bluuebunny/crossref_metadata_2025_split huggingface dataset:
Associations of stroke with all-cause and cause-specific mortality: A population-based matched cohort study
Authors: Kim Juyeong , Park Eun-Cheol 
Published: February 2022

AbstractBackgroundThis study aimed to assess the specific associations between stroke and all-cause and cause-specific mortality among Korean adults.MethodsWe used data extracted from the Korean National Health Insurance claims database from 2002 to 2013, including information on individuals with or without stroke aged 20 years and older. Patients with intracerebral hemorrhage, ischemic stroke or unspecified stroke were classified as stroke patients, while a reference population matched in terms of sex and age were also selected. The outcomes were all-cause mortality, natural causes of death (i.e. all natural causes, death by stroke and death by other diseases) and suicide. Survival analysis was performed using the Cox proportional hazards model.ResultsOf the 73 150 eligible participants—including 14 630 stroke patients and 58 520 age- and sex-matched controls—11 121 (15.2%) died during the study period. Of them, 10 513 participants (94.5%) died of natural causes, including 1653 (14.5%) who died due to stroke and 8860 (79.7%) who died due to other diseases. Two hundred and fifty patients (2.2%) died by suicide. Stroke patients showed higher adjusted hazard ratios (HR) for all-cause (HR = 6.48, 95% CI, 3.87–10.86), all-natural-cause (HR = 2.68, 95% CI, 2.53–2.84), stroke (HR = 21.16, 95% CI, 17.49–25.61), other disease (HR = 1.69, 95% CI, 1.58–1.81) and suicide mortality (HR = 3.34, 95% CI, 2.24–4.98) than those without stroke. The effect size of stroke for suicide mortality was greater than that for other causes of mortality (except stroke mortality).ConclusionsStroke was associated with a higher risk of all-cause, natural cause and suicide mortality; stroke was more strongly associated with risk of suicide mortality than with any mortality for any other causes. From a policy standpoint, these results suggest the need for greater supportive care to prevent unnatural deaths among stroke patients.
Racial Disparities in Postoperative Outcomes Following Operative Management of Pediatric Developmental Dysplasia of the Hip
Authors: Malyavko Alisa , Quan Theodore , Howard Peter G. , Recarey Melina , Manzi Joseph E. , Tabaie Sean 
Published: February 2022

Background:
Developmental dysplasia of the hip in pediatric patients can be managed conservatively or operatively. Understanding patient risk factors is important to optimize outcomes following surgical treatment of developmental dysplasia of the hip. Racial disparities in procedural outcomes have been studied, however, there is scarce literature on an association between race and complications following pediatric orthopaedic surgery. Our study aimed to determine the association between pediatric patients’ race and outcomes following operative management of hip dysplasia by investigating 30-day postoperative complications and length of hospital stay.

Methods:
The National Surgical Quality Improvement Program-Pediatric database was utilized from the years 2012 to 2019 to identify all pediatric patients undergoing surgical treatment for hip dysplasia. Patients were stratified into 2 groups: patients who were White and patients from underrepresented minority (URM) groups. URM groups included those who were Black or African American, Hispanic, Native American or Alaskan, and Native Hawaiian or Pacific Islander. Differences in patient demographics, comorbidities, and postoperative outcomes were compared between the 2 cohorts using bivariate and multivariate analyses.

Results:
Of the 9159 pediatric patients who underwent surgical treatment for hip dysplasia between 2012 and 2019, 6057 patients (66.1%) were White and 3102 (33.9%) were from URM groups. In the bivariate analysis, compared with White patients, patients from URM groups were more likely to experience deep wound dehiscence, pneumonia, unplanned reintubation, cardiac arrest, and extended length of hospital stay. Following multivariate analysis, patients from URM groups had an increased risk of unplanned reintubation (odds ratio: 3.583; P=0.018).

Conclusions:
Understanding which patient factors impact surgical outcomes allows health care teams to be more aware of at-risk patient groups. Our study found that pediatric patients from URM groups who underwent surgery for correction of hip dysplasia had greater odds of unplanned reintubation when compared with patients who were White. Further research should investigate the relationship between multiple variables including race, low socioeconomic status, and language barriers on surgical outcomes following pediatric orthopaedic procedures.

Level of Evidence:
Level III—retrospective cohort analysis.
Guided Growth Procedures: Broken Tension Band Implants in Patients With Blount Disease
Authors: Chapman Paige , Dueber David M. , Stephenson Lindsay P. , Scott Allison C. , Lerman Joel A. , Powell Kenneth P. , Nossov Sarah B. , Franklin Corinna C. , Westberry David E. , Ackman Jeffery D. , Walker Janet L. 
Published: February 2022

Background:
Tension band plate and screw implants (TBI) are frequently used for temporary hemiepiphyseodeses to manage angular deformity in growing children. The reported implant breakage rate, when TBI is used for deformities in patients with Blount disease, is much higher than when used in other diagnoses. Our hypothesis is that perioperative factors can identify risks for TBI breakage.

Methods:
A retrospective case-control study was performed of 246 TBI procedures in 113 patients with Blount disease at 8 tertiary pediatric orthopaedic centers from 2008 to 2018. Patient demographics, age at diagnosis, weight, body mass index (BMI), radiographic deformity severity measures, location, and types of implants were studied. The outcome of implant breakage was compared with these perioperative factors using univariate logistic regression with Bonferroni correction for multiplicity to significance tests.

Results:
There were 30 broken implants (12%), failing at mean 1.6 years following implantation. Most failures involved the metaphyseal screws. Increased BMI was associated with increased implant breakage. Increased varus deformity was directly associated with greater implant breakage and may be a more important factor in failure for those below 7 years compared with those 8 years or above at diagnosis. There was a 50% breakage rate for TBI with solid 3.5 mm screws in Blount disease with onset 8 years or above of age. No demographic or implant factors were found to be significant.

Conclusions:
Breakage of TBI was associated with increased BMI and varus deformity in patients with Blount disease. Larger studies are required to determine the relative contribution and limits of each parameter. Solid 3.5 mm screws should be used with caution in TBI for late-onset Blount disease.

Level of Evidence:
Level III.
3D-printed Cutting Guides for Lower Limb Deformity Correction in the Young Population
Authors: Gigi Roy , Gortzak Yair , Barriga Moreno Juan , Golden Eran , Gabay Ronnie , Rumack Netta , Yaniv Moshe , Dadia Solomon , Segev Eitan 
Published: February 2022

Background:Three-dimensional (3D) virtual surgical planning technology has advanced applications in the correction of deformities of long bones by enabling the production of 3D stereolithographic models, patient-specific instruments and surgical-guiding templates. Herein, we describe the implementation of this technology in young patients who required a corrective osteotomy for a complex 3-plane (oblique plane) lower-limb deformity.Patients and Methods:A total of 17 patients (9 males, average age 14.7 y) participated in this retrospective study. As part of preoperative planning, the patients’ computerized tomographic images were imported into a post-processing software, and virtual 3D models were created by a segmentation process. Femoral and tibial models and cutting guides with locking points were designed according to the deformity correction plan. They were used for both planning and as intraoperative guides. Clinical parameters, such as blood loss and operative time were compared with a traditional surgical approach group.Results:All osteotomies in the 3D group were executed with the use intraoperative customized cutting guides which matched the preoperative planning simulation and allowed easy fixation with prechosen plates. Surgical time was 101±6.2 minutes for the 3D group and 126.4±16.1 minutes for the control group. The respective intraoperative hemoglobin blood loss was 2.1±0.2 and 2.5+0.3 g/dL.Clinical and radiographic follow-up findings showed highly satisfactory alignment of the treated extremities in all 3D intervention cases, with an average time-to-bone union (excluding 2 neurofibromatosis 1 patients) of 10.3 weeks (range 6 to 20 wk).Conclusion:The use of 3D-printed models and patient-specific cutting guides with locking points improves the clinical outcomes of osteotomies in young patients with complex bone deformities of the lower limbs.Level of Evidence:Level III.
Characterizing Negative Online Reviews of Pediatric Orthopaedic Surgeons
Authors: Richman Evan H. , Ogbaudu Ewoma , Pollock Jordan R. , Brinkman Joseph C. , Moore Michael Lane , Arthur Jaymeson R. , Karlen Judson W. 
Published: February 2022

Background:
The growing focus on subjective patient experiences has created an increase in popularity for physician rating websites. The purpose of this study was to characterize extremely negative reviews of pediatric orthopaedic surgeons.

Methods:
Pediatric orthopaedic surgeons were randomly selected using the Pediatric Orthopaedic Society of North America comprehensive list of surgeons. A search was then performed on Healthgrades.com, Vitals.com, and Yelp.com for 1-star reviews. Reviews were classified into clinical and nonclinical categories. Statistical analyses were performed regarding the frequency of reviews and complaints for each respective category.

Results:
Of the 279 one-star reviews categorized, 248 reviews (88.9% of reviews) included nonclinical complaints, and 182 reviews (65.2% of reviews) included clinical complaints. Nonsurgical patients were associated with 255 reviews, and the remaining 24 were related to surgical patients. Of the 430 comments within reviews, 248 referenced nonclinical aspects of care, and 182 referenced clinical care. Clinical factors most frequently noted included clinical disagreement (37%), unclear treatment plan (25%), complication (17%), misdiagnosis (15%), uncontrolled pain (13%), and delay in care (8%). The most addressed nonclinical factors included physician bedside manner (68%), time spent with provider (21%), wait time (18%), unprofessional staff (17%), scheduling issues (9%), cost (8%), and billing (8%). Compared with surgical reviews, nonsurgical reviews were more likely to contain nonclinical complaints (rate ratio: 1.5; P<0.05) and less likely to contain clinical complaints (rate ratio: 0.7; P<0.05). The most common complaint by surgical patients was complications (91.7%).

Conclusions:
To our knowledge, this is the first study to examine the factors associated with negative reviews of pediatric orthopaedic surgeons. The majority of reviews of pediatric orthopaedic surgeons were left by nonsurgical patients and were related to nonclinical aspects of care. We also found surgeon-dependent factors such as poor physician bedside manner, unclear treatment plan, or parents’ disagreement with treatment plan were the most common reasons for negative reviews.

Level of Evidence:
Level IV.
Higher efficacy of oral etoposide for mobilization of peripheral blood stem cells in patients with multiple myeloma
Authors: Qiang Wanting , Jiang Hua , Guo Pei , Lu Jing , Liu Jin , Li Lu , He Haiyan , Hu Xiaoxia , Fu Weijun , Du Juan 
Published: February 2022

Abstract
This study compares the efficacy, toxicity, hematopoietic recovery, and cost of stem-cell mobilization using intermediate-dose cyclophosphamide (IDCy) plus granulocyte colony-stimulating factor (G-CSF) compared with etoposide (VP-16) plus pegylated granulocyte colony-stimulating factor (PEG-rhG-CSF) in multiple myeloma (MM) patients. Two hundred forty-four consecutive patients undergoing mobilization with IDCy (3-3.5 g/m
2
) plus G-CSF (n = 155) were compared with patients receiving VP-16 plus PEG-rhG-CSF (n = 89), including oral etoposide (n = 65) and intravenous etoposide (n = 24). Compared with IDCy, VP-16 use was associated with significantly higher median peak peripheral blood CD34 + cell count (8.20 [range: 1.84-84] × 106/kg vs 4.58 [range: 0.1-27.9] × 106/kg, P
= .000), and ideal CD34 + cell yield of more than 6 × 106/kg (56.8% vs 35.1%, P
= .001), notably with a higher efficacy in oral VP-16 use compared with IDCy use (CD 34 + cell counts: median peak peripheral blood 5.87 vs 4.58 × 106/kg and ≥6 × 106/kg [48.4% vs 35.1%]). The median number of apheresis courses was reduced from two in the IDCy group to one in the VP-16 group (P = .000). IDCy use was associated with significantly more frequent episodes of neutropenia (70.2% vs 35.2%; P
= .000), intravenous antibiotic use (13.2% vs 11.4%; P
= .672), and hospitalization (P = .000). The recoveries of neutrophils and platelets after autologous stem-cell transplantation were significantly faster in the VP-16 group compared with the IDCy group (P = .000). Our data indicate robust stem-cell mobilization in MM patients with VP-16 delivered either orally or intravenously. When compared with intravenous VP-16, oral VP-16 mobilization was associated with significantly more convenient, lower average total costs, and especially decreased the risk of hospital visits and exposure.
Small RNA sequencing reveals placenta-derived exosomal microRNAs associated with preeclampsia
Authors: Lu Jing , Sun Yifan , Cao Yuming , Zhang Yuanzhen 
Published: February 2022

Objective:
Preeclampsia is one of the most important complications during pregnancy and the leading cause of maternal morbidity and mortality; however, the pathogenesis of preeclampsia remains partially misunderstood. The aim of this study was to identify placenta-derived exosomal microRNAs (miRNAs) involved in the preeclampsia process.

Methods:
Peripheral blood was collected from normal and preeclampsia pregnant women, and placenta-derived exosomes were extracted. Small RNA sequencing was performed to identify the exosomal miRNAs involved in preeclampsia. The function of a differentially expressed exosomal miRNA was verified.

Results:
The extracted exosomes presented round or ovallike structures with diameters of approximately 80 nm and could be recognized by antibodies against CD9, CD81, and placental alkaline phosphatase. A total of 1013 exosomal miRNAs were identified by small RNA sequencing, of which 946 were known miRNAs and 67 were novel miRNAs. Twenty-six miRNAs were identified as differentially expressed when comparing the data of the preeclampsia and normal groups. One of the differentially expressed miRNAs, hsa-miR-370–3p, which was upregulated in the preeclampsia group, was shown to bind to the 3’ untranslated region of C-X-C motif chemokine 12, a chemokine that plays important role during preeclampsia process. Moreover, functional analysis revealed that hsamiR-370–3p could inhibit proliferation, migration, and invasion while promoting apoptosis of HTR-8/SVneo cells.

Conclusion:
A total of 1013 placenta-derived exosomal miRNAs were identified by small RNA sequencing, of which 26 were differentially expressed. The function of one differentially expressed miRNA (hsa-miR-370–3p) was verified. Our results provide new perspectives on the pathogenesis of preeclampsia and potential biomarkers for preeclampsia diagnosis.
A Pilot Randomized Control Trial to Assess the Impact of Lavender on Anxiety and Comfort After Cesarean Birth and the Barriers Encountered
Authors: Burgess Adriane , Harris Amy , Wheeling Julia 
Published: February 2022

Abstract

Purpose:
This study aimed to assess the effect of lavender aromatherapy on anxiety and comfort after cesarean birth.

Study Design:
Randomized control trial.

Methods:
Forty-eight patients who had a cesarean birth were asked to complete the six-item State and Trait Anxiety (STAI-6) score to assess their level of anxiety pre- and postapplication of either lavender aromatherapy or placebo during their inpatient postpartum stay. Their comfort and pain levels pre- and postadministration were assessed, and differences between groups were analyzed. Results: There was no difference in postintervention STAI-6 scores between the aromatherapy and placebo groups (p = .56). Women who received the lavender aromatab® had significantly (p = .037) higher self-reported levels of comfort (M 2.6 SD .82) when compared with those who received placebo (M 2.0 SD 1.0).

Clinical Implications:
Many women use aromatherapy at home to promote comfort and relaxation. Women feel lavender aromatherapy improves their comfort in the hospital setting after cesarean birth. Clinicians should consider ways to safely use aromatherapy as one option to promote postoperative cesarean birth care.
Noise reduction in the ICU: a best practice implementation project
Authors: Souza Regina Claudia da Silva , Calache Ana Lucia Siqueira Costa , Oliveira Ester Goes , Nascimento Jonl Carlos do , Silva Natalia Dalforno da , Poveda Vanessa de Brito 
Published: February 2022

ABSTRACT

Introduction:
Sleep deprivation is a relevant problem among patients hospitalized in ICUs. Further, noise is the most critical disruptive factor according to patients.

Objective:
To implement scientific evidence-based best practices for noise control in an adult ICU.

Methods:
This was an evidence-based implementation project of best practices in noise control, conducted in a high-complexity hospital's adult ICU. The intervention consisted of three steps: baseline audit and identification of barriers, implementation of best practices, and a follow-up audit.

Results:
No compliance with best practices was detected in the baseline audit. After the implementation phase, the unit reached compliance levels of 78–88% for most of these criteria only one criterion related to noise level did not match the expected compliance.

Conclusion:
Adherence to best practices regarding noise control was satisfactory, achieving more than 70% compliance in the six audit criteria. Only the noise level did not reach the threshold recommended by the WHO - a difficulty reported in other studies.

Relevance to clinical practice:
Best practices related to noise control are essential for managing sleep deprivation in ICUs and include changes in the behaviour of involved professionals.
Molnupiravir (MK-4482) is efficacious against Omicron and other SARS-CoV-2 variants in the Syrian hamster COVID-19 model
Authors: Rosenke Kyle , Okumura Atsushi , Lewis Matthew C. , Feldmann Friederike , Meade-White Kimberly , Bohler W. Forrest , Griffin Amanda , Rosenke Rebecca , Shaia Carl , Jarvis Michael A. , Feldmann Heinz 
Published: February 2022

ABSTRACTThe recent emergence of the SARS-CoV-2 Omicron variant of concern (VOC) containing a heavily mutated spike protein capable of escaping preexisting immunity, identifies a continued need for interventional measures. Molnupiravir (MK-4482), an orally administered nucleoside analog, has demonstrated efficacy against earlier SARS-CoV-2 lineages and was recently approved for SARS-CoV-2 infections in high-risk adults. Here we assessed the efficacy of MK-4482 against the earlier Alpha, Beta and Delta VOCs and Omicron in the Syrian hamster COVID-19 model. Omicron replication and associated lung disease in vehicle treated hamsters was reduced compared to the earlier VOCs. MK-4482 treatment inhibited virus replication in the lungs of Alpha, Beta and Delta VOC infected hamsters. Importantly, MK-4482 profoundly inhibited virus replication in the upper and lower respiratory tract of hamsters infected with the Omicron VOC. Consistent with its mutagenic mechanism, MK-4482 treatment had a more pronounced inhibitory effect on infectious virus titers compared to viral RNA genome load. Histopathologic analysis showed that MK-4482 treatment caused a concomitant reduction in the level of lung disease and viral antigen load in infected hamsters across all VOCs examined. Together, our data indicate the potential of MK-4482 as an effective antiviral against known SARS-CoV-2 VOCs, especially Omicron, and likely future SARS-CoV-2 variants.One Sentence SummaryMK-4482 inhibits replication of multiple SARS-CoV-2 variants of concern, including Omicron, in the Syrian hamster COVID-19 model
GANscan: continuous scanning microscopy using deep learning deblurring
Authors: Fanous Michael John , Popescu Gabriel 
Published: February 2022

AbstractMost whole slide imaging (WSI) systems today rely on the “stop-and-stare” approach, where, at each field of view, the scanning stage is brought to a complete stop before the camera snaps a picture. This procedure ensures that each image is free of motion blur, which comes at the expense of long acquisition times. In order to speed up the acquisition process, especially for large scanning areas, such as pathology slides, we developed an acquisition method in which the data is acquired continuously while the stage is moving at high speeds. Using generative adversarial networks (GANs), we demonstrate this ultra-fast imaging approach, referred to as GANscan, which restores sharp images from motion blurred videos. GANscan allows us to complete image acquisitions at 30x the throughput of stop-and-stare systems. This method is implemented on a Zeiss Axio Observer Z1 microscope in brightfield mode, requires no specialized hardware, and accomplishes successful reconstructions at stage speeds of up to 5,000 μm/s. We validate the proposed method by imaging H&E stained tissue sections. Our method not only retrieves crisp images from fast, continuous scans, but also corrects any defocusing that occurs during scanning. Using a consumer GPU, the inference runs at <20ms/ image.
A light-gated transcriptional recorder for detecting cell-cell contacts
Authors: Cho Kelvin F. , Gillespie Shawn M. , Kalogriopoulos Nicholas A. , Quezada Michael A. , Jacko Martin , Monje Michelle , Ting Alice Y. 
Published: February 2022

AbstractTechnologies for detecting cell-cell contacts are powerful tools for studying a wide range of biological processes, from neuronal signaling to cancer-immune interactions within the tumor microenvironment. Here we report TRACC, a GPCR-based transcriptional recorder of cellular contacts, which converts contact events into stable transgene expression. TRACC is derived from our previous protein-protein interaction recorders, SPARK (Kim et al., 2017) and SPARK2 (Kim et al., 2019). TRACC incorporates light gating via the LOV domain, which provides user-defined temporal control of tool activation and reduces background. We show that TRACC detects cell-cell contacts with high specificity and sensitivity in mammalian cell culture and that it can be used to interrogate interactions between neurons and glioma, a form of brain cancer.