bluuebunny/crossref_metadata_2025_split huggingface dataset:
Graphical Presentations of Clinical Data in a Learning Electronic Medical Record
Authors: Calzoni Luca , Clermont Gilles , Cooper Gregory F. , Visweswaran Shyam , Hochheiser Harry 
Published: October 2020

AbstractBackground Complex electronic medical records (EMRs) presenting large amounts of data create risks of cognitive overload. We are designing a Learning EMR (LEMR) system that utilizes models of intensive care unit (ICU) physicians' data access patterns to identify and then highlight the most relevant data for each patient.Objectives We used insights from literature and feedback from potential users to inform the design of an EMR display capable of highlighting relevant information.Methods We used a review of relevant literature to guide the design of preliminary paper prototypes of the LEMR user interface. We observed five ICU physicians using their current EMR systems in preparation for morning rounds. Participants were interviewed and asked to explain their interactions and challenges with the EMR systems. Findings informed the revision of our prototypes. Finally, we conducted a focus group with five ICU physicians to elicit feedback on our designs and to generate ideas for our final prototypes using participatory design methods.Results Participating physicians expressed support for the LEMR system. Identified design requirements included the display of data essential for every patient together with diagnosis-specific data and new or significantly changed information. Respondents expressed preferences for fishbones to organize labs, mouseovers to access additional details, and unobtrusive alerts minimizing color-coding. To address the concern about possible physician overreliance on highlighting, participants suggested that non-highlighted data should remain accessible. Study findings led to revised prototypes, which will inform the development of a functional user interface.Conclusion In the feedback we received, physicians supported pursuing the concept of a LEMR system. By introducing novel ways to support physicians' cognitive abilities, such a system has the potential to enhance physician EMR use and lead to better patient outcomes. Future plans include laboratory studies of both the utility of the proposed designs on decision-making, and the possible impact of any automation bias.
Isolated Articular Fractures of the Canine Talus: Diagnosis and Signalment in Fourteen Dogs
Authors: Carbonell Buj Elena , Burton Neil , Mosley John R. , Meeson Richard L. , Major Alison , Whitelock Richard G. , Parsons Kevin , Langley-Hobbs Sorrel J. 
Published: October 2020

AbstractObjective The aim of this retrospective multicentre case series was to describe signalment, presenting signs and imaging findings in dogs with isolated articular fractures of the talus.Study Design Medical records (2008–2019) of dogs with isolated articular talar fractures were reviewed.Results Fourteen dogs met the inclusion criteria; affected breeds were four German Pointer (three shorthair and one wirehaired), three Labrador Retrievers, two Rottweilers, two Springer Spaniels, one cross breed, one Greyhound and one Great Münsterländer. The age range was 1 to 8 years with a median of 4.7 years. Lameness was usually acute in onset and had been present for a range of 4 to 540 days prior to referral.The most common fracture configuration involved the lateral trochlear ridge only (n = 9). Two of the fourteen fractures affected both trochlear ridges. Thirteen dogs were initially assessed radiographically with classic orthogonal views, but a fracture was only visible in five cases. The remainder were confirmed with further radiographic projections (n = 4) or computed tomography (n = 5). In one case, the lameness was located to the tarsus by scintigraphy.Conclusion Isolated articular fracture of the talus is rare and may prove a diagnostic challenge due to the varied presentations and complex anatomy of the bone. Pathology of the talus may be suspected in any case of lameness localized to the tarsus and oblique/skyline radiographic views or advanced imaging should be performed if standard radiographic views are unremarkable.
Pain Management following Open Reduction and Internal Fixation of Distal Radius Fractures
Authors: Niedermeier Steven R. , Crouser Nisha , Hidden Krystin , Jain Sonu A. 
Published: October 2020

Abstract
Background Distal radius fractures (DRF) are commonly treated with open reduction and internal fixation (ORIF). Few studies address perioperative and postoperative pain control for this procedure.
Questions/Purpose We attempt to demonstrate efficacy of pain management modalities during the perioperative and acute postoperative period after ORIF. Specifically, does the type of perioperative anesthesia used during fixation of DRF affect pain control postoperatively? Does the quantity of narcotic pain medication prescribed or type of pain medication given postoperatively affect pain management?
Methods We retrospectively reviewed 294 adult (≥18 years old) patients who underwent outpatient ORIF of acute DRF between December 2012 and December 2014. All procedures were performed with a standard volar plating technique through a flexor carpi radialis approach. Patient demographics, fracture laterality, severity of fracture, type of operative anesthesia, and details regarding postoperative oral pain medications were recorded. We reviewed the number and timing of patient phone calls regarding postoperative pain and refills of pain prescriptions.
Results Two-hundred ninety-four patients (average age 48.7 years) were included. One-hundred twenty-two injuries were right-sided (41.5%), 168 were left-sided (57.1%), and four were bilateral (1.4%). One-hundred fifty-one patients (51.4%) received regional anesthesia prior to surgery. Average number of narcotics tablets prescribed was 58. There were 66 patients who called the orthopaedic patient hotline regarding pain-control issues at a median of 7.0 days postoperatively. One-hundred twenty-nine (43.9%) patients required refills of narcotic pain medication postoperatively. There was no significant difference in the number of calls or refills given with regard to the type of anesthesia used or postoperative pain regimen prescribed.
Conclusions More than one-fifth of patients who underwent ORIF experienced pain severe enough to call our institution's orthopaedic hotline to ask for help at a median of 7 days after fixation.
Clinical Relevance Our study demonstrates poor pain control regardless of intraoperative anesthesia or utilization of varying postoperative pain regimens.
Epidemiology of Cranial Cruciate Ligament Rupture and Patellar Luxation in Dogs from the Province of Buenos Aires, Argentina
Authors: Rudd Garces Gabriela , Arizmendi Analía , Barrientos Laura S. , Crespi Julián A. , Morales Hernán , Peral García Pilar , Padula Gisel , Giovambattista Guillermo 
Published: October 2020

AbstractObjective The aim of this study was to investigate the prevalence of cranial cruciate ligament rupture and patellar luxation and the associated risk factors in dogs.Materials and Methods A total of 13,072 clinical records of dogs were reviewed from School Hospital (Faculty of Veterinary Sciences, National University of La Plata). Data of age, breed, sex, body weight, patellar luxation and cranial cruciate ligament rupture condition were registered. Chi-squared and Fisher's exact tests were used to compare the prevalence of cranial cruciate ligament rupture and patellar luxation with the variables and then univariable logistic regression was used to evaluate the risk of having cranial cruciate ligament rupture and patellar luxation. Multivariable logistic regression was used including all variables to assess the odds of having patellar luxation and cranial cruciate ligament rupture.Results Of 13,072 patients treated, 72 and 51 had cranial cruciate ligament rupture and patellar luxation respectively. Sex was not a major risk factor for either condition. Adult (odds ratio [OR] = 8.2) and senior (OR = 4.3) patients had increased risk of having cranial cruciate ligament rupture, while for patellar luxation age was not a risk factor. Groups 2, 3 and 8 were more likely to have cranial cruciate ligament rupture (OR = 5.5, OR = 9.1 and OR = 2.6), and group 11 had lower risk of having patellar luxation (OR = 0.08). Maxi (OR = 2.4) and giant (OR = 6.0) breeds had higher risk of having cranial cruciate ligament rupture, and medium and maxi breeds had higher risk of patellar luxation (OR = 0.05 and OR = 0.3). Multivariate OR test confirmed that age (adult), body size (giant and maxi) and breed group (Group 3) were significantly associated with having cranial cruciate ligament rupture, and age was associated with having patellar luxation.Clinical Significance This is the first epidemiological study of cranial cruciate ligament rupture and patellar luxation in dogs from School Hospital (Faculty of Veterinary Sciences, National University of La Plata). Giant and large adult dogs from the Molossoid and Terrier breeds were more likely to have cranial cruciate ligament rupture, while mixed and large dog breeds showed the lowest risk of having patellar luxation.
Salter-Harris Type II Humeral Head Fracture with Kirschner Wire Fixation in a Goat
Authors: Walmsley Darby W. , Shaw Tania , Kudnig Simon T. 
Published: October 2020

AbstractThe aim of this study was to describe a case of a Salter-Harris type II fracture of the humeral head in a goat repaired with Kirshner wire fixation. A 3-year-old, 52 kg, male, non-domesticated goat was referred for evaluation. Approximately 11 days prior, the goat sustained suspected vehicular trauma, and was found on the side of the road with a non-weight bearing lameness of the right thoracic limb. Orthogonal radiographic assessment identified a Salter-Harris type II fracture of the humeral head with proximolateral displacement of the humerus. The fracture was repaired with multiple Kirschner wire fixation. Orthogonal radiographic assessment of the right humerus at 8 weeks postoperatively revealed implant quiescence with radiographic union of the fracture site. Long-term telephone follow-up at 3 and 6 months postoperatively found the patient was no longer restricted in activity, with free access to the field, and was not displaying an overt lameness. The authors describe a novel fracture configuration in the goat successfully repaired with multiple Kirschner wire fixation.
Effects of VEGF on Prefabricated Vascularized Bone Allografts in Rats
Authors: Tobiume Sachiko , Kaji Yoshio , Nakamura Osamu , Yamaguchi Konosuke , Oka Kunihiko , Yamamoto Tetsuji 
Published: October 2020

Abstract
Background Massive bone defects after wide resection of malignant bone tumors or a serious injury require treatment using vascularized bone grafts. Although cadaveric bone allografts combined with vascularized bone autografts are currently thought to be ideal in terms of size and durability, this treatment requires the scarification of healthy bone tissue. In a previous study, we attempted to improve this situation by prefabricating a vascularized bone allograft in recipient rats. In this study, we added vascular endothelial growth factor (VEGF)-containing hydroxyapatite/collagen composite (HAp/Col) to a prefabricated vascularized bone allograft to stimulate angiogenesis, which is known to be important for bone formation.
Methods Sprague Dawley rats (n = 50) were used as donors and Wistar rats (n = 50) as recipients. All rats were 9 weeks old. The recipient rats were divided into five groups according to the use of vascular bundles, HAp/Col, and an additive substance (VEGF). The bone allografts collected from the donors were transplanted into the thigh region of the recipients, and a saphenous vein and 10 μg HAp/Col with VEGF were inserted into the bone allografts through the slit. After 4 weeks, the transplanted bone allografts were harvested, and histologic and genetic evaluations were performed in relation to bone formation and resorption.
Results The results showed that, compared with the control group, the implantation of the vascular bundles and VEGF-containing HAp/Col significantly stimulated angiogenesis and bone formation in the rats with the bone allografts. However, histological and genetic evaluations of bone resorption revealed that resorption was not observed in any group.
Conclusion These results suggest that VEGF-containing HAp/Col effectively stimulates angiogenesis and bone formation, but not bone resorption, in prefabricated vascularized bone allografts. This method could therefore become a useful tool for treating large bone defects.
Risk Factors for Neuropathic Pain Following Major Upper Extremity Amputation
Authors: Lans Jonathan , Hoftiezer Yannick , Lozano-Calderón Santiago A. , Heng Marilyn , Valerio Ian L. , Eberlin Kyle R. 
Published: October 2020

Abstract
Background Active treatment (targeted muscle reinnervation [TMR] or regenerative peripheral nerve interfaces [RPNIs]) of the amputated nerve ends has gained momentum to mitigate neuropathic pain following amputation. Therefore, the aim of this study is to determine the predictors for the development of neuropathic pain after major upper extremity amputation.
Methods Retrospectively, 142 adult patients who underwent 148 amputations of the upper extremity between 2000 and 2019 were identified through medical chart review. All upper extremity amputations proximal to the metacarpophalangeal joints were included. Patients with a follow-up of less than 6 months and those who underwent TMR or RPNI at the time of amputation were excluded. Neuropathic pain was defined as phantom limb pain or a symptomatic neuroma reported in the medical charts at 6 months postoperatively. Most common indications for amputation were oncology (n = 53, 37%) and trauma (n = 45, 32%), with transhumeral amputations (n = 44, 30%) and shoulder amputations (n = 37, 25%) being the most prevalent.
Results Neuropathic pain occurred in 42% of patients, of which 48 (32%) had phantom limb pain, 8 (5.4%) had a symptomatic neuroma, and 6 (4.1%) had a combination of both. In multivariable analysis, traumatic amputations (odds ratio [OR]: 4.1, p = 0.015), transhumeral amputations (OR: 3.9, p = 0.024), and forequarter amputations (OR: 8.4, p = 0.003) were independently associated with the development of neuropathic pain.
Conclusion In patients with an upper extremity amputation proximal to the elbow or for trauma, there is an increased risk of developing neuropathic pain. In these patients, primary TMR/RPNI should be considered and this warrants a multidisciplinary approach involving general trauma surgeons, orthopaedic surgeons, plastic surgeons, and vascular surgeons.
The Double Stitch Everting Technique in the End-to-Side Microvascular Anastomosis: Validation of the Technique Using a Randomized N-of-1 Trial
Authors: Dindelegan George C. , Dammers Ruben , Oradan Alex V. , Vinasi Ramona C. , Dindelegan Maximilian , Volovici Victor 
Published: October 2020

Abstract
Background The double stitch everting (DSE) technique, in which time is won by leaving the needle inside the vessel wall in-between stitching, is a modification of the end-to-side (ETS) anastomosis in the interest of reducing anastomosis time. This ensures proper wall eversion, intima-to-intima contact, and improved suture symmetry.
Methods We designed an N-of-1 randomized trial with each microsurgeon as their own control. We included 10 microsurgeons of different levels of experience who were then asked to perform classic and DSE ETS anastomoses on the chicken leg and rat femoral models. Every anastomosis was cut and evaluated using blinded assessment. Two-way analysis of variance (ANOVA) and multivariable logistic regression were used to analyze the results and for confounder adjustment.
Results A total of 210 anastomoses were performed, of which 177 on the chicken leg and 43 on the rat femoral artery and vein. From the 210 anastomoses, 111 were performed using the classic technique and 99 using the DSE technique. The mean anastomosis time was 28.8 ± 11.3 minutes in the classic group and 24.6 ± 12 minutes in the DSE group (p < 0.001, t-test). There was a significant reduction (p < 0.001, two-way ANOVA) in the number of mistakes when using the DSE technique (mean 5.5 ± 2.6) compared with those using the classic technique (mean 7.7 ± 3.4).
Conclusion The DSE technique for ETS anastomoses improves anastomoses times in experienced and moderately experienced microsurgeons while also improving or maintaining suture symmetry and lowering the number of mistakes.
Intraoperative Real-Time Visualization of the Lymphatic Vessels Using Microscope-Integrated Laser Tomography
Authors: Hayashi Akitatsu , Yoshimatsu Hidehiko , Visconti Giuseppe , Sujarittanakarn Sasithorn , Giacalone Guido , Hayashi Nobuko , Yamamoto Takumi , Yang Johnson Chia-Shen , Hong Joon Pio 
Published: October 2020

AbstractBackground Detection and selection of the lymphatic vessels are important for maximizing therapeutic efficacy of lymphaticovenular anastomosis (LVA). Some imaging modalities have been reported to be useful for intraoperative identification of the lymphatic vessels, but they have limitations. In this article, we present new capabilities of intraoperative laser tomography, which was used to evaluate the lumen of the lymphatic vessel and to validate the patency of anastomosis.Methods Fifty-two patients with upper extremity lymphedema secondary to breast cancer treatment underwent indocyanine green (ICG) lymphography and real-time laser tomography imaging of ICG-enhanced lymphatic vessels intraoperatively before transecting the vessels during LVA. The imaging findings of the lymphatic vessels in laser tomography were investigated. Time required for scanning of the lymphatic vessels was compared between laser tomography and ultrasonography. The correlation between the thickness of the lymphatic vessel wall measured with laser tomographic imaging and the histologically measured thickness of the lymphatic vessel wall was examined. The patency of anastomosis sites was determined based on the image using laser tomography immediately after establishment of LVA.Results A total of 132 ICG-enhanced lymphatic vessels were scanned with laser tomography showing clear lumen with surrounding vessel wall. The required time for lymphatic vessel scanning was significantly shorter with laser tomography than with ultrasonography (1.6 ± 0.3 vs. 4.8 ± 1.2 minutes; p = 0.016). Strong correlation was seen between the thickness of the lymphatic vessels wall measured using laser tomography and the histologically measured thickness of the lymphatic vessel wall (r = 0.977, 95% confidence interval: 0.897–0.992, p < 0.001). The quality of patency was evaluated immediately after anastomosis, which assisted in deciding whether reanastomosis was needed.Conclusion Microscope-integrated laser tomography provides real-time images of the lymphatic vessels in extremely high resolution and enables evaluation of lymphatic lumen condition and objective post-LVA anastomosis status.
Design principles for self-forming interfaces enabling stable lithium-metal anodes
Authors: Zhu Yingying , Pande Vikram , Li Linsen , Wen Bohua , Pan Menghsuan Sam , Wang David , Ma Zi-Feng , Viswanathan Venkatasubramanian , Chiang Yet-Ming 
Published: October 2020

Significance
It is possible to nearly double the energy density of existing lithium-ion batteries by using lithium metal anodes. However, it has been known for decades that the lithium dendrites and mossy lithium formed during charging (electrodeposition) limit the cycle life of the batteries. It is important to change the growth behavior of lithium metal, which is closely related to the properties of the solid–electrolyte interface (SEI) formed via spontaneous reactions between the lithium metal and the electrolyte. In this experimental-modeling integrated study, we reveal the design principles of the SEI that facilitates the dendrite-free and dense deposition of lithium and demonstrate one of the best cycling performances of lithium metal anode to date under practically relevant conditions.
Interspecific competition slows range expansion and shapes range boundaries
Authors: Legault Geoffrey , Bitters Matthew E. , Hastings Alan , Melbourne Brett A. 
Published: October 2020

Significance
Range expansion is how invasive species spread and how species track habitats shifting from climate change, so understanding this process is a key applied and basic challenge. Ecologists have long theorized that a competitor can slow or even halt range expansion. However, there has never been definitive empirical evidence of interspecific competition affecting expansion dynamics, and forecasts of spread generally do not consider competitive interactions. We demonstrate experimentally that competition between species can slow range expansion across multiple generations. We also show that competition and density-dependent dispersal continuously alter the shape of the expanding range boundary such that the shape changes over time. Therefore, accurate forecasts of range expansion must account for interactions between competing species.
Model-free decision making is prioritized when learning to avoid harming others
Authors: Lockwood Patricia L. , Klein-Flügge Miriam C. , Abdurahman Ayat , Crockett Molly J. 
Published: October 2020

Significance“Do no harm” is a universal principle of human social life. But how do we learn which of our actions help or harm others? Learning theory suggests there are two different systems that govern how we link actions and outcomes: a model-free system that is efficient and a model-based system that is deliberative. Here we show that people rely more on model-free decision making when learning to avoid harming others compared to themselves. Model-free neural signals that distinguish self and other are observed in the thalamus/caudate, and reliance on model-free moral learning for others varies with individual differences in moral judgment. These findings suggest that moral decision making for others is more model-free and has a specific neural signature.
TLR4 signaling and macrophage inflammatory responses are dampened by GIV/Girdin
Authors: Swanson Lee , Katkar Gajanan D. , Tam Julian , Pranadinata Rama F. , Chareddy Yogitha , Coates Jane , Anandachar Mahitha Shree , Castillo Vanessa , Olson Joshua , Nizet Victor , Kufareva Irina , Das Soumita , Ghosh Pradipta 
Published: October 2020

Significance
To ensure immunity, and yet limit pathology, inflammatory responses must be confined within the proverbial “Goldilocks zone.” TLR4 is the prototypical sensor that orchestrates inflammatory responses through a series of well-characterized downstream cascades. How TLR4 signals are confined remains incompletely understood. Using trans-scale approaches ranging from disease modeling in live animals, through cell-based interventional studies, to structure-guided biochemical studies that offer an atomic-level resolution, this study unravels the existence of a “brake” within the TLR4-signaling cascade, i.e., GIV; the latter is a prototypical member of an emerging class of scaffold proteins. By showing that GIV uses conserved mechanisms to impact multi-TLR signaling, this work unravels a multiscale point of convergence of immune signaling of broader impact beyond TLR4.