bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparative Evaluation of Keyhole Technique and Delta Technique for Cervical Disc Herniation: a retrospective comparative cohort study.
Authors: Yu Tong , Wu Jiu-Ping , Zhang Jun , Yu Hai-Chi , Liu Qinyi 
Published: January 2020

Abstract
Background p-PECD is an effective strategy for cervical diseases which working cannula ranges from 3.7 mm to 6.9 mm. However, no studies were performed to compare the clinical outcomes of keyhole technique (diameter of 3.7 mm) and delta technique (diameter of 6.9 mm) in CDH patients. The purpose of this study was to compare the clinical outcomes of unilateral cervical disc herniation (CDH) patients treated with posterior percutaneous endoscopic cervical discectomy (p-PECD) applying the keyhole technique with those treated with the delta technique.Methods From January 2016 to June 2018, totally 28 consecutive patients presented with single-level CDH who received p-PECD using the keyhole technique or the delta technique were enrolled in this study. Patients were evaluated neurologically pre- and postoperatively. The clinical outcomes, including the operation time, the hospitalization, the visual analogue scale (VAS) and the modified MacNab criteria, were evaluated. Cervical fluoroscopy, CT, and MRI were performed during follow up.Results In both groups, faster “V” point identification, more quickly overlying soft tissue removal and laminoforaminotomy, and shorter operative time, were found in the delta group. Postoperatively, the VAS and MacNab scores of the two techniques were improved significantly. Nevertheless, the differences between the two groups were not significant (P>0.05). One case suffered nerve root outer membrane torn in delta group.Conclusion Both keyhole technique and delta technique are effective methods for CDH in selected patients, and there is no significant difference in clinical outcomes. Delta technology is superior to keyhole technology in the efficiency of “V” point identification, overlying soft tissue removal and spinal cord injury prevention. Furthermore, delta technology is inferior to keyhole technology in anterior decompression of the intervertebral foramen.
High incidence of surgical site infection may be related to suboptimal case selection of non-selective arterioembolisation during resuscitation of patients with pelvic fractures
Authors: Lai Chih-Yang , Tseng I-Chuan , Su Chun-Yi , Hsu Yung-Heng , Chou Ying-Chao , Chen Huan-Wu , Yu Yi-Hsun 
Published: January 2020

Abstract
Background In most institutions, arterioembolisation (AE) remains a standard procedure to achieve haemostasis in the resuscitation of patients with pelvic fractures. However, the actual benefits from AE are controversial. Methods We retrospectively reviewed data from patients with closed pelvic fractures between 2014 and 2017 in a single institute. The details of AE and clinical parameters were recorded and analysed to determine whether poor outcomes could be predicted. Results During the study period, 545 patients with closed pelvic fractures were enrolled. Angiography was performed in 131 patients, and 129 patients underwent AE. The patients who underwent AE had higher injury severity score, more numbers of shock status on arrival, and higher incidence of unstable fracture patterns when compared to non-AE group. A higher number of patients who underwent AE required osteosynthesis and experienced surgical site infection (SSI) after osteosynthesis than those who did not receive AE. Nonselective bilateral internal iliac artery embolisation (nBIIAE) was the major approach for AE (74%). Overall, 11 patients experienced SSI in the AE group, 9 of whom had received nBIIAE. The positive predictive value of contrast extravasation (CE) on computed tomography (CT) was 29.6%, with a negative predictive value of 91.3%. Mortality was higher in patients without CE on CT than patients with identifiable CE (30.0% vs. 11.0%, p = 0.03). Conclusion Using the finding of CE on CT examination as a decision for AE is not a reliable indicator because of its low positive predictive value. Considering the high incidence of SSI following nBIIAE, candidates should be carefully selected for this procedure. Other haemostasis procedures such as preperitoneal pelvic packing might be considered for select cases, given the high mortality rate among patients without CE during image studies, relative to patients with identifiable CE.
Novel Biallelic Loss-of-Function Variants in CEP290 Cause Joubert Syndrome in Two Siblings
Authors: Wang Xiang , Zhang Zhu , Zhang Xueguang , Shen Ying , Liu Hongqian 
Published: January 2020

Abstract
BackgroundJoubert Syndrome (JS) is a rare genetic disorder, which can be defined by brainstem malformation, cerebellar vermis hypoplasia and consequent “molar tooth sign” (MTS). JS always shares variety of phenotypes in development defects. With the development of next-generation sequencing, dozens of causative genes have been identified to JS so far. Here we investigated a JS case in two male siblings aged 4 and 10 years old and uncovered a novel pathogenesis through combined methods.Results The siblings shared similar features of nystagmus, delayed intellectual development. typical MTS, and abnormal morphology in fourth ventricle. Whole exome sequencing (WES) and chromosome comparative genomic hybridization (CGH) were then performed on the proband. Strikingly, a maternal inherited nonsense mutation (NM_025114.3: c.5953G>T [p.E1985*]) in CEP290 gene and a paternal inherited deletion in 12q21.32 including exon 1 to 10 of CEP290 gene were identified in the two affected siblings. We further confirmed the two variants by in vitro experiments: qPCR, and PCR-sequencing.Conclusions In this study, we first reported a novel causative mechanism of Joubert Syndrome: a copy number variation (CNV) compounding with a point mutation in CEP290 gene, which can be helpful in the genetic diagnosis of this disease.
Comparison of tendency and accuracy in predicted post-operative refraction and recommended IOL power between IOL Master and VERION before and after optimizing IOL-constant in the VERION
Authors: Teshigawara Takeshi , Meguro Akira , Mizuki Nobuhisa 
Published: January 2020

Abstract
Background: We assessed the accuracy and tendency of the VERION image-guided system (Alcon) and the intra-ocular lens (IOL) Master 700 (Zeiss), by comparing mean refractive shift (MRS) of predicted post-operative refraction (PPR), mean absolute error (MAE) of PPR, recommended IOL power (RIP) and K-value before and after optimizing the IOL-constant in VERION, to show the importance of optimization.Methods: This retrospective study involved 72 eyes. K-value was measured with both biometers. Axial length (AL) and anterior chamber depth (ACD) measured by the IOL Master were applied to the VERION because it cannot measure these variables. The User group for Laser Interference Biometry (ULIB) IOL-constant for the IOL Master was applied to the VERION before optimizing the IOL constant, since no such official measure was established for it. MRS of PPR, MAE of PPR, RIP and K-value as measured by both biometers were compared before and after optimizing the IOL-constant in the VERION. Finally, correlations between the MRS, MAE, RIP, and K-value were analyzed in the VERION. The Wilcoxon signed-rank test was used for analysis.Results: Compared to the IOL Master, K-value was significantly higher in the VERION. Prior to optimization, MRS of PPR showed a significant myopic shift in the VERION, and MAE of PPR was significantly higher. Additionally, RIP in the VERION was significantly lower. After optimization, there were no significant differences in the MRS of PPR and RIP between the VERION and IOL Master. MAE of PPR in the IOL Master was significantly higher than in the VERION. No significant correlations were found between MRS and MAE of PPR and RIP with K-value in the VERION. Conclusions: Before optimization, the VERION was less reliable in MRS, MAE and RIP than the IOL Master. However, after optimization, the difference in MRS and RIP between the two devices became insignificant. This study indicates that optimization of IOL-constant in the VERION is vital. After optimization, the VERION is more accurate in PPR than the IOL Master.
Age-related changes of the corneal endothelium in a Hispanic elderly population.
Authors: Valdez-Garcia J , Ortiz-Morales Gustavo , Morales-Mancillas Nallely , Domene-Hickman Jorge Luis , Hernandez-Camarena Julio , Loya-Garcia Denise , Zavala Judith , Rodriguez-Garcia Alejandro 
Published: January 2020

Abstract
Purpose: To assess the corneal endothelial morphometry in healthy elderly Hispanic eyes.Methods: A retrospective, cross-sectional, observational, descriptive, and analytical study was designed to assess by specular microscopy the central region of the corneal endothelium. In a 4-year period, a total of 75 eyes from 42 patients were studied. All eyes included were from patients 65 or older (mean: 73.87±6.86), without ocular disease or surgeries.Results: The mean cell density (MCD) was 2268±597.0 cells/mm2. 44% of patients had polymegethism, with an average coefficient of variation (CV) of 42.04 ± 10.1%. 76% of patients had low pleomorphism, with an average of 42.3 ± 8.9% hexagonal cells. The mean corneal thickness was 537±38.2 μm. There was no statistically significant difference between age groups for MCD, CV, hexagonality and pachymetry (p=>.05). 27% of patients had corneal guttata.Conclusion: This study suggests that the elderly Hispanic population has a high prevalence of polymegethism, pleomorphism and guttata. Surprisingly, the oldest age group (>85) had an above average MCD, low polymegethism and good pleomorphism.
A pioneer usage of nanogold sandwich ELISA in the detection of hydatid antigen in humans as a tool for improvement of serodiagnostic testing.
Authors: Elawamy Waleed E , Rashed Samia M , Nassr Mona E , Shalash Ibrahim R A , Ali Nagwa S , Elghanam Amera S , Nageeb Marwa M 
Published: January 2020

Abstract
Background: Human cystic echinococcosis is a zoonosis occurring due to dogs handling and exposure to Echinococcus granulosus ova in their stools being an accidental intermediate host. Serology remains the only sure and important tool to diagnose this disease. Our objectives in this research are to improve the serodiagnostic abilities of sandwich ELISA through its binding to gold nanoparticle and proving the role of minute nanoparticles in serodiagnosis. Methods: gold nanoparticles (AuNPs) were employed for the capture of the antigens of protoscolices (pAg) in the patient’s serum by sandwich ELISA. Cross-reactivity for antigens from Hymenolepis nana , Entrobius vermicularis , and Fasciola gigantica was ruled out by using anti-protoscolices polyclonal antibodies (ppAb). (pAg) of sonicated protoscolices which were removed from camel lung cysts, was purified by diethyl aminoethyl Sephadex (DEAE-Sephadex) and injected to a New zealand white rabbit giving ppAb which then conjugated to horseradish peroxidase (HRP) and loaded on AuNPs being used as a diagnostic indicator for circulating pAg by both sandwich ELISA and nanogold sandwich ELISA techniques. Results: Nanogold sandwich ELISA was able to give positive results with 96.3% of hydatid patients and 5% of non-hydatid patients while sandwich ELISA showed 81.4% and 20% positive cases of the same groups respectively. The sensitivity and specificity of nanogold sandwich ELISA were 96.3% & 95% against 81.5% & 80% for those of sandwich ELISA respectively. Conclusion: The conjugation of AuNPs to anti- Echinococcus IgG antibodies seems to be beneficial to maximize the sensitivity of sandwich ELISA, reduce the overall cost of the assay as less antibody was needed, solve harsh buffering conditions and achieve greater stability which provides a reliable quantitation of analytes.
Prevalence and associated factors of chlamydial infection among patients seeking clinic-based STI services in Shenzhen, China
Authors: Wang Hong-Lin , Cai Yu-Mao , Chen Xiang-Sheng , Yu Wei-Ye , Hong Fu-Chang , Feng Tie-Jian , Liu Jin-Hong , Zhang Chun-Lai , Wen Li-Zhang , Wang Feng , Ye Jian-Bin , Weng Rong-Xing , Tang Fen 
Published: January 2020

Abstract
Objectives Prevalence assessment is one of the core components of WHO-recommended STI surveillance programming. This study aimed to provide prevalence and associated factors data for estimating the disease burden of CT, developing intervention programmes, and planning for resource allocations.Methods We carried out a cross-sectional survey among patients attending clinics for STI services. We collected background information from patients (aged 18-49) and determined positivity of CT by nucleic acid amplification test (NAAT) with self-collected urine specimens. Associated factors identified through logistic regression.Results Among the 8324 participants, 751 were detected to be positive for CT, giving an overall prevalence of 9.0% with 10.7% for male and 8.3% for female respectively. Aged older than 24 (OR=0.78, 95%CI=0.62-0.98), married (OR=0.61, 95%CI=0.50-0.75), college or higher education (OR=0.66, 95%CI=0.51-0.86), having no access to health insurance (OR=1.28, 95%CI=1.07-1.51), and positive for NG (OR=4.45, 95%CI=3.22-6.15) were factors found to be significantly associated with CT infection.Conclusions We found that CT infection is prevalent among patients seeking clinic-based STI services in Shenzhen, China. A comprehensive CT screening, surveillance, and treatment programme targeting this population are warranted. And the CT integrated prevention and control projects could be considered as routine public health services by the government.
Prevalence of gastrointestinal bleeding and frequency of selected predictors of mortality on the Medical Emergency Ward at Mulago Hospital
Authors: KISUULE IVAN , Seremba Emmanuel , Kagimu Magid 
Published: January 2020

Abstract
Background Gastroenterologists of Mulago hospital noted that many patients with gastrointestinal bleeding are transferred to their ward from the emergency ward without adequate resuscitation. They recommended that blood should be ring fenced for patients with gastrointestinal bleeding (GI) on the emergency ward so that urgent resuscitation can be done. There was however no current data on the prevalence of GI bleeding in the emergency ward to provide a guide of how much blood should be ring fenced. This was partly because the medical records are not adequately completed as designed. We thus undertook a study to estimate the prevalence of GI bleeding on the emergency ward by incorporating quality improvement methods in the process of data collection to improve the documentation practice on the Casualty assessment form (CAF).Methods This was a cross sectional study incorporating quality improvement methods in the process of data collection from the CAF for patients attending the emergency ward. Focus group discussions and key informant interviews were conducted to ascertain the root causes of inadequate completion of this form. The health care team was educated on documentation of GI bleeding while being assessed weekly for knowledge and practice of completion of the CAF. The filled CAF were assessed for adequate completion while looking out for a documented diagnosis of GI bleeding and selected predictors of mortality.Results Of the 1881 CAF assessed, 278 had a documented diagnosis of GI bleeding, resulting in a prevalence of 6.8%. Of the patients with GI bleeding, 14.1% of them had age greater than 60 years old, 24.0% had a systolic blood pressure less than 100mmHg and 44.5% had a heart rate greater than 100 beats per minute.Conclusion The prevalence of GI bleeding on the medical emergency ward of Mulago hospital is high, with 1 in every 15 patients having this condition. This calls for strategies for resuscitative management of this potentially life threatening condition. Among the selected predictors of mortality, tachycardia was most frequent followed by hypotension. These should always be assessed in a patient with GI bleeding and resuscitative measures with blood transfusion and intravenous fluids undertaken to correct them.
NAFLD progression is related with plasma pro-oxidative biomarkers rather than liver tissue-measured nitrogen metabolism biomarkers in population with obesity and metabolic syndrome
Authors: Suárez-Cuenca Juan Antonio , Domínguez-Pérez Gabriela Alexandra , Hernández-Muñóz Rolando Efraín , Hernández-Patricio Alejandro , Vera-Gómez Eduardo , Gutiérrez-Buendía Juan Ariel , Cázares-García Ollin , Salamanca-García Moisés , Ortíz-Fernández Moisés , Montoya-Ramírez Jesús , Gaytán-Fuentes Omar Felipe , Blas-Azotla Ricardo , Melchor-López Alberto , Vaca Rebeca Pérez-Cabeza de , Mondragón-Terán Paul 
Published: January 2020

Abstract
Background. The metabolic syndrome (MS) is associated with an increased production of nitrogen metabolites and elevated oxidative stress, which favor the development and progression of non-alcoholic fatty liver disease (NAFLD). Subjects with the phenotype known as metabolically unhealthy obese (MUO) meet most of the MS cardiometabolic risk criteria and show a higher prevalence of NAFLD and fibrosis progression risk, compared to the so-known as metabolically healthy obese (MHO). The present study aimed to explore whether liver-specific biomarkers of nitrogen metabolism and oxidative stress, measured in both plasma and in liver tissue, may relate to NAFLD severity and/or metabolic phenotype. Methods. This observational, cross-sectional study included candidates for bariatric surgery with biopsy-proven NAFLD diagnosis and staging. For comparison, the study population was divided according to NAFLD progression (steatohepatitis F0-F1 vs F2-F4) and metabolic phenotype (MHO vs MUO, based on the MS criteria). Hepatic and plasma concentrations of nitrogen metabolites and oxidative stress biomarkers were determined by enzymatic kinetics assays, ELISA and Griess reaction. Results. The study population consisted of 28 patients with obesity and higher prevalence of dyslipidemia, diabetes mellitus and hypertension. NAFLD progression was related with the metabolic phenotype. According to plasma biomarkers, MUO phenotype was related to higher cardiometabolic risk; while NAFLD severity progression was related to higher Hb A1c and triglycerides. Elevated hepatic concentrations of ammonium, nitrites, arginine and citrulline were found in MUO phenotype, but only higher plasma concentration of MDA was found as specifically related to NAFLD progression. Conclusions. Circulating biomarkers of redox state were selectively related with NAFLD progression, supporting prognostic and therapeutic potential target. Hepatic concentrations of nitrogen metabolism biomarkers may be more related to cardiometabolic risk.
Developing a roadmap to improve trial delivery for underserved groups: results from a UK multi-stakeholder process
Authors: Witham Miles D , Anderson Eleanor , Carroll Camille , Dark Paul M , Down Kim , Hall Alistair S , Knee Joanna , Maier Rebecca H , Mountain Gail A , Nestor Gary , Oliva Laurie , Prowse Sarah R , Tortice Amanda , Wason James , Rochester Lynn 
Published: January 2020

Abstract
Background Participants in clinical research studies often do not reflect the populations for which healthcare interventions are needed or will be used. Enhancing representation of underserved groups in clinical research is important to ensure that research findings are widely applicable. We describe a multicomponent workstream project to improve representation of underserved groups in clinical trials.Methods The project comprised three main strands: 1) a targeted scoping review of literature to identify previous work characterising underserved groups and barriers to inclusion; 2) surveys of professional stakeholders and participant representative groups involved in research delivery to refine these initial findings and identify examples of innovation and good practice; 3) a series of workshops bringing together key stakeholders from funding, design, delivery and participant groups to reach consensus on definitions, barriers and a strategic roadmap for future work. The work was commissioned by the UK National Institute for Health Research Clinical Research Network. Output from these strands was integrated by a steering committee to generate a series of goals, workstream plans, and a strategic roadmap for future development work in this area.Results ‘Underserved groups’ was identified and agreed by the stakeholder group as the preferred term. Three-quarters of stakeholders felt that a clear definition of underserved groups did not currently exist; definition was challenging and context-specific but exemplar groups were identified as underserved. Barriers to successful inclusion of underserved groups could be clustered into: communication between research teams and participant groups; how trials are designed and delivered, differing agendas of research teams and participant groups; and lack of trust in the research process. Four key goals for future work were identified: building long-term relationships with underserved groups; developing training resources to improve design and delivery of trials for underserved groups; developing infrastructure and systems to support this work, and working with funders, regulators and other stakeholders to remove barriers to inclusion.Conclusions The work of the INCLUDE group over the next 12 months will build on these findings by generating resources customised for different underserved groups to improve the representativeness of trial populations.
Fertility outcomes of deep infiltrating endometriosis with fertility desire—a meta analysis
Authors: shen yue , Feng Ziyi , Jiang Lili , Li Yue , Liu Kuiran 
Published: January 2020

Abstract
Background: The morbidity of endometriosis has been ascending in recent years. Deep infiltrating endometriosis is the most advanced type of endometriosis. The treatments for patients with DIE and fertility desire are controversial. Materials and Methods: We had search Pubmed, OVID Medline, Cochrane Library published before 2019-10-31, According to the inclusion criteria and exclusion criteria, a total of 17 articles were selected. A 95% confidence interval (CI) was used for clinical pregnancy data, and a random-effect model was used for meta-analysis. Subgroup analysis and sensitivity analysis were performed using Review manager 5.3. Results: Among patients with fertility desire, 370/1142 (32.40%) conceived spontaneously after surgery, compared with 306/1108(27.62%) got pregnant after surgery and assisted reproductive technology（P=0.36,I2=82%）.There is no significant statistical significance in this comparison and the heterogeneity is high. Then，we performed subgroup analysis and found that the heterogeneity was not caused by fertility status ,surgical methods or study characteristics. Conclusion: Through this meta-analysis, we think that surgery combined ART or not doesn’t effect on pregnancy rate in patients with DIE. But further investigations are required to determine fertility outcomes according to age, endometrioma, adenomyosis, ASRM scores and so on.