bluuebunny/crossref_metadata_2025_split huggingface dataset:
High-concentration continuous local antibacterial perfusion therapy: safety and potential efficacy for acute and chronic periprosthetic knee joint infection
Authors: Suzuki Yuki , Iwasaki Koji , Joutoku Zenta , Onodera Tomohiro , Matsuoka Masatake , Hishimura Ryosuke , Hamasaki Masanari , Kondo Eiji , Iwasaki Norimasa 
Published: November 2024

Background: Periprosthetic joint infections (PJIs) following total knee arthroplasty (TKA) are among the most challenging pathologies to manage. Recently, continuous local antibiotic perfusion (CLAP) therapy has been introduced for treating musculoskeletal infections in orthopedics. This study aimed to determine the outcomes and risks of CLAP therapy combined with conventional treatment for PJIs after TKA. Methods: We retrospectively evaluated 14 patients with PJIs. For acute PJIs, CLAP therapy was performed alongside debridement, intravenous antibiotics, and implant retention. For chronic PJIs, a two-stage revision with CLAP therapy and intravenous antibiotics was performed. Implants were replaced with a cement mold incorporating CLAP therapy, followed by revision surgery after 3 months. For all patients, 120 mg/day of gentamicin (GM) was locally administered into the knee joint for 2 weeks as part of CLAP therapy, in combination with perioperative intravenous antibiotics. Results: Five patients developed acute PJIs, and nine developed chronic PJIs after TKA. The mean follow-up period was 18.4 (15.2–21.1) months. All five patients with PJIs treated with one-stage surgery (debridement and insert exchange only) successfully preserved their implants. Among the nine patients with chronic PJIs, seven underwent CLAP therapy combined with two-stage revision surgery, resulting in successful treatment without relapse, whereas the remaining two patients were initially treated with one-stage surgery and CLAP therapy but failed to retain their implants, and subsequently required additional two-stage revision surgery, which ultimately succeeded. No adverse effects from GM were reported. Conclusions: Our results suggest that CLAP therapy is safe and may be effective for treating acute and most chronic PJIs after TKA.
Cardiac Troponin-I Level at 24 hours of Age in Stable Newborn Infants Born at ≥35 Weeks of Gestation
Authors: Rosario David C. , Pezzano Chad , Ward Lesa , Cerone Jennifer , Randall Jess , Munshi Upender K. 
Published: November 2024

Objective Cardiac troponin-I is a known biomarker of myocardial injury in adults and children but its diagnostic utility is unclear in newborns.This study aimed to establish normative data for troponin-I in stable newborns and assess any variation due to maternal diabetes status, mode of delivery, and Apgar scores.
Study Design Prospective, observational study of stable newborn ≥35 weeks gestation admitted to a well-baby nursery at a single institution. Infants with respiratory distress, congenital infections, malformations, or syndromes were excluded. Troponin-I values were obtained by a validated point-of-care capillary blood sample at 24 hours of age.
Results A total of 132 patients were included for analysis. Thirteen infants were born to mothers with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) during pregnancy and analyzed as a subgroup, with the remaining 119 infants comprising the base cohort to establish baseline normative troponin-I levels in stable newborn infants. The mean (standard deviation) troponin-I level of infants in the base cohort group was 0.019 ± 0.018 ng/mL and in infants born with maternal SARS-CoV-2 infection during pregnancy troponin-I level was 0.081 ± 0.1 ng/mL (p < 0.001). In infants of the base cohort, there was no significant difference in troponin-I levels between diabetic versus nondiabetic mothers, vaginal birth versus cesarean section, and 5-minute Apgar score of <7 versus ≥7.
Conclusion Cardiac troponin-I level in healthy term newborns was 0.019 ± 0.018 ng/mL, which conforms to healthy children and adult lab values. There was no statistically significant difference in troponin-I levels in infants of maternal diabetes or normal glucose status, mode of delivery, cesarean versus vaginal, or 5-minute Apgar score of <7 or ≥7. Troponin-I levels in asymptomatic neonates born to mothers with a history of SARS-CoV-2 during pregnancy demonstrated an elevation when compared to the baseline group of infants.
Key Points
In-Hospital Outcomes of Neonates with Hypoxic–Ischemic Encephalopathy Receiving Sedation–Analgesia during Therapeutic Hypothermia
Authors: Pease Mary E. , Yi Erica , Joshi Swosti , Poletto Erica , Menkiti Ogechukwu , Quiñones Cardona Vilmaris 
Published: November 2024

Objective This study aimed to compare magnetic resonance imaging (MRI) severity scores and in-hospital outcomes among neonates with perinatal hypoxic–ischemic encephalopathy (HIE) with and without exposure to sedation–analgesia (SA) during therapeutic hypothermia (TH).
Study Design A single-center, retrospective cohort study of neonates with perinatal HIE undergoing TH between January 2010 and December 2020. Demographics, clinical characteristics, MRI scores, and in-hospital outcomes were compared between patients without SA exposure and those with SA use.
Results Of the 131 neonates, 55 (42%) did not have SA exposure, and 76 (58%) had SA during TH. Groups were similar in birth weight, gestational age, and severity of HIE. A higher proportion of neonates in the SA group received inhaled nitric oxide (iNO, 39.4% vs. 2%, p < 0.001) and vasopressors (41% vs. 20%, p = 0.012) compared to no SA group. There was no difference in median MRI severity scores for neither T1 (2 [2, 4.25] vs. 3 [2, 6], p = 0.295), T2 (2 [0, 3] vs. 3 [1.5, 5.5], p = 0.088) nor diffusion-weighted images (0 [0, 2] vs. 0 [0, 4.25], p = 0.090) between SA and no SA groups, respectively. In-hospital outcomes were similar between groups except for lower survival to discharge (87% vs. 98%, p = 0.020) in the SA group compared to those without SA. A regression analysis showed death was associated with the concomitant use of iNO (p < 0.001) and inotropes (p < 0.001).
Conclusion SA during TH for perinatal HIE did not alter early MRI severity scores. A lower survival to discharge in the SA group may be related to illness severity rather than SA use alone.
Key Points
Dabigatran Attenuates the Binding of Thrombin to Platelets—A Novel Mechanism of Action
Authors: Lindahl Tomas L. , Kumar Aishwarya Prasanna , Hallström Teresia , Al-Hashimi Ahmed , du Rietz Anna , Arlaman Elena , Uvdal Kajsa , Macwan Ankit S. 
Published: November 2024

Background Thrombin is a multifunctional regulatory enzyme of the haemostasis and has both pro- and anticoagulant roles. It has, therefore, been a main target for drug discovery over many decades. Thrombin is a serine protease and possesses two positively charged regions called exosites, through which it is known to bind to many substrates. Dabigatran is a thrombin inhibitor and is widely used as an oral anticoagulant for the antithrombotic treatment of atrial fibrillation and venous thromboembolism. The mechanism by which dabigatran inhibits thrombin is the blockage of the active site, however, its effect on thrombin binding to its substrates has not been studied thoroughly and is thus poorly understood.
Material and Methods The effect of dabigatran on thrombin binding to platelets was evaluated by flow cytometry using fluorescently labelled thrombin and washed platelets. Further, to confirm the results we utilized modern techniques for biomolecular binding studies, microscale thermophoresis (MST) and surface plasmon resonance (SPR), which validated the results.
Results Dabigatran inhibited thrombin binding to platelets as analysed by flow cytometry. The inhibition was dose dependent with IC50 of 118 nM which was slightly lower than for inhibition of platelet activation and is close to the clinically relevant plasma concentration of dabigatran. MST and SPR also confirmed inhibitory effect of dabigatran on thrombin binding to platelets.
Conclusion Apart from blocking the active site, dabigatran also inhibits thrombin binding to platelets. Since thrombin has numerous functions beyond the cardiovascular system, this finding may have important implications.
The Impact of Perioperative Blood Transfusion on Flap Survival: A Single-Center Review of Limb Salvage in the Trauma Setting
Authors: O'Brien Devon , Pekcan Asli , Stanton Eloise , Roohani Idean , Zachary Paige , Parikh Neil , Daar David A. , Carey Joseph N. 
Published: November 2024

Abstract
Background Limb salvage following traumatic lower extremity (LE) injury often necessitates blood transfusion for adequate tissue perfusion. Appropriate transfusion decision-making via a risk–benefit analysis could maximize the opportunity for flap survival. This study aims to examine the impact of perioperative blood transfusion on postoperative complications in traumatic LE reconstruction.
Methods A retrospective review was conducted at a level 1 trauma center on patients who underwent LE reconstruction between January 2007 and October 2023. Patient demographics, comorbidities, perioperative blood transfusions, flap characteristics, and postoperative complications were recorded. Outcomes investigated included postoperative amputation rates, infection, partial flap necrosis, and flap loss. Univariate analysis and multivariable logistic regression were performed to examine the impact of patient factors on flap necrosis.
Results In total, 234 flaps met inclusion criteria. Of these, 149 cases (63.7%) received no transfusion during their hospital stay (Tf − ) and 85 cases (36.3%) received at least one unit of packed red blood cells intraoperatively through 48 hours following flap placement (Tf + ). Overall flap survival rates were similar across both cohorts (Tf + : 92.9 vs. Tf − : 96.6%, p = 0.198). The Tf+ cohort had significantly higher rates of partial flap necrosis (12.9 vs. 2.0.%, p < 0.001), amputation (6.0 vs. 0.7%, p = 0.015), and postoperative hardware infection (10.6 vs. 2.7%, p = 0.011) relative to the Tf− cohort. Multivariable logistic regression demonstrated that transfusion status was independently associated with a 5.1 fold increased risk of flap necrosis (p = 0.033).
Conclusion Transfusions administered intraoperatively through the acute postoperative period were associated with a significantly increased likelihood of flap necrosis. Surgeons should consider a conservative transfusion protocol to optimize flap viability in patients with traumatic LE injuries.
Microsurgeon Development, Attrition, and Hope for the Future: A Qualitative Analysis
Authors: Mauch Jaclyn T. , Byrnes Yasmeen M. , Kotian Alesha A. , Catzen Hannah Z. , Byrnes Mary E. , Myers Paige L. 
Published: November 2024

Abstract
Background The field of microsurgery continues to grow, yet barriers to practice still exist. This qualitative study aims to elucidate factors both strengthening and threatening this subspecialty through structured interviews with fellowship-trained microsurgeons.
Methods An interview guide was designed, and structured interviews were conducted with practicing fellowship-trained microsurgeon members of the American Society of Reconstructive Microsurgeons between August 2021 and May 2022. Three independent reviewers transcribed, content-coded, and thematically analyzed the interviews. Themes and subthemes were discussed and finalized.
Results Twenty-one practicing microsurgeons were interviewed, hailing from all four Census geographical regions of the United States. The most common practice model was academic (43%, n = 9). Five overarching themes emerged: a passion for microsurgery, training and mentorship, practical considerations, team support, and hope for the future. Microsurgeons reported early exposure to microsurgery as catalyzing their passion, whereas a strong training foundation and lifelong mentors sustained it. Practical challenges arose when establishing and maintaining a microsurgery practice, such as poor reimbursement and unfavorable referral patterns. Team support from staff and other microsurgeons (e.g., a co-surgeon model) was crucial to success. Finally, microsurgeons hoped that future advances would expand access to microsurgical reconstruction for patients and plastic surgeons.
Conclusion This unique, qualitative description of the current landscape of microsurgery revealed that though practical barriers exist, team-based models can alleviate some difficulties. Future advances that increase accessibility may further strengthen this unique and versatile field.
Risk Factors for Hearing Screen Failure in a Single-Family Room Neonatal Intensive Care Unit
Authors: Suflas Rebecca , Cox Rebecca , Viscardi Rose M. , Leung Jocelyn C. 
Published: November 2024

Objective This study aimed to determine hearing screen outcomes and identify clinical and environmental risk factors for hearing screen failure in very preterm infants at a level IV single-family room (SFR) neonatal intensive care unit (NICU).
Study Design We conducted a retrospective study of infants <33 weeks gestational age admitted to a level IV SFR NICU who survived to discharge and had automated auditory brainstem response results available. Demographics, antenatal and postnatal factors, and respiratory support modes and their duration were collected from the electronic medical record.
Results Of 425 eligible infants with documented hearing screen results, 353 (83%) passed and 72 (17%) failed the hearing screen (unilateral, N = 44 [61%]; bilateral, N = 28 [39%]). Compared to infants who passed the hearing screen, infants with hearing screen failure were lower gestational age and birth weight, male sex, were screened at later postnatal and postmenstrual ages (PMAs), had lower 1- and 5-minute Apgar scores, longer duration of furosemide therapy, early hypotension, intraventricular hemorrhage (IVH) ≥Grade 3, and bronchopulmonary dysplasia (BPD) at 36 weeks PMA. Infants with hearing screen failure experienced longer exposures to invasive and noninvasive respiratory support. Heated, humidified, high flow nasal cannula >2 liters per minute exposure was significantly longer in infants with bilateral hearing screen failure (18.4 ± 18.4 d) compared to duration in infants who passed (7.4 ± 12.8 d) and those with unilateral failure (9 ± 13 d), (mean ± standard deviation [SD], p < 0.001). In the final logistic model, IVH ≥Grade 3 (odds ratio [OR] = 3.22, 95% confidence interval [CI]: 1.15–8.98, p = 0.026) and BPD (OR = 2.27, 95% CI: 1.25–4.11, p = 0.007) were the factors with the greatest risk for hearing screen failure.
Conclusion We speculate that the association of BPD with hearing screen failure may be mediated, in part, by chronic noise exposure, including from respiratory support devices. Attention to hearing protection in at-risk infants during respiratory support may mitigate the risk of hearing loss.
Key Points
Chemotherapy-Induced Fingerprint Effacement Leading to Deprivation of Health Insurance: A Case Series and Review of Literature
Authors: Bansal Shashank , Agrawal Deepika , Mishra Hemendra , Kharbandha Mahima , Patidar Rajesh , Chitalkar P.G. 
Published: November 2024

AbstractAyushman Bharat Pradhan Mantri Jan Arogya Yojana (PMJAY) is a game changer for the Indian health care system, where patients with cancer are the major beneficiaries. Some intrinsic procedural shortcomings are restricting the beneficiaries to utilize it optimally. We report a case series of patients receiving chemotherapy who had developed adermatoglyphia because of chemotherapeutic treatment. Therefore, these patients became ineligible for getting the benefits of PMJAY, because of failure of the biometric system to recognize their fingerprints. Hence, patient treatment could not be completed. As a solution, we suggest that the alternatives to fingerprint recognition like face recognition and iris scanning be incorporated into the biometric system to ensure continuous benefit of PMJAY to such patients.
The impact of climate risk on bank profitability through liquidity creation channel: empirical evidence from G7 countries
Authors: Lee Seungho , Alam Md Zahangir 
Published: November 2024

AbstractThis study investigates the impact of climate change-induced risk on bank profitability in the G7 countries from 2001 to 2022. Using dynamic panel GMM estimation to analyse banking industry data with climate risk factors, we find that climate risk has a negative effect on bank profitability. The study also demonstrates that bank liquidity creation plays a key role in transmitting the adverse impact of climate risk on bank profitability. Additionally, the results of the study are robust and withstand different measures of bank liquidity creation. Furthermore, our empirical findings indicate that the influence of climate risk factors is consistent, even for banks primarily focussed on the insurance business. These findings suggest that policymakers may need to implement climate risk management policies to mitigate the detrimental effects of climate change on the banking sector.
Development of a high-voltage power supply with ultra-low ripple of beam current on electron beam gun
Authors: Ma Xun , Li Songjie , Li Bo , Li Chen , Kang Longfei , Kang Chuanhui , Zhao Juan , Li Hongtao 
Published: November 2024

Electron beam guns with grid-controlled electrodes and hot-cathodes are widely used in accelerator physics facilities, high-voltage electron beam welding machines, electron beam 3D additive manufacturing, x-ray sources, etc. The ripple of electron beam current is one of the most critical factors affecting beam quality, and the electron beam current ripple is generally more than 2% with traditional circuit topology. This paper presents the expression for beam current, high voltage, and bias voltage derived from experimental data on a certain electron beam gun. Furthermore, the main causes of affecting beam current ripple are analyzed, and a novel circuit topology is proposed. According to the ISO14744, Welding-Acceptance inspection of electron beam welding machines, a Faraday cup is used to collect the beam from the electron beam gun. In this paper, the ripple of the beam current of the electron gun driven by the traditional and proposed circuits is tested, respectively. The experimental results show that the ripple of beam current of the novel circuit topology can be achieved to within ±0.18% when the voltage is 150 kV and the beam current is 33 mA, lower than 10 percent of that of the traditional power supply. The stability of beam current is better than 5 μA at 150 kV and 3.3 mA.
Learning medical terminology in an ESP medical course
Authors: Gaffas Zainab M. 
Published: November 2024

Abstract
This quasi-experimental study investigated the efficacy of two distinct approaches for vocabulary learning, namely
vocabulary notebooks and word lists, specifically in the context of learning medical terms. Sixty first-year undergraduate EFL
students enrolled in an English for Specific Purposes (ESP) medical course were recruited and divided equally into three groups:
one group received guidance on using and maintaining vocabulary notebooks to learn 50 target terms, one group was instructed in
the use of word lists to study the same 50 target words, and the control group did not undergo any intervention. The results
indicate that both treatment approaches yielded significant advancements in vocabulary learning from pretests to posttests.
However, the vocabulary notebook group demonstrated significantly superior performance in long-term effectiveness compared with
the word list group. The findings imply that both approaches should be incorporated in a medical ESP curriculum.
Asymmetric multichannel spin-dependent splitting based on a single-layer dielectric metasurface
Authors: Ke Yougang , Tian Jibo , Zhang Rui , Zeng Kang , Zeng Linzhou , Min Li , Zhou Xinxing 
Published: November 2024

Abstract
Realization of multichannel spin-dependent splitting that allows for wavefront shaping is urgently required in applications based on the photonic spin Hall effect (PSHE). In this paper, we implement the multichannel spin-dependent splitting that supports preset laser modes by using a single-layer dielectric metasurface. This metasurface introduces a dynamic phase and a Pancharatnam–Berry phase simultaneously, which allows for encoding two independent phase distributions to the two orthogonal circular polarizations. We demonstrate that in the proposed multichannel spin-dependent splitting, the intensities of the beams, the locations of the spots, and the number of the spin-dependent channels, can be asymmetric. Consistent results given by the Fresnel diffraction integral formula and the finite difference time domain method reveal the good performance of the implemented multichannel spin-dependent splitting. This paper offers a simple and convenient approach to manipulate spin photons, which may serve the PSHE-based applications in optical information processing, precision metrology, and edge imaging.
Generalized representative structures for atomistic systems
Authors: Goff James M , Mullen Coreen , Yang Shizhong , Starovoytov Oleg N , Wood Mitchell A 
Published: November 2024

Abstract
A new method is presented to generate atomic structures that reproduce the essential characteristics of arbitrary material systems, phases, or ensembles. Previous methods allow one to reproduce the essential characteristics (e.g. the chemical disorder) of a large random alloy within a small crystal structure. The ability to generate small representations of random alloys, along with the restriction to crystal systems, results from using the fixed-lattice cluster correlations to describe structural characteristics. A more general description of the structural characteristics of atomic systems is obtained using complete sets of atomic environment descriptors. These are used within for generating representative atomic structures without restriction to fixed lattices. A general data-driven approach is provided here utilizing the atomic cluster expansion (ACE) basis. The N-body ACE descriptors are a complete set of atomic environment descriptors that span both chemical and spatial degrees of freedom and are used within for describing atomic structures. The generalized representative structure (GRS) method presented within generates small atomic structures that reproduce ACE descriptor distributions corresponding to arbitrary structural and chemical complexity. It is shown that systematically improvable representations of crystalline systems on fixed parent lattices, amorphous materials, liquids, and ensembles of atomic structures may be produced efficiently through optimization algorithms. With the GRS method, we highlight reduced representations of atomistic machine-learning training datasets that contain similar amounts of information and small 40–72 atom representations of liquid phases. The ability to use GRS methodology as a driver for informed novel structure generation is also demonstrated. The advantages over other data-driven methods and state-of-the-art methods restricted to high-symmetry systems are highlighted.