bluuebunny/crossref_metadata_2025_split huggingface dataset:
Vaginal stones caused by urethrovaginal fistula
Authors: Wei Dongmei , Xie Yao , Niu Xiaoyu 
Published: November 2019

Abstract

Rationale:
Vaginal stone is a rare condition that is often misdiagnosed due to its low incidence. It can be divided into 2 types, primary vaginal and secondary vaginal, based on the etiology of the disease. Vaginal stones involve pathologic calcification. The formation of vaginal stones is mainly due to stasis and urine infection. We describe a procedure for the safe extraction of vaginal stones.

Patient concerns:
We report a case of a 25-year-old female patient with congenital genitourinary malformation and urethrovaginal fistula. A urogenital tract malformation repair operation was performed before she was 21 years old. Frequency of urination occurred before and after menstruation for 9 years, and dyspareunia occurred for 1 year.

Diagnoses:
B ultrasound examination showed a 59 × 55 × 23 mm fusiform region of increased signal intensity in the vagina followed by a sound shadow. We performed a gynecologic examination and found that the long diameter of the vaginal opening was 20 mm. A brown substance observed in her vagina had a hard texture and felt like a stone, and a palpation hand test revealed the size was approximately 60 × 50 mm. A cystoscope was inserted into the urethra and revealed that the broken end of the urethra was connected to the vagina. The proximal broken end of the urethra was 20 mm from the distal end.

Interventions:
The purpose of this operation was to make a definite diagnosis and remove the stones. We performed vaginal stone removal surgery and cystoscopy under anesthesia.

Outcomes:
We removed the stone successfully. The patient was discharged from the hospital after a smooth recovery without any complications. Follow-up was conducted 1 month after the operation and then every 3 months.

Lessons:
Although vaginal stones are rare, we must pay attention to this disease, especially in patients with congenital genitourinary malformations and urethrovaginal or vesicovaginal fistulas. Obstruction of urine discharge combined with repeated urinary tract infection is the main cause of vaginal stone formation. For these patients, follow-up every 3 months, including a physical examination, B-mode ultrasonography of the urinary system and cystoscopy if necessary, can avoid the occurrence of the disease.
Comparison of survival outcomes of alcohol-related hepatocellular carcinoma with or without liver cirrhosis; a ten-year experience
Authors: Shin Jongbeom , Yu Jung Hwan , Jin Young-Joo , Chae Myoung Hun , Yoon Chang Hwi , Lee Jin-Woo 
Published: November 2019

Abstract
We evaluated overall survivals (OSs) of alcohol-related hepatocellular carcinoma (HCC) patients without LC compared to those with LC.
Between 2005 and 2015, 1343 patients were initially diagnosed as having HCC in our hospital. Of these, 186 alcohol-related HCC patients were enrolled in this study, and their medical records were retrospectively analyzed. Significant alcohol intake was defined as more than 210 grams/week for men and more than 140 grams/week for women.
Non-cirrhotic HCC was observed in 37.1% of the 186 patients. Cumulative OS rates were significantly higher in non-cirrhotic patients (P = .006). For the 117 cirrhotic patients, cumulative OS rate was significantly higher in the CTP class A patients than in the CTP class B (P < .001) or CTP class C (P < .001) patients, respectively. In the 69 non-cirrhotic patients, cumulative OS rate was significantly higher in the CTP class A patients than in the CTP class C patients (P < .001), but, not than in the CTP class B patients (P = .157). Multivariate analyses revealed that CTP class B (P
< .001), CTP class C (P
< .001), and tumor size (P = .006) were significant predictors for OS in cirrhotic patients, and that CTP class C (P
= .002) and tumor size (P = .023) were significant predictors for OS in non-cirrhotic patients.
OS was found to be better for non-cirrhotic than cirrhotic patients with alcohol-related HCC. Survivals of alcohol-related HCC patients without cirrhosis were comparable between patients with CTP class A and B.
Are inferior facetectomies adequate and suitable for surgical treatment of adolescent idiopathic scoliosis?
Authors: Yoshihara Hiroyuki , Penny Gregory S. , Kaur Harleen , Shah Neil V. , Paulino Carl B. 
Published: November 2019

Abstract

Study Design:
Retrospective review.

Background:
Inferior facetectomies, with the utilization of segmental pedicle screw constructs for corrective fixation, can provide adequate flexibility and post less risk of neural tissue and blood loss. We analyzed outcomes of surgical treatment for adolescent idiopathic scoliosis (AIS) using inferior facetectomies and segmental pedicle screw constructs. We hypothesized that adequate main curve correction and suitable surgical outcomes would be observed using this technique.

Methods:
We reviewed 38 AIS patients who underwent inferior facetectomies and segmental pedicle screw constructs by 2 surgeons at a single institution between May 2014 and December 2016. Coronal and sagittal radiographic measurements were evaluated over 1-year follow-up by 2 trained observers not associated with the surgeries. Surgical details, complications, and hospital length of stay (LOS) were also recorded.

Results:
Mean fusion levels were 11.0 ± 1.7. The mean Cobb angle of main AIS curves improved from 48.6± 10.1 degree preoperatively to 11.8± 6.2 degree postoperatively and 12.4± 6.2 degree at 1-year follow-up, which percentage correction was 75.9% and 74.6%, respectively. The mean thoracic kyphosis (T5-12) angle was 20.7± 11.6 degree preoperatively, 17.4± 8.0 degree postoperatively, and 16.8± 8.4 degree at 1-year follow-up. The mean surgical time, estimated blood loss, and LOS were 232.4 ± 35.7 minutes, 475.0 ± 169.6 mL, and 3.5 ± 1.3 days. Twelve patients received blood transfusion. There were no neurological or wound complications.

Conclusions:
This case series demonstrated adequate correction of main AIS curves, acceptable thoracic kyphosis and blood loss, and short surgical time and LOS in AIS patients treated with inferior facetectomies and segmental pedicle screw constructs, potentially indicating that inferior facetectomies are adequate and suitable for AIS surgery when segmental pedicle screw constructs are utilized.
Comparison of computer-assisted navigation and conventional instrumentation for bilateral total knee arthroplasty
Authors: Hsu Robert Wen-Wei , Hsu Wei-Hsiu , Shen Wun-Jer , Hsu Wei-Bin , Chang Shr-Hsin 
Published: November 2019

Abstract
It remains unclear if computer-assisted surgery (CAS) technique actually improves the clinical outcomes of total knee arthroplasty (TKA) and decreases the failure rate. The purpose of this retrospective study was to compare the functional results of TKA in a series of patients who underwent staged bilateral TKAs with CAS TKA in 1 knee and conventional TKA in the contralateral knee.
From January 1997 to December 2010, we collected 60 patients who were randomly assigned to receive CAS TKA in 1 limb and conventional TKA in the other. The Brainlab Vector Vision navigation system was used for CAS TKA, and the DePuy press-fit condylar sigma guide system was used for conventional TKA. Patients were assessed before surgery, 3 months and 1 year after surgery, and annually thereafter. IKS criteria were used for radiographic evaluation. Clinical and functional evaluation using the scoring system of hospital for special surgery (HSS), international knee society (IKS), Western Ontario and McMaster University osteoarthritis index (WOMAC), and short form-36 (SF-36) were obtained on each knee, before surgery, and at each follow-up visit. Pertinent statistical methods were adopted for data analysis.
Fifty-six patients were available for analysis and 44 of the patients were female. The mean duration of follow-up was 8.1 years. Less blood loss (P = .007) and longer operation time were noted for CAS TKAs when compared with conventional TKAs. Precise alignment and fewer outliers of the lower limb and prosthetic component positions were found for CAS TKAs (P < .001). There were no differences between the 2 groups before surgery and at the latest follow-up with regard to scores for HSS, IKS, WOMAC, and SF-36 as well as active range of motion.
The clinical outcomes of CAS TKAs at the 8-year follow-up were similar to those of conventional TKAs despite the better radiographic alignment and fewer outliers achieved with navigation assistance.
Hemodynamic effects of inotropic drugs in heart failure
Authors: Long Ling , Zhao Hao-tian , Shen Li-min , He Cong , Ren Shan , Zhao He-ling 
Published: November 2019

Abstract

Background:
There is currently no consensus on the appropriate selection of inotropic therapy in ventricular dysfunction. The objective of the study was to detect the effects of different inotropes on the hemodynamics of patients who developed low cardiac output.

Methods:
PubMed, Embase, and the Cochrane Central Register of Controlled Trials (CENTRAL) were searched (all updated December 31, 2017). The inclusion criteria were as follows: low cardiac index (CI < 2.5 L/min/m2) or New York Heart Association class II–IV, and at least 1 group receiving an inotropic drug compared to another group receiving a different inotropic/placebo treatment. The exclusion criteria were studies published as an abstract only, crossover studies, and studies with a lack of data on the cardiac index.

Results:
A total of 1402 patients from 37 trials were included in the study. Inotropic drugs were shown to increase the cardiac index (0.32, 95%CI:0.25, 0.38), heart rate (7.68, 95%CI:6.36, 9.01), and mean arterial pressure (3.17, 95%CI:1.96, 4.38) than the placebo. Overall, the pooled estimates showed no difference in terms of cardiac index, heart rate, mean arterial pressure, systemic vascular resistance, and mean pulmonary arterial pressure among the groups receiving different inotropes.

Conclusions:
Our systematic review found that inotrope therapy is not associated with the amelioration of hemodynamics. An accurate evaluation of the benefits and risks, and selection of the correct inotropic agent is required in all clinical settings.
The Impact of Low Socioeconomic Status in Adults With Chronic Pain
Authors: Booher Lydia 
Published: November 2019

OBJECTIVE:
The objective of this study was to describe evidence about chronic pain (CP) in lower socioeconomic status (SES) adult populations.

DESIGN:
The study design was an integrative review.

DATA SOURCES used were MEDLINE, CINAHL, and PsycINFO, published from January 2008 to February 2018.

REVIEW/ANALYSIS METHOD:
Whittemore and Kanfl's 5 staged methodology (problem identification, literature search, data evaluation, data analysis, and presentation) was used to guide the review.

RESULTS:
Disparities based on SES affect CP development and management. Childhood risk factors impact CP experience over the life course. Neighborhood SES affects pain-related outcomes, and those with lower SES in rural settings have a higher prevalence of prescription opioid use.

NURSING IMPLICATIONS:
Findings from this review will support nurses to interpret CP through the lens of SES.
Elective Revisions after Breast Reconstruction: Results from the Mastectomy Reconstruction Outcomes Consortium
Authors: Nelson Jonas A. , Voineskos Sophocles H. , Qi Ji , Kim Hyungjin M. , Hamill Jennifer B. , Wilkins Edwin G. , Pusic Andrea L. 
Published: November 2019

Background:
Rates of breast reconstruction following mastectomy continue to increase. The objective of this study was to determine the frequency of elective revision surgery and the number of procedures required to achieve a stable breast reconstruction 2 years after mastectomy.

Methods:
Women undergoing first-time breast reconstruction after mastectomy were enrolled and followed for 2 years, with completion of reconstruction occurring in 1996. Patients were classified based on the absence or presence of complications. Comparisons within cohorts were performed to determine factors associated with revisions and total procedures. Mixed-effects regression modeling identified factors associated with elective revisions and total operations.

Results:
Overall, 1534 patients (76.9 percent) had no complications, among whom 40.2 percent underwent elective revisions. The average number of elective revisions differed by modality (p < 0.001), with abdominally based free autologous reconstruction patients undergoing the greatest number of elective revisions (mean, 0.7). The mean total number of procedures also differed (p < 0.001), with tissue expander/implant reconstruction patients undergoing the greatest total number of procedures (mean, 2.4). Complications occurred in 462 patients (23.1 percent), with 67.1 percent of these patients undergoing elective revisions, which was significantly higher than among patients without complications (p < 0.001). The mean number of procedures again differed by modality (p < 0.001) and followed similar trends, but with an increased mean number of revisions and procedures overall. Mixed-effects regression modeling demonstrated that patients experiencing complications had increased odds of undergoing elective revision procedures (OR, 3.2; p < 0.001).

Conclusions:
Breast reconstruction patients without complications undergo over two procedures on average to achieve satisfactory reconstruction, with 40 percent electing revisions. If a complication occurs, the number of procedures increases.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Risk, II.
Five Challenges in the Design and Conduct of IS Trials for HIV Prevention and Treatment
Authors: Hargreaves James R. , Hassan Syreen , Schellenberg Joanna , Hayes Richard , Webster Jayne , Lewis James J. 
Published: November 2019

Background:
Implementation science (IS) trials in HIV treatment and prevention evaluate implementation strategies that deliver health-enhancing tools such as antiretroviral medicines or prevention technologies to those who need them, rather than evaluating the tools themselves.

Method:
Opinion piece drawing on a non-systematic review of HIV prevention and treatment trials to inform an assessment of 5 key challenges for IS trials.

Results:
Randomized controlled trials (RCTs) are an appropriate design for IS but must address 5 challenges. IS trials must be feasible to deliver, which will require addressing challenges in maintaining multisectoral partnerships, strengthening routine data, and clarifying ethical principles. IS trials should be informative, evaluating implementation strategies that are well designed and adequately described, and measuring implementation outcomes, coverage of tools, and, when appropriate, epidemiological impacts. IS trials should be rigorous, striving for internally valid estimates of effect by adopting best practices, and deploying optimal nonrandomized designs where randomization is not feasible. IS trials should be relevant, considering and documenting how “real-life” is the implementation monitoring and whether research participants are representative of the target population. Finally, IS trials should be useful, deploying process evaluations to provide results that can be used in onward decision-making.

Conclusions:
IS trials can help ensure that efficacious tools for HIV prevention and treatment have maximum impact in the real world. These trials will be an important component of this scientific agenda if they are feasible to deliver and if their results are informative, rigorous, relevant, and useful.
Use of Organ Dysfunction as a Primary Outcome Variable Following Cecal Ligation and Puncture: Recommendations for Future Studies
Authors: Abraham Mabel N. , Kelly Alexander P. , Brandwein Ariel B. , Fernandes Tiago D. , Leisman Daniel E. , Taylor Matthew D. , Brewer Mariana R. , Capone Christine A. , Deutschman Clifford S. 
Published: November 2019

ABSTRACT
Outcomes variables for research on sepsis have centered on mortality and changes in the host immune response. However, a recent task force (Sepsis-3) revised the definition of sepsis to “life-threatening organ dysfunction caused by a dysregulated host response to infection.” This new definition suggests that human studies should focus on organ dysfunction. The appropriate criteria for organ dysfunction in either human sepsis or animal models are, however, poorly delineated, limiting the potential for translation. Further, in many systems, the difference between “dysfunction” and “injury” may not be clear. In this review, we identify criteria for organ dysfunction and/or injury in human sepsis and in rodents subjected to cecal ligation and puncture (CLP), the most commonly used animal model of sepsis. We further examine instances where overlap between human sepsis and CLP is sufficient to identify translational endpoints. Additional verification may demonstrate that these endpoints are applicable to other animals and to other sepsis models, for example, pneumonia. We believe that the use of these proposed measures of organ dysfunction will facilitate mechanistic studies on the pathobiology of sepsis and enhance our ability to develop animal model platforms to evaluate therapeutic approaches to human sepsis.
Suppression of DSB Formation by Polβ in Active DNA Demethylation is Required for Postnatal Hippocampal Development
Authors: Uyeda Akiko , Onishi Kohei , Hirayama Teruyoshi , Hattori Satoko , Miyakawa Tsuyoshi , Yagi Takeshi , Yamamoto Nobuhiko , Sugo Noriyuki 
Published: November 2019

AbstractGenome stability is essential for brain development and function. However, the contribution of DNA repair to genome stability in neurons remains elusive. Here, we demonstrate that the base excision repair protein Polβ is involved in hippocampal neuronal differentiation via a TET-mediated active DNA demethylation during early postnatal stages. Polβ deficiency induced extensive DNA double-strand breaks (DSBs) in hippocampal neurons, and a lesser extent in cortical neurons, during a period in which decreased levels of 5-methylcytosine were observed in genomic DNA. Inhibition of the hydroxylation of 5-methylcytosine by microRNAs miR29a/b-1 expression diminished DSB formation. Conversely, its induction by TET1 overexpression increased DSBs. The damaged hippocampal neurons exhibited aberrant neuronal gene expression profiles and dendrite formation. Behavioral analyses revealed impaired spatial learning and memory in adulthood. Thus, Polβ maintains genome stability in the active DNA demethylation that occurs during postnatal neuronal development, thereby contributing to differentiation and subsequent behavior.
A systematic review of Green Business Process Management
Authors: Couckuyt Dries , Van Looy Amy 
Published: November 2019

Purpose
Green Business Process Management (BPM) focusses on the ecological impact of business processes. Although it is an emerging field, different attitudes exist towards the discipline’s name, the objectives and the approaches to realise them. By means of a systematic literature review, the purpose of this paper is to arrive at a common understanding of the discipline for successful development.

Design/methodology/approach
The review methodology relies on a hermeneutic framework which integrates the search, analysis and interpretation of the literature. The sample is used in a text analysis to find an appropriate definition (RQ1), a bibliometric analysis to give insights in current Green BPM contributions (RQ2) and a content analysis to present differences with conventional BPM (RQ3).

Findings
Green BPM follows a similar development as conventional BPM, namely from a more technical perspective to also including the managerial perspective. More research is required that goes beyond the traditional business process lifecycle.

Originality/value
The research questions generated a comprehensive overview about application domains and research topics, which in turn can deliver benefits for both research and practitioner-related communities. Researchers identify future research avenues, while practitioners find appropriate Green BPM techniques for their domain.
Analyzing the startup ecosystem of India: a Twitter analytics perspective
Authors: Singh Shiwangi , Chauhan Akshay , Dhir Sanjay 
Published: November 2019

Purpose
The purpose of this paper is to use Twitter analytics for analyzing the startup ecosystem of India.

Design/methodology/approach
The paper uses descriptive analysis and content analytics techniques of social media analytics to examine 53,115 tweets from 15 Indian startups across different industries. The study also employs techniques such as Naïve Bayes Algorithm for sentiment analysis and Latent Dirichlet allocation algorithm for topic modeling of Twitter feeds to generate insights for the startup ecosystem in India.

Findings
The Indian startup ecosystem is inclined toward digital technologies, concerned with people, planet and profit, with resource availability and information as the key to success. The study categorizes the emotions of tweets as positive, neutral and negative. It was found that the Indian startup ecosystem has more positive sentiments than negative sentiments. Topic modeling enables the categorization of the identified keywords into clusters. Also, the study concludes on the note that the future of the Indian startup ecosystem is Digital India.

Research limitations/implications
The analysis provides a methodology that future researchers can use to extract relevant information from Twitter to investigate any issue.

Originality/value
Any attempt to analyze the startup ecosystem of India through social media analysis is limited. This research aims to bridge such a gap and tries to analyze the startup ecosystem of India from the lens of social media platforms like Twitter.