bluuebunny/crossref_metadata_2025_split huggingface dataset:
Delayed discharges at a tertiary rehabilitation centre in Saudi Arabia: contributing factors and cost impact
Authors: Gudal Bayan Adam , Ahmed Salwa Ali , Qureshi Ahmad Zaheer , Almacen Grace , Azhari Ghassan , Algarras Mostafa 
Published: December 2023

Abstract
There are various challenges in discharging hospitalized patients with disabilities. Discharge process for individuals with disabilities is multifactorial and can vary from one health system to another. The current study is aimed to explore the factors contributing to delayed discharges and to determine the number of exceeded bed days and subsequent cost impact at a government rehabilitation facility in Saudi Arabia. This retrospective cohort study was conducted at the Rehabilitation Hospital of King Fahad Medical City, Riyadh. All the 2285 discharges from inpatient rehabilitation from August 2011 to March 2017 were included in the study. Patients with delayed discharge were identified. Information about the diagnosis and reasons for delayed discharge was obtained from the rehabilitation hospital bed utilization data. The cost impact was calculated based on the number of days patients stayed beyond the estimated length of stay for each diagnosis. Of the 2285 discharges, 531 (23.3%) were delayed. The most common clinical conditions of patients with delayed discharge included spinal cord injury (n = 168, 31.6%) and traumatic brain injury (n = 145, 27.3%). The factors that led to delayed discharges were medical complications (n = 352, 66.7%), organizational factors (n = 83, 15.7%), family factors (n = 46, 8.7%), and external factors (n = 46, 8.7%). A total of 21 817 hospital bed days were exceeded, with an approximate estimated cost of 80 million Saudi Arabian Riyals. Early rehabilitation and enhancement of the discharge process may significantly decrease delayed discharge rates. Strategies need to be adapted to identify patients at risk of delayed discharge based on the factors highlighted in this study. Development of long-term care capacity, community services, and optimizing family and social support can promote timely discharge.
Observation and quantitative analysis of dislocations in steel using electron channeling contrast imaging method with precise control of electron beam incident direction
Authors: Mori Takashige , Amino Takafumi , Yokoyama Chie , Taniguchi Shunsuke , Yonezawa Takayuki , Taniyama Akira 
Published: December 2023

Abstract
Electron channeling contrast imaging (ECCI) was applied by precisely controlling the primary electron beam incident direction of the crystal plane in scanning electron microscope (SEM), and the dislocation contrast in steel materials was investigated in detail via SEM/ECCI. The dislocation contrast was observed near a channeling condition, where the incident electron beam direction of the crystal plane varied, and the backscattered electron intensity reached a local minimum. Comparing the dislocation contrasts in the visualized electron channeling contrast (ECC) images and transmission electron microscope (TEM) images, the positions of all dislocation lines were coincident. During the SEM/ECCI observation, the dislocation contrast varied depending on the incident electron beam direction of the crystal plane and accelerating voltages, and optimal conditions existed. When the diffraction condition g and the Burgers vector b of dislocation satisfied the condition g⸱b = 0, the screw dislocation contrast in the ECC image disappeared. An edge dislocation line was wider than a screw dislocation line. Thus, the SEM/ECCI method can be used for dislocation characterization and the strain field evaluation around dislocation, like the TEM method. The depth information of SEM/ECCI, where the channeling condition is strictly satisfied, can be obtained from dislocation contrast deeper than 5ξg, typically used for depth of SEM/ECCI.
Large language model may assist diagnosis of SAPHO syndrome by bone scintigraphy
Authors: Mori Yu , Izumiyama Takuya , Kanabuchi Ryuichi , Mori Naoko , Aizawa Toshimi 
Published: December 2023

ABSTRACT

Objective
In this study, we employed a large language model to evaluate the diagnostic efficacy of radiology reports of bone scintigraphy in the context of identifying SAPHO syndrome, and further examined the potential of such a model to augment the diagnostic procedure.

Methods
Imaging data and clinical information of 151 patients (105/46 women/men, mean age: 53.5 years) who underwent bone scintigraphy for suspected Synovitis, Acne, Pustulosis, Hyperostosis, and Osteitis (SAPHO) syndrome between January 2007 and December 2022 were retrospectively reviewed. ChatGPT-4.0 was used as the large language model. The diagnostic performance of the large language model was verified by comparing the cases judged to have SAPHO syndrome that fulfilled Kahn’s classification criteria based on a combination of concise radiology reports and skin lesions such as palmoplantar pustulosis, with cases diagnosed with SAPHO syndrome by rheumatologists based on all clinical information.

Results
The diagnostic accuracy of a large language model for analysing bone scintigraphy radiology reports in conjunction with information about skin symptoms, such as palmoplantar pustulosis, achieved a sensitivity of 83.5%, specificity of 69.4%, and an overall accuracy of 76.8%.

Conclusion
This research indicates the prospective value of extensive language models in scrutinizing radiology accounts from bone scintigraphy for the diagnosis of SAPHO syndrome.
Identification of miRNA858 long-loop precursors in seed plants
Authors: Wang Wen-qiu , Liu Xiao-fen , Zhu Yong-jing , Zhu Jia-zhen , Liu Chao , Wang Zhi-ye , Shen Xing-Xing , Allan Andrew C , Yin Xue-ren 
Published: December 2023

Abstract
MicroRNAs (miRNAs) are a class of nonprotein-coding short transcripts that provide a layer of post-transcriptional regulation essential to many plant biological processes. MiR858, which targets the transcripts of MYB transcription factors, can affect a range of secondary metabolic processes. Although miR858 and its 187-nt precursor have been well studied in Arabidopsis (Arabidopsis thaliana), a systematic investigation of miR858 precursors and their functions across plant species is lacking due to a problem in identifying the transcripts that generate this subclass. By re-evaluating the transcript of miR858 and relaxing the length cut-off for identifying hairpins, we found in kiwifruit (Actinidia chinensis) that miR858 has long-loop hairpins (1,100 to 2,100 nt), whose intervening sequences between miRNA generating complementary sites were longer than all previously reported miRNA hairpins. Importantly, these precursors of miR858 containing long-loop hairpins (termed MIR858L) are widespread in seed plants including Arabidopsis, varying between 350 and 5,500 nt. Moreover, we showed that MIR858L has a greater impact on proanthocyanidin and flavonol levels in both Arabidopsis and kiwifruit. We suggest that an active MIR858L-MYB regulatory module appeared in the transition of early land plants to large upright flowering plants, making a key contribution to plant secondary metabolism.
Sex dimorphic cortical brain volumes associated with antisocial behavior in young adults
Authors: Ding Ke , Xu Miao , Huang Taicheng , Song Yiying , Kong Feng , Zhen Zonglei 
Published: December 2023

Abstract

Background
Although sex differences in antisocial behavior are well-documented, the extent to which neuroanatomical differences are related to sex differences in antisocial behavior is unclear. The inconsistent results from different clinical populations exhibiting antisocial behaviors are mainly due to the heterogeneity in etiologies, comorbidity inequality, and small sample size, especially in females.

Objective
The study aimed to find sexual dimorphic brain regions associated with individual differences in antisocial behavior while avoiding the issues of heterogeneity and sample size.

Methods
We collected structural neuroimaging data from 281 college students (131 males, 150 females) and analyzed the data using voxel-based morphometry.

Results
The gray matter volume in three brain regions correlates with self-reported antisocial behavior in males and females differently: the posterior superior temporal sulcus, middle temporal gyrus, and precuneus. The findings have controlled for the total cortical gray matter volume, age, IQ, and socioeconomic status. Additionally, we found a common neural substrate of antisocial behavior in both males and females, extending from the anterior temporal lobe to the insula.

Conclusion
This is the first neuroanatomical evidence from a large non-clinical sample of young adults. The study suggests that differences in males and females in reading social cues, understanding intentions and emotions, and responding to conflicts may contribute to the modulation of brain morphometry concerning antisocial behavior.
Accelerated electron thermometer: observation of 1D Planck radiation
Authors: Lynch Morgan H , Ievlev Evgenii , Good Michael R R 
Published: December 2023

Abstract
We report on the observation of thermal photons from an accelerated electron via examination of radiative beta decay of free neutrons measured by the RDK II collaboration. The emitted photon spectrum is shown to corroborate a thermal distribution consistent with the dynamical Casimir effect. Supported by a robust chi-squared statistic, we find the photons reside in a 1D Planck spectrum with a temperature predicted by the moving mirror model. Subject Indices: B50 (Electromagnetic processes and properties), D29 (Nuclear decays and radioactivities (including fission)), and E76 (Quantum field theory on curved space)
Controlling chloroform content to a safe level in a pharmaceutical oral solution of chloral hydrate
Authors: McQuillan James T , Hashim Hashim , Woodbridge Nesta , Swaminathan Kalyanaraman 
Published: December 2023

Abstract
Chloral hydrate is a halogenated hydrocarbon with sedative and hypnotic properties and has been used for its medicinal properties for many years. Its solubility and permeability determine it as a Biopharmaceutical Classification System class 1 compound, and as such is ideal to be pharmaceutically presented as an aqueous oral liquid presentation. Its primary route of degradation is by hydrolysis to form formic acid and chloroform and hence licensed pharmaceutical presentations require validated methods to analyse these degradants. The content of the toxic chloroform degradation product was determined via a head-space gas chromatograph with a flame ionisation detector, and its content was controlled to a safe pharmaceutically acceptable level. This can be achieved by solution pH optimisation in the oral solution, incorporating a buffering system to control the rate of this degradation mechanism.
Where other behavioural and pharmacological therapies have failed for the treatment of short-term severe insomnia, a chloral hydrate 500 mg/5 ml oral solution presentation with an optimised safety profile has been developed as a medication for prescription. Extensive analytical and formulation development work has arrived at a room temperature stable oral solution, with a multiyear expiry date.
Key findings: The use of Chloral hydrate in medicinal practice is often associated with high levels of the carcinogen chloroform as a degradation product. The research described herein has shown that the rate of formation of chloroform can be reduced by controlling the impact that the pH has on the stability of the oral solution.
The Ph Eur monograph for Chloral hydrate oral solution (unlicensed medicines) does not include a criterion for chloroform quantification, hence Specials manufacturers of this oral solution are potentially risking the safety of patients without appropriate control of chloroform. This research has used validated analytical techniques to support the detection of chloroform, and other possible impurities, thus ensuring a safe product can be provided to the patient.
Consumers and the green transition between saying and doing: promising consumer empowerment while restricting consumers’ choices is dangerous
Authors: De Almeida Lucila , Esposito Fabrizio 
Published: December 2023

Abstract
To deliver the Green Transition, the European Commission is just asking consumers to make green choices when they want. At the same time, EU legislative measures force consumers to take responsibility by restricting their freedom of making environmentally unsustainable choices. This mismatch is undesirable. The article first shows the existence of this mismatch and then explains why it is undesirable. The mismatch is shown with a discourse analysis of the main Commission’s Communications concerning the Green Transition and a comparison with the related Directives and Regulations and their respective proposals for review. To investigate the negative consequences of this mismatch, the article identifies two mechanisms that reduce the effectiveness of the measures implementing the EU Green Deal because of the mismatch. The article concludes with the modest recommendation of a more transparent explanation of the role consumers have to play to achieve the Green Transition.
Nerve Growth Factor/Tyrosine Kinase A Receptor Pathway Enhances Analgesia in an Experimental Mouse Model of Bone Cancer Pain by Increasing Membrane Levels of δ-Opioid Receptors
Authors: Kan Bu-Fan , Liu Xing-Yun , Han Ming-Ming , Yang Cheng-Wei , Zhu Xia , Jin Yan , Wang Di , Huang Xiang , Wu Wen-Jie , Fu Tong , Kang Fang , Zhang Zhi , Li Juan 
Published: December 2023

Background
The role of nerve growth factor (NGF)/tyrosine kinase A receptor (TrKA) signaling, which is activated in a variety of pain states, in regulating membrane-associated δ-opioid receptor (mDOR) expression is poorly understood. The hypothesis was that elevated NGF in bone cancer tumors could upregulate mDOR expression in spinal cord neurons and that mDOR agonism might alleviate bone cancer pain.

Methods
Bone cancer pain (BCP) was induced by inoculating Lewis lung carcinoma cells into the femoral marrow cavity of adult C57BL/6J mice of both sexes. Nociceptive behaviors were evaluated by the von Frey and Hargreaves tests. Protein expression in the spinal dorsal horn of animals was measured by biochemical analyses, and excitatory synaptic transmission was recorded in miniature excitatory synaptic currents.

Results
The authors found that mDOR expression was increased in BCP mice (BCP vs. sham, mean ± SD: 0.18 ± 0.01 g vs. mean ± SD: 0.13 ± 0.01 g, n = 4, P < 0.001) and that administration of the DOR agonist deltorphin 2 (Del2) increased nociceptive thresholds (Del2 vs. vehicle, median [25th, 75th percentiles]: 1.00 [0.60, 1.40] g vs. median [25th, 75th percentiles]: 0.40 [0.16, 0.45] g, n = 10, P = 0.001) and reduced miniature excitatory synaptic current frequency in lamina II outer neurons (Del2 vs. baseline, mean ± SD: 2.21 ± 0.81 Hz vs. mean ± SD: 2.43 ± 0.90 Hz, n = 12, P < 0.001). Additionally, NGF expression was increased in BCP mice (BCP vs. sham, mean ± SD: 0.36 ± 0.03 vs. mean ± SD: 0.16 ± 0.02, n = 4, P < 0.001), and elevated NGF was associated with enhanced mDOR expression via TrKA signaling.

Conclusions
Activation of mDOR produces analgesia that is dependent on the upregulation of the NGF/TrKA pathway by increasing mDOR levels under conditions of BCP in mice.

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Early Weightbearing Following Surgical Treatment of Ankle Fractures without Trans-Syndesmotic Fixation is Safe and Improves Short Term Outcomes
Authors: Herbosa Christopher G. , Saleh Hesham , Kadiyala Manasa L. , Solasz Sara , McLaurin Toni M. , Leucht Philipp , Egol Kenneth A. , Tejwani Nirmal C. 
Published: December 2023

OBJECTIVES:
To ascertain outcome differences after fixation of unstable rotational ankle fractures allowed to weight bear two weeks postoperatively compared to six weeks.

METHODS:

Design:
Prospective Case-Control Study

Setting:
Academic medical center; Level 1 trauma center

Patient Selection Criteria:
Patients with unstable ankle fractures (OTA:44A-C) undergoing ORIF were enrolled. Patients requiring trans-syndesmotic fixation were excluded. Two surgeons allowed weightbearing at two weeks postoperatively (early weightbearing group (EWB)). Two other surgeons instructed standard non-weightbearing until six weeks postoperatively (NWB group).

Main Outcome Measures and Comparisons: Outcomes included Olerud-Molander, SF-36, and Visual Analog Scale (VAS) at six-weeks, three-months, six-months, 12-months postoperatively, and complications, return to work, range of ankle motion, and reoperations at 12-months.

RESULTS:
107 patients were included. The two cohorts did not differ in demographics or pre-injury scores (p>0.05). Six weeks postoperatively EWB patients had improved functional outcomes as measured by the Olerud-Molander and SF-36 questionnaires. Early weightbearing patients also had better VAS scores (Standardized Mean Difference (SMD) -0.98, 95% Confidence Interval (CI) -1.27 to -0.70, p<0.05) and a greater proportion returning to full capacity work at six weeks (Odds Ratio (OR) = 3.42, 95%CI 1.08 to 13.07, p<0.05). One year postoperatively, EWB had improved pain measured by SF-36 (SMD 6.25, 95%CI 5.59 to 6.92, p<0.01) and VAS scores (SMD -0.05, 95%CI -0.32 to 0.23, p<0.01). There were no differences in complications or reoperation at 12 months (p>0.05).

Conclusions:
EWB patients had improved early function, final pain scores, earlier return to work, without an increased complication rate compared to those kept NWB for six weeks.
Finding Your Job in Orthopaedic Trauma: A Survey Revealing the Cold Hard Facts
Authors: Davis Max E. , Ishmael Chad , Fram Brianna , Light Jonathan J. , Obremskey William T. , Cannada Lisa K. 
Published: December 2023

Introduction:
Finding a first job after fellowship can be stressful due to the uncertainty about which resources to utilize, including fellowship program directors (PDs), residency faculty and other sources. There are over 90 orthopaedic trauma fellows seeking jobs annually. We surveyed orthopaedic trauma fellows to determine the job search process.

Methods:
An anonymous 37 question survey was created online and sent to orthopaedic trauma fellows from the five fellowship-cycle years of 2016 – 2021. The primary questions were related to the job search process, current job, and work details. The secondary questions addressed job satisfaction. Data analysis was performed using STATA 17.

Results:
There were 159 responses (40%). Most respondents completed a fellowship at an academic program (84%). Many (50%) took an academic job and 24% were hospital employed. Sixteen percent had a job secured before fellowship and 49% went on 2-3 interviews. Word of mouth was the top resource for finding a job (53%) compared to fellowship PD (46%) and residency faculty (33%). While 82% reported ending up in their first-choice job, 34% of respondents felt they “settled.” The number of trauma cases was important (62%), ranked above compensation (52%) as a factor affecting job choice. Surgeons who needed to supplement their practice (46%) did so with primary and revision total joints (37%).

Conclusions:
Jobs were most often found by word of mouth. Most fellows landed their first job choice, but still a third of respondents reporting settling on a job. Case volume played a significant role in factors affecting job choice.
Vertical versus Pfannenstiel incision modified Stoppa approach in the treatment of acetabular fractures
Authors: Kara Deniz , Elmadag Nuh Mehmet , Ali Jotyar , Misir Abdulhamit , Huzeyfe Cetin  , Demirkiran Cemil Burak , Mraja Hamisi , Pulatkan Anil 
Published: December 2023

OBJECTIVES:
To compare the patient and fracture characteristics, radiological, functional, and quality of life outcomes, the need for a lateral window approach and requirement of total hip arthroplasty (THA), and complications in patients with simple and complex acetabular fractures who underwent a modified Stoppa approach through vertical and Pfannenstiel incisions.

METHODS:

Design:
Retrospective comparison study

Setting:
Level one trauma center

Patient Selection Criteria:
Patients with acetabular fractures (OTA/AO type 62A-B-C) treated with vertical (Group V) or Pfannenstiel (Group P) incision modified Stoppa approach between 2010 and 2020.
Outcome Measures and Comparisons: Patient characteristics, radiological evaluations (reduction quality and posttraumatic osteoarthritis), patient functional outcomes (SF-12 PCS, SF-12 MCS, HHS, and Merle d'Aubigne Apostel), approach modifications and stratification by fracture type and complications were compared between those treated with vertical or Pfannenstiel incisions.

RESULTS:
104 patients (mean age of 38.5 ±14.3 year) were included. There was no significant difference between the Pfannenstiel or vertical groups regarding patient and fracture characteristics (p = 0.137), postoperative reduction quality (p = 0.130), or the mean functional and quality of life outcome scores at the last follow-up (p = 0.483 for HHS, p = 0.717 for Merle d'Aubigne Apostel score, p = 0.682 for SF-12 PCS, and p = 0.781 for SF-12 MCS). In group P, significantly more patients needed additional lateral incisions (40.8% vs. 10.9%; p 0.001) and total hip replacement procedures (12.2% vs. 1.8%; p = 0.049). The total, early, and late complication rates were significantly higher in group P (p 0.001, p = 0.034, and p = 0.049, respectively).

CONCLUSION:
Pfannenstiel incision was associated with higher complication rates than vertical incision in acetabular fractures treated through a modified Stoppa approach. Fracture complexity is associated with the need for a lateral window approach and THA, as well as a worse functional and radiological outcome regardless of incision type. However, it was not associated with the development of intraoperative or postoperative complications.