bluuebunny/crossref_metadata_2025_split huggingface dataset:
Trans-catheter closure of ASD and abnormal connection of left pulmonary vein to vertical vein: A case report
Authors: Shabestari Mahmoud Mohamadzadeh , Kerachian Abdollah , Poorzand Hoorak , Eshraghi Ali , Keihanian Faeze 
Published: October 2022

Rationale:
Partial anomalous pulmonary venous connection is a rare congenital anomaly in which one or more pulmonary veins are connected to the venous circulation leading to left to right heart shunt. Although correction of anomalous pulmonary venous connection is achieved through surgery, there are rare instances where the abnormal pulmonary vein has dual connection to both left atrium and the major systemic veins. Under these circumstances, catheter-based treatment might become a feasible option.

Patient concerns:
A 22-year-old female presented with exertional dyspnea, holo-systolic murmur in left sternal border, and fixed splitting of S2 in examination.

Diagnosis:
The patient was diagnosed with secundum type atrial septal defect (ASD) and dual drainage of left upper pulmonary vein.

Interventions:
The patient was candidate for device closure. Under TEE guidance, occluder devices were deployed in the upper part of vertical vein and subsequently in place of ASD.

Outcomes:
Echocardiogram in the next day showed complete occlusion of flow through the vertical vein and ASD. Dual antiplatelet was prescribed on discharge. Follow-up echocardiography after 3 months showed obvious improvement in RV size. Due to suspicion for clot formation, TEE was done and thrombosis with approximate length of extension of 15 mm was detected back to the device. The patient is following for 5 years. Repeated TEE after 2 years did not show any change in the burden of clot.

Lessons:
For comprehensive evaluation of patients with ASD, assessment of pulmonic veins is crucial and in the presence of a vertical vein, the dual drainage of pulmonic veins should be considered.
Opioid prescribing practices in trauma patients at discharge: An exploratory retrospective chart analysis
Authors: Premachandran Priyanka , Nippak Pria , Begum Housne , Meyer Julien , McFarlan Amanda 
Published: October 2022

This study examined the opioid prescribing patterns at discharge in the trauma center of a major Canadian hospital and compared them to the guidelines provided by the Illinois surgical quality improvement collaborative (ISQIC), a framework that has been recognized as being associated with reduced risk.
This was a retrospective chart review of patient data from the trauma registry between January 1, 2018, and October 31, 2019. A total of 268 discharge charts of naïve opioid patients were included in the analysis. A Morphine Milligram Equivalents per day (MME/day) was computed for each patient who was prescribed opioids and compared with standard practice guidelines.
About 75% of patients were prescribed opioids. More males (75%) than females (25%) were prescribed opioids to patients below 65 years old (91%). Best practice guidelines were followed in most cases. Only 16.6% of patients were prescribed over 50 mg MME/day, the majority (80.9%) were prescribed opioids for =<3 days and only 1% for >7 days. Only 7.5% were prescribed extended-release opioids and none were strong like fentanyl. Patients received a multimodal approach with alternatives to opioids in 88.9% of cases and 82.9% had a plan for opioid discontinuation. However, only 23.6% received an acute pain service referral.
The majority of the prescriptions provided adhered to the best practice guidelines outlined by the ISQIC framework. These results are encouraging with respect to the feasibility of implementing opioid prescription guidelines effectively. However, routine monitoring is necessary to ensure that adherence is maintained.
Studies on Kyphoplasty over 20 years by science mapping method: Kyphoplasty by science mapping method
Authors: Comert Serhat 
Published: October 2022

Design:
This is a bibliometric analysis. Performed by Scientific Mapping technique. The purpose of the study is to analyze articles on Kyphoplasty. Kyphoplasty is a minimally invasive surgical method. Bibliometrics is the mathematical and statistical quantitative analysis of works. One of the primary uses of bibliometric analysis is scientific mapping.

Method:
To conduct the bibliometric analysis of the subject of Kyphoplasty, the Web of Science Core Collection database was preferred. After the selection of the data set, the data were filtered; as a result, the study was carried out on 2236 articles. Researchers, journals, articles, institutions, and the studies’ countries were analyzed.

Results:
According to the number of articles published in Kyphoplasty, China, USA, Germany, Korea, and Italy are among the leading countries. According to the analysis, the authors with the highest h-index value are Yang HL and Hirsch JA. The European Spine Journal and the Spine are the most impactful journals.

Conclusions:
Our study was carried out with the Science Mapping technique using Bibliometrics software. This type of work has become popular in recent years. Such studies are not common in the field of neurosurgery.
Mobile application for home exercise adherence in patients with knee osteoarthritis: A pilot study
Authors: Yamamoto Yohei , Murata Yasuaki , Tanaka Naofumi , Shigemura Tomonori , Maruyama Juntaro , Nakane Ryo , Wada Yuichi 
Published: October 2022

Background:
The adherence to home exercise is generally low despite its well-known effect on knee osteoarthritis. Therefore, we developed a home exercise application, LongLifeSupport, to provide patients with daily basic exercise videos and an automatic recording calendar. We hypothesized that this application would encourage patients to exercise and help maintain their motivation; this pilot study aimed to determine their exercise adherence rates. Using outcome measures, we also aimed to determine the effect of home exercise using this application and the factors for its continuation.

Methods:
Twenty patients with knee osteoarthritis were included. The participants exercised for 12 weeks. Using pre- and post-tests, we examined their satisfaction with continuation (only in the post-test), Japanese knee osteoarthritis measure score, short physical performance battery score, bilateral knee extension muscle strength, and short test battery for locomotive syndrome. Furthermore, we investigated correlations between adherence rates and pretest scores of Japanese knee osteoarthritis measure and short test battery and between pretest scores and variations in Japanese knee osteoarthritis measure and short test battery.

Results:
The mean adherence rate was 82.4%. The participants showed ease of continuation (100%) and significant improvements in the degree of knee pain, pain, and stiffness, and daily life conditions using the Japanese knee osteoarthritis measure score, total score, walk seconds, and chair stand seconds of the short physical performance battery, as well as the extension muscle strength of the right- and pain-side knee. No significant correlations were identified between the adherence rate and the pretest or variation.

Conclusion:
The adherence rate to the application was over 80%. Participants with knee osteoarthritis showed almost full satisfaction, reduced pain, and improved physical ability. Therefore, the use of this application provided a safe exercise program and maintained the exercise motivation of participants. Thus, it may be useful for unsupervised home exercise.
Compound heterozygous protein C deficiency with pulmonary embolism caused by a novel PROC gene mutation: Case report and literature review
Authors: Zhang Zhaorui , Yang Zhen , Chen Mei , Li Yuzhu 
Published: October 2022

Rationale:
Protein C is an anticoagulation agent, and protein C deficiency results in vascular thrombosis disease. Hereditary protein C deficiency is a risk factor for pulmonary embolism in adults. Pathogenic variants of the Protein C, Inactivator Of Coagulation Factors Va And VIIIa (PROC) gene which encodes protein C have been identified as a cause of protein C deficiency.

Patient concerns:
We describe a patient with a novel mutation in the PROC gene who was diagnosed with pulmonary embolism in a Chinese family.

Diagnosis:
According to the results of the pulmonary computed tomography angiography (CTA) and the level of blood protein C, the patient was diagnosed with pulmonary embolism caused by protein C deficiency.

Interventions:
Whole-exome sequencing (WES) was performed for the molecular analysis.

Outcome:
The results of patient’s deoxyribonucleic acid revealed a heterozygous mutation (c.237 + 5G > A) in intron 3 of the PROC gene. His father also harbored the same mutation in the PROC gene. We also reviewed the protein C deficiencies caused by PROC gene mutations in cases.

Lessons:
A novel mutation in intron 3 of PROC gene has not been previously reported in patients with pulmonary embolism caused by protein C deficiency. After anticoagulation therapy, the patient recovered, and CT showed resolution of the thrombosis. Pulmonary embolism may be caused by protein C deficiency and the rare compound heterozygous mutation in intron 3 of the PROC gene could cause protein C deficiency via impairment of the secretory activity of protein C.
Expression profile and prognostic values of SMC family members in HCC
Authors: Yan Wei , Wang Dan-Dan , Zhang He-Da , Huang Jinny , Hou Jun-Chen , Yang Su-Jin , Zhang Jian , Lu Ling , Zhang Qian 
Published: October 2022

Objective:
The structural maintenance of chromosome (SMC) gene family, including 6 proteins, is involved in a wide range of biological functions in different human cancers. Nevertheless, there is little research on the expression patterns, potential functions and prognostic value of SMC genes in hepatocellular carcinoma (HCC). Based on publicly available databases and integrative bioinformatics analysis, we tried to determine the value of SMC gene expression in predicting the risk of developing HCC.

Methods:
The expression and copy number variations data of SMC family members were obtained from TCGA (The Cancer Genome Atlas). We identified the prognostic values of SMC family members and their clinical features. GSEA (Gene Set Enrichment Analysis) was conducted to detect the mechanism underlying the involvement of SMC family members in liver cancer. We used Tumor Immune Estimation Resource database to explore the associations between TIICs (Tumor Immune Infiltrating Cells) and the SMC family members.

Results:
Our analysis proved that downregulation of SMC family members was common modification in HCC patients. In HCC, the expression of SMC1A, SMC2, SMC3, SMC4, SMC6 were upregulated. Upregulation of SMC2, SMC3, and SMC4, along with the clinical stage of HCC, were associated with a poor prognosis according to the results of univariate and multivariate Cox proportional hazards regression analysis. SMC2, SMC3, and SMC4 are also related to tumor purity and immune infiltration levels of HCC. The GSEA results proved that SMC family members take part in numerous biological processes underlying tumorigenesis.

Conclusion:
In this study, we comprehensively analyzed the expression of SMC family members in patients with HCC. This can provide insights for further investigation of the SMC members as potential therapeutic targets in HCC and suggest that the use of SMC inhibitor targeting SMC2, SMC3, and SMC4 can be a practical strategy for the therapy of HCC.
Physical Therapy Provider Continuity Predicts Functional Improvements in Inpatient Rehabilitation
Authors: Adam Mitchell D. , Ness Debra K. , Hollman John H. 
Published: October 2022

Background and Purpose:
Health care continuity has been linked to improved patient outcomes in a variety of professions and settings. Patients in inpatient rehabilitation receive a consistent dosage of physical therapy (PT) treatment; however, the providing physical therapist may vary. Despite the potential influence of PT provider continuity on functional outcomes in the inpatient rehabilitation setting, this association has not yet been studied.

Methods:
An observational retrospective chart review was conducted on 555 discharged inpatient rehabilitation patients. The relationship between the number of PT providers from whom a patient received care and Quality Indicator (QI) Mobility discharge scores was examined with Pearson product-moment correlation coefficients, initially with the entire patient group and secondarily with distinct diagnostic groups. Data from subgroups for whom a significant relationship was established were then included in a hierarchical linear regression analysis accounting for relevant covariates.

Results:
The number of PT providers correlated negatively with QI Mobility discharge scores (r = −0.41, P ≤ 0.001). When controlling for QI Mobility admission scores, the “Stroke” (partial r = −0.17, P = 0.02), “Spinal Cord Injury” (partial r = −0.28, P = 0.002), and “Other Neuromuscular” (partial r = −0.35, P = 0.03) groups demonstrated significant inverse relationships. A hierarchical linear regression incorporating these 3 diagnostic groups revealed that the number of PT providers remained a significant predictor of QI Mobility discharge scores (B = −1.50, P ≤ 0.001) when accounting for covariates.

Discussion and Conclusions:
PT provider continuity is related to the functional improvement of neurologically impaired patients in inpatient rehabilitation.

Video Abstract available for more insights from the authors (see the Video, Supplemental Digital Content 1, http://links.lww.com/JNPT/A405, which discusses the findings of this work in a narrative format).
Immunization Status and the Management of Febrile Children in the Pediatric Emergency Department
Authors: Curtis Molly , Kanis Jessica , Wagers Brian , Coffee R. Lane , Sarmiento Elisa , Grout Sarah , Johnson Olivia , DiGregory Sydney , Grout Randall 
Published: October 2022

Objectives
Widespread Haemophilus influenzae and Streptococcus pneumoniae immunization has decreased occult bacteremia and bacterial meningitis rates. Practice has evolved in pediatric emergency departments (PEDs) to favor fewer diagnostic tests for and empiric treatment of invasive bacterial infection. We lack evidence-based guidance on evaluation and treatment of unimmunized (UnI) or underimmunized (UnderI) febrile children. This study aims to determine how parental report of immunization status in febrile PED patients impacts rates of diagnostic testing, interventions, and hospital admissions.

Methods
This is a retrospective cohort study with chart review of encounters of children aged 3 to 36 months presenting to an academic, tertiary care PED in 2019 using International Classification of Diseases-10 code for fever (R50.9). Inclusion criteria were documented fever of 38°C and higher and well appearance. Encounters were excluded if there was a history of chronic illness or documentation of ill appearance or hemodynamic instability. Encounters were grouped by provider-documented immunization status. Fischer exact test and logistic regression compared rates of diagnostic testing (serum, urine or cerebrospinal fluid laboratory studies, and chest radiographs), interventions (intravenous fluid bolus, intravenous antibiotic or steroid administration, respiratory support, or breathing treatment), and hospital admissions between UnderI, UnI, and fully immunized (FI) groups.

Results
Of the 1813 encounters reviewed, 1093 (60%) included provider-documented immunization status and 788 (43%) met final inclusion criteria: 23 (2.1%) UnI, 44 (5.8%) UnderI, and 721 (92.1%) FI. The UnderI and UnI children experienced significantly higher rates of laboratory evaluation including complete blood count and blood culture, medical intervention, and antibiotic prescriptions while in the PED. No significant differences were observed for rates of chest radiographs, hospital admissions, or 72-hour PED return visits.

Conclusions
Higher rates of laboratory testing and interventions were observed in UnderI and UnI versus FI febrile patients at a PED, likely demonstrating increased clinical suspicion for invasive bacterial infection in this group despite lacking national guidelines. Given continued vaccine hesitancy, further studies are needed for guiding management of febrile UnI and UnderI children presenting for emergency care.
Who is informed of trauma informed care? Patients' primary language and comprehensiveness of initial trauma assessment
Authors: Kundu Souma , Costantini Todd W. , Doucet Jay J. , Berndtson Allison E. 
Published: October 2022

BACKGROUND
For patients with limited English proficiency, language poses a unique challenge in patient-provider communication. Using certified medical interpretation (CMI) can be difficult in time- and resource-limited settings including trauma. We hypothesized that there would be limited use of CMI during major trauma resuscitations, less comprehensive assessments, and less empathetic communication for Spanish-speaking patients (SSPs) with limited English proficiency compared with English-speaking patients (ESPs).

METHODS
We analyzed video-recorded encounters of trauma initial assessments at a Level 1 trauma center. Each encounter was evaluated from patient arrival until completion of the secondary survey per Advanced Trauma Life Support protocol. A standard checklist of provider actions was used to assess comprehensiveness of the primary and secondary surveys and communication events such as provider introduction, reassurances, and communicating next steps to patients. We compared the SSP and ESP cohorts for significant differences in completion of checklist items.

RESULTS
Fifty patients with Glasgow Coma Scale scores of 14 and 15 were included (25 SSPs, 25 ESPs). The median age was 34 years (interquartile range, 25–65 years) for SSPs and 40 years (interquartile range, 29–54 years) for ESPs. In SSPs, 72% were male; in ESPs, 60% were male. Spanish-speaking patients received less comprehensive motor (48% complete SSPs vs. 96% ESPs, p < 0.001) and sensory (4% complete SSPs vs. 68% ESPs, p < 0.001) examinations, and less often had providers explain next steps (32% SSPs vs. 96% ESPs, p < 0.001) or reassure them (44% SSPs vs. 88% ESPs, p = 0.001). No patients were asked their primary language. Two SSP encounters (8%) used CMI; most (80%) used ad hoc interpretation, and 12% used English.

CONCLUSION
We found significant differences in the initial care provided to trauma patients based on primary language. Inclusion of an interpreter as part of the trauma team may improve the quality of care provided to trauma patients with limited English proficiency.

LEVEL OF EVIDENCE
Therapeutic/Care Management; Level IV.
Estimation of helicopter emission and greenest helicopters for London
Authors: Orhan Ilkay 
Published: October 2022

PurposeThis study aims to estimate the greenest helicopters and the emission amount based on the helicopter movement within the London Heathrow and London city control zone.Design/methodology/approachThe helicopter flight data recorded by the UK’s specialist aviation regulator Civil Aviation Authority and the helicopter type with engine emission data from the Federal Office of Civil Aviation (FOCA) were used for calculation. Based on the approach adopted, the greenest and the most environmentally friendly helicopters were identified for a light-duty helicopter with single-engine, a light-duty helicopter with twin-engine and a heavy-duty helicopter with twin-engine.FindingsComparing a flight consisting of landing and take-off cycle, and 1-h phase based on helicopters emissions in the FOCA database, B06 with DDA250-C20R single-engine in the light utility, A109 with PT6B-37 twin-engine in the light utility, and the A139 helicopter with the PT6C-67C twin-engine in the high utility has been identified as the most environmentally friendly helicopter.Practical implicationsThis study provides the opportunity to compare between the best and the worst helicopter with engine type according to the emission values released to the environment.Originality/valueThis study raises awareness of the emission levels caused by helicopter in urban air transport in developed countries in terms of environmental and human health. It also provides justification for the authorities to encourage the development and use of green engines and technologies.
Study of secondary particles resulting along 50–150 MeV accelerated protons in liver tissues using MCNPX and abdomen DICOM images
Authors: Abo Shdeed Tawfik 
Published: October 2022

PurposeThis paper aims to study the resulting Brag peak and secondary particles (neutrons, photons, deuterons, alpha, helium_3, and tritons) along protons’ path in tissue.Design/methodology/approachMATLAB program and MCNP code were used to read abdomen Digital Imaging and Communications in Medicine (DICOM) images and build a 3D phantom to liver in purpose to study resulting Bragg peak and secondary particles (neutrons, photons, deuterons, alpha, helium_3 and tritons) along protons’ path.FindingsFrom the study, it was found that Bragg peak varies from a 2 cm depth within the tissue for 50 MeV protons to a 14.2 cm depth for 150 MeV protons; in the other hand, the total deposited energy decreases from 0.656 [MeV/g]/proton, at the depth 2 cm and 50 MeV protons, to the value 0.220 [MeV/g]/proton, at the depth 14 cm and 150 MeV protons.Originality/valueAs for the flow rate of secondary neutrons and photons, the flow rate of secondary neutrons takes a maximum value (peak) in the middle of the proton path, i.e. when the energy of the protons drops to the value of 30 MeV, and this maximum value of the neutrons flow rate is accompanied by a maximum value of the photon flow rate, as for the rest of the secondary particles produced (alpha particles, deuterons, electrons, tritons and triple helium), they deposit most of their energy locally.
Understanding the determinants of the intention to innovate with open government data among potential commercial innovators: a risk perspective
Authors: Yang Zhenbin , Ha Sangwook , Kankanhalli Atreyi , Um Sungyong 
Published: October 2022

PurposeThis study aims to examine factors influencing potential commercial innovators' intention to innovate with open government data (OGD) via a risk perspective.Design/methodology/approachThe authors develop a theoretical model that explains how different forms of uncertainty (i.e. financial, technology, competitive, demand, and data) and their inter-relationships influence potential commercial innovators' intention to innovate with OGD. The model is tested using survey data collected from 144 potential commercial innovators from a developed Asian country.FindingsThe results suggest that all other forms of uncertainty, except competitive uncertainty, negatively influence potential commercial innovators' intention to innovate, mediated by their perceived risk of innovating with OGD. The results also show positive relationships between different forms of uncertainty, i.e. competitive and financial, demand and competitive, data and financial uncertainty.Originality/valueThis paper identifies major forms of innovation uncertainty, perceived risk, their inter-relationships, and impacts on the intention to innovate with OGD. It also finds support for a unique form of uncertainty for OGD innovation (i.e. data uncertainty).