bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison of Patient Self-Reported Quality of Life and Health Care Professional-Assessed Symptoms in Terminally ill Patients With Cancer
Authors: Matsumura Chikako , Koyama Nanako , Sako Morito , Kurosawa Hideo , Nomura Takehisa , Eguchi Yuki , Ohba Kazuki , Yano Yoshitaka 
Published: July 2020

Background: Few studies evaluated whether health care professionals accurately assess several symptoms for patients with cancer in palliative care units. We determined the agreement level for several symptoms related to quality of life (QOL) between patient-reported QOL assessment and health care professional-assessed symptoms based on the Support Team Assessment Schedule (STAS). Method: An observational study was performed with terminally ill patients with cancer hospitalized in the palliative care unit between June 2018 and December 2019. Patients and health care professionals independently assessed 7 symptoms at the time of hospitalization and after 1 week. Patients completed the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C15-PAL). In examining the proportions of exact agreement, “exact agreement” referred to the pairs of the scores (QLQ-C15-PAL vs STAS) being (1 vs 0), (2 vs 1), (3 vs 2 or 3), or (4 vs 4). The relationships of physical functioning between QLQ-C15-PAL and Palliative Performance Scale (PPS) were examined. Results: Of 130 patients, approximately 60% had PPS scores from 40 to 60. The highest mean score on QLQ-C15-PAL was for fatigue (63.8). The exact agreement on symptoms between patients and health care professionals ranged from 15.4% (fatigue) to 57.7% (nausea and vomiting). The mean of the transformed QLQ-C15-PAL and proportions of exact agreement were negatively correlated ( R 2 = 0.949, P < .05). The physical function scores in QLQ-C15-PAL for each PPS group showed no differences. Conclusion: We expect patient-reported outcomes including QLQ-C15-PAL to be added to health care professionals’ assessment of serious symptoms such as fatigue in terminally ill patients with cancer.
Trends in Published Palliative Care Research: A 15-Year Review
Authors: Mehta Ambereen K. , Patel Rishi , Patel Dheer , Davis Mellar P. 
Published: July 2020

Background: There has been a call for palliative care (PC) published research to support the impact and need for more specialty PC services. Objective: The purpose of this study was to characterize research in PC over a 15-year period in 3 PC journals published in the United States. Design: The authors reviewed every issue of the Journal of Pain and Symptom Management, Journal of Palliative Medicine, and American Journal of Hospice and Palliative Medicine from 2004 through 2018. Studies included were original articles and brief reports. Study type (qualitative, quantitative), author (first and last), gender, and professional degree of the author (first and last) were recorded. Results: A total of 4881 articles were included in this study. The proportion of quantitative papers significantly increased across 3 time points from 63% to 67% to 78%. The proportion of women first authors increased across all 3 time points (54%, 2004-2008; 57%, 2009-2013; 60%, 2014-2018), and the proportion of women last authors increased across all time points (38%, 2004-2008; 44%, 2009-2013; 46%, 2014-2018). More than 40% of authors were physicians. Conclusions: Published PC studies are increasingly quantitative in design. Gender authorship is female dominant for the first authors and increasingly equal across genders for the last authors.
22q12.3-q13.1 microdeletion including SOX10 causes atypical Waardenburg syndrome
Authors: Zhang Wenqiu , Xiao Lirong , Chen Bingjie , Xu Yingwen , Yan Naihong 
Published: July 2020

Purpose: To identify disease associated mutations in a male infant with congenital heart defects and heterochromia. Methods: A detailed clinical examination and routine laboratory tests were performed on the patient. We applied whole exome sequencing to identify the causal mutation on the proband and other family members. Results: The patient presented with severe congenital heart disease, strabismus, and pigment disturbances of the iris. We identified a deletion of 1.99 megabase [arr[hg19]22q12.3-13.1 (chr22:36656004-38643920) *1], including SOX10 and 13 RefSeq genes on this patient, which was associated with atypical Waardenburg syndrome. Conclusion: Our results suggest that a deletion of 1.99 megabase (including SOX10) acts as a dominant pathogenic variant on the clinical presentations of this patient with atypical Waardenburg syndrome.
Smart properties of carbon nanotube-epoxy composites
Authors: Tian Changjin , Wang Youzhi , Yang Qilin , Ge Zhi , Du Yefeng 
Published: July 2020

Intelligent smart materials can not only monitor the damage and degradation of architectural structures in real time but also the health structure. In recent years, carbon nanotubes materials have emerged to possess both excellent mechanical and electrical properties. Moreover, when carbon nanotubes are added to epoxy resin, intelligent composite materials with significant sensitivity are created. In this study, the stress–strain curves and anelasticity of carbon nanotube/epoxy resin composites with different carbon nanotube concentrations is analyzed. Through changing the level of carbon nanotubes using the two-pole method, the percolation threshold of carbon nanotube/epoxy composites was determined. Thereafter, the effect of temperature on the composites’ conductive properties was investigated. Moreover, using the stepwise cyclic loading method, the piezoresistivity of the carbon nanotube/epoxy composites was investigated. The test results show that the elastic limit, the yield point, and the elastic modulus range of the carbon nanotube/epoxy composites is approximately 45 MPa, 50 MPa, and 1–2 GPa, respectively. The anelasticity of the carbon nanotube/epoxy composites increases with the gradual increase of the stress level. The percolation threshold interval of carbon nanotube/epoxy composites ranges from 0.5 to 1.0 wt%. The rate of change of resistance for the different concentrations on carbon nanotube/epoxy specimens corresponds to the temperature. Notably, the carbon nanotube/epoxy composites have better discrimination and pressure sensitivity for different grades of load. When the carbon nanotube content is 0.5 wt%, the sensitivity of the carbon nanotube/epoxy composites pressure-sensitive property is the largest, which is in agreement with the threshold curve. The results of this investigation have implications for the application of carbon nanotube/epoxy composites in structural health monitoring.
Routine Placement of Temporary Epicardial Pacing Leads Is Not Required After Minimally Invasive Aortic Valve Replacement
Authors: Amirjamshidi Hossein , Vidovich Courtney , Knight Peter A. 
Published: July 2020

Objective Our objective is to identify the incidence of urgent transvenous (TV) pacing wire placement following minimally invasive aortic valve replacement (mini-AVR). Methods This is a single-center, retrospective, observational study including 359 individuals who underwent isolated mini-AVR through right anterior mini-thoracotomy between January 2015 and September 2019. Patients were grouped according to avoidance or insertion of epicardial pacing wires, and further subdivided based on the requirement for postoperative emergent temporary TV pacing or permanent pacemaker (PPM) placement during the index admission. Results Two hundred forty-two (67.4%) had acceptable rate and no high-degree atrioventricular (AV) block prior to chest closure and did not have insertion of epicardial pacing wires. Of those patients, only 3 (1.2%) required emergent TV pacing and 6 (2.5%) required nonemergent TV pacing with or without PPM placement during the index admission. Sixty-two (17.3%) patients received only atrial epicardial pacing leads secondary to sinus bradycardia or junctional rhythm and 3 (4.8%) of those patients required PPM placement due to sick sinus syndrome and 1 (1.6%) patient required nonemergent TV pacing and PPM due to high-grade AV heart block. Fifty-five (15.3%) patients received ventricular leads due to high-grade AV heart block and 7 (12.7%) of those patients required PPM placement during the index admission. Conclusions Temporary epicardial lead insertion is not routinely required in mini-AVR in patients with normal rate and acceptable AV conduction prior to chest closure. In the absence of epicardial ventricular lead insertion, the chance of requiring urgent TV pacing wire placement during the index admission is 0.99%.
The Latarjet procedure in competitive athletes younger than 20 years old with a significant glenoid bone loss
Authors: Rossi Luciano A , Tanoira Ignacio , Bruchmann María G , Pasqualini Ignacio , Ranalletta Maximiliano 
Published: July 2020

Purpose To analyze return to sports, functional outcomes, and complications following the Latarjet procedure in competitive athletes younger than 20 years old with a significant glenoid bone loss. Methods Between 2010 and 2017, 60 competitive athletes younger than 20 years old with a significant glenoid bone loss were operated with the Latarjet procedure. Return to sports, range of motion, and the Rowe and the Athletic Shoulder Outcome Scoring System score were used to assess functional outcomes. Complications and bone consolidation were also evaluated. Results The mean follow-up was 58 months and the mean age was 16.3 years. Overall, 93% were able to return to sports and 84% returned at the same level. The Rowe and Athletic Shoulder Outcome Scoring System scores showed statistical improvement after operation ( P <  .001). The total complication rate was 22% and the revision rate was 1.6%. The recurrence rate was 3.3%. The bone block healed in 93% of the cases. Conclusions In competitive athletes younger than 20 years old with a significant glenoid bone loss, the Latarjet procedure resulted in excellent functional outcomes, with most of the patients returning to sports and at the same level they had before injury with a low rate of recurrences. However, this procedure is associated with a significant rate of complications and should preferably be performed by experienced surgeons.
Pressurized intraperitoneal aerosol chemotherapy with cisplatin and doxorubicin or oxaliplatin for peritoneal metastasis from pancreatic adenocarcinoma and cholangiocarcinoma
Authors: Di Giorgio Andrea , Sgarbura Olivia , Rotolo Stefano , Schena Carlo Alberto , Bagalà Cinzia , Inzani Frediano , Russo Andrea , Chiantera Vito , Pacelli Fabio 
Published: July 2020

Background: Systemic chemotherapy for pancreatic adenocarcinoma (PDAC) and cholangiocarcinoma (CC) with peritoneal metastases (PM) is affected by several pharmacological shortcomings and low clinical efficacy. Pressurized intraperitoneal aerosol chemotherapy (PIPAC) is expected to maximize exposure of peritoneal nodules to antiblastic agents. This study aims to evaluate safety and efficacy of PIPAC for PM of PDAC and CC origin. Methods: This is a retrospective analysis of consecutive PDAC and CC cases with PM treated with PIPAC at two European referral centers for peritoneal disease. We prospectively recorded from August 2016 to May 2019 demographic, clinical, surgical, and oncological data. We performed a feasibility and safety assessment and an efficacy analysis based on clinical and pathological regression. Results: Twenty patients with PM from PDAC (14) and CC (six) underwent 45 PIPAC administrations. Cisplatin–doxorubicin or oxaliplatin were administered to eight and 12 patients, respectively. We experienced one intraoperative complication (small bowel perforation) and 18 grade 1–2 postoperative adverse events according to Common Terminology Criteria for Adverse Events version 4.0. A pathological regression was recorded in 50% of patients (62% in the cisplatin–doxorubicin cohort and 42% in the oxaliplatin one). Median survival from the first PIPAC was 9.7 and 10.9 months for PDAC and CC, respectively. Conclusion: PIPAC resulted feasible and safe without relevant toxicity issues, with both cisplatin–doxorubicin and oxaliplatin. The pathological response observed supports the evidence of antitumoral activity. Despite the study limitations, these outcomes are encouraging, recommending PIPAC in prospective, controlled trials in the palliative setting or the first line chemotherapy for PM from PDAC and CC.
Hybrid Anterior Cervical Discectomy and Fusion and Cervical Disc Arthroplasty: An Analysis of Short-Term Complications, Reoperations, and Readmissions
Authors: Boddapati Venkat , Lee Nathan J. , Mathew Justin , Vulapalli Meghana M. , Lombardi Joseph M. , Dyrszka Marc D. , Sardar Zeeshan M. , Lehman Ronald A. , Riew K. Daniel 
Published: July 2020

Study Design: Retrospective cohort study. Objectives: Although cervical disc arthroplasty (CDA) has become a well-established and effective treatment for symptomatic cervical degeneration, many patients with multilevel disease are not good candidates for CDA at all levels. For such patients, hybrid surgery (HS)—a combination of adjacent anterior cervical discectomy and fusion (ACDF) and CDA—may be more appropriate. Given the novelty of HS and the relative dearth of studies adequately assessing short-term perioperative complications, this current study sought to assess the short-term morbidity profile of HS, differences in operative duration, length of stay (LOS), and readmission and reoperation rates and reasons relative to a 2-level ACDF cohort. Methods: All patients who underwent HS and 2-level ACDF were identified between 2011 and 2018 using a large, prospectively collected registry. Baseline patient characteristics and postoperative complications were compared using bivariate and/or multivariate analysis. Results: A total of 390 patients undergoing HS were identified. Two-level procedures were the most common (74.9%). Patients undergoing HS were more likely to be younger, male, and have fewer comorbidities. There were no differences between HS and 2-level ACDF in rates of any postoperative complication, transfusion, readmissions, and operative duration. However, HS had a decreased LOS (0.5 days), relative to a 2-level ACDF. HS patients had low rates of reoperation (1.28%) with 1 case for hematoma evacuation and another for revision CDA. Conclusions: This study represents one of the largest cohorts of patients undergoing HS reported to date. Patients undergoing HS are not at increased risk of perioperative complications relative to a 2-level ACDF and may benefit from shorter LOS.
Biomechanical Comparison of Graft Preparation Techniques for All-Inside Anterior Cruciate Ligament Reconstruction
Authors: Bowes Julia , Mohamed Nada , Baptiste Jonelle Jn , Westover Lindsey , Hui Catherine , Sommerfeldt Mark 
Published: July 2020

Background: All-inside anterior cruciate ligament reconstruction (ACLR) is an emerging technique used to treat ACL injuries. The all-inside technique uses a 4-stranded graft made from a single tendon that is looped on itself. The 4 strands of the graft must be secured to each other to become a closed-loop structure. Various suture configurations exist to secure the graft to adjustable loop devices, and there is a lack of data to support one technique over another. In addition to the primary sutures used to fasten the graft together, accessory sutures can be tied over the button as secondary fixation. Purpose: To evaluate biomechanical properties of 4-stranded grafts prepared in 5 different configurations. Study Design: Controlled laboratory study. Methods: Porcine flexor tendons (N = 25) were prepared in 5 different configurations (n = 5 tendons per group): simple-interrupted sutures (unsecured fixation), side-to-side fixation with and without secondary fixation, and end-to-end fixation with and without secondary fixation. The grafts were put through the same mechanical testing protocol (cyclic loading, pull to failure) to measure average load at graft failure, average displacement at failure, average stiffness, and average elongation rate. Differences between graft preparation techniques were investigated using 1-way analyses of variance (ANOVAs) with post hoc t tests ( P < .05). Results: Significant 1-way ANOVAs for each biomechanical property were found. Unsecured fixation was the weakest graft preparation with the lowest stiffness (167 ± 12 N/mm), lowest ultimate failure load (637 ± 99 N), and highest elongation rate (0.0033 ± 0.0007 mm/s). End-to-end fixation without secondary fixation showed the highest ultimate failure load (846 ± 26 N), highest stiffness (212 ± 10 N/mm), and lowest rate of elongation (0.0025 ± 0.0001 mm/s). End-to-end fixation, both with and without secondary fixation, as well as side-to-side fixation with secondary fixation showed significantly higher ultimate failure loads than grafts with unsecured fixation. End-to-end fixation performed better than side-to-side fixation; however, for most variables, the difference was not statistically significant. Secondary fixation did not provide significant improvement. Conclusion: The all-inside ACL graft with simple-interrupted sutures is biomechanically inferior to a graft that has its free ends secured to the adjustable tibial loop. Adding secondary fixation to the tibial button does not significantly change the biomechanical properties. Further clinical studies are required to determine whether these findings translate into differences in clinical outcome. Clinical Relevance: All-inside ACLR is gaining popularity in hamstring ACL reconstructive techniques. These results provide surgeons with guidance on the best graft preparation method when using a single quadrupled hamstring tendon graft.
National Board of Medical Examiners and Curriculum Change: What Do Scores Tell Us? A Case Study at the University of Balamand Medical School
Authors: Al Ojaimi Mode , Khairallah Megan , Younes Rayya , Salloum Sara , Zgheib Ghania 
Published: July 2020

Objectives: This study describes the results of NBME (National Board of Medical Examiners) implementation in Balamand Medical School (BMS) from 2015 to 2019, after major curricular changes were introduced as of 2012. BMS students’ performance was compared with the international USMLE step 1 (United States Medical Licensing Examination, herein referred to as step 1) cohorts’ performances. The BMS students’ NBME results were analyzed over the successive academic years to assess the impact of the serial curricular changes that were implemented. Methods: This longitudinal study describes the performance of BMS preclinical second year medicine (Med II) students on all their NBME exams over 4 academic years starting 2015-2016 to 2018-2019. These scores were compared with the step 1 comparison group scores using item difficulty. The t test was computed for each of the NBME exams to check whether the scores’ differences were significant. Results: Results revealed that all BMS cohorts scored lower than the international USMLE step 1 comparison cohorts in all disciplines across the 4 academic years except Psychiatry. However, the results were progressively approaching step 1 results, and the difference between step 1 scores and BMS students’ NBME scores became closer and not significant as of year 4. Conclusions: The results of the study are promising. They show that the serial curricular changes enabled BMS Med II students’ scores to reach the international cohorts’ scores after 4 academic years. Moreover, the absence of statistical difference between cohort 4 scores and step 1 cohorts is not module dependent and applies to all clinical modules. Further studies should be conducted to assess whether the results obtained for cohort 4 can be maintained.
Krukenberg tumor secondary to gall bladder carcinoma masquerading C3 glomerulopathy
Authors: Meena Priti , Bhargava Vinant , Rana Devinder Singh , Bhalla Anil Kumar , Gupta Ashwani , Gupta Pallav 
Published: July 2020

Background: C3 glomerulopathy is caused by dysregulation of the alternative complement pathway. Association with solid organ tumors is rare. However, there have been a few case reports of membranoproliferative glomerulonephritis secondary to gastrointestinal neoplasms. Case: A 38-year-old female presented with abdominal distension, loss of appetite, amenorrhea, and easy fatigability. She had been diagnosed 8 months back with C3 glomerulopathy and had received immunosuppression. On evaluation, she was incidentally detected to have Krukenberg tumor. The primary site of malignancy was gall bladder. Conclusion: Our case report highlights a possible association between C3 glomerulopathy and Krukenberg tumor secondary to gall bladder carcinoma and emphasizes the fact that even in cases of C3 glomerulopathy, occult malignancy should be considered as an underlying pathology.
Making India’s cleanest city: Sanitation, intersectionality, and infrastructural violence
Authors: Truelove Yaffa , O’Reilly Kathleen 
Published: July 2020

Inaugurated in 2014, India’s Swachh Bharat Mission (SBM) intends to eradicate open defecation in urban and rural areas by 2019. In cities, the scheme ranks municipalities for achieving open defecation-free status and other measures of cleanliness. In 2017, Indore was first nationally recognized with the national Cleanest City award. In the weeks before the city was evaluated, it sponsored a number of activities that demolished housing and sanitation infrastructures, singled out the female body for humiliation, and forced residents to revert back to the very sanitation practices the city was allegedly trying to eradicate. This paper traces the differing articulations of power at work between the extension and demolition of the city’s infrastructure. It focuses particularly on latrines, the metrics, and the urban vision to make Indore the Cleanest City, but also gives attention to the additional infrastructures connected to latrine-making and unmaking, including housing. We specifically explore two dimensions of what we call the “infrastructural intersectionality” of the Clean City Mission, which discloses differing forms of compounding infrastructural violence that include the dissolution of both material and social infrastructures. Firstly, the intersectionality of gender/caste/class/race social identities and power relations that are embedded and reified through infrastructures and, secondly, the intersectionality of multiple infrastructures that are inter-connected and co-constituted through each other. We argue that bringing the lens of intersectionality is critical for recognizing the socially differentiated and gendered dimensions of sanitation infrastructure, the SBM, and its situated infrastructural violence. By exploring two themes related to infrastructure and intersectionality, we show the criticality of embodied and gendered approaches to analyzing the power of infrastructure in the everyday.