bluuebunny/crossref_metadata_2025_split huggingface dataset:
The greater tuberosity radius ratio: maybe a new predictor in diagnosis of rotator cuff tear
Authors: Ma Qi , Sun Changjiao , Liu Pu , Wu Sha , Cai Xu 
Published: July 2020

Abstract
Background

The role of the greater tuberosity of humerus in subacromial impingement should be of equal important as the acromion. In this study we concerned on the morphological characteristics of the greater tuberosity of humerus and proposed the greater tuberosity radius ratio (GTRR) as a new predictor for the diagnosis of rotator cuff tear. We hypothesized that a larger value of the GTRR could increase the risk of developing rotator cuff tear.
Methods

This was a retrospective study and clinical data and preoperative computed tomography images of the patients with rotator cuff tears (defined as the RCT group, simple size: 61) or without rotator cuff tears (defined as the control group, simple size: 56) were collected. Three-dimensional models of shoulders were established by multiplanar reconstruction of computed tomography scans. In a standard anteroposterior view, the radius of the best-fit circle of the humeral head (the r) and the radius of the concentric circle passing through the most superolateral edge of the greater tuberosity (the R) were measured for each shoulder. The ratio of R and r (R/r) was defined as the greater tuberosity radius ratio (GTRR). Independent samples t tests were used to find significant differences within the r, the R and the GTRR between groups. Receiver operating characteristic (ROC) curve based on the values of GTRR was performed to determine an applied cutoff value which may be useful in clinical practice.
Results

There was no significant difference in the values of r or R. However, the mean values of GTRR were 1.339 ± 0.143 (range, 1.087–1.684) and 1.244 ± 0.172 (range, 1.040–1.706) in the two groups respectively (p = 0.002). According to the ROC curve, an optimized cutoff value of GTRR was determined as 1.262, whose sensitivity was 72% and specificity was 65% for diagnosis of rotator cuff tear.
Conclusion

The greater tuberosity of humerus contributes to the mechanisms of rotator cuff tear. The greater tuberosity radius ratio is recommended as a new predictor for diagnosis of rotator cuff tear, with an optimized cutoff value set as 1.262.
Pulmonary CT signs in patients with COVID-19 infection
Authors: Zarad Carmen Ali , Shanab Waleed Said Ahmed Abo 
Published: July 2020

Abstract
Background: The aim of the study is to investigate the pulmonary CT signs in patients with confirmed COVID-19 infection. This study included 100 patients, 54 male and 46 female their ages ranged from 6 to 85 years. All Patients tested positive for COVID-19 infection by RT-PCR test included in this study. All the patients performed pulmonary CT scan and the CT findings were evaluated.Results: 90 patients (90%) had abnormal pulmonary CT. Two lungs affected in 79 patients (79%). Lesions involved 1 lobe (11%), 2-3 lobes (35%) and 4-5 lobes (44%). The most involved pulmonary lobes were right lower lobe (77 patients, 77%), followed by left lower lobe (71 patients, 71%), the most involved pulmonary segments were posterior segments (69 patients, 69%),peripheral sub-pleural lesions were the commonest lesions location (64 patients, 64%). The most common lesions pattern were ground glass pattern (44 patients, 44%), followed by mixed ground glass and consolidation patterns (33 patients, 33%). The commonest lesion shape was patchy opacities (40 patients, 40%). Reversed halo sign (28 patients, 28%), air bronchogram sign (39 patients, 39%), crazy paving pattern (77 patients, 77%), vascular thickening (66 patients, 66%), and pleural thickening (7 patients, 7%) CONCLUSION: The main pulmonary CT signs in patients with COVID-19 infection are bilateral, peripheral, multi-lobar patchy and nodular Ground glass opacification with or without consolidation. Other signs may also present include crazy paving pattern, reversed halo sign vascular thickening, and air bronchogram sign with no extra-pulmonary signs except for few pleural thickening.
MiR-106b-5p represses neuropathic pain by regulating P2X4 receptor in the spinal cord in mice
Authors: Du Huiying , Tan Xinran , Wei Xuhong , Yuan Zhongmin , Gong Qingjuan 
Published: July 2020

Abstract
Background: P2X4 receptor (P2X4R)-mediated spinal microglial activation makes a critical contribution to pathologically enhanced pain processing in the dorsal horn. It can be upregulated under conditions of neuropathic pain. However, the specific mechanism of pathogenesis and potential molecular targets has not yet been made explicit. MicroRNAs (miRNAs) are commonly recognized as indicators in neuropathic pain pathophysiology.Methods: We established the pain model of spared nerve injury (SNI), and the 50% paw withdrawal thresholds (PWMTs) were used to assess behavior of mouse. MiRNA expression profiling was performed to detect differential expressed miRNA. The western-bolt and quantitative real time PCR to examine P2X4R and miRNA expression in the mouse. Dual-luciferase reporter assays confirmed the correlation between P2X4R and miRNA. Fluorescence in situ hybridization was used to show location between P2X4R and miRNA. Results: In the present study, we found that P2X4R was up-regulated in the spinal dorsal horn of mice following spared nerve injury (SNI), and we identified 69 miRNAs (46 up-regulated and 23 down-regulated miRNAs) were differently expressed (fold change > 2, P < 0.05). P2X4R was a major target of miR-106b-5p (one of down-regulated miRNAs in SNI) with bioinformatics technology and quantitative real time PCR analysis validated the expressed change of miR-106b-5p, and dual-luciferase reporter assays confirmed the correlation between them. Fluorescence in situ hybridization showed that miR-106b-5p was co-localized with P2X4R in the spinal cord. Transfection with miR-106b-5p mimic on BV2 cells reversed the up-regulation of P2X4R induced by LPS. Moreover, miR-106b-5p overexpression significantly attenuated neuropathic pain induced by SNI, with decreased expression of P2X4R mRNA and protein in the spinal cord.Conclusion: Taken together, our results suggest that miR-106b-5p can serve as an important regulator of neuropathic pain development by targeting P2X4R.
Lower Diagnostic Costs Associated With Early Deployment of Capsule Endoscopy in Non-hematemesis Gastrointestinal Bleeding: A Cost-utilization Analysis
Authors: Jawaid Salmaan , Maranda Louise , Cave David 
Published: July 2020

Abstract
Introduction: Often, the diagnostic workup of patients presenting with non-hematemesis gastrointestinal bleeding (NHGIB) is inconclusive. Consequently, the diagnostic evaluation may incur unnecessary health care costs and diagnostic times. The use of a cost decision-analytical model of the current diagnostic management strategy applied to patients presenting with NHGIB may reveal alternative strategies for the evaluation of NHGIB.Methods: Cost decision-analytical model that retrospectively follows the diagnostic course of 231 consecutive patients presenting with NHGIB to the emergency department (ED) of a tertiary medical center. We measured the effect (cost and relative times) of selecting a specific procedure, plus the effect of pursuing secondary procedures after non-diagnostic primary procedures.Results: A primary VCE had a diagnostic rate of 68% vs. 45% and 48% for a primary EGD and COLO, respectively. Combining the diagnostic rates for each primary procedure with the cost of performing subsequent procedures (after non-diagnostic primary procedures), demonstrates the primary use of VCE (n=9) results in a total cost of $12,146 vs. $12,746 and $13,162 for a primary EGD (n=47) and COLO (n=33), respectively. Similarly, the use of VCE as a primary diagnostic procedure in NHGIB patients admitted to the floor would take 74 unit hours to reach a diagnosis compared to 104 and 131 for EGD and COLO, respectively.Conclusion: Our model suggests initial use of VCE for the diagnosis of acute NHGIB, may reduce time to diagnosis and management costs.
Impact of risk of bias on the magnitude of treatment effects of randomized controlled trials in implant dentistry
Authors: Ding Ruolin , Lu Wenxin , Yi Jianru , Zhang Liang , Zhao Zhihe 
Published: July 2020

Abstract
Background: Risk of bias (RoB) could influence the magnitude of treatment effects of randomized controlled trials (RCTs). This study aims to investigate the potential influence of RoB on treatment effects estimates in RCTs in implant dentistry. Methods: The RCTs published in five leading oral implant journals during the recent five years were electronically searched. The RoB was assessed using the Cochrane Collaboration RoB tool. The meta-regression analysis and Monte Carlo permutation test were performed to identify the association between RoB and the magnitude of treatment effects.Results: A considerable amount of studies have high RoB in blinding of participants and personnel, and unclear RoB in allocation concealment and selective reporting. The treatment effects were exaggerated by flaws in allocation concealment for binary outcomes and by deficiencies in random sequence generation and selective reporting for continuous outcomes.Conclusion: RoB frequently exists in RCTs recently published in implant dentistry, which may lead to the exaggeration of treatment effects. Better study design, implementation, and reporting are required for clinical trials in implant dentistry to ensure more reliable evidence.
Validation and Reliability of the Chinese Version of the Miller Behavioral Style Scale
Authors: Zhuo Qiqi , Liang Hongmin , Bai Yangjuan , Hu Qiulan , Hanum Ardani Latifah , Yang Mingfang , Wang Yanjiao , Wei Wei , Ding Lan , Ma Fang 
Published: July 2020

Abstract
Objectives: To test the psychometric properties of the Chinese version of Miller Behavioral Style Scale(C-MBSS).Methods: The forward-back-translation procedure was adopted in the translation of the Miller Behavioral Style Scale. Content validity was assessed in a panel of experts. In a sample of 1343 individuals, reliability and construct validity were assessed using Cronbach’s alpha coefficient and factor analysis. For exploratory factor analysis, parallel analysis was used to decide number of factors, principal axis factoring and direct oblimin rotation method were used to select factor. For confirmatory factor analysis, structural equation modelling was established to verify the extracted factor structure.Results: The C-MBSS achieved conceptual and semantic equivalence with the original scale. The item content validity index(I-CVI) of each item ranged from 0.78 to 1, and the averaging scale content validity index(S-CVI/ Ave) was 0.95. The cronbach`s alpha coefficient for the scale and sub-scales were over 0.6. The exploratory factor analysis resulted in 2-factor assumption for each hypothetical threat-evoking scenario. Confirmatory factor analysis provided confirmatory evidence for the second-order factor structure of 2-factor solution (Monitoring and Blunting) and demonstrated a good fit between theoretical model and data. Conclusions: This study verified the psychometric properties of the C-MBSS and indicated that the C-MBSS can be used to identify individual`s information-seeking style in Chinese population. With the use of the C-MBSS, health care professionals in China can deliver health education based on patients’ information-seeking behavior, which can improve the effect of health education and patients’ health outcomes.
Integrating Transcriptomics for the Identification of Potential Age-related Genes and Cells in Three Major Urogenital Cancers Across the Cancer Genome Atlas
Authors: Cao Jinlong , Li Jianpeng , Yang Xin , Li Pan , Yao Zhiqiang , Han Dali , Ying Lijun , Wang Lijie , Tian Junqiang 
Published: July 2020

Abstract
Background: Cancer is often defined as a disease of aging. The majority of patients with urogenital cancers are the elderly, whose clinical characteristics are greatly affected by age and aging. Here, we aimed to explore age-related biological changes in three major urogenital cancers by integrative bioinformatics analysis.Methods: First, mRNA (count format) and clinical data for bladder cancer, prostate cancer and renal cell carcinoma were downloaded from the Cancer Genome Atlas (TCGA) portal. The expressions of 64 cells were obtained by xCell deconvolution method. EdgeR package and limma package were used to analyze differentially expressed genes and cells in the young group and the old group, respectively. ClusterProfiler R package and clueGO plugin were used for enrichment analysis, and cytohubba plugin was used for hub genes analysis. Then co-expression analysis and chromosome distribution for hub genes were analyzed and demonstrated by RIdeogram R package. The clinical correlation of hub genes and key cells was analyzed by Graphpad Prism software. Finally, the correlation between hub genes and key cells was explored by corrplot R package.Results: We screened and identified 14 hub genes and 4 key cells related to age and urogenital cancers. The age-related differentially expressed genes and co-expressed genes were mainly enriched in muscle movement (Cl-, Ca2+), inflammatory response, antibacterial humoral immune response, substance metabolism and transport, redox reaction, etc. Most of the age-related genes are on chromosome 17. Moreover, the correlation between cells and genes was analyzed. Conclusion: Our study analyzed age-related genes and cells in the tumor microenvironment of urogenital cancers, and explored the pathways involved. This could contribute to personalized therapy for patients of different ages and a new understanding of the potential relationship between the aging microenvironment and urogenital cancers.
Mediating Effect of Deteriorated Kidney Function in Comorbidity-related Excess Deaths in COVID-19: A Retrospective Cohort Study
Authors: Luo Dongling , Liu Qiaomei , Xie Changming , Wang Weidong , Wang Xiong , Wu Juan , Xi Maomao , Yin Yilin , Xiong Di , Wu Yuwei , Xie Yuqing , Shi Ximin , Luo Pengcheng , Dong Fang , Huang Hui 
Published: July 2020

Abstract
Background In-hospital death risks vary in COVID-19 patients with comorbidities. Kidney function decline is prevalent in this course. Methods To explore the exact role of deteriorated kidney function, we applied a retrospective cohort study including 1266 participants in Wuhan Tongren Hospital between January 27 and March 3, 2020. Demographic characteristics, preexisting comorbidities history, organ function data and outcomes were extracted. Deteriorated kidney function was identified as the decline percentage, assessed by an increase in peak serum creatinine from the baseline. Mediating effect was calculated by mediation analysis. Key Results 1266 hospitalized COVID-19 patients (60±15 years, 47.8% are male) were included, with an overall in-hospital death rate of 4.42% (56/1266). For critical cases, 77.02% had at least one preexisting comorbidity. Patients with comorbidities suffered higher in-hospital death and more severe decline of kidney function. Compared to patients with minor function decline (<10%), significant risk increase was found in those with more severe one (OR 3.57; 95%CI 1.70 to 7.52; P=.001 for moderate with 10-50% decline, and 37.45; 95%CI 18.71 to 74.55; P＜.001 for severe with>50%). More interestingly, the mediation analysis found deteriorated kidney function played as an important mediator between different comorbidities and COVID-19 patients’ in-hospital death, with the mediation effect of 11%, 12%, 16% and 32% respectively for hypertension, COPD, CVD and CKD.Conclusions Deteriorated kidney function is strongly associated with increase of in-hospital death in COVID-19 and partially mediates the facilitating effect of preexisting comorbidities on in-hospital death. Thus, dynamic monitoring kidney function, preventing the deterioration of kidney function might be helpful to improve survival in COVID-19 patients, especially those with preexisting comorbidities.
“Patient-Related Risk Factors For Superficial Surgical Site Infection And The Correlation To Periprosthetic Joint Infection – A 5year Follow-up Of 1291 Elective Primary Total Joint Arthroplasties”
Authors: Eriksson Hannah K , Lazarinis Stergios 
Published: July 2020

Abstract
Background: The incidence of superficial surgical site infection (SSSI) may increase the risk of subsequent periprosthetic joint infection (PJI). Optimisation or even avoiding patient-related risk factors for SSSI preoperatively, may decrease the risk of subsequent PJI. Purpose: To identify patient-related risk factors associated with SSSI and investigate their correlation with the progression of PJI. Methods: 1,291 primary elective hip and knee prosthesis were included. Patients were personally contacted by a nurse ≥ 3 month after surgery to answer questions about the postoperative period, including any occurrences of SSSI. The diagnosed PJI was determined by an orthopaedic surgeon together with a specialist in infectious diseases, and all patients with PJI underwent revision surgery. The patient-related risk factors considered relevant were joint, age, sex, American Society of Anesthesiologists classification (ASA), body mass index (BMI), smoking, diabetes and rheumatological disease. Results: 7,0 % of included patients developed an SSSI, and 1,9 % a PJI. Factors with a significantly increased adjusted risk ratio for SSSI were; knee surgery 1,9 (95% CI: 1,2 – 3,1), age ≥ 65 years 1,7 (95% CI: 1,1 – 2,8), BMI ≥35 2,3 (95% CI: 1,2 – 4,2) and for PJI; knee surgery 2,6 (95% CI: 1,1 – 6,4), ASA-class ≥ 3 3,2 (95% CI: 1,3 – 7,9), BMI ≥35 3,0 (95% CI: (1,2 – 4,2) and male gender 3,0 (95% CI: (1,2 – 7,5). Male patients showed a significant risk of developing PJI following SSSI, with a risk ratio of 3,3 (95% CI: 1,1 – 10,5).Conclusions: Male patients planned for total knee prostheses (TKA) aged 65 or over, with high ASA-class and high BMI should be selected with care due to the increased risk of postoperative infection.
Mutually Risk Roles of Oral Cleanliness and Stroke-associated Pneumonia in Patients with Acute Ischemic Stroke: A Cross-Sectional Study
Authors: Yang Xiaohua , Chen Huijuan , Yang Wanling , Deng Bin , Zheng Jialing , Wei Juan , Li Chunguang , Huang Yanjun , Gao Xiaoya , Xie Haiting , Li Minzi , Chen Aimin , Huang Zhilin , Yang Qin , He Juan , Zhang Juan , Hu Tingting , Tao Xi , Wang Qing 
Published: July 2020

Abstract
Background: Stroke-associated pneumonia (SAP) is a major complication after stroke, oral microorganisms are important contributors to SAP. Here, we aimed to investigate whether the oral hygiene was associated with SAP and related risk factors of them in patients with acute ischemic stroke. Methods: We performed a cross-sectional study that recruited 331 patients with acute ischemic stroke from two medical centers. A series of assessments were performed to evaluate the neurological status and habits of oral hygiene. According to whether the oral hygiene was abnormal and SAP occurred, univariate analyses were performed in cohort 1 (normal / abnormal oral hygiene groups) and cohort 2 (SAP / non-SAP groups). Multiple logistic regression analyses were conducted to confirm risk factors of oral cleanliness and SAP in stroke patients. Results: A total of 12 and 8 independent variables were included in the model 1 and 2 analysis. After adjusting for confounders, multivariable logistic regression analysis showed that oral cleanliness was not only closely related to SAP (OR=2.219, P=0.026), dental caries (OR=1.292, P=0.005) and age (OR=1.030, P=0.006) in model 1, but also an independent risk factor for predicting SAP (OR=1.678, P=0.001) in model 2. Barthel index was a protective factor for oral cleanliness (OR=0.986, P=0.019) and SAP (OR=0.977, P=0.002) in ischemic stroke patients. Conclusions: Mutually primary risk roles of abnormal oral cleanliness and SAP exist in patients with acute ischemic stroke. Dental caries and aging are important risk factors for oral health disorders. Improving the activities of daily living would have protective effects on both oral hygiene and SAP prevention in stroke patients.
Impact of the Covid-19 lockdown period on adult musculoskeletal injuries and surgical management: a retrospective monocentric study
Authors: Crenn Vincent , Kinani Monia El , Pietu Guy , Marie Leteve , Persigant Mike , Toanen Cécile , Varenne Yoann , Goffinet Nicolas , Buffenoir Kevin , Javaudin François , Montassier Emmanuel 
Published: July 2020

Abstract
Background

The coronavirus disease 2019 (COVID-19) pandemic has led to the worldwide implementation of unprecedented public protection measures. On the 17th of March, the French government announced a lockdown of the population for 8 weeks. This monocentric study assessed the impact of this lockdown on the musculoskeletal injuries treated at the emergency department as well as the surgical indications.
Methods

We carried out a retrospective study in the Emergency Department and the Surgery Department of Nantes University Hospital from 18 February to 11 May 2020. We collected data pertaining to the demographics, the mechanism, the type, the severity, and inter-hospital transfer for musculoskeletal injuries from our institution. We compared the four-week pre-lockdown period and the eight-week lockdown period divided into two four-week periods: early lockdown and late lockdown.
Results

There was a 52.1% decrease in musculoskeletal injuries among patients presenting to the Emergency Department between the pre-lockdown and the lockdown period (weekly incidence: 415.3 ± 44.2 vs. 198.5 ± 46.0, respectively, p < .001). The number of patients with surgical indications decreased by 33.4% (weekly incidence: 44.3 ± 3.8 vs. 28.5 ± 10.2, p = .048). The policy for inter-hospital transfers to private entities resulted in 64 transfers (29.4%) during the lockdown period. There was an increase in the incidence of surgical high severity trauma (Injury Severity Score > 16) between the pre-lockdown and the early lockdown period (2 (1.1%) vs. 7 (7.2%), respectively, p = .010) as well as between the pre-lockdown and the late lockdown period (2 (1.1%) vs. 10 (8.3%), respectively, p = .004). We observed a significant increase in the weekly emergency department patient admissions between the early and the late lockdown period (161.5 ± 22.9, 235.5 ± 27.7, respectively, p = .028).
Conclusion

A pronounced decrease in the incidence of musculoskeletal injuries was observed secondary to the lockdown measures, with emergency department patient admissions being halved and surgical indications being reduced by a third. The increase in musculoskeletal injuries during the late confinement period and the higher incidence of severe trauma highlights the importance of maintaining a functional trauma center organization with an inter-hospital transfer policy in case of a COVID-19 second wave lockdown.
A Case Report on the Surgical Management of Subhepatic Perforated Appendicitis: A Rare Presentation
Authors: Hakim Mumin , Mostafa Rania , Shehri Mohammed Al , Sharawy Sherif 
Published: July 2020

Abstract
Background: Subhepatic appendicitis is an exceedingly rare presentation accounting for 0.01% of Acute appendicitis. It is of prime importance to be aware of various variants and thereby managing such challenging cases accordingly.Case presentation: We present a middle-aged female patient with subhepatic perforated appendicitis and peritonitis who underwent an exploratory laparotomy and appendectomy.Conclusions: Surgical management of such patients is challenging due to an atypical presentation. The surgical management of such patients is discussed with a brief review of literature.