bluuebunny/crossref_metadata_2025_split huggingface dataset:
Electrically evoked auditory brainstem response in cochlear implantation: what you need to know (short review)
Authors: Nada Nashwa , Kolkaila Enaas , Schendzielorz Philipp , El Mahallawi Trandil 
Published: May 2022

Abstract
Background
Electrically evoked auditory brainstem response (E-ABR) is an evoked potential recorded from the auditory nerve in response to electric stimulation. It is considered a short latency evoked potential. It plays a vital role, especially after the increased number of cochlear implant receivers.

Body of abstract
E-ABR is characterized by three positive peaks (eII, eIII, and eV) generated from the auditory nerve, cochlear nucleus, and perhaps from neurons in the lateral lemniscus or inferior colliculus. The largest is corresponding to wave V of the acoustic one. There are differences between both acoustic auditory brainstem response (A-ABR) and E-ABR. E-ABR is characterized by larger amplitudes and shorter latencies than the acoustic, and it has a steeper latency-intensity function. There are many variables affecting the E-ABR waveform, including recording-related variables, stimulus-related variables, and subject-related variables. E-ABR has potential clinical applications in cochlear implants (pre, inter, and postoperative).

Conclusion
After the increase in the number of cochlear implant receivers, E-ABR provides a promising new tool that can be used to evaluate auditory nerve functions. A lot of factors affect its waveform, including recording-related factors and stimulus-related and subject-related variables. E-ABR has many clinical applications, not only in post-implantation situations but also in preimplantation.
HIV and FIV glycoproteins increase cellular tau pathology via cGMP-dependent kinase II activation
Authors: Sathler Matheus F. , Doolittle Michael J. , Cockrell James A. , Nadalin India R. , Hofmann Franz , VandeWoude Sue , Kim Seonil 
Published: May 2022

ABSTRACT
As the development of combination antiretroviral therapy (cART) against human immunodeficiency virus (HIV) drastically improves the lifespan of individuals with HIV, many are now entering the prime age when Alzheimer's disease (AD)-like symptoms begin to manifest. It has been shown that hyperphosphorylated tau, a known AD pathological characteristic, is prematurely increased in the brains of HIV-infected individuals as early as in their 30s and that its levels increase with age. This suggests that HIV infection might lead to accelerated AD phenotypes. However, whether HIV infection causes AD to develop more quickly in the brain is not yet fully determined. Interestingly, we have previously revealed that the viral glycoproteins HIV gp120 and feline immunodeficiency virus (FIV) gp95 induce neuronal hyperexcitation via cGMP-dependent kinase II (cGKII; also known as PRKG2) activation in cultured hippocampal neurons. Here, we use cultured mouse cortical neurons to demonstrate that the presence of HIV gp120 and FIV gp95 are sufficient to increase cellular tau pathology, including intracellular tau hyperphosphorylation and tau release to the extracellular space. We further reveal that viral glycoprotein-induced cellular tau pathology requires cGKII activation. Taken together, HIV infection likely accelerates AD-related tau pathology via cGKII activation.
Incidence and quality of care for open fractures in England between 2008 and 2019
Authors: Shah Anjali , Judge Andrew , Griffin Xavier L. 
Published: May 2022

Aims This study estimated trends in incidence of open fractures and the adherence to clinical standards for open fracture care in England. Methods Longitudinal data collected by the Trauma Audit and Research Network were used to identify 38,347 patients with open fractures, and a subgroup of 12,170 with severe open fractures of the tibia, between 2008 and 2019 in England. Incidence rates per 100,000 person-years and 95% confidence intervals were calculated. Clinical care was compared with the British Orthopaedic Association Standards for Trauma and National Major Trauma Centre audit standards. Results In total, 60% of all open fractures occurred in males; the median age was 48 years (interquartile range (IQR) 29 to 68). Between 2012 and 2019, the overall incidence in England was 6.94 per 100,000 person-years. In males, the highest incidence observed was in those aged 20 to 29 years (11.50 per 100,000 person-years); in females, incidence increased with age, peaking at 32.11/100,000 person-years at 90 years of age and over. Among those with severe open fractures of the tibia, there was a bimodal distribution in males, peaking at 20 to 29 years (3.71/100,000 person-years) and greater than 90 years of age (2.84/100,000 person-years) respectively; among females, incidence increased with age to a peak of 9.91/100,000 person years at 90 years of age and over. There has been variable improvement with time in the clinical care standards for patients with severe open fractures of the tibia. The median time to debridement was 13.0 hours (IQR 6.4 to 20.9); almost two-thirds of patients underwent definitive soft-tissue coverage within 72 hours from 2016 to 2019. Conclusion This is the first time the incidence of all open fractures has been studied using data from a national audit in England. While most open fractures occurred in young males, the incidence increased with age in females to a much greater level than observed in older males. The degree of missing data in the national audit is startling, and limits the certainty of inferences drawn concerning open fracture care. Cite this article: Bone Joint J 2022;104-B(6):736–746.
Perioperative myocardial injury and mortality after revision surgery for orthopaedic device-related infection
Authors: Kvarda Peter , Puelacher Christian , Clauss Martin , Kuehl Richard , Gerhard Hatice , Mueller Christian , Morgenstern Mario ,   on behalf of the BASEL-PMI-Ortho Research Group
Published: May 2022

Aims Periprosthetic joint infections (PJIs) and fracture-related infections (FRIs) are associated with a significant risk of adverse events. However, there is a paucity of data on cardiac complications following revision surgery for PJI and FRI and how they impact overall mortality. Therefore, this study aimed to investigate the risk of perioperative myocardial injury (PMI) and mortality in this patient cohort. Methods We prospectively included consecutive patients at high cardiovascular risk (defined as age ≥ 45 years with pre-existing coronary, peripheral, or cerebrovascular artery disease, or any patient aged ≥ 65 years, plus a postoperative hospital stay of > 24 hours) undergoing septic or aseptic major orthopaedic surgery between July 2014 and October 2016. All patients received a systematic screening to reliably detect PMI, using serial measurements of high-sensitivity cardiac troponin T. All-cause mortality was assessed at one year. Multivariable logistic regression models were applied to compare incidence of PMI and mortality between patients undergoing septic revision surgery for PJI or FRI, and patients receiving aseptic major bone and joint surgery. Results In total, 911 consecutive patients were included. The overall perioperative myocardial injury (PMI) rate was 15.4% (n = 140). Septic revision surgery for PJI was associated with a significantly higher PMI rate (43.8% (14/32) vs 14.5% (57/393); p = 0.001) and one-year mortality rate (18.6% (6/32) vs 7.4% (29/393); p = 0.038) compared to aseptic revision or primary arthroplasty. The association with PMI persisted in multivariable analysis with an adjusted odds ratio (aOR) of 4.7 (95% confidence interval (CI) 2.1 to 10.7; p < 0.001), but was not statistically significant for one-year mortality (aOR 1.9 (95% CI 0.7 to 5.4; p = 0.240). PMI rate (15.2% (5/33) vs 14.1% (64/453)) and one-year mortality (15.2% (5/33) vs 9.1% (41/453)) after FRI revision surgery were comparable to aseptic long-bone fracture surgery. Conclusion Patients undergoing revision surgery for PJI were at a risk of PMI and death compared to those undergoing aseptic arthroplasty surgery. Screening for PMI and treatment in specialized multidisciplinary units should be considered in major bone and joint infections. Cite this article: Bone Joint J 2022;104-B(6):696–702.
No correlation identified between the proportional size of a prolapsed intravertebral disc with disability or leg pain
Authors: Dunsmuir Robert A. , Nisar Sohail , Cruickshank James A. , Loughenbury Peter R. 
Published: May 2022

Aims The aim of the study was to determine if there was a direct correlation between the pain and disability experienced by patients and size of their disc prolapse, measured by the disc’s cross-sectional area on T2 axial MRI scans. Methods Patients were asked to prospectively complete visual analogue scale (VAS) and Oswestry Disability Index (ODI) scores on the day of their MRI scan. All patients with primary disc herniation were included. Exclusion criteria included recurrent disc herniation, cauda equina syndrome, or any other associated spinal pathology. T2 weighted MRI scans were reviewed on picture archiving and communications software. The T2 axial image showing the disc protrusion with the largest cross sectional area was used for measurements. The area of the disc and canal were measured at this level. The size of the disc was measured as a percentage of the cross-sectional area of the spinal canal on the chosen image. The VAS leg pain and ODI scores were each correlated with the size of the disc using the Pearson correlation coefficient (PCC). Intraobserver reliability for MRI measurement was assessed using the interclass correlation coefficient (ICC). We assessed if the position of the disc prolapse (central, lateral recess, or foraminal) altered the symptoms described by the patient. The VAS and ODI scores from central and lateral recess disc prolapses were compared. Results A total of 56 patients (mean age 41.1 years (22.8 to 70.3)) were included. A high degree of intraobserver reliability was observed for MRI measurement: single measure ICC was 0.99 (95% confidence interval (CI) from 0.97 to 0.99 (p < 0.001)). The PCC comparing VAS leg scores with canal occupancy for herniated disc was 0.056. The PCC comparing ODI for herniated disc was 0.070. We found 13 disc prolapses centrally and 43 lateral recess prolapses. There were no foraminal prolapses in this group. The position of the prolapse was not found to be related to the mean VAS score or ODI experienced by the patients (VAS, p = 0.251; ODI, p = 0.093). Conclusion The results of the statistical analysis show that there is no direct correlation between the size or position of the disc prolapse and a patient’s symptoms. The symptoms experienced by patients should be the primary concern in deciding to perform discectomy. Cite this article: Bone Joint J 2022;104-B(6):715–720.
Developing a minimum common dataset for hip fracture audit to help countries set up national audits that can support international comparisons
Authors: Johansen Antony , Ojeda-Thies Cristina , Poacher Arwel T. , Hall Andrew J. , Brent Louise , Ahern Emer C. , Costa Matt L. ,   on behalf of the Global Fragility Fracture Network Hip Fracture Audit Special Interest Group
Published: May 2022

Aims The aim of this study was to explore current use of the Global Fragility Fracture Network (FFN) Minimum Common Dataset (MCD) within established national hip fracture registries, and to propose a revised MCD to enable international benchmarking for hip fracture care. Methods We compared all ten established national hip fracture registries: England, Wales, and Northern Ireland; Scotland; Australia and New Zealand; Republic of Ireland; Germany; the Netherlands; Sweden; Norway; Denmark; and Spain. We tabulated all questions included in each registry, and cross-referenced them against the 32 questions of the MCD dataset. Having identified those questions consistently used in the majority of national audits, and which additional fields were used less commonly, we then used consensus methods to establish a revised MCD. Results A total of 215 unique questions were used across the ten registries. Only 72 (34%) were used in more than one national audit, and only 32 (15%) by more than half of audits. Only one registry used all 32 questions from the 2014 MCD, and five questions were only collected by a single registry. Only 21 of the 32 questions in the MCD were used in the majority of national audits. Only three fields (anaesthetic grade, operation, and date/time of surgery) were used by all ten established audits. We presented these findings at the Asia-Pacific FFN meeting, and used an online questionnaire to capture feedback from expert clinicians from different countries. A draft revision of the MCD was then presented to all 95 nations represented at the Global FFN conference in September 2021, with online feedback again used to finalize the revised MCD. Conclusion The revised MCD will help aspirant nations establish new registry programmes, facilitate the integration of novel analytic techniques and greater multinational collaboration, and serve as an internationally-accepted standard for monitoring and improving hip fracture services. Cite this article: Bone Joint J 2022;104-B(6):721–728.
Implementation of Transfer Learning for Covid-19 and Pneumonia Disease Detection Through Chest X-Rays Based on Web
Authors: Apsari Nindya Eka , Sugiyanto Sugiyanto , Handajani Sri Sulistijowati 
Published: May 2022

<p align="justify">Coronavirus disease 2019, known as COVID-19, attacks the human respiratory system caused by severe acute respiratory syndrome coronavirus-2 (SARS-Cov-2). COVID-19 disease and pneumonia show similar symptoms such as fever, cough, even headache. Diagnosis of pneumonia can be tested through diagnostic tests, including blood tests, chest X-rays, and pulse oximetry, while the diagnosis of COVID-19 recommended by WHO is with swab test (RT-PCR). But in fact, the swab test method takes a relatively long time, for about one to seven days, for the result, and is not cheap. For that, there needs to be a development that can be one of the options in diagnosing COVID-19 and pneumonia at once, especially since both diseases have similar symptoms. One option that can be done is the diagnosis using a chest X-ray. This research aims to detect COVID-19 disease and pneumonia through chest X-rays using transfer learning to increase the accuracy of disease diagnosis with a more efficient time. The architecture used is EfficientNet B0 with variations in optimization parameters, learning rates, and epochs. EfficientNet B0 Adam optimization with a learning rate of 0.001 in the 6th epochs is a great model that we obtained. Furthermore, the evaluation of the model got accuracy, precision, recall, and f1-score of 92%. Then the model visualization is done using Grad-CAM. To implement the best model, web application development is done to make it easier to detect COVID-19 disease and pneumonia.</p><p><strong>Keywords</strong><strong>: </strong>COVID-19; pneumonia; EfficientNet; transfer learning; web</p>
Examining the barriers faced by female surgical trainees: a qualitative study
Authors: Morgan JL , Manning K , Wyld L 
Published: May 2022

Introduction Today, women make up 56% of medical students, yet just 13% of surgical consultants – a number that has remained static since 2013. This qualitative study explored some of the barriers to female success in modern surgery. Methods Semistructured qualitative interviews were undertaken primarily with female surgical trainees to determine the barriers they face. Male trainees and training programme directors (TPDs) were also interviewed for triangulation. Results 20 interviews were performed (16 female trainees, 3 male trainees, and 1 TPD) between October 2019 and March 2020. Family pressures and becoming a mother were significant barriers for women training in surgery – a barrier that did not apply to male trainees who were fathers, often resulting in women choosing to train less than full time (LTFT). Unfortunately LTFT training presents further obstacles for female trainees. The set-up of the national training programme in surgery provides many non-gender-specific barriers, chiefly moving hospital every 6 months causing disrupted training and long commutes, disproportionately affecting females with child care responsibilities. Sexism and discrimination are still common, both from colleagues and patients. Many participants perceived inherent differences between genders in communication and methods for coping with stress. Conclusion Greater gender equality in surgery may be achieved by changes in the structure and organisation of training to reduce the tension between the professional role and the predominantly female-led role of raising children. Better equality and diversity training and awareness at all levels in surgery may help to mitigate some of the conscious and unconscious bias that still exists.
Evaluation of the quality of information online for arthroscopic Bankart repair
Authors: Shazil Jamal M , Hurley ET , Davey MS , Asad H , Gaafar M , Mullett H 
Published: May 2022

Purpose The purpose of this study was to evaluate the quality and readability of information online for patients searching terms related to arthroscopic Bankart repair (ABR). Methods Google, Yahoo and Bing were searched with terms related to ABR. The quality of information was assessed using the Journal of the American Medical Association (JAMA) Benchmark criteria, DISCERN Score, and the Flesch–Kincaid Reading Ease & Grade Level. The presence of the HONcode marker was noted. Additionally, we used a scoring system specific to content relating to the ABR (AB score), a 1–20 Likert scale. Websites were also categorised according to the source: academic institution, physician, allied healthcare, commercial, media or social media. Statistical analysis was performed using GraphPad Prism. Results Ninety-six unique websites were evaluated, with the most common website category being physician websites (52) and academic institution websites (24). There were nine websites with the HONcode marker. The average JAMA Benchmark criteria score was 1.95 (1–4), the average DISCERN score was 48.8 (20–78), with an average Flesch–Kincaid reading ease of 50.9 (11–96) and grade level of 8 (1–18). The average AB score was 5.9 (0–18), and there was a strong correlation with a higher DISCERN score (r=0.57), but not JAMA score (r=0.18) or Flesch–Kincaid grade (r=0.16). Websites with the HONcode marker did not score higher in any criteria than those without it (p>0.05). The quality of information on physician websites was better than (statistically insignificant) non-physician websites; however, the readability of information in the former was poorer (statistically significant) than the latter. Conclusion There was wide variability in the quality and readability online of the information on ABR, and the AB scoring system was shown to correlate strongly with increased quality.
Patient-reported outcome measures show FIT as an acceptable investigation to rule out colorectal cancer in the two-week wait cohort
Authors: Maclean W , Whyte MB , Farkas N , Benton SC , Rockall T , Jourdan I 
Published: May 2022

Introduction Use of faecal immunochemical testing (FIT) for symptomatic patients is increasing. FIT is recommended as a triage tool from primary care to the two-week wait (TWW) suspected cancer pathway, but there is still little known about patient attitudes. Aim The aim of this study was to explore patient opinions of FIT and how it might be applied in the TWW pathway. Methods A telephone survey was conducted for patients from the TWW pathway who had undergone both conventional colonic investigation and FIT. Five questions explored expectations, attitudes towards results and experience of the investigations using a Likert scale 1–5. Differences in opinion were compared using median and mode scores and visualised using bar charts. Results One hundred and nine TWW patients agreed to answer the five questions. All had taken a stool sample for FIT, 50 underwent colonoscopy, 51 had a CT colonography and 8 underwent flexible sigmoidoscopy. Most patients (85%) scored 5 (completely satisfied) with these conventional colonic investigation methods they underwent for ruling out colorectal cancer (median 5). However, 30% of patients scored 5 (completely satisfied) if using a negative FIT to not require additional colonic investigation. The median score to perform FIT was 5 (very easy) compared with a median of 4 (easy) to undergo the other colonic investigations. Conclusions Symptomatic patients can perform FIT with little difficulty, and often would have been happy to avoid conventional colonic investigations with a negative result. However, shared decision-making should be employed to identify those who would be dissatisfied with relying on FIT for further investigation decisions.
Drowning in antibiotics
Authors: Gelder CL , Robinson S , Leitch F , McMahon AJ 
Published: May 2022

Introduction The National Confidential Enquiry into Perioperative Deaths (NCEPOD) report recommended that ‘fluid prescribing be given the same value as drug prescribing’, yet fluid prescription is commonly delegated to junior doctors despite being a notoriously challenging topic. When antibiotics are given as an infusion they are diluted in 100ml of fluid, which is often unaccounted for when thinking about a patient’s fluid requirements. This closed-loop audit aimed to assess first, intravenous (IV) fluid therapy and second, electrolyte prescribing compliance with National Institute for Health and Care Excellence (NICE) guidelines, with and without the additional fluid given with antibiotic administration. Methods Two retrospective audits were performed. Total fluid and electrolyte volume received with and without antibiotic fluids was correlated with recommendations in the NICE guidelines. Between cycles 1 and 2, potassium chloride with sodium chloride and glucose (PSG) was introduced as an alternative to IV maintenance fluid, and bolusing of antibiotics was mandatory. Results When analysing total fluid volume input per day, 10.4% and 7.45% of patients met their fluid requirement accurately in the first and second cycles, respectively. Within cycle 1, the mean total additional fluid that was given over 3 days with antibiotics was 1,572.73ml. In cycle 2, this decreased to 469.44ml when antibiotics were given as a bolus. Conclusions In this closed-loop audit we noted that patients receiving IV fluids and IV antibiotics received too much additional fluid when the antibiotic dilution fluid was taken into account. Additional fluid was reduced alongside the proportion of electrolyte complications when bolusing of antibiotics was introduced. We recommend that that all nurses are trained to give antibiotics as a bolus because it can help to reduce fluid-related complications.