bluuebunny/crossref_metadata_2025_split huggingface dataset:
Monorail External Fixation in Humeral Lengthening and Deformity Correction with Glenohumeral Reduction
Authors: Li Shanyu , Xu Jia , Kang Qinglin 
Published: February 2023

Case:
External fixation has an established use in humeral lengthening and deformity correction. An 11-year-old boy presented with left-sided humeral shortening, proximal varus deformity, and glenohumeral dislocation. Anatomical and functional corrections were achieved through innovative monorail external fixation, including bifocal osteotomies of the surgical neck and diaphysis proximal to the deltoid insertion.

Conclusion:
Monorail external fixation with bifocal osteotomies of the surgical neck and diaphysis proximal to the deltoid insertion may improve the anatomical and functional outcomes in humeral shortening and proximal varus deformity with glenohumeral dislocation.
Anomalous Posterior Tibial Artery Course—Anatomic Considerations for the Posterolateral Ankle Approach
Authors: Perugini Anthony J. , Passias Braden J. , Pelz Nicholas C. , Temperato Joseph R. , Mehta Sanjay 
Published: February 2023

Case:
We report a unique anatomical case of an anomalous course of the posterior tibial artery found on dissection during the posterolateral approach to the ankle. To the best of our knowledge, no such case has been documented.

Conclusion:
The vascular bundle consistent with that of the posterior tibial artery and vein was encountered in the far lateral aspect of the deep posterior compartment, which suggests physicians should proceed with caution when performing the posterolateral approach to the ankle so as to avoid iatrogenic injury of this named anatomic structure.
Measuring Intracompartmental Pressures in the Lower Leg
Authors: Vogels S. , de Vries D. , Bakker E.W.P. , Miller T.L. , Hoencamp R. , Zimmermann W.O. 
Published: February 2023

Background:
The purpose of the present study was to evaluate whether unilateral intracompartmental pressure (ICP) measurements correctly represent the contralateral ICP value in patients suspected to have bilateral chronic exertional compartment syndrome (CECS) in the anterior compartment of the leg.

Methods:
A retrospective cohort study was performed that included military service members who had been referred to a secondary care department for bilateral anterolateral exercise-related leg pain. The obtained ICP values were utilized to assess 2 possible measurement strategies to perform unilateral ICP measurements: the right-leg strategy (i.e., always testing the right leg) and the most-symptomatic-leg strategy (i.e., always testing the most symptomatic). The diagnostic cutoff value for CECS in this cohort was 35 mmHg in the first minute after provocation. Four outcome categories were created to describe the pressure classification of the second leg if only 1 leg would have been measured: correct (category 1: both values ≥35 mmHg; category 2: both values <35 mmHg) or incorrect (category 3: measured leg, ≥35 mmHg and contralateral leg, <35 mmHg; category 4: measured leg, <35 mmHg and contralateral leg, ≥35 mmHg).

Results:
A total of 442 patients (884 legs) were included. In 88% of patients, the unilateral value would have correctly diagnosed the other symptomatic leg, whereas in 12% of patients, the contralateral leg would have been diagnosed incorrectly. The right-leg strategy had a slightly smaller proportion of cases in which the contralateral leg would have been incorrectly diagnosed (7% compared with 8% for the most symptomatic leg strategy). In 89% of the 390 patients in categories 1 and 2, the ICP values deviated by >5 mmHg from the 35-mmHg cutoff value compared with 40% of the 52 patients in categories 3 and 4.

Conclusions:
In military service members with bilateral chronic anterolateral exertional pain, a unilateral ICP measurement seems to be justified, especially among those with pressure values >5 mmHg above or below the diagnostic cutoff value. When a unilateral pressure measurement is within 5 mmHg above or below the cutoff value, a bilateral ICP measurement may be warranted.

Level of Evidence:
Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
Factors Associated with the Success and Timing of Orthopaedic Surgery Resident Research Thesis Project Publication
Authors: Kuhn Andrew W. , Inclan Paul M. , Brogan David M. , Aleem Alexander W. , Brophy Robert H. 
Published: February 2023

Introduction:
Scholarship and research are important aspects of orthopaedic surgery training. Many orthopaedic surgery residency programs have developed dedicated research curricula, often culminating in a capstone thesis project with the intended goal of peer-reviewed publication. However, data on the success of these programs are scarce. The purpose of the current study was to determine the success rate and time to publication of resident research thesis projects at our own institution while evaluating factors associated with these outcomes.

Methods:
Resident research thesis projects performed over the past 15 years were aggregated and reviewed. Additional data regarding the projects and former trainees who performed them were collected using public resources which included measures of current academic aptitude (i.e., H-index and number of publications) as well as project and publication characteristics. Cox and linear regression analyses were conducted to assess the relation between numerous predictor variables and the success and time to publication. All analyses were conducted at the 95% confidence interval (CI) level.

Results:
Sixty-eight (n = 68; 83%) resident research thesis projects were published an average of 2,582.8 days, or roughly 7 years from the start of their residency training. Graduate adjusted H-index was associated with increased success and decreased time to publication (hazard ratio 1.183 [95% CI: 1.059-1.322], p = 0.003). A lower journal impact factor was associated with taking significantly shorter time to reach publication (F(1,66) = 7.839, p = 0.007; Β1 = 146.45, p = 0.007). Study type (clinical vs. laboratory), posttraining practice setting (academic vs. private), and whether the research topic was within the same area of the trainee's matched fellowship(s) did not predict publication success.

Discussion/Conclusion:
Over the past 15 years, 83% of orthopaedic resident research thesis projects at our institution were published. A higher adjusted H-index was associated with greater completion and faster timing to publication. A lower journal impact factor was also associated with quicker publication. These data highlight the publication metrics of a formalized resident research program and identify factors associated with success and timing of publication.
Diagnosis and Treatment of Neuropathic Ankle Fractures
Authors: Czerwonka Natalia , Yi Anthony , Miller Christopher P. 
Published: February 2023

» Standard 3-view ankle radiographs are the first-line imaging modality for suspected neuropathic ankle fractures. Computed tomography is helpful to evaluate for concomitant osseous changes and soft-tissue infection.» Nonoperative management may be considered for low-demand, elderly, or comorbid patients for whom surgery and anesthesia are contraindicated. However, the presence of comorbidities alone should not necessarily preclude operative intervention. Given the overall poor results of nonoperative treatment in the neuropathic ankle fracture population, operative intervention may in fact be less risky to the patient.» The authors have 2 preferred treatment techniques. For cases in which the vascular supply and bone stock are adequate, open reduction and internal fixation (ORIF) with locking fixation for the fibula, a medial buttress/hook plate with lag screws for the medial malleolus, multiple syndesmotic screws for additional fixation even in the absence of a syndesmotic injury, and temporary transfixation Steinmann pins from the calcaneus into the tibia are used. For cases in which there is a concern for wound healing or previously failed ORIF, minimally invasive surgical tibiotalocalcaneal arthrodesis with a retrograde locked intramedullary nail is used.
Physicians’ challenges when working in the prehospital environment, -A qualitative study using grounded theory
Authors: Bäckström Denise , Alvinius Aida 
Published: February 2023

Abstract
Background
In the rapid development in prehospital medicine the awareness of the many challenges in prehospital care is important as it highlights which areas need improvement and where special attention during education and training should be focused. The purpose of this study is to identify challenges that physicians face when working in the prehospital environment. The research question is thus; what challenges do physicians face when working in prehospital care?
Method
This is a qualitative study with an inductive approach and is based on interviews. The interviews were analyzed using the Grounded Theory (GT) method. The interviews were conducted as semi-structured interviews via the digital platform Zoom during winter / early spring 2022.
Results
Challenges for prehospital physicians can be understood as a process that involves a balancing act between different factors linked to the extreme environment in which they operate. This environment creates unique challenges not usually encountered in routine hospital practice, which results in trade-offs that they would not otherwise be faced with. Their individual situation needs to be balanced against organizational conditions, which means, among other things, that their medical decisions must be made based on limited information as a result of the constraints that exist in the pre-hospital environment. They must, both as individuals and as part of a team, manoeuvre in time and space for decision-making and practical tasks. This theory of balancing different entities is based on four themes; thus the theory is the relation between the four themes: leadership, environment, emotion management and organization.
Conclusions
With the help of previous studies and what we have found, it is reasonable to review what training is needed before starting to work prehospital as a physician. This should include components of the themes we have described: organization, environment, leadership and emotional management.
case report :an uncommon cause of non -hemorrhegic ischemic stroke associated with left atrial myxoma
Authors: RAUT DIPTI GURUDEO , SINGH SEEMA , SHARMA RANJANA 
Published: February 2023

Abstract
Introduction:
Up to 3 out of every 1000 patients may develop an atrial myxoma, the most unusual benign primary heart tumor. The morbidity and death of patients are significantly impacted by these malignancies. Myxoma is the least common primary cardiac neoplasm. Between 0.001 0% and 0.3 0% of autopsies reveal heart malignancies. Even when the ischemic stroke is uncommon, it is still important to consider the probable pattern of left atrial myxoma disclosure while making a stroke differential diagnosis.
Case presentation:
A case of rapidly growing left atrial myxoma in a 60-year-old female who was suffering from a stroke 15 days ago, she started complaining of breathlessness and chest tightness and incidentally going through transthoracic echocardiography reveals that a large left atrial myxoma. she transferred to cardiovascular thoracic surgery department for further treatment. after all investigation, they planned for open-heart surgery to remove of LA mass.
Conclusion:
The superior portion of the heart can develop an atrial myxoma, a benign growth, on either the left or right side. Atrial myxoma can have several negative effects if untreated, including irregular heartbeat, pulmonary edema, and blood clots termed emboli (embolisms) that block the heart's blood vessels and impede blood flow. A targeted functional impairment is brutally imposed as part of an ischemic stroke. The prompt surgical removal of a rapidly expanding myxoma that is probably a malignant tumor may be necessary. They may show up as a variety of neurologic conditions, such as ischemic stroke. The most common neurologic symptom of heart malignancies is ischemic stroke.
An analysis of UGT1A1 genotype-phenotype correlation in Chinese patients with Gilbert and Crigler-Najjar II syndrome
Authors: Wu Lina , Li Zhenkun , Song Yi , Li Yanmeng , Zhang Wei , Zhong Xuemei , Wang Xiaoming , Huang Jian , Ou Xiaojuan 
Published: February 2023

Abstract

Background: The spectrum of UDP-glucuronosyltransferase (UGT1A1) variants, which are associated with Gilbert syndrome (GS) and Crigler-Najjar syndrome (CNS-II), has been reported in Chinese and western countries. However, the genotype-phenotype correlation of the individual UGT1A1 variants in GS and CNS-II remains to be clarified.
Methods: To explore the UGT1A1 variant pattern and genotype-phenotype correlations, we enrolled 310 Chinese patients, including 232 patients with GS and 78 with CNS-II. Peripheral blood samples were collected from screening variants in the gene UGT1A1 by a polymerase chain reaction and Sanger sequencing. The correlation between different UGT1A1 variants and clinical phenotypes was analyzed.
Results: Total cholesterol and serum high-density lipoprotein levels were higher in patients with GS than those with CNS-II. A total of 21 UGT1A1 variants were identified, including nine novel variants, four of which are in-silico predicted to be probably damaging. The allele frequency showed that the most common variants were A(TA)7TAA, p.G71R, p.Y486D, p.P364L, and p.P229Q, which are different from western countries. The mean value of serum total bilirubin in patients with the p.Y486D variant in both heterozygote and homozygote was significantly high compared with other high-frequency variants. Additionally, serum triglyceride and low-density lipoprotein in patients with a heterozygous p.P229Q variant were significantly elevated compared with other high-frequency variants.
Conclusions: The spectrum of UGT1A1 variants in Chinese patients appears distinct from western countries. Total bilirubin and plasma lipid are different among the individual UGT1A1 variants.
Deep learning-based image-analysis identifies a DAT-negative subpopulation of dopaminergic neurons in the lateral Substantia nigra.
Authors: Burkert Nicole , Roy Shoumik , Häußler Max , Wuttke Dominik , Müller Sonja , Wiemer Johanna , Hollmann Helene , Ramirez-Franco Jorge , Benkert Julia , Fauler Michael , Duda Johanna , Pötschke Christina , Goillard Jean-Marc , Münchmeyer Moritz , Parlato Rosanna , Liss Birgit 
Published: February 2023

Abstract
Here we present a deep learning-based image analysis platform (DLAP), tailored to autonomously quantify numbers of neuronal subtypes in defined areas, and of fluorescence signals, derived from RNAscope probes or immunohistochemistry, in defined cellular compartments. As proof-of-principle, we utilized DLAP to analyse subtypes of dopaminergic midbrain neurons in mouse and human brain-sections. These neurons modulate complex behaviour like voluntary movement, and are differentially affected in Parkinson’s and other diseases. DLAP allows the analysis of large cell numbers from different species, and facilitates the identification of small cellular subpopulations, based on differential mRNA- or protein-expression, and anatomical location. Using DLAP, we identified a small subpopulation of dopaminergic midbrain neurons (~5%), mainly located in the very lateral Substantia nigra (SN), that was immunofluorescence-negative for the plasmalemma dopamine transporter (DAT). These results have important implications, as DAT is crucial for dopamine-signalling, and its expression is commonly used as marker for dopaminergic SN neurons.
Artificial homeostasis system with electrochemical sensing and pharmaceutical stimulation for impaired brain function
Authors: Jung Han Hee , Lee Hyeokjun , Ha Jeongdae , Park Jeongrak , Kang Seongtak , Kim Jinmo , Jung Han Na , Yea Junwoo , Oh Saehyuck , Jekal Janghwan , Song Soojung , Son Jieun , Yu Tae Sang , Lee Youngjeon , Won Jinyoung , Lim Kyung Seob , Choi Ji-Woong , Jeong Jae-Woong , Song Young Min , Kim Samhwan , Rah Jong-Cheol , Lee Taeyoon , Keum Hohyun , Xu Sheng , Lee Yoon Kyung , Oh Yong-Seok , Jang Kyung-In 
Published: February 2023

Abstract
Treatment trends for Parkinson’s disease are revolutionizing from conventional pharmaceutical treatment depending on the patient’s symptoms to closed-loop electroceutical treatment in order to minimize the crucial pharmacokinetic drawbacks. Over the decades, closed-loop neuromodulations have been achieved by electroceutical devices based on continuous electrical stimulation and sensing of electrophysiological biomarkers. However, critical drawbacks have been observed with vulnerable to artefacts from the nearby stimulation electrode and frequent adjustment of stimulation parameters. On the contrary, direct monitoring of neurochemicals allows high spatial resolution, signal specificity and interference-free detection compared to closed-loop DBS. Here, we propose an artificial homeostasis system with electrochemical sensing and pharmaceutical stimulation for impaired brain function. In order to implement the artificial homeostasis system by mimicking the brain system, we have reported an implantable multi-deformable double-sided DA-sensing probe with an all-in-one structure by integrating three-electrode system and drug refillable microfluidic probe with controllable injection for synchronized diagnosis and treatment. The experimental and computational analysis clearly indicate that the proposed probes could serve as potential tools for building artificial homeostasis by the bio-responsive closed-loop system with an electropharmaceutical approach.
Leveraging AI in the Kenyan Judiciary: A Case for Utilizing Text Classification Models for Data Completeness in Case Law Meta Data in Kenya’s Employment and Labor Relations Court
Authors: Ogonjo Florence , Wairegi Angeline , Gitonga Joseph 
Published: February 2023

Abstract
AI has been revolutionary in improving different professional fields. In the legal sector, AI is utilized, in a number of jurisdictions, for different purposes both at the bar and bench level. The study investigates the efficacy of an AI algorithm in completing missing data in digitized documents, i.e., how AI can be utilized to achieve data completeness of precedents in the judiciary through text classification in order to achieve an optimal foundational basis for the creation of data sets that will facilitate the utilization of AI for different purposes. The Employment and Labor Relations court is used as a case study. The study analyzed the efficacy of 5 text classifier models: passive aggressive, linear regression, decision tree, random forest, and support vector machine (SVM) model. The results obtained from the study show that text classification can be automated successfully using machine learning techniques to generate case metadata. The accuracy of the text classifier methods utilized in the study range between 82% and 98%. Despite the data limitations faced in this study, the results obtained help increase confidence that advanced NLP techniques have matured enough to be applicable to legal text in the Kenyan Judiciary. Findings from the study suggest that the success rates of the text classifier techniques are not merely dependent on text content, but the context of this content is also a determining factor - the nature of the cases and the structure of the legal system play an important role in the performance of text classifier models.
Initial insights into the impact and implementation of Creating Active Schools in Bradford, UK
Authors: Morris Jade Lynne , Chalkley Anna E , Helme Zoe E , Timms Oliver , Young Emma , McLoughlin Gabriella M , Bartholomew John , Daly-Smith Andy 
Published: February 2023

Abstract
Background
Few whole-school physical activity programmes integrate implementation science frameworks within the design, delivery, and evaluation. As a result, knowledge of the key factors that support implementation at scale is lacking. The Creating Active School programme was co-designed and is underpinned by the COM-B model and the Consolidated Framework for Implementation Research. The study aims to understand the initial impact and implementation of CAS in Bradford over 9 months using McKay’s implementation evaluation roadmap.
Methods
Focus groups and interviews were conducted with school staff (n = 30, schools = 25) CAS Champions (n = 9) and the CAS strategic lead (n = 1). Qualitative data were analysed both inductively and deductively. The deductive analysis involved coding data into a priori themes based on McKay et al’s implementation evaluation roadmap, using a codebook approach to thematic analysis. The inductive analysis included producing initial codes and reviewing themes before finalising.
Results
Identified themes aligned into three categories: (i) key ingredients for successful adoption and implementation of CAS, (ii) CAS implementation: challenges and solutions, and (iv) the perceived effectiveness of CAS at the school level. This included the willingness of schools to adopt and implement whole-school approaches when they are perceived as high quality and aligned with current school values. The programme implementation processes were seen as supportive; schools identified and valued the step-change approach to implementing CAS long-term. Formal and informal communities of practice provided “safe spaces” for cross-school support. Conversely, challenges persisted with gaining broader reach within schools, school staff's self-competence and shifting school culture around physical activity. This resulted in varied uptake between and within schools.
Conclusions
This study provides novel insights into the implementation of CAS, with outcomes aligning to the adoption, reach, and sustainability. Successful implementation of CAS was underpinned by determinants including acceptability, intervention complexity, school culture and school stakeholders’ perceived self-efficacy. The combination of McKay’s evaluation roadmap and CFIR establishes a rigorous approach for evaluating activity promotion programmes underpinned by behavioural and implementation science. Resultantly this study offers originality and progression in understanding the implementation and effectiveness of whole-school approaches to physical activity.
Access to global reserves determines vulnerability to supply disruption of Ukrainian wheat
Authors: Bertassello Leonardo , Müller Marc , Winters Paul 
Published: February 2023

Abstract
While the war in Ukraine has dramatically affected global wheat supplies, its food security implications vary substantially across countries, depending on their vulnerability to supply disruptions and ability to access food reserves. New trade data obtained after the onset of the conflict reveal a 75% decrease in wheat export from Ukraine, with the potential to push average calorie intakes below malnutrition thresholds in the most vulnerable countries. Differences in access to international trade determine the impact of supply disruptions and suggest the need for policy measures to defuse the impending food crisis.