bluuebunny/crossref_metadata_2025_split huggingface dataset:
Achieving Correct Balance in Total Knee Arthroplasty with Fixed Varus Deformity
Authors: Sarrel Kara , Weinberg Maxwell , Scuderi Giles 
Published: October 2023

AbstractVarus knee deformity is one of the most common deformities presenting for total knee arthroplasty (TKA). When present, a varus knee deformity contributes to overload of the medial joint compartment during gait, leading to increased medial compartment forces as well as lateral soft tissue lengthening. Additionally, a fixed varus deformity is associated with medial soft tissue contractures of the deep and superficial medial collateral ligament (MCL) and posteromedial capsule. With a fixed varus deformity, soft tissue releases may be necessary to create equivalent and rectangular flexion and extension gaps. There may also be anteromedial tibial bone defects, medial femoral condyle defects, and occasionally flexion contractures, especially in more severe cases. In cases of severe varus deformity with medial tibial bone loss, bone defects must be addressed to ensure adequate implant support. In many cases, a primary knee implant can be utilized in cases of varus knee deformity, but occasionally prostheses with higher levels of constraint may be required to balance and stabilize the knee. TKA has had a successful track record, with high levels of long-term implant survivorship even in cases of severe varus. Iatrogenic MCL instability and tibial aseptic loosening are complications associated with TKA in cases of severe varus, and multiple methods to avoid complications are presented here.
Anatomic Referencing Restores the Anatomy of the Distal Femur with Less Compromise
Authors: Knapp Paul W. , Scuderi Giles R. 
Published: October 2023

AbstractHistorically, anterior referencing and posterior referencing are two specific techniques that surgeons can use for proper sizing of the femoral component in total knee arthroplasty (TKA). In this review, we introduce the concept of “anatomic referencing” which has become useful with more incremental sizes of the femoral component to more perfectly match the native anatomy of each patient and reduce overstuffing of the patellofemoral joint and medial-lateral (ML) overhang. Fifty consecutive TKA cases were reviewed where the novel anatomic referencing technique was used. Lateral radiographic projections were obtained preoperatively and postoperatively. The posterior condylar offset (PCO) was evaluated on the lateral radiographs by measuring the distance between the tangent line of the femoral diaphysis posterior cortex and the posterior condylar margin. PCO ratio (PCOR) was calculated by dividing the PCO by the distance between the posterior condylar border and a tangent line along the anterior cortex of the femoral diaphysis. Forty-five patients (50 TKAs) were reviewed. Average age of the patients was 70.34, range: 47–91. There were 19 males and 26 females reviewed in this series. On average, the delta PCOR was 0.022 (standard deviation = 0.032; min: –0.049, max: 0.082). When grouping our results into three main groups: < –0.03, –0.03 to 0.03, and > 0.03, we found that 62% fell within the –0.03 to 0.03 range. There was no statistically significant difference in delta PCOR between standard and narrow implants (p = 0.418). The proposed novel anatomic referencing technique has allowed for proper sizing of patients' femurs in the anteroposterior and ML direction while avoiding component overhang or the need for component downsizing to obtain a proper ML fit. This radiographic review confirmed this to be a highly accurate and reproducible technique.
Examination of Diels–Alder/Tsuji–Trost Route towards Kopsia Alkaloids
Authors: Mikhaylov Andrey A. , Zhigileva Ekaterina A. , Molchanova Marina V. , Solyev Pavel N. , Korlyukov Alexander A. , Baranov Mikhail S. 
Published: October 2023

AbstractA reaction sequence of Diels–Alder cycloaddition and Tsuji–Trost allylation was examined in terms of its application to the synthesis of kopsinine and the related Kopsia alkaloids. Results of the studies in two synthetic directions are presented herein: 1) synthesis of the properly substituted diene, required for the Diels–Alder step; and 2) model studies and optimization of the key reaction sequence in the absence of side-chain. Details on the challenging introduction of the side-chain into tetrahydrocarboline ketone and its silylation, resulting in rare but unproductive vinylogous Claisen cyclization, and the successful Mannich/Mukaiyama aldol sequence are disclosed in the first direction. In the second direction, the endo-selective Diels–Alder reaction with allyl acrylate and Tsuji–Trost allylation providing incorrect stereochemistry are disclosed. Interaction of both dienes with an alkyne provides carbazoles via Alder–Rickert reaction.
Identifying and Addressing Barriers to Implementing Core Electronic Health Record Use Metrics for Ambulatory Care: Virtual Consensus Conference Proceedings
Authors: Levy Deborah R. , Moy Amanda J. , Apathy Nate , Adler-Milstein Julia , Rotenstein Lisa , Nath Bidisha , Rosenbloom S. Trent , Kannampallil Thomas , Mishuris Rebecca G. , Alexanian Aram , Sieja Amber , Hribar Michelle R. , Patel Jigar S. , Sinsky Christine A. , Melnick Edward R. 
Published: October 2023

AbstractPrecise, reliable, valid metrics that are cost-effective and require reasonable implementation time and effort are needed to drive electronic health record (EHR) improvements and decrease EHR burden. Differences exist between research and vendor definitions of metrics.
Process We convened three stakeholder groups (health system informatics leaders, EHR vendor representatives, and researchers) in a virtual workshop series to achieve consensus on barriers, solutions, and next steps to implementing the core EHR use metrics in ambulatory care.
Conclusion Actionable solutions identified to address core categories of EHR metric implementation challenges include: (1) maintaining broad stakeholder engagement, (2) reaching agreement on standardized measure definitions across vendors, (3) integrating clinician perspectives, and (4) addressing cognitive and EHR burden. Building upon the momentum of this workshop's outputs offers promise for overcoming barriers to implementing EHR use metrics.
Educational Status of Minimally Invasive Spine Surgery
Authors: Pereira Bernardo de Andrada , Garg Kanwaljeet , Mamaril-Davis James , Chaurasia Bipin , Guiroy Alfredo , Asghar Jahangir , Turner Jay D. , Hurlbert R. John 
Published: October 2023

Abstract
Introduction The objective of this study was to understand how spine surgeons learn minimally invasive spine surgery (MISS) and how the COVID-19 pandemic impacted the educational experience of MISS. Potential solutions for increasing the spine surgeon's access to MISS educational resources were also discussed.
Methods An internet survey was distributed to neurosurgical and orthopedic spine surgeons across multiple online platforms from April to June 2021, asking specific questions about education and training for MISS. Online survey tools were used to contact spine surgeons in the five geographical continents.
Results A total of 303 spine surgeons responded to the survey: 272 (89.7%) neurosurgeons and 31 (10.3%) orthopedic surgeons. The six countries with the greatest number of participants were: Argentina (n = 70; 23.1%), India (n = 47; 15.5%), Brazil (n = 34; 11.2%), Pakistan (n = 10; 3.3%), Mexico (n = 9; 3.0%), and Chile (n = 8; 2.6%).
Conclusion Most spine surgeons were able to attend virtual learning events during the pandemic, but cadaveric study was still considered the gold standard for learning MISS. Multidisciplinary effort is needed to develop structured curriculums for teaching MISS that include a variety of educational tools such as cadaver laboratory, guidance from experienced surgeons, and virtual demonstrations.
Unusual Breast Malignancies—Going A Step Ahead of Breast Imaging Reporting and Data System
Authors: Arora Jyoti , Gauba Richa 
Published: October 2023

AbstractWith the advent of the Breast Imaging Reporting and Data System (BIRADS), the categorization of the entire gamut of breast lesions has been simplified. However, there are many unusual breast lesions, both benign and malignant, which cannot be categorized accurately using the BIRADS descriptors due to the overlap of features. Carcinomas such as medullary, papillary, and mucinous (colloid) types, may be difficult to recognize as malignant because they may have relatively benign-appearing morphologic features. Well-circumscribed, small, and hyperechoic lesions may not be benign in all cases, and the presence of any microlobulations in margin, vascularity, heterogeneity, round shape, or interval change in size or appearance should raise suspicion of a sinister etiology. Therefore, it is important to be aware of the imaging features of such malignancies so that any mismanagement or undue delay in the diagnosis of any sinister etiology can be avoided.
Outcomes of Injection Laryngoplasty for Deep Interarytenoid Groove
Authors: Mothersole Kelsey H. , Ulualp Seckin O. , Johnson Romaine F. , Brown Ashley F. , Shah Gopi B. , Liu Christopher C. , Chorney Stephen R. 
Published: October 2023

Abstract
Introduction Deep interarytenoid groove (DIG) may cause swallowing dysfunction in children; however, the management of DIG has not been established.
Objective We evaluated the subjective and objective outcomes of interarytenoid augmentation with injection in children with DIG.
Methods Consecutive children under 18 years of age who underwent injection laryngoplasty for DIG were reviewed. Data pertaining to demographics, past medical history, past surgical history, and results of pre and postoperative video fluoroscopic swallow study (VFSS) were obtained. The primary outcome measure was the presence of thin liquid aspiration or penetration on postoperative VFSS. The secondary outcome measure was caregiver-reported improvement of symptoms.
Results Twenty-seven patients had VFSS before and after interarytenoid augmentation with injection (IA). Twenty (70%) had thin liquid penetration and 12 (44%) had thin liquid aspiration before the IA. Thin liquid aspiration resolved in 9 children (45%) and persisted in 11 (55%). Of the 12 children who had thin liquid aspiration prior to IA, 6 (50%) had resolution of thin liquid aspiration after IA.
Conclusions Injection laryngoplasty is a safe tool to improve swallowing function in children with DIG. Further studies are needed to assess the long-term outcomes of IA and identify predictors of successful IA in children with DIG.
Knowledge of and Attitudes Toward Hearing Loss Among Primary Care Physicians in the Public Health Sector of Mauritius
Authors: Foondun Taslima , Pottas Lidia , Soer Maggi 
Published: October 2023

Abstract
Introduction Primary care physicians are essential first points of contact for patients with hearing loss. Thus, knowledge of hearing loss and related aspects is essential to ensure the optimal management of individuals with suspected hearing loss.
Objective This study aimed to determine the knowledge of and attitudes toward hearing loss among primary care physicians in the public health sector in Mauritius.
Methods In this cross-sectional descriptive cohort study, 320 primary care physicians completed an online questionnaire adapted from previous questionnaires on knowledge of and attitudes toward hearing loss. Responses were analyzed using descriptive statistics and cross-sectional analyses.
Results Primary care physicians showed limited knowledge of hearing loss in areas such as early identification and intervention, professionals responsible for hearing assessments, and hearing tests used for assessing hearing sensitivity. However, the responses also showed positive attitudes toward hearing loss. Significant associations between knowledge of and attitudes toward hearing loss were obtained regarding the type of physician, length of practice, and department posted in. Ear, nose, and throat specialists, as well as pediatricians, demonstrated significantly higher scores for both knowledge of and positive attitudes toward hearing loss.
Conclusions The findings highlight a strong need for ongoing medical education to spread awareness about hearing loss among primary care physicians in the public health sector of Mauritius.
Spring-Assisted Cranial Expansion for Multisuture Craniosynostosis: First Case Report from the Indian Subcontinent
Authors: Gujjalanavar Rajendra S. , Doddamani Rajalaxmi , Deraje Vybhav , Gopal Swaroop 
Published: October 2023

AbstractWe present a first use case report from the Indian subcontinent of a 5-month-old child with multisuture craniosynostosis with raised intracranial pressure managed by spring-assisted cranial expansion followed by traditional fronto-orbital advancement and cranial vault remodeling. We emphasize the advantages of spring-assisted cranial expansion in extremely young infants with raised intracranial pressure over posterior vault distraction osteogenesis and open posterior vault remodeling.
Prognostic Neuroimaging Biomarkers in Acute Vascular Brain Injury and Traumatic Brain Injury
Authors: Krawchuk Lindsey J. , Sharrock Matthew F. 
Published: October 2023

AbstractPrognostic imaging biomarkers after acute brain injury inform treatment decisions, track the progression of intracranial injury, and can be used in shared decision-making processes with families. Herein, key established biomarkers and prognostic scoring systems are surveyed in the literature, and their applications in clinical practice and clinical trials are discussed. Biomarkers in acute ischemic stroke include computed tomography (CT) hypodensity scoring, diffusion-weighted lesion volume, and core infarct size on perfusion imaging. Intracerebral hemorrhage biomarkers include hemorrhage volume, expansion, and location. Aneurysmal subarachnoid biomarkers include hemorrhage grading, presence of diffusion-restricting lesions, and acute hydrocephalus. Traumatic brain injury CT scoring systems, contusion expansion, and diffuse axonal injury grading are reviewed. Emerging biomarkers including white matter disease scoring, diffusion tensor imaging, and the automated calculation of scoring systems and volumetrics are discussed.
Does local democratization improve societal outcomes? Effects of mayoral direct elections in Indonesia
Authors: Lurusati Yasmin , Torenvlied René 
Published: October 2023

AbstractLocal democratization aims to improve the decentralized capacity of governance regimes to generate meaningful municipal spending geared towards realizing societal outcomes. In the late 1990s, following the Asian financial crisis, Indonesia initiated a significant institutional transition from centralistic and authoritarian rule towards decentralized and more democratic governance through the introduction of direct mayoral elections. Extant research analyzed the effects of the introduction of these elections on local public spending and local societal outcomes separately. This paper offers an integrated analysis of the impact of the introduction of direct mayoral elections on both local public spending and local societal outcomes in 456 Indonesian municipalities between 2002 and 2012. Analyses of growth models, using panel data on three domains (education, health, and infrastructure) provided by Indonesian Ministry of Finance, Indonesian Ministry of Home Affairs, and Statistics Indonesia, show that the introduction of direct mayoral elections in Indonesia resulted in an increased growth in educational expenditures. It also improved outcomes in health and infrastructure domains. However, the introduction of direct mayoral elections reversed a positive association between public spending and the attainment of societal outcomes or worsened a negative association between them. These results would support a view on local democratization in Indonesia asserting that the introduction of direct mayoral elections stimulated local clientelist practices rather than local accountability and policy responsiveness.
Ways to bring private investment to the tourism industry for green growth
Authors: Gong Fengxiao , Chen Hui 
Published: October 2023

AbstractGreen economic growth is a crucial subject in environmental economics over the last half-century, emphasizing the need for different economic sectors to adapt their activities based on environmental concerns. This research explores the impacts of green growth, inflation rate, economic uncertainty, green finance, and financial development on the composite indicator of sustainable tourism in 10 ASEAN economies from 2000 to 2021, utilizing the PMG (Pooled Mean Group) technique. The findings reveal that, in the short run, financial development and green finance have insignificant coefficients, while green growth exhibits the most substantial positive coefficient. Economic uncertainty and inflation rate negatively affect sustainable tourism. In the long term, green financing has the most profound impact on sustainable tourism development, along with green growth and deepening financial markets, which accelerate sustainable tourism. Conversely, economic uncertainty and inflation rate have adverse effects on the green tourism industry. Primary practical policies to promote sustainable tourism include providing a comprehensive financial policy package, developing ICT-based tourism services, establishing an early warning system, and leveraging blockchain technology and cryptocurrency in green investments, enabling governments and stakeholders to foster sustainable tourism practices and advance environmental sustainability within the ASEAN region.
Framing influence of emotions and attitudes towards Alzheimer’s disease on Slovak and Spanish laypersons: a cross-cultural approach
Authors: Cuadrado Fátima , Lackova Lucia , Mikulajová Marina , Antolí Adoración , Boleková Veronika , Gellen Michal , Vacas Julia 
Published: October 2023

AbstractRepresentations about Alzheimer’s disease (AD) influence both emotions and attitudes towards this dementia. This study aimed to explore how the AD framing used in awareness campaigns influences self-reported emotions and attitudes towards AD, and whether this influence differs between Slovak and Spanish cultures. For this purpose, posters including framed messages on AD (Dualism, Unity, and control) were designed and presented to 275 participants (Mage = 21.23 years, SDage = 5.13, 81.1% females) from Slovakia (n = 134) and Spain (n = 141). To analyse the framing effect, attitudes towards AD were measured twice (before and after the posters display) and a mixed design of repeated measures ANOVA was used to compare both measures. The emotions elicited by the stimulus exposure were also recorded and a MANOVA test was performed on them. Elicited emotions and attitude change were compared in both Slovak and Spanish samples. Results showed that Slovak participants displayed positive attitudes towards AD, but to a lesser extent compared with the Spanish ones. Unity-framed messages resulted in a positive change in attitudes regardless of the participants’ culture and led to a higher degree of happiness, whereas Dualism-framed messages produced more negative emotions (i.e., sadness, anger, fear, and disgust) and had a major impact on participants without changing their attitudes. Using positive frames as Unity seems to be relevant to achieve a positive attitudinal change in both targeted cultures (Slovak and Spanish), even though the Slovak participants initially presented fewer positive attitudes at the beginning. In conclusion, reframing should be considered as a worldwide tool to help improve attitudes towards AD and reduce the stigma associated with this form of dementia in the general population, regardless the culture’s audience.
A whole learning process-oriented formative assessment framework to cultivate complex skills
Authors: Xu Xianlong , Shen Wangqi , Islam A.Y.M. Atiquil , Zhou Yang 
Published: October 2023

AbstractIn the 21st century, cultivating complex skills has become an urgent educational need, especially in vocational training and learning. The widespread lack of formative assessment during complex problem-solving and skill-learning processes limits students’ self-perception of their weakness and teachers’ effective monitoring of students’ mastery of complex skills in class. To investigate methods of how to design and carry out formative assessments for the learning of complex skills, a whole learning process-oriented formative assessment framework for complex skills was established. To verify the feasibility and effects of the formative assessment, a controlled experiment involving 35 students majoring in industrial robotics from one of Shanghai’s Technical Institutes was designed. The results indicate that the formative assessment can effectively promote students’ learning of conceptual knowledge and the construction and automation of cognitive schema as well as improve students’ competency in the implementation and transference of complex skills. In addition, the formative assessment, which can optimize the allocation of psychological effort by increasing the proportion of germane cognitive load within the overall cognitive load, does not place an additional cognitive load on students. It can provide methodological support for promoting students’ learning of complex skills.
Brillouin lasers in a graphene microresonator for multispecies and individual gas molecule detection
Authors: An Ning , Li Yiwei , Zhang Hao , Liang Yupei , Tan Teng , Guo Yongzheng , Liu Zihan , Liu Mingyu , Guo Yanhong , Wu Yu , Peng Bo , Rao Yunjiang , Zhao Guangming , Yao Baicheng 
Published: October 2023

Optical microcavities offer a promising platform for highly efficient light–matter interactions. Recently, the combination of microresonators and 2D materials in nanoscale has further enriched the optoelectronics of the microcavity geometries, spurring broad advances ranging from lasers, nonlinear converters, modulators to sensors. Here, we report the concept of a Brillouin laser sensor, by depositing graphene on an over-modal microsphere. Driven by a single continuous-wave pump at 1550 nm, multiple Brillouin lasers from distinct mode families are co-generated in a single device. The Brillouin lasers excited in the high Q cavity produce heterodyne beating notes with phase noise down to −161 dBc/Hz at 1 MHz offset, not only enabling label-freely identifiable detection of multispecies gas molecules adsorbed on the graphene in situ but also rendering it possible to trace individual molecules. Such a combination of graphene optoelectronics and Brillouin lasers in microcavities demonstrates a novel physical paradigm and offers insights into powerful tools for fast and precise optical sensing.