bluuebunny/crossref_metadata_2025_split huggingface dataset:
Demographic Distribution of Foot and Ankle Surgeries Among Orthopaedic Surgeons and Podiatrists: A 10-Year Database Retrospective Study
Authors: Burton Alex , Aynardi Michael C. , Aydogan Umur 
Published: March 2020

Background: Foot and ankle surgeries in the United States (US) are currently performed by orthopaedic surgeons or podiatrists with specialty surgical training. With the trend in healthcare now placing increased emphasis on quality and standardizing patient care, this study aimed to characterize the distribution, volume, and trends of certain foot and ankle surgeries performed in the US by both orthopaedic surgeons and podiatrists. Materials and Methods: A retrospective analysis was performed using the Marketscan Claims Database (Truven Health Analytics, Ann Arbor, Michigan) which covers most privately insured patients under the age of 65 in the USA from 2005 to 2014. We searched current procedural terminology (CPT) codes for total ankle replacement (TAR), triple arthrodesis, hallux valgus correction, pilon fracture open reduction and internal fixation (ORIF), calcaneus fracture ORIF, and ankle fracture ORIF. We recorded the timing and nature of procedures along with various features associated with the surgeon and the geographic location of the treatment facility. Results: We found that the number of foot and ankle procedures performed annually is steadily increasing. Orthopaedic surgeons are the main treating surgeon for common foot and ankle traumatic conditions or complex hind foot cases like TAR. On the other hand, our study showed that podiatrists perform almost 9 out of 10 hallux valgus correction surgeries. Discussion: Our study showed the trends in surgical volumes and differences between surgical podiatrists and orthopaedic surgeons and the evolution of these volumes over a ten year period and differences in surgical repertoire between orthopaedists and podiatrists. Levels of Evidence: Level IV: Case series, Clinical research
Preoperative Squid embolization of carotid paragangliomas with direct puncture
Authors: Pérez-García Carlos , Rosati Santiago , Serrano-Hernando Francisco Javier , López-Ibor Aliño Luis , Moreu Manuel 
Published: March 2020

Background and purpose Preoperative embolization of carotid paragangliomas is a common procedure in interventional neuroradiology. Direct puncture embolization has shown less morbidity and mortality than endovascular embolization and a higher percentage of devascularization. We describe our experience using Squid® as the only embolic agent in direct puncture glomus embolization. Methods We retrospectively reviewed pre-embolization imaging tests, emphasizing the volume of the lesion, clinical history data, technical aspects of the procedure, as well as the approximate amount of blood lost during the surgical procedure in all patients with preoperative embolization of carotid paragangliomas performed at our tertiary care hospital. Results Six patients met our criteria from May 2017 to August 2018. The volume of the mass ranged from 1.4–18.5 mL and the quantity of Squid® injected varied from 1.1–15 mL. Total devascularization was achieved in almost all cases (>90%), with one puncture needed in all but one patient, who was punctured two times. No hemorrhagic complications were described in surgery, no blood transfusions were needed, and the mean decrease of hemoglobin after surgery was 1.04 g/dL. Conclusions Direct puncture embolization of carotid paragangliomas only using Squid® is a safe and relatively simple procedure that facilitates the subsequent surgery with minimal blood loss.
Coiling for a saccular aneurysm on the caudal channel in double origin of the posterior inferior cerebellar artery
Authors: Maeda Kazushi , Takagishi Soh , Kawano Yosuke , Maehara Naoki , Michiwaki Yuhei , Nagaoka Shintaro , Gi Hidefuku , Kanemoto Yukihide 
Published: March 2020

Background Double origin of the posterior inferior cerebellar artery (DOPICA) is a rare cranial imaging finding with an incidence of 0.36–6% reported in various retrospective studies. Aneurysms on a DOPICA are even rarer. Case description A 34-year-old women hospitalised for subarachnoid haemorrhage showed a ruptured aneurysm arising from the caudal channel of the DOPICA. Endovascular treatment was selected, and the aneurysm was successfully and completely embolised using two coils. Conclusions To date, a total of three previous saccular aneurysms of the DOPICA itself have been reported, all of which were treated using endovascular methods. Our case is the first report of a ruptured saccular aneurysm arising from the non-branching segment of the caudal channel of the DOPICA.
Improving bystander defibrillation in out-of-hospital cardiac arrests at home
Authors: Karlsson Lena , Hansen Carolina M , Vourakis Christina , Sun Christopher LF , Rajan Shahzleen , Søndergaard Kathrine B , Andelius Linn , Lippert Freddy , Gislason Gunnar H , Chan Timothy CY , Torp-Pedersen Christian , Folke Fredrik 
Published: March 2020

Aims:Most out-of-hospital cardiac arrests occur at home with dismal bystander defibrillation rates. We investigated automated external defibrillator coverage of home arrests, and the proportion potentially reachable with an automated external defibrillator before emergency medical service arrival according to different bystander activation strategies.Methods and results:Cardiac arrests in homes (private/nursing/senior homes) in Copenhagen, Denmark (2008–2016) and registered automated external defibrillators (2007–2016), were identified. Automated external defibrillator coverage (distance from arrest to automated external defibrillator) and accessibility at the time of arrest were examined according to route distance to nearest automated external defibrillator and emergency medical service response time. The proportion of arrests reachable with an automated external defibrillator by bystander was calculated using two-way (from patient to automated external defibrillator and back) and one-way (from automated external defibrillator to patient) potential activation strategies. Of 1879 home arrests, automated external defibrillator coverage ≤100 m was low (6.3%) and a two-way bystander could potentially only retrieve an accessible automated external defibrillator before emergency medical service in 31.1% (n=37) of cases. If a bystander only needed to travel one-way to bring an automated external defibrillator (≤100 m, ≤250 m and ≤500 m), 45.4% (n=54/119), 37.1% (n=196/529) and 29.8% (n=350/1174) could potentially be reached before the emergency medical service based on current automated external defibrillator accessibility.Conclusions:Few home arrests were reachable with an automated external defibrillator before emergency medical service if bystanders needed to travel from patient to automated external defibrillator and back. However, nearly one-third of arrests ≤500 m of an automated external defibrillator could be reached before emergency medical service arrival if the bystander only needed to travel one-way from the automated external defibrillator to the patient.
Post‐induction infliximab trough levels and disease activity in the clinical evolution of pediatric ulcerative colitis
Authors: Moore Hillary , Dolce Pasquale , Devas Nina , Baldassano Robert , Martinelli Massimo 
Published: March 2020

Background and aimsRecent adult evidence suggests that infliximab (IFX) trough levels (TL) in patients with severe ulcerative colitis (UC) may be decreased. The aims of our study were to compare post‐induction IFX TL of children with severe versus moderate UC and to evaluate short‐ and long‐term outcomes.MethodsIn this single‐center retrospective study, children with a diagnosis of UC starting IFX with a Pediatric Ulcerative Colitis Activity Index (PUCAI) ≥35 and with available post‐induction TL were recruited. UC characteristics, IFX dosage and interval, primary non‐response, IFX failure, and surgery after 24 months were collected. Post induction TL, anti‐IFX antibodies, and laboratory evaluations at the time of starting IFX were also acquired.ResultsA total of 90 children were enrolled, of whom 39 (43.3%) were classified as severe UC and 51 (56.6%) as moderate UC. Median post‐induction IFX TL were lower in severe UC versus moderate group (5.5 vs 10.3; p  = 0.03), despite a more frequently intensified IFX regimen. Children in the higher TL quartiles showed increased rates of clinical, biological, and combined remission (p  = 0.04, p  < 0.001, and p  = 0.01, respectively). In a multivariate analysis, a PUCAI ≥65 and time interval from last IFX infusion were the only predictors associated with IFX TL. At 24 months, children in the higher TL quartiles had a decreased risk of IFX failure (p  = 0.002). The severe UC group showed a higher risk of IFX failure at 24 months (16/23 (41%) vs. 11/40 (21.6%); p  = 0.05). Kaplan–Meier methods demonstrated a trend toward statistical significance, with a two‐year cumulative colectomy rate of 15.38% (95% confidence interval (CI) 8.1–15.6%) in children with severe UC and 3.92% (95% CI 2.9–10.8%) in patients with moderate UC (logrank test p  = 0.06).ConclusionsChildren starting IFX with severe UC showed lower post‐induction TL and poor disease outcomes. Achieving adequate TL was associated with better efficacy outcomes.
Photodynamic detection of a feline meningioma using 5-aminolaevulinic acid hydrochloride
Authors: Osaki Tomohiro , Gonda Kengo , Murahata Yusuke , Sunden Yuji , Amaha Takao , Kunisue Narumi , Takahashi Kiwamu , Ishizuka Masahiro , Tanaka Tohru , Li Liming , Yokoe Inoru , Yamashita Masamichi , Azuma Kazuo , Tsuka Takeshi , Ito Norihiko , Imagawa Tomohiro , Okamoto Yoshiharu 
Published: March 2020

Case summary The present study describes the case of a feline meningioma that was detected using 5-aminolaevulinic acid hydrochloride (5-ALA)-induced protoporphyrin IX (PpIX) fluorescence at surgery. An extra-axial mass in the temporoparietal region was observed by MRI. Following craniectomy and durotomy, photodynamic detection (PDD) was performed for detection of the tumour. Intratumour PpIX was detected using fluorescence spectrum evaluation and high-performance liquid chromatography. PDD revealed bright fluorescence of PpIX induced by 5-ALA, facilitating fluorescence-guided resection of the tumour tissue. Postoperative examination demonstrated an intratumour PpIX protein concentration of 16.8 nmol/g, and based on histopathological findings we diagnosed the mass as meningioma. Relevance and novel information PDD using 5-ALA has been used to identify the surgical margins during resection of primary human brain tumours. Recently, we have reported post-mortem PDD using 5-ALA for a canine glioblastoma. To our knowledge, this technique has not been previously used for the detection and resection of feline brain tumours. Our findings suggest that PDD using 5-ALA is useful for intraoperative fluorescence-guided resection of malignant meningioma in cats.
Returning to Work After Articular Cartilage Repair Intervention: A Systematic Review
Authors: Nimkingratana Puwapong , Brittberg Mats 
Published: March 2020

Background: The process of returning to work after cartilage treatment has not been studied in depth, even though a better understanding of potential outcomes could lead to significant benefits for the general population. Purpose: To determine which surgical interventions are most effective in helping patients return to work after cartilage repair and to identify factors that affect the ability to return to work. Study Design: Systematic review; Level of evidence, 4. Methods: This systematic review followed PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines in analyzing reports on articular cartilage treatment and return to work published from January 1966 (when the first system of classifying articular cartilage injuries based on the mechanism of injuries and type of lesions was developed) to January 2019. General surgical information and available clinical scores were used to assess outcomes. Results: Only 5 studies describing 283 patients were found to be relevant to our objectives and were therefore included in the analysis. Autologous chondrocyte implantation (ACI) and osteochondral allografts were the only 2 procedures for which information was included regarding patient return to work rates. The mean (overall) return-to-work time after a cartilage repair operation was 4.80 ± 3.02 months. ACI was the most common procedure (3 studies; 227 patients). Return to work after ACI or ACI with high tibial osteotomy (HTO) occurred in almost 100% of cases, whereas the rate of return to work was 51.78% for patients who underwent osteochondral allograft ( P < .01); further, patients who had ACI or ACI+HTO returned to work sooner compared with patients who underwent osteochondral allograft. The Knee injury and Osteoarthritis Outcome Score (KOOS) and Single Assessment Numerical Evaluation (SANE) scores were significantly higher in patients who fully returned to work. No significant difference was found in rates of return to work after ACI related to sex, area of the lesion, or size of the defect. Conclusion: The vast majority of published results on articular cartilage repair do not include data on return to work. Although available data on articular cartilage repair in the general population reveal a high rate of return to work, including those patients treated with ACI, the data do not stratify patients by the type and demand of work. No randomized studies have examined return-to-work rates. Hence, authors should include these data in future studies. A refined definition of work intensity, rather than just return to work, may provide a clearer picture of the relative effectiveness of different surgical interventions. To that end, the authors propose a return to work prognostic score called the Prognostic Cartilage Repair Return to Work Score, or PROCART-RTW score.
Ensemble disease gene prediction by clinical sample-based networks
Authors: Luo Ping , Tian Li-Ping , Chen Bolin , Xiao Qianghua , Wu Fang-Xiang 
Published: March 2020

Abstract
Background
Disease gene prediction is a critical and challenging task. Many computational methods have been developed to predict disease genes, which can reduce the money and time used in the experimental validation. Since proteins (products of genes) usually work together to achieve a specific function, biomolecular networks, such as the protein-protein interaction (PPI) network and gene co-expression networks, are widely used to predict disease genes by analyzing the relationships between known disease genes and other genes in the networks. However, existing methods commonly use a universal static PPI network, which ignore the fact that PPIs are dynamic, and PPIs in various patients should also be different.

Results
To address these issues, we develop an ensemble algorithm to predict disease genes from clinical sample-based networks (EdgCSN). The algorithm first constructs single sample-based networks for each case sample of the disease under study. Then, these single sample-based networks are merged to several fused networks based on the clustering results of the samples. After that, logistic models are trained with centrality features extracted from the fused networks, and an ensemble strategy is used to predict the finial probability of each gene being disease-associated. EdgCSN is evaluated on breast cancer (BC), thyroid cancer (TC) and Alzheimer’s disease (AD) and obtains AUC values of 0.970, 0.971 and 0.966, respectively, which are much better than the competing algorithms. Subsequent de novo validations also demonstrate the ability of EdgCSN in predicting new disease genes.

Conclusions
In this study, we propose EdgCSN, which is an ensemble learning algorithm for predicting disease genes with models trained by centrality features extracted from clinical sample-based networks. Results of the leave-one-out cross validation show that our EdgCSN performs much better than the competing algorithms in predicting BC-associated, TC-associated and AD-associated genes. de novo validations also show that EdgCSN is valuable for identifying new disease genes.
Accurately estimating the length distributions of genomic micro-satellites by tumor purity deconvolution
Authors: Wang Yixuan , Zhang Xuanping , Xiao Xiao , Zhang Fei-Ran , Yan Xinxing , Feng Xuan , Zhao Zhongmeng , Guan Yanfang , Wang Jiayin 
Published: March 2020

Abstract
Background
Genomic micro-satellites are the genomic regions that consist of short and repetitive DNA motifs. Estimating the length distribution and state of a micro-satellite region is an important computational step in cancer sequencing data pipelines, which is suggested to facilitate the downstream analysis and clinical decision supporting. Although several state-of-the-art approaches have been proposed to identify micro-satellite instability (MSI) events, they are limited in dealing with regions longer than one read length. Moreover, based on our best knowledge, all of these approaches imply a hypothesis that the tumor purity of the sequenced samples is sufficiently high, which is inconsistent with the reality, leading the inferred length distribution to dilute the data signal and introducing the false positive errors.

Results
In this article, we proposed a computational approach, named ELMSI, which detected MSI events based on the next generation sequencing technology. ELMSI can estimate the specific length distributions and states of micro-satellite regions from a mixed tumor sample paired with a control one. It first estimated the purity of the tumor sample based on the read counts of the filtered SNVs loci. Then, the algorithm identified the length distributions and the states of short micro-satellites by adding the Maximum Likelihood Estimation (MLE) step to the existing algorithm. After that, ELMSI continued to infer the length distributions of long micro-satellites by incorporating a simplified Expectation Maximization (EM) algorithm with central limit theorem, and then used statistical tests to output the states of these micro-satellites. Based on our experimental results, ELMSI was able to handle micro-satellites with lengths ranging from shorter than one read length to 10kbps.

Conclusions
To verify the reliability of our algorithm, we first compared the ability of classifying the shorter micro-satellites from the mixed samples with the existing algorithm MSIsensor. Meanwhile, we varied the number of micro-satellite regions, the read length and the sequencing coverage to separately test the performance of ELMSI on estimating the longer ones from the mixed samples. ELMSI performed well on mixed samples, and thus ELMSI was of great value for improving the recognition effect of micro-satellite regions and supporting clinical decision supporting. The source codes have been uploaded and maintained at https://github.com/YixuanWang1120/ELMSI
for academic use only.
Conversion from electrocardiosignals to equivalent electrical sources on heart surface
Authors: Zhikhareva G. V. , Kramm Mikhail N. , Bodin O. N. , Seepold Ralf , Madrid Natividad Martinez , Chernikov A. I. , Kupriyanova Y. A. , Zhuravleva N. A. 
Published: March 2020

Abstract
Background
The actual task of electrocardiographic examinations is to increase the reliability of diagnosing the condition of the heart. Within the framework of this task, an important direction is the solution of the inverse problem of electrocardiography, based on the processing of electrocardiographic signals of multichannel cardio leads at known electrode coordinates in these leads (Titomir et al. Noninvasiv electrocardiotopography, 2003), (Macfarlane et al. Comprehensive Electrocardiology, 2nd ed. (Chapter 9), 2011).

Results
In order to obtain more detailed information about the electrical activity of the heart, we carry out a reconstruction of the distribution of equivalent electrical sources on the heart surface. In this area, we hold reconstruction of the equivalent sources during the cardiac cycle at relatively low hardware cost. ECG maps of electrical potentials on the surface of the torso (TSPM) and electrical sources on the surface of the heart (HSSM) were studied for different times of the cardiac cycle. We carried out a visual and quantitative comparison of these maps in the presence of pathological regions of different localization. For this purpose we used the model of the heart electrical activity, based on cellular automata.

Conclusions
The model of cellular automata allows us to consider the processes of heart excitation in the presence of pathological regions of various sizes and localization. It is shown, that changes in the distribution of electrical sources on the surface of the epicardium in the presence of pathological areas with disturbances in the conduction of heart excitation are much more noticeable than changes in ECG maps on the torso surface.
Visually guided classification trees for analyzing chronic patients
Authors: Soguero-Ruiz Cristina , Mora-Jiménez Inmaculada , Mohedano-Munoz Miguel A. , Rubio-Sanchez Manuel , Miguel-Bohoyo Pablo de , Sanchez Alberto 
Published: March 2020

Abstract
Background
Chronic diseases are becoming more widespread each year in developed countries, mainly due to increasing life expectancy. Among them, diabetes mellitus (DM) and essential hypertension (EH) are two of the most prevalent ones. Furthermore, they can be the onset of other chronic conditions such as kidney or obstructive pulmonary diseases. The need to comprehend the factors related to such complex diseases motivates the development of interpretative and visual analysis methods, such as classification trees, which not only provide predictive models for diagnosing patients, but can also help to discover new clinical insights.

Results
In this paper, we analyzed healthy and chronic (diabetic, hypertensive) patients associated with the University Hospital of Fuenlabrada in Spain. Each patient was classified into a single health status according to clinical risk groups (CRGs). The CRGs characterize a patient through features such as age, gender, diagnosis codes, and drug codes. Based on these features and the CRGs, we have designed classification trees to determine the most discriminative decision features among different health statuses. In particular, we propose to make use of statistical data visualizations to guide the selection of features in each node when constructing a tree. We created several classification trees to distinguish among patients with different health statuses. We analyzed their performance in terms of classification accuracy, and drew clinical conclusions regarding the decision features considered in each tree. As expected, healthy patients and patients with a single chronic condition were better classified than patients with comorbidities. The constructed classification trees also show that the use of antipsychotics and the diagnosis of chronic airway obstruction are relevant for classifying patients with more than one chronic condition, in conjunction with the usual DM and/or EH diagnoses.

Conclusions
We propose a methodology for constructing classification trees in a visually guided manner. The approach allows clinicians to progressively select the decision features at each of the tree nodes. The process is guided by exploratory data analysis visualizations, which may provide new insights and unexpected clinical information.