bluuebunny/crossref_metadata_2025_split huggingface dataset:
Epidemiology of penetrating injury in an urban versus rural level 1 trauma center in the Netherlands
Authors: Rikken Quinten GH , Chadid Abdes , Peters Joost , Geeraedts Leo MG , Giannakopoulos Georgios F , Tan Edward CTH 
Published: February 2020

Background:Penetrating injury can encompass a large spectrum of injuries dependent on the penetrating object, the location of entry, and the trajectory of the object through the human body. Therefore, the management of penetrating injuries can be challenging and often requires rapid assessment and intervention. No universal definition of penetrating injury exists in the literature and little is known about the demographics and outcome of penetrating injury in the Netherlands.Objective:A research was carried out to ascertain the size and outcome of penetrating injuries in two level‐one trauma centers in the Netherlands.Methods:Using the trauma registry of the Radboud University Medical Center in Nijmegen and VU University Medical Center in Amsterdam, all patients with penetrating injury were identified who were admitted to these level 1 trauma centers in the period between January 1, 2009, and January 1, 2014. Penetrating injury was defined as an injury that caused disruption of the body surface and extended into the underlying tissue or into a body cavity. Data concerning age, gender, mechanism of injury, Glasgow Coma Scale, number of injuries, type of injury, and Injury Severity Score were collected and analyzed. Patient results were stratified by Injury Severity Score.Results:In total, 354 patients were identified, making up around 2% of all admitted trauma patients 3.1% (VU Medical Center) and 1.6% (Radboud Medical Center). Patients were overwhelmingly male (83.1%) and median age was 36 years (range = 1–88 years). Most injuries were caused by stabbings (51.1%) followed by shootings (26.3%). Admission to the intensive care unit occurred in 41.1% of all patients. Median stay in the intensive care unit was 5.1 days (range = 1–96 days) and median total hospital stay was 8 days (range = 1–95 days). Mortality among these patients was 7.1%, ranging from 0% among patients with Injury Severity Score 1–8 to 100% in patients with Injury Severity Score > 34. High mortality figures were associated with injuries caused by firearms (19.4%), injuries to the head (27.9%), and alleged assaults (10.9%). Differences in demographics between the two centers were not significant.Conclusion:Penetrating injury is a relative rare occurrence in the Netherlands compared with other countries. It is associated with high mortality and substantial hospital costs. The incidence of penetrating injuries is higher in metropolitan areas than in rural areas. A universal definition of penetrating trauma should be agreed upon in order to ensure that future studies remain free of bias, and also to ensure that data remain homogeneous.
All Polymer Dielectric Films for Achieving High Energy Density Film Capacitors by Blending Poly(Vinylidene Fluoride-Trifluoroethylene-Chlorofluoroethylene) with Aromatic Polythiourea
Authors: Li Chengwei , Shi Liuwei , Yang Wenyao , Zhou Yujiu , Li Xiali , Zhang Chengguang , Yang Yajie 
Published: February 2020

AbstractConstruct dielectric films with high energy density and efficiency are the key factor to fabricate high-performance dielectric film capacitors. In this paper, an all organic composite film was constructed based on high dielectric polymer and linear dielectric polymer. After the optimized polycondensation reaction of a linear dielectric polymer aromatic polythiourea (ArPTU), the proper molecular weight ArPTU was obtained, which was introduced into poly(vinylidene fluoride-trifluoroethylene-chlorofluoroethylene) (PVDF-TrFE-CFE) terpolymer for a composite dielectrics. The results indicate that the addition of ArPTU molecules reduces the dielectric loss and improves the breakdown field strength of the PVDF-TrFE-CFE effectively. For the PVDF-TrFE-CFE/ArPTU (90/10) composite film, the maximum energy density about 22.06 J/cm3at 407.57 MV/m was achieved, and high discharge efficiency about 72% was presented. This composite material can be casted on flexible substrate easily, and PVDF-TrFE-CFE/ArPTU organic composite films having high energy density, high breakdown field strength, low dielectric loss, and higher discharge efficiency are obtained. This is an unreported exploration about high energy density organic dielectric films based on PVDF-TrFE-CFE matrix and linear polymer dielectrics, and the findings of this research can provide a simple and scalable method for producing flexible high energy density materials for energy storage devices.
Takotsubo cardiomyopathy complicated by cardiac tamponade due to non-hemorrhagic pericardial effusion: a case report
Authors: Nagamori Yuta , Hamaoka Takuto , Murai Hisayoshi , Takashima Shinichiro , Kato Takeshi , Usui Soichiro , Sakata Kenji , Furusho Hiroshi , Kawashiri Masaaki , Takamura Masayuki 
Published: February 2020

Abstract
Background
Cardiac tamponade is a rare but serious complication of Takotsubo cardiomyopathy (TC). Two cases of cardiac tamponade subsequent to TC have been reported. The pericardial effusion in these cases was hemorrhagic and caused by ventricular rupture. Cardiac tamponade induced by an inflammatory effusion complicated with TC has not been reported. This is the first case report of TC, which developed cardiac tamponade during the recovery phase with a large volume non-hemorrhagic inflammatory effusion.

Case presentation
We describe a case of an 81-year-old woman admitted to our hospital because of severe chest pain. Her symptoms began soon after her son’s hospitalization. We diagnosed her with TC based on results of an electrocardiogram, echocardiogram, and emergent coronary angiography. Her symptoms and left ventricular dysfunction improved gradually. She developed newly confirmed chest pain and dyspnea on day 9 after admission. A large pericardial effusion developed, resulting in cardiac tamponade. Her symptoms and hemodynamic status improved immediately after the pericardiocentesis. The effusion was non-hemorrhagic and exudative. No specific signs of infection, collagen disease, or malignant tumors were observed, except for TC.

Conclusions
We experienced a case of circulatory collapse induced by TC-related inflammatory pericardial effusion at recovery phase. This case emphasizes the importance of careful follow-up even after improved left ventricular dysfunction in a patient with TC.
Unpacking the dynamics of double stigma: how the HIV-TB co-epidemic alters TB stigma and its management among healthcare workers
Authors: Wouters Edwin , Sommerland Nina , Masquillier Caroline , Rau Asta , Engelbrecht Michelle , Van Rensburg André Janse , Kigozi Gladys , Ponnet Koen , Van Damme Wim 
Published: February 2020

Abstract
Background
HIV and tuberculosis (TB) are intricably interlinked in South Africa. The social aspects of this co-epidemic remain relatively unexplored. More specifically, no research has quantitatively explored the double stigma associated with HIV and TB in this context, and more specifically the impact of the co-epidemic on [1] the stigmatisation of TB and [2] the TB stigma mangement strategy of covering (i.e. the use of TB as a cover for having HIV). The current study aims to address this research gap by disentangling the complex mechanisms related to HIV-TB stigma.

Methods
Using Structural Equation Modelling (SEM), data of 882 health care workers (HCWs) in the Free State province, South Africa, are analysed to investigate the link between the stigmatization of HIV and TB and the stigma management by those affected. The current study focuses on health care workers (HCWs), as both TB and HIV have a severe impact on this professional group.

Results
The results demonstrate that the perceived link between the epidemics is significantly associated with double HIV-TB stigmatization. Furthermore, the link between the illnesses and the double stigma are driving the stigmatization of TB. Finally, the link between HIV and TB as well as the stigmatization of both diseases by colleagues are associated with an increased use of covering as a stigma management strategy.

Conclusions
This is the first quantitative study disentagling the mediating role of double stigma in the context of the co-epidemic as well as the impact of the co-epidemic on the social connotations of TB. The results stress the need for an integrated approach in the fight against HIV and TB recognizing the intertwined nature of the co-epidemic, not only in medical-clinical terms, but also in its social consequences.

Trial registration
South African National Clinical Trials Register, registration ID: DOH-27-1115-5204. Prospectively registered on 26 August 2015.
Tumour content ratio matters for detecting epidermal growth factor receptor mutation by cobas test in small biopsies; a retrospective study
Authors: Kogo Mariko , Fujimoto Daichi , Hosoya Kazutaka , Nagata Kazuma , Nakagawa Atsushi , Tachikawa Ryo , Yamashita Daisuke , Kitamura Yuka , Imai Yukihiro , Tomii Keisuke 
Published: February 2020

Abstract
Background
Recent studies indicate the benefit of treatment with osimertinib over that with conventional epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKI) for untreated EGFR-mutated non-small cell lung cancer (NSCLC). Cobas ver2 is the only companion diagnostic method for detecting EGFR mutations with osimertinib treatment. We clinically experience false negative cases with this test, but its actual sensitivity is unknown. Moreover, no study has suggested the importance of tumour dissection, and most facilities do not routinely perform them on small biopsies. The purpose of this study was to evaluate the sensitivity of cobas in clinical practice and clarify the role of dissection as a component of the cobas testing.

Methods
We examined 132 patients with EGFR-mutated NSCLC diagnosed by bronchoscopy and confirmed with PCR clamp. Patients were tested with cobas and the EGFR-positive rate was calculated. Samples with undetected EGFR mutations were retested after tumour dissection and the rate of samples whose EGFR mutation was corrected to positive was assessed. To evaluate tumour cellularity, the tumour content ratio was assessed by calculating tumour cell count over the total cell count on the slide.

Results
The positive rate of EGFR mutation identification was 76% with cobas, although EGFR mutation-negative patients retained responses to TKI therapy equivalent to positive patients did; however, the tumour content ratio of negative samples was significantly lower than that of positive samples. Twenty-nine negative samples underwent dissection and 24% were corrected to positive. Moreover, 53% of the samples with a tumour content ratio below 10% was negative for cobas, but 33% of these turned positive after dissection.

Conclusions
Cobas had a high false negative rate in clinical practice, and tumour content ratio might be associated with this rate. Dissection could improve the sensitivity of cobas, especially in samples with low tumour cellularity.
Rural-urban differences in the association between individual, facility, and clinical characteristics and travel time for cancer treatment
Authors: Segel Joel E. , Lengerich Eugene J. 
Published: February 2020

Abstract
Background
Greater travel time to cancer care has been identified as a potential barrier to care as well as associated with worse health outcomes. While rural cancer patients have been shown to travel farther for care, it is not known what patient, facility, and clinical characteristics may differentially be associated with greater roundtrip travel times for cancer patients by rurality of residence. Identifying these factors will help providers understand which patients may be most in need of resources to assist with travel.

Methods
Using 2010–2014 Pennsylvania Cancer Registry data, we examined the association between patient, facility, and clinical characteristics with roundtrip patient travel time using multivariate linear regression models. We then estimated separate models by rural residence based on the Rural-Urban Continuum Code (RUCC) of a patient’s county of residence at diagnosis to understand how the association of each factor with travel time may vary for patients separated into metro residents (RUCC 1–3); and two categories of non-metro residents (RUCC 4–6) and (RUCC 7–9).

Results
In our sample (n = 197,498), we document large differences in mean roundtrip travel time—mean 41.5 min for RUCC 1–3 patients vs. 128.9 min for RUCC 7–9 patients. We show cervical/uterine and ovarian cancer patients travel significantly farther; as do patients traveling to higher volume and higher-ranked hospitals.

Conclusions
To better understand patient travel burden, providers need to understand that factors predicting longer travel time may vary by rurality of patient residence and cancer type.
Root dentine thickness of danger zone in mesial roots of mandibular first molars
Authors: Zhou Guangchao , Leng Diya , Li Mingming , Zhou Yang , Zhang Cuifeng , Sun Chao , Wu Daming 
Published: February 2020

Abstract
Background
Better understanding of the danger zone anatomy in mesial roots (MRs) of mandibular first molars (MFMs) may serve to decrease the risk of mishaps. This study aimed to measure the minimal distal dentine thicknesses of danger zone in MRs of MFMs in a native Chinese population using cone-beam computed tomography (CBCT).

Methods
CBCT images of 1792 MFMs from 898 Chinese patients were analyzed. The minimal distal dentine thicknesses of the mesiobuccal (MB) and mesiolingual (ML) canals below the furcation 1, 2, 3, 4, 5 mm were measured. The association between the minimal distal dentine thicknesses and the root lengths, patient’s age and gender, side were assessed.

Results
The minimal distal dentine thicknesses of MB and ML canals are located 3 ∼ 4 mm below the furcation for both men and women. There are no differences between MB and ML canals, while the minimal distal dentine thicknesses of MB and ML canals were higher in men than women (P < 0.05), except at 1 and 3 mm of ML canals (P > 0.05). The minimal distal dentine thicknesses of MB and ML canals increased with age in both men and women at each location (P < 0.05). The minimum distal dentine thickness at every location were significantly different between long teeth and short teeth both in men and women (P < 0.05), with short teeth having the smallest mean values. There are no significant differences between two sides (P > 0.05).

Conclusions
The minimal distal dentine thicknesses of MRs in MSMs have close correlation with root length, patient’s age and gender.
Evaluation of the maxillary midline, curve of the upper lip, smile line and tooth shape: a prospective study of 140 Caucasian patients
Authors: Melo María , Ata-Ali Javier , Ata-Ali Fadi , Bulsei Marco , Grella Perluigi , Cobo Teresa , Martínez-González José María 
Published: February 2020

AbstractBackgroundA number of reference patterns such as the interincisal line, curve of the upper lip, width of the smile or shape of the teeth have been studied in different populations. Determining the frequency of different smile aesthetic parameters in a European Caucasian population and exploring possible gender differences is important in order to obtain predictable treatment outcomes.MethodsPhotographs were obtained under resting and forced smiling conditions in 140 individuals (70 males and 70 females) with a mean age of 20.1 ± 4.3 years. Different variables were recorded, including the position of the maxillary interincisal midline in relation to the facial midline, the arc and width of the smile, and the shape of the teeth. The data were processed using the SPSS version 15.0 statistical package, with application of the chi-squared test and a confidence level of 95%. The statistical power was 80%, and the level of significance 5% (α = 0.05).ResultsA total of 94.3% of the sample presented a maxillary interincisal midline coinciding with the facial midline, and 80% had a consonant smile line. The curve of the upper lip was upwards in 47.1% of the cases, followed by a straight curve in 41.4%. Most of the subjects (84.3%) presented a medium smile line with tooth exposure to the second premolar (61.4%). There were no significant differences between males and females.ConclusionsThe integration of aesthetic criteria is needed in order to guarantee satisfactory and predictable dental treatment outcomes. There were no statistically significant differences between males and females. The maxillary interincisal midline coincided with the facial midline, with a consonant smile arc and a medium smile line, upward lip curve and oval tooth shape.
The tensions between micro-, meso- and macro-levels: physiotherapists’ views of their role towards fall prevention in the community – a qualitative study
Authors: Cerderbom Sara , Bjerk Maria , Bergland Astrid 
Published: February 2020

AbstractBackgroundFalls are a global public health concern. Physiotherapists are a key resource in this context, but there is sparse knowledge about how they perceive their role in the primary care setting. Therefore, the purpose of the present study is to explore physical therapists’ (PTs) view of how they experience and perceive their role working with fall prevention in a community care setting.MethodsSemi-structured interviews were conducted with 17 physiotherapists. Data were analysed using a qualitative thematic analysis.ResultsThe analysis resulted in a core theme and three subthemes. The core theme was ‘capability to cope with the tensions between the micro-, meso- and macro-levels in fall, prevention’, which indicated the importance of an evolving multifaceted, evidence based and innovative physiotherapy role. A key factor for this role is to take an integrative biopsychosocial approach based on how biological and psychosocial factors are uniquely related in fall prevention. The three themes were as follows: 1) always moving and changing: the competent explorative knowledge-hungry clinician’s multifaceted role; 2) multiprofessional – but in the end alone; 3) reaching out–from the bottom to the top. Success in the role of physiotherapists in fall prevention depends on the empowering leadership and working culture, as well as on the time and multifaceted professional competence of the clinicians.ConclusionOur findings indicate that the PTs’ role reflects their abilities to change and improve their professional work in accordance with evidence based knowledge. To ensure good quality the PTs focused on the special needs of the patients, evidence-based fall prevention, interdisciplinary team work, good clinical competences, good skills in communication, and interpersonal relations. Attention should be placed on the importance of biopsychosocial perspective framing in the actual clinical and political context. The PTs saw the need for working at the micro-, meso- and macro-levels to succeed in the work of fall prevention.
Gender differences in pulmonary arterial hypertension patients with BMPR2 mutation: a meta-analysis
Authors: Ge Xiaoyue , Zhu Tiantian , Zhang Xinyi , Liu Ye , Wang Yonglong , Zhang Weifang 
Published: February 2020

AbstractObjectiveTo investigate the differences in the proportions of BMPR2 mutations in familial hereditary pulmonary arterial hypertension (HPAH) and idiopathic pulmonary arterial hypertension (IPAH) between males and females and the relationship between BMPR2 mutation and PAH severity.MethodsA computer was used to search the electronic Cochrane Library, PubMed/MEDLINE, and EMBASE databases for clinical trials containing information on the relationship between PAH prognosis and BMPR2 mutations through March 2019. After obtaining the data, a meta-analysis was performed using Review Manager Version 5.3 and Stata.ResultsA meta-analysis was performed on 17 clinical trials (2198 total patients: 644 male, 1554 female). The results showed that among patients with HPAH and IPAH, the BMPR2 mutation rate is higher in male than in female patients [male group (224/644, 34.78%), female group (457/1554, 29.41%), OR = 1.30, 95% CI: 1.06~1.60,P = 0.01, I2 = 10%]. Furthermore, haemodynamic and functional parameters were more severe in IPAH and HPAH patients with BMPR2 mutations than in those without, and those with BMPR2 mutation were diagnosed at a younger age. The risk of death or transplantation was higher in PAH patients with BMPR2 mutations than in those without (OR = 2.51, 95% CI: 1.29~3.57,P = 0.003, I2 = 24%). Furthermore, the difference was significant only in male patients (OR = 5.58, 95% CI: 2.16~14.39,P = 0.0004, I2 = 0%) and not in female patients (OR = 1.41, 95% CI: 0.75~2.67,P = 0.29, I2 = 0%).ConclusionAmong patients with HPAH and IPAH, men are more likely to have BMPR2 mutations, which may predict more severe PAH indications and prognosis.
Crosstalk between autophagy and metabolic regulation of cancer stem cells
Authors: El Hout Mouradi , Cosialls Emma , Mehrpour Maryam , Hamaï Ahmed 
Published: February 2020

AbstractCancer is now considered as a heterogeneous ecosystem in which tumor cells collaborate with each other and with host cells in their microenvironment. As circumstances change, the ecosystem evolves to ensure the survival and growth of the cancer cells. In this ecosystem, metabolism is not only a key player but also drives stemness. In this review, we first summarize our current understanding of how autophagy influences cancer stem cell phenotype. We emphasize metabolic pathways in cancer stem cells and discuss how autophagy-mediated regulation metabolism is involved in their maintenance and proliferation. We then provide an update on the role of metabolic reprogramming and plasticity in cancer stem cells. Finally, we discuss how metabolic pathways in cancer stem cells could be therapeutically targeted.
Thunder-fire moxibustion for cervical spondylotic radiculopathy: Study protocol for a randomized controlled trial
Authors: Huang Yunxuan , Zhang Jiabi , Xiong Buhui , Huang Ruina , Zhao Wenjing , Zhou Mengxue , Chen Qi , Xu Danghan , Chen Xinghua 
Published: February 2020

Abstract
Background
Thunder-fire moxibustion originated in China and contains traditional Chinese medicine. It can produce strong firepower, infrared thermal radiation, and medicinal effects when burning on the acupoints. Thunder-fire moxibustion is commonly used in patients with neck pain, but its efficacy has rarely been systematically demonstrated. We designed a randomized trial of thunder-fire moxibustion on cervical spondylotic radiculopathy (CSR) to investigate whether it is more effective than ibuprofen sustained-release capsules.

Methods
One hundred patients will be recruited and randomly divided into thunder-fire moxibustion and ibuprofen groups. The intervention consists of ten treatments and will last for 2 weeks. The Yasuhisa Tanaka 20 Score Scale is used as the primary outcome measure. It contains a combination of the self-conscious symptom in patients, objective clinical evaluation from doctors, and social evaluation (the ability to work and live). The objective and comprehensive evaluation of CSR patients before and after treatment is particularly needed. The Short-Form McGill Pain Questionnaire-2 (SF-MPQ-2), Neck Disability Index score scale (NDI), and the Quality of Life Assessment (SF-36) are applied as secondary outcome measures. The assessment will take place at the baseline and the first and second weekends of treatment. If an adverse event (AEs) occurs, it will be reported.

Discussion
The aim of this trial is to determine whether thunder-fire moxibustion is more effective than ibuprofen in the treatment of patients with CSR.

Trial registration
Chinese Clinical Trial Registry (http://www.chictr.org.cn), ChiCTR1800018820. Registered on 11 October 2018.