bluuebunny/crossref_metadata_2025_split huggingface dataset:
What is the incidence of renal impairment in patients presenting with renal colic?
Authors: Aitken Neill , Nointin Natasha , Bhattacharjee Rahul , Adamson Elliott , Pham Chris , Klim Sharon , Kelly Anne-Maree 
Published: May 2020

Objective: Nonsteroidal anti-inflammatory drugs (NSAIDs) are the recommended agents for treatment of renal colic pain. Some clinicians express concern about their prescription when renal function in unknown. This study aimed to determine the prevalence of renal impairment in patients presenting to emergency departments (ED) with a clinical diagnosis of renal colic. Patients and methods: This retrospective observational study included patients with an ED diagnosis of renal colic. Exclusions were patients younger than 18, previous inclusion and missing medical records. The primary outcome of interest was the proportion of patients with abnormal estimated glomerular filtration rate (eGFR), stratified by eGFR group. Results: A total of 1805 patients were studied: median age 46 years and 72% male. In the population overall, the proportion with eGFR less than 45 was 2.6% (95% confidence interval (CI) 2–3.4%). In the subgroup without known renal impairment, the proportion with eGFR less than 45 was 1.7% (95% CI 1.2–2.4%). On multivariate analysis, the only variable predictive of eGFR less than 45 in patients without known renal impairment was age 60 years or older (odds ratio 1.09, 95% CI 1.06–1.12). Conclusion: The proportion of patients with clinical renal colic who have an eGFR less than 45 at ED presentation is very low (<2%). This evidence supports administration of NSAIDs for pain relief in patients without known renal impairment before eGFR is known. Level of evidence: Not applicable for this multicentre audit.
Concussion disclosure in middle and high school youth: Who gets the message and are they trained to receive it?
Authors: Wicklund Alissa , Coatsworth J Douglas 
Published: May 2020

Background Disclosure of concussion is vital for proper diagnosis and treatment. Youth have many stakeholders to whom they may disclose concussion, including parents, peers, coaches, and school personnel. We examined whom high school and middle school youth report concussion and the level of concussion education of the recipients of the disclosure. Methods Data were analyzed from 2362 students, 680 parents, and 150 school personnel who completed an online survey about concussion reporting, education, and training. Results Youth were most likely to disclose concussions to parents, particularly mothers, and their peer group. Middle school youth reported to teachers and school nurses at higher rates than high school youth. High school youth were more likely to disclose concussion to coaches and athletic trainers than middle school youth. While mothers were the most likely recipient of youths’ reporting, they were least likely to have received concussion education. Conclusions Recipients of youth concussion disclosure differs by school level. Parents are the most common recipients of disclosure. The role of school personnel and coaches changes as youth enter high school. Youth primarily report concussions to parents, yet parents receive the least amount of concussion training. These findings highlight the need for targeted concussion training for stakeholder groups as their role in disclosure may differ by school age.
Massive Spondylectomy for Metastatic Spinal Cord Compression From Non–Small-Cell Lung Cancer With Local Failure After Radiotherapy
Authors: Xu Wei , Yang Minglei , Zhao Chenglong , Wang Peng , Deng Kan , Yang Xinghai , Wei Haifeng , Xiao Jianru 
Published: May 2020

Study Design.: A retrospective multivariate analysis. Objective.: To analyze clinical outcomes of surgical treatment and prognostic factors of local failure after stereotactic body radiation therapy (SBRT) in patients with spinal metastatic non–small-cell lung cancer (NSCLC). Methods.: This study included patients with metastatic spinal cord compression (MSCC) from spinal NSCLC after radiotherapy who received massive spondylectomy for circumferential decompression of spinal cord and reconstruction of spinal stability in our center between May 2006 and February 2017. Neurological function was evaluated using the Frankel score. Overall survival (OS) was estimated by the Kaplan-Meier method. Factors with Pvalues ≤.1 were subjected to multivariate analysis for OS by proportional hazard analysis. Values of P<.05 were considered statistically significant. Results.: The mean age of the 55 included patients (36 male and 19 female) was 57.76 ± 8.94 (median 58, range 36-77) years, with a mean postoperative OS of 14.98 ± 14.81 (median 10.0, range 1-84) months. Neurological function was improved in 46 (83.6%) of the 55 patients after surgery. Prognostic analysis suggested that preoperative frankel score (FS) score, visceral metastasis, D-dimer (D-D) level, and neutrophil/lymphocyte ratio (NLR) were independent prognostic factors for selected patients. Conclusions.: Massive spondylectomy could provide circumferential decompression and improve the neurological function of patients with MSCC from spinal NSCLC after radiotherapy. A preoperative FS score of C/D, no visceral metastasis, D-D <1000 μg/L, and NLR <5 are predictors of better prognosis.
The sialyltransferase ST3Gal-IV guides murine T-cell progenitors to the thymus
Authors: Sitte Selina , Doehler Daniela , Sperandio Markus , Marth Jamey D. , Voehringer David 
Published: May 2020

AbstractT lymphocytes are important players in beneficial and detrimental immune responses. In contrast to other lymphocyte populations that develop in the bone marrow, T-cell precursors need to migrate to the thymus for further development. The interaction of P-selectin and P-selectin glycoprotein ligand-1 (PSGL-1) is crucial for thymic entry of T-cell precursors during settings of T-cell lineage reconstitution. PSGL-1 has to be sialylated to function as a ligand for P-selectin, and the sialyltransferase ST3Gal-IV might play a critical role in this process. We therefore investigated the role of ST3Gal-IV for T-cell development using competitive mixed bone marrow chimeric mice. We found that ST3Gal-IV is dispensable for homing and engraftment of hematopoietic precursors in the bone marrow. However, ST3Gal-IV deficiency affects seeding of the thymus by early T-cell progenitors, leading to impaired restoration of the peripheral T-cell compartment. This defect could be restored by ectopic retroviral expression of ST3Gal-IV in hematopoietic stem cells derived from ST3Gal-IV–deficient donor mice. Our findings show that ST3Gal-IV plays a critical and nonredundant role for efficient T-cell lineage reconstitution after bone marrow transplantation.
A survey of the working status of family medicine physicians in clinics and hospitals in Korea
Authors: Shin Hyun-Young 
Published: May 2020

Abstract
Background
In the approximately 35 years since family medicine was established in South Korea, family medicine physicians have sought to expand their expertise to cover clinical fields beyond primary medicine. This study examines their working status and compares the working conditions of family medicine physicians in clinics and hospitals in Korea.

Methods
We conducted an online survey with 4057 family medicine physicians in Korea in 2016. The results were analyzed using descriptive statistics.

Results
Of the respondents, 572 doctors were working in clinics and 441 in hospitals. In the analysis of treatment pattern by doctors, the rate of chronic disease management was 84.7% in clinics and 93.4% in hospitals (p <  0.001), and the rate of diseases covered by national insurance was 74.8% in clinics and 76.9% in hospitals (p = 0.005). Among physicians younger than 40 years, the rate of chronic disease management and diseases covered by national insurance were 64.6 and 68.0% in clinics and 93.6 and 78.5% in hospitals, retrospectively.

Conclusions
Family medicine physicians working in hospitals have higher rates of chronic disease management and diseases covered by national insurance. This discrepancy of treatment pattern became larger for doctors younger than 40 years. More in-depth studies of the treatment pattern and its tendencies between family medicine physicians in clinics and hospitals are needed in the future.
General methods for measuring and comparing medical interventions in childbirth: a framework
Authors: Svelato Alessandro , Ragusa Antonio , Manfredi Piero 
Published: May 2020

Abstract
Background
The continue increase of interventions during labour in low risk population is a controversial issue of the current obstetric literature, given the lack of evidence demonstrating the benefits of unnecessary interventions for women or infants’ health. This makes it important to have approaches to assess the burden of all medical interventions performed.

Methods
Exploiting the nature of childbirth intervention as a staged process, we proposed graphic representations allowing to generate alternative formulas for the simplest measures of the intervention intensity namely, the overall and type-specific treatment ratios. We applied the approach to quantify the change in interventions following a protocol termed Comprehensive Management (CM), using data from Robson classification, collected in a prospective longitudinal cohort study carried out at the Obstetric Unit of the Cà Granda Niguarda Hospital in Milan, Italy.

Results
Following CM a substantial reduction was observed in the Overall Treatment Ratio, as well as in the ratios for augmentation (amniotomy and synthetic oxytocin use) and for caesarean section ratio, without any increase in neonatal and maternal adverse outcomes. The key component of this reduction was the dramatic decline in the proportion of women progressing to augmentation, which resulted not only the most practiced intervention, but also the main door towards further treatments.

Conclusions
The proposed framework, once combined with Robson Classification, provides useful tools to make medical interventions performed during childbirth quantitatively measurable and comparable. The framework allowed to identifying the key components of interventions reduction following CM. In its turn, CM proved useful to reduce the number of medical interventions carried out during childbirth, without worsening neonatal and maternal outcomes.
Are cancer patients better off if they participate in clinical trials? A mixed methods study
Authors: Engelbak Nielsen Zandra , Eriksson Stefan , Schram Harsløf Laurine Bente , Petri Suzanne , Helgesson Gert , Mangset Margrete , Godskesen Tove E. 
Published: May 2020

Abstract
Background
Research and cancer care are closely intertwined; however, it is not clear whether physicians and nurses believe that clinical trials offer the best treatment for patients and, if so, whether this belief is justified. The aim of this study was therefore: (i) to explore how physicians and nurses perceive the benefits of clinical trial participation compared with standard care and (ii) whether it is justified to claim that clinical trial participation improves outcomes for cancer patients.

Methods
A mixed methods approach was used employing semi-structured interviews with 57 physicians and nurses in oncology and haematology and a literature review of the evidence for trial superiority, i.e. the idea that receiving treatment in a clinical trial leads to a better outcome compared with standard care. Inductive thematic analysis was used to examine the interview data. A literature review comprising nine articles was conducted according to a conceptual framework developed by Peppercorn et al. and evaluated recent evidence on trial superiority.

Results
Our findings show that many physicians and nurses make claims supporting trial superiority, however very little evidence is available in the literature comparing outcomes for trial participants and non-participants that supports their assertions.

Conclusions
Despite the recent rapid development and use of targeted therapy and immunotherapy, we find no support for trial participation to provide better outcomes for cancer patients than standard care. Hence, our present results are in line with previous results from Peppercorn et al. A weaker version of the superiority claim is that even if a trial does not bring about a direct positive effect, it brings about indirect positive effects. However, as the value of such indirect effects is dependent on the individual’s specific circumstances and preferences, their existence cannot establish the general claim that treatment in trials is superior. Belief in trial superiority is therefore unfounded. Hence, if such beliefs are communicated to patients in a trial recruitment context, it would provide misleading information. Instead emphasis should be on patients volunteering to give an altruistic contribution to the furthering of knowledge and to the potential benefit of future patients.
Modified percutaneous Kyphoplasty technique in the treatment of osteoporotic thoracolumbar burst fractures: could it reduce the odds of cement leakage?
Authors: Deng Xuan-geng , Xiong Xiao-ming , Wan Dun , Shi Hua-gang , Mei Guo-long , Cui Wei 
Published: May 2020

Abstract
Background
Osteoporotic thoracolumbar burst fracture (OTLBF) is common in seniors. Due to the fracture of the posterior vertebra and spinal canal occupancy, the risk of cement leakage and spine injury is high in OTLBF patients, thus the application of vertebroplasty and kyphoplasty is limited in these patients. This study aims to investigate the efficacy and safety of the modified percutaneous kyphoplasty (MPKP) in the treatment of OTLBF.

Methods
Clinical data of the OTLBF patients treated with MPKP and the osteoporotic thoracolumbar compression fracture (OTLCF) patients undergone PKP from January 2014 to June 2016 were collected. The key procedure of the MPKP was to fill the bone cavity with gel-foam by the first balloon inflation and to press the gel-foam by a second balloon inflation. Pain intensity, Oswestry disability index (ODI), and bone cement leakage of the patients in the two groups were analyzed.

Results
In the burst fracture group, the overall spinal canal occupancy was relatively low, and the maximum occupancy was 1/3 of the sagittal diameter of the spinal canal. The surgical duration was longer in the burst fracture group (39.0 ± 5.0 min with 95% CI: 37.7, 40.3) than in the compression fracture group (31.7 ± 4.3 min with 95% CI: 31.1, 32.3), and the difference between the two groups was statistically significant (Z = -8.668 and P = 0.000). Both the Oswestry disability index (ODI) and the visual analog scales (VAS) were apparently improved, but there was no significant difference between the two groups. Cement leakage occurred in 13 out of the 53 cases (24.5%) in the burst fracture group and 35 out of the 193 cases (18.1%) in the compression fracture group, and there was no significant difference between the two groups (Z = − 1.038 and P = 0.299). Neither group had consequential symptoms, such as spinal cord lesion, pain, and numbness of the peripheral nerve.

Conclusion
Similar to the efficacy of PKP in the treatment of OTLCF, MPKP efficiently reduced the cement leakage rate and improved the safety of the surgery, although it prolonged the surgical duration and introduced more surgical steps.
Practice guidelines on migrants’ health: assessment of their quality and reporting
Authors: Lotfi Tamara , Itani Mohamad I. , Howeiss Pamela , Kilzar Lama , Rizk Nesrine A. , Akl Elie A. 
Published: May 2020

Abstract
Background
Migrants may carry with them communicable and non communicable diseases as they move to the host country. Screening migrants may help in improving their health status and in preventing the spread of infections to the host population.

Objective
To identify and assess the quality of published practice guidelines addressing migrants’ health.

Methods
We included practice guidelines addressing migrants’ health at the clinical, public health or health systems levels. We searched Medline, Embase, the National Guideline Clearinghouse and the Canadian Medical Association’s Clinical Practice Guidelines Database. Two teams of two reviewers conducted in duplicate and independent manner study selection, data abstraction, assessment of the guideline quality (using the AGREE II instrument), and assessment of the quality of the reporting (using the RIGHT statement).

Results
Out of 2732 citations captured by the electronic search, we included 24 eligible practice guidelines, all addressing the level of post-arrival to the host country and published between 2011 and 2017. The majority of guidelines (57%) addressed non-communicable diseases, 95% addressed screening, while 52% addressed prevention and treatment respectively. The majority of the guidelines reported their funding sources. 86% used the GRADE approach as part of the development process. The included guidelines scored high on the majority of the items, and low on the following two domains of the AGREE II instrument: rigor of development and applicability. The mean number of the RIGHT checklist items met by the included guidelines was 27, out of a total of 35. Most of the guidelines were based on systematic reviews (95.6%). A minority of the included guidelines (26%) reported considering the values and preferences of the target populations or the costs and resource implications (30%) in the formulation of recommendations.

Conclusion
We identified 23 practice guidelines addressing migrants’ health, the majority of which addressed screening services. The vast majority of the captured guidelines targeted screening because the population of interest is migrants, meaning that the intention of the guidelines is to deal with additional factors than usual ones, such as prevalence of disease in country of origin, endemic diseases and others.
The guidelines suffered limitations on two quality domains (rigor of development and applicability), and have room for improvement of their reporting.
Point‐of‐care bedside ultrasound examination for the exclusion of clinically significant ankle and fifth metatarsal bone fractures; a single blinded prospective diagnostic cohort study
Authors: Crombach Aniek , Azizi Nasim , Lameijer Heleen , El Moumni Mostafa , ter Maaten Jan C. 
Published: May 2020

AbstractObjectiveThe aim of this study was to assess the diagnostic value of point‐of‐care bedside ultrasound (PoCUS) as in usual clinical practice in suspected ankle and fifth metatarsal bone fractures, compared to the standard of radiographic imaging.MethodsThis prospective study included patients ≥17 years presenting to the Emergency Department with ankle trauma and positive Ottawa Ankle Rules. All patients underwent PoCUS of the ankle by a (resident) emergency physician, the images were assessed by an ultrasound expert. Both were blinded for the medical history and clinical findings of the patients. Radiography of the ankle followed, evaluated by a radiologist blinded from the PoCUS findings. Primary outcome measures were sensitivity and specificity of PoCUS.ResultsA total of 242 patients were included, with 35 (22%) clinically significant (non‐avulsion) fractures observed with radiography. The sensitivity of PoCUS in detecting clinically significant fractures by all sonographers was 80.0% (95% Confidence Interval (CI) 63.0 to 91.6%), specificity 90.3% (95% CI 83.7 to 94.9%), positive predictive value 70.0% (95% CI 57.0 to 80.3%) and the negative predictive value 94.1% (95% CI 89.1 to 96.9%). The sensitivity of PoCUS in detecting clinically significant fractures by the expert was 82.8% (95% CI 66.3 to 93.4%), specificity 99.2% (95% CI 95.5 to 99.9%), positive predictive value 96.7% (95% CI 80.3 to 99.5%) and the negative predictive value 95.3% (95% CI 91.0 to 98.2%).ConclusionPoCUS combined with the OAR has a good diagnostic value in usual clinical practice in the assessment of suspected ankle and fifth metatarsal bone fractures compared to radiographic imaging. More experience with PoCUS will improve the diagnostic value.Trial registrationRegistered in the local Research Register, study number 201500597.
Serum lncRNA HAND2-AS1 is downregulated in diabetic patients with chronic renal failure and ameliorates cell apoptosis
Authors: Dong Changqing , Liu Shengmao , Li Yanling , Cui Yingchun 
Published: May 2020

Abstract
Background
LncRNA HAND2-AS1 has been reported to be a tumor suppressor in several types of malignancy, while its involvement in other human diseases is unclear. Our preliminary RNA-seq analysis revealed the downregulation of lncRNA HAND2-AS1 in diabetic patients with chronic renal failure, indicating the involvement of lncRNA HAND2-AS1 in this disease. This study was therefore carried out to explore the role of lncRNA HAND2-AS1 in the development of chronic renal failure in diabetic patients.

Methods
Mouse podocyte cells and plasma samples of diabetic patients (46 diabetic patients with chronic renal failure, 38 diabetic patients without obvious complications and 42 healthy volunteers) were used in this study. Cell apoptosis assay and PCR were performed.

Results
LncRNA HAND2-AS1 was downregulated in diabetic patients with chronic renal failure but not in diabetic patients without obvious complications. Downregulation of lncRNA HAND2-AS1 distinguished diabetic patients with chronic renal failure from diabetic patients and healthy controls. High glucose environment did not affect the expression of lncRNA HAND2-AS1 in mouse podocyte cells. Overexpression of lncRNA HAND2-AS1 inhibited the apoptosis of mouse podocyte cells under high glucose treatment.

Conclusions
We therefore conclude that lncRNA HAND2-AS1 may participate in the development of chronic renal failure in diabetic patients by regulating cell apoptosis.
Adaptive dictionary learning based on local configuration pattern for face recognition
Authors: Wei Dongmei , Chen Tao , Li Shuwei , Jiang Dongmei , Zhao Yuefeng , Li Tianping 
Published: May 2020

AbstractSparse representation based on classification and collaborative representation based classification with regularized least square has been successfully used in face recognition. The over-completed dictionary is crucial for the approaches based on sparse representation or collaborative representation because it directly determines recognition accuracy and recognition time. In this paper, we proposed an algorithm of adaptive dictionary learning according to the inputting testing image. First, nearest neighbors of the testing image are labeled in local configuration pattern (LCP) subspace employing statistical similarity and configuration similarity defined in this paper. Then the face images labeled as nearest neighbors are used as atoms to build the adaptive representation dictionary, which means all atoms of this dictionary are nearest neighbors and they are more similar to the testing image in structure. Finally, the testing image is collaboratively represented and classified class by class with this proposed adaptive over-completed compact dictionary. Nearest neighbors are labeled by local binary pattern and microscopic feature in the very low dimension LCP subspace, so the labeling is very fast. The number of nearest neighbors is changeable for the different testing samples and is much less than that of all training samples generally, which significantly reduces the computational cost. In addition, atoms of this proposed dictionary are these high dimension face image vectors but not lower dimension LCP feature vectors, which ensures not only that the information included in face image is not lost but also that the atoms are more similar to the testing image in structure, which greatly increases the recognition accuracy. We also use the Fisher ratio to assess the robustness of this proposed dictionary. The extensive experiments on representative face databases with variations of lighting, expression, pose, and occlusion demonstrate that the proposed approach is superior both in recognition time and in accuracy.