bluuebunny/crossref_metadata_2025_split huggingface dataset:
Treatment for Wassel Types V and VI Thumb Polydactyly
Authors: Bessho Yuki , Takagi Takehiko , Seki Atsuhito , Takayama Shinichiro 
Published: April 2020

Background: Polydactyly of the thumb is the most common congenital anomaly of the hand, but there have been few reports regarding Wassel types V and VI. The purpose of this study is to present our surgical strategies and outcomes for cases of Wassel types V and VI polydactyly of the thumb. Methods: Twenty-nine thumbs of 29 patients were included in this study; 17 cases were Wassel type V and 12 cases were type VI. Our strategies for initial surgery were appropriate tendon and muscle relocations. Opponensplasty with the abductor digiti minimi or the flexor digitorum superficialis and osteotomy were not performed in the initial surgery. We evaluated pinch motion ability and the number of additional surgical procedures. The first web space and radial instability of the metacarpophalangeal (MCP) joint were measured by radiography while the patient held a polystyrene foam cone. Results: Twenty-two patients were able to perform a pulp pinch. Narrowing of the first web defined as the angle between the first and second metacarpus (1–2 MCA) < 40° occurred in five cases. Radial instability of the MCP joint defined as the angle between the first metacarpus and thumb proximal phalanx (1 MPA) > 20° occurred in seven cases. Additional surgery was performed in seven cases (24%) to improve insufficient thumb opposition, radial instability of the MCP joint, and narrowing of the first web. Patients in all reoperation cases were able to perform a pulp pinch. Conclusions: Our strategies for initial surgery often had satisfactory outcomes, but careful follow-up observations and appropriate reoperation for cases with poor initial outcomes were more important.
Time to Resolution of Triggering after Steroid Injection for First Presentation Trigger Digits
Authors: Yak Ryan Siqi , Lundin Anna-Carin , Tay Poi Hoon , Chong Alphonsus KS. , Sebastin Sandeep Jacob 
Published: April 2020

Background: Steroid injection is a proven treatment for trigger digits. The time taken for resolution of triggering following an injection is a question often asked by patients and one that has not been adequately addressed in existing literature. The aim of this study was to determine the time taken for triggering to resolve after a single steroid injection in patients presenting for the first time with a trigger digit. Methods: A prospective study was conducted in patients with first presentation of a grade II or grade III trigger digit(s) that received a steroid injection. Data with regards to age, gender, digit(s) involved, duration of symptoms, trigger grade, and presence of diabetes were collected. They were given a stamped addressed postcard with instructions to fill in the date that the triggering resolved and mail the postcard back to us. If the postcard was not received at three weeks, we contacted the patient by telephone to ask for the date of resolution of trigger. Results: 56 patients with 66 trigger digits were included in the study. 52 out of 66 digits (79%) had resolution of the trigger at one month. The mean duration for resolution of trigger was 8.8 days (range 1–30 days). Conclusions: Patients can be counselled that a steroid injection is effective in resolving the trigger in 79% of trigger digits presenting for the first time and that the mean time taken for resolution of triggering is 8.8 days. It is recommended to wait for at least one month before considering another injection or alternative treatments.
C-reactive Protein and Future Risk of Clinical and Molecular Subtypes of Colorectal Cancer
Authors: Bodén Stina , Myte Robin , Harbs Justin , Sundkvist Anneli , Zingmark Carl , Löfgren Burström Anna , Palmqvist Richard , Harlid Sophia , Van Guelpen Bethany 
Published: April 2020

Abstract

Background:
Inflammation has been implicated in colorectal cancer etiology, but the relationship between C-reactive protein (CRP) and colorectal cancer risk is unclear. We aimed to investigate the association between prediagnostic plasma CRP concentrations and the risk of clinical and molecular colorectal cancer subtypes.

Methods:
We used prospectively collected samples from 1,010 matched colorectal cancer case–control pairs from two population-based cohorts in Northern Sweden, including 259 with repeated samples. Conditional logistic regression and linear mixed models were used to estimate relative risks of colorectal cancer, including subtypes based on BRAF and KRAS mutations, microsatellite instability status, tumor location, stage, lag time, and (using unconditional logistic regression) body mass index.

Results:
CRP was not associated with colorectal cancer risk, regardless of clinical or molecular colorectal cancer subtype. For participants with advanced tumors and blood samples &lt;5 years before diagnosis, CRP was associated with higher risk [OR per 1 unit increase in natural logarithm (ln) transformed CRP, 1.32; 95% confidence interval (CI), 1.01–1.73]. CRP levels increased over time, but average time trajectories were similar for cases and controls (Pinteraction = 0.19).

Conclusions:
Our results do not support intertumoral heterogeneity as an explanation for previous inconsistent findings regarding the role of CRP in colorectal cancer etiology. The possible association in the subgroup with advanced tumors and shorter follow-up likely reflects undiagnosed cancer at baseline.

Impact:
Future efforts to establish the putative role of chronic, low-grade inflammation in colorectal cancer development will need to address the complex relationship between systemic inflammatory factors and tumor microenvironment, and might consider larger biomarker panels than CRP alone.
Anesthesia for TORS for Oropharyngeal Carcinoma: Factors Associated with Prolonged Phase I Postanesthesia Recovery
Authors: Puccinelli Cassandra L. , Moore Eric J. , Yin Linda X. , Price Daniel L. , Janus Jeffrey R. , Weingarten Toby N. , Van Abel Kathryn M. 
Published: April 2020

ObjectivesClinical variables affecting anesthetic recovery following transoral robotic surgery (TORS) to resect oropharyngeal squamous cell carcinoma have not been described. We aimed to explore risk factors associated with prolonged postanesthesia recovery following TORS.Study DesignRetrospective case‐control study.SettingTertiary referral center, January 2010 to November 2016.Subjects and MethodsPatients included adults undergoing primary TORS ± neck dissection for oropharyngeal squamous cell carcinoma. Patients were categorized by phase I recovery time into the “goal” recovery group (75th percentile [lower 3 quartiles], n = 272) and the “prolonged” recovery group (n = 91). Univariate and multivariate logistic regression analyses were performed to assess the associations between clinical characteristics and prolonged phase I recovery.ResultsA total of 363 patients were included. Median (interquartile range) duration of postanesthesia recovery was 1.5 hours (1.0‐2.0). Prolonged recovery was associated with isoflurane (odds ratio, 2.83 [95% CI, 1.56‐5.14], P <. 001), midazolam (2.77 [1.50‐5.12], P =. 001), and larger opioid doses (1.26 [1.01‐1.58] per 10‐mg intravenous morphine equivalents, P =. 040) and inversely associated with multimodal antiemetic therapy (0.34 [0.15‐0.78], P =. 011). Prolonged cases had higher rates of postoperative nausea and vomiting (n = 43 [47.2%] vs 86 [31.6%], P =. 008), respiratory depression (28 [30.8%] vs 12 [4.4%], P <. 001), sedation (Richmond Agitation‐Sedation Scale < –2; 26 [28.6%] vs 35 [12.9%], P =. 001), severe pain (numeric rating score ≥7; 31 [34.4%] vs 45 [17.2%], P =. 001), and longer hospital stays (4 vs 3 days, P <. 001).ConclusionsSeveral anesthetic factors are associated with anesthesia recovery duration, which may be shortened by efforts to reduce postoperative sedation, severe pain, and nausea/vomiting. Shortened anesthesia recovery time may reduce hospital stay.
Association between physical activity patterns and sarcopenia in Arab men
Authors: Alkahtani Shaea , Aljuhani Osama , Alhussain Maha , Habib Syed Shahid 
Published: April 2020

Objective In this study, we aimed to examine the association between physical activity patterns and sarcopenia in Arab men. Methods This cross-sectional study included 363 men (47.7 ± 15.4 years). We analyzed appendicular lean mass (ALM), handgrip strength test, and physical activity levels. ALM divided by height (meters) squared was calculated (ALM/Ht 2 ), and participants with −1 and −2 standard deviations below the sex-specific mean for Saudi young adults were considered to have sarcopenia class I and class II, respectively. Independent t-tests, analysis of variance, and Mann–Whitney U tests were performed to determine mean and median differences. Results We observed a significant difference between participants with and without sarcopenia in moderate-to-vigorous physical activity (MVPA); the correlation between ALM/H2 and MVPA was borderline significant. With a 1-hour/week increase in MVPA, ALM/Ht 2 increased by 0.30 kg/m2. Total and ALM, handgrip strength, and MVPA were significantly lower in participants age >60 years; fat mass and waist circumference were unchanged as compared with middle-aged participants. Conclusions We identified an association between time spent in recreational MVPA and lean muscle mass among Arab men. Future studies should examine the role of MVPA training programs on muscle mass and strength in older men.
Bilateral retinoblastoma and osteogenesis imperfecta, a very rare association: Two cases
Authors: De Francesco Sonia , Sgheri Arianna , Di Maggio Alessandro , Rana Francesco , Anna Maria Pinto , Alessandra Renieri , Hadjistilianou Theodora 
Published: April 2020

Introduction This case report presents two patients affected by a very rare association of bilateral retinoblastoma and osteogenesis imperfecta. Case report Two Caucasian males with familial history and clinical signs of osteogenesis imperfecta came to our attention for bilateral leukocoria. The ocular fundus examination revealed bilateral retinoblastoma. Proper therapies were dispensed in order to achieve full regression. Genetic counseling was performed. Discussion The primary role of genetics in retinoblastoma pathogenesis in widely known, and different genes have been identified. Osteogenesis imperfecta is a rare connective tissue disorders, caused by mutated genes encoding for collagen. The single gene defect in osteogenesis imperfecta type VI is Serpin Family F Member 1 ( SERPINF1), a neurotrophic factor for the neuronal differentiation in retinoblastoma cells. The association of bilateral retinoblastoma and osteogenesis imperfecta could be the result of the mutation of a single gene playing a role in a hypothetical common pathway.
Nomogram for predicting overall survival of patients with bladder cancer: A population-based study
Authors: Wang Jiawu , Wu Yan , He Weiyang , Yang Bo , Gou Xin 
Published: April 2020

Objective: The aim of this study was to develop and validate a reliable nomogram to estimate overall survival in bladder cancer. Method: Patients diagnosed with bladder cancer identified in the Surveillance, Epidemiology, and End Results database were randomly divided into training and validation cohorts. The powerful prognostic variables were examined using Cox regression analyses. A nomogram was developed on the prognostic factors. Results: The results suggested that age, sex, race, grade, histologic type, primary site, pathological stage, surgical treatment, and number of primary tumors, were the powerful prognostic factors. All these factors were integrated to construct the nomogram. The nomogram for predicting overall survival showed better discrimination power than the tumor-node-metastasis (TNM) stage system 8th edition. Conclusion: The nomogram has the potential to provide an individualized prediction of overall survival in patients with bladder cancer.
Comparison of sinus tarsi approach and extensile lateral approach for calcaneal fractures: A systematic review of overlapping meta-analyses
Authors: Yu Tao , Xiong Yuan , Kang Alex , Zhou Haichao , He Wenbao , Zhu Hui , Yang Yunfeng 
Published: April 2020

Purpose: Accumulated literature has reported the comparative efficacy of the sinus tarsi approach (STA) and the extensile lateral approach (ELA) for the treatment of calcaneal fractures (CFs). However, the best alternative treatment for CF is still inconsistent. Herein, the present systematic review of overlapping meta-analyses aims to achieve an evident conclusion by performing a comprehensive reanalysis of previous meta-analyses regarding the comparison of the STA and the ELA. Methods: We searched several databases, including Pubmed, Medline, Embase, the Cochrane Library, SpringerLink, Clinical Trials.gov , OVID, and CNKI for the meta-analyses comparing the STA and the ELA for the treatment of CF. All related meta-analyses of randomized controlled trials and cohort studies were included. Two researchers independently assessed the quality of the articles and extracted the data. The Jadad decision algorithm was used to evaluate the evidence of the articles. Results: Ultimately, five meta-analyses were included in the present study. The Assessment of Multiple Systematic Reviews scores of these articles ranged from 5 to 9 with a median of 7. The analysis of best quality, Bai 2018, was selected based on the Jadad algorithm. In this article, the significant differences were found in wound complications and operating time, recovery of Böhler’s angle, the American Orthopaedic Foot and Ankle Society scores, and the visual analog scale. Conclusion: The clinical relevance of the present study is that both the STA and the ELA are effective in alleviating pain and improving functionality in the treatment of CF. However, due to a shorter operation duration and lower complication rates, the STA was indicated to be a superior alternative for CF treatment.
Perceived Need and Acceptability of a Community-Based Peer Navigator Model to Engage Key Populations in HIV Care in Tijuana, Mexico
Authors: Pitpitan Eileen V. , Mittal Maria Luisa , Smith Laramie R. 
Published: April 2020

Introduction: Prior work found <4% of key populations living with HIV (KPLWH) in Tijuana, Mexico, were on antiretroviral therapy (ART). The goal of this pilot study was to examine community stakeholders’ perceived need and acceptability of a peer-navigator program to improve ART coverage. Methods: We held a community forum and measured perspectives of key stakeholders in local organizations that serve KPLWH using online surveys, and in-depth interviews (with select key informants). Results: Univariate descriptive statistics and emergent thematic analysis illustrated that there was general consensus that the program could improve ART coverage for KPLWH by helping to overcome geographic, transportation, and sociostructural barriers to HIV care. Police harassment, mobility, and non-HIV comorbidities were identified as challenges the program would need to navigate. Conclusions: Community stakeholders expressed perceived need and acceptability of a program to improve HIV care outcomes among KPLWH in Tijuana. The program should address the challenges identified by community stakeholders.
Management of Patients With Sepsis in Canadian Community Emergency Departments: A Retrospective Multicenter Observational Study
Authors: Lo Victor C. K. , Su Haitong , Lam Yuet Ming , Willis Kathleen , Pullar Virginia , Kowgier Matthew , Hubner Ryan P. , Tsang Jennifer L. Y. 
Published: April 2020

Background: Sepsis is a life-threatening syndrome and a leading cause of morbidity and mortality representing significant financial burden on the health-care system. Early identification and intervention is crucial to maximizing positive outcomes. We studied a quality improvement initiative with the aim of reviewing the initial management of patients with sepsis in Canadian community emergency departments, to identify areas for improving the delivery of sepsis care. We present a retrospective, multicenter, observational study during 2011 to 2015 in the community setting. Methods: We collected data on baseline characteristics, clinical management metrics (triage-to-physician-assessment time, triage-to-lactate-drawn time, triage-to-antibiotic time, and volume of fluids administered within the first 6 hours of triage), and outcomes (intensive care unit [ICU] admission, in-hospital mortality) from a regional database. Results: A total of 2056 patients were analyzed. The median triage-to-physician-assessment time was 50 minutes (interquartile range [IQR]: 25-104), triage-to-lactate-drawn time was 50 minutes (IQR: 63-94), and triage-to-antibiotics time was 129 minutes (IQR: 70-221). The median total amount of fluid administered within 6 hours of triage was 2.0 L (IQR: 1.5-3.0). The ICU admission rate was 36% and in-hospital mortality was 25%. We also observed a higher ICU admission rate (51% vs 24%) and in-hospital mortality (44% vs 14%) in those with higher lactate concentration (≥4 vs ≤2 mmol/L), independent of other sepsis-related parameters. Conclusion: Time-to-physician-assessment, time-to-lactate-drawn, time-to-antibiotics, and fluid resuscitation in community emergency departments could be improved. Future quality improvement interventions are required to optimize management of patients with sepsis. Elevated lactate concentration was also independently associated with ICU admission rate and in-hospital mortality rate.
Ultramicrostructural reductions in teeth: implications for dietary transition from non-avian dinosaurs to birds
Authors: Li Zhiheng , Wang Chun-Chieh , Wang Min , Chiang Cheng-Cheng , Wang Yan , Zheng Xiaoting , Huang E-Wen , Hsiao Kiko , Zhou Zhonghe 
Published: April 2020

Abstract
Background
Tooth morphology within theropod dinosaurs has been extensively investigated and shows high disparity throughout the Cretaceous. Changes or diversification in feeding ecology, i.e., adoption of an herbivorous diet (e.g., granivorous), is proposed as a major driver of tooth evolution in Paraves (e.g., Microraptor, troodontids and avialans). Here, we studied the microscopic features of paravian non-avian theropod and avialan teeth using high-spatial-resolution synchrotron transmission X-ray microscopy and scanning electron microscopy.

Results
We show that avialan teeth are characterized by the presence of simple enamel structures and a lack of porous mantle dentin between the enamel and orthodentin. Reduced internal structures of teeth took place independently in Early Cretaceous birds and a Microraptor specimen, implying that shifts in diet in avialans from that of closely related dinosaurs may correlate with a shift in feeding ecology during the transition from non-avian dinosaurs to birds.

Conclusion
Different lines of evidence all suggest a large reduction in biting force affecting the evolution of teeth in the dinosaur-bird transition. Changes in teeth microstructure and associated dietary shift may have contributed to the early evolutionary success of stemward birds in the shadow of other non-avian theropods.
RETRACTED ARTICLE: Psychometric properties of a short version of the Job Anxiety Scale
Authors: Schmalbach Bjarne , Kalkbrenner Andreas , Bassler Markus , Hinz Andreas , Petrowski Katja 
Published: April 2020

Abstract
Background
Occupational stress and specifically job anxiety are crucial factors in determining health outcomes, job satisfaction as well as performance. In order to assess this phenomenon, the Job Anxiety Scale is one of the instruments available. It consists of 70 items that are clustered in 14 subscales and five dimensions. The aim of this paper is to create a more efficient, short version of the Job Anxiety Scale, while retaining the five dimensions, and to assess its psychometric properties.

Methods
The sample consists of 991 – mostly psychosomatic – patients from two different clinics. We applied methods of factor analysis and bivariate correlations to explore and test factor structure and the nomological net of related constructs.

Results
After reducing the item pool via the construction of subsets and tests using ant-colony-optimization, a 15-item version of the Job Anxiety Scale evinced very good psychometric properties. We found very good model fit, high internal consistency, and invariance across participant age and sex. It displayed improved discriminant validity compared to the original scale, and we found the expected pattern of convergent correlations.

Conclusions
With this short version of the Job Anxiety Scale, researchers can assess job related worries in a much more economic manner. The questionnaire is particularly useful in large-scale surveys and/or in samples that struggle with extensive assessments.
Comparative cost-effectiveness of cabozantinib as second-line therapy for patients with advanced hepatocellular carcinoma in Germany and the United States
Authors: Sieg Maximilian , Hartmann Michael , Settmacher Utz , Arefian Habibollah 
Published: April 2020

Abstract
Background
Cabozantinib was approved by the European Medicines Agency and the Federal Drug Administration as an option for sorafenib-resistant advanced hepatocellular carcinoma, increasing overall survival and progression-free survival compared with placebo. We evaluated the cost-effectiveness of cabozantinib in the second-line setting for patients with an advanced hepatocellular carcinoma from the German statutory health insurance perspective compared with an US scenario using US prices.

Methods
A Markov model was developed to compare the costs and effectiveness of cabozantinib with best supportive care in the second-line treatment of advanced hepatocellular carcinoma over a lifetime horizon. Health outcomes were measured in discounted life years and discounted quality-adjusted life years. Survival probabilities were estimated using parametric survival distributions based on CELESTIAL trial data. Utilities were derived from the literature. Costs contained drugs, monitoring and adverse events measured in US Dollars. Model robustness was addressed in univariable, scenario and probabilistic sensitivity analyses.

Results
Cabozantinib generated a gain of 0.18 life years (0.15 quality-adjusted life years) compared with best supportive care. The total mean cost per patient was $56,621 for cabozantinib and $2064 for best supportive care in the German model resulting in incremental cost-effectiveness ratios for cabozantinib of $306,778/life year and $375,470/quality-adjusted life year. Using US prices generated costs of $177,496 for cabozantinib and $4630 for best supportive care and incremental cost-effectiveness ratios of $972,049/life year and $1,189,706/quality-adjusted life year.

Conclusions
Our analysis established that assuming a willingness-to-pay threshold of $163,371/life year (quality-adjusted life year) for the German model and $188,559/life year (quality-adjusted life year) for the US model, cabozantinib is not cost-effective compared with best supportive care. Sensitivity analyses showed that cabozantinib was not cost-effective in almost all our scenarios.