bluuebunny/crossref_metadata_2025_split huggingface dataset:
Early detection of breast cancer rectifies inequality of breast cancer outcomes
Authors: Tabár László , Chen Tony Hsiu-Hsi , Yen Amy Ming-Fang , Dean Peter B , Smith Robert A , Jonsson Håkan , Törnberg Sven , Chen Sam Li-Sheng , Chiu Sherry Yueh-Hsia , Fann Jean Ching-Yuan , Ku May Mei-Sheng , Wu Wendy Yi-Ying , Hsu Chen-Yang , Chen Yu-Ching , Svane Gunilla , Azavedo Edward , Grundström Helene , Sundén Per , Leifland Karin , Frodis Ewa , Ramos Joakim , Epstein Birgitta , Åkerlund Anders , Sundbom Ann , Bordás Pál , Wallin Hans , Starck Leena , Björkgren Annika , Carlson Stina , Fredriksson Irma , Ahlgren Johan , Öhman Daniel , Holmberg Lars , Duffy Stephen W 
Published: May 2020

Objectives To explain apparent differences among mammography screening services in Sweden using individual data on participation in screening and with breast cancer–specific survival as an outcome. Methods We analysed breast cancer survival data from the Swedish Cancer Register on breast cancer cases from nine Swedish counties diagnosed in women eligible for screening. Data were available on 38,278 breast cancers diagnosed and 4312 breast cancer deaths. Survival to death from breast cancer was estimated using the Kaplan–Meier estimate, for all cases in each county, and separately for cases of women participating and not participating in their last invitation to screening. Formal statistical comparisons of survival were made using proportional hazards regression. Results All counties showed a reduction in the hazard of breast cancer death with participation in screening, but the reductions for individual counties varied substantially, ranging from 51% (95% confidence interval 46–55%) to 81% (95% confidence interval 74–85%). Survival rates in nonparticipating women ranged from 53% (95% confidence interval 40–65%) to 74% (95% confidence interval 72–77%), while the corresponding survival in women participating in screening varied from 80% (95% confidence interval 77–84%) to 86% (95% confidence interval 83–88%), a considerably narrower range. Conclusions Differences among counties in the effect of screening on breast cancer outcomes were mainly due to variation in survival in women not participating in screening. Screening conferred similarly high survival rates in all counties. This indicates that the performance of screening services was similar across counties and that detection and treatment of breast cancer in early-stage reduces inequalities in breast cancer outcome.
An Ethereum bill of lading under the UNCITRAL MLETR
Authors: Abdellatif Niels-Philip 
Published: May 2020

The paper bill of lading remains pervasive despite numerous problems associated with its form. Blockchain heralds change as it allows unique tokens to be possessed and traded peer-to-peer instantaneously over the internet without the need for a trusted central administrator. Blockchain furthermore promises to ease processes thanks to its applicability in smart contracting procedures. The Model Law on Electronic Transferable Records (MLETR), passed by UNCITRAL in 2017, provides the relevant legal framework for legal protection of the blockchain bill of lading. This paper proposes Ethereum as a viable smart contract-enabled blockchain platform for a bill of lading system and examines said system’s compatibility with the MLETR. The analysis also shows that blockchain technology may have significant consequences for the ‘control’ approach for establishing possession of an electronic transferable record.
Racial Disparities in Utilization of Palliative Care Among Patients Admitted With Advanced Solid Organ Malignancies
Authors: Lee Kimberley , Gani Faiz , Canner Joseph K. , Johnston Fabian M. 
Published: May 2020

Background: There is increasing recognition of the importance of early incorporation of palliative care services in the care of patients with advanced cancers. Hospice-based palliative care remains underutilized for black patients with cancer, and there is limited literature on racial disparities in use of non-hospice-based palliative care services for patients with cancer. Objective: The primary objective of this study is to describe racial differences in the use of inpatient palliative care consultations (IPCC) for patients with advanced cancer who are admitted to a hospital in the United States. Design: This retrospective cohort study analyzed 204 175 hospital admissions of patients with advanced cancers between 2012 and 2014. The cohort was identified through the National Inpatient Dataset. International Classification of Disease, Ninth Revision codes were used to identify receipt of a palliative care consultation. Results: Of this, 57.7% of those who died received IPCC compared to 10.5% who were discharged alive. In multivariable logistic regression models, black patients discharged from the hospital, were significantly less likely to receive a palliative care consult compared to white patients (odds ratio [OR] black: 0.69, 95% CI: 0.62-0.76). Conclusions: Death during hospitalization was a significant modifier of the relationship between race and receipt of palliative care consultation. There are significant racial disparities in the utilization of IPCC for patients with advanced cancer.
Comparison of 5-Year Patient-Reported Outcomes (PROMs) of Total Ankle Replacement (TAR) to Total Knee Replacement (TKR) and Total Hip Replacement (THR)
Authors: Ramaskandhan Jayasree , Rashid Anjum , Kometa Simon , Siddique Malik S. 
Published: May 2020

Background: Total ankle replacement (TAR) is becoming a more common alternative to ankle arthrodesis for the improvement of pain and function in end-stage arthritis of the ankle. The effects of end-stage arthritis of the ankle are similar to those of end-stage hip arthritis. There is a paucity of literature on patient-reported outcome measures (PROMs) following TARs in comparison with total hip replacement (THR) or total knee replacement (TKR). We aimed to study the 1-, 3-, and 5-year outcomes of TAR in comparison with TKR and THR. Methods: PROMs data from patients who underwent a primary THR, TKR, or TAR performed between March 2008 and 2013 over a 5-year period were collected from our hospital patient registry. They were divided into 3 groups based on the type of primary joint replacement. Patient demographics and patient-reported outcomes (Western Ontario and McMaster Universities Osteoarthritis Index [WOMAC], 36-item Short-Form (SF-36) scores, and patient satisfaction scores at follow-up) were compared preoperatively and at the 1-, 3-, and 5-year follow-ups. Results: There were data available on 2672 THR, 3520 TKR, and 193 TAR patients preoperatively. Preoperatively, TAR patients reported statistically significantly higher function scores when compared with THR and TKR patients (40 vs 33; P = .001 [ P < .05] and 40 vs 36; P = .001 [ P < .05]). For SF-36 scores, there was no statistically significant difference between groups for the general health and role emotional components ( P = .171 and .064, respectively [ P > .05]); TAR patients reported similar scores to TKR patients for physical domains at the 3- and 5-year follow-ups ( P > .05), and TAR patients also reported similar scores to both THR and TKR patients for the mental domains ( P > .05). At 5 years postoperatively, TAR patients reported lower scores than THR and TKR patients for function and stiffness. For SF-36 scores, TAR patients reported similar outcomes to THR and TKR patients for mental health components ( P > .05), similar scores to TKR patients for 3 of 4 physical domains ( P < .05), but lower satisfaction rates for activities of daily living (ADL) and recreation when compared with THR ( P < .05). Conclusion: TAR patients had similar outcomes to THR and TKR patients for disease-specific and mental health domains, and lower patient satisfaction rates in terms of pain relief, ADL, and recreation. Further research is warranted including clinical outcomes along with PROMs with a long-term follow-up. Level of Evidence: Level III, retrospective comparative series.
Orbital malformation with dysplastic infraorbital artery in neurofibromatosis type 1
Authors: Li Zhengkang , Zhang Leilei , Deng Yuan 
Published: May 2020

Purpose: To report a case with neurofibromatosis type 1 presenting as prominent enophthalmos and abnormal infraorbital artery. Case description: A 19-year-old man with a family history of neurofibromatosis presented with prominent right enophthalmos. Computed tomography showed orbital dysplasia and enlarged inferior orbital fissure but no plexiform neurofibroma. Prominent intraoperative hemorrhage originated from several abnormal arteries in the infraorbital region during orbital reconstruction. A tortuous and dysplastic infraorbital artery was verified postoperatively by computed tomography angiography. The bleeding vessels were supposed to be the orbital branches of the dysplastic infraorbital artery. Conclusions: The orbital malformation and enlargement of inferior orbital fissure probably resulted in an abnormal infraorbital artery. Selective artery embolization may be chosen as a preceding treatment before orbital reconstruction surgery.
Outcomes of arteriovenous fistula creation: A Jordanian experience
Authors: Obeidat Khaled A , Saadeh Rami A , Hammouri Hanan M , Obeidat Motaz A , Tawalbeh Ra’fat A 
Published: May 2020

Objective: The arteriovenous fistula is considered the preferred hemodialysis access due to its lower complication rate and longer patency. The aim of this study is to report the outcomes of arteriovenous fistula creation and to study the predictive factors for these outcomes. Study design and method: This is a retrospective study of all patients who underwent autogenous arteriovenous fistula creation procedure by a single surgeon during the period from October 2011 till December 2017. Material: All the procedures were performed at an academic referral center by a single surgeon. All patients who underwent arteriovenous fistula creation in the upper limb during the study period were included. All patients were diagnosed with end-stage renal disease and referred for arteriovenous fistula creation either before or after initiating hemodialysis. Method: Data were collected from the patients’ charts. The primary outcomes were the primary failure and secondary patency rates. Secondary outcome was to find the factors associated with decreased patency. The Kaplan–Meier curve with the log-rank test was used to describe the patency while univariate and multivariate analyses were done to the factors considered relevant to the patency. Results: The total number of procedures was 291; of which, 18 were lost to follow-up. The primary failure rate was 12%. Secondary patency rate at 1 and 5 years was 79% and 53%, respectively. Diabetes mellitus and fistulae placed on right side were associated with decreased patency. Conclusion: The primary failure rate was relatively low in this study but the long-term functionality of the arteriovenous fistulae needs to be improved.
Angiotensin II type 1 receptor blockers favorably affect renal angiotensin II and MAS receptor expression in patients with diabetic nephropathy
Authors: Ma Ye-Ping , Yang Yue , Jiang Shi-Min , Liu Lin , Zhang Zheng , Wang Yi-Ning , Zou Gu-Ming , Li Wen-Ge 
Published: May 2020

Introduction: The aims of this study were to assess the renal expression of angiotensin II type 1 receptor (AT1R), angiotensin II type 2 receptor (AT2R), and MAS receptor in human type 2 diabetic nephropathy (DN). Materials and methods: In total, 115 patients diagnosed with DN by renal biopsy were enrolled in this study. The protein expression levels of the AT1R, AT2R, and MAS receptors were assessed by immunohistochemistry. Results: The protein expression levels of AT1R, AT2R, and MAS receptor in the renal biopsy tissue were correlated with the pathologic classification of DN. Tubulointerstitial AT1R expression in patients of class IIb was significantly stronger than control samples ( p < 0.05). Expression of AT2R and MAS receptors were highest with class IIb DN patients. When DN patients were treated with AT1R blocker (ARB), the expression of AT1R was downregulated ( p < 0.05), and the MAS receptor was upregulated in tubular interstitial ( p < 0.05). Conclusions: Our results directly observed that renal expression levels of AT1R increase during the early stages of DN, ARB reducing AT1R while increasing MAS receptor. Therefore, ARB should be used as soon as possible in patients with DN.
Identification of key genes, pathways and potential therapeutic agents for IgA nephropathy using an integrated bioinformatics analysis
Authors: Chen Xiaoxue , Sun Mindan 
Published: May 2020

Purpose: This study aims to identify immunoglobulin-A-nephropathy-related genes based on microarray data and to investigate novel potential gene targets for immunoglobulin-A-nephropathy treatment. Methods: Immunoglobulin-A-nephropathy chip data was obtained from the Gene Expression Omnibus database, which included 10 immunoglobulin-A-nephropathy and 22 normal samples. We used the limma package of R software to screen differentially expressed genes in immunoglobulin-A-nephropathy and normal glomerular compartment tissues. Functional enrichment (including cellular components, molecular functions, biological processes) and signal pathways were performed for the differentially expressed genes. The online analysis database (STRING) was used to construct the protein-protein interaction networks of differentially expressed genes, and Cytoscape software was used to identify the hub genes of the signal pathway. In addition, we used the Connectivity Map database to predict possible drugs for the treatment of immunoglobulin-A-nephropathy. Results: A total of 348 differentially expressed genes were screened including 107 up-regulated and 241 down-regulated genes. Functional analysis showed that up-regulated differentially expressed genes were mainly concentrated on leukocyte migration, and the down-regulated differentially expressed genes were significantly enriched in alpha-amino acid metabolic process. A total of six hub genes were obtained: JUN, C3AR1, FN1, AGT, FOS, and SUCNR1. The small-molecule drugs thapsigargin, ciclopirox and ikarugamycin were predicted therapeutic targets against immunoglobulin-A-nephropathy. Conclusion: Differentially expressed genes and hub genes can contribute to understanding the molecular mechanism of immunoglobulin-A-nephropathy and providing potential therapeutic targets and drugs for the diagnosis and treatment of immunoglobulin-A-nephropathy.
Management of Complex Traumatic Renal Artery–Inferior Vena Cava Fistula: A Case Report and Review of the Literature
Authors: Choudhary Narendra , Agarwal Harshit , Ghoshal Soumya , Uniyal Madhur , Kumar Abhinav , Gupta Amit 
Published: May 2020

Background: Renal artery–inferior vena cava (IVC) fistula is usually caused by penetrating injury to the back. However, it is a very rarely reported entity with only 20 cases reported in the literature. They may present acutely with hemodynamic instability or chronically as congestive heart failure. A thorough examination and adequate imaging are required to avoid missing such injuries. Case Presentation: A 28-year-old gentleman presented after sustaining stab injury to the back. The stab had penetrated the renal artery and IVC, leading to arteriovenous fistula. He was managed surgically, as he went into hemorrhagic shock, with a successful outcome. The case is also unique as an accessory renal artery was also involved in the fistula. Conclusion: Early identification and management of renal artery–IVC fistula is important to ensure a successful outcome. Such fistulas can be managed by either endovascular approach or surgical approach. The decision of approach depends on the level of expertise available and hemodynamic status of the patient.
Outcomes of bell-bottom technique compared to standard endovascular aneurysm repair
Authors: Massière Bernardo , Leão Ronaldo , Vescovi Alberto , Leal Daniel , Vivas Paula , Vasconcelos Adriana , von Ristow Arno 
Published: May 2020

Objective The bell-bottom technique is a widely used technique to treat aortoiliac aneurysms with preservation of the hypogastric arteries. The published data are scarce with conflicting results regarding the evolution. The aim of this study was to compare the outcomes of patients submitted to endovascular abdominal aortic aneurysm repair with standard technique (S-EVAR) versus bell-bottom technique. Methods This retrospective cohort study compared the outcomes of standard endovascular aneurysm repair (<16 mm iliac limbs) and bell-bottom technique (≥16 mm iliac limbs) in a tertiary vascular center between 2010 and 2015. The end points of this study were type IB endoleak, reintervention and 30-day mortality. The follow-up protocol included CT scans within 30 days of implantation and 12 months. Duplex ultrasound was performed yearly thereafter. Results Two hundred and three patients were treated with bell-bottom technique ( n = 84, mean age 72.2 ± 8.9) and S-EVAR ( n = 119, mean age 72.7 ± 8.4). The overall 30-day mortality was 1.9%, with no significant difference between groups. There was higher prevalence of coronary heart disease in the bell-bottom technique group compared to the S-EVAR group (41.6% vs. 18.4%, p < 0.01). One patient in the S-EVAR group (0.85%) and four patients in the bell-bottom technique (4.6%) developed type IB endoleak. The mean follow-up period was 35.2 ± 30.4 months. By Kaplan-Meier analysis, freedom from type IB endoleak in 80 months was 85.2% in the bell-bottom technique group and 98.7% in the S-EVAR group ( p = 0.05). The freedom from reintervention in 80 months was 74.0% in the bell-bottom technique group and 94.1% in the S-EVAR group ( p = 0.6). Conclusions This study shows lower freedom from type IB endoleak in the bell-bottom group compared to the standard repair group. There is no significant difference in reoperation rate and 30-day mortality.
A randomized controlled trial of high-intensity interval training and inspiratory muscle training for chronic heart failure patients with inspiratory muscle weakness
Authors: Sadek Zahra , Salami Ali , Youness Mahmoud , Awada Charifa , Hamade Malek , Joumaa Wissam H , Ramadan Wiam , Ahmaidi Said 
Published: May 2020

Objectives Chronic heart failure is a major public health problem in which supervised exercise programs are recommended as part of non-pharmacological management. There are various reports of the success of high-intensity aerobic interval training (HI-AIT) and inspiratory muscle training (IMT) in the management of chronic heart failure patients. This study tested the hypothesis that the combination of HI-AIT and IMT could result in additional benefits over the IMT and the HI-AIT alone in terms of inspiratory muscle function, exercise capacity, and quality of life in patients with chronic heart failure and inspiratory muscle weakness. Methods Forty patients with ejection fraction ≤45% and inspiratory muscle weakness described by maximal inspiratory pressure <70% predicted, underwent three exercise training sessions per week for 12 weeks. Patients were randomly allocated to one of four groups: the HI-AIT group, the IMT group, the combined (HI-AIT & IMT) group, and the control group. Before and after completing their training period, all patients underwent different tests that are mentioned above. Results No changes were detected in the control group. However, the combined group, when compared to HI-AIT and IMT groups, respectively, resulted in additional significant improvement in maximal inspiratory training (62%, 24%, 25%), exercise time (62%, 29%, 12%), the 6-minute walk test (23%, 15%, 18%), and the Minnesota Living with Heart Failure Questionnaire (56%, 47%, 36%). Conclusion In patients with chronic heart failure and inspiratory muscle weakness, the combination of the HI-AIT and the IMT resulted in additional benefits in respiratory muscle function, exercise performance, and quality of life compared to that of HI-AIT or IMT alone. Trial Registration number: NCT03538249
Pain-related beliefs are associated with arm function in persons with frozen shoulder
Authors: De Baets L , Matheve T , Traxler J , Vlaeyen JWS , Timmermans A 
Published: May 2020

Background Frozen shoulder is a painful glenohumeral joint condition. Pain-related beliefs are recognized drivers of function in musculoskeletal conditions. This cross-sectional study investigates associations between pain-related beliefs and arm function in frozen shoulder. Methods Pain intensity, arm function (Disabilities of the Arm, Shoulder and Hand Questionnaire (DASH)), pain catastrophizing (Pain Catastrophizing Scale (PCS)), pain-related fear (Tampa Scale for Kinesiophobia (TSK-11)) and pain self-efficacy (Pain Self-Efficacy Questionnaire (PSEQ)) were administered in 85 persons with frozen shoulder. Correlation analyses assessed associations between pain-related beliefs and arm function. Regression analysis calculated the explained variance in arm function by pain-related beliefs. Results Pain-related fear, pain catastrophizing and pain self-efficacy were significantly associated with arm function (r = 0.51; r = 0.45 and r = −0.69, all p < .0001, respectively). Thirty-one percent of variance in arm function was explained by control variables, with pain intensity being the only significant one. After adding TSK-11, PCS and PSEQ scores to the model, 26% extra variance in arm function was explained, with significant contributions of pain intensity, pain-related fear and pain self-efficacy (R2 = 0.57). Conclusions Attention should be paid towards the negative effect of pain-related fear on outcomes in frozen shoulder and towards building one’s pain self-efficacy given its protective value in pain management.
A Retrospective Radiographic Evaluation of a Modified Method of Lateral Column Lengthening
Authors: Wapner Keith , Freeland Erik , Kirwan Gregory , Baldwin Keith 
Published: May 2020

Background: Lateral column lengthening (LCL) is a commonly performed procedure for patients with stage II adult-acquired flatfoot deformity (AAFD) to correct forefoot abduction. This procedure is frequently completed concomitantly with both soft-tissue and bony procedures, including a medial slide calcaneal osteotomy to further reduce hindfoot valgus. The purpose of this study is to investigate and identify the radiographic outcomes of a modified step-cut LCL utilized as an alternative approach for correction of stage II AAFD. Methods: A retrospective radiographic review was performed on 15 feet in 14 patients who underwent correction of stage II AAFD using a step-cut LCL between August 2009 and January 2012. Two independent examiners utilizing 6 radiographic parameters evaluated preoperative and postoperative weight-bearing radiographs of the foot. Results: At a mean follow-up of 13.4 (range 12-16) weeks, weight-bearing radiographs demonstrated a significant median decrease in the lateral talometatarsal angle of 14.4° (P < .001), lateral talocalcaneal angle of 7° (P < .001), anteroposterior talometatarsal angle of 14.5° (P < .001), anteroposterior talocalcaneal angle of 5.5° (P < .001), and talonavicular coverage angle of 26.5° (P < .001). Additionally, a significant median increase in calcaneal pitch of 8.5° (P < .001) was noted. Conclusion: This study demonstrates statistically significant improvement of radiographic outcomes with use of a modified step-cut LCL as an alternative approach for correction of stage II AAFD. Levels of Evidence: Level IV: Retrospective case series