bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cartiva Protocol
Authors: Mates Aaron 
Published: November 2022

Category: Midfoot/Forefoot Introduction/Purpose: Previous studies show mixed results for the use of a hydrogel synthetic cartilage implant (SCI) for the treatment of hallux rigidus. Independent retrospective reviews have put results into question with respect to outcomes and reproducibility. The purpose of this article is to report modification of patient-selection, implantation technique and postoperative protocols. Which may be necessary to improve patient outcomes. Methods: This was a retrospective chart review of patients undergoing hydrogel synthetic cartilage implant for the treatment of hallux rigidus from 2017 to 2021. Data collected included patient demographics, radiographic grading/alignment, and outcomes with respect to revision rate and complications. 50 patients, with an average age of (range,) years were analyzed. The average latest follow-up was (range,) months. None were diabetic or smokers. Results: All patients reported improvement upon follow-up, except 2 that reported continued stiffness and occasional pain. No patients required revision or adjuvant procedures to date. There were no infections or related complications. Conclusion: Modification of patient-selection, implantation technique and postoperative protocols should be considered for synthetic cartilage implantation for the treatment of hallux rigidus. In this review improved pain and outcomes at short and long term follow up were demonstrated. There were no reoperations, infections or conversions to fusions. With only two patients experiencing stiffens.
Early Results using a Locking Intramedullary Nail for Charcot Reconstruction
Authors: Mates Aaron , Jones Carroll P. , Davis W. Hodges , Loveland Jeffrey 
Published: November 2022

Category: Other; Basic Sciences/Biologics; Diabetes; Hindfoot; Trauma Introduction/Purpose: The goal for this review was to show the early results from a novel locking intramedullary nail within the medial column for use in the reconstruction of Charcot arthropathy. We hypothesized that the utilization of the locking intramedullary nail would lead to successful fusion and stabilization. Our primary aim was to assess the rate of fusion, with secondary aims of an acceptable reduction between pre- and postoperative Meary's angle, time to return to function, and safety. Methods: This case series was designed and implemented by JL and AM. Informed consent was obtained from all patients to allow their clinical data and images to be used for research. The authors examined all patients, collected all data for the study, and performed all surgical procedures at their respective sites. Additional patients were included from Carroll Jones, MD and W. Hodges Davis, MD. All chart and radiographic reviews were also performed by JL and AM. The Advarra Institutional Review Board (IRB; Columbia, MD) determined that this research was exempt from IRB oversight. This study was conducted in compliance with the ethical principles from the 1964 Declaration of Helsinki and the International Conference on Harmonisation guidelines for Good Clinical Practice, along with the latest Health Insurance Portability and Accountability Act (HIPAA) regulations. Results: With respect to safety, there were no intraoperative complications. Additionally, there were no instances of recurrent ulceration in those patients who had ulcerations preoperatively. There were no instances of hardware failure or limb loss in the case series. There were 3 adverse events (21.43%), all of which are to be considered major events that required operative intervention for resolution. There were 2 instances of wound dehiscence (14.29%) that required operative debridement and 1 instance of a stable partial nonunion along the medial column (7.14%) which was a braceable deformity (Table 3). Conclusion: Overall, this case series review of the use of a locking intramedullary nail in Charcot neuroarthropathy patients showed efficacy by rate fusion and time to weightbearing and safety by the low number of adverse events. The data show that the utilization of the locking intramedullary nail can lead to successful fusion and stabilization, even in these high-risk patients.
Minimally Invasive Neuropathic Reconstruction (MiNR study)
Authors: Ruiz Sammy , Pagen Dianne , Fries Jake , Pham Judy , Mates Aaron 
Published: November 2022

Category: Diabetes; Ankle; Hindfoot; Midfoot/Forefoot; Trauma; Other Introduction/Purpose: Charcot neuroarthropathy (CN) is caused by peripheral neuropathy leading to undetected injuries of the bones, joints, and soft tissues [1]. Currently, the surgical management of CN is guided by small retrospective case series and expert opinions [2, 3, 5, 7, 32]. Traditional reconstructive surgical approaches involve large, open incisions to remove bone, as well as the use of internal and external fixation in an attempt to fuse dislocated joints. Theoretically 1ninimally invasive surgery takes the tension off the soft tissues which ensures that there is still good tissue cover without compromising the blood supply to the skin and reduces risk of infection [25]. Also, minimally invasive techniques are associated with fewer wound complications and fewer nerve complications when compared to open classical approaches [9, 10]. The purpose of our retrospective study is to determine if open versus minimally invasive Charcot foot reconstruction fusion rates and complication rates are equivalent or better in the minimally invasive group. Methods: We define minimally invasive surgery as any percutaneous technique, simple exostectomy, arthrodesis, and reconstruction with relatively small surgical incisions. Results: The study analyzed the pre and post operative course of 44 patients. The study included 25 male and 19 female participants between the ages of 41 - 89 and a mean participant age of 67.5. We looked at patients who underwent treatment for Charcot's foot and found that 68% of these patient had diabetes mellitus. Of the surgical patients 32% were minimally invasive, 55% open and I 3% both minimally invasive and open combination. Conclusion: At 6 months there was no significant difference in the fusion rates or complications across the open, MIS and combination groups. Further study is warranted to determine the optimal candidate and scenario for such technique.
MLM-based typographical error correction of unstructured medical texts for named entity recognition
Authors: Lee Eun Byul , Heo Go Eun , Choi Chang Min , Song Min 
Published: November 2022

AbstractBackgroundUnstructured text in medical records, such as Electronic Health Records, contain an enormous amount of valuable information for research; however, it is difficult to extract and structure important information because of frequent typographical errors. Therefore, improving the quality of data with errors for text analysis is an essential task. To date, few prior studies have been conducted addressing this. Here, we propose a new methodology for extracting important information from unstructured medical texts by overcoming the typographical problem in surgical pathology records related to lung cancer.MethodsWe propose a typo correction model that considers context, based on the Masked Language Model, to solve the problem of typographical errors in real-world medical data. In addition, a word dictionary was used for the typo correction model based on PubMed abstracts. After refining the data through typo correction, fine tuning was performed on pre-trained BERT model. Next, deep learning-based Named Entity Recognition (NER) was performed. By solving the quality problem of medical data, we sought to improve the accuracy of information extraction in unstructured text data.ResultsWe compared the performance of the proposed typo correction model based on contextual information with an existing SymSpell model. We confirmed that our proposed model outperformed the existing model in a typographical correction task. The F1-score of the model improved by approximately 5% and 9% when compared with the model without contextual information in the NCBI-disease and surgical pathology record datasets, respectively. In addition, the F1-score of NER after typo correction increased by 2% in the NCBI-disease dataset. There was a significant performance difference of approximately 25% between the before and after typo correction in the Surgical pathology record dataset. This confirmed that typos influenced the information extraction of the unstructured text.ConclusionWe verified that typographical errors in unstructured text negatively affect the performance of natural language processing tasks. The proposed method of a typo correction model outperformed the existing SymSpell model. This study shows that the proposed model is robust and can be applied in real-world environments by focusing on the typos that cause difficulties in analyzing unstructured medical text.
Orthostatic hypotension is associated with malnutrition diagnosed by GLIM in elderly hypertensive patients
Authors: Zhang Qizhe , Shen Shanshan , Guan Huilan , Zhang Jingmei , Chen Xujiao 
Published: November 2022

Abstract
Background
Orthostatic Hypotension (OH) and malnutrition, are common health problems in elderly hypertensive patients. This study aimed to analyze the relationship between malnutrition and OH in elderly hypertensive patients.

Methods
This is a cross-sectional single-center study. All participants underwent a Comprehensive Geriatric Assessment (CGA), in which malnutrition was defined according to the Global Leadership Initiative on Malnutrition (GLIM) criteria based on four different methods of diagnosing muscle mass loss. Furthermore, the accuracy of these methods was verified by Receiver Operating Characteristic (ROC) analysis. Univariate and multivariate logistic regression analyses were used to identify risk factors for OH in elderly hypertensive patients.

Results
For GLIM criteria, when Fat-Free Mass Index (FFMI) was the gold standard for muscle mass loss, the Area Under ROC Curve (AUC) values for Upper Arm Circumference (UAC), Calf Circumference (CC), and Hand Grip Strength (HGS) were 0.784, 0.805, and 0.832, with moderate accuracy in diagnosing malnutrition. Multivariate analysis showed that females, Diabetes Mellitus (DM), diuretics, and malnutrition diagnosed by GLIM-UAC were risk factors for OH in elderly hypertensive patients.

Conclusion
Prompt detection of malnutrition in the elderly and attention to changes in UAC may be critical. Similarly, we should strengthen medication and disease management in elderly hypertensive patients.
Risk factors and outcomes associated with persistent vancomycin resistant Enterococcal Bacteremia
Authors: Fox Emily , Ha David , Bounthavong Mark , Meng Lina , Mui Emily , Holubar Marisa , Deresinski Stanley , Alegria William 
Published: November 2022

Abstract
Background
Prior studies have identified that vancomycin resistant enterococcus (VRE) bacteremia that persists for four days or more is an independent predictor of mortality. Despite this, there is no published data to identify those patients at highest risk of developing persistent VRE bacteremia.

Methods
This was a single center, retrospective, case-control study of adult patients with a VRE bloodstream infection (BSI). Case patients were those with persistent bacteremia (≥ 4 days despite VRE-directed therapy) and control patients were those with non-persistent bacteremia. Logistic regression was used to assess risk factors associated with persistent VRE BSIs. Secondary outcomes included in-hospital mortality, recurrent bacteremia, and breakthrough bacteremia.

Results
During the study period, 24/108 (22%) patients had persistently positive blood cultures. Risk factors for persistent bacteremia included severe neutropenia (OR 2.13), 4 out of 4 positive index blood cultures (OR 11.29) and lack of source control (OR 11.88). In an unadjusted analysis, no statistically significant differences in in-hospital mortality (58% versus 40%; p = 0.121), recurrent bacteremia (17% versus 6%; p = 0.090), or breakthrough bacteremia (13% versus 7%; p = 0.402) were observed between groups.

Conclusion
Patients with severe neutropenia, 4 out of 4 positive index blood culture bottles, and lack of source control were more likely to develop persistent VRE bacteremia despite directed antibiotic treatment.
Case report: novel PCDH15 variant causes usher syndrome type 1F with congenital hearing loss and syndromic retinitis pigmentosa
Authors: Chen Nelson , Lee Hane , Kim Angela H. , Liu Pei-Kang , Kang Eugene Yu-Chuan , Tseng Yun-Ju , Seo Go Hun , Khang Rin , Liu Laura , Chen Kuan-Jen , Wu We-Chi , Hsiao Meng-Chang , Wang Nan-Kai 
Published: November 2022

Abstract
Background
Usher syndrome (USH) is an autosomal recessive disorder primarily responsible for deaf-blindness. Patients with subtype Usher syndrome type 1 (USH1) typically experience congenital sensorineural hearing loss, abnormal vestibular function, and retinitis pigmentosa (RP). Here we present a case of Usher syndrome type 1F (USH1F) with a novel homozygous variant in the calcium-dependent cell-cell adhesion protocadherin-15 (PCDH15) gene.

Case presentation
Ophthalmic examinations were evaluated over a course of 10 years and the disease-causing variant was identified by whole exome sequencing (WES). Initial and follow-up examination of color fundus photos after 10 years revealed an increase in bone spicule pigment deposits in both eyes. A parafoveal hyper-AF ring in both eyes was shown in fundus autofluorescence (FAF) with a progressive diameter-wise constriction observed over 8 years. Outer nuclear layer (ONL) loss was observed in parafoveal and perifoveal regions of both eyes on spectral domain–optical coherence tomography (SD-OCT). Full-field electroretinography (ffERG) showed extinguished global retinal function. WES identified a novel two-base-pair deletion, c.60_61del (p.Phe21Ter), in the PCDH15 gene, confirming the diagnosis of USH1F.

Conclusions
We report a novel homozygous PCDH15 pathogenic variant expected to lead to nonsense-mediated decay (NMD) of PCDH15 mRNA. The patient exhibits a loss of function with USH1F, experiencing congenital hearing loss and syndromic RP.
Anxiety, depression, and sleep disturbances among people on long-term efavirenz-based treatment for HIV: a cross-sectional study in Beijing, China
Authors: Xiao Jing , Liu Ying , Li Bei , Zhang Leidan , Han Junyan , Zhao Hongxin 
Published: November 2022

Abstract
Background
Efavirenz (EFV)-induced neuropsychiatric toxicity bothers people living with HIV (PLHIV). Neuropsychiatric adverse effects of EFV may differ by length of time on EFV-based antiretroviral treatment (ART).

Methods
A cross-sectional, single-center study was conducted at Beijing Ditan Hospital in China from June–August 2020 among ART-experienced PLHIV who were on long-term EFV-based ART. 424 eligible virological suppressed participants were enrolled and divided into four groups according to time on EFV-based ART: group A (0.5 ≤ ART < 2 year), B (2 ≤ ART < 4 year), C (4 ≤ ART < 6 year), and D (ART ≥ 6 year). The questionnaires about 12-item Short Form Health Survey (SF-12), Hospital Anxiety and Depression Scale (HADS) and Pittsburgh Sleep Quality Index (PSQI) were administered to assess neuropsychiatric adverse events of EFV among different groups.

Results
Overall mental component summary scores (MCS) of SF-12 in PLHIV was 50.2, which was lower than general population. Overall prevalence of anxiety, depression and sleep disturbances was 15.6%, 15.3% and 58%, respectively. Prevalence of anxiety, depression and sleep disturbances did not vary significantly between the time-on-ART groups. Anxiety, depression, sleep disturbances had no correlation with time on EFV-based ART or CD4+ T cells counts.

Conclusions
In ART-experienced PLHIV in China, neuropsychiatric adverse events exist persistently and prevalence do not significantly change with prolonged time on EFV-based ART. The prevalence of sleep disturbances was high, suggesting that clinicians should pay more attention to long-standing psychiatric health to perform early and effective interventions.
Diseases among Orang Asli community in Malaysia: a systematic review
Authors: Mahmud Muhammad Hilmi , Baharudin Ummi Mirza , Md Isa Zaleha 
Published: November 2022

AbstractOrang Asli, the indigenous people of Peninsular Malaysia, is a minority population and placed behind in terms of socioeconomy, education and health. The Malaysian government has supported Orang Asli since the second Malaysia Plan in the 1970s, resulting in changes in their living standard, access to health, education and occupation. Hence, this review aims to assess the recent prevalence of diseases among Orang Asli in Peninsular Malaysia. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) review protocol guided this systematic review. The research question was formulated based on Population, Interest, Comparison and Outcome (PICO). The selected databases include Web of Science, Scopus, Ovid and EBSCOhost. The process of identification, screening and inclusion identified 33 articles. The mixed methods appraisal tool (MMAT) was then used to rank the quality of the articles. Selangor is the most frequent state involved in this review (12 studies), followed by Perak (10 studies), Pahang (10 studies) and Kedah (one study). We categorised into four categories of diseases, namely neglected tropical disease (n = 20), non-communicable disease (n = 6), nutritional status (n = 5), and hepatic disease (n = 2). The prevalence of diseases among Orang Asli is higher than in the general population, especially for soil-transmitted helminth (STH) and malnutrition. There is increasing research on non-communicable diseases due to an increasing trend in the socioeconomic status and lifestyle of the Orang Asli. Government agencies and private organisations must work together to empower Orang Asli with a healthy lifestyle, improve their socioeconomic status, and enhance food security, all of which will improve Orang Asli's health and reduce the prevalence of diseases.
Comparison of agreement in asthmagen exposure assessments between rule-based automatic algorithms and a job exposure matrix in healthcare workers in Australia and Bhutan
Authors: Rai Rajni , Fritschi Lin , Glass Deborah C , Dorji Nidup , El-Zaemey Sonia 
Published: November 2022

Abstract
Background:
Assessment of occupational exposures is an integral component of population-based studies investigating the epidemiology of occupational diseases. However, all the available methods for exposure assessment have been developed, tested and used in high-income countries. Except for a few studies examining pesticide exposures, there is limited research on whether these methods are appropriate for assessing exposure in LMICs. The aim of this study is to compare a task-specific algorithm-based method (OccIDEAS) to a job-specific matrix method (OAsJEM) in the assessment of asthmagen exposures among healthcare workers in a high-income country and a low- and middle- income country (LMIC) to determine an appropriate assessment method for use in LMICs for future research.

Methods:
Data were obtained from a national cross-sectional survey of occupational asthmagens exposure in Australia and a cross-sectional survey of occupational chemical exposure among Bhutanese healthcare workers. Exposure was assessed using OccIDEAS and the OAsJEM. Prevalence of exposure to asthmagens and inter-rater agreement were calculated.

Results:
In Australia, the prevalence was higher for a majority of agents when assessed by OccIDEAS than by the OAsJEM (13 versus 3). OccIDEAS identified exposures to a greater number of agents (16 versus 7). The agreement as indicated by κ (Cohen’s Kappa coefficient) for six of the seven agents assessed was poor to fair (0.02 to 0.37). In Bhutan, the prevalence of exposure assessed by OccIDEAS was higher for four of the seven agents and κ was poor for all the four agents assessed (-0.06 to 0.13). The OAsJEM overestimated exposures to high-level disinfectants by assigning exposures to all participants from 10 (Bhutan) and 12 (Australia) ISCO-88 codes; whereas OccIDEAS assigned exposures to varying proportions of participants from these ISCO-codes.

Conclusion:
There was poor to fair agreement in the assessment of asthmagen exposure in healthcare workers between the two methods. The OAsJEM overestimated the prevalence of certain exposures. As compared to the OAsJEM, OccIDEAS appeared to be more appropriate for evaluating cross-country exposures to asthmagens in healthcare workers due to its inherent quality of assessing task-based determinants and its versatility in being adaptable for use in different countries with different exposure circumstances.
Modified the 8th AJCC staging system for patients with advanced prostate cancer: a study based on SEER database
Authors: Sun Chengwen , Yang Dongrong , Zhu Jin , Zhou Yibin , Xiang Congming , Wu Sheng 
Published: November 2022

Abstract
Background
The American Joint Committee on Cancer (AJCC) 8th staging system of prostate cancer may be insufficient in predicting the prognosis of some staged patients. This study aimed to modify the AJCC 8th staging system in patients with advanced prostate cancer.

Methods
Data of patients with advanced prostate cancer from the Surveillance, Epidemiology, and End Results (SEER) database between 2004 and 2016 were enrolled in this cohort study. All patients were divided into the training set and the testing set with a ratio of 6:4. Multivariate Cox survival model was utilized to obtain the nomogram score for each stage variable. The modified staging system was based on the total nomogram score. The C-index and Kaplan-Meier (K-M) curves were used to show the prognostic prediction effect of patients with different staging systems.

Results
A total of 28,006 patients were included for analysis. T stage, N stage, M stage, primary Gleason pattern score, secondary Gleason pattern score, and PSA level were included as stage variables. Patients with AJCC stage III C [hazard ratio (HR) = 4.17, 95% confidence interval (CI), 3.39–5.13] and AJCC stage IV B (HR = 3.19, 95%CI, 1.79–5.69) were associated with worse prognosis compared with those of AJCC stage III B, while no statistical significance was found in patients with stage IV A (P > 0.05). In terms of the modified staging system, patients with modified stage III C (HR = 2.06, 95%CI, 1.46–2.92), modified stage IV A (HR = 6.91, 95%CI, 4.81–9.94), and modified stage IV B (HR = 21.89, 95%CI, 14.76–32.46) were associated with a poorer prognosis compared with patients with modified stage III B. The prognostic ability (C-index) of the modified staging system (0.789; 95%CI, 0.777–0.801) was better than that of the AJCC 8th edition system (0.762; 95%CI, 0.748–0.776) (0.789 vs. 0.762, P = 0.004). The K-M curves indicated that the modified staging system may be distinguished prognostic differences in patients with different stages.

Conclusion
Modified staging system may be better than AJCC 8th staging system for predicting prognosis in prostate cancer patients. The AJCC 8th staging system should be further optimized.