bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Rise of Total Ankle Arthroplasty Use: A Database Analysis Describing Case Volumes and Incidence Trends in the United States Between 2009 and 2019
Authors: Karzon Anthony L. , Kadakia Rishin J. , Coleman Michelle M. , Bariteau Jason T. , Labib Sameh A. 
Published: September 2022

Background: Ankle arthrodesis has been the mainstay treatment for end-stage ankle arthritis. The popularity of total ankle arthroplasty (TAA) has been on the rise due to improved implant design and postoperative outcomes. The purpose of this study was to describe the basic epidemiology and trends of annual procedure volumes and incidence in the general American population as well as in different population subgroups from 2009 to 2019. We hypothesize that the incidence of TAA has significantly risen while the median length of hospital stay has decreased nationwide. Methods: The IBM MarketScan database was queried for patients who underwent TAA from January 2009 to December 2019 based on Current Procedural Terminology coding. Population estimates from the US Census Bureau were used to calculate the annual incidence of TAA. Procedural volume and incidence were calculated for annual sums, gender, age subgroups, inpatient and outpatient TAA, as well as in four statistical geographic regions in the United States. Median length of hospital stay was calculated and trended annually for inpatient TAA. Results: A total of 41,060 primary TAAs were identified in the database from 2009 to 2019, in which 52.5% were performed in males. Annual volumes increased by 136.1%, from 2180 to 5147 procedures nationwide. Incidence reported per 100 000 population increased by 120.8%. Both inpatient and outpatient procedures have increased, by 242.5% and 86.6%, respectively. Median length of hospital stay decreased from 3 days in 2009 to 1 day in 2019 and did not differ between genders. Growth in incidence was demonstrated in males and females above the age of 54 years with the largest growth in annual incidence found between 65 and 74 years. Incidence rose in the South and West of the United States by 111.8% and 136.5%, respectively. Conclusion: We found that annual volumes and incidence rates of primary TAA has increased between 2009 and 2019. Although both inpatient and outpatient surgery have become more frequent, inpatient volumes and incidence have increased almost 3 times more than those of outpatient surgery. Length of hospital stay decreased over the study years. When adjusted for the same study period, the cumulative annual growth rates of TAA were found to be 2 times greater than total knee arthroplasty and 3.6 times greater than total hip arthroplasty. Level of Evidence: Level III, retrospective database review.
Impact of a hybrid medical care model in the rheumatoid arthritis patient-reported outcomes: A non-inferiority crossover randomized study
Authors: Guaracha-Basáñez Guillermo A , Contreras-Yáñez Irazú , Estrada González Vivian A , Pacheco-Santiago Lexli D , Valverde-Hernández Salvador S , Pascual-Ramos Virginia 
Published: September 2022

Objective Patients and physicians can naturally adopt hybrid healthcare models that combine face-to-face consultations with telemedicine. The study's objective was to compare the impact of two healthcare interventions, hybrid care modality and face-to-face consultation, on the patient-reported outcomes of rheumatoid arthritis patients, during the COVID-19 pandemic. Methods Consecutive outpatients reincorporated to a clinic previously in lockdown were invited to a non-inferiority, randomized study (October 2020–-May 2022). Patients were randomized to 6 months of face-to-face consultation or hybrid care modality (intervention period-1) and then the converse modality (intervention period-2). The primary outcome was disease activity/severity behavior (Routine Assessment of Patient Index Data 3). Additional patient-reported outcomes were disability (Health Assessment Questionnaire Disability Index), quality-of-life (World Health Organization quality of life questionnaire-brief version), adherence and satisfaction with medical care, and treatment recommendation. Sample size calculation established 55 patients/healthcare interventions. Results There were 138 patients invited to participate, 130 agreed and 121 completed their study participation. Sixty-one and 60 patients respectively, received face-to-face consultation and hybrid care modality over intervention period-1. Patients were primarily middle-aged females (90.1%), with (median, IQR) 12 (9–16) years of education, long-standing disease, working (62.8%), receiving disease-modifying anti-rheumatic drugs (96.7%), and corticosteroids (61.2%). Patients had low disease activity (median Routine Assessment of Patient Index Data 3: 2.7) and Health Assessment Questionnaire Disability Index score that translated into the absence of disability, while quality of life was compromised. Baseline characteristics were similar between patients assigned to each healthcare intervention. Differences in Routine Assessment of Patient Index Data 3 behavior were below the non-inferiority margin. Results considered the order in which patients received the intervention and baselines scores, and extended to the patient-reported outcomes left. Conclusions Hybrid care modality was non-inferior to in-person consultations in achieving patient-reported outcomes during the COVID-19 pandemic in rheumatoid arthritis patients.
Eleven years of teledermoscopy in the Netherlands: A retrospective quality and performance analysis of 18,738 consultations
Authors: van Sinderen Femke , Tensen Esmée , Lansink Rick AB , Jaspers Monique WM , Peute Linda WP 
Published: September 2022

Introduction Teledermoscopy supports and enhances the early detection of skin lesions by general practitioners in primary practice through remote consultation with dermatologists. Teledermoscopy has been a regular health service in Dutch primary care since February 2009. Teledermoscopy quality and performance outcomes on Dutch general practitioner primary care 11 years after its implementation were assessed. Methods Dutch primary care teledermoscopy consultation data was retrospectively analysed on timestamps and responses on non-mandatory evaluation questions posed to the general practitioner and teledermatologist during the teledermoscopy consultation process. Anonymized data (February 2009–February 2020) was extracted from a Dutch teledermoscopy service database. The timestamps and evaluation questions data were subject to the teledermoscopy quality and performance outcomes. A limited cost evaluation was performed. Results A total of 18,738 teledermoscopy consultations were sent by 1341 general practitioners (February 2009–February 2020). For 3908 (31.9%) teledermoscopy consultations, the general practitioner requested second opinion advice which led to 712 (18.2%) extra teledermoscopy referrals of patients who would not have been referred without teledermoscopy, including skin cancer teledermoscopy diagnoses. The general practitioner followed the teledermatologists’ advice on patient referral for 8813 (88.5%) patients, reported 97.3% of the teledermoscopy consultations as helpful and 95.1% as instructive, referred 68.0% less patients with teledermoscopy availability, referred overall 59.4% less patients, and needed 5.4 minutes (median) for sending a teledermoscopy consultation. Teledermatologist's median answer and response time was 2 minutes and 2.4 hours, respectively. The estimated cost reduction was €144.18 ($164.65) (50.2%) per teledermoscopy patient. Discussion Teledermoscopy is a useful service in general practitioner practice for requesting dermatologist advice in primary care settings to support the detection of skin lesion at an early stage and at lower costs. Teledermoscopy could also decrease the burden of secondary dermatology care since general practitioners reported that they did not refer the majority of patients to a dermatologist after the teledermoscopy consultation compared to their initial referral decision. General practitioners reported the teledermoscopy system as helpful and instructive which could contribute to enhancement of their dermatological knowledge.
Nationwide implementation of a centralised telemedicine platform in Singapore to fight the COVID-19 pandemic
Authors: Kok Ta Wei Kevin , Chong Si Jack , Yau Wen Kien Joachim , Raj Kumar Praveen , Chua Swee Boon Raymond 
Published: September 2022

Introduction This study aims to share the experience of the Ministry of Health (Singapore) in deploying a centrally managed Telemedicine service to triage, and manage COVID-19 cases in the community during the COVID-19 Omicron wave. Material and methods Data from the deployed telemedicine system, Telemedicine Allocation and Reconciliation System, over a 14-week period (3 January 2022–10 April 2022) was analysed to determine the safety and efficacy of both the (i) National COVID-19 sorting logic algorithm and (ii) the use of a centralised telemedicine platform with privacy protection in a pandemic. Results There was a total of 47,754 children (aged 1–11 years old), 75,702 adolescents and adult patients (aged 12–69 years old) and 55,774 geriatric patients (aged > = 70 years old) who were directly managed by this platform. Amongst them, 64,961 were from the higher-risk special populations (pregnant, end-stage renal failure and immunocompromised and geriatric population). The total number of patients requiring escalations to public health institutions were 4212. This accounts for 1.32%, 3.00% and 2.35% of the children, teenagers and adults, and geriatric population respectively.
Psychomotor agitation and irritability in adolescents with manic episode: Clinical data from three inpatient units
Authors: Turan Serkan , Ermiş Çağatay , Eray Şafak , Ağaç Nilay , Aksoy Sena , Yüksel Ayşe Sena , Bezir Karaca Ayça , Güler Duru , Tunçtürk Mustafa , Çıray Remzi Oğulcan , Mutlu Caner , Karaçetin Gül , Youngstrom Eric A , İnal Neslihan 
Published: September 2022

Objectives We aimed to investigate the characteristics of adolescents with Bipolar disorder-I with irritability and agitation (Mania+IA) compared to those without irritability and agitation (Mania-IA) in a multi-center representative sample. Methods Data of 145 patients from three tertiary-care inpatient units between 2016 and 2021 were obtained. Psychomotor agitation was defined as a score of ≥3 on the YMRS “Increased Motor Activity––Energy” item, irritability as a score of ≥4 on the YMRS ‘irritability’ item, and severity anchors of speech and thought disturbance on the YMRS ‘6 and 7’ items. Results Previous manic episodes ( p = 0.013), involuntary hospitalization ( p = 0.006), psychotic features ( p = 0.001), formal thought disorder ( p = 0.010) and aggressive/disruptive behavior ( p = 0.021) were more frequent in the Mania+IA group. Conversely, depressive episodes ( p = 0.006) and family history of depression ( p = 0.024) were more frequent in the Mania-IA group. The Mania+IA had poorer functioning at the time of discharge. Conclusions Irritability and agitation were closely related to complications, psychotic symptoms and thought disorder. Assessment and monitoring of psychomotor agitation and irritability may help child and adolescent psychiatrists to predict clinical difficulties and appropriate interventions.
Characteristics analysis and optimization design of bridge crane based on improved particle swarm optimization algorithm
Authors: Wang Yahui , Ma Chaojie , Wang Chong , Zhang Huipeng , Fan Suxiang 
Published: September 2022

Large redundant metal structures have high stability with large cost. An excellent mechanical structure should have the lower weight when satisfying its stability. Aiming at the large redundancy of the main beam metal structure of the double-beam bridge crane, the paper extracts six important parameters to determine its quality, and the corresponding value is set. The orthogonal test table is designed to calculate the strength and stiffness. In order to avoid resonance, the fixed vibration frequency and excitation frequency are calculated. The experimental results are fitted to obtain the six parameters of the quality, strength, stiffness, and natural frequency. Moreover, particle swarm optimization algorithm is used to solve the multi-objective optimization mathematical model with the design quality as the goal and the stiffness, strength, and easy resonance interval as constraints. In view of the long calculation time and poor convergence of particle swarm optimization algorithm, a module that limits the particle forward speed is added and the generation conditions of particles are redefined. The improved particle swarm algorithm shows that the first-order vibration frequency of the main beam increases from 18 Hz to 27.55 Hz. It improves the stability of the overall structure and avoids resonance with the motor frequency. Under the condition of satisfying the stability of the main beam, the quality of the main beam is reduced from 1.23 tons to 0.53 tons, with a reduction of 6%.
Narrative Review of Risk Assessment of Abdominal Aortic Aneurysm Rupture Based on Biomechanics-Related Morphology
Authors: Ren Shuqi , Guidoin Robert , Xu Zaipin , Deng Xiaoyan , Fan Yubo , Chen Zengsheng , Sun Anqiang 
Published: September 2022

An abdominal aortic aneurysm (AAA) is a typical aortic disease with serious complications. In clinical practice, the decision to intervene in treatment depends on the rupture risk of AAA. Therefore, monitoring the progression of the disease and accurately assessing the rupture risk is of great importance for its treatment. Studies have shown that the biomechanical indicators based on multi-scale models are more effective in accurately assessing the rupture risk of AAA. However, using computational fluid dynamics (CFD) to simulate the biomechanical environment is a cumbersome and time-consuming process, which is inadequate to meet the needs of clinical monitoring and quick decisions. While the hemodynamic environment of AAA is heavily dependent on geometry, more and more biomechanics-related morphological parameters have been raised and validated. In this review, we summarized typical morphological parameters associated with AAA rupture and their relationships with the mechanical environment, including maximum diameter, deformation rate, saccular index, asymmetry, AAA volume, tortuosity, and intraluminal thrombus (ILT), providing a reference for clinical preoperative risk assessment. Clinical Impact Studies have shown that the biomechanical indicators based on multi-scale models are more effective in accurately assessing the rupture risk of AAA. To meet the need for clinical monitoring and rapid decision making, the typical morphological parameters associated with AAA rupture and their relationships with the mechanical environment have been summarized, which provide a reference for clinical preoperative risk assessment of AAA.
Liquid Drug Delivery Approaches for the Treatment of Occlusive Arterial Disease: A Systematic Review
Authors: Todd Meagan , Nair Pradeep K. , Ohayon Jacques , Pettigrew Roderic I. , Yazdani Saami K. 
Published: September 2022

Objective: Local Liquid drug (LLD) delivery devices have recently emerged as a novel approach to treat peripheral arterial disease. This systemic review aims to identify and evaluate the clinical utility of the most commonly used delivery devices. Methods: A systemic review was performed using the Medical Subjects Heading terms of “drug delivery,” “liquid,” “local,” and “cardiovascular disease” in PubMed, Google Scholar, and Scopus. Results: Four commonly used delivery devices were identified, including (1) the Bullfrog Micro-Infusion Device, (2) the ClearWay RX Catheter, (3) the Occlusion Perfusion Catheter, and (4) the Targeted Adjustable Pharmaceutical Administration. All have shown to successfully deliver liquid therapeutic into the target lesion and have exhibited favorable safety and efficacy profiles in preclinical and clinical trials. The LLD devices have the ability to treat very long or multiple lesions with a single device, providing a more economical option. The safety profile in LLD clinical studies is also favorable in view of recent concerns regarding adverse events with crystalline-paclitaxel–coated devices. Conclusion: There is clear clinical evidence to support the concept of local liquid delivery to treat occlusive arterial disease. Clinical Impact The ‘leave nothing behind’ strategy has been at the forefront of the most recent innovations in the field of interventional cardiology and vascular interventions. Although drug coated balloons have overcome limitations associated with plain old balloon angioplasty and peripheral stents, recent safety concerns and cost considerations have impacted their usage. In this review, various liquid drug delivery devices are presented, showcasing their capabilities and success in both preclinical and clinical settings. These innovative liquid delivery devices, capable of targeted delivery and their ability to be re-used for multiple treatment sites, may provide solutions for current unmet clinical needs.
In vitro testing of a funnel-tip catheter with different clot types to decrease clot migration in mechanical thrombectomy
Authors: Payne Emily S. , Krost-Reuhl Samantha , Heimann Axel , Keric Naureen , Masomi-Bornwasser Julia , Gerber Tiemo , Seidman Larissa , Kirschner Stefanie , Brockmann Marc A. , Tanyildizi Yasemin 
Published: September 2022

Background Mechanical thrombectomy is the standard treatment for acute ischemic stroke in patients with large vessel occlusion and can be performed up to 24h after symptom onset. Despite high recanalization rates, embolism in new territories has been reported in 8.6% of the cases. Causes for this could be clot abruption during stent retrieval into the smaller opening of a standard distal access catheter, and antegrade blood flow via collaterals despite proximal balloon protection. A funnel-shaped tip with a larger internal diameter was developed to increase the rate of first-pass recanalization and to improve the safety and efficacy of mechanical thrombectomy. Methods This in vitro study compared the efficacy of a funnel-shaped tip with a standard tip in combination with different clot compositions. Mechanical thrombectomy was performed 80 times for each tip, using two stent retrievers (Trevo XP ProVue 3/20 mm, 4/20 mm) and four different clot types (hard vs. soft clots, 0–24h vs. 72h aged clots). Results Significantly higher first-pass recanalization rates (mTICI 3) were observed for the funnel-shaped tip, 70.0% versus 30.0% for the standard tip (absolute difference, 32; relative difference 57.1%; P < .001), regardless of the clot type and stent retriever. Recanalization could be increased using harder Chandler loop clots versus softer statically generated clots, as well as 0–24h versus 72h aged clots, respectively. Conclusion The funnel-shaped tip achieved higher first-pass recanalization rates than the smaller standard tip and lower rates of clot abruption at the tip. Clot compositions and aging times impacted recanalization rates.
Rickettsia conorii: Unusual case of acute aortic thrombosis
Authors: Fernández Álvarez Iria , Fernández Lorenzo Javier , de Sá Jose Manuel Encisa 
Published: September 2022

Objectives Mediterranean spotted fever is a common zoonosis in Europe caused by Rickettsia conorii bacterium . Among its wide range of clinical presentations, arterial thrombosis of large vessels has never been described before. Methods We report a case of a complete acute infrarenal aortic thrombosis in a 61-year-old male with R. conorii infection . Results and Conclusion The patient was successfully operated using open aortic surgery and subsequent treatment with doxycycline. To our knowledge, this is the first report of aortic thrombosis associated with infection by this parasite, extending the clinical spectrum of the disease.
Declining first-ever stroke incidence rates in 15- to 54-year-old residents of Tartu, Estonia, from 1991 to 2017
Authors: Kõrv Liisa , Vibo Riina , Kõrv Janika 
Published: September 2022

Background: Having a stroke at a young age has a huge socioeconomic impact. Data on the trends of stroke incidence in young adults from prospective population-based studies are scarce. Aims: The aim of this study was to analyze the trends in stroke incidence in 15- to 54-year-old residents of Tartu, Estonia from 1991 to 2017. Methods: Three population-based studies with identical study protocols determining the incidence of first-ever stroke have previously been conducted in Tartu, Estonia (1991–1993, 2001–2003, and 2013–2017). All residents of Tartu with first-ever stroke (ischemic stroke, spontaneous intracerebral hemorrhage, and subarachnoid hemorrhage) who were hospitalized to the Department of Neurology, Tartu University Hospital in respective study periods were included prospectively. Overlapping data sources for case ascertainment were used to include both hospitalized and non-hospitalized cases. Trends in first-ever stroke incidence in 15- to 54-year-old residents of Tartu were calculated and compared using rate ratio (RR). Results: Altogether 259 strokes were identified. From 1991 to 2017, the proportion of women increased from 38.3% to 43.6%. Mean age at onset in women decreased from 46.9 (standard deviation (SD): 7.3) to 42.6 (SD: 8.9). Overall crude incidence rates per 100,000 decreased significantly from 1991 to 2003 (from 57.2 (95% confidence interval (CI): 46.9–69.1) to 35.7 (95% CI: 25.7–48.3)); RR: 0.62 (95% CI: 0.44–0.89). While also present in women, the decrease was most notable in 45- to 54-year-old men (RR: 0.55 (95% CI: 0.30–0.99)). In 35- to 44-year-old men, the incidence rates decreased significantly from 2001 to 2017 (RR: 0.37 (95% CI: 0.14–0.99)). Conclusion: The overall first-ever stroke incidence rates decreased from 1991 to 2003 and remained stable thereafter.
Development and Validation of Inpatient Hypoglycemia Models Centered Around the Insulin Ordering Process
Authors: Wright Aileen P. , Embi Peter J. , Nelson Scott D. , Smith Joshua C. , Turchin Alexander , Mize Dara E. 
Published: September 2022

Background: The insulin ordering process is an opportunity to provide clinicians with hypoglycemia risk predictions, but few hypoglycemia models centered around the insulin ordering process exist. Methods: We used data on adult patients, admitted in 2019 to non-ICU floors of a large teaching hospital, who had orders for subcutaneous insulin. Our outcome was hypoglycemia, defined as a blood glucose (BG) <70 mg/dL within 24 hours after ordering insulin. We trained and evaluated models to predict hypoglycemia at the time of placing an insulin order, using logistic regression, random forest, and extreme gradient boosting (XGBoost). We compared performance using area under the receiver operating characteristic curve (AUCs) and precision-recall curves. We determined recall at our goal precision of 0.30. Results: Of 21 052 included insulin orders, 1839 (9%) were followed by a hypoglycemic event within 24 hours. Logistic regression, random forest, and XGBoost models had AUCs of 0.81, 0.80, and 0.79, and recall of 0.44, 0.49, and 0.32, respectively. The most significant predictor was the lowest BG value in the 24 hours preceding the order. Predictors related to the insulin order being placed at the time of the prediction were useful to the model but less important than the patient’s history of BG values over time. Conclusions: Hypoglycemia within the next 24 hours can be predicted at the time an insulin order is placed, providing an opportunity to integrate decision support into the medication ordering process to make insulin therapy safer.