip (n=35, 54.3% males). Knee range of movement (ROM) (flexion and extension), a visual analogue pain score (VAS) and limb circumference were documented at day 1, 2 and 14, as well as 6 and 12 weeks post-surgery. ROM was also recorded at day 90, while medication use and length of hospital stay were documented. Patient reported outcome measures (PROMs) including the KOOS and patient satisfaction questionnaire were employed.The GR group demonstrated 2.3° more (p=0.05) knee extension ROM overall, as well as 2. 8° more at day 1 (p=0.048), 3.8° at day 14 (p=0.007) and 5.4° at 3 months (p=0.017). There were no group differences (p>0.05) observed in pain (VAS), flexion ROM, limb circumference, opioid use or other PROMs. Across the full cohort, higher pain levels resulted in increased opioid intake (p=0.002), older patients used significantly less opioids (p<0.001) and males reported significantly less pain (VAS) than females (p=0.048).Using GR following TKA is a safe, non-invasive tool that can be used to aid in the post-operative recovery period.Patients using the GR cryocompression device gained significantly more extension ROM compared to the conventional ice with compression group, despite no other group differences.
THE ASSESSMENT OF THE SAGITTAL SPINOPELVIC ALIGNMENT THROUGH THE L1-PELVIS ANGLE
Authors: Boudali A.M. , Chai Y. , Farey J. , Vigdorchik J. , Walter W.L. 
Published: February 2023

The spinopelvic alignment is often assessed via the Pelvic Incidence-Lumbar Lordosis (PI-LL) mismatch. Here we describe and validate a simplified method to evaluating the spinopelvic alignment through the L1-Pelvis angle (L1P). This method is set to reduce the operator error and make the on-film measurement more practicable.126 standing lateral radiographs of patients presenting for Total Hip Arthroplasty were examined. Three operators were recruited to label 6 landmarks. One operator repeated the landmark selection for intra-operator analysis. We compare PI-LL mismatch obtained via the conventional method, and our simplified method where we estimate this mismatch using PI-LL = L1P - 90°. We also assess the method's reliability and repeatability.We found no significant difference (p > 0.05) between the PI-LL mismatch from the conventional method (mean 0.22° ± 13.6) compared to L1P method (mean 0.0° ± 13.1). The overall average normalised root mean square error (NRMSE) for PI-LL mismatch across all operators is 7.53% (mean −3.3° ± 6.0) and 6.5% (mean −2.9° ± 4.9) for the conventional and L1P method, respectively. In relation to intra-operator repeatability, the correlation coefficients are 0.87 for PI, 0.94 for LL, and 0.96 for L1P. NRMSE between the two measurement sets are PI: 9.96%, LL: 5.97%, and L1P: 4.41%. A similar trend is observed in the absolute error between the two sets of measurements.Results indicate an equivalence in PI-LL measurement between the methods. Reproducibility of the measurements and reliability between operators were improved. Using the L1P angle, the classification of the sagittal spinal deformity found in the literature translates to: normal L1P<100°, mild 100°<L1P<110°, and severe L1P>110°. Surgeons adopting our method should expect a small improvement in reliability and repeatability of their measurements, and a significant improvement of the assessment of the mismatch through the visualisation of the angle L1P.
NO DIFFERENCE BETWEEN RP AND FB IN TKA AFTER TWO YEARS IN MULTIPLE PROMS: A PROSPECTIVE, MULTICENTRE, NON-RANDOMIZED STUDY
Authors: Mohammed Abdul N. , Yates P. , Bernard T. 
Published: February 2023

Total Knee Arthroplasty (TKA) is an effective surgery performed for knee osteoarthritis. Despite this success up to 20% of patients are less than fully satisfied. Rotating platform (RP) bearings have demonstrated significant reduction in rates of wear in laboratory studies but thus far have failed to demonstrate a clinical difference compared to fixed bearing (FB) arthroplasty in patients. This may be due to studies limited by small sample size and single centre design. Additionally, no studies have utilised modern patient-reported outcome measures (PROMs) such as PKIP to investigate differences between these bearings.A non-randomised, prospective, multi-centre study was conducted across centres in Australia, United Kingdom and the United States from November 2012 to May 2015. Knee prosthesis included were the RP and FB models of the PFC Sigma Knee (Depuy, Synthes) and the ATTUNE Knee (Depuy, Synthes). Data was collected on pre-arthroplasty interventions, demographics and PROMs. PROMs included were the KOOS, OKS, EQ53DL and PKIP. Participants were followed-up for 2 years.A total of 1,718 patients were recruited across 27 centres. 959 participants underwent a FB TKA, 759 participants underwent a RP TKA. No significant difference was found between RP and FB in change from baseline at 2 years across any parameter in all PROMs investigated at 2 years. Body Mass Index pre-operatively was the biggest indicator of change from baseline at 2 years.Our data demonstrates similar improvements in the short-term in both RP and TKA across all PROMs. Patients reported similar scores in satisfaction, confidence, mobility and stability in the PKIP PROM for both RP and FB groups. We have not found any evidence to suggest that RP TKA is disadvantageous at 2 years, and this is reassuring for any surgeon looking to utilise this bearing type in practice.Our data does not demonstrate a clinical advantage in RP TKA over FB TKA at 2 years in any PROM.
BIOMECHANICAL ANALYSIS OF PLATING TECHNIQUES FOR UNSTABLE LATERAL CLAVICLE FRACTURES WITH CORACOCLAVICULAR LIGAMENT DISTRUPTION (NEER TYPE-IIB)
Authors: Jo O. , Almond M. , Rupasinghe H. , Jo O.I. , Ackland D.C. , Ernstbrunner L. , Ek E.T. 
Published: February 2023

Neer Type-IIB lateral clavicle fractures are inherently unstable fractures with associated disruption of the coracoclavicular (CC) ligaments. A novel plating technique using a superior lateral locking plate with antero-posterior (AP) locking screws, resulting in orthogonal fixation in the lateral fragment has been designed to enhance stability. The purpose of this study was to biomechanically compare three different clavicle plating constructs.24 fresh-frozen cadaveric shoulders were randomised into three groups (n=8 specimens). Group 1: lateral locking plate only (Medartis Aptus Superior Lateral Plate); Group 2: lateral locking plate with CC stabilisation (Nr. 2 FiberWire); and Group 3: lateral locking plate with two AP locking screws stabilising the lateral fragment. Data was analysed for gap formation after cyclic loading, construct stiffness and ultimate load to failure, defined by a marked decrease in the load displacement curve.After 500 cycles, there was no statistically significant difference between the three groups in gap-formation (p = 0.179). Ultimate load to failure was significantly higher in Group 3 compared to Group 1 (286N vs. 167N; p = 0.022), but not to Group 2 (286N vs. 246N; p = 0.604). There were no statistically significant differences in stiffness (Group 1: 504N/mm; Group 2: 564N/mm; Group 3: 512N/mm; p = 0.712). Peri-implant fracture was the primary mode of failure for all three groups, with Group 3 demonstrating the lowest rate of peri-implant fractures (Group 1: 6/8; Group 2: 7/8, Group 3: 4/8; p = 0.243).The lateral locking plate with orthogonal AP locking screw fixation in the lateral fragment demonstrated the greatest ultimate failure load, followed by the lateral locking plate with CC stabilization. The use of orthogonal screw fixation in the distal fragment may negate against the need for CC stabilization in these types of fractures, thus minimizing surgical dissection around the coracoid and potential complications.