bluuebunny/crossref_metadata_2025_split huggingface dataset:
Medical malpractice claims in Hepatology: Rates, Reasons, and Results
Authors: Holman Alexis , McKeown Ellen , Quinn Moira , Parikh Neehar D. , Tapper Elliot B. 
Published: April 2023

Background:
Clinicians are motivated to provide safe, high-quality care to patients with chronic liver disease. This includes the desire to avoid litigation. Data are limited regarding the actual sources of medicolegal risk in chronic liver disease.

Methods:
We conducted a review of a national liability insurer (Candello) with an additional granular analysis of our institution’s registry of liability claims. We included closed cases involving chronic liver disease-related encounters between 2012 and 2021. We determined rates of legal claims from a denominator of unique patients with cirrhosis or transplant care seen over the study period.

Results:
Local database: We retrieved 39 claims of which 15 involved patients with non-cirrhotic chronic liver disease, 13 involved cirrhosis (0.06% incidence), and 11 involved patients who underwent transplantation (0.6% incidence). Most claims involved periprocedural complications. Others included adverse reactions to prophylactic plasma transfusion, medication-induced HE, and falls/fractures.

National database:
We found 94 claims related to liver disease out of 102,575 (0.09%) total claims. Overall, 56% involved diagnosis-related issues (failure/delay in ordering a diagnostic test, failure to appreciate and reconcile a symptom/sign or result, or the misinterpretation of a diagnostic study). Miscommunication between providers and between providers and patients was implicated in 22% of cases. Patient behavior-related factors (nonadherence with scheduled appointments, treatments, or diagnostic testing) factored in 20% of cases. Selection or the management of therapy played a role in 7% of cases. Very rarely were cases associated with technical skill (4%), house staff supervision (3%), or weekend/holiday care (1%). Fifty-one (55%) claims involved HCC.

Conclusion:
We provide the rates and reasons for medical malpractice claims in hepatology.
Race-based reporting and participation of Black individuals in registered pain clinical trials, United States, 2000 to 2019
Authors: Vo Anh Khoa , Cerdeña Jessica P. , Loree Jonathan M. , Cairns Brian E. , Conklin Annalijn I. , Kaseweter Kimberley , Chondoma Lerato , Cragg Jacquelyn J. , Kramer John L.K. 
Published: April 2023

Abstract
There are numerous, well-established racial disparities in the management of pain. The degree to which these are evident at the stage of conducting clinical trials is unknown. To address this knowledge gap, we examined race-based reporting, participation of Black individuals, and the factors associated with reporting and participation in pain clinical trials in the United States. Data were extracted from Clinicaltrials.gov and published articles. One thousand two hundred trials met our inclusion criteria; 482 (40.2%) reported participant race. More recent, publicly funded, and larger trials were more likely to report race. Of 82,468 participants included in pain clinical trials that reported race, 15,101 were Black individuals (18.3%). Participation of Black individuals was significantly associated with pain type (ß = +27% in cardiovascular disease pain compared with acute pain, P < 0.05), study population (ß = +33% and +7% in pain in minoritized populations and women, respectively, compared with general population, P < 0.05), pain intervention (ß = +7.5% for trials of opioid interventions compared with nonopioid interventions, P < 0.05), and a diverse team of investigators (ß = +8.0% for studies incorporating a visible non-White investigator compared with those that did not, P < 0.05). Our results indicate that representation of Black participants in pain clinical trials generally aligns with national demographics in the United States. Increased representation corresponds with health conditions more prevalent among Black individuals (eg, cardiovascular disease) and with a diverse study team composition. Despite these encouraging results, less than half of pain trials reported race, which introduces potential publication bias and limits external validity.
Lessons learned from a novel 3-year longitudinal stepwise “Residents-as-Teachers” program
Authors: Liang Jen-Feng , Cheng Hao-Min , Huang Chia-Chang , Yang Ying-Ying , Chen Chen-Huan 
Published: April 2023

Background:
Most residents-as-teachers (RaT) programs are delivered over days to weeks without comprehensive evaluation, and stepwise approaches have rarely been applied to RaT activities. This study aimed to depict the implementation experience and evaluate the effectiveness of a novel longitudinal 3-year, stepwise RaT program.

Methods:
The longitudinal RaT program included three once yearly face-to-face courses according to the different teaching roles of the residents. To evaluate the effectiveness of the new longitudinal program, we designed a randomized controlled study for first-year residents of all specialties in one medical center. The effectiveness was evaluated by the objective structured teaching exercise (OSTE), feedback from participants and medical students, and evaluation of clinical practice performance by program directors.

Results:
A total of 35 (37.6%) of 93 residents participated in this study, and 13 (37.1%) of all enrolled residents completed all 3-year courses, including seven for the longitudinal program and six for the traditional. The serial OSTE revealed significantly higher scores in the longitudinal group in the second and third years (13.43 vs 9.50, p = 0.001 and 14.29 vs 10.33, p = 0.015). Satisfaction was higher when advanced topics were taught in the second and third years compared with those taught in the first year (4.43 vs 3.89, p = 0.02). The feedback from medical students was similar between the two groups, and the evaluation from program directors revealed insignificantly better clinical performance among the longitudinal course participants.

Conclusion:
It is challenging to conduct a multi-year longitudinal RaT program on young residents. Nevertheless, this longitudinal program was potentially associated with better learning retention and higher satisfaction and worthy to be promoted.
Immune checkpoint inhibitor sintilimab-induced lethal myocarditis overlapping with myasthenia gravis in thymoma patient: A case report
Authors: Wang Chen , Zhong Bingdi , He Jing , Liao Xiaohong 
Published: April 2023

Rationale:
Immune checkpoint inhibitors have been extensively used and significantly improved the clinical outcomes in multiple types of cancer. But the immune-related adverse events occur frequently, particularly in thymoma. The cardiac immune-related adverse, which is relatively rare but fatal, have been increasing reported.

Patient concerns:
A 45-year-old thymoma patient was admitted to our hospital after receiving anti-programmed cell death-1 treatment with sintilimab 14 days later, accompanied by abdominal pain, intermittent chest tightness and dizziness.

Diagnoses:
The laboratory tests revealed elevated serum troponin I. Electrocardiogram reported the prolongation of QTc interval. Echocardiography showed small amount of pericardial effusion, a left ventricular ejection fraction of 71%. Coronary artery computed tomography angiography revealed localized noncalcified plaque in the middle of the left anterior descending artery and mild stenosis of the lumen. Enhanced computed tomography scanning of the whole abdomen showed no abnormal signs in the parenchyma organs. Combining the results of the examinations, the Immune checkpoint inhibitor induced myocarditis was diagnosed.

Interventions:
The patient was treated with glucocorticoids (120 mg/day, IV, methylprednisolone) within 24 hours of admission. Seven days later, the patient experienced tachy ventricular arrhythmia and cardiogenic shock and was transferred to intensive care unit after electrical cardioversion, tracheal intubation and cardiopulmonary resuscitation. Intravenous immunoglobulin therapy at 25 g/day was given and methylprednisolone was reduced to 40 mg/day for the next 3 days. Intravenous esmolol and lidocaine were used for correcting arrhythmias. Ventilator positive pressure ventilation was used for respiratory support. She was administrated with plasmapheresis when the electrocardiogram monitoring showed ventricular arrhythmia storms.

Outcome:
The patient progressed to ventricular arrhythmia storms and cardiac failure, which eventually resulted in death.

Lessons:
The case aims to raise awareness of immune-mediated cardiotoxicity and bring thoughts to the prospects of immunotherapy in thymoma.
Increasing Understanding and Perceived Confidence of Nurses Working in an Emergency Department in Assessing Patients at Risk of Violent Behavior
Authors: Inuenwi Blossom , Lommel Lisa , Peter Swapna B. , Carley Annette 
Published: April 2023

Purpose
The aims of this quality improvement project were to improve understanding and perceived confidence in using a tool that assesses patients at risk of violence.

Project Description
The Brøset Violence Checklist is valid at assessing patients at risk of violence. Participants were given access to an e-learning module that demonstrated how to use the tool. Improvement in understanding and perceived confidence in using the tool were assessed preintervention and postintervention via an investigator-developed survey. Analysis of the data was conducted using descriptive statistics, and open-ended survey responses were analyzed using content analysis.

Outcome
Participants did not demonstrate an increase in understanding and perceived confidence after introduction of the e-learning module. Nurses reported that the Brøset Violence Checklist was easy to use, clear, reliable, and accurate and could be used to standardize assessments of at-risk patients.

Conclusion
Emergency department nursing staff were educated in use of a risk assessment tool for identifying patients at risk of violence. This supported the implementation and integration of the tool into emergency department workflow.
Demographic and clinical characteristics of children with limb loss in Saudi Arabia: A retrospective study
Authors: Alghamdi Mohammed S. , Alenazi Aqeel M. , Alghadier Mshari , Elnaggar Ragab K. , Alshehri Mohammed M. , Alqahtani Bader A. , Al-Nowaisri Khalid , Ghazal Haitham , Alodaibi Faris , Alhowimel Ahmed S. 
Published: April 2023

Purpose:
The aim of this study was to describe the demographic and clinical characteristics of children with limb loss in Saudi Arabia.

Methods:
This is a retrospective study on children attending a limb loss clinic in a tertiary hospital in Riyadh, Saudi Arabia, between July 2012 and June 2020. Descriptive statistics were computed to describe the sample characteristics. A Chi-Squared test was conducted to explore the relationship between a child's sex with the type of limb loss (congenital or acquired) and extent of limb loss (major and minor) and the association between child's age and the mechanism of injury in traumatic limb loss.

Results:
A total of 122 children aged 2–16 years were included of whom 52% were boys. Congenital limb loss represented 57% of the sample with upper extremity loss accounting for 63.7% of all limb loss in this type. Trauma-related limb loss represented the most frequent etiology (88.2%) in the acquired limb loss group. Road traffic accidents accounted for 51.7% of the mechanism of injuries in trauma-related limb loss. Child's sex was not associated with the type of limb loss nor the extent of limb loss (p > 0.05). In addition, child's age was not associated with the mechanism of injury in traumatic limb loss (p > 0.05).

Conclusion:
Child's sex was not a determinant of type nor the extent of limb loss. Most of the acquired limb loss was trauma-related with road traffic accidents as the most common mechanism of injury. The findings of this study illuminate the importance of ongoing prosthetic care for children with a limb loss because young children may require multiple prostheses as they grow in age and size.
Transcriptomic profiling of nuclei from PFA-fixed and FFPE brain tissues
Authors: Guo Yunxia , Ma Junjie , Dang Kaitong , Li Zhengyue , Ge Qinyu , Huang Yan , Wang Guangzhong , Zhao Xiangwei 
Published: April 2023

AbstractFormalin-fixed and paraffin-embedded (FFPE) tissue archives are the largest repository of clinically annotated specimens, and FFPE-compatible single cell gene expression workflow had been developed and applied recently. However, for tissues where cells are hard to dissociate or brains with complex neuronal cells, nuclear transcriptomic profiling are desirable. Moreover, the effects of standard pathological practice on the transcriptome of samples obtained from such archived specimens was also largely anecdotal. Here, we performed RNA-seq of nuclei from hippocampal of mice that underwent freezing, paraformaldehyde (PFA) fixation, and paraffin embedding. Then, we comprehensively evaluated the parameters affecting mRNA quality, transcription patterns, functional level and cell states of nuclei, including PFA fixation time and storage time of FFPE tissues. The results showed that the transcriptome signatures of nuclei isolated from fresh PFA-fixed and fresh FFPE tissues were more similar to matched frozen samples. By contrast, the brain fixed for more than 3 days had prominent impacts on the sequencing data, such as the numbers and biotypes of gene, GC content and ratio of reads interval. Commensurately, prolonged fixation time will result in more differentially expressed genes, especially those enriched in spliceosome and synaptic related pathways, affecting the analysis of gene splicing and neuron cells. MuSiC deconvolution results revealed that PFA infiltrating brains for 3 days will destroy the real cell states, and the proportion of neuron, endothelial and oligodendrocytes diminished while that of microglia was reversed. Yet the effect of storage time on cell composition was more neglectable for FFPE samples. In addition, oligodendrocyte precursor cells were most affected in all fixed samples, and their destruction was independent of fixation time and preservation time. The comprehensive results highlighted that fixation time had much more influences on the nuclear transcriptomic profiles than FFPE retention time, and the cliff-like effects appeared to occur over a fixed period of 1-3 days, with no more differences from additional fixation durations.
An Equivariant Generative Framework for Molecular Graph-Structure Co-Design
Authors: Zhang Zaixi , Liu Qi , Lee Chee-Kong , Hsieh Chang-Yu , Chen Enhong 
Published: April 2023

ABSTRACTDesigning molecules with desirable physiochemical properties and functionalities is a long-standing challenge in chemistry, material science, and drug discovery. Recently, machine learning-based generative models have emerged as promising approaches forde novomolecule design. However, further refinement of methodology is highly desired as most existing methods lack unified modeling of 2D topology and 3D geometry information and fail to effectively learn the structure-property relationship for molecule design. Here we present MolCode, a roto-translation equivariant generative framework forMolecular graph-structureCo-design. In MolCode, 3D geometric information empowers the molecular 2D graph generation, which in turn helps guide the prediction of molecular 3D structure. Extensive experimental results show that MolCode outperforms previous methods on a series of challenging tasks includingde novomolecule design, targeted molecule discovery, and structure-based drug design. Particularly, MolCode not only consistently generates valid (99.95% Validity) and diverse (98.75% Uniqueness) molecular graphs/structures with desirable properties, but also generate drug-like molecules with high affinity to target proteins (61.8% high affinity ratio), which demonstrates MolCode’s potential applications in material design and drug discovery. Our extensive investigation reveals that the 2D topology and 3D geometry contain intrinsically complementary information in molecule design, and provides new insights into machine learning-based molecule representation and generation.
Neural Basis Of Sound-Symbolic Pseudoword-Shape Correspondences
Authors: Barany Deborah A. , Lacey Simon , Matthews Kaitlyn L. , Nygaard Lynne C. , Sathian K. 
Published: April 2023

ABSTRACTNon-arbitrary mapping between the sound of a word and its meaning, termed sound symbolism, is commonly studied through crossmodal correspondences between sounds and visual shapes, e.g., auditory pseudowords, like ‘mohloh’ and ‘kehteh’, are matched to rounded and pointed visual shapes, respectively. Here, we used functional magnetic resonance imaging (fMRI) during a crossmodal matching task to investigate the hypotheses that sound symbolism (1) involves language processing; (2) depends on multisensory integration; (3) reflects embodiment of speech in hand movements. These hypotheses lead to corresponding neuroanatomical predictions of crossmodal congruency effects in (1) the language network; (2) areas mediating multisensory processing, including visual and auditory cortex; (3) regions responsible for sensorimotor control of the hand and mouth. Right-handed participants (n= 22) encountered audiovisual stimuli comprising a simultaneously presented visual shape (rounded or pointed) and an auditory pseudoword (‘mohloh’ or ‘kehteh’) and indicated via a right-hand keypress whether the stimuli matched or not. Reaction times were faster for congruent than incongruent stimuli. Univariate analysis showed that activity was greater for the congruent compared to the incongruent condition in the left primary and association auditory cortex, and left anterior fusiform/parahippocampal gyri. Multivoxel pattern analysis revealed higher classification accuracy for the audiovisual stimuli when congruent than when incongruent, in the pars opercularis of the left inferior frontal (Broca’s area), the left supramarginal, and the right mid-occipital gyri. These findings, considered in relation to the neuroanatomical predictions, support the first two hypotheses and suggest that sound symbolism involves both language processing and multisensory integration.HIGHLIGHTSfMRI investigation of sound-symbolic correspondences between auditory pseudowords and visual shapesFaster reaction times for congruent than incongruent audiovisual stimuliGreater activation in auditory and visual cortices for congruent stimuliHigher classification accuracy for congruent stimuli in language and visual areasSound symbolism involves language processing and multisensory integration
Paired yeast one-hybrid assays to detect DNA-binding cooperativity and antagonism across transcription factors
Authors: Berenson Anna , Lane Ryan , Soto Luis , Patel Mahir , Ciausu Cosmin , Li Zhaorong , Chen Yilin , Shah Sakshi , Santoso Clarissa , Liu Xing , Spirohn Kerstin , Hao Tong , Hill David E. , Vidal Marc , Fuxman Bass Juan I. 
Published: April 2023

ABSTRACTCooperativity and antagonism between transcription factors (TFs) can drastically modify their binding to regulatory DNA elements. While mapping these relationships between TFs is important for understanding their context-specific functions, existing approaches either rely on DNA binding motif predictions, interrogate one TF at a time, or study individual TFs in parallel. Here, we introduce paired yeast one-hybrid (pY1H) assays to detect cooperativity and antagonism across hundreds of TF-pairs at DNA regions of interest. We provide evidence that a wide variety of TFs are subject to modulation by other TFs in a DNA sequence-specific manner. We also demonstrate that TF-TF relationships are often affected by alternative isoform usage, and identify cooperativity and antagonism between human TFs and viral proteins. pY1H assays provide a broadly applicable framework to study how different functional relationships affect protein occupancy at regulatory DNA regions.
Sustainable halal food supply chain management in a small rentier halal market
Authors: Ab Talib Mohamed Syazwan , Zulfakar Mohd Hafiz 
Published: April 2023

PurposeThere is limited knowledge of the sustainable halal food supply management in Brunei Darussalam (Brunei), although it is reputable in the halal economy and advocates the United Nations (UN) Sustainable Development Goals (SDGs). Therefore, this paper highlights issues faced in a small, rentier halal market and proposes sustainable supply chain management (SSCM) initiatives for halal-certified food companies in Brunei.Design/methodology/approachThis paper draws data from published academic research and employs a normative and narrative assessment of SSCM and halal supply chain literature.FindingsFour normative SSCM initiatives and propositions that could be implemented by Brunei halal-certified food businesses in achieving the SDGs are highlighted: responsible sourcing, environmental purchasing, sustainable packaging and green transportation.Practical implicationsThis viewpoint paper provides a basis for achieving the “Brunei Vision 2035” through a sustainable supply chain lens that may increase well-being and develop a productive and sustainable economy. It also lays a foundation for realising the SDGs, specifically Goal 12 of Sustainable Consumption and Production.Originality/valueThe dedicated attention to smaller halal markets, such as Brunei, would enrich the literature, reveal unforeseen issues or address gaps in the domains of SSCM and halal food supply chains.
Consumer-based brand equity of South African luxury fashion brands
Authors: Appiah-Nimo Kenneth , Muthambi Amukelani , Devey Richard 
Published: April 2023

PurposeSouth Africa is the leading market for luxury goods in Africa – a fact evident from the statistics on luxury retail and the expanding footprint of international and local luxury brands. In a market that is dominated by prominent international brands, indigenous South African brands are seldom the subject of empirical research. This study addresses this gap by analysing the consumer-based brand equity (CBBE) of South African luxury fashion brands and its outcomes on the purchase/repurchase intention of consumers of South African luxury fashion brands.Design/methodology/approachThe study adopted quantitative research methods and utilized survey questionnaires to acquire data from 130 respondents. Structural equation modelling was used in testing the proposed alternative hypotheses.FindingsThe study affirmed the relevance of Aaker's (1991) CBBE model for luxury goods in the emerging economy of South Africa. It established perceived quality and behavioural loyalty as significant predictors of brand equity while affirming the prevalence of hedonism and behavioural loyalty in South Africa's luxury fashion market.Research limitations/implicationsThe small sample size and the limited geographic scope of the study had a significant adverse impact on the broad application of the study's outcome. Furthermore, Aaker's (1991) CBBE model, while adequate, may have diminished the probability of a nuanced outcome.Originality/valueThis study advances the frontiers of interdisciplinary research by applying the marketing framework of CBBE to fashion studies in South Africa. The validated measurement scale, which emphasises the relevance of hedonism and behavioural loyalty in South Africa, may be useful for a similar study on luxury fashion brands in other emerging economies.