bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluating the Efficiency of Work of the Department of Computed Tomography and Magnetic Resonance Imaging
Authors: Osadchiy K. K. , Mershina E. A. , Bragina A. E. , Sinitsyn V. E. 
Published: November 2019

Objectives. (1) To evaluate the efficiency of work of the Department of Computed Tomography (CT) and Magnetic Resonance Imaging (MRI); (2) to study of its work processes; and (3) to elaborate recommendations for their optimization.Material and methods. Using the principles of lean manufacturing and the original methodology of the Philips Co., the investigators made a comprehensive assessment of the work of the Tomography Department, Center for Radiation Diagnosis, Treatment and Rehabilitation, Ministry of Health of the Russian Federation, in December 2016 to February 2017, including: (1) a study of management reports; (2) oral interviews of employees; (3) a survey of employees, by using a specially designed questionnaire; (4) direct observation and subsequent description of work processes; and (5) assessment of patient satisfaction, by calculating the net promoter score. Based on the findings, the investigators calculated the throughput potential of CT and MRI, described the factors influencing the possibility of realizing this potential, developed recommendations to enhance the efficiency of work processes, and ranked the latter by the magnitude of the expected effect, by the complexity of implementation, and by material costs, followed by prioritization.Results. Assessment of the throughput potential has shown that CT and MRI examinations can be performed by 50.6% and 23.2% more, respectively. This can be achieved by additionally attracting patients, reducing equipment downtime, optimizing work processes, most of all at the stage of patient recording and registration, as well as at the stage of image interpretation and creation of a conclusion. The developed recommendations for optimizing work processes included measures of varying effectiveness and complexity, which could rank them according to three priority levels and identify long-term strategic initiatives.Conclusion. The comprehensive study of the efficiency of work of the Departments of CT and MRI made it possible to quantify the potential for increasing the throughput of CT and MRI, to consider in detail the stages of a medical service delivery process, to reveal areas for improving the process, and to form a set of recommendations for their optimization.
The Potentials and Role of Diffusion-Weighted Magnetic Resonance Imaging in Evaluating the Efficiency of Antitumor Treatment of Patients with Breast Liver Metastasis
Authors: Lukiyanchenko А. B. , Medvedeva B. М. , Kolobanova E. S. , Romanova К. A. , Magamedova S. S. 
Published: November 2019

Objective.To compare the informative value of using dynamic magnetic resonance imaging (MRI) and diffusion-weighted MRI (DW-MRI) in patients with breast liver metastasis during chemotherapy.Material and methods.The investigation enrolled 30 patients with breast liver metastasis during their treatment. The results of standard intravenous contrast-enhanced abdominal MRI studies (by evaluating the liver in the arterial, venous, and delayed phases) were compared with those of DW-MRI with different B-factor values (50, 400 and 800 sec/mm2).Results.Comparison of the findings of initial studies prior to chemotherapy (those of only dynamic intravenous contrast-enhanced MRI and only DW-MRI) revealed a complete correspondence with the number of detected foci in 10 patients. Ten patients had a larger number of metastatic foci at DW-MRI than at intravenous contrast-enhanced MRI, in the aggregate by 44 foci more (of them 36 foci measured less than 1 cm). The remaining 10 of the 30 patients were found to have multiple, unquantifiable (more than 20–40) metastatic foci of various sizes (1–6 cm) at both intravenous contrast-enhanced MRI and DW-MRI. Nineteen of the 30 patients were followed up during their chemotherapy. Seven of the 19 patients showed a stabilized liver metastatic process that was similarly evidenced by both techniques. Eleven of the 19 patients were observed to have a progressive metastatic process that was reflected by the similar increase in the number and size of metastases in 5 of the 11 patients, as shown by both of the above techniques. In the remaining 6 of the 11 patients, the number of newly detected liver tumors proved to be larger at DW-MRI than at intravenous contrast-enhanced MRI. Both techniques showed that the last patient of the 19 cases had a decrease in the number of small liver metastases that maintained their sizes (less than 1 cm).Conclusion.DW-MRI has been shown to be much more effective in detecting metastases than conventional intravenous contrast-enhanced MRI, which necessitates the inclusion of this technique in standard abdominal MRI protocols for patients with liver metastasis.
Magnetic Resonance Spectroscopy in the Diagnosis and Prognosis of Breast Cancer
Authors: Egorov M. V. , Sinitsyn V. E. , Bakunovich A. V. 
Published: November 2019

Objective. To evaluate the efficiency of magnetic resonance spectroscopy in the diagnosis and prognosis of breast cancer (BC).Material and methods. Twenty-eight patients aged 37 to 80 years with established primary invasive BC were examined. Its grade was determined according to pathomorphological verification with immunohistochemical analysis. Breast MRI was performed using the standard protocol, by determining the measured diffusion coefficient (MDC), dynamic contrast enhancement (DCE). Proton magnetic resonance spectroscopy was carried out using the Breeze software package. The clinical and morphological findings and the results of radiation studies were compared to determine Nottingham prognostic index (NPI) scores. To identify the Spearman rank correlation coefficient between MRI findings (the type of pharmacokinetic curves, the total choline-containing (tCho) peak integral) and the values characterizing tumor size and grade.Results. NPI calculation showed that the scoring range was 2.4 to 6.76; the expected 5-year survival rates reached 93%. The mean MDC was 0.856×10-3 mm2/sec; type II pharmacokinetic curve prevailed (n=16; 57.1%). There was a statistically significant negative correlation between the values of MDC, the type of a contrast agent accumulation curve, the levels of HER2/neu and the proliferation marker Ki-67; there was a statistically significant strong positive correlation between the presence of 1H-MPC tCho peak and the indicators determining tumor malignancy (the levels of HER2/neu and Ki-67). Statistically significant differences between the type of a pharmacokinetic curve in DCE and the level of tCho in the prognostic groups defined when calculating NPI were determined in patients with moderate (n=4; 14.2%) and poor (n=10; 35.7%) prognosis.Conclusion. The capabilities of MR spectroscopy are superior in information content to the data obtained by determining the MDC, the nature of contrast medium accumulation in breast tumor, and are comparable with the data determining the type of a tumor (the presence of the HER2/neu gene, Ki-67 proliferation marker) in predicting BC cancer grade and 5-year survival rates.
Staged Bilateral Total Knee Arthroplasty: Increased Risk of Recurring Complications
Authors: Grace Trevor R. , Tsay Ellen L. , Roberts Heather J. , Vail Thomas P. , Ward Derek T. 
Published: November 2019

Background:
As the demand for knee arthroplasty increases, risk assessment and counseling are critical for optimal patient outcomes perioperatively. The purpose of this study was to determine if specific complications occurring after unilateral knee replacement predict the risk of recurrence after a staged replacement of the contralateral knee for patients with bilateral symptomatic disease.

Methods:
Linked, nationwide data from the U.S. Hospital Cost and Utilization Project from 2005 to 2014 were used to measure the occurrence of complications after the first and second procedures in staged bilateral total knee arthroplasties (TKAs). Odds ratios (ORs) and conditional probabilities were determined to assess whether having a specific complication after the first TKA increased the chance that the same complication occurred after the second procedure.

Results:
A total of 36,278 patients who underwent staged bilateral TKAs were analyzed. All complications occurring after the first arthroplasty were associated with both a significantly increased probability and odds of recurrence following the second arthroplasty. These included myocardial infarction (OR, 56.63 [95% confidence interval (CI), 18.04 to 155.44]; p < 0.001), ischemic stroke (OR, 41.38 [95% CI, 1.98 to 275.82]; p = 0.03), other cardiac complications (OR, 7.73 [95% CI, 4.24 to 14.11]; p < 0.001), respiratory complications (OR, 8.58 [95% CI, 2.85 to 23.17]; p = 0.002), urinary complications (OR, 11.19 [95% CI, 5.44 to 22.25]; p = 0.001), hematoma (OR, 15.05 [95% CI, 7.90 to 27.27]; p < 0.001), deep vein thrombosis (OR, 7.40 [95% CI, 5.37 to 10.08]; p < 0.001), and pulmonary embolism (OR, 11.00 [95% CI, 5.01 to 23.92]; p < 0.001).

Conclusions:
Medical complications that occur postoperatively after TKA are associated with a significantly increased risk of recurrence of these complications after staged replacement of the contralateral knee. Although overall complication rates remain low, patients who develop these medical complications after the first replacement should be counseled on their increased risk profile prior to the contralateral surgical procedure.

Level of Evidence:
Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
Bilateral Girdlestone Procedure as a Treatment Modality in a Case of Complicated Adult-Onset Osteopetrosis
Authors: Agrawal Aniruddh , Maniar Adit , Maniar Rajesh 
Published: November 2019

Case:
We describe a nonambulatory 39-year-old man who presented with a diagnosis of osteopetrosis and ankyloses, having experienced bilateral fractures of his proximal femora, undergone unsuccessful conventional surgical interventions, and having developed chronic osteomyelitis of his right proximal femur. Bilateral Girdlestone procedures were performed. Postoperative range of hip motion and Harris hip scores improved, and he became ambulatory, achieving optimal function considering the circumstances at 12 months postoperatively.

Conclusions:
Although the indications of the bilateral Girdlestone procedure remain undefined, these procedures may constitute acceptable treatment in patients with osteopetrosis with ankylosis and chronic osteomyelitis of the proximal femur.
Isolated Rupture of the Short Head of the Biceps at the Proximal Musculotendinous Junction
Authors: Kozak Thomas Augustyn , Kozak Tomasz Konstanty Walenty 
Published: November 2019

Case:
Two men aged 19 and 21 years sustained wakeboarding injuries where the towrope was forced against the anterior region of the arm. Physical examination revealed bruising and tenderness over the biceps with weakness in elbow flexion. Magnetic resonance imaging demonstrated complete musculotendinous rupture of their short head of biceps. Surgical repair followed by cast immobilization led to an excellent outcome in both cases.

Conclusions:
This is a unique series of complete musculotendinous rupture of the short head of the biceps occurring in wakeboarding accidents, with the mechanism of injury resisted shoulder adduction and flexion.
Subacute High-Energy Traumatic Knee Dislocation in an Ambulatory Patient
Authors: Britt Elise , Covey D.C. 
Published: November 2019

Case:
A 62-year-old man presented with a posterolateral knee dislocation sustained in a motorcycle collision initially managed nonsurgically. His treatment was complicated by recurrent dislocation from noncompliance with bracing and weight-bearing restrictions and by comorbidities including peripheral artery disease, type 2 diabetes, and heavy smoking and drinking. He was treated with a multiplanar knee-spanning external fixator and patellar tendon repair without further ligamentous reconstruction. This treatment provided a stable, functional knee with minimal pain.

Conclusions:
In this complex, noncompliant patient with a subacute knee dislocation, knee-spanning biplanar external fixation and patellar tendon repair without ligament reconstruction were crucial in achieving a satisfactory outcome.
Epidural Abscess Caused by Gas-Producing Clostridium Septicum
Authors: Money Adam J. , Molloy Seth , Grabowski Gregory 
Published: November 2019

Case:
Few cases have reported Clostridium species of bacteria as a source for vertebral osteomyelitis and epidural abscesses. The subspecies of Clostridium septicum has not been described as a cause. This case describes a 69-year-old man who hematogenously spread C. septicum without associated malignancy, subsequently failed conservative management in the form of intravenous antibiotics, and was definitively treated with surgical intervention through a minimally invasive approach.

Conclusions:
An epidural abscess occurring in a surgically naive patient is a rare phenomenon. An epidural abscess caused by C. septicum is even rarer. Appropriate imaging, early recognition, and surgical debridement can lead to a favorable outcome.
A STUDY ON AFFECTING FACTORS OF WHITE-NEST SWIFTLET (COLLOCALIA FUCIPHAGA) FARMING PERFORMANCE IN HAURGEULIS DISTRICT, INDRAMAYU REGENCY
Authors: Wahyudi Dodo , Suwarto Suwarto , Irianto Heru 
Published: November 2019

Indonesia is a major supplier of Edible-nest swiftlet to China, reaching 102 million USD in 2017. Products of Edible-nest swiftlet, containing very high glycoproteins, are exported to China by Indonesia which come from Java, included Haurgeulis District, Indramayu Regency. White-nest businesses in that area have been developed since 1950s although the productivity subsequently decline in the rate of deforestation of the concession area nowadays. These problems are henceforth set as the focus of the study, based on the inference Malcom Baldrige Criteria for Performance Excellence (MBCfPE). The purpose of this study is to recognize the association white-nest business performance. Some internal factors, observed as the endogenous-predictor factors of business performance, include achievement-motivation factor, strategic planning, technical aspects and technologies, guanxi (personal relationship), and leadership. Surveillance activities is undertaken by using simple random sampling with questionnaire method for collecting the data, followed by using path analysis method for testing the hypothesis of the association. The test results show that all of internal factor have significant effect on the performance of the white-nest business by the leadership intervening. The leadership factor is the largest influence for managing white-nest swiftlet (Collocalia fuciphaga) farming performance which has the straight influence to business performance. The association of each internal factors and the white-nest business performance described by a structural model.
“Simple” Well Spacing Calculations are Inaccurate and Costly
Authors: Jacobs Trent 
Published: November 2019

The distance between horizontal wells in the North American shale patch is almost always reported as a single measurement, often in clean round numbers, e.g. 450 ft or 600 ft. The problem with accepting such figures as the whole picture is that they are too simplistic, which can lead shale producers to make multimillion-dollar mistakes when it comes to drafting up the next drilling campaign.
This is the conclusion reached by Enverus (formerly Drilling Info), which says in a recently published report on well spacing that it has adopted a new method to determine the distance between horizontal wells and analyze the impact that distance has on production. The analytics and business intelligence firm points out that it had been using “simple” spacing calculations that it now considers to be “inaccurate.”
The traditional method, used not just by Enverus but others across the shale sector, relies on a single parameter known as a midpoint measurement between wells. The new method presented by Enverus uses 300 different inputs to come up with a better answer.
“Well spacing is complex and incredibly important in today’s current free-cash-flow era,” said Sarp Ozkan, the energy analysis director at Enverus. In a press release he compared trying to understand the issue with “peeling back an onion.”
Some of the layers Enverus is using to better assess well spacing and its impact on production include taking into account that wellbore separation can vary all along the laterals. Horizontal distances represent the conventional way to look at well spacing, but Enverus says vertical separation must also be considered, which is especially relevant to stacked formations. When an operator’s directional drilling data is not avail-able, the company is modeling “synthetic” well trajectories.
This enhanced analysis is all part of a well-spacing toolkit Enverus has rolled out in recent months. Its arrival comes as capital markets are hitting the brakes on funding the US shale sector due to disappointing well results and difficulties in establishing free cash flow.•
As a result, many producers have pivoted their focus from production growth to drilling lower-cost wells that have stronger rates of return. However, this shift has not necessarily delivered all the answers on how far apart to drill infill wells to avoid fracture interference and excessive crosswell communication.
Midpoint Malaise
Enverus used several case studies in its report to show that misjudging optimal well spacing has led shale producers to over drill their assets. The result of landing just one or two unneeded wells is a severe downgrade in a drilling section’s net present value.
Laryngeal mask airway reduces incidence of post-operative sore throat after thyroid surgery compared with endotracheal tube: a single-blinded randomized controlled trial
Authors: Gong Yahong , Xu Xiaohan , Wang Jin , Che Lu , Wang Weijia , Yi Jie 
Published: November 2019

Abstract
Background: Sore throat is a remarkable complication after thyroid surgery with endotracheal tube (ETT). Many studies revealed that laryngeal mask airway (LMA) might reduce the incidence and severity of postoperative sore throat. However, little is known about the use of a flexible reinforced LMA (FLMA) in thyroid surgery. The purpose of this study was to explore the potential benefits of FLMA compared with ETT on postoperative sore throat. Methods:In thisprospective, single-blinded, randomized, controlled trial, ninety-six patients aged 20-80 years, scheduled for elective radical thyroidectomy under general anesthesia were enrolled. They were randomly divided into ETT group and FLMA group. All the included patients received total intravenous anesthesia (with propofol, fentanyl and rocuronium) and controlled mechanical ventilation during the surgery. Cuff pressure of ETT and FLMA were strictly controlled. Incidence and severity of postoperative sore throat, numbness and hoarseness at 1, 24, and 48 h after surgery was evaluated and compared between the two groups. Incidence and severity of buckling during extubation and the hemodynamic profile during intubation were also recorded and compared. Results:The incidence of sore throat and hoarseness was significantly lower in FLMA group than those in ETT group at 1h, 24h and 48h postoperatively, as well as the severity of sore throat. Compared to ETT group, there was a significantly lower incidence of buckling during extubation and less fluctuation of HR and BP at 1min and 3min after intubation in FLMA group. Conclusions:Patients undergoing thyroid surgery with FLMA had less postoperative laryngopharyngeal symptoms when compared with ETT. The use of FLMA also achieved less buckling during extubation and better hemodynamic profiles during intubation. Trial registration:The research was registered in Chinese Clinical Trial Registry (ChiCTR-IOR-15006602) on May 23th, 2015.
The levels of urinary joining chain containing IgG immune complexes are associated with disease severity in IgA nephropathy
Authors: Li Guanhong , Yue Cai , Fan Xiaohong , Wen Yubing , Chen Gang , Qin Yan , Gao Ruitong , Li Xuemei 
Published: November 2019

Abstract
Background: Circulating levels of aberrantly glycosylated IgA1 and its immune complexes (IgA/IgG-IC) are elevated and correlated with disease severity in IgA nephropathy (IgAN). The pathologic IgA containing immune complexes deposits in the kidney were found to be in dimeric or polymeric forms, suggesting that those deposited IgA immune complexes contain joining chain, which is critical for the multimerization and transportation of IgA. Both the dimeric IgA and polymeric IgA can cause renal damage by inducing the release of cytokines from mesangial cells. We aimed to investigate the urinary J chain containing IgG immune complexes/creatinine ratio (UJGCR) and analyze its relationship with disease severity in IgAN. Methods: The UJGCR were measured by sandwich enzyme linked immunosorbent assay in 26 patients with IgAN, 31 patients with other kidney diseases and 32 healthy volunteers. Results: The levels of UJGCR were higher in patients with IgAN than that in non-IgAN patients ( P =0.006) and healthy volunteers ( P <0.0001). Importantly, receiver operating characteristics curve analysis confirmed that UJGCR had good discrimination between non-IgAN patients and IgAN patients. The levels of UJGCR positively correlated with 24-hour urinary protein excretion (r=0.63, P =0.0006), serum creatinine (r=0.55, P =0.003), and negatively correlated with estimated glomerular filtration rate (r= -0.61, P =0.0008) in IgAN. Furthermore, the levels of UJGCR were higher in IgAN patients with IgA mesangial deposition of (+/++) than patients with (+++/++++). And IgAN patients with tubular atrophy/interstitial fibrosis showed higher levels of UJGCR than that without ( P =0.03). Similarly, the levels of urinary IgA-IgG/creatinine ratio (UAGCR) were also found to be elevated and associated with clinical and pathological parameters as UJGCR in IgAN. Besides, significant correlation between the levels of UJGCR and UAGCR was shown, suggesting UJGCR was mainly composed of J-IgA-IgG. Conclusions: The levels of UJGCR are associated with disease severity in IgAN. UJGCR is a potential biomarker for both glomerular and tubulointerstitial lesions in IgAN.
Musculoskeletal consequences in cyber-addicted students - Is it really a matter of health? A ROC curve analysis for prioritizing risk factors
Authors: Moghadam Rashid Heidari , Babamiri Mohammad , Ghasemi Fakhradin , Ghaffari Mohammad Ebrahim , Razie Mahdi , Bandehelahi Khadijeh , Mortezapour Alireza 
Published: November 2019

Abstract
Background The high prevalence and also multiple consequences of addiction to various online content, including online games and social networks, have become a major challenge. The ability to predict musculoskeletal disorders from this addiction can help reveal in students' health status in the near future. The aim of this study was to determine the prevalence of this addiction and the ability to predict neck pain from this matter in students.Methods This study was carried out among 665 students. Data collection was performed through three questionnaires on problematic use of online games, social networking addiction, and Nordic musculoskeletal disorders. Data were compared with Chi-square and independent T-test, and the logistic regression model was then presented at a significant level of 0.05. Finally, the area under the receiver operating characteristic (ROC) curve and Discriminant analysis with SPSS and STATA software were conducted to clarify associations.Results The prevalence of Internet-related content addiction was 32.8%. The results showed that addiction to social networks and online games can increase the risk of neck disorder. Also 0.58 area under ROC curve depicted the ability to predict neck pain from this addiction.Conclusions In students with internet - related content addiction, neck disorder can be predicted. Given the high prevalence of internet addiction in students, it is essential to take immediate and appropriate interventions to avoid the associated adverse effects such as neck problems.