bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Picture Is Worth a Thousand Words: Emotion Recognition and Qualitative Impressions of Armand Henrion’s Self-Portraits Displaying Mixed Emotions
Authors: Müller Lauriane , Mohr Christine , Cano Caroline , Camenzind Lucia , Soborun Yanisha , Jonauskaite Domicele 
Published: November 2022

Abstract
Researchers often study recognition of single emotions. Realistic faces, however, display several emotions in quick sequence or at the same time (mixed emotions). This likely causes interindividual differences in peoples’ reactions to the same situations and stimuli. We studied such differences using 11 self-portraits painted by Armand Henrion (1875–1958), in which he depicts himself as a Pierrot clown displaying different affective states. Thirty-eight adult participants (15 men) saw the self-portraits twice (one brief, then one unlimited presentation). After the first brief presentation (1–2 s), participants (i) selected the most prominent emotion (out of 20) and (ii) rated the intensity of this emotion. After the second unlimited presentation, participants performed the same selections and ratings before describing what could have caused the facial expression (qualitative data). Results confirmed that Armand Henrion’s self-portraits display mixed emotions: participants selected diverse emotions, sometimes differing in valence. Participants selected comparable emotions between presentations but rated them as more intense the second time. The qualitative answers complemented the selected emotions. For instance, when some participants chose ‘disgust’, others chose ‘sadness’ for the same self-portrait. The qualitative answer matched this choice, indicating that the character either “ate or drank something they don’t like” or “lost something or someone”. We conclude that Armand Henrion’s self-portraits provide a promising set of facial stimuli to investigate mixed emotions. Each self-portrait displays diverse emotions of varying intensities and they are realistic because they could all be linked to possible situations.
Comparison of short-term results of subxiphoid and conventional video-assisted thoracoscopic surgery in diagnostic wedge resections
Authors: Sezen Celal Bugra , Dogru Mustafa Vedat , Tanrıkulu Gamze , Aker Cemal , Erduhan Semih , Saydam Ozkan , Metin Muzaffer 
Published: November 2022

Background This study aimed to compare early results in patients who underwent subxiphoid wedge resection with those operated on using a multiportal approach. Methods We retrospectively evaluated 151 patients who underwent diagnostic wedge resection for suspected interstitial lung disease. Patients who underwent wedge resection via subxiphoid video-assisted thoracoscopic surgery and conventional video-assisted thoracoscopic surgery were compared. Results The study included 90 men (59.6%) and 61 women (40.4%) with a mean age of 54.8 ± 12 years. Of these, 127 patients underwent conventional video-assisted thoracoscopic surgery and 24 patients underwent subxiphoid video-assisted thoracoscopic surgery. Postoperative complications occurred in 13 patients (8.6%), with no significant difference according to surgical technique. Sex was a significant factor in the rate of complications (12.2% in men vs. 3.2% in women). There was no intraoperative mortality; the 30-day mortality rate was 4% (n = 6). Five nonsurviving patients were in the conventional video-assisted thoracoscopic surgery group and 1 was in the subxiphoid video-assisted thoracoscopic surgery group ( p = 0.95). Conclusion The results of this study indicate that the subxiphoid approach reduced procedure time and length of hospital stay in the early period, while there was no significant difference between the techniques in terms of complications or mortality. Based on these findings, we conclude that surgical outcomes were as successful with the subxiphoid approach as with conventional video-assisted thoracoscopic surgery.
Trends of re-operative coronary artery bypass grafting: A two-decade experience
Authors: Sajja Lokeswara Rao , Mannam Gopichand , Kamtam Devanish Narasimhasanth , Saikiran Krishnamurthy Venkata Satya Siva , Sompalli Sriramulu 
Published: November 2022

Background The prevalence of redo coronary artery bypass grafting has markedly changed over the last two decades. We aim to assess the trends of redo coronary artery bypass grafting and clinical outcomes of redo coronary artery bypass grafting over two different periods. Methods This is a retrospective, metachronous, observational study of patients who underwent redo coronary artery bypass grafting between January 1998 through December 2004 and January 2005 through September 2021 who were categorized into group 1 and group 2, respectively. The trends in the prevalence of redo coronary artery bypass grafting, and 30-day outcomes were analyzed. Results A total of 261 patients underwent a redo coronary artery bypass grafting. Group 1 and group 2 included 114 and 147 patients, respectively. 62.59% of group 2 patients underwent off-pump coronary artery bypass grafting compared to 6.14% in group 1 ( p < 0.01). The patients undergoing redo coronary artery bypass grafting in group 2 were significantly older (60.65 ± 7.78 years vs. 50.99 ± 7.66 years, p < 0.001) and were more likely to be hypertensive (49.66% vs. 29.82%, p < 0.001). There was no significant difference in the proportion of diabetes ( p = 0.82), smoking ( p = 0.24), dyslipidemia ( p = 0.64), and preoperative myocardial infarction ( p = 0.14). The proportion of patients who presented post-PCI was significantly higher in group 2 (27.89% vs. 10.53%, p < 0.001). There was also a shift in the usage of grafts from the left internal thoracic artery to the saphenous vein graft ( p < 0.001). Conclusion The annual rate of redo coronary artery bypass grafting was declining but has now reached a plateau. The current outcomes of patients undergoing redo coronary artery bypass grafting are comparable to that of the earlier times despite a higher co-morbidity burden in patients of recent times.
Couple Classes of Depressive Symptom Trajectories and Associations with Relationship Satisfaction
Authors: Morgan Preston C , Wittenborn Andrea K 
Published: November 2022

The literature indicates a robust negative relationship between depression and couple relationship satisfaction. However, less is known about the differential effects of romantic relationships on depression over time and whether one or both partners experience depression. Using data from 1215 couples across 4 years, we sought to examine couple classes of depressive symptom trajectories and investigate the degree to which relationship satisfaction predicted class membership. Using joint-probability growth mixture modeling, we found three couple classes of depressive symptom trajectories: women’s moderate, men’s low class, men’s moderate, women’s low class, and men’s and women’s low class. Logistic regression results revealed both men’s and women’s higher relationship satisfaction was associated with women’s moderate, men’s low class membership while both partners’ higher relationship satisfaction was not associated with men’s moderate, women’s low class membership, in comparison to the men’s and women’s low stable class. These findings contribute to the literature by identifying the heterogeneity of patterns of depressive symptom trajectories among couples and the association of relationship satisfaction with couple classes.
Anemia and Its Severity Is Associated With Worse Postoperative Outcomes Following Open Reduction Internal Fixation of Ankle Fractures
Authors: Ortiz-Babilonia Carlos D. , Badin Daniel , Gupta Arjun , Guilbault Ryan , Hsu Nigel , Ficke James R. , Aiyer Amiethab A. 
Published: November 2022

Background: Ankle fractures are often treated in a nonemergent fashion and therefore offer the chance for treatment of preoperative anemia. Although preoperative anemia has been associated with postoperative morbidity following certain types of orthopaedic procedures, its effect on postoperative outcomes following open reduction internal fixation (ORIF) of ankle fractures has not been evaluated. The purpose of this study was to determine the influence of preoperative anemia on 30-day postoperative outcomes following ankle fracture ORIF. Methods: The American College of Surgeons National Surgical Quality Improvement Program (ASC-NSQIP) registry was queried from 2005 to 2019 for patients undergoing ankle fracture ORIF. Patients were stratified into nonanemic, mildly anemic, and moderately to severely anemic. Univariate analyses were used to assess differences in patient characteristics between cohorts. Multivariate logistic regressions adjusting for these differences were performed to assess the effect of preoperative anemia on 30-day postoperative outcomes. Results: We obtained data for 21 211 patients, of whom 14 931 (70.39%) were not anemic, 3982 (18.77%) were mildly anemic, and 2298 (10.83%) were moderately to severely anemic. After adjustment, mild preoperative anemia was associated with higher odds of any adverse event ( P < .001), deep surgical site infections (SSIs; P = .013), sepsis ( P = .001), 30-day readmission ( P < .001), and extended length of stay (LOS) ( P < .001). Similarly, moderate to severe anemia in these patients was also associated with increased odds of any adverse event ( P < .001), deep SSIs ( P = .003), sepsis ( P = .001), readmission ( P < .001), and extended LOS ( P < .001). Both mild ( P = .004) and moderate to severe ( P < .001) anemia groups had higher odds of requiring a blood transfusion. Conclusion: Preoperative anemia is associated with an increased risk of adverse postoperative outcomes in patients undergoing ORIF for ankle fractures. Future studies should evaluate whether optimization of hematocrit in these patients results in improved outcomes. Level of Evidence: Level III, comparative study.
First-Line Osimertinib in Patients With EGFR-Mutated Non-Small Cell Lung Cancer: Effectiveness, Resistance Mechanisms, and Prognosis of Different Subsequent Treatments
Authors: Nie Naifu , Li Jianghua , Zhang Jian , Dai Jie , Liu Zhulin , Ding Zhenyu , Wang Yubo , Zhu Mengxiao , Hu Chen , Han Rui , Tang Huan , Li Li , He Yong 
Published: November 2022

Background: Although the clinical application of osimertinib, a third-generation epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI), has been a new step forward in the first-line treatment of non-small cell lung cancer (NSCLC), an increasing number of patients with progression on osimertinib represents a great challenge clinically. The patterns of resistance mechanisms and subsequent treatment strategies after first-line osimertinib resistance are not well established. Methods: Between January 1, 2016 and October 31, 2020, a consecutive of 56 EGFR-mutant lung cancer patients treated with osimertinib as first-line therapy at Daping Hospital (Chongqing, China) were retrospective screened. The samples of pre-osimertinib and osimertinib-resistance were all detected by next-generation sequencing (NGS) panels. Statistical analyses were carried out using SPSS 23.0 software. Survival analyses were performed using the Kaplan–Meier method and compared using a log-rank test between groups. Results: Among 47 patients with osimertinib effectiveness analysis, the median progression free survival (mPFS) was 15.4 months (95% confidence interval [CI]: 12.2-24.9 months), and median overall survival (mOS) was 35.5 months (95% CI: 23.9 months -NA). A total of 21 patients underwent repeated NGS tests upon osimertinib resistance. MET amplification was the most common resistance mechanism (6/21, 28.6%), followed by C797S mutation (5/21, 23.8%). A total of 15 patients received subsequent treatments, with mPFS of 7.3 months (95% CI 5.0 months -NA). Among them, 7 patients with EGFR C797 S or/and MET amplification received subsequent second-line targeted therapy, achieving mPFS of 7.3 months (95% CI 4.5 months -NA). Of note, 3 patients received immunotherapy as second- or third-line treatment after osimertinib resistance, achieving median clinical benefit of 37.3 months. Conclusions: MET amplification and C797S mutation are main resistance mechanisms, which could be targeted by crizotinib and gefitinib, respectively. More than 50% patients could receive subsequent anticancer targetable therapies after first-line osimertinib resistance. Immunotherapy may also be an acceptable choice after osimertinib resistance.
Monitoring and recovery of hyperglycaemia-induced endothelial dysfunction with rheopheresis in diabetic lower extremity ulceration with hyperviscosity
Authors: Gál Kristóf , Asbóth Georgina , Vass Melinda , Bíró Attila , Markovich Arnold , Homoki Judit , Fidler Gábor , Paholcsek Melinda , Cziáky Zoltán , Németh Norbert , Remenyik Judit , Soltész Pál 
Published: November 2022

Aims Rheopheresis is an extracorporeal haematotherapy that improves haemorheological status by filtering proteins that enhance blood viscosity. It also has anti-inflammatory effects by removing inflammatory cytokines. Our study aims to examine the effects of rheopheresis on the endothelial status in diabetic lower extremity ulceration. Methods In vitro experiments were performed in a HUVEC model to mimic hyperglycaemic stress. We determined the changes in gene expression levels of IL-6, IL-8, TNF-alpha, endothelin convertase enzyme, ET-1, and NO synthase, as well as the ROS and intracellular GSH levels upon hyperglycaemia. In in vivo studies, two rheopheresis procedures were performed on seven patients with diabetic lower extremity ulceration with hyperviscosity, and we measured the changes in plasma concentrations of ET-1, TXB2, SOD enzyme activity, and extracellular components of the glutathione pool depending on treatments. Results Our results showed that hyperglycaemia increases endothelial expression of inflammatory cytokines, ET-1, and endothelin convertase enzyme, while NO synthase was decreased. As a result of rheopheresis, we observed decreased ET-1 and TXB2 concentrations in the plasma and beneficial changes in the parameters of the glutathione pool. Conclusion To summarize our results, hyperglycaemia-induced oxidative stress and endothelial inflammation can be moderated by rheopheresis in diabetic lower extremity ulceration with hyperviscosity.
Manual and Visual Clinical Assessment of Foot Type and Posture Correlate Poorly with Radiographic Assessment
Authors: Bayer Steve , LeVasseur Clarissa , Munsch Maria , Chen Stephen , Murawski Christopher D. , Murphy Conor I. , LaBaze Dukens , Gabrielli Alexandra , Kane Gillian , Anderst William , Hogan MaCalus V. 
Published: November 2022

Category: Midfoot/Forefoot; Hindfoot Introduction/Purpose: Accurate characterization of foot type can facilitate identification of patients at risk for different foot disorders and direct operative treatment. Foot type can be determined qualitatively with visual assessment and quantitatively using arch index (AI), calcaneal pitch (CP), Meary's angle (MA), and foot posture index (FPI). Agreement between various foot typing measures is unclear. The purpose of this study was to assess the agreement between different measurements of foot type. We hypothesized that quantitative measures would have better interrater reliability than qualitative measures, and that visual assessment of foot type would be strongly correlated with radiographic assessment. Methods: Bilateral foot photographs were acquired from 92 asymptomatic participants (50 men, 42 women, mean age of 43.3+- 18.6 years) to assess photographic arch type (PAT) and photographic foot posture (PFP). Hindfoot alignment and lateral radiographs were acquired of each foot to assess calcaneal pitch (CP), Meary's angle (MA), x-ray foot posture (XFP), and x-ray arch type (XAT). Photographs and radiographs were assessed by five reviewers in random order. Foot Posture Index (FPI) was determined through manual exam. Arch Index (AI) was measured on lightbox images. Interrater reliability was assessed using Intraclass Correlation Coefficient (ICC) for continuous variables and Kendall's W for categorical variables. Correlations between measures and sensitivity/specificity were assessed using calcaneal pitch as the reference standard with cavus feet >= 26 degrees and planus feet measuring <= 19 degrees. Results: Interrater reliability of XFP (W=0.522), XAT (W=0.676), PAT (W=0.831), PFP (W=0.612) ranged from strong to extremely strong. Interrater reliability of MA (ICC=0.711) and CP (ICC=0.804) were moderate and good. Correlations between foot arch measurements ranged from low to high (Table 1). Fair correlations were identified between foot posture measurements (r=0.356 to r=0.442). Overall, XAT had the greatest sensitivity and specificity for planus (0.68, 0.93) and normal feet (0.92, 0.62), and the greatest specificity for cavus feet (0.98). AI demonstrated the greatest sensitivity (0.47) for cavus feet. Compared to AI, photographs had superior sensitivity for identifying normal feet (0.73 vs. 0.43), the greatest sensitivity for identifying planus feet (0.54 vs. 0.06), and the greatest specificity for identifying cavus feet (0.95 vs. 0.71). Conclusion: Agreement between methods varied widely, suggesting that classification is dependent upon methodology and cutoff values selected. PAT had the highest interrater reliability, whereas correlation between XAT and PAT was moderate, suggesting that radiographs are needed to accurately assess the longitudinal arch.
Do the Number of Screws and the Use of a Lateral Fibular Autograft Influence the Union Rate in Ankle Arthrodesis? A Systematic Review
Authors: Bernasconi Alessio , Izzo Antonio , Vallefuoco Salvatore , Lintz Francois , Smeraglia Francesco , Mariconda Massimo 
Published: November 2022

Category: Ankle Arthritis; Ankle Introduction/Purpose: Ankle arthrodesis, well-known as a reliable option to treat end-stage ankle osteoarthritis (AO), may be fixed using screws in various configurations. The purpose of this study was to determine whether the number of screws and the use of a lateral distal fibular autograft during the procedure might influence the union and complication rate. We hypothesized that a greater number of screws and the use of a fibular autograft might increase the union rate and reduce the number of complications. Methods: Following the PRISMA-compliant PROSPERO-registered checklist, the Medline, Scopus, Web of Science and Cochrane databases were searched, including studies reporting patients affected by AO and undergone Ankle Arthrodesis (AA) using screws as exclusive fixation method. Data were harvested regarding the cohort (sample size, age, sex, etiology), the study design (type of study, level of evidence), the surgical technique (open/arthroscopic procedure, the number of screws, the use of autograft) and the final outcome (union, complication and reoperation rate) at the longest follow-up. The risk of bias was assessed using the modified Coleman Methodology Score (mCMS) was used to assess the methodological quality of studies. Three groups were built based on the type of fixation: arthrodeses fixed with 2 screws (Group 1, G1), with 3 screws (Group 2, G2), and those augmented with a lateral fibular autograft (Group 3, G3). Results: Twenty series of patients from nineteen studies (732 ankles) were selected (G1=252 ankles, G2=209, G3=271). The pooled proportion estimate revealed a similar nonunion rate in the 2-screw group as compared to the 3-screw group (6% vs 1%; p=0.43) The pooled proportion of complications appeared higher in G1 (18%) than in G2 (8%) but it was not significantly different either (p=0.27). After exclusion of 'symptomatic hardware and screw removal' the difference was still not significant (p=0.62) although it resulted lower in G1 than in G2 (3% vs 8%, respectively). The pooled proportion of nonunions (p=0.48) and complications (p=0.76) did not differ between the AA performed without or with a fibular autograft. Conclusion: Fixation of Ankle Arthrodesis using three screws as compared to two screws seems to be advantageous in terms of reduced risk of nonunion and complications, although the difference did not achieve statistical significance in this study. The use of an adjuvant lateral distal fibular autograft does not seem to significantly increase the chances of fusion as compared to a no- autograft construct. The evidence provided so far is based on retrospective and short-term follow-up studies of moderate methodological quality. Further comparative and prospective analyses are warranted to define how to achieve the best outcome in Ankle Arthrodesis stabilized using screws.
Role of Syndesmotic Ligaments in Lateral Ankle Instability
Authors: Bhimani Rohan , Sato Go , Saengsin Jirawat , Lubberts Bart , Waryasz Gregory R. , DiGiovanni Christopher W. , Guss Daniel 
Published: November 2022

Category: Ankle; Sports; Trauma Introduction/Purpose: Despite the success of surgical intervention, about 13-35% of patients continue to have ankle symptoms after surgery for lateral ankle instability which could be due to presence of undetected and thus untreated injury to other ankle ligaments.Concomitant lateral ankle ligament and syndesmotic ligamentous injuries are common. It is unknown, however, whether syndesmotic ligaments directly contribute to lateral ankle stability. Therefore, the aim of this study was to fluoroscopically evaluate whether the syndesmotic ligaments contributes to lateral ankle stability. Methods: Twenty-four above-knee cadaveric specimens were divided into three groups that underwent fluoroscopic evaluation for lateral ankle stability. In all the groups, the assessment was first done with all syndesmotic and ankle ligaments intact. Thereafter, Group 1 underwent sequential transection of the lateral ankle ligaments: (1) anterior talofibular ligament (ATFL), (2)calcaneofibular ligament(CFL), and (3)posterior talofibular ligament (PTFL). Group 2 underwent sequential transection of the lateral ankle ligaments followed by the syndesmotic ligaments: (1) ATFL, (2) CFL, (3) PTFL, (4) anterior inferior tibiofibular ligament(AITFL), (5)interosseous ligament(IOL), and (6)posterior inferior tibiofibular ligament (PITFL). Group 3 alternating and sequential transection of the syndesmotic and lateral ankle ligaments: (1) AITFL, (2) ATFL, (3) CFL, (4) IOL, (5) PTFL, and (6) PITFL. In all scenarios, three loading conditions were considered:(1)An anterior drawer test at 50N and 80N of direct force, (2) talar tilt under 1.7Nm torque, and (2) lateral clear space (LCS) under 1.7Nm torque. Wilcoxon rank-sum test was used to compare the findings of each ligamentous transection state to the intact state. Results: The lateral ankle remained stable after transection of all syndesmotic ligaments (AITFL, IOL, PITFL). However, after additional transection of the ATFL, the lateral ankle became unstable in varus and anterior drawer testing conditions (p-values ranging from 0.036-0.012). Lateral ankle instability was also observed after transection of the ATFL and AITFL (p-values ranging from 0.036-0.012). Subsequent transection of the CFL worsened the lateral ankle instability. Conclusion: Our findings suggest that syndesmotic injuries can destabilize otherwise stable lateral ankle sprains. When treating lateral ankle instability, clinician should maintain a lower threshold for operative intervention for syndesmotic stabilization if there are any residual symptoms over the AITFL.