bluuebunny/crossref_metadata_2025_split huggingface dataset:
Orthostatic Intolerance-Type Events Following Hip and Knee Arthroplasty
Authors: de Campos Tarcisio F. , Vertzyas Nick , Wolden Mitch , Hewawasam Deshitha , Douglas Ben , McIllhatton Christopher , Hili Jessica , Molnar Chloe , Solomon Michael I. , Gass Gregory C. , Mungovan Sean F. 
Published: February 2023

Background:
Orthostatic intolerance (OI)-type events following hip and knee arthroplasty increase the risk of falls, hospital length of stay, and health-care costs. There is a limited understanding of the incidence of and risk factors for OI-type events in patients during the acute hospital stay. Our aim was to systematically review the incidence of and risk factors for OI-type events during the acute hospital stay following hip and knee arthroplasty.

Methods:
A systematic review and meta-analysis of studies that investigated the incidence of and risk factors for OI-type events was undertaken. A comprehensive search was performed in MEDLINE, Embase, and CINAHL from their inception to October 2021. The methodological quality of identified studies was assessed using the modified version of the Quality in Prognosis Studies (QUIPS) tool.

Results:
Twenty-one studies (14,055 patients) were included. The incidence was 2% to 52% for an OI event, 1% to 46% for orthostatic hypotension, and 0% to 18% for syncope/vasovagal events. Two studies reported female sex, high peak pain levels (>5 out of 10) during mobilization, postoperative use of gabapentin, and the absence of postoperative intravenous dexamethasone as risk factors. There was no consensus on the definition and assessment of an OI-type event.

Conclusions:
OI-type events are common during the acute hospital stay following hip and knee arthroplasty, and 4 risk factors have been reported for OI-type events. High-quality prospective cohort studies are required to systematically and reliably determine the incidence of and risk factors for OI-type events.

Level of Evidence:
Prognostic Level IV. See Instructions for Authors for a complete description of levels of evidence.
A Different Take on Lumbar Stenosis
Authors: Tobert Daniel G. 
Published: February 2023

Update
This article was updated on February 23, 2023, because of a previous error. In the subtitle on page e12, the name that had read “Robert W. Hwang” now reads “Raymond W. Hwang.”
An erratum has been published: J Bone Joint Surg Am. 2023 Apr 5;105(7):e22.
Iatrogenic Nerve Injuries of the Upper Extremity
Authors: Crowe Christopher S. , Shin Alexander Y. , Pulos Nicholas 
Published: February 2023

» Iatrogenic nerve injuries may occur after any intervention of the upper extremity.» Causes of iatrogenic nerve lesions include direct sharp or thermal injury, retraction, compression from implants or compartment syndrome, injection, patient positioning, radiation, and cast/splint application, among others.» Optimal treatment of iatrogenic peripheral nerve lesions relies on early and accurate diagnosis.» Advanced imaging modalities (e.g., ultrasound and magnetic resonance imaging) and electrodiagnostic studies aid and assist in preoperative planning.» Optimal treatment of iatrogenic injuries is situation-dependent and depends on the feasibility of direct repair, grafting, and functional transfers.
Team Approach: Management of Pathologic Fractures
Authors: Hammad Aws , Ahmed Osman , Connell Philip P. , Olson Daniel , Balach Tessa 
Published: February 2023

» Optimal care for pathologic fractures centers on the use of a multidisciplinary team; thus, whenever there is a concern for pathologic fracture and proper workup is unable to be performed, prompt referral to a center equipped to manage these injuries should occur.» Fixation strategies for pathologic fractures must take into account patient characteristics, cancer subtypes, and overall goals of treatment.» As the treatments of cancers improve, patient life expectancy with disease will improve as well. This will lead to an increase in the incidence of impending or completed pathologic fractures. The broader subspecialties of orthopaedics must be aware of general principles in the diagnosis and management of these injuries.
Complications and Outcomes After Surgical Intervention in Clavicular Nonunion
Authors: Yetter Thomas , Harper Jacob , Weatherby Paul J. , Somerson Jeremy S. 
Published: February 2023

Background:
Surgical repair of clavicle fractures is being employed more frequently, although most fractures are still treated conservatively. Both can result in nonunion. Current treatments for clavicle nonunion include open reduction with internal fixation (ORIF) plating without bone graft, ORIF plating with bone graft, and intramedullary pin fixation.

Methods:
We performed a systematic review and meta-analysis of studies reporting outcome, complication, and reoperation rates following surgical treatment for clavicle nonunion. Subgroup analysis was undertaken for outcome and complication rates between single plating and intramedullary pin fixation, bone graft use, and nonunion time length definition.

Results:
Fifty-three studies met inclusion criteria (1,258 clavicle nonunions). Mean clinical follow-up was 2.6 years. Seventy-two percent of nonunions were of the middle third, 1% were proximal third, 12% were distal third, and 15% were not reported. Forty-eight percent of nonunions were atrophic or oligotrophic and 17% were hypertrophic (35% not reported). Mean time to union was 13.6 weeks. Ninety-five percent of patients achieved union after the primary nonunion surgery. Overall complication rate was 17%. Single-plating fixation had significantly faster union time (15.2 vs. 19.8 weeks), lower reoperation rate (23% vs. 37%), and hardware removal rate (20% vs. 34%) than intramedullary pin fixation. Bone graft had significantly lower rates of delayed union (0.6% vs. 3.6%) but higher complication (15% vs. 8%) and reoperation rates (29% vs. 14%) than the other groups. Studies that defined nonunion after 3 months had significantly faster union times than the 6-month studies (13 vs. 16 weeks). The 3-month group had a significantly lower overall complication rate (12% vs. 25%) and hardware/fixation failure rate (3% vs. 5.5%) than the 6-month group.

Conclusions:
This systematic review is the largest report of complications, reoperations, and patient outcomes of clavicle nonunions after surgical intervention in the current literature. Plating showed faster time to union and lower reoperation rates than intramedullary pin fixation. Bone graft use showed lower rates of delayed union but substantially higher rates of complications and reoperations. Reports with a definition of nonunion at 3 months showed faster union times and lower complication rates compared to reports with a definition of nonunion that was 6 months or greater. Surgery could be considered at 3 months post-injury in cases of symptomatic non-united clavicle fracture, and plating results in reliable outcomes. Adjuvant bone grafting requires further study to determine its value and risk/benefit ratio.

Level of Evidence:

Level IV, Systematic Review. See Instructions for Authors for a complete description of levels of evidence.
The Biomechanical Burden of Orthopaedic Procedures and Musculoskeletal Injuries Sustained by Orthopaedic Surgeons
Authors: Xu Amy L. , Covarrubias Oscar G. , Yakkanti Ramakanth R. , Sotsky Rachel B. , Aiyer Amiethab A. 
Published: February 2023

Background:Orthopaedic surgeons are at high risk for experiencing work-related musculoskeletal (MSK) injuries and chronic pain due to repetitive large magnitude forces, altered posture from lead vests, and prolonged irregular body positions. We sought to synthesize available evidence regarding (1) the biomechanics of orthopaedic surgery and (2) MSK injuries sustained by orthopaedic surgeons with subsequent treatment and consequences.Methods:To conduct this systematic review, we queried 4 databases (PubMed, Embase, MEDLINE, and Web of Science) for original research studies presenting on the biomechanics of orthopaedic surgery or MSK injuries sustained by orthopaedic surgeons. Studies were excluded if they were not original research (i.e., reviews) or reported on non-MSK injuries and injuries in patients or nonorthopaedic specialists. The literature search yielded 3,202 publications, 34 of which were included in the final analysis.Results:Eight studies reported on the biomechanics of orthopaedic surgery. Surgeons spent an average 41.6% of operating time slouched. Head and whole spine angles were closest to natural standing position when using a microscope for visualization and with higher surgical field heights. Use of lead aprons resulted in a shifted weight distribution on the forefoot, gain in thoracic kyphosis, and increase in lateral deviation from postural loading. Twenty-six studies reported on MSK symptoms and injuries experienced by orthopaedic surgeons, with an overall prevalence from 44% to 97%. The most common body regions involved were lower back (15.2%-89.5%), hip/thigh (5.0%-86.6%), neck (2.4%-74%), hand/wrist (10.5%-54%), shoulder (7.1%-48.5%), elbow (3.1%-28.3%), knee/lower leg (7.9%-27.4%), and foot/ankle (7%-25.7%). Of surgeons with any reported MSK symptom or injury, 27% to 65.7% required nonoperative treatment, 3.2% to 34.3% surgery, and 4.5% to 31% time off work. Up to 59.3% of surgeons reported that their injuries would negatively influence their ability to perform surgical procedures in the future.Conclusions:The orthopaedic surgeon population experiences a high prevalence of MSK symptoms and injuries, likely secondary to the biomechanical burdens of tasks required of them during strenuous operations.Level of Evidence:Level III. See Instructions for Authors for a complete description of levels of evidence.
Data-Driven Reduced-Order Models for Volve Field Using Reservoir Simulation and Physics-Informed Machine Learning Techniques
Authors: Behl M. V. , Tyagi M. 
Published: February 2023

Summary
Reservoir simulation is the industry standard for prediction and characterization of processes in the subsurface. However, large gridblock counts simulation is computationally expensive and time-consuming. This study explores data-driven reduced-order models (ROMs) as an alternative to detailed physics-based simulations. ROMs that use neural networks (NNs) effectively capture nonlinear dependencies and only require available operational data as inputs. NNs are usually labeled black-box tools that are difficult to interpret. On the other hand, physics-informed NNs (PINNs) provide a potential solution to these shortcomings, but they have not yet been applied extensively in petroleum engineering.
In this study, a black-oil reservoir simulation model from Volve public data release was used to generate training data for an ROM leveraging long short-term memory (LSTM) NNs’ temporal modeling capacity. Network configurations were explored for their optimal configuration. Monthly oil production was forecast at the individual wells and full-field levels, and then validated against real field data for production history to compare its predictive accuracy against the simulation results. The governing equations for a capacitance resistance model (CRM) were then added to the reservoir-scale NN model as a physics-based constraint and to analyze parameter solutions for efficacy in characterization of the flow field.
Data-driven ROM results indicated that a stateless LSTM, with single time lag as input, generated the most accurate predictions. Using a walk-forward validation strategy, the single well ROM increased prediction accuracy by about 95% average when compared with the reservoir simulation and did so with much less computational resources in short time duration. Physical realism of reservoir-scale predictions was improved by the addition of CRM constraint, demonstrated by the removal of negative flow rates. Parameter solutions to the governing equation showed good agreement with the field-scale streamline plots and demonstrated the ROM ability to detect spatial irregularities. These results clearly demonstrate the ease with which ROMs can be built and used to meet or exceed the predictive capabilities of certain time-history production data using the reservoir simulation.
Physics-Based and Data-Driven Polymer Rheology Model
Authors: AlAbdullah M. B. , Delshad M. , Sepehrnoori K. , Balhoff M. T. , Foster J. T. , Al-Murayri M. T. 
Published: February 2023

Summary
Polymer flooding is a common enhanced oil recovery (EOR) method used to increase aqueous phase sweep efficiency by increasing viscosity. Estimating polymer viscosity for given reservoir conditions (i.e., oil viscosity, temperature, and brine composition) requires intensive laboratory work. There are existing empirical models to estimate polymer bulk rheology without prior laboratory work; however, they have many coefficients, simple brine composition, and lack physics-based regression boundaries. This study benchmarks the existing polymer empirical and machine learning (ML) models against a new data-driven model with some physics basis for common synthetic polymers. We cover a broad range of polymer concentrations, temperature, salinity, and hardness with an upper limit of 5,000 ppm, 120℃, 290,000 ppm, and 33,000 ppm, respectively. The data were preprocessed through data analytics techniques, and a model was developed with some physics basis by fitting Martin’s equation for Carreau model coefficients. Our regression boundaries obey flexible polymers’ physical and laboratory behavior. We benchmarked the bulk rheological model with existing models in the literature. We used the published models’ coefficients and then tuned their coefficients for our data set for a fair comparison. We then investigated ML as a predictive tool without compromising overfitting the data using the simplest ML model (linear regression) all the way to artificial neural network (ANN) and hybrid ML models. This is the first study that comprehensively benchmarks polymer rheology models and proposes a simple, least number of coefficients, and tunable polymer-rheology model. We provide a predictive bulk rheology model that enables the user to accurately predict polymer viscosity without laboratory measurements and for a wide range of temperatures and brine compositions. Moreover, our study includes the recently common polymer SAV-10 that was not previously studied. We present a simple water viscosity model for a broad brine salinity and temperature range. Our study shows that ML techniques might provide deceptively high accuracy for small data sets, unless due diligence is done to avoid a high-variance model.
Unstable EBV latency drives inflammation in multiple sclerosis patient derived spontaneous B cells
Authors: Soldan Samantha , Su Chenhe , Monaco Maria Chiara , Brown Natalie , Clauze Annaliese , Andrada Frances , Feder Andries , Planet Paul , Kossenkov Andrew , Schäffer Daniel , Ohayon Joan , Auslander Noam , Jacobson Steve , Lieberman Paul 
Published: February 2023

Abstract

Epidemiological studies have demonstrated that Epstein-Barr virus (EBV) is a known etiologic risk factor, and perhaps prerequisite, for the development of MS. EBV establishes life-long latent infection in a subpopulation of memory B cells. Although the role of memory B cells in the pathobiology of MS is well established, studies characterizing EBV-associated mechanisms of B cell inflammation and disease pathogenesis in EBV (+) B cells from MS patients are limited. Accordingly, we analyzed spontaneous lymphoblastoid cell lines (SLCLs) from multiple sclerosis patients and healthy controls to study host-virus interactions in B cells, in the context of an individual’s endogenous EBV. We identify differences in EBV gene expression and regulation of both viral and cellular genes in SLCLs. Our data suggest that EBV latency is dysregulated in MS SLCLs with increased lytic gene expression observed in MS patient B cells, especially those generated from samples obtained during “active” disease. Moreover, we show increased inflammatory gene expression and cytokine production in MS patient SLCLs and demonstrate that tenofovir alafenamide, an antiviral that targets EBV replication, decreases EBV viral loads, EBV lytic gene expression, and EBV-mediated inflammation in both SLCLs and in a mixed lymphocyte assay. Collectively, these data suggest that dysregulation of EBV latency in MS drives a pro-inflammatory, pathogenic phenotype in memory B cells and that this response can be attenuated by suppressing EBV lytic activation. This study provides further support for the development of antiviral agents that target EBV-infection for use in MS.
A Spaced Learning, Small–Group Course in Electrocardiogram Interpretation: A Peer–Led Pilot Study in Graduate Internal Medicine Education
Authors: Pillai Balakrishnan , Reejhsinghani Risheen 
Published: February 2023

Abstract
Background
Electrocardiogram (ECG) interpretation remains a perennial challenge for trainees, however a superior method of instruction for ECG analysis has yet to be determined. Many physicians struggle with a lack of confidence in ECG analysis, leading to medical errors. A body of current literature supports the benefits of small-group sessions, spaced learning, and peer-led endeavors in medical education. The authors’ aim was to develop a pilot ECG interpretation course, utilizing peer-led teaching in a spaced learning format, that was deliverable in the graduate medical education context.
Methods
As the trend of the “resident as teacher” model continues to blossom, the authors implemented a resident–led, small–group, spaced learning course in ECG interpretation. The course was conducted with participation of first–year Internal Medicine residents during busy inpatient rotations at a major academic medical center in February 2022, and used surveys to gauge learner confidence, competence, and subjective experience.
Results
This course was designed and conducted by residents, for residents, and increased learner competence and comfort in interpreting ischemic ECG patterns, conduction system pathology, supraventricular arrhythmias and ventricular rhythms. Scores reflecting confidence in ECG interpretation showed a trend towards improvement following this course, trainees preferred this course to traditional ECG didactic courses, and participants indicated that they would recommend it to others at their training level.
Conclusions
Given the feasibility and scalability of this intervention, the authors’ next steps will be to incorporate this course into the annual incoming resident orientation, and directly compare the perceived and measurable learning outcomes against traditional didactic methods on a larger scale.
Applying Deep learning in Recognizing the Properties of Vitreous Opacity on Ophthalmic Ultrasound Images
Authors: feng li , Zhang Yanzhu , Wei Wei , Qiu Hui , Shi Mingyu 
Published: February 2023

Abstract
BACKGROUND: To explore the feasibility of artificial intelligence technology based on deep learning to automatically recognize the properties of vitreous opacities in ophthalmic ultrasound images.
METHODS: The normal and three typical vitreous opacities confirmed as physiological vitreous opacity (VO), asteroid hyalosis (AH) and vitreous hemorrhage (VH)，were selected and marked from 2000 gray scale Color Doppler ultrasound images for each lesion. Five residual networks (ResNet) and two GoogLeNet models were trained to recognize the vitreous lesions. 75% images were randomly selected as the training set, the remaining 25% as a test set. The accuracy and parameters were recorded and compared among these seven different deep learning (DL) models. The precision, recall, FI score and the area under the receiver operating characteristic curves (AUC) values of recognizing the vitreous lesions were calculated with the most accurate DL model.
RESULTS: There were significant statistical differences in the accuracy and parameters among these seven DL models. GoogleNet inception V1 achieved the highest accuracy (95.5%) and the least parameters (10315580) in recognizing the vitreous lesions. GoogleNet inception V1 achieved 0.94, 0.94, 0.96, and 0.96 precision；0.94, 0.93, 0.97and 0.98 recall ；0.94, 0.93, 0.96 and 0.97 F1Score in recognizing normal, VO, AH, and VH. The AUC values of these four vitreous lesions were 0.99, 1.0, 0.99 and 0.99, respectively.
CONCLUSIONS: GoogLeNet inception V1 has shown promising results in recognizing the ophthalmic ultrasound image. With more and more ultrasound image data, a wide variety of hidden information in the eye diseases can be clearly detected automatically by the artificial intelligence technology based on deep learning.
Shengxian decoction protects against chronic heart failure in a rat model via energy regulation mechanisms
Authors: Yang Ze-Qi , Han Yang-Yang , Gao Fan , Tian Jia-Ye , Bai Ran , Guo Qiu-Hong , Liu Xing-Chao 
Published: February 2023

Abstract
Background
Energy metabolism imbalance plays an important role in the pathological process of chronic heart failure (CHF). Improving myocardial energy metabolism is a new strategy for the treatment of CHF. Shengxian decoction (SXT), a well-known traditional Chinese medicine (TCM) formula, has good therapeutic effects on the cardiovascular system. However, the mechanism of the therapeutic effects of SXT in treating CHF remains largely unclear.
Methods
SD rats were randomly assigned into 6 groups: sham, model, positive control (trimetazidine) and high-, middle-, and low-dose SXT groups. Echocardiography was used to evaluate cardiac function. H&E, Masson and TUNEL staining were performed to examine myocardial structure and myocardial apoptosis. Western blotting was used to examine the expression of related proteins. Colorimetry was used to determine myocardial ATP levels in experimental rats. Transmission electron microscopy was used to observe the ultrastructure of myocardial mitochondria. ELISA was used to estimate CK, cTnI, and NT-proBNP levels, and LA、FFA、MDA、SOD levels.
Results
Treatment with SXT improved cardiac function and ventricular remodelling and inhibited cardiomyocyte apoptosis and oxidative stress levels induced by CHF. Moreover, CHF caused decrease ATP synthesis, which was accompanied by a reduction in ATP 5D protein levels, damage to mitochondrial structure, abnormal glucose and lipid metabolism, and changes in the expression of PGC-1α related signal pathway proteins, all of which were significantly alleviated by treatment with SXT.
Conclusion
SXT reverses CHF-induced cardiac dysfunction and maintains the integrity of myocardial structure by regulating energy metabolism. The beneficial effect of SXT on energy metabolism may be related to regulating the expression of the PGC-1α signalling pathway.
Neighborhoods and COVID-19 Fatalities: Evidence from a full population study in Sweden
Authors: Wixe Sofia , Lobo Jose , Mellander Charlotta , Bettencourt Luis 
Published: February 2023

Abstract

The COVID-19 pandemic has highlighted a debate about whether marginalized communities suffered the disproportionate brunt of the pandemic’s mortality. Empirical studies addressing this question typically suffer from statistical uncertainties and potential biases associated with uneven and incomplete reporting. We use geo-coded micro-level data for the entire population of Sweden to analyze how local neighborhood characteristics affect the likelihood of dying from COVID-19. We control for several individual and neighborhood characteristics to compare the results in specific communities to overall death patterns in Sweden during 2020. We find that individuals residing in socioeconomically disadvantaged neighborhoods were not more likely to die with COVID-19. We also find that the individuals show a generally higher probability of death from any cause in these neighborhoods. Nevertheless, ethnicity is an important explanatory factor for COVID-19 deaths for foreign-born individuals, especially from East Africa, who are more likely to pass away regardless of the residential neighborhood.