bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effective and Rapid Microbial Identification in Pediatric Osteoarticular Infections Using Blood Culture Bottles
Authors: Shin Chang Ho , Lim Chaemoon , Kim Taek Soo , Choi Eun Hwa , Cho Tae-Joon , Choi In Ho , Yoo Won Joon 
Published: August 2020

Background:
The detection and identification of pathogenic microorganisms are essential for the treatment of osteoarticular infection. However, obtaining a sufficient amount of specimen from pediatric patients is often difficult. Herein, we aimed to demonstrate the effectiveness of the blood culture bottle (BCB) system in pediatric osteoarticular infections. We hypothesized that our BCB culture method is superior to the conventional swab and tissue culture methods in terms of required specimen size, incubation time, and microbial identification rate.

Methods:
We analyzed the prospectively collected data of pediatric patients who underwent surgical treatment for osteoarticular infections between August 2016 and October 2019. Four needles were dipped in the infected fluid or tissue during the surgical procedure as soon as the infected area was exposed and were used to inoculate 2 aerobic pediatric BCBs and 2 anaerobic general BCBs. We also collected 2 conventional swab samples and 2 tissue samples from the identical area. The microbial identification rate and the time required for identification were compared between BCB, swab, and tissue cultures.

Results:
Forty patients constituted the study group; 13 patients had osteomyelitis, 17 patients had septic arthritis, and 10 patients had both. Of these 40 patients, the microbial identification rate was higher with BCB cultures (27 [68%]) than with swab cultures (18 [45%]; p = 0.004) or tissue cultures (15 [38%]; p < 0.001). Nine samples (9 patients [23%]) were only positive in the BCB culture. Positive microbial growth was not detected with conventional culture methods when microorganisms did not grow on the BCB culture. Compared with swab culture (4.3 ± 1.1 days; p < 0.001) or tissue culture (4.4 ± 1.1 days; p < 0.001), the BCB culture reduced the time required for microbial identification (3.5 ± 0.9 days).

Conclusions:
In pediatric osteoarticular infections, the BCB culture system improved the microbial identification rate, reduced the time to identification, and permitted a smaller-volume specimen, compared with traditional culture systems.

Level of Evidence:
Diagnostic Level II. See Instructions for Authors for a complete description of levels of evidence.
Postoperative Dexamethasone Following Posterior Spinal Fusion for Adolescent Idiopathic Scoliosis
Authors: Fletcher Nicholas D. , Ruska Tracy , Austin Thomas M. , Guisse Ndeye F. , Murphy Joshua S. , Bruce Robert W. 
Published: August 2020

Background:
Surgeons have hesitated to use steroids in patients undergoing posterior spinal fusion because of the risk of wound complications. The literature has supported the use of postoperative steroids in other areas of orthopaedics on the basis of more rapid recovery and improved postoperative pain control. We hypothesized that a short course of postoperative dexamethasone following posterior spinal fusion for the treatment of adolescent idiopathic scoliosis (AIS) would decrease opioid usage without increasing wound-healing problems.

Methods:
Consecutive patients undergoing posterior spinal fusion for the treatment of AIS from 2015 to 2018 at a single hospital were included. A review of demographic characteristics, curve characteristics, surgical data, and postoperative clinic notes was performed. Opioid usage was determined by converting all postoperative opioids given into morphine milligram equivalents (MME).

Results:
Sixty-five patients underwent posterior spinal fusion for the treatment of AIS without postoperative steroids (the NS group), and 48 patients were managed with 3 doses of postoperative steroids (the WS group) (median, 8.0 mg/dose). There was no difference between the groups in terms of curve magnitude, number of vertebrae fused, or estimated blood loss. There was a 39.6% decrease in total MME used and a 29.5% decrease in weight-based MME used in the group receiving postoperative steroids (82.0 mg [1.29 mg/kg] in the NS group versus 49.5 mg [0.91 mg/kg] in the WS group]; p < 0.001). This difference persisted after accounting for gabapentin, ketorolac, and diazepam usage; surgical time; curve size; levels fused; and number of osteotomies (median decrease, 0.756 mg/kg [95% CI, 0.307 to 1.205 mg/kg]; p = 0.001). Three patients in the NS group (4.6%) and 4 patients in the WS group (8.3%) developed wound dehiscence requiring wound care (p = 0.53). One patient in the NS group required surgical debridement for the treatment of an infection. Patients in the WS group were more likely to walk at the time of the initial physical therapy evaluation (60.4% versus 35.4%; p = 0.013).

Conclusions:
A short course of postoperative steroids after posterior spinal fusion was associated with a 40% decrease in the use of opioids, with no increase in wound complications. Surgeons may consider the use of perioperative steroids in an effort to decrease the use of postoperative opioids following posterior spinal fusion for the treatment of AIS.

Level of Evidence:
Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
Association of Radial Longitudinal Deficiency and Thumb Hypoplasia
Authors: Forman Malka , Canizares Maria F. , Bohn Deborah , James Michelle A. , Samora Julie , Steinman Suzanne , Wall Lindley B. , Bauer Andrea S. ,   the CoULD Study Group*
Published: August 2020

Background:
Deficiency of the radial aspect of the forearm and hand is the most common congenital longitudinal deficiency of the upper limb. Radial longitudinal deficiency is associated with several named syndromes. The purpose of the present study was to explore patterns of radial longitudinal deficiency and thumb hypoplasia in syndromes and to examine the severity of these differences across various syndromes.

Methods:
Data were collected from the Congenital Upper Limb Differences (CoULD) registry. Congenital differences are classified in the registry with use of the Oberg-Manske-Tonkin (OMT) classification system. Diagnosis of a syndrome by a physician as noted in the CoULD registry was recorded. Thumb deficiency and radial deficiency were classified according to the modified versions of the Blauth criteria and the Bayne and Klug criteria, respectively.

Results:
We identified 259 patients with 383 affected limbs with radial deficiency. Eighty-three of these patients had a diagnosed syndrome. The severity of radial deficiency was correlated with the severity of thumb deficiency. The Kendall tau coefficient indicated significant correlation between radial severity and thumb severity (tau = 0.49 [95% confidence interval = 0.40 to 0.57]; p < 0.05). Subjects with a syndrome were twice as likely to have bilateral deficiency and 2.5 times more likely to have both radial and thumb deficiency compared with subjects without a syndrome. Subjects with VACTERL syndrome (vertebral defects, anal atresia, cardiac anomalies, tracheoesophageal fistula, renal anomalies, and limb defects) had patterns of thumb and radial deficiency similar to the general cohort, whereas subjects with Holt-Oram syndrome, TAR (thrombocytopenia absent radius) syndrome, and Fanconi anemia demonstrated varied presentations of thumb and radial deficiency.

Conclusions:
The present study investigated the characteristics of patients with radial longitudinal deficiency and thumb hypoplasia. Our results support the findings of previous research correlating the severity of radial deficiency with the severity of thumb deficiency. Furthermore, we identified characteristic features of patients with radial longitudinal deficiency and associated syndromes.
Publishing Characteristics of Foot and Ankle Research Over a 15-Year Time Interval
Authors: Alexander Bradley K. , Hicks James W. , Agarwal Abhinav , Cage Benjamin B. , Solar Spaulding F. , Jha Aaradhana J. , McGwin Gerald , Shah Ashish 
Published: August 2020

Background:
As the foot and ankle subspecialty continues to grow in orthopaedics, trends in published literature provide valuable insights to help understand and strengthen the field. The current study evaluates the changes in the characteristics of foot and ankle articles in The Journal of Bone & Joint Surgery (American Volume) (JBJS-A) from 2004 to 2018.

Methods:
Foot and ankle-related articles in JBJS-A from 2004 to 2018 were identified and categorized by type of study, level of evidence, number of authors, academic degree(s) of the first and last authors, male and female authorship, number of citations, number of references, region of publication, and use of patient-reported outcomes (PROs).

Results:
A total of 336 foot and ankle articles from 2004 to 2018 were reviewed. The type of study published has changed over time, with more clinical therapeutic evidence and less case reports. The level of evidence grades, as rated by JBJS-A and objective evaluators, have increased over the past 15 years. The total number of authors per article has increased, and female authorship has increased significantly. The number of references per article has increased, and the number of citations per year has decreased. The field of foot and ankle surgery has seen an increase in global publications.

Conclusions:
The results of this study suggest that the foot and ankle literature that has been published in JBJS-A has continued to increase in quality and diversity over the past 15 years.
The 2019 Austrian-Swiss-German Traveling Fellowship
Authors: Thaler Martin , Wassilew Georgi I. , Giesinger Karlmeinrad , Holzapfel Boris Michael 
Published: August 2020

Abstract:
The Austrian-Swiss-German (ASG) Traveling Fellowship was established over 40 years ago as an annual exchange program between the English-speaking countries of the United States, Great Britain, and Canada and the German-speaking countries of Austria, Germany, and Switzerland. In 2019, 4 German-speaking consultant orthopaedic surgeons represented their national societies in this unique and prestigious fellowship program: Karlmeinrad Giesinger from the St. Gallen Hospital, sponsored by the Swiss Society of Orthopaedics and Traumatology; Boris Michael Holzapfel from the Julius-Maximilians University in Wuerzburg, and Georgi Wassilew from the Greifswald Medical University, both sponsored by the German Society for Orthopaedics and Traumatology; and Martin Thaler from the Medical University of Innsbruck, sponsored by the Austrian Orthopaedic Association. This article describes the 2019 ASG Traveling Fellowship.
Risk and prognostic factors of breast cancer with liver metastases
Authors: ji Lei , Cheng Lei , Zhu Xiuzhi , Gao Yu , Fan Lei , wang zhonghua 
Published: August 2020

Abstract
Background: Liver metastasis is a significant adverse predictor of overall survival (OS) among breast cancer patients. The purpose of this study was to determine the risk and prognostic factors of breast cancer with liver metastases (BCLM). Methods: Data on 311,573 breast cancer patients from the Surveillance, Epidemiology, and End Results (SEER) database and 1728 BCLM patients from Fudan University Shanghai Cancer Center (FUSCC) were included. Logistic regression was used to identify risk factors for liver metastasis. Cox proportional hazards regression model was adopted to determine independent prognostic factors in BCLM patients.Results: Young age, invasive ductal carcinoma, higher pathological grade, and subtype of triple-negative and human epidermal growth factor receptor 2 positive (HER2+) were risk factors for developing liver metastasis. The median OS after liver metastasis was 20.0 months in the SEER database and 27.3 months in the FUSCC dataset. Molecular subtypes also played a critical role in the survival of BCLM patients. We observed that hormone receptor-positive (HR+)/HER2+ patients had the longest median OS (38.0 for SEER vs. 34.0months for FUSCC), whereas triple-negative breast cancer had the shortest OS (9.0 vs. 15.6 months) in both SEER and FUSCC. According to the results from the FUSCC, the subtype of HR+/HER2+ (hazard ratio (HR)=2.62; 95% confidence interval (CI)= 1.88-3.66; P<0.001) and HR-/HER2+ (HR=3.43; 95% CI=2.28-5.15; P<0.001) were associated with a significantly increased death risk in comparison with HR+/HER2- patients if these patients did not receive HER2-targeted therapy. For those who underwent HER2-targeted therapy, however, HR+/HER2+ subtype reduced death risk compared with HR+/HER2- subtype (HR=0.74; 95% CI=0.58-0.95; P<0.001).Conclusions: Breast cancer patients at a high risk for developing liver metastasis deserve more attention during the follow-up. BCLM patients with HR+/HER2+ subtype displayed the longest median survival than HR+/HER2- and triple-negative patients due to the introduction of HER2-targeted therapy and therefore it should be recommended for HER2+ BCLM patients.
Clinical study on primary screening of oral cancer and precancerous lesions by oral cytology
Authors: Sukegawa Shintaro , Ono Sawako , Nakano Keisuke , Takabatake Kiyofumi , Kawai Hotaka , Nagatsuka Hitoshi , Furuki Yoshihiko 
Published: August 2020

Abstract
BackgroundThis study was conducted to compare the histological diagnostic accuracy of conventional oral-based cytology and liquid-based cytology (LBC) methods.MethodsHistological diagnoses of 251 cases were classified as negative (no malignancy lesion, inflammation, or mild/moderate dysplasia) and positive [severe dysplasia/carcinoma in situ (CIS) and squamous cell carcinoma (SCC)]. Cytological diagnoses were classified as negative for intraepithelial lesion or malignancy (NILM), oral low-grade squamous intraepithelial lesion (OLSIL), oral high-grade squamous intraepithelial lesion (OHSIL), or SCC. Cytological diagnostic results were compared with histology results.ResultsOf NILM cytology cases, the most frequent case was negative [LBC n = 50 (90.9%), conventional n = 22 (95.7%)]. Among OLSIL cytodiagnoses, the most common was negative (LBC n = 34; 75.6%, conventional n = 14; 70.0%). Among OHSIL cytodiagnoses (LBC n = 51, conventional n = 23), SCC was the most frequent (LBC n = 31; 60.8%, conventional n = 7; 30.4%). Negative cases were common (LBC n = 13; 25.5%, conventional n = 14; 60.9%). Among SCC cytodiagnoses SCC was the most common (LBC n = 16; 88.9%, conventional n = 14; 87.5%). Regarding the diagnostic results of cytology, assuming OHSIL and SCC as cytologically positive, the LBC method/conventional method showed a sensitivity of 79.4%/76.7%, specificity of 85.1%/69.2%, false-positive rate of 14.9%/30.7%, and false-negative rate of 20.6%/23.3%.ConclusionsLBC method was superior to conventional cytodiagnosis methods. It was especially superior for OLSIL and OHSIL. Because of the false-positive and false-negative cytodiagnoses, it is necessary to make a comprehensive diagnosis considering the clinical findings.
Stagewise resolution of temperature-dependent embryonic and postembryonic development in the cowpea seed beetle Callosobruchus maculatus (F.)
Authors: Kutcherov Dmitry 
Published: August 2020

Abstract
Background

The thermal plasticity of life-history traits receives wide attention in the recent biological literature. Of all the temperature-dependent traits studied, developmental rates of ectotherms are especially often addressed, and yet surprisingly little is known about embryonic responses to temperature, including changes in the thermal thresholds and thermal sensitivity during early development. Even postembryonic development of many cryptically living species is understood superficially at best.

Results

This study is the first to estimate the exact durations of developmental stages in the cowpea seed beetle C. maculatus from oviposition to adult emergence at five permissive constant temperatures from 20 to 32°C. Early embryonic development was tracked and documented by means of destructive sampling and subsequent confocal imaging of fluorescently stained specimens. Late embryonic and early larval development was studied with the use of destructive sampling and light microscopy. Well-resolved temporal series based on thousands of embryos allowed precise timing of the following developmental events: formation of the blastoderm; formation, elongation, and retraction of the germ band; dorsal closure; the onset and completion of sclerotization of the cuticle; hatching, and penetration of the first-instar larva into the cowpea seed. Pupation and adult eclosion were observed directly through an incision in the seed coat. The thermal phenotype of C. maculatus was found to vary in the course of ontogeny and different stages scaled disproportionately with temperature, but pitfalls and caveats associated with analyses of relative durations of individual stages are also briefly discussed.

Conclusion

Disproportionate changes in developmental durations with temperature may have important implications when study design requires a high degree of synchronization among experimental embryos or when the occurrence of particular stages in the field is of interest, as well as in any other cases when development times need to be estimated with precision. This work provides one of the first examples of integration of embryological techniques with ecophysiological concepts and will hopefully motivate similar projects in the future. While experiments with Drosophila remain to be the main source of information on animal development, knowledge on other model species is instrumental to building a broader picture of developmental phenomena.
Dynamic Changes in the Immune Response Correlate with Disease Severity and Outcomes During Infection with SARS-CoV-2
Authors: Zheng Fang , Chen Ruochan , Yao Run , Huang Yaxiong , Li Ning , Liu Jiyang , xie Yuanlin 
Published: August 2020

Abstract
Background:Little is known about the dynamic changes in the patient immune responses to SARS-CoV-2, and how different responses are correlated with disease severity and outcomes.Method:A total of 74 patients with confirmed COVID-19 were included from January 29th to February 15th 2020. Clinical characteristics and dynamic changes in immune response were analyzed and compared between severe and non-severe patients. ResultsOf the 74 patients, 17 suffered from severe disease and 57 from non-severe disease. Patients with severe disease tended be older (65.29 ± 12.33 years vs. 45.37 ± 18.66 years), and had a greater degree of underlying disease (41.18% vs. 24.56%) , lower lymphocytes counts (0.69 ± 0.36 × 10⁹ vs. 1.46 ± 0.75 × 10⁹) , higher neutrophil-lymphocyte-ratios (NLRs; 3.76 (3.15–5.51) vs. 2.07 (1.48–2.93)) and lower eosinophil counts (0.01 ± 0.01 × 10⁹ vs. 0.05 ± 0.07 × 10⁹), than that in non-severe patients. The number of immune cell subtypes, including helper T cells, suppressor T cells, B cells, and natural killer cells was significantly decreased in severe cases compared to that in non-severe cases (335.47 vs. 666.46/mL; 158 vs. 334/mL; 95 vs. 210/mL; 52 vs. 122/mL, respectively). As the condition of the patients improved, the number of neutrophils decreased significantly in the severe patients. All patients who recovered exhibited a gradual and persistent increase in eosinophil counts and lymphocyte counts, including helper T cells, suppressor T cells, and natural killer cells. In addition, the levels of most of inflammatory cytokines, including IFN-γ, IL-2, IL-4, IL-6, IL-10, IL-17A, and TNF–α generally decreased as the patients gradually recovered.ConclusionsCollectively, our study provides novel information on the kinetics of the immune responses to COVID-19. Furthermore, our study indicates that both innate and adaptive immune responses correlate with better clinical outcomes.
Development and Validation of a Prognostic Implications of Chromosome Abnormalities Algorithm for Newly Diagnosed Multiple Myeloma
Authors: Luo Tiancheng , Qiang Wanting , Lu Jing , He Haiyan , Liu Jin , Li Lu , Jiang Hua , Fu Weijun , Du Juan 
Published: August 2020

Abstract
BACKGROUND: Fluorescence in situ hybridization (FISH) evaluation is essential for initial risk stratification in multiple myeloma (MM). While the presence of specific cytogenetic abnormalities confers a heterogeneity impact on prognosis, the cutoff values are not exactly comparable among different centers, we performed K-Adaptive Partitioning (Kaps), a novel statistical method, to development and validation of a prognostic implications of chromosome abnormalities algorithm for newly diagnosed multiple myelomaMETHODS: A total of 533 patients with newly diagnosed MM admitted to Shanghai Changzheng Hospital were enrolled. All patients underwent FISH detect cytogenetic abnormalities. The prognostic impact of cytogenetic abnormalities (CA) detected by FISH were analyzed. RESULTS: The K-Adaptive Partitioning method was used to calculate the chromosomal abnormal cut-off values as follows: 17p - 20.1%, 13q - 85%, 1q21 + 39%, t (11, 14) 55.5%, t (14,16) 87%, t (4,14) 53.5%. According to EMN criteria for CA, 17p- and 1q21 + are the independent factors affecting both OS and PFS among CA. The analysis based on the cutoff value obtained by Kaps suggests that 13q-, t(14,16) , 17p- and 1q21 + are independent factors affecting OS among CA; t(14,16) , 17p- and 1q21 + are independent factors affecting PFS among CA. Based on the survival analysis results, the prognostic model was constructed. The c-index of the prognostic model calculated by the Kaps method was 0.719 (95% CI, 0.683 to 0.756; corrected 0.707), while the c-index of the prognostic model according to the EMN criteria was 0.714 (95% CI, 0.678 to 0.751; corrected 0.696). To analyze the influence of the number of adverse CA on the prognosis, both the EMN criteria and the criteria analysis by the Kaps suggest that the more adverse CA, the OS and PFS became shorter.CONCLUSION: This study shows that chromosomal abnormalities in different proportions and combinations can affect the prognosis of multiple myeloma patients. Effective criteria should be formulated to evaluate the prognosis of MM patients better.
Clinical analysis of tracheobronchial foreign body aspiration in children: A focus on external and intrinsic factors
Authors: gan weigang , Xiao Ning , Feng Yiyuan , zhou danmei , hu juanjuan , Liu Shixi , zou Jian 
Published: August 2020

Abstract
BackgroundTo judge the external factors and intrinsic factors affecting clinical feature of TFBA in west China and propose potential effective intervention measures.Methods: We retrospectively analyzed the clinical data of pediatric patients diagnosed with TFBA and removed foreign body(FBs) by rigid bronchoscopy under general anesthesia at otolaryngeal department from December 2017 to November 2018.ResultsThe gender constituent ratio of male(72) to female(53) was 1.4:1. The patients aged from 1 to 3 years accounting for 76% (95/125). Cough, continous fever and dyspnea were premier symptoms. Right primary bronchus was the most common position invovled where FBs were detected by rigid bronchoscopy in 67 cases(53.6%). Organic foreign bodis were commonest in our study. The guardians of patients between rural(parents 16, grandparents 31) and urban(parents 52, grandparents 26) group were significantly different(χ2=12.583, p=0.000). More children were paid attention delayedly over 72 hours in rural group than urban. More children in group of no hsitory of foreign body aspiration(12, 25%) were treated over 72 hours than in the contrary group.ConclusionPediatric tracheobronchial foreign body aspiration is a kind of common emergency in otolaryngology. Age, gender, tracheobronchial anatomy and other physiological elements were defined as intrinsic factors, while guardians, residence, FBs species and prehospital time were defined as external factors of TFBA. External factors would determine the morbidity, and intrinsic factors would determine patient's condition and mortality. It is very important to take effective measures to control external factors, which was expected to decrease morbidity and mortality.