bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comaneci device-assisted embolization of wide-necked carotid aneurysms with an unfavorable ratio
Authors: Molina-Nuevo Juan David , López-Martínez Lorena , Pedrosa-Jiménez María José , Juliá-Molla Enrique , Hernández-Fernández Francisco 
Published: October 2020

Abstract
Background
Endovascular treatment is the technique of choice for most intracranial aneurysms. However, the treatment of morphologically complex wide-necked aneurysms with an unfavorable anatomy is still a therapeutic challenge.
The purpose of the study is to describe the initial experience with the Comaneci embolization assist device for the treatment of wide-necked aneurysms with an unfavorable ratio for direct embolization.

Methods
We report a retrospective single-center analysis taken from a prospective database of consecutive aneurysms of the anterior circulation treated using the Comaneci device in the period from March 2017 to March 2019.

Results
Eighteen aneurysms were collected from 16 patients (9 women and 7 men) treated using the Comaneci device. The mean age was 48.4 years (range 36–81). Twelve patients had SAH, three were incidental aneurysms and one had compressive symptoms. A complete asymptomatic occlusion rate of 88.8% was obtained. The major complication rate was 5.55%.

Conclusion
The Comaneci embolization assist device is a safe, effective option for endovascular treatment of complex aneurysms with an unfavorable ratio.
A cross-sectional study on the correlation between cytokines in a pelvic environment and tubal factor infertility
Authors: Yan Jiacong , Liu Chengbo , Zhao Han , Wang Chunyan , Yao Huimei , Lu Qiong , Liu Jia , Feng Yun 
Published: October 2020

Abstract
Background
This cross-sectional study aimed to evaluate the levels of tumor necrosis factor-alpha (TNF-ɑ), interleukin-8 (IL-8), interleukin-6 (IL-6), and transforming growth factor-beta 1 (TGF-β1) in patients with primary and secondary tubal factor infertility (TFI) compared with fertile subjects, and to compare immune indexes in the serum and peritoneal fluid samples obtained from patients with TFI.

Methods
The pelvic fluid and peripheral blood of patients with TFI diagnosed by hysteroscopy and laparoscopy were taken as the study objects. The pelvic fluid and peripheral blood of patients who underwent hysteromyomectomy at the same time were taken as the control group. The contents of TNF-ɑ, IL-8, IL-6, and TGF-β1 in serum and peritoneal fluid were determined by enzyme-linked immunosorbent assay, and the levels of these cytokines in serum and pelvic fluid were compared between the two groups.

Results
Patients with secondary TFI showed significantly higher levels of TNF-ɑ, IL-8, IL-6 and TGF-β1 in the serum (26.15 ± 3.51 vs. 19.61 ± 0.157, 32.18 ± 15.13 vs. 5.73 ± 1.99, 38.84 ± 3.46 vs. 30.48 ± 0.61, and 38.37 ± 3.14 vs. 32.25 ± 1.69, respectively) and peritoneal fluid samples (129.73 ± 183.4 vs. 34.63 ± 0.56, 111.44 ± 207.42 vs. 15.34 ± 0.41, 80.01 ± 109.91 vs. 15.67 ± 0.52, and 82.54 ± 115.99 vs. 45.34 ± 0.41, respectively) compared with the control group. Patients with primary TFI exhibited significantly elevated concentration of TNF-α, IL-8, IL-6 and TGF-β1 in the peritoneal fluid samples (36.88 ± 2.67 vs. 34.63 ± 0.56, 19.47 ± 3.51 vs. 15.34 ± 0.41, 80.01 ± 109.91 vs. 15.67 ± 0.52, and 82.54 ± 115.99 vs. 45.34 ± 0.41, respectively) when compared to the controls. In patients with secondary infertility, the levels of TNF-α (26.15 ± 3.51 vs. 129.73 ± 183.4), IL-8 (32.18 ± 15.13 vs. 111.44 ± 207.42), IL-6 (38.84 ± 3.46 vs. 80.01 ± 109.91) and TGF-β1 (38.37 ± 3.14 vs. 82.54 ± 115.99) in the serum were significantly lower than those in the peritoneal fluid, whereas no significant difference was observed in the primary TFI group between the serum and peritoneal fluid cytokines levels.

Conclusion
The expression of cytokines in the pelvic environment of patients with TFI is upregulated compared to patients who do not have infertility issues. The detection of cytokines TNF-ɑ, IL-6, IL-8, and TGF-β1 in the pelvic fluid of tubal infertility patients can allow for further understanding of the etiology of TFI.
Maternal excessive gestational weight gain as a risk factor for autism spectrum disorder in offspring: a systematic review
Authors: Kheirouri Sorayya , Alizadeh Mohammad 
Published: October 2020

Abstract
Background
Abnormal gestational weight gain (GWG) is a prenatal complication that may contribute to long-term behavioral and neurodevelopmental differences in offspring. This systematic review summarizes research on the association between maternal GWG and risk of autism spectrum disorder (ASD) in offspring.

Methods
Google and electronic databases, including PubMed, SCOPUS, Embase, Cochrane Library and Google Scholar, were searched for original human studies published in English through June 2020. Articles that examined the association between GWG and risk of ASD in offspring were included. Duplicate and irrelevant studies were removed; and data were obtained through critical analysis.

Results
Of 96 articles searched, eight studies were included in the final review. All studies (n = 7) investigating the association of maternal excessive GWG with risk of ASD in offspring indicated that high GWG was independently associated with an increased risk of ASD. Of five studies investigating the association of inadequate GWG with the risk of ASD, four indicated that low GWG was not associated with an increased risk of ASD. Of seven studies examining the association of maternal pre-pregnancy BMI or weight with the risk of ASD, five reported that maternal pre-pregnancy BMI or weight did not appear to be independently associated with risk of ASD. The GWG-ASD association is independent of maternal BMI and child’s intellectual disability, but offspring’s genetic susceptibility connection to the GWG-ASD association remains a topic of debate.

Conclusions
The findings suggest that maternal excessive GWG may be associated with increased risk of ASD in offspring. However, insufficient GWG does not appear to have such association.
An exploratory study to evaluate visual function endpoints in non-advanced age-related macular degeneration
Authors: Narayanan Divya , Rodriguez John , Wallstrom Garrick , Welch Donna , Chapin Matthew , Arrigg Paul , Abelson Mark 
Published: October 2020

Abstract
Background
To prevent irreversible vision loss in age-related macular degeneration (AMD), it is critical to detect retinal dysfunction before permanent structural loss occurs. In the current study we evaluated a series of visual function tests to identify potential endpoints to detect visual dysfunction in non-advanced AMD.

Methods
A series of visual function tests were performed on 23 non-advanced AMD subjects (AREDS grade 1–4 on simplified scale) and 34 age-matched normals (AREDS grade 0). Tests included some commonly used endpoints such as ETDRS visual acuity (VA), low luminance (LL) 2.0ND ETDRS VA, MNREAD as well as newly developed tests such as the Ora-VCF™ test, Ora-tablet reading test, color sensitivity etc. Differences between the two groups were compared for each test. Test-retest repeatability and reproducibility was assessed on a subset of subjects and percent agreement was calculated.

Results
There was no difference in standard ETDRS VA between non-advanced AMD (0.06 ± 0.02 logMAR) and normal groups (0.04 ± 0.02 logMAR) (p = 0.57). LL 2.0 ETDRS VA and MNREAD showed no difference between the groups (p > 0.05). Ora-VCF™ test was significantly worse in the non-advanced AMD group compared to normals (0.67 ± 0.07 in AMD; 0.45 ± 0.04 in normals, p = 0.005). Non-advanced AMD subjects also had significantly worse reading performance using the Ora-tablet with LL 2.0ND (114.55 ± 11.22 wpm in AMD; 145.17 ± 9.55 wpm in normals p = 0.049). No significant difference between the groups was noted using other tests. Repeatability was 82% for Ora-VCF™ test and 92% for Ora-tablet LL 2.0ND reading. Reproducibility was 89% for both Ora-VCF™ test and Ora-tablet LL 2.0ND reading.

Conclusion
While there was no significant difference between non-advanced AMD and normal groups using some current common endpoints such as ETDRS VA, LL 2.0 ETDRS VA or MNREAD, Ora-VCF™ test and Ora-tablet LL 2.0ND reading tests were able to identify significant visual dysfunction in non-advanced AMD subjects. These tests show promise as endpoints for AMD studies.
Primary orbital extraskeletal osteosarcoma and review of literature
Authors: Hui Jingwen , Zhao Yun , Zhang Lei , Lin Jinyong , Zhao Hong 
Published: October 2020

Abstract
Background
Extraskeletal osteosarcoma is a malignant tumour composed of an osteoid and/or cartilaginous matrix; it arises in soft tissues without connection to the skeleton, and to our knowledge, this type of tumour is extremely rare.

Case presentation
The present study reports a 57-year-old man with primary orbital extraskeletal osteosarcoma who presented with a history of painful swelling in the left orbit that had occurred for 11 months. Imaging of the orbit showed an atypical, well-defined heterogeneous mass attached to the posterior globe of the left orbit. The patient underwent an anterior orbitotomy and complete excision of the tumour. The mass was originated from neither the globe nor the bony orbital wall but from the soft tissue. Histopathology demonstrated an extraskeletal osteosarcoma. After 13 months of follow-up, there was apparent recurrence of the tumour. The medical history showed no complaints of previous trauma or radiotherapy.

Conclusions
ESOS is a highly malignant tumour. Immunosuppression, trauma and adjuvant radiotherapy are possible predisposing factors in the development of this tumour. Prompt recognition and thorough treatment are essential for preventing orbital lesions and presence of metastasis from other organs.
Gender differential impact of bereavement on health outcomes: evidence from the China Health and Retirement Longitudinal Study, 2011–2015
Authors: Chen Zhuo , Ying Jiahui , Ingles Justin , Zhang Donglan , Rajbhandari-Thapa Janani , Wang Ruoxi , Emerson Kerstin Gerst , Feng Zhanchun 
Published: October 2020

Abstract
Background
Bereavement is the experience of an individual following the death of a person of significance to the individual, most often referring to the spouse. Increased morbidity, health care utilization, and mortality are known to be associated with bereavement. Given China’s growing population of older adults, there is a critical need to assess the health consequences of bereavement.

Method
We use data from the China Health and Retirement Longitudinal Study to examine the impact of bereavement on mental health and quality of life among a sample of mid- and older-aged adults. We use propensity score matching to construct a matching sample and difference-in-differences method to estimate the impact of bereavement on mental health and self-assessed health.

Results
We find bereavement is associated with increased depression symptoms among women (1.542 point or 0.229 standard deviations of Center for Epidemiologic Studies Depression (CES-D) 10 score) but not consistently for men over time. No statistically significant effect of bereavement on self-assessed health is found.

Conclusions
Our results show a harmful impact of bereavement on mental health among older women in China and point to the need for a comprehensive policy on survivor benefits in China, particularly for rural older women.
Effectiveness of upgraded maternity waiting homes and local leader training on improving institutional births: a cluster-randomized controlled trial in Jimma, Ethiopia
Authors: Kurji Jaameeta , Gebretsadik Lakew Abebe , Wordofa Muluemebet Abera , Morankar Sudhakar , Bedru Kunuz Haji , Bulcha Gebeyehu , Bergen Nicole , Kiros Getachew , Asefa Yisalemush , Asfaw Shifera , Mamo Abebe , Endale Erko , Thavorn Kednapa , Labonte Ronald , Taljaard Monica , Kulkarni Manisha A. 
Published: October 2020

Abstract
Background
Maternity waiting homes (MWHs), residential spaces for pregnant women close to obstetric care facilities, are being used to tackle physical barriers to access. However, their effectiveness has not been rigorously assessed. The objective of this cluster randomized trial was to evaluate the effectiveness of functional MWHs combined with community mobilization by trained local leaders in improving institutional births in Jimma Zone, Ethiopia.

Methods
A pragmatic, parallel arm cluster-randomized trial was conducted in three districts. Twenty-four primary health care units (PHCUs) were randomly assigned to either (i) upgraded MWHs combined with local leader training on safe motherhood strategies, (ii) local leader training only, or (iii) usual care. Data were collected using repeat cross-sectional surveys at baseline and 21 months after intervention to assess the effect of intervention on the primary outcome, defined as institutional births, at the individual level. Women who had a pregnancy outcome (livebirth, stillbirth or abortion) 12 months prior to being surveyed were eligible for interview. Random effects logistic regression was used to evaluate the effect of the interventions.

Results
Data from 24 PHCUs and 7593 women were analysed using intention-to-treat. The proportion of institutional births was comparable at baseline between the three arms. At endline, institutional births were slightly higher in the MWH + training (54% [n = 671/1239]) and training only arms (65% [n = 821/1263]) compared to usual care (51% [n = 646/1271]). MWH use at baseline was 6.7% (n = 256/3784) and 5.8% at endline (n = 219/3809). Both intervention groups exhibited a non-statistically significant higher odds of institutional births compared to usual care (MWH+ & leader training odds ratio [OR] = 1.09, 97.5% confidence interval [CI] 0.67 to 1.75; leader training OR = 1.37, 97.5% CI 0.85 to 2.22).

Conclusions
Both the combined MWH+ & leader training and the leader training alone intervention led to a small but non-significant increase in institutional births when compared to usual care. Implementation challenges and short intervention duration may have hindered intervention effectiveness. Nevertheless, the observed increases suggest the interventions have potential to improve women’s use of maternal healthcare services. Optimal distances at which MWHs are most beneficial to women need to be investigated.

Trial registration
The trial was retrospectively registered on the Clinical Trials website (https://clinicaltrials.gov) on 3rd October 2017. The trial identifier is NCT03299491.
Accurate implant fit and leg alignment after cruciate-retaining patient-specific total knee arthroplasty
Authors: Arnholdt Jörg , Kamawal Yama , Horas Konstantin , Holzapfel Boris M. , Gilbert Fabian , Ripp Axel , Rudert Maximilian , Steinert Andre F. 
Published: October 2020

Abstract
Background
For improved outcomes in total knee arthroplasty (TKA) correct implant fitting and positioning are crucial. In order to facilitate a best possible implant fitting and positioning patient-specific systems have been developed. However, whether or not these systems allow for better implant fitting and positioning has yet to be elucidated. For this reason, the aim was to analyse the novel patient-specific cruciate retaining knee replacement system iTotal™ CR G2 that utilizes custom-made implants and instruments for its ability to facilitate accurate implant fitting and positioning including correction of the hip-knee-ankle angle (HKA).

Methods
We assessed radiographic results of 106 patients who were treated with the second generation of a patient-specific cruciate retaining knee arthroplasty using iTotal™ CR G2 (ConforMIS Inc.) for tricompartmental knee osteoarthritis (OA) using custom-made implants and instruments. The implant fit and positioning as well as the correction of the mechanical axis (hip-knee-ankle angle, HKA) and restoration of the joint line were determined using pre- and postoperative radiographic analyses.

Results
On average, HKA was corrected from 174.4° ± 4.6° preoperatively to 178.8° ± 2.2° postoperatively and the coronal femoro-tibial angle was adjusted on average 4.4°. The measured preoperative tibial slope was 5.3° ± 2.2° (mean +/− SD) and the average postoperative tibial slope was 4.7° ± 1.1° on lateral views. The joint line was well preserved with an average modified Insall-Salvati index of 1.66 ± 0.16 pre- and 1.67 ± 0.16 postoperatively. The overall accuracy of fit of implant components was decent with a measured medial overhang of more than 1 mm (1.33 mm ± 0.32 mm) in 4 cases only. Further, a lateral overhang of more than 1 mm (1.8 mm ± 0.63) (measured in the anterior-posterior radiographs) was observed in 11 cases, with none of the 106 patients showing femoral notching.

Conclusion
The patient-specific iTotal™ CR G2 total knee replacement system facilitated a proper fitting and positioning of the implant components. Moreover, a good restoration of the leg axis towards neutral alignment was achieved as planned. Nonetheless, further clinical follow-up studies are necessary to validate our findings and to determine the long-term impact of using this patient- specific system.
Low rates of all-cause revision in displaced subcapital femoral neck fractures treated with hip hemiarthroplasty - a retrospective review of 4516 patients from a single institute
Authors: Yeung Chi-Yung , Tsai Shang-Wen , Wu Po-Kuei , Chen Cheng-Fong , Chang Ming-Chau , Chen Wei-Ming 
Published: October 2020

Abstract
Background
Femoral neck fracture (FNF) is among the commonest fractures affecting the geriatric population. Hemiarthroplasty (HA) is a standard treatment procedure and has been performed by hip surgeons for decades. Recently, primary total hip replacement has proved advantageous for the treatment of such fractures.
The aim of this study is to retrospectively review all causes of failure of all patients who underwent HA in our institute and reevaluated whether HA remains a favourable choice of treatment for patients with displaced FNFs.

Methods
A total of 4516 patients underwent HA at our centre from 1998 to 2017. The HA implants included unipolar and bipolar prostheses. Patients diagnosed with displaced FNF, underwent primary HA initially, required second revision procedures, and followed up for a minimum of 36 months were included in this study. Data were collected and comprehensively analysed.

Results
In 4516 cases, 99 patients underwent second surgeries. The revision rate was 2.19%. Reasons for failure were acetabular wear (n = 30, 30.3%), femoral stem subsidence (n = 24, 24.2%), periprosthetic fracture (n = 22, 22.2%), infection (n = 16, 16.2%), and recurrent dislocation (n = 7, 7.1%). The mean follow-up period was 78.1 months. The interval between failed HA and revision surgery was 22.8 months.

Conclusion
HA has a low revision rate and remains a favourable choice of treatment for patients with displaced FNFs.

Levels of evidence
Level III, Retrospective Cohort Study, Therapeutic Study.
The application of laparoscopy combined with indocyanine green fluorescence imaging technique for hepatic cystic echinococcosis
Authors: Li Yu-Peng , Ma Zhi-Gang , Tuxun Tuerhongjiang , Li Zhi-De , Meng Yuan , Chen Xiong 
Published: October 2020

Abstract
Background
With the mature application of laparoscopy in hepatobiliary surgery, laparoscopic treatment of hepatic cystic echinococcosis (CE) has made certain progress. But, due to the inherent limitations of laparoscopy and the growth characteristics of cystic echinococcosis, distinguishing the boundary between cystic lesion and normal hepatic parenchyma is pivotal importance for successful surgery. Indocyanine green (ICG) fluorescence imaging technology can view the boundary of lesion and normal tissue during the treatment of hepatic cystic echinococcosis. Applied laparoscopy combined with ICG fluorescence imaging technique for hepatic cystic echinococcosis may be an effective surgical strategy.

Methods
The clinical data contained nine patients with hepatic cystic echinococcosis who underwent laparoscopic surgery with indocyanine green fluorescence imaging technique in authors’ institution from December 2018 to December 2019 were retrospectively analyzed. Indocyanine green was administered intravenously three days prior to surgery. The fluorescence acquisition system for real-time imaging was used during the surgery and the patients were followed up after surgery.

Results
Of reported nine patients, six are male and the remaining three are female. The average age is (36.4 ± 7.6) years. For all subjects, surgical procedures were performed under laparoscopy with indocyanine green fluorescence system. This technique showed the clear boundary of the hepatic cyst with normal liver parenchyma. Total cystectomy in six patients, subtotal cystectomy in two patients and partial hepatectomy in one patient were performed respectively. The average operation time was 3.8 ± 0.9 h, blood loss 206.0 ± 120.7 ml. Neither blood transfusion nor post-operative complication was experienced. The average abdominal drainage time was 3.4 ± 0.9 days with hospital stay 5.7 ± 2.1 days. During the 6–12 months follow-up period, neither recurrence nor intraperitoneal implantation was found.

Conclusions
Applied laparoscopy combined with ICG fluorescence imaging technique for hepatic cystic echinococcosis is safe and feasible. Enhanced boundary image can assist surgeons to complete radical resection and reduce complications.