bluuebunny/crossref_metadata_2025_split huggingface dataset:
Management of Endovascular Treatment for Acute Ischemic Stroke During the COVID-19 Pandemic at a Single Institution in Beijing, China: A Brief Report
Authors: Li Shu , Zeng Min , Dong Jia , Li Muhan , Yan Xiang , Li Ruowen , Zhang Yuewei , Huo Xiaochuan , Miao Zhongrong , Wang Shuo , Peng Yuming , Han Ruquan 
Published: November 2020

Background:
The coronavirus disease (COVID-19) pandemic is currently a major challenge for health care systems around the world. For a time-sensitive emergency such as acute ischemic stroke (AIS), streamlined workflow times are essential to ensure good clinical outcomes.

Methods:
The aim of this single-center, retrospective, observational study was to describe changes in stroke workflow patterns and clinical care during the COVID-19 pandemic. Data from AIS patients undergoing emergent endovascular treatment (EVT) between 23 January and 8 April 2020 were retrospectively collected and compared with data from patients admitted during a similar period in 2019. The primary outcome was difference in time from symptom onset to recanalization. Secondary outcomes included workflow times, clinical management, discharge outcomes, and health-economic data.

Results:
In all, 21 AIS patients were admitted for emergent EVT during the 77-day study period, compared with 42 cases in 2019. Median time from symptom onset to recanalization was 132 minutes longer during the pandemic compared with the previous year (672 vs. 540 min, P=0.049). Patients admitted during the pandemic had a higher likelihood of endotracheal intubation (84.6% vs. 42.4%, P<0.05) and a higher incidence of delayed extubation after EVT (69.2% vs. 45.5%, P<0.05). National Institutes of Health Stroke Scale at hospital discharge was similar in the 2 cohorts, whereas neurointensive care unit stay was longer in patients admitted during the pandemic (10 vs. 7 days, P=0.013) and hospitalization costs were higher (123.9 vs. 95.2 thousand Chinese Yuan, P=0.052).

Conclusion:
Disruptions to medical services during the COVID-19 pandemic has particularly impacted AIS patients undergoing emergent EVT, resulting in increased workflow times. A structured and multidisciplinary protocol should be implemented to minimize treatment delays and maximize patient outcomes.
Ankle Morphology and Juvenile Osteochondritis Dissecans (JOCD) of the Talus: Is There an Association? An MRI Study
Authors: Masquijo J. Javier , Allende Felicitas , Carabajal Miguel 
Published: November 2020

Purpose:
Factors that contribute to the development of juvenile osteochondritis dissecans (JOCD) of the talus are poorly understood. Some authors suggest that a higher loading of the affected zone may be a cofactor in osteochondral lesions. Therefore, the purpose of the study is to evaluate any association between ankle morphology and talus JOCD using morphologic parameters from magnetic resonance images. Our hypothesis is that ankles with JOCD lesions would have differences in the anatomy compared with age and sex-matched unaffected ankles.

Methods:
We evaluated a total of 75 extremities. There were 22 patients (25 ankles) with talus JOCD lesions, and 50 patients (50 ankles) sex and age-matched individuals with healthy ankles served as controls. Two examiners conducted independent measurements of 8 magnetic resonance images parameters: tibial anterior surface angle, tibial shaft both malleoli angle (TBM), tibial axis-medial malleolus angle, anterior opening angle of the talus, malleolar width, tibial lateral surface angle, Maximal tibial thickness, length of trochlea tali arc, and height of trochlea tali arc. Measurement reliability was assessed using intraclass correlation coefficients. Differences in parameters between JOCD patients and controls were evaluated using independent t test. The level of significance was taken to be P<0.05.

Results:
Intraclass correlation coefficients demonstrated good to excellent consistency for all measurements. Sagittal parameters demonstrated a significant length of trochlea tali arc increase in ankles with JOCD lesions compared with normal ankles (P=0.015). There was no statistical difference in any of the axial or coronal parameters.

Conclusions:
Ankle morphology may have a relationship with JOCD lesions. Future larger studies will be useful for further clarifying our findings, and detecting other potential predisposing factors with clinical relevance and how they can be modified.

Study Design:
Cross-sectional study (Level of evidence III).
Neoadjuvant immunotherapy in nonsmall cell lung cancer
Authors: Pall Georg 
Published: November 2020

Purpose of review
Immune-checkpoint inhibitors have improved treatment outcomes for metastatic nonsmall cell lung cancer (NSCLC). Whether this therapeutic potential might also translate into survival gains in earlier stages is an area of active research. Based on preclinical rationale the neoadjuvant administration of immunotherapeutic agents is of special interest. This review is intended to summarize the existing background, published early clinical evidence, and provide perspective on future developments regarding neoadjuvant immunotherapy in NSCLC.

Recent findings
Preclinical data and early clinical trials suggest promising efficacy of immune-checkpoint inhibitors in early-stage NSCLC when administered in a neoadjuvant manner. Compared to historical controls, the rates of pathologic and radiographic regression seem to be improved, in particular when immunotherapy is combined with standard platinum-based chemotherapy. These favorable treatment effects are accompanied by a moderate toxicity profile without impairing surgical outcomes. Several phase III trials are underway to provide definitive evidence.

Summary
Neoadjuvant immunotherapy has the potential to substantially improve outcomes in early-stage NSCLC and therefore to change daily clinical practice in the near future.
Beyond Initial Screening: One-Year Follow-up of Adolescents with Internalizing Problems on the Pediatric Symptom Checklist
Authors: Holcomb Juliana M. , Arauz Boudreau Alexy , Riobueno-Naylor Alexa , Haile Haregnesh , Lucke Cara M. , Bergmann Paul , Joseph Bernard , Jellinek Michael , Murphy J. Michael 
Published: November 2020

ABSTRACT:

Objective:
Screening for adolescent depression is a quality indicator for pediatric care, and the parent-completed, 17-item Pediatric Symptom Checklist's internalizing (PSC-17P-INT) subscale has been validated for this purpose. The current study assessed the feasibility of PSC-17P-INT screening, the prevalence of risk on 2 consecutive PSC-17P-INTs, and rates of behavioral health (BH) service use before and after screening.

Methods:
The parent-report PSC-17 was completed on tablet devices before well-child visits (WCVs) with results instantaneously available to clinicians in the electronic health record. Billing data were used to identify adolescents with 2 consecutive WCVs and possible BH service utilization 6 months before and after their first screen.

Results:
In 2017, 1,068 adolescents (12–17 years old) were seen for a WCV, and 637 (59.6%) of them had one in 2018. Most (93.9%; N = 604) completed a PSC at both visits. Patients who scored positively on their first PSC-17P-INT were about 9 times more likely to receive subsequent BH services than patients who screened negative (24.3% vs 2.6%, χ2 = 59.65, p < 0.001). However, risk prevalence increased from the first (11.6%) to the second (14.9%) screen, and only 37.1% of at-risk patients remitted.

Conclusion:
The current study demonstrated that screening adolescents for depression using the PSC-17P-INT was feasible and associated with a significant increase in BH treatment rates. The study also demonstrated that the PSC could be used to track adolescents at risk for depression, found that most youth who screened positive remained at risk 1 year later, and supported recent quality guidelines calling for annual depression screening and follow-up for adolescents with depression.
Impact of the Opioid Epidemic on Drug Testing
Authors: McMillin Gwendolyn A. , Johnson-Davis Kamisha L. , Kelly Brian N. , Scott Bonnie , Yang Yifei K. 
Published: November 2020

Background:
This review provides a description of how the opioid epidemic has impacted drug testing.

Methods:
Four major service areas of drug testing were considered, including emergency response, routine clinical care, routine forensics, and death investigations.

Results:
Several factors that the opioid epidemic has impacted in drug testing are discussed, including specimens, breadth of compounds recommended for testing, time to result required for specific applications, analytical approaches, interpretive support requirements, and examples of published practice guidelines.

Conclusions:
Both clinical and forensic laboratories have adapted practices and developed new testing approaches to respond to the opioid epidemic. Such changes are likely to continue evolving in parallel with changes in both prescription and nonprescription opioid availability and use patterns, as well as emerging populations that are affected by the “waves” of the opioid epidemic.
Radiation Exposure Dose Distribution of Workers Engaged in Decontamination and Related Work Following the Fukushima Nuclear Disaster
Authors: Fukunaga Hisanori , Ogawa Tsubasa , Asano Tomohiro , Ito Atsuo 
Published: November 2020

Abstract
Since the Fukushima nuclear disaster in March 2011, decontamination operations have been conducted across a wide area of Japan. The Japanese System of Registration and Management of Radiation Exposure Doses for Decontamination and Related Work, which was launched in November 2013, is administered by the Radiation Effects Association with the participation of prime contractors who perform decontamination and related work. This study aims to investigate the radiation exposure dose distribution of workers engaged in decontamination and related work, using data obtained from the above registration system. We analyzed the radiation exposure dose distributions among workers in 11 Fukushima prefectural municipalities (Futaba, Iitate, Katsurao, Kawamata, Kawauchi, Namie, Naraha, Minamisōma, Okuma, Tamura, and Tomioka) from 2013 to 2018. The mean radiation exposure doses of workers in each municipality were generally low, although a Kruskal–Wallis test showed a significant regional difference in the figures. The highest mean dose was 0.5 mSv in Okuma in 2018, and the second highest was that of Futaba. The workers engaged in the land development and construction of the interim facilities may have been exposed to more radiation than other workers across 11 Fukushima prefectural municipalities. Following large-scale nuclear accidents or radiation emergencies, radiation dose monitoring and health management for each worker need to be optimized according to their work assignments.
Correlation of Automated Computed Tomography Volumetric Analysis Metrics With Motility Disturbances in Thyroid Eye Disease
Authors: Law James J. , Mundy Kevin M. , Kupcha Anna C. , Chaganti Shikha , Nelson Katrina M. , Harrigan Robert L. , Landman Bennett A. , Mawn Louise A. 
Published: November 2020

Purpose:
The authors sought to examine relationships between CT metrics derived via an automated method and clinical parameters of extraocular muscle changes in thyroid eye disease (TED).

Methods:
CT images of 204 orbits in the setting of TED were analyzed with an automated segmentation tool developed at the institution. Labels were applied to orbital structures of interest on the study images, which were then registered against a previously established atlas of manually indexed orbits derived from 35 healthy individuals. Point-wise correspondences between study and atlas images were then compared via a fusion algorithm to highlight metrics of interest where TED orbits differed from healthy orbits.

Results:
Univariate analysis demonstrated several correlations between CT metrics and clinical data. Metrics pertaining to the extraocular muscles—including average diameter, maximum diameter, and muscle volume—were strongly correlated (p < 0.05) with the presence of ocular motility deficits with regards to the superior, inferior, and lateral recti (with exception of superior rectus motility deficits being mildly correlated with muscle volume [p = 0.09]). Motility defects of the medial rectus were strongly correlated with muscle volume, and only weakly correlated with average and maximum muscle diameter.

Conclusions:
The novel method of automated imaging metrics may provide objective, rapid clinical information which may have utility in prevention and recognition of visual impairments in TED before they reach an advanced or irreversible stage and while they are able to be improved with immunomodulatory treatments.
Postoperative Blepharoptosis After Pars Plana Vitrectomy Procedure
Authors: Abdolalizadeh Parya , Kashkouli Mohsen Bahmani , Falavarjani Khalil Ghasemi , Karimi Nasser , Khademi Behzad , Sedaghat Ahad 
Published: November 2020

Purpose:
To describe the frequency of blepharoptosis and factors affecting it after the pars plana vitrectomy (PPV) procedure.

Methods:
In a prospective study, patients were recruited consecutively from October 2016 to June 2018. Upper eyelid margin reflex distance 1 and 2 (MRD1 and 2), upper eyelid crease height, and levator function were measured before, 1 and at least 6 months after surgery by the same investigator. Clinical and Clinically significant ptosis were defined as ≥0.5 and ≥2 mm drop of MRD1.

Result:
There were 60 eyes from 57 patients. The majority of surgeries were performed by the fellows (63.3%, 38/60) and under general anesthesia (95.0%, 57/60). Clinical and clinically significant ptosis following PPV were 47.2% (25/53) and 11.3% (6/53) at the last follow up (at least 6 months), respectively. MRD2 (p = 0.389) and eyelid crease height (p = 0.057) did not significantly change. Surgeons’ level, time of the procedure and other variables were not significantly impacting the frequencies.

Conclusion:
Persistent clinically significant ptosis was observed in 11% of patients undergoing PPV. No variable was significantly associated with persistent postoperative ptosis after PPV.
Pharmaceutical and Supply Waste in Oculofacial Plastic Surgery at a Hospital-Based Outpatient Surgery Center
Authors: Bhatter Param , Cypen Sanja G. , Carter Steven L. , Tao Jeremiah P. 
Published: November 2020

Purpose:
To investigate the financial and environmental waste burden of unused disposable surgical supplies and pharmaceutical products in oculofacial plastic surgery at a hospital-based outpatient surgery center.

Methods:
This descriptive study was performed at a single academic hospital-based outpatient surgery center. Unused pharmaceuticals and disposable surgical materials were recorded for each of 34 consecutive oculofacial plastic surgeries performed by the same surgical team. Pharmaceutical products were grouped as local anesthetic (tetracaine, bupivacaine, lidocaine, and sodium bicarbonate), intraoperative (basic saline solution, methylene blue, and oxymetazoline hydrochloride), or antiseptic/antimicrobial (erythromycin ointment and hydrogen peroxide). Percentage of unused pharmaceutical product and disposable surgical material were calculated and extrapolated to direct costs to the institution and greenhouse gas emissions.

Results:
The mean percentage of disposable surgical supply waste per case was 11.6% ($29.32). The mean percentage of pharmaceutical waste was 96.1% ($271.84) for local anesthetic, 71.0% ($163.47) for intraoperative medications, and 26.7% ($2.19) for antiseptic medication. The mean emissions per surgical case for unused disposable surgical equipment and unused pharmaceutical product were 10 and 103 kg of carbon equivalent gases (kg CO2-e), respectively.

Conclusions:
Surgical supply waste was nominal, but pharmaceutical waste was considerable in this single hospital-based outpatient surgery center study. There may exist opportunities for quality improvement in waste, especially pharmacologic burden, in oculofacial plastic surgery.
Organizational Perspectives on How to Successfully Integrate Health Promotion Activities into Occupational Health and Safety
Authors: Biswas Aviroop , Begum Momtaz , Van Eerd Dwayne , Smith Peter M. , Gignac Monique A.M. 
Published: November 2020

Objective:
There is increasing recognition of the value of integrating efforts to promote worker health with existing occupational health and safety activities. This paper aimed to identify facilitators, barriers and recommendations for implementing integrated worker health approaches.

Methods:
Thirteen stakeholders from different job sectors participated in a workshop that targeted key issues underlying integrated worker health approaches in their own and other organizations. Included were participants from human resources, occupational health and safety, government, and unions. Thematic analysis and an online ranking exercise identified recommendation priorities and contributed to a conceptual framework.

Results:
Participants highlighted the importance of planning phases in addition to implementation and evaluation. Themes highlighted organizational priorities, leadership buy-in, external pressures, training, program promotion and evaluation metrics.

Conclusions:
Findings provide practical directions for integrating worker health promotion and safety and implementation steps.
Website Survey Method for Assessing Higher Education Employee Health and Safety Programs
Authors: Malomet Maayan S. , Harber Philip 
Published: November 2020

Objective:
The higher education industry in the United States is large (almost four million employees and 19 million students) with diverse hazards.

Methods:
We apply a novel health services research approach to systematically assess a sample of 55 institutional websites. The accessibility, content, and coverage of occupational health/safety program information were systematically coded for several domains (eg, Occupational Safety and Health Administration (OSHA)-related, specific hazards, clinical, person-oriented, COVID-19, and coverage).

Results:
Information was more available for programs related to OSHA mandates (eg, chemical hygiene) and specific hazards than for person-oriented programs (eg, counseling). Larger institutions provide better information and more comprehensive programs than smaller institutions.

Conclusions:
Higher education institutions warrant increasing attention to occupational health and safety, particularly as COVID-19 increased attention to workplace health issues.
REabsorbable vs. DUrable Polymer Drug-Eluting Stents in All-Comer PatiEnts: the REDUCE registry
Authors: Piccirillo Francesco , Caiazzo Gianluca , Miglionico Marco , Nusca Annunziata , Melfi Rosetta , Gallo Paolo , Ricottini Elisabetta , De Michele Mario , Golino Luca , Manganiello Vincenzo , Fattore Luciano , Mangiacapra Fabio , Di Sciascio Germano 
Published: November 2020

Background
While the superiority of reabsorbable-polymer drug-eluting stents (RP-DES) over bare-metal stents and first-generation durable-polymer (DP)-DES has been largely established, their advantage compared with new-generation DP-DES is still controversial. This study aimed was to compare clinical outcomes of all-comer patients undergoing percutaneous coronary intervention (PCI) with new generation DP-DES or RP-DES implantation.

Methods
We prospectively enrolled 679 consecutive patients treated with PCI with RP-DES or DP-DES. The primary endpoint was the 1-year incidence of major adverse clinical events (MACE), a composite of death, myocardial infarction (MI), and target vessel revascularization (TVR). Target lesion revascularization (TLR) and definite stent thrombosis were also recorded.

Results
A total of 439 (64.6%) received RP-DES and 240 (36.4%) received DP-DES. No significant difference in the incidence of MACE (5.9 vs. 4.9%; hazard ratio, 1.23; 95% confidence interval (CI), 0.61–2.49; P = 0.569), death (1.8 vs. 1.7%; hazard ratio, 1.09; 95% CI, 0.33–3.64; P = 0.882), MI (2.3 vs. 2.1%; hazard ratio, 1.05; 95% CI, 0.36–3.08; P = 0.927), TVR (2.3 vs. 1.3%; hazard ratio, 1.70; 95% CI, 0.47–6.20; P = 0.418), TLR (1.4 vs. 0.4%; hazard ratio, 3.06; 95% CI, 0.37–25.40; P = 0.301), and definite stent thrombosis (0.5 vs. 0.4%; hazard ratio, 1.09; 95% CI, 0.10–12.10; P = 0.942) was observed between RP-DES and DP-DES patients at 1-year follow-up. These results were confirmed in a propensity score-matched cohort (n = 134 per group).

Conclusion
In our registry including a real-world population of all-comer patients undergoing PCI, RP-DES, or durable polymer-DES showed similar efficacy and safety at a 1-year follow-up.
A randomized comparison of a novel iopromide-based paclitaxel-coated balloon Shenqi versus SeQuent Please for the treatment of in-stent restenosis
Authors: Zhu Jinzhou , Liu Lili , Zhu Zhengbin , Yang Zhenkun , Hu Jian , Ding Fenghua , Zhou Yujie , Su Xi , Ge Junbo , Liu Xuebo , Tang Lijiang , He Yong , Zhou Guowei , Ji Zheng , Li Ying , Pang Wenyue , Zhang Ruiyan 
Published: November 2020

Background
Treatment of coronary in-stent restenosis (ISR) remains challenging in contemporary clinical applications. Drug-coated balloon (DCB) angioplasty offers an effective treatment for ISR. Shenqi is a novel iopromide-based paclitaxel-coated balloon and its clinical safety, effectiveness and angiographic efficacy in patients with ISR have not been investigated.

Methods
A total of 216 subjects with the first occurrence of ISR at 11 investigational sites in China were randomly allocated in a 1:1 fashion to treatment with DCB SeQuent Please or Shenqi. Clinical follow-up was planned at 1, 6, 9 and 12 months, and angiographic follow-up was planned at 9 months. The study was powered for the primary endpoint of 9-month in-segment late loss.

Results
At 9-month follow-up, the in-segment late loss was 0.29 ± 0.43 mm with Shenqi versus 0.30 ± 0.46 mm with SeQuent Please, and the one-sided 97.5% upper confidence limit of the difference was 0.14 mm, achieving noninferiority of Shenqi compared with SeQuent Please (P = 0.002). In total, 12 patients developed target lesion failure (TLF) in the Shenqi group compared with 16 patients in the SeQuent Please group (10.91% versus 15.09%; P = 0.42) within 1 year. TLF was mainly driven by target lesion revascularization (9.09%) followed by target vessel-related myocardial infarction (1.82%) and cardiovascular death (0.91%) in the Shenqi group.

Conclusions
Shenqi DCB was noninferior to SeQuent Please DCB for the primary endpoint of 9-month in-segment late loss. Shenqi DCB may become an attractive alternative treatment for patients with coronary ISR, withholding the need for additional stent implantation.
Adult obesity and its complications: a pediatric disease?
Authors: Malhotra Sonali , Sivasubramanian Ramya , Singhal Vibha 
Published: November 2020

Purpose of review
Approximately 2.6 million people die each year secondary to obesity related diseases. The risk of developing serious comorbidities depends on the age of onset as well as duration of obesity. In this review, we discuss trends in BMI trajectories from early childhood to adulthood with latest evidence on comorbidities in adulthood stemming from pediatric obesity and benefits of early intervention and treatment in childhood obesity.

Recent findings
Childhood obesity poses high risk of metabolic and cardiovascular disorders like type 2 diabetes, hypertension, atherosclerosis, coronary artery disease, and some types of cancer in adulthood. Early life obesity also increases risks of developing menstrual irregularities, infertility, and pregnancy complications. Several grave concerns including malignancies, autoimmune disorders, higher asthma morbidity, and psychiatric implications are found to be associated with childhood obesity. Disease outcomes can be transgenerational, causing suboptimal health in children of mothers with obesity. Encouragingly, many risks associated with childhood obesity can be reduced, delayed, or even reversed by early resolution of obesity necessitating close BMI monitoring and treatment early.

Summary
Early identification and aggressive management of childhood obesity is critical in prevention of debilitating comorbidities in adult life.

Video abstract

http://links.lww.com/COE/A19