bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluating the Effects of Enhanced Recovery Pathways in Craniosynostosis
Authors: Wu Shannon S. , Cai Yida , Sunshine Kerrin , Boas Samuel R. , Kumar Anand R. 
Published: April 2021

Background
Enhanced Recovery After Surgery (ERAS) pathways are multimodal approaches aimed at minimizing postoperative surgical stress, reducing hospitalization time, and lowering hospitalization charges. Enhanced Recovery After Surgery is broadly and increasingly implemented in hospitals across the country. Early reports have shown ERAS to reduce length of stay (LOS) after commonly performed pediatric surgeries. However, LOS and hospital charges after craniosynostosis have not been studied. We hypothesized that extended hospital LOS is correlated with increased hospitalization charges associated with open cranial vault surgery (CVS) and that over a multiyear timeframe, LOS and cost would decrease because of the increased adoption of ERAS in pediatric surgery.

Methods
The Healthcare Cost and Utilization Project's National Inpatient Sample database was analyzed from January 2007 to December 2014. All patients who were diagnosed with craniosynostosis who underwent CVS were included. Variables of interest included demographic data, hospital characteristics, hospitalization data, and total hospital charges. Univariate and generalized linear regression models were used to examine associations between selected variables and the hospitalization charges.

Results
There were 54,583 patients diagnosed with craniosynostosis between 2007 and 2014. Of these patients, 22,916 (41.9%) received CVS. The median total hospital charge was $66,605.77 (interquartile range, $44,095.60–$101,071.17). The median LOS was 3 days (interquartile range, 2–4 days), and there was no significant change in LOS by year (P = 0.979). However, despite a stable LOS, mean hospitalization charge increased significantly by year (P < 0.01). Regression analysis demonstrated the proportion of eligible patients who underwent CVS substantially increased over the selected timeframe (P < 0.01). Most procedures were performed in urban teaching hospitals and high-volume hospitals. There was no significant association between hospital volume and hospitalization charge (P = 0.331).

Conclusions
Increasing hospital charges despite constant LOS for craniosynostosis CVS procedures was observed between 2007 and 2014. Although ERAS has reduced LOS for common pediatric surgical procedures, no decrease in LOS for CVS has been observed. The charges significantly increased over the same period including high-volume centers. Further study to safely lower LOS and hospitalization charges for this procedure may reduce the overall health care burden.
The Coverage of Soft-Tissue Defects Around the Foot and Ankle Using Free or Local Flaps
Authors: Yuan Kaizong , Zhang Feng , Lineaweaver William C. , Chen Xinglong , Li Zhijie , Yan Hede 
Published: April 2021

Background
The purpose of this study was to compare the reconstructive outcomes of soft-tissue defects around foot and ankle with local or free flaps and attempt to provide an optimal strategy for these patients in comparison with the conventional guidelines.

Methods
A retrospective review of all continuous patients with foot and ankle reconstruction using different flaps from 2010 to 2018 was performed. Based on the flap types, the patients were divided into 2 groups: local flap group and free flap group. Outcomes were assessed according to the flap survival rate, recipient complications, aesthetic outcomes, and donor-site complications.

Result
A total of 130 flaps including 47 free flaps and 83 local flaps were collected. There was no difference in flap survival rate between the 2 groups; however, a significant difference in aesthetic outcomes was noted between them: the free flap group presented a better overall aesthetic outcomes in comparison with the local flap group in terms of color and contour match. Moreover, local flaps had more donor-site morbidities including the need for skin grafting and wound infection.

Conclusions
Free flaps in wound coverage of foot and ankle can achieve better outcomes than local flaps in terms of recipient benefits and donor-site compromise with a comparable flap survival rate.
Anatomic Variations and Malformations as Rare Causes of Median Nerve Compression in Adults
Authors: Peperkamp Kirsten , Natroshvili Tina , Malyar Masoud A. , Heine Erwin P. , Walbeehm Erik T. 
Published: April 2021

Objective
The median nerve can become compressed at multiple points in the arm, causing carpal tunnel-, pronator-, anterior interosseous-, or lacertus syndrome. Anatomical variations are potential reasons of persisting or recurrent symptoms of median nerve compression and are often recognized late. The objective of this study is to provide a comprehensive list of rare anatomical variations and malformations causing median nerve compression.

Methods
A total of 62 studies describing median nerve compression due to an anatomical structure in adults published from 2000 in English were included. The findings were: 35 tenomuscular, 16 vascular causes, and 4 cases with nerve involvement. Only 1 osseous and 18 combined anomalies caused compression. In 18 cases, the anomaly was found in the proximal forearm.

Results
In 44 cases, the median nerve was surgical released and 35 anomalies were completely resected. Persistent or recurrent symptoms were present in 13 cases. During follow-up, 1 case of recurrence was reported.
Standard operative option for median nerve compression consists of an open median nerve release.

Conclusions
In case of persistent or recurrent carpal tunnel syndrome, unilateral symptoms, the presence of a palpable mass, manifestation of symptoms at young age and pain in the forearm or upper arm, the surgeon has to rule out the presence of an anatomical anomaly. Complete resection of the anomaly is not always necessary. The surgeon should be aware of potential anomalies to avoid inadvertent damage at surgery.
The Effect of Vibration on Pain During Intravenous Injection of Propofol
Authors: Hwang Lyahn K. , Nash David W. , Yedlin Adam , Greige Nicolas , Larios-Valencia Jessie , Choice Curtis , Pothula Aravind 
Published: April 2021

PurposePain is a common side effect of intravenous injection of propofol. We conducted a randomized, prospective, single-blinded controlled trial to assess the efficacy of vibration analgesia on pain during propofol infusion in ambulatory surgery.MethodsAfter institutional review board approval, 100 patients undergoing elective ambulatory surgery with general anesthesia were randomized into 2 groups. A control group (n = 50) consisted of patients who received infusion of propofol without vibration analgesia. A treatment group (n = 50) consisted of patients who received infusion of propofol with vibration analgesia using the Buzzy device. Pain was assessed using a 4-point pain manifestation scale scored by 2 independent, blinded observers.ResultsParticipants in the treatment group with vibration analgesia were 0.47 times less likely (95% confidence interval, 0.24–0.94;P= 0.03) to experience any pain than the control group. The median summative pain score in the treatment group was significantly less than that of the control group [1 (interquartile range, 1–2) vs 2 (interquartile range, 2–4);P< 0.01] among participants who experienced any pain. Agreement between the 2 blinded observers regarding pain scores was excellent withκw= 0.82 (P< 0.001). Age, sex, body mass index, needle location or size, and medication doses did not differ significantly between the 2 groups.ConclusionVibration analgesia is an effective, low-risk modality that reduces the pain of intravenous propofol injection in general anesthesia.
Technical Considerations and Clinical Applications of the Free Anterior Branch Split Latissimus Dorsi Flap
Authors: Cohen-Shohet Rachel N. , Samant Sonja S. , Chim Harvey 
Published: April 2021

Background
The free anterior branch split latissimus dorsi flap has a reliable anatomy and advantages over the traditional latissimus dorsi flap. By preserving the posterior branch of the thoracodorsal nerve, morbidity at the donor site is reduced, preserving shoulder strength.

Methodology
The purpose of this article is to review our experience with the split latissimus flap, describe our surgical technique, and finally review representative cases of reconstruction in different anatomical regions.

Results
From April 2017 to October 2020, 39 free split latissimus flaps were performed at a single center. Flaps were performed for coverage in the upper extremity (n = 2), lower extremity (n = 32), and head and neck (n = 5). Flap success rate was 97.4%. Mean dimensions of the flap were 17.0 × 8.3 cm, with a mean area of 145 cm2.

Conclusions
The flap has a broad application and can be utilized in many different reconstructive scenarios including for coverage of defects in the extremities, trunk, and head and neck.
Financial Decisions and Reopening a Practice During the COVID-19 Pandemic
Authors: Crowley Jiwon Sarah , Reghunathan Meera , Kadakia Nikita , Barttelbort Scott , Gosman Amanda 
Published: April 2021

Background
On March 11, 2020, the World Health Organization declared COVID-19 as a global pandemic. As a response, the United States shut down public gatherings and businesses in an effort to quarantine. This included the stopping of elective operations, which greatly affected plastic surgeons and their practices during the initial shutdown.

Objectives
We aim to study the early impact of COVID-19 on the financial implications and practice patterns of plastic surgeons in the state of California during the initial shutdown of elective surgery and provide guidelines for effective management during future crises.

Methods
A 20-question survey was sent using Qualtrics XM software to 851 surgeon members of the California Society of Plastic Surgeons. The survey was open from May 13, 2020, to May 29, 2020. Standard statistical analysis was completed to compare private practice and nonprivate practice plastic surgeons.

Results
We had a total of 140 respondents to our survey for a 16.5% response rate. The majority (77.1%) of the respondents were in a private practice setting. Private practice plastic surgeons reported a higher financial impact with a 79% reduction in financial income compared with nonprivate practice plastic surgeons at a 37% reduction (P < 0.0001). Additionally, private practice plastic surgeons demonstrated a higher reduction in case volume and were more likely to lay off or furlough staff, close their practice, and apply for loans (P < 0.001).

Conclusions
Our survey study showed that private practice plastic surgeons in the state of California faced the most financial hardship during the early shutdown of the COVID-19 pandemic. It serves as a valuable snapshot in our economic history and depicts the heavy financial impact of the stopping of elective surgery. Since the reopening of practices, new guidelines have been implemented to maintain safe elective surgery while the pandemic continues. Further follow-up studies on both the state and national level need to be completed to see the continued financial effects on private and nonprivate plastic surgery practices since the reopening and resumption of elective surgery.
Do Organizational Characteristics of Lung Procurement Operations Matter: The Association Between Transplant Center Centrality and Volume With Total Ischemic Time
Authors: Placona Andrew , Shay Patrick , Goff Rebecca R. , Carrico Bob 
Published: April 2021

Background.
To understand the association of 2 organizational characteristics of transplant center (TXC), volume and closeness centrality, with total ischemic time for deceased donor lung transplants in conjunction with the removal of donation service area (DSA) lung allocation policy. The organization of donor procurements has received increased attention since DSA was removed from allocation policy. Consistent with network theories of organization, organizational characteristics of a TXC could affect procurement efficiency, as volume and closeness centrality (measuring how connected a TXC is within the Organ Procurement and Transplantation Network) could be associated with total ischemic time. These associations could have changed because of the removal of DSA from allocation policy.

Methods.
We conducted a retrospective, pooled cross-sectional study of total ischemic time for nonperfused deceased donor lung transplants (n = 9281) between 2015 and 2019, using within-between regression.

Results.
Higher volume TXCs exhibited lower total ischemic times after the removal of DSA from lung allocation policy (P = 0.011); however, all TXCs that had increased volumes, after the removal of DSA from lung allocation policy, exhibited higher levels of total ischemic time (P ≤ 0.001). Before the removal of DSA, TXCs that had increased volumes exhibited lower levels of ischemic time (P ≤ 0.001). Both within and between closeness centrality exhibited u-shaped associations with total ischemic time (P = 0.012; P = 0.006) and the effect of closeness centrality on total ischemic time was different after DSA removal (P < 0.001).

Conclusions.
Organizational characteristics were associated with the efficiency of deceased organ procurements. The effects on total ischemic time were dependent on whether DSA was used for lung allocation.
Identifiability and predictability of integer- and fractional-order epidemiological models using physics-informed neural networks
Authors: Kharazmi Ehsan , Cai Min , Zheng Xiaoning , Lin Guang , Karniadakis George Em 
Published: April 2021

ABSTRACTWe analyze a plurality of epidemiological models through the lens of physics-informed neural networks (PINNs) that enable us to identify multiple time-dependent parameters and to discover new data-driven fractional differential operators. In particular, we consider several variations of the classical susceptible-infectious-removed (SIR) model by introducing more compartments and delay in the dynamics described by integer-order, fractional-order, and time-delay models. We report the results for the spread of COVID-19 in New York City, Rhode Island and Michigan states, and Italy, by simultaneously inferring the unknown parameters and the unobserved dynamics. For integer-order and time-delay models, we fit the available data by identifying time-dependent parameters, which are represented by neural networks (NNs). In contrast, for fractional differential models, we fit the data by determining different time-dependent derivative orders for each compartment, which we represent by NNs. We investigate the identifiability of these unknown functions for different datasets, and quantify the uncertainty associated with NNs and with control measures in forecasting the pandemic.
Efficient and scalable integration of single-cell data using domain-adversarial and variational approximation
Authors: Hu Jialu , Zhong Yuanke , Shang Xuequn 
Published: April 2021

AbstractSingle-cell data provides us new ways of discovering biological truth at the level of individual cells, such as identification of cellular sub-populations and cell development. With the development of single-cell sequencing technologies, a key analytical challenge is to integrate these data sets to uncover biological insights. Here, we developed a domain-adversarial and variational approximation framework, DAVAE, to integrate multiple single-cell data across samples, technologies and modalities without anypost hocdata processing. We fit normalized gene expression into a non-linear model, which transforms a latent variable of a lower-dimension into expression space with a non-linear function, a KL regularizier and a domain-adversarial regularizer. Results on five real data integration applications demonstrated the effectiveness and scalability of DAVAE in batch-effect removing, transfer learning, and cell type predictions for multiple single-cell data sets across samples, technologies and modalities. DAVAE was implemented in the toolkit package “scbean” in the pypi repository, and the source code can be also freely accessible athttps://github.com/jhu99/scbean.
On evaluation metrics for medical applications of artificial intelligence
Authors: Hicks Steven A. , Strümke Inga , Thambawita Vajira , Hammou Malek , Riegler Michael A. , Halvorsen Pål , Parasa Sravanthi 
Published: April 2021

ABSTRACTClinicians and model developers need to understand how proposed machine learning (ML) models could improve patient care. In fact, no single metric captures all the desirable properties of a model and several metrics are typically reported to summarize a model’s performance. Unfortunately, these measures are not easily understandable by many clinicians. Moreover, comparison of models across studies in an objective manner is challenging, and no tool exists to compare models using the same performance metrics. This paper looks at previous ML studies done in gastroenterology, provides an explanation of what different metrics mean in the context of the presented studies, and gives a thorough explanation of how different metrics should be interpreted. We also release an open source web-based tool that may be used to aid in calculating the most relevant metrics presented in this paper so that other researchers and clinicians may easily incorporate them into their research.
TCA-soluble blood serum proteins of COVID-19 patients as possible predictive markers for the disease severity
Authors: Orfin Andrii , Starykovych Marina , Alexanyan Tamila , Tkachuk Svitlana , Starodub Anatoliy , Luchyshyn Taras , Sibirny Andriy , Souchelnytskyi Serhiy , Kit Yuriy 
Published: April 2021

AbstractCoronavirus disease 19 (COVID-19) is a global health crisis on a planetary scale. COVID-19 in many people has mild or moderate manifestation, although significant number of people, especially the elderly, suffer heavy from this illness, which often resulting in death. There are reports of similarities in immune response between COVID-19 and some autoimmune diseases. Earlier, we have demonstrated that fraction of TCA-soluble blood serum proteins containing a 48 kDA fragment of unconvential Myosin C1 have linked with development of multiple sclerosis and rheumatoid arthritis. Here we analyze use of these proteins in determining the severity of disease in COVID-19 patients. We found that blood serum of COVID-19 patients in acute disease manifestation contains, in contrast to healthy individuals, the TCA-soluble proteins with molecular masses 48 kDa and 76 kDA which were identified as a short form of unconventional myosin 1c and a modified form of human serum albumin.
Results Availability and Timeliness of Registered COVID-19 Clinical Trials: A Cross-Sectional Study
Authors: Salholz-Hillel Maia , Grabitz Peter , Pugh-Jones Molly , Strech Daniel , DeVito Nicholas J. 
Published: April 2021

ABSTRACTObjectiveTo examine how and when the results of COVID-19 clinical trials are disseminated.DesignCross-sectional bibliographic studySettingThe COVID-19 clinical trial landscapeParticipants285 registered interventional clinical trials for the treatment and prevention of COVID-19 completed by 30 June 2020Main outcome measuresOverall reporting and reporting by dissemination route (i.e., by journal article, preprint, or results on a registry); time to reporting by dissemination route.ResultsFollowing automated and manual searches of the COVID-19 literature, we located 41 trials (14%) with results spread across 47 individual results publications published by 15 August 2020. The most common dissemination route was preprints (n = 25) followed by journal articles (n = 18), and results on a registry (n = 2). Of these, four trials were available as both a preprint and journal publication. The cumulative incidence of any reporting surpassed 20% at 119 days from completion. Sensitivity analyses using alternate dates available and definitions of results did not appreciably change the reporting percentage. Expanding minimum follow-up time to 3 months increased the overall reporting percentage to 19%.ConclusionCOVID-19 trials completed during the first six months of the pandemic did not consistently yield rapid results in the literature or on clinical trial registries. Our findings suggest that the COVID-19 response may be seeing quicker results disclosure compared to non-emergency conditions. Issues with the reliability and timeliness of trial registration data may impact our estimates. Ensuring registry data is accurate should be a priority for the research community during a pandemic. Data collection is underway for Phase 2 of the DIRECCT study expanding our trial population to those completed anytime in 2020.
Behavioural responses to Covid-19 health certification: A rapid review
Authors: Drury John , Mao Guanlan , John Ann , Kamal Atiya , Rubin G James , Stott Clifford , Vandrevala Tushna , Marteau Theresa M 
Published: April 2021

AbstractBackgroundCovid-status certification – certificates for those who test negative for the SARS-CoV-2 virus, test positive for antibodies, or who have been vaccinated against SARS-CoV-2 – has been proposed to enable safer access to a range of activities. Realising these benefits will depend in part upon the behavioural and social impacts of certification. The aim of this rapid review was to describe public attitudes towards certification, and its possible impact on uptake of testing and vaccination, protective behaviours, and crime.MethodA search was undertaken in peer-reviewed databases, pre-print databases, and the grey literature, from 2000 to December 2020. Studies were included if they measured attitudes towards or behavioural consequences of health certificates based on one of three indices of Covid-19 status: test-negative result for current infectiousness, test-positive for antibodies conferring natural immunity, or vaccination(s) conferring immunity.ResultsThirty-three papers met the inclusion criteria, only three of which were rated as low risk of bias. Public attitudes were generally favourable towards the use of immunity certificates for international travel, but unfavourable towards their use for access to work and other activities. A significant minority was strongly opposed to the use of certificates of immunity for any purpose. The limited evidence suggested that intention to get vaccinated varied with the activity enabled by certification or vaccination (e.g., international travel). Where vaccination is seen as compulsory this could lead to unwillingness to accept a subsequent vaccination. There was some evidence that restricting access to settings and activities to those with antibody test certificates may lead to deliberate exposure to infection in a minority. Behaviours that reduce transmission may decrease upon health certificates based on any of the three indices of Covid-19 status, including physical distancing and handwashing.ConclusionsThe limited evidence suggests that health certification in relation to COVID-19 – outside of the context of international travel – has the potential for harm as well as benefit. Realising the benefits while minimising the harms will require real-time evaluations allowing modifications to maximise the potential contribution of certification to enable safer access to a range of activities.