bluuebunny/crossref_metadata_2025_split huggingface dataset:
Unsolicited Patient Complaints in Orthopaedic Surgery: An Analysis Utilizing a Large National Database
Authors: Sarfani Shumaila 
Published: January 2022

Category: Other Introduction/Purpose: Unsolicited patient complaints (UPCs) about surgeons have been shown to correlate with surgical complications and malpractice claims in several specialties. Analysis of UPCs in orthopaedics is limited and using large national databases of UPCs may prove informative to orthopaedic providers and administrators. Our purpose was to 1) Evaluate the differences in the number and distribution of UPCs between orthopaedic surgeons as compared to other surgeons, and non- surgeons. 2) Describe the distribution of UPCs among orthopaedic sub-specialties. 3) Assess for clinical characteristics that may be associated with UPCs. Methods: Patient complaint reports recorded at 36 medical centers between January 1st, 2015 through December 31st, 2018 were coded using a previously validated coding algorithm, PARS® (Patient Advocacy Reporting System®). We (1) evaluated the distribution of UPCs across orthopaedic surgeons, (2) compared orthopaedic surgeons’ UPC distribution with those of other surgeons and non-surgeons, and (3) analyzed differences in complaint types across orthopaedic sub-specialties. Results: A total of 33,174 physicians had four consecutive years of data across the 36 nation-wide participating medical centers and met other inclusion criteria, including 1,148 orthopaedic surgeons, 6,747 other surgeons, and 25,279 non-surgeons. Orthopaedic surgeons experienced more UPCs per physician than non-orthopaedic surgeons and non-surgeons (5 vs. 2 vs. 1 respectively, p<0.05); the top 20% of orthopaedic surgeons with UPCs accounted for half of all complaints about orthopaedic surgeons received by the organizations in the study. The sub-specialties that had significantly more UPCs compared to general orthopaedic surgeons were Foot and Ankle (OR 2.6 [1.4-4.6], p=.002), followed by Adult Reconstruction (OR 2.2 [1.3-3.8], p=.002), Spine [OR 2.2 (1.3-3.8), p=.005), and Trauma (OR 2.2 [1.2-4.0], p =.01). Surgeons in the midwest were less likely to get complaints that surgeons in the northeast and sex was not a predicting factor. Conclusion: Orthopaedic surgeons receive comparatively more UPCs than other surgical and non-surgical specialties. Among orthopaedic surgeons, the subspecialties of Foot and Ankle, Adult, Reconstruction, Spine, and Trauma received the most UPCs. As increased UPCs have been linked to higher risk of malpractice claims, individual orthopaedic surgeons with high numbers of UPCs may benefit from being made aware of their elevated risk status in ways that invite reflection on underlying causes.
Posterior Tibial Transfer to the Lateral Cuneiform in a Young, Active Patient with Foot Drop: A Case Report
Authors: Yoder Robert G. , Lipari Nicholas , Groth Adam T. 
Published: January 2022

Category: Ankle; Midfoot/Forefoot; Sports; Other Introduction/Purpose: We report the case of a 23-year-old male who underwent a posterior tibial tendon (PTT) transfer after suffering foot drop secondary to a traumatic knee dislocation five years earlier. The common peroneal nerve is a commonly injured peripheral nerve due to its anatomic location. Peroneal nerve palsy leads to the inability to clear the foot during the swing phase of gait due to paralysis of the tibialis anterior- the strongest dorsiflexor of the foot. In the event that nerve function does not spontaneously return, tendon transfer surgeries are an established definitive treatment. Despite this, the optimal method of tendon transfer has not yet been determined. Thus, pre-operative assessment and planning remains crucial in determining which method is to be used. Conclusion: Surgeons must decide which tendon to transfer, which route to utilize, and where to insert in effort to maximize biomechanical outcomes. Careful consideration must be made to ensure maximum strength and optimal forefoot balance to allow patients undergoing tendon transfer to become brace free. Our patient underwent a PTT transfer via the interosseous route to the lateral cuneiform- a common option for those with traumatic peroneal nerve injury. By three months post-operation, our patient achieved adequate dorsiflexion to clear swing phase. By one year post-operation and beyond, our patient has participated in physical activity brace free without any complications.
Assessing the Accuracy, Quality, and Readability of Online Patient Resources on Tarsal Coalition
Authors: Zhang Hui , Foster Brian , Graham Jove , Seeley Mark 
Published: January 2022

Category: Other; Hindfoot Introduction/Purpose: The internet is an inexpensive and convenient source for health information. However, without regulation, the quality and accuracy of the information is unknown. Tarsal coalition is a common cause of pediatric foot pain and disability. We hypothesized that the online patient information on tarsal coalition is of low accuracy, low quality, and of poor readability. Additionally, we hypothesized that sources found on the first search page were of higher quality, greater accuracy, and more readable. Methods: A cross-sectional review of the internet was performed using the term 'tarsal coalition' on the 3 most popular search engines. Unique sites were categorized based on authorship and search result order. Websites were evaluated using a novel content score based on the AAOS OrthoInfo site on tarsal coalition (max score: 20), JAMA Benchmark and DISCERN scores for quality, and Flesch-Kincaid Grade Level (FKGL) and Flesch Reading Ease (FRE) for readability. Results: A total of 47 unique websites were evaluated. They ranged from professional organization/society websites to websites for individual practices and professional blogs. The average content score was 13.1 (range: 4-20). The average DISCRN score was 34.2 (range: 19-57.5). We did find a positive correlation between the content score and DISCERN scores of the included resources (p=0.04). The average 11.4 (range 8.5-15.5). Only 2 of the websites (4%) were written at or below an 8th grade reading level, which has been documented as the average reading level of the general population in the United States. Websites that were authored by physicians had greater DISCRN and readability scores compared to academic and private practice websites (DISCERN 40.4 vs 32.3 (p=0.001) and 31.7 (p=0.01), respectively, FKGL 13.0 vs 10.4 (p=0.002) and 11.1 (p=0.03), respectively, FRE 31.5 vs 48.7 (p=0.0001) and 45.2 (p=0.025), respectively). Conclusion: Online patient resources on tarsal coalition are of low quality, inaccurate, and too complex for the average reader. Physician authored websites may serve as better resources compared to academic or private practice sites. Physicians should caution patients using the internet for information on tarsal coalition.
The effect of select systemic medications on outcomes in diabetics with central retinal vein occlusion
Authors: Simmons Kirsten , Singh Pali , Borkar Durga S. , Birnbaum Faith , Thomas Akshay S. , Fekrat Sharon 
Published: January 2022

Background: Diabetes mellitus is a risk factor for central retinal vein occlusion (CRVO); however, it is unclear whether certain commonly used medications among diabetics or glycemic control impact visual outcomes in diabetic eyes with CRVO. Purpose: To evaluate the effect of select systemic medications and glycemic control on presenting features, treatment burden, and outcomes in patients with diabetes who develop a central retinal vein occlusion (CRVO). Methods: Retrospective longitudinal cohort study at a single tertiary academic referral center from 2009–2017 investigating eyes of patients being treated for diabetes mellitus at CRVO onset. Eyes with a prior history of anti-vascular endothelial growth factor (anti-VEGF) therapy or laser treatment within the year prior to CRVO onset were excluded. Main outcomes and measures were visual acuity (VA), central subfield thickness (CST), cystoid macular edema (CME), and number of intravitreal injections and laser treatment throughout follow-up. Results: We identified 138 eyes of 138 participants who were diabetic at CRVO onset. Of these, 49% had an ischemic CRVO. Median follow-up time was 25.5 months. Fifty-five eyes (40%) had a HbA1c within 6 months of CRVO presentation. HbA1c was positively correlated with both presenting CST ( p = 0.04) and presence of CME ( p < 0.01). In all 138 eyes, mean presenting VA was 20/246, and mean final VA was 20/364. Better-presenting VA was significantly associated with aspirin 325 mg use ( p = 0.04). Lower CST at presentation was significantly associated with metformin use ( p = 0.02). Sitagliptin use at CRVO onset was associated with a lower prevalence of CME at final follow-up ( p < 0.01). Lower final CST was significantly associated with glipizide use at CRVO onset ( p = 0.01). There were no significant associations between systemic medications or HbA1c and treatment burden or final VA ( p > 0.05). Conclusion: Although aspirin 325 mg, metformin, sitagliptin, and glipizide were associated with better-presenting VA, lower-presenting CST, lower prevalence of macular edema at final visit, and lower final CST, respectively, none of these systemic agents or glycemic control were associated with decreased treatment burden or improved visual outcomes in diabetics with CRVO.
SFPQ-ABL1 and BCR-ABL1 use different signaling networks to drive B-cell acute lymphoblastic leukemia
Authors: Brown Lauren M. , Hediyeh-zadeh Soroor , Sadras Teresa , Huckstep Hannah , Sandow Jarrod J. , Bartolo Ray C. , Kosasih Hansen J. , Davidson Nadia M. , Schmidt Breon , Bjelosevic Stefan , Johnstone Ricky , Webb Andrew I. , Khaw Seong L. , Oshlack Alicia , Davis Melissa J. , Ekert Paul G. 
Published: January 2022

Abstract
Philadelphia-like (Ph-like) acute lymphoblastic leukemia (ALL) is a high-risk subtype of B-cell ALL characterized by a gene expression profile resembling Philadelphia chromosome–positive ALL (Ph+ ALL) in the absence of BCR-ABL1. Tyrosine kinase–activating fusions, some involving ABL1, are recurrent drivers of Ph-like ALL and are targetable with tyrosine kinase inhibitors (TKIs). We identified a rare instance of SFPQ-ABL1 in a child with Ph-like ALL. SFPQ-ABL1 expressed in cytokine-dependent cell lines was sufficient to transform cells and these cells were sensitive to ABL1-targeting TKIs. In contrast to BCR-ABL1, SFPQ-ABL1 localized to the nuclear compartment and was a weaker driver of cellular proliferation. Phosphoproteomics analysis showed upregulation of cell cycle, DNA replication, and spliceosome pathways, and downregulation of signal transduction pathways, including ErbB, NF-κB, vascular endothelial growth factor (VEGF), and MAPK signaling in SFPQ-ABL1–expressing cells compared with BCR-ABL1–expressing cells. SFPQ-ABL1 expression did not activate phosphatidylinositol 3-kinase/protein kinase B (PI3K/AKT) signaling and was associated with phosphorylation of G2/M cell cycle proteins. SFPQ-ABL1 was sensitive to navitoclax and S-63845 and promotes cell survival by maintaining expression of Mcl-1 and Bcl-xL. SFPQ-ABL1 has functionally distinct mechanisms by which it drives ALL, including subcellular localization, proliferative capacity, and activation of cellular pathways. These findings highlight the role that fusion partners have in mediating the function of ABL1 fusions.
Inhibition of β-catenin signaling attenuates arteriovenous fistula thickening in mice by suppressing myofibroblasts
Authors: Liu Chung-Te , Hsu Shih-Chang , Hsieh Hui-Ling , Chen Cheng-Hsien , Chen Chun-You , Sue Yuh-Mou , Chen Tso-Hsiao , Hsu Yung-Ho , Lin Feng-Yen , Shih Chun-Ming , Shiu Yan-Ting , Huang Po-Hsun 
Published: January 2022

Abstract
Background
Arteriovenous fistula (AVF) is the most important vascular access for hemodialysis; however, preventive treatment to maintain the patency of AVFs has not been developed. In endothelium, β-catenin functions in both the intercellular adherens complex and signaling pathways that induce the transition of endothelial cells to myofibroblasts in response to mechanical stimuli. We hypothesize that mechanical disturbances in the AVF activate β-catenin signaling leading to the transition of endothelial cells to myofibroblasts, which cause AVF thickening. The present study aimed to test this hypothesis.

Methods
Chronic kidney disease in mice was induced by a 0.2% adenine diet. AVFs were created by aortocaval puncture. Human umbilical vein endothelial cells (HUVECs) were used in the cell experiments. A pressure-culture system was used to simulate mechanical disturbances of the AVF.

Results
Co-expression of CD31 and smooth muscle alpha-actin (αSMA), loss of cell–cell adhesions, and the expression of the myofibroblast marker, integrin subunit β6 (ITGB6), indicated transition to myofibroblasts in mouse AVF. Nuclear translocation of β-catenin, decreased axin2, and increased c-myc expression were also observed in the AVF, indicating activated β-catenin signaling. To confirm that β-catenin signaling contributes to AVF lesions, β-catenin signaling was inhibited with pyrvinium pamoate; β-catenin inhibition significantly attenuated AVF thickening and decreased myofibroblasts. In HUVECs, barometric pressure-induced nuclear localization of β-catenin and increased expression of the myofibroblast markers, αSMA and ITGB6. These changes were attenuated via pretreatment with β-catenin inhibition.

Conclusions
The results of this study indicate that mechanical disturbance in AVF activates β-catenin signaling to induce the transition of endothelial cells to myofibroblasts. This signaling cascade can be targeted to maintain AVF patency.
Prolonged migraine aura resembling ischemic stroke following CoronaVac vaccination: an extended case series
Authors: Suwanwela Nijasri C. , Kijpaisalratana Naruchorn , Tepmongkol Supatporn , Rattanawong Wanakorn , Vorasayan Pongpat , Charnnarong Chutibhorn , Tantivattana Jarturon , Roongruang Sirigunya , Ongphichetmetha Tatchaporn , Panjasriprakarn Poonnakarn , Chutinet Aurauma , Akarathanawat Wasan , Saver Jeffrey L. 
Published: January 2022

Abstract
Background
After the initiation of the COVID-19 vaccination program in Thailand, thousands of patients have experienced unusual focal neurological symptoms. We report 8 patients with focal neurological symptoms after receiving inactivated virus vaccine, CoronaVac.

Case series
Patients were aged 24–48 years and 75% were female. Acute onset of focal neurological symptoms occurred within the first 24 h after vaccination in 75% and between 1-7d in 25%. All presented with lateralized sensory deficits, motor deficits, or both, of 2–14 day duration. Migraine headache occurred in half of the patients. Magnetic resonance imaging of the brain during and after the attacks did not demonstrate any abnormalities suggesting ischemic stroke. All patients showed moderately large regions of hypoperfusion and concurrent smaller regions of hyperperfusion on SPECT imaging while symptomatic. None developed permanent deficits or structural brain injury.

Discussions
Here, we present a case series of transient focal neurological syndrome following Coronavac vaccination. The characteristic sensory symptoms, history of migraine, female predominant, and abnormal functional brain imaging without structural changes suggest migraine aura as pathophysiology. We propose that pain related to vaccine injection, component of vaccine, such as aluminum, or inflammation related to vaccination might trigger migraine aura in susceptible patients.
Effects of Random Nanosized TiN Grain on Characteristic of Gate-All-Around FinFETs with Ferroelectric HZO Layer
Authors: Li Yiming , Chuang Min-Hui , Tsai Yu-Chin 
Published: January 2022

AbstractIn this paper, we computationally study electrical characteristics for gate-all-around fin field effect transistors (GAA FinFETs) and negative capacitance GAA FinFETs (NC-GAA FinFETs) for sub-3-nm technological nodes. For the devices with the fin height of 55 nm, the on-state current increases (about 33% improvement) and the off-state current decreases (about 73% suppression) due to the NC effect. NC-GAA FinFETs have larger standard deviation of threshold voltage induced by the workfunction fluctuation (WKF) for both N-/P-type devices than those of GAA FinFETs. It is attributed to the variation of polarization in the different position of the ferroelectric layer. Notably, the inverter of NC-GAA FinFETs has larger noise margin and shorter delay time, compared with the inverter of GAA FinFETs; however, the characteristics of inverter of NC-GAA FinFETs suffer larger variability induced by the WKF.
Genome-scale analysis of genetic regulatory elements in Streptomyces avermitilis MA-4680 using transcript boundary information
Authors: Lee Yongjae , Lee Namil , Hwang Soonkyu , Kim Woori , Cho Suhyung , Palsson Bernhard O. , Cho Byung-Kwan 
Published: January 2022

Abstract
Background
The gram-positive bacterium, Streptomyces avermitilis, holds industrial importance as the producer of avermectin, a widely used anthelmintic agent, and a heterologous expression host of secondary metabolite-biosynthetic gene clusters. Despite its industrial importance, S. avermitilis’ genome organization and regulation of gene expression remain poorly understood. In this study, four different types of Next-Generation Sequencing techniques, including dRNA-Seq, Term-Seq, RNA-Seq and ribosome profiling, were applied to S. avermitilis to determine transcription units of S. avermitilis at a genome-wide level and elucidate regulatory elements for transcriptional and translational control of individual transcription units.

Result
By applying dRNA-Seq and Term-Seq to S. avermitilis MA-4680, a total of 2361 transcription start sites and 2017 transcript 3′-end positions were identified, respectively, leading to determination of 1601 transcription units encoded in S. avermitilis’ genome. Cataloguing the transcription units and integrated analysis of multiple high-throughput data types revealed the presence of diverse regulatory elements for gene expression, such as promoters, 5′-UTRs, terminators, 3′-UTRs and riboswitches. The conserved promoter motifs were identified from 2361 transcription start sites as 5′-TANNNT and 5′-BTGACN for the − 10 and − 35 elements, respectively. The − 35 element and spacer lengths between − 10 and − 35 elements were critical for transcriptional regulation of functionally distinct genes, suggesting the involvement of unique sigma factors. In addition, regulatory sequences recognized by antibiotic regulatory proteins were identified from the transcription start site information. Analysis of the 3′-end of RNA transcript revealed that stem structure formation is a major determinant for transcription termination of most transcription units.

Conclusions
The transcription unit architecture elucidated from the transcripts’ boundary information provides insights for unique genetic regulatory mechanisms of S. avermitilis. Our findings will elevate S. avermitilis’ potential as a production host for a diverse set of secondary metabolites.
Complete opioid transition to sublingual Buprenorphine after abdominal surgery is associated with significant reductions in opioid requirements, but not reduction in hospital length of stay: a retrospective cohort study
Authors: Heldreich Charlotte , Ganatra Sameer , Lim Zheng , Meyer Ilonka , Hu Raymond , Weinberg Laurence , Tan Chong O. 
Published: January 2022

Abstract
Background
The use of sublingual buprenorphine (SLBup) for acute pain after major abdominal surgery may offer the potential advantages of unique analgesic properties and more reliable absorption during resolving ileus. We hypothesized that complete opioid transition to SLBup rather than oral oxycodone (OOxy) in the early postoperative period after major abdominal surgery would reduce hospital length of stay, and acute pain and total OMEDD (Oral Morphine Equivalent Daily Dose) requirements in the first 24 h from post-parenteral opioid transition.

Methods
We reviewed 146 patients who had undergone elective and emergency abdominal surgery under our quaternary referral centre’s Upper Gastro-Intestinal and Colo-Rectal Surgical Units 6 months before and after the introduction of complete postoperative transition to sublingual buprenorphine, rather than oral oxycodone, in July 2017. Our primary endpoint was 24-hourly post-transition OMEDDs; secondary endpoints were 24-hourly post-transition Mean NRS-11 pain scores on movement (POM) and length of hospital stay (LOS). Univariate analysis and linear multivariate regression analyses were used to quantify effect size and identify surgical, patient & other analgesic factors associated with these outcome measures.

Results
Patients transitioning to SLBup had reduced 24-hourly post-transition OMEDD requirements on postoperative day 2 (POD) (26 mg less, p = 0.04) and NRS-11 POM at POD1 (0.7 NRS-11 units less, p = 0.01). When adjusting for patient, surgical and special analgesic factors, SLBup was associated with a similar reduction in OMEDDs (Unstandardised beta-coefficient -26 mg, p = 0.0001), but not NRS-11 POM (p = 0.47) or hospital LOS (p = 0.16).

Conclusions
Our change of practice from use of OOxy to SLBup as primary transition opioid from patient-controlled analgesia delivered full opioid agonists was associated with a clinically significant decrease in 24-hourly post-parenteral opioid transition OMEDDs and improved NRS-11 POM, but without an association with hospital LOS after major abdominal surgery. Further prospective randomized work is required to confirm these observed associations and impact on other important patient-centred outcomes.
Unfractionated heparin improves the clinical efficacy in adult sepsis patients: a systematic review and meta-analysis
Authors: Fu Sifeng , Yu Sihan , Wang Liang , Ma Xiaochun , Li Xu 
Published: January 2022

Abstract
Background
The anticoagulant treatment and clinical efficacy of heparin in sepsis remains controversial. We conducted a meta-analysis to estimate the clinical efficacy of unfractionated heparin (UFH) in adult septic patients.

Method
A systematic review of Medline, Cochrane Library, PubMed, Embase, WEIPU database, CNKI database, WANFANG database was performed from inception to January 2021. We included Randomized controlled trials (RCTs) and the main outcome was 28 d mortality. Data analysis was performed with Review Manager (RevMan) version 5.3 software. The meta-analysis included 2617 patients from 15 RCTs.

Results
Comparing to control group, UFH could reduce 28 d mortality (RR: 0.82; 95% CI: 0.72 to 0.94) especially for patient with Acute Physiology and Chronic Health Evaluation II (APACHE II) > 15, (RR: 0.83; 95% CI: 0.72 to 0.96). In UFH group, the platelet (PLT) (MD: 9.18; 95% CI: 0.68 to 17.68) was higher, the activated partial thromboplastin time (APTT) was shorter (MD: -8.01; 95% CI: − 13.84 to − 2.18) and the prothrombin time (PT) results (P > 0.05) failed to reach statistical significance. UFH decreased multiple organ dysfunction syndrome (MODS) incidence (RR: 0.61; 95% CI: 0.45 to 0.84), length of stay (LOS) in ICU (MD: -4.94; 95% CI: − 6.89 to − 2.99) and ventilation time (MD: -3.01; 95% CI: − 4.0 to − 2.02). And UFH had no adverse impact on bleeding (RR: 1.10; 95% CI: 0.54 to 2.23).

Conclusion
This meta-analysis suggests that UFH may reduce 28 d mortality and improve the clinical efficacy in sepsis patients without bleeding adverse effect.