bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Effect of Surgical Approach on Outcomes Following Total Hip Arthroplasty Performed for Displaced Intracapsular Hip Fractures
Authors: Matharu Gulraj S. , Judge Andrew , Deere Kevin , Blom Ashley W. , Reed Mike R. , Whitehouse Michael R. 
Published: November 2019

Background:
Studies have suggested that the anterolateral approach is preferable to the posterior approach when performing total hip arthroplasty (THA) for a displaced intracapsular hip fracture, because of a perceived reduced risk of reoperations and dislocations. However, this suggestion comes from small studies with short follow-up. We determined whether surgical approach in THAs performed for hip fracture affects revision-free hip survival, patient survival, and intraoperative complications.

Methods:
We retrospectively analyzed all stemmed primary THAs for hip fracture that were recorded in the National Joint Registry for England, Wales, Northern Ireland and the Isle of Man that were performed between 2003 and 2015. The 2 surgical approach groups, posterior and anterolateral, were matched for patient and surgical confounding factors using propensity scores, with outcomes compared using regression modeling (with regression model ratios of <1 representing a reduced risk of the specified outcome in the posterior group). Outcomes were 5-year hip survival free from revision (all-cause revision, revision for dislocation and/or subluxation, and revision for periprosthetic fracture), patient survival (30 days, 1 year, and 5 years postoperatively), and intraoperative complications.

Results:
After matching, 14,536 THAs (7,268 per group) were studied. Five-year cumulative revision-free survival rates were similar (posterior group, 97.3%, and anterolateral group, 97.4%; subhazard ratio [SHR], 1.15 [95% confidence interval (CI), 0.93 to 1.42]). Five-year survival rates free from revision for dislocation (SHR, 1.28 [95% CI, 0.89 to 1.84]) and for periprosthetic fracture (SHR, 1.03 [95% CI, 0.68 to 1.56]) were also comparable between the 2 approach groups. Thirty-day patient survival was significantly higher following a posterior approach (99.5% compared with 98.8%; hazard ratio [HR], 0.44 [95% CI, 0.30 to 0.64]), which persisted at 1 year (HR, 0.73 [95% CI, 0.64 to 0.84]) and 5 years (HR, 0.87 [95% CI, 0.81 to 0.94]) postoperatively. The posterior approach was associated with a lower risk of intraoperative complications (odds ratio [OR], 0.59 [95% CI, 0.45 to 0.78]).

Conclusions:
In THA for hip fracture, the posterior approach was associated with a similar risk of revision and a lower risk of both patient mortality and intraoperative complications compared with the anterolateral approach. We propose that the posterior approach is as safe as the anterolateral approach when performing THA for hip fracture and that either approach may be used according to surgeon preference.

Level of Evidence:
Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
Orthopaedic Manifestations of Alagille Syndrome
Authors: Hall Matthew , Borsinger Tracy , Nicholson Allen , Carter Cordelia W. 
Published: November 2019

Case:
Case 1 is a 6-month-old female who presented for evaluation of asymptomatic vertebral anomalies in the setting of jaundice and cardiac murmur; she was diagnosed with Alagille syndrome (AGS). Her spine has been monitored clinically. Case 2 is a 10-year-old female who sustained a pathologic femur fracture in the setting of known AGS, requiring operative stabilization and optimization of her bone mineral density.

Conclusions:
Pediatric orthopaedists care for children with AGS both in management of congenital musculoskeletal anomalies and in treatment of pathologic fractures. Familiarity with the current AGS literature is necessary for provision of optimal multidisciplinary care.
Capacity and predictors to perform integrated leading, managing and governing practices for results among the health system workforce: cross-sectional survey
Authors: Ambelie Yeshambel Agumas , Alene Getu Degu , Gebrekiros Damen Hailemariam 
Published: November 2019

Abstract
Introduction: Observing over-led and under-managed, over-managed and under-governed, and even out of these health organizations remains a common phenomenon in low and middle-income countries. Objective: To determine the capacity and predictors to perform integrated leading, managing and governing practices for results among the health system workforce.Methods: A cross-sectional study, from December to January 2018, was carried out in northwest Ethiopia. Eight hundred thirteen health facility employees were selected to rate her/his respective staff’s capacity on performing integrated leading, managing and governing practices for results. The capacity with 95% CI was computed from 20 items loaded in a four-factor measurement model and leveled into four ordinal categories. Moreover, predictors of this capacity were identified by conducting ordinal logistic regression analysis.Results: From 813 participants, 396 (48.7%) and 582 (71.6%) were females and service owners respectively. The magnitude estimates for the low, moderate, high and very high capacity levels with 95% CI were 41.3% (37.8, 44.6); 42.7% (39.5, 46.0); 13.5% (11.2, 15.9) and 2.5% (1.5, 3.7), respectively. Sex (p = .031) and responsibility (p = .019) were identified as the main predictors.Conclusions: The capacity to perform integrated leading, managing and governing practices for results among the health system workforce in northwest Ethiopia is inadequate. Sex and responsibility are identified as the main statistically significant predictors. The policymakers, program planners and researchers need to take action giving due attention to females and service owners. Feature research could be conducted considering hierarchical variables, mixed design, and large sample size.
Contraceptive utilization and associated factors among women in the extended post-partum period in wukro town, Tigray, Ethiopia: a community based cross sectional study
Authors: Assefa Natnael Etsay , Berhe Yodit Zewdie , Werid Weldu Mammo , Mengesha Meresa Berewo , Tekola Kidanemariam Berhe , Abady Gdiom Gebreheat , Gebru Tesfay Tsegay , Berhe Lidya Zewdie , Weldemariam Mulu Gebretsadik 
Published: November 2019

Abstract
The authors have withdrawn this preprint from Research Square
Functional study of early intervention for degenerative retinopathy through hydrogel sustained release system of rhEPO
Authors: Zhang Zhimeng , Dai Hehua , Li Ruyi , Li Yuyu , Li Genlin 
Published: November 2019

Abstract
Background Retinitis pigmentosa (RP) is the most common cause of blindness in retinal disease. Long-lasting ocular administration is an effective therapy to delay the progression of RP. And hydrogel sustained release system may be an available and stable drug carrier in the treatment of RP.Method Hydrogel sustained release system was constructed as a drug carrier of recombinant human erythropoietin (rhEPO). We administered retinal degenerative (rd) mice (Pdeb rd1 / Pdeb rd1 ) via subconjunctival or retrobulbar injection at postnatal 2 weeks (PN-2w), examined the mice and tested the factors of retina at two weeks after injection. Electroretinogram (ERG) was used to examine retinal function at PN-4w, western blot and q-PCR were used to test the expression of Bax, Bcl-2, iNOS and VEGFa of retina.Result Photoreceptor apoptosis were alleviated in all rhEPO administrated groups. The retinal blood supply was improved in injection groups. Compared with placebo and blank control groups, rhEPO treatment could enhance the retinal function and delay the progression of disease. Although there was no significant difference between rhEPO hydrogel and rhEPO treated group, photoreceptor apoptosis in rhEPO hydrogel group was less than that in rhEPO group, and the retinal function was better in rhEPO hydrogel group. Moreover, different routes of administration might have little effect on treatment in this research.Conclusion Early intervention can effectively control the progression of the disease. Anti-apoptosis,neuroprotection and erythropoietin of rhEPO could be useful in the treatment of RP. Hydrogel as a long-lasting drug sustained release system was stable and available, and might become a potential drug carrier in the future.
Optic Nerve Sheath Diameter in retrobulbar ultrasound as a surrogate measure for intracranial pressure before and after non-invasive strategies.
Authors: diab aldo saad , Martínez Benailim , Gámez Albana , Bucott Yvan 
Published: November 2019

Abstract
Background : Raised intracranial pressure is a complication that leads to adverse outcomes. In the critically ill, invasive measurement by an intraventricular catheter is the gold standard; its use in non-specialized centers is limited, besides neuroimaging by computed tomography or magnetic resonance imaging scans entail transfer of a critically ill patient out of the ICU. Dilatation of the optic nerve sheath has been shown to be a much earlier manifestation of ICP rise. The optic nerve sheath diameter (ONSD) is fairly easy to visualize by ultrasonography by insonation across the orbitMethods: 90 patients, divided into three groups. Group M received mannitol 20% 0.5gr kg -1 , Group H received NaCl 7.5% 1.5 ml kg -1 and Group P patients were positioned on reverse Trendelenburg position 30 degrees. ONSD was measured 3 mm behind the optic disc. The measurements T1 before and T2 after the strategies according to group 30min, T3 at 60min, and T4 at 90minResults: Similar trend between invasive monitoring and ONSD measurement was observed. Invasive measurement the intracranial pressure was 40.2 at T1, there was a sustained and significant decrease in the three groups at 30, 60 and 90 minutes. ONSD measured at baseline, average was 7.0mm in group M, 7.1 in group H and 6.7 in group P, and subsequently it was significantly reduced at 30, 60 (p=0.002) and 90 minutes (p=0.003).Conclusion: ONSD in retrobulbar ultrasound is a reliable method to detect intracranial pressure variations before and after non-invasive strategies to reduce it acutely Keywords: intracranial hypertension, intracranial pressure, optic nerve sheath diameter, osmotherapy, Reverse Trendelenburg position. Trial registration: Clinical Trials; NCT03634176 ; registered August 16, 2018; https://clinicaltrials.gov/ct2/show/NCT03634176 .
The Disruptive bEhavior manageMEnt ANd prevention in hospitalized patients using a behaviORal intervention team (DEMEANOR) study protocol: a pragmatic, cluster, crossover trial
Authors: Morrison Jay , Hasselblad Michele , Kleinpell Ruth , Buie Reagan , Ariosto Deborah , Hardiman Erin , Osborn Stephen W , Lindsell Christopher J 
Published: November 2019

Abstract
Background Disruptive behavior in hospitalized patients has become a priority area of safety concern for clinical staff, as well as having consequences for patient management and hospital course. Proactive screening and intervention of patients with behavioral co-morbidities has been reported to reduce disruptive behavior in some settings, but has not been studied in a rigorous way.Methods The D isruptive b E havior manage ME nt AN d prevention in hospitalized patients using a behavi OR al intervention team (DEMEANOR) study is a pragmatic, cluster, cross-over trial being conducted. Each month, the behavioral intervention team, comprised of a psychiatric-mental health advanced practice nurse and a clinical social worker, with psychiatrist consultation as needed, rotates between an adult medicine unit and a mixed cardiac unit at Vanderbilt University Medical Center in Nashville, TN. The team proactively screens patients upon admission utilizing a protocol which includes a comprehensive chart review, and if indicated, a brief interview, seeking to identify those patients who possess risk factors indicative of either a potential psychological barrier to their own clinical progress or a potential risk for exhibiting disruptive, aggressive or self-injurious behavior during their hospitalization. Once identified, the team provides interventions aimed at mitigating these risks, educates and supports the patient care teams (nurses, physicians and others), and assists non-psychiatric staff in the management of patients who require behavioral health care. Patients who are both admitted to and discharged from either unit are included in the study. Anticipated enrollment is approximately 1790 patients. The two primary outcomes are i) a composite of objective measures related to the patients’ disruptive, threatening or acting out behaviors, and ii) staff self-reported comfort with and confidence in their ability to manage patients exhibiting disruptive, threatening or acting out behavior. Secondary outcomes include patient length of stay, patient attendant (sitter) use, and the unit nursing staff retention.Discussion This ongoing trial will provide evidence on the real-world effectiveness of a proactive behavioral intervention to prevent disruptive, threatening or acting out events in adult hospitalized patients.
Impact of a paediatric-adult care transition programme on the health status of patients with sickle cell disease: study protocol for a randomised controlled trial (the DREPADO trial)
Authors: Hoegy Delphine , Bleyzac Nathalie , Gauthier-Vasserot Alexandra , Cannas Giovanna , Denis Angélique , Hot Arnaud , Bertrand Yves , Occelli Pauline , Touzet Sandrine , Dussart Claude , Janoly-Dumenil Audrey 
Published: November 2019

Abstract
Background: Thanks to the advancements in medical care, a majority of sickle cell disease patients worldwide live beyond 18 years of age, and therefore patients initially followed in paediatric departments are then transferred to adult departments. This paediatric-adult care transition is a period with an increased risk of discontinuity of care and so morbidity and mortality. During this period, the patient will have to manage new interlocutors and places of care, and personal issues related to the period of adolescence. To take into consideration all these aspects, an interesting approach is to refer to the patient as a whole system as presented in biopsychosocial approach. The aim of this trial is to evaluate the impact of the proposed biopsychosocial paediatric-adult transition programme. Methods: The DREPADO study is a multicentre randomised control trial comparing a control group ( Arm A ) versus an interventional group with paediatric-adult transition programme based on a biopsychosocial approach ( Arm B ). To be included, patients should suffer of SS, SC or Sβ-form of sickle cell disease and aged between 16 and 17 years. The randomisation in a 1:1 ratio assigns the Arm A or B . The primary outcome is the number of hospital admissions and emergency in the index hospital for complications, in the 2-years after the first consultation in the adult department of care. Secondary outcomes consider the quality of life, but also included coping skills such as self-efficacy feeling and disease knowledge. To provide patient and parent knowledge and coping skills, the transition program is composed of 3 axis : educational, psychological and social, conducted in individual and group.Discussion: By providing self-care knowledge and coping skills related to SCD and therapeutics, helping patient's empowerment related to pain management and emotions and facilitating the relationship to oneself, others and care in the Arm B of DREPADO study, we believe that the morbidity and mortality of patients with SCD may be reduced after the proposed paediatric-adult transition programme. Trial registration: ClinicalTrials.gov, ID: NCT03786549; registered on 17 th December 2018; https://clinicaltrials.gov/.
Mri And Emg Findings In Patients With Cervicobrachialgia
Authors: González-Uriel Pablo , Casado Nabil Sabbagh , Pérez Víctor Armesto , Suárez-Quintanilla Juan Antonio 
Published: November 2019

Abstract
Background The aim of this study is to describe the alterations in complementary tests (MRI and EMG) in patients with cervicobrachialgia according to sex and age.Methods Retrospective study of 184 patients with cervicobrachialgia who underwent an MRI and/or EMG. The variables analyzed were gender, age, elements of spondylosis (osteophytes, arthropathy, spondylolisthesis and canal stenosis), the type of disc disease (protrusion and herniated disc) and curvature in the sagittal plane. The EMG was used to evaluate the neurogenic findings in the muscles dependent on the spinal roots of C4 to C8-T1.Results Average age 53.65±11.96 years. The patients were evaluated for the presence of osteophytes (n = 111), arthropathy (n = 76), spondylolisthesis (n = 15) and stenosis of the spinal canal (n = 35). The highest incidences were osteophytes in C5-C6 (n=108), protrusions in C5-C6 (n=58), herniated disc in C5-C6 (n=18) and neurogenic findings in C7 (n=130). The rectification of cervical lordosis appeared in 130 patients.Conclusions Spondylosis increases with age. Disc herniations, disc protrusions and motor radiculopathy were more frequent in the 5th to 6th years of life. In patients with cervicobrachialgia, the sagittal rectification is more common than the normal lordosis.
Ultrasonographic features of medullary thyroid carcinoma nodules less than 1 cm compare with papillary thyroid microcarcinomas: a retrospective analysis
Authors: Li Xiaoyu , Zhou Wei , Zhan Weiwei 
Published: November 2019

Abstract
Objective: The aim of this study was to retrospectively analyze the ultrasonographic characteristics of medullary thyroid carcinomas (MTCs) with size less than 1 cm (MTMCs) compared with those of papillary thyroid microcarcinomas (PTMCs).Materials and Methods: This study included 41 patients with 46 MTMCs between January 2008 to April 2017 and 104 consecutive patients with 136 PTMCs between January to June 2015. All thyroid carcinoma nodules were surgically and histologically proved. Age and nodules size were analyzed by independent sample t test. Sex, multiplicity and cervical lymph node metastases were evaluated by χ2 or Fisher’s exact tests. Univariate analysis and multivariate logistic regression analysis were performed on the sonographic features of thyroid carcinoma nodules, including location, composition, echogenicity, shape, margin, boundary, calcifications and vascularization degree.Results: More MTMCs presented cervical lymph node metastases than PTMCs (36.59% vs 20.19%, p = 0.040). Compared with PTMCs, MTMCs tended to have an ovoid to round shape (P = 0.000, odds ratio [OR], 4.018; 95% CI, 1.295-12.473), more commonly showed solid composition (P = 0.004, OR, 0.13; 95% CI, 0.020-0.842), and macrocalcifications (P = 0.001, OR, 0.085; 95% CI, 0.016-0.454) and hypervascularity (P=0.000, OR, 10.778; 95% CI, 3.939-29.488). There were no significant differences in the location, margin, boundary, echogenicity, peripheral halo ring, the present of calcifications, microcalcifications and between MTMCs and PTMCs. Conclusion: MTMCs have the ultrasonographic features of general malignant nodules, such as hypoechoic or markedly hypoechoic solid lesions with unique characteristics including ovoid to round shape, macrocalcifications and hypervascularity.
Hard-threshold-Neural-Network based Prediction of Organic Synthetic Outcomes
Authors: Hu Haoyang , Yuan Zhihong 
Published: November 2019

Abstract
Retrosynthetic analysis is the canonical technique to plan the synthesis route of organic molecules in medicine development. In this technique, the screening of synthetic tree branches requires accurate forward reaction prediction, but existing software is still far from completing this step independently. Previous studies have attempted to apply neural network in the forward reaction prediction, but the accuracy is not satisfying. Through using the Edit-based Description and Extended-Connectivity Fingerprints to transform reaction into vector, the presented work focuses on the update of neural network to improve the template-based forward reaction prediction. Hard-threshold activation and target propagation algorithm are implemented by introducing the mixed-convex combinatorial optimization. Comparative tests are conducted to explore the optimal hyperparameter set. Using 15 000 experimental reaction records from granted United States patents, the proposed hard-threshold neural network is systematically trained and tested. The results demonstrate that a higher prediction accuracy is obtained when compared to the traditional neural network with backpropagation algorithm. Indeed, the prediction accuracy of the proposed hard-threshold neural network can reach 73.9% which is higher than Coley’s result with 71.8% ( Coley et al. ACS Cent. Sci, 2017 ). Some successfully predicted reaction examples are also briefly discussed.
Survival analysis of pregnancy-associated breast cancer: multiparous women might have better outcomes
Authors: Han Bo-yue , Li Xiao-guang , Zhao Hai-yun , Hu Xin , Ling Hong 
Published: November 2019

Abstract
Purpose: Pregnancy-associated breast cancer (PABC) is an aggressive disease and since China began to encourage childbearing in 2015, the incidence of PABC has increased. The study was to investigate the characteristics and survival rates of PABC patients. Methods: Patients with PABC who underwent surgery at Fudan University, Shanghai Cancer Center, from 2005 to 2018 were enrolled. First, the study divided the population into two groups: first-pregnancy group and non-first pregnancy group. Second, patients were categorized as those having breast cancer during pregnancy with/without an abortion or during the lactation period. Results: Overall, 203 patients were recruited. Since 2016, 63.9% patients were diagnosed with PABC during their second or third pregnancy, while at that time in Shanghai, only 25% of newborns were non-first births. Luminal B accounted for the highest proportion (38.4%), followed by triple-negative breast cancer (30.0%). Compared with the non-first pregnancy group, the first-pregnancy group preferred to delay treatment until the fetus was born (time from initial symptoms to treatment: 6.20 vs. 4.67 m, P=0.106). The patients in the first pregnancy group were presented with 57.0% of HR negative tumors and 26.6% of HER-2 positive tumors, while the HR negative tumors accounted for 47.6% (P=0.281) and the proportion of HER-2 positive tumors was 36.3% (P=0.108) in the non-first pregnancy group. The 3-year disease-free survival rate of the first-pregnancy group was 78.4%, and that of the non-first pregnancy group was 83.7% (P=0.325). Conclusions: Our study proves that the proportion of PABC developed during the second or third pregnancy of women was extremely large relative to the newborn populations. Patients in the first-pregnancy group tended to be presented with less aggressive tumor pathological characteristics but a worse survival outcome than those in the non-first pregnancy group.