bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effects of Aspirin on Postoperative Bruising and Bleeding Complications in Upper Eyelid Surgery
Authors: Winkler Kathryn P. , Beaulieu Robert , Bevill Lauren , Mishulin Aleksey , Black Evan H. 
Published: April 2020

Purpose:
We evaluated the effects of aspirin versus placebo in patients undergoing upper eyelid blepharoplasty and/or levator advancement or plication blepharoptosis repair in this randomized, prospective study.

Methods:
Patients who presented between October 2017 and April 2019 requiring blepharoptosis repair and/or upper eyelid blepharoplasty who were taking 81 mg aspirin were randomized to receive 1 week of aspirin tablets or 1 week of placebo tablets prior to surgery. Postoperative complications, such as bleeding, hematoma, or hemorrhage, were noted as well as perioperative thromboembolic complications. Photos were obtained at the patient’s first postoperative visit and later judged on bruising severity. The 2 groups were subsequently compared.

Results:
A total of 48 patients and 89 eyelids were evaluated in this study. Fifty-two eyelids were included in the aspirin group and 37 eyelids were included in the placebo group. There was no statistically significant difference in bruising rating between groups. There was no statistically significant difference in the number of patients who experienced mild postoperative bleeding. No patients experienced vision loss. No patients experienced a thromboembolic event. There were no patients who experienced hemorrhage, hematoma, or retrobulbar hemorrhage.

Conclusions:
Continuation of aspirin does not appear to effect outcomes with respect to postoperative bruising in patients undergoing upper eyelid blepharoplasty or blepharoptosis repair. The study was not powered to determine statistical significance with regard to bleeding complications and would require a significantly higher sample size. We suggest changing the current guidelines to recommend routine continuation of low dose 81 mg aspirin before upper eyelid surgery.
Identifiable relatives in the family history: not without individual consent
Authors: Nunes José Pedro L. , Faria Maria do Sameiro , Abreu Amorim Carlos 
Published: April 2020

Abstract
The family history is a traditional section of the clinical record. Data on family members in the clinical record may be anonymous but yet these may be easily identifiable; therefore, exposing the relatives of the patient to the fact that a written record is produced, mentioning them, without their consent. This is in direct contradiction with European data protection and other regulations and in contradiction with a reasonable ethical perspective. For the purpose of obtaining an image of the present state of affairs, we used as a convenience sample, the series of Case Records published in 2019 in The New England Journal of Medicine (January to December). From a total number of 40 reports, identifiable relatives were present in 30. The number of identifiable relatives varied between none and 6. It is not the right of each individual to disclose sensitive clinical information regarding other persons, without consent from these latter. Family history should no longer include identifiable relatives, unless consent is obtained from each identifiable person. The authors offer the following guidelines on this topic: (1) Do not mention any identifiable relative of the patient in the medical history without consent from the said relative; (2) Do not mention in the family history clinical conditions seemingly unrelated to the present clinical situation; (3) Do not mention in the family history clinical conditions that the patient does not (him/) herself have and that may be seen as social stigmata; (4) Consult the institutional Ethics committee in case of reasonable doubt.
NursE led Atrial Fibrillation Management: The NEAT Study
Authors: Gallagher Celine , Orchard Jessica , Nyfort-Hansen Karin , Sanders Prashanthan , Neubeck Lis , Hendriks Jeroen M. 
Published: April 2020

Background
Atrial fibrillation (AF) is a growing epidemic. Current models of care delivery are inadequate in meeting the needs of the population with AF. Furthermore, quality of life is known to be poor in patients with AF and is associated with adverse patient outcomes.

Objective
The aim of this study was to determine if nurse-led education and cardiovascular risk factor modification, undertaken using the principles of motivational interviewing, facilitated by an electronic decision support tool to ensure the appropriate use of oral anticoagulation (OAC), could improve health-related quality of life (HRQoL), guideline adherence to OAC, and cardiovascular risk factor profiles in individuals with AF.

Methods
This was a multicenter, prospective, randomized controlled feasibility study of 72 individuals with AF. The intervention involved 1 face-to-face nurse-delivered education and risk factor management session with 4 follow-up telephone calls over a 3-month period to monitor progress. The primary outcome measure was HRQoL as assessed by the Short Form-12 survey.

Results
A total of 72 participants were randomized, with 36 individuals in each arm completing follow-up. Mean age was 65 ± 11 years and 44% were women. At 3 months follow-up, no significant differences between groups were observed for the physical or mental component summary scores of the Short Form-12, nor any of the subscales. Appropriate use of OAC did not differ between groups at final follow-up.

Conclusions
A brief nurse-delivered educational intervention did not significantly impact on HRQoL or risk factor status in individuals with AF. Further research should focus on interventions of greater intensity to improve outcomes in this population.
Trial Registration: ACTRN12615000928516
Cardiac Iron Overload by MRI in Children With B-Thalassemia Major and its Correlation With Cardiac Function by Echocardiography
Authors: El-Shanshory Mohammed , Tolba Osama , El-Shafiey Rasha , Elgamasy Mohamed , Hablas Nahed , Mawlana Wegdan 
Published: April 2020

Background:
Serial echocardiography is strongly recommended in asymptomatic B-thalassemia major (TM) patients for early detection of subtle cardiac dysfunction. T2*magnetic resonance imaging (MRI) is a noninvasive measurement of myocardial iron burden. Yet, it is not always available in many centers. Our study aimed to evaluate the myocardial function in TM patients using different echocardiographic modalities and to correlate these findings with cardiac T2*MRI.

Patients and Methods:
This is a cross-sectional study that was carried out on 140 children with a mean age of 10.9±3.7 years. One hundred children with TM and 40 healthy children were matched for age and sex as a control group. Serum ferritin, serum iron, and iron-binding capacity were measured. Cardiac iron overload was assessed by T2*MRI and cardiac function was assessed by echocardiography. The local ethics committee approved the study.

Results:
Among 100 children with TM, only 32% had cardiac iron overload of 8.525±5.45 detected by cardiac T2*MRI. Iron deposition correlated significantly with age. Markers of iron overload were significantly correlated with cardiac T2*MRI. There were significantly lower values of myocardial performance index, longitudinal strain, circumferential strain, area strain, and radial strain in TM patients compared with the controls (P<0.001). Only the myocardial performance index was correlated with T2*MRI.

Conclusions:
This study confirms that some parameters measured by tissue Doppler imaging such as the myocardial performance index could be useful for the early detection of cardiac impairment in asymptomatic TM patients when cardiac MRI is lacking. Further studies on a large scale to identify other parameters with high sensitivity are recommended.
Septic Polyarthritis by Staphylococcus aureus of “Unknown Origin”
Authors: Azevedo Soraia , Sousa-Neves Joana , Santos-Faria Daniela , Silva Joana Leite , Rodrigues Joana Ramos , Peixoto Daniela , Alcino Sérgio , Teixeira Filipa , Afonso Carmo , Tavares-Costa José 
Published: April 2020

Abstract
More than 90% of septic arthritis cases are monoarticular. Joint infection can occur through several mechanisms such as hematogenous dissemination, by contiguity from adjacent infected soft tissue, surgical contamination, direct inoculation, or joint trauma.
We report the case of a 69-year-old man admitted to our hospital with septic polyarthritis. The presented case is remarkable given its atypical presentation. The patient had no known risk factors for septic arthritis, comorbidities, or history of recurrent infections that could suggest some degree of immunosuppression. The atypical polyarticular involvement at presentation, the absence of sustained fever, and the good general condition of the patient delayed the diagnosis and treatment.
X-ray Dark-Field Radiography
Authors: Braig Eva-Maria , Roiser Nathalie , Kimm Melanie A. , Busse Madleen , Andrejewski Jana , Scholz Josef , Petrich Christian , Gustschin Alex , Sauter Andreas , Bodden Jannis , Meurer Felix , Korbel Rüdiger , Pfeiffer Franz , Herzen Julia , Pfeiffer Daniela 
Published: April 2020

Objective
The aim of this study was to evaluate the potential of x-ray dark-field radiography for the noninvasive detection of monosodium urate (MSU) crystals as a novel diagnostic tool for gout.

Materials and Methods
Contrast-to-noise ratios of MSU crystals in conventional radiography and dark-field radiography have been compared in a proof of principle measurement. Monosodium urate crystals have been injected into mouse legs in an ex vivo experimental gout setup. Three radiologists independently evaluated the images for the occurrence of crystal deposits in a blinded study for attenuation images only, dark-field images only, and with both images available for a comprehensive diagnosis. All imaging experiments have been performed at an experimental x-ray dark-field setup with a 3-grating interferometer, a rotating anode tube (50 kVp), and a photon-counting detector (effective pixel size, 166 μm).

Results
X-ray dark-field radiography provided a strong signal increase for MSU crystals in a physiological buffer solution compared with conventional attenuation radiography with a contrast-to-noise ratio increase from 0.8 to 19.3. Based on conventional attenuation images only, the reader study revealed insufficient diagnostic performance (sensitivity, 11%; specificity, 92%) with poor interrater agreement (Cohen's coefficient κ = 0.031). Based on dark-field images, the sensitivity increased to 100%, specificity remained at 92%, and the interrater agreement increased to κ = 0.904. Combined diagnosis based on both image modalities maximized both sensitivity and specificity to 100% with absolute interrater agreement (κ = 1.000).

Conclusions
X-ray dark-field radiography enables the detection of MSU crystals in a mouse-based gout model. The simultaneous avaliability of a conventional attenuation image together with the dark-field image provides excellent detection rates of gout deposits with high specificity.
177Lu-DOTATOC Peptide Receptor Radionuclide Therapy in a Patient With Neuroendocrine Breast Carcinoma and Breast Invasive Ductal Carcinoma
Authors: Liu Qingxing , Zhang Jingjing , Kulkarni Harshad R. , Baum Richard P. 
Published: April 2020

Abstract
Radiolabeled somatostatin analogs for somatostatin receptor (SSTR)–targeted imaging and peptide receptor radionuclide therapy (PRRT) have demonstrated remarkable success in the management of SSTR-expressing neuroendocrine neoplasms. Primary neuroendocrine breast carcinoma is rare. Heterogeneous SSTR overexpression has also been documented in breast cancer, in both human breast cancer specimens and clinical studies. We report here a case of a 69-year-old woman who had both breast invasive ductal carcinoma and primary large-cell neuroendocrine breast carcinoma (Ki-67 proliferation index of 20%), with disseminated bone and lymph node metastases, demonstrating exceptional tracer uptake on 68Ga-DOTATOC PET/CT, and remarkably partial remission after 177Lu-DOTATOC PRRT.
Low-Grade Versus High-Grade Glioma… That Is the Question. 18F-Fluorocholine PET in the Detection of Anaplastic Focus
Authors: García Vicente Ana María , Cordero García José Manuel , López Menéndez Carlos , Borrás Moreno Jose María , Soriano Castrejón Angel 
Published: April 2020

Abstract
Gliomas are characterized by intratumoral histological heterogeneity, coexisting foci of low and high grade. First, in low-grade gliomas, neoangiogenesis has not yet developed and cellularity is low, so alterations on perfusion MRI may not be present. Second, a non-negligible number of high-grade gliomas show none, patchy, or weak contrast enhancement on MRI, so they can be misdiagnosed as low-grade glioma, preventing their correct management. We present 4 cases of patients in which 18F-fluorocholine PET defined the anaplastic tumor component and therefore the tumor aggressiveness, solving the limitations of MRI.
Radiation Dose Reduction Using a Novel Fluoroscopy System in Patients Undergoing Diagnostic Invasive Coronary Angiography
Authors: Kraemer Bjoern F. , Tesche Christian , Hapfelmeier Alexander , Finsterer Sebastian , Ebersberger Ullrich , Schlüter Mathis , Ziegler Martin , Martens Eimo , Laugwitz Karl-Ludwig , Schmidt Martin 
Published: April 2020

Background:
Invasive coronary angiography (ICA) still causes a significant amount of radiation exposure for patients and operators. In February 2017, the Azurion system was introduced, a new-generation fluoroscopy image acquisition and processing system. Radiation exposure in patients undergoing ICA was assessed comparing the novel Azurion 7 F12 angiography system to its predecessor Allura Xper in a randomized manner.

Methods:
Radiation exposure was prospectively analyzed in 238 patients undergoing diagnostic ICA. Patients were randomly assigned to the novel Azurion system (119 patients) or its predecessor Allura Xper system (119 patients). In each patient, 8 predefined standard projections (5 left coronary artery, 3 right coronary artery) were performed. Image quality was quantified by grading of the images on the basis of a 5-point grading system.

Results:
Radiation dose area product was significantly lower in the Azurion group 109 (interquartile range [IQR 75-176] cGy cm2) compared with the Allura Xper group 208 [IQR 134-301] cGy cm2 (P<0.001). Body mass index (26.6 [IQR 23.9-29.7] kg/m2 vs. 26.2 [IQR 24.2-29.4] kg/m2; P=0.607), body surface area (1.96 [IQR 1.81-2.11] m2 vs. 1.90 [IQR 1.77-20.4] m2; P=0.092), and procedure duration (1.5 [IQR 1.2-2.3] min vs. 1.6 [IQR 1.2-2.5] min; P=0.419) were similar in both groups. Images from the Azurion system were at least of equal quality compared with Allura Xper (image quality grade 4.82±0.45 vs. 4.75±0.52, P=0.43).

Conclusion:
Use of the novel Azurion 7 F12 angiography system resulted in a significant reduction of dose area product in patients undergoing diagnostic ICA by 56%.
Estimating effects of intervention measures on COVID-19 outbreak in Wuhan taking account of improving diagnostic capabilities using a modelling approach
Authors: Liang Jingbo , Yuan Hsiang-Yu , Wu Lindsey , Pfeiffer Dirk U. 
Published: April 2020

AbstractBackgroundAlthough by late February 2020 the COVID-19 epidemic was effectively controlled in Wuhan, China, the virus has since spread around the world and been declared a pandemic on March 11. Estimating the effects of interventions, such as transportation restrictions and quarantine measures, on the early COVID-19 transmission dynamics in Wuhan is critical for guiding future virus containment strategies. Since the exact number of COVID-19 infected cases is unknown, the number of documented cases was used by many disease transmission models to infer epidemiological parameters. However, this means that it would not be possible to adequately estimate epidemiological parameters and the effects of intervention measures, because the percentage of all infected cases that were documented changed during the first 2 months of the epidemic as a consequence of a gradually increasing diagnostic capability.MethodsTo overcome the limitations, we constructed a stochastic susceptible-exposed-infected-quarantined-recovered (SEIQR) model, accounting for intervention measures and temporal changes in the proportion of new documented infections out of total new infections, to characterize the transmission dynamics of COVID-19 in Wuhan across different stages of the outbreak. Pre-symptomatic transmission was taken into account in our model, and all epidemiological parameters were estimated using Particle Markov-chain Monte Carlo (PMCMC) method.ResultsOur model captured the local Wuhan epidemic pattern as a two-peak transmission dynamics, with one peak on February 4 and the other on February 12, 2020. The impact of intervention measures determined the timing of the first peak, leading to an 86% drop in the Re from 3.23 (95% CI, 2.22 to 4.20) to 0.45 (95% CI, 0.20 to 0.69). An improved diagnostic capability led to the second peak and a higher proportion of documented infections. Our estimated proportion of new documented infections out of the total new infections increased from 11% (95% CI 1% - 43%) to 28% (95% CI 4% - 62%) after January 26 when more detection kits were released. After the introduction of a new diagnostic criterion (case definition) on February 12, a higher proportion of daily infected cases were documented (49% (95% CI 7% - 79%)).
LesionQuant for assessment of MRI in multiple sclerosis - a promising supplement to the visual scan inspection
Authors: Brune Synne , Høgestøl Einar A. , Cengija Vanja , Berg-Hansen Pål , Sowa Piotr , Nygaard Gro O. , Harbo Hanne F. , Beyer Mona K. 
Published: April 2020

AbstractBackground and goalsMultiple sclerosis (MS) is a central nervous system inflammatory disease where magnetic resonance imaging (MRI) is an important tool for diagnosis and disease monitoring. Quantitative measurements of lesion volume, lesion count, distribution of lesions and brain atrophy have a potentially significant value for evaluating disease progression. We hypothesize that utilizing software designed for evaluating MRI data in MS will provide more accurate and detailed analyses compared to the visual neuro-radiological evaluation.MethodsA group of 56 MS patients (mean age 35 years, 70% females and 96% relapsing-remitting MS) was examined with brain MRI one and five years after diagnosis. The T1 and FLAIR brain MRI sequences for all patients were analysed using the LesionQuant(LQ) software. These data were compared with data from structured visual evaluations of the MRI scans performed by a neuro-radiologist, including assessments of atrophy and lesion count. Correlations with clinical tests like the timed 25-foot walk test (T25FT) were performed to explore additional value of LQ analyses.ResultsLesion count assessments by LQ and by the neuro-radiologist were significantly correlated one year (cor=0.92, p=2.2×10−16) and five years (cor=0.84, p=2.7×10−16) after diagnosis. LQ detected a reduction in whole brain percentile >10 in 10 patients across the time-points, whereas the neuro-radiologist assessment identified six of these. The neuro-radiologist additionally identified five patients with increased atrophy in the follow-up period, all of them displayed decreasing low whole brain percentiles (median 11, range 8-28) in the LQ analysis. Significant positive correlation was identified between lesion volume measured by LQ and test performance on the T25FT both at one year and five years after diagnosis.ConclusionFor the number of MS lesions at both time-points, we demonstrated strong correlations between the assessments done by LQ and the neuro-radiologist. Lesion volume evaluated with LQ correlated with T25FT performance. LQ-analyses were more sensitive in capturing brain atrophy than the visual neuro-radiological evaluation. In conclusion, LQ seems like a promising supplement to the evaluation performed by neuro-radiologists, providing an automated tool for evaluating lesions and brain volume in MS patients in both a longitudinal and cross-sectional setting.
Simulation of trajectories in the illness-death model for chronic diseases: discrete event simulation, Doob-Gillespie algorithm and coverage of Wald confidence intervals
Authors: Brinks Ralph , Hoyer Annika 
Published: April 2020

AbstractWe compare two approaches for simulating events in the illness-death model in a test example about type 2 diabetes in Germany. The first approach is a discrete event simulation, where relevant events, i.e., onset of disease and death, are simulated for each subject individually. The second approach is the Doob-Gillespie algorithm, which simulates the number of people in each state of the illness-death model at each point in time. The algorithms are compared in terms of bias, variance and speed. Based on the results of the comparison in the test example, we assess coverage of the corresponding Wald confidence intervals.
Dynamic Estimation of Epidemiological Parameters of COVID-19 Outbreak and Effects of Interventions on Its Spread
Authors: Zhang Hongzhe , Zhao Xiaohang , Yin Kexin , Yan Yiren , Qian Wei , Chen Bintong , Fang Xiao 
Published: April 2020

AbstractA key challenge for estimating the epidemiological parameters of the COVID-19 out-break in Wuhan is the discrepancy between the officially reported number of infections and the true number of infections. A common approach to tackling the challenge is to use the number of infections exported from Wuhan to infer the true number in the city. This approach can only provide a static estimate of the epidemiological parameters before Wuhan lockdown on January 23, 2020, because there are almost no exported cases thereafter. Here, we propose a method to dynamically estimate the epidemiological parameters of the COVID-19 outbreak in Wuhan by recovering true numbers of infections from day-to-day official numbers. Using the method, we provide a comprehensive retrospection on how the disease had progressed in Wuhan from January 19 to March 5, 2020. Particularly, we estimate that the outbreak sizes by January 23 and March 5 were 11,239 [95% CI 4,794–22,372] and 124,506 [95% CI 69,526–265,113], respectively. The effective reproduction number attained its maximum on January 24 (3.42 [95% CI 3.34–3.50]) and became less than 1 from February 7 (0.76 [95% CI 0.65–0.92]). We also estimate the effects of two major government interventions on the spread of COVID-19 in Wuhan. In particular, transportation suspension and large scale hospitalization respectively prevented 33,719 and 90,072 people from getting infected in the nine-day time period right after its implementation.
Synchronized travel restrictions across cities can be effective in COVID-19 control
Authors: Liu Haiyan , Bai Xuemei , Shen Huanfeng , Pang Xiaoping , Liang Zeyu , Liu Yue 
Published: April 2020

AbstractThe COVID-19 outbreak is under control in China. Mobility interventions, including both the Wuhan lockdown and travel restrictions in other cities, have been undertaken in China to mitigate the epidemic. However, the impact of mobility restrictions in cites outside Wuhan has not been systematically analyzed. Here we ascertain the relationships between all mobility patterns and the epidemic trajectory in Chinese cities outside Hubei Province, and we estimate the impact of local travel restrictions. We estimate local inter-city travel bans averted 22.4% (95% PI: 16.8–27.9%) more infections in the two weeks after the Wuhan lockdown, while local intra-city travel prevented 32.5% (95% PI: 18.9–46.1%) more infections in the third and fourth weeks. More synchronized implementation of mobility interventions would further decrease the number of confirmed cases in the first two weeks by 15.7% (95% PI:15.4–16.0%). This study shows synchronized travel restrictions across cities can be effective in COVID-19 control.