bluuebunny/crossref_metadata_2025_split huggingface dataset:
Swept-source optical coherence tomography angiography vitreo-retinal segmentation in proliferative diabetic retinopathy
Authors: Papayannis Alessandro , Tsamis Emmanouil , Stringa Francesco , Iacono Pierluigi , Battaglia Parodi Maurizio , Stanga Paulo Eduardo 
Published: July 2020

Purpose: To identify a new cortical vitreous segmentation protocol for non invasive standardised investigation of Neovascularisation (NV) with detection of regression of NV activity in Proliferative Diabetic Retinopathy (PDR). Design: Retrospective study. Participants: One hundred and eighty-six eyes of 93 consecutive diabetic patients (mean age: 52.6 ± 11.0 years) imaged using Topcon Triton® Swept-Source Optical Coherence Tomography Angiography (SS-OCTA) from June 2015 to January 2017. Methods: Scans were performed through the macula, optic disc and areas of possible NV in mid-peripheral retina using 6 × 6 mm and/or 9 × 9 mm raster-patterns in three segmentation protocols: Vitreo-Retinal (VRS), Outer-Vitreous (OVS) and Core-Vitreous Segmentation (CVS). Any suspicion of PDR was confirmed in all patients by Heidelberg® Widefield-Fundus-Fluorescein-Angiography (WF-FFA) and/or Optos® Ultra-WF-FFA (UWF-FFA). Inter-observer reproducibility of NV diagnosis and agreement between SS-OCTA and UWF-FFA were assessed. Primary outcome was the identification of an effective and reproducible segmentation protocol. Secondary outcome was the identification of NV regression after treatment. Results: Sensitivity-specificity reached, respectively, the value of 100 to 100 in detecting NVD, and 96.6 to 100 in detecting NVE in compared areas. SS-OCTA was able to confirm absence of blood flow within the residual NV plexus when using VRS protocol in 30 eyes in which regression of NV with absence of leakage was documented on FFA. Conclusion: Three segmentation protocols (VRS, OVS and CVS) with different but complementary characteristics, allowed a reproducible and standardised investigation of NVD and NVE. The proposed new SS-OCTA cortical vitreous segmentation protocols may be of value when identifying and assessing NV-activity (VRS, OVS and CVS) or NV-regression (VRS) in PDR and therefore, response to therapy.
Comparison between Fundus Automated Perimetry and Humphrey Field Analyzer: Performance and usability of the Fundus Automated Perimetry and Humphrey Field Analyzer in healthy, ocular hypertensive, and glaucomatous patients
Authors: Morbio Roberta , Longo Chiara , De Vitto Antonia Maria Luce , Comacchio Francesco , Della Porta Lucia Barbara , Marchini Giorgio 
Published: July 2020

Purpose: We compared the performance and usability of the Fundus Automated Perimetry (FAP) and Humphrey Field Analyzer (HFA) in patients with glaucoma, ocular hypertension, and healthy subjects. Materials and methods: A total of 60 participants, divided in three groups of 20, glaucoma (POAG), ocular hypertension (OHT), and controls group, underwent a HFA test 24-2 SITA standard and a FAP test 24-2 ZEST sequence, in randomized order. The mean differences between perimeters of mean deviation (MD), pattern standard deviation (PSD) were correlated using the t-test and the Bland–Altman plot while execution time, Glaucoma Staging System 2 (GSS2), Hodapp–Parrish–Anderson staging system, localization of the defect, false positives (FP), and false negatives (FN) were compared with t-test analysis. Usability was measured through answers of a dedicated questionnaire. Results: MD’s difference was higher for FAP than HFA: OHT −2.20 ± 1.33 dB ( p < 0.001), POAG −2.00 ± 1.66 dB ( p < 0.001), and controls −1.08 ± 1.43 dB ( p < 0.001). PSD’s difference was higher for FAP than HFA: OHT 0.85 ± 1.16 dB ( p < 0.001), POAG 0.78 ± 2.32 dB ( p = 0.043), and controls 0.49 ± 1.15 dB ( p < 0.001). GSS2’s difference showed that FAP found more severe defects than HFA. Exams duration was longer for FAP versus HFA: in OHT 363 s versus 301 s, in POAG 494 s versus 362 s, and in controls 360 s versus 277 s. For FN and FP, there were no statistically significant differences. The 77% of all subjects preferred FAP to HFA test. Conclusion: Considering MD and GSS2 classification, FAP finds more severe defects. Moreover, although FAP duration is longer, this method is preferred by most of the patients.
Endoscopic ultrasound-guided biliary drainage for malignant biliary obstruction with surgically altered anatomy: a multicenter prospective registration study
Authors: Minaga Kosuke , Takenaka Mamoru , Ogura Takeshi , Tamura Takashi , Kuroda Taira , Kaku Toyoma , Uenoyama Yoshito , Noguchi Chishio , Nishikiori Hidefumi , Imai Hajime , Sagami Ryota , Fujimori Nao , Higuchi Kazuhide , Kudo Masatoshi , Chiba Yasutaka , Kitano Masayuki 
Published: July 2020

Background: Endoscopic treatment for malignant biliary obstruction (MBO) in patients bearing surgically altered anatomy (SAA) is not well-established. Although endoscopic ultrasound-guided biliary drainage (EUS-BD) has emerged as a new treatment option for MBO, limited data are available regarding the efficacy and safety of EUS-BD in patients with SAA. We conducted a multicenter prospective registration study to evaluate the efficacy and safety of EUS-BD in this population. Methods: This study involved 10 referral centers in Japan. Patients with SAA who were scheduled to receive EUS-BD for unresectable MBO between May 2016 and September 2018 were prospectively registered. The primary endpoint was technical success and the secondary outcomes were clinical success, procedure time, procedure-related adverse events (AEs), stent patency, and overall survival. Results: In total, 40 patients were prospectively enrolled. The surgical reconstruction methods were gastrectomy with Roux-en-Y reconstruction (47.5%), gastrectomy with Billroth-II reconstruction (15%), pancreaticoduodenectomy (27.5%), and hepaticojejunostomy with Roux-en-Y reconstruction (10%). EUS-BD was performed for primary biliary drainage in 31 patients and for rescue biliary drainage in nine patients. Transmural stenting alone (60%), antegrade stenting alone (5%), and a combination of the two techniques (35%) were selected for patients treated with EUS-BD. Technical and clinical success rates were 100% (95% confidence interval, 91.2–100.0%) and 95% (95% confidence interval, 83.1–99.4%), respectively. Mean procedure time was 36.5 min. Early AEs were noted in six patients (15%): three self-limited bile leak, one bile peritonitis, and two pneumoperitonea. Late AEs occurred in six patients (15%): one jejunal ulcer and five stent occlusions. Stent patency rate after 3 months of survival was 95.7% (22/23). Median overall survival was 96 days. Conclusion: EUS-BD for MBO in patients with SAA appears to be effective and safe not only as a rescue drainage technique after failed endoscopic retrograde cholangiography but also as a primary drainage technique. Clinical Trial Registration: UMIN000022101
Outcomes of the Latarjet procedure with minimum 5- and 10-year follow-up: A systematic review
Authors: Gilat Ron , Lavoie-Gagne Ophelie , Haunschild Eric D , Knapik Derrick M , Parvaresh Kevin C , Fu Michael C , Forsythe Brian , Verma Nikhil , Cole Brian J 
Published: July 2020

Background The purpose of this study was to evaluate mid- and long-term outcomes following the Latarjet procedure for anterior shoulder instability. Methods PubMed, MEDLINE, Embase, and Cochrane libraries were systematically searched, in line with PRISMA guidelines, for studies reporting on outcomes following the Latarjet procedure with minimum five-year follow-up. Outcomes of studies with follow-up between 5 and 10 years were compared to those with minimum follow-up of 10 years. Results Fifteen studies reporting on 1052 Latarjet procedures were included. Recurrent instability occurred in 127 patients, with an overall random summary estimates in studies with a minimum five-year follow-up of 0–18% (I2 = 90%) compared to 5–26% (I2 = 59%) for studies with a minimum 10-year follow-up. Overall rates for return to sports, non-instability related complications, and progression of arthritis estimated at 65–100% (I2 = 87%), 0–20% (I2 = 85%), and 8–42% (I2 = 89%) for the minimum five-year follow-up studies and 62–93% (I2 = 86%), 0–9% (I2 = 28%), and 9–71% (I2 = 91%) for the minimum 10-year follow-up studies, respectively. All studies reported good-to-excellent mean PRO scores at final follow-up. Conclusions The Latarjet is a safe and effective procedure for patients with shoulder instability. The majority of patients return to sport, though at long-term follow-up, a trend towards an increased incidence of recurrent instability is appreciated, while a significant number may demonstrate arthritis progression.
Targeting aggressive osteosarcoma with a peptidase-enhanced cytotoxic melphalan flufenamide
Authors: Byrgazov Konstantin , Anderson Claes , Salzer Benjamin , Bozsaky Eva , Larsson Rolf , Gullbo Joachim , Lehner Manfred , Lehmann Fredrik , Slipicevic Ana , Kager Leo , Fryknäs Mårten , Taschner-Mandl Sabine 
Published: July 2020

Background: Low survival rates in metastatic high-grade osteosarcoma (HGOS) have remained stagnant for the last three decades. This study aims to investigate the role of aminopeptidase N (ANPEP) in HGOS progression and its targeting with a novel lipophilic peptidase-enhanced cytotoxic compound melphalan flufenamide (melflufen) in HGOS. Methods: Meta-analysis of publicly available gene expression datasets was performed to determine the impact of ANPEP gene expression on metastasis-free survival of HGOS patients. The efficacy of standard-of-care anti-neoplastic drugs and a lipophilic peptidase-enhanced cytotoxic conjugate melflufen was investigated in patient-derived HGOS ex vivo models and cell lines. The kinetics of apoptosis and necrosis induced by melflufen and doxorubicin were compared. Anti-neoplastic effects of melflufen were investigated in vivo. Results: Elevated ANPEP expression in diagnostic biopsies of HGOS patients was found to significantly reduce metastasis-free survival. In drug sensitivity assays, melflufen has shown an anti-proliferative effect in HGOS ex vivo samples and cell lines, including those resistant to methotrexate, etoposide, doxorubicin, and PARP inhibitors. Further, HGOS cells treated with melflufen displayed a rapid induction of apoptosis and this sensitivity correlated with high expression of ANPEP. In combination treatments, melflufen demonstrated synergy with doxorubicin in killing HGOS cells. Finally, Melflufen displayed anti-tumor growth and anti-metastatic effects in vivo. Conclusion: This study may pave the way for use of melflufen as an adjuvant to doxorubicin in improving the therapeutic efficacy for the treatment of metastatic HGOS.
Treatment Strategy for Odontogenic Sinusitis
Authors: Yoo Byung Joon , Jung Seon Min , Lee Ha Na , Kim Hyung Gu , Chung Jae Ho , Jeong Jin Hyeok 
Published: July 2020

Background The treatment options for odontogenic sinusitis (OS) include medical management including antibiotics and saline nasal irrigation, endoscopic sinus surgery (ESS), and dental treatment. Objective The purpose of this study was to evaluate whether OS caused by dental caries and periapical abscess can be cured by dental treatment alone and which patients should consider surgery early. Methods A total of 33 patients with OS caused by dental caries and periapical abscess were enrolled. Patients with OS caused by dental implants, trauma, surgery, or tooth extraction were excluded. All patients were initially treated with dental treatment and medical management without ESS. The patients were divided into two groups according to the results of dental treatment and multiple clinical parameters were compared between the two groups. Results Among the 33 enrolled patients, 22 patients (67%) were cured with dental and medical management, and 11 patients (33%) required ESS after the failure of dental and medical management. Based on the multivariate analysis results, patients who were smokers (OR 33.4) and had a higher Lund-Mackay score on CT (OR 2.0) required ESS after the failure of dental and medical treatment. Conclusions Two-thirds of the patients with OS caused by dental caries and periapical abscess were cured with dental treatment and medical management without ESS. We recommend dental treatment and medical management first in OS caused by dental caries and periapical abscess. However, we recommend early ESS in patients with smoking habits and severe CT findings of the sinus.
Long-term effects of a standardized feedback-driven quality improvement program for timely reperfusion therapy in regional STEMI care networks
Authors: Scholz Karl Heinrich , Lengenfelder Björn , Jacobshagen Claudius , Fleischmann Claus , Moehlis Hiller , Olbrich Hans G , Jung Jens , Maier Lars S , Maier Sebastian K G , Bestehorn Kurt , Friede Tim , Meyer Thomas 
Published: July 2020

Abstract

Aims
Current European Society of Cardiology guidelines state that repetitive monitoring and feedback should be implemented for ST-elevation myocardial infarction (STEMI) treatment, but no evidence is available supporting this recommendation. We aimed to analyze the long-term effects of a formalized data assessment and systematic feedback on performance and mortality within the prospective, multicenter Feedback Intervention and Treatment Times in STEMI (FITT-STEMI) study.

Methods
Regular interactive feedback sessions with local STEMI management teams were performed at six participating German percutaneous coronary intervention (PCI) centers over a 10-year period starting from October 2007.

Results
From the first to the 10th year of study participation, all predefined key-quality indicators for performance measurement used for feedback improved significantly in all 4926 consecutive PCI-treated patients – namely, the percentages of patients with pre-hospital electrocardiogram (ECG) recordings (83.3% vs 97.1%, p &lt; 0.0001) and ECG recordings within 10 minutes after first medical contact (41.7% vs 63.8%, p &lt; 0.0001), pre-announcement by telephone (77.0% vs 85.4%, p = 0.0007), direct transfer to the catheterization laboratory bypassing the emergency department (29.4% vs 64.2%, p &lt; 0.0001), and contact-to-balloon times of less than 90 minutes (37.2% vs 53.7%, p &lt; 0.0001). Moreover, this feedback-related continuous improvement of key-quality indicators was linked to a significant reduction in in-hospital mortality from 10.8% to 6.8% (p = 0.0244). Logistic regression models confirmed an independent beneficial effect of duration of study participation on hospital mortality (odds ratio = 0.986, 95% confidence interval = 0.976–0.996, p = 0.0087). In contrast, data from a nationwide PCI registry showed a continuous increase in in-hospital mortality in all PCI-treated STEMI patients in Germany from 2008 to 2015 (n = 398,027; 6.7% to 9.2%, p &lt; 0.0001).

Conclusions
Our results indicate that systematic data assessment and regular feedback is a feasible long-term strategy and may be linked to improved performance and a reduction in mortality in STEMI management.
The effect of socioemotional wealth on the relationship between entrepreneurial orientation and family business performance
Authors: Hernández-Linares Remedios , Kellermanns Franz W , López-Fernández María Concepción , Sarkar Soumodip 
Published: July 2020

This study examines how five key entrepreneurial orientation (EO) dimensions—risk taking, innovativeness, proactiveness, competitive aggressiveness, and autonomy—affect family business performance, as well as the moderating effect of socioemotional wealth (SEW) on these relationships. The findings, based on a sample of 609 Spanish and Portuguese family firms, reveal that not all EO dimensions are equally important for performance, as only proactiveness, competitive aggressiveness, and autonomy were significant. However, we also find that the EO–performance relationship is affected by concern for SEW preservation, as our SEW measure moderates risk taking positively and innovativeness negatively. JEL CLASSIFICATION: L20; L26; M10
Factors associated with the presence of headache in hospitalized COVID-19 patients and impact on prognosis: a retrospective cohort study
Authors: Trigo Javier , García-Azorín David , Planchuelo-Gómez Álvaro , Martínez-Pías Enrique , Talavera Blanca , Hernández-Pérez Isabel , Valle-Peñacoba Gonzalo , Simón-Campo Paula , de Lera Mercedes , Chavarría-Miranda Alba , López-Sanz Cristina , Gutiérrez-Sánchez María , Martínez-Velasco Elena , Pedraza María , Sierra Álvaro , Gómez-Vicente Beatriz , Arenillas Juan Francisco , Guerrero Ángel L. 
Published: July 2020

AbstractIntroductionHeadache is one of the most frequent neurologic manifestations in COVID-19. We aimed to analyze which symptoms and laboratory abnormalities were associated with the presence of headache and to evaluate if patients with headache had a higher adjusted in-hospital risk of mortality.MethodsRetrospective cohort study. We included all consecutive patients admitted to the Hospital with confirmed SARS-CoV-2 infection between March 8th and April 11th, 2020. We collected demographic data, clinical variables and laboratory abnormalities. We used multivariate regression analysis.ResultsDuring the study period, 576 patients were included, aged 67.2 (SD: 14.7), and 250/576 (43.3%) being female. Presence of headache was described by 137 (23.7%) patients. The all-cause in-hospital mortality rate was 127/576 (20.0%). In the multivariate analysis, patients with headache had a lower risk of mortality (OR: 0.39, 95% CI: 0.17–0.88,p = 0.007). After adjusting for multiple comparisons in a multivariate analysis, variables that were independently associated with a higher odds of having headache in COVID-19 patients were anosmia, myalgia, female sex and fever; variables that were associated with a lower odds of having headache were younger age, lower score on modified Rankin scale, and, regarding laboratory variables on admission, increased C-reactive protein, abnormal platelet values, lymphopenia and increased D-dimer.ConclusionHeadache is a frequent symptom in COVID-19 patients and its presence is an independent predictor of lower risk of mortality in COVID-19 hospitalized patients.
Comparison of various risk scores for the prognosis of hemorrhagic upper gastrointestinal mucosal disorder
Authors: Kita Shinya , Shirai Yasuyuki , Yoshida Tomoharu , Shiraishi Kei , Nakamura Ayako , Kawano Michitaka , Kinoshita Yoshihiro , Noguchi Tatsuya , Ito Syunsuke 
Published: July 2020

Abstract
Background
Various risk scores have been proposed that are useful for the management of upper gastrointestinal bleeding (UGIB), which is an important disease in emergency medicine. Few studies have examined the usefulness of Charlson Comorbidity index (CCI) in this disease, which evaluates the patient’s general condition by scoring the patient’s underlying disease. There have been no studies investigating the efficacy of CCI compared to other risk scores in the management of UGIB requiring endoscopic hemostasis.

Methods
In addition to the Glasgow-Blatchford score, AIMS65 score, and Rockall score, we investigated the efficacy of the outcome prediction obtained by the original CCI and the updated CCI, scored only with respect to the underlying disease. We also examined the cutoff value when using the risk score. This retrospective study included 265 patients with hemorrhagic upper gastrointestinal mucosal lesions who underwent emergency endoscopic hemostasis during a 6-year period between 2011 and 2016 in our hospital.

Results
The updated CCI and AIMS65 score correlated with prognosis in multivariate analysis (p = 0.002 and p = 0.003, respectively). In clinical practice, the prognosis might be worse if both updated CCI and AIMS65 score were 3 point or more.

Conclusion
In addition to the AIMS65 score, the updated CCI can be a useful tool for managing upper gastrointestinal mucosal disorder bleeding that requires endoscopic hemostasis.
Characteristics and management of testicular torsion in patients admitted to the Urology Department at Chris Hani Baragwanath Academic Hospital
Authors: Mukendi Alain Mwamba , Kruger Deirdre , Haffejee Mohamed 
Published: July 2020

Abstract
Background
The study was carried out to determine the trend of referrals with testicular torsion; the pre-surgery duration of symptoms; the rate of orchidectomy; as well as the seasonality and the age-related laterality of testicular torsion.

Methods
This was a retrospective study conducted at Chris Hani Baragwanath Academic Hospital using patients’ records from 2006 to 2018 from which data were obtained and analyzed.

Results
A total of 308 patients with testicular torsion were included in this study; the mean age was 17.2 ± 4.12 (10–33) years. The median (IQR) time from onset to hospital was 47 h, and 194/308 (63%) underwent orchidectomy. Although the orchidectomy rate was higher (95%) in those who had surgery beyond 72 h, 3.6% had reperfusion after detorsion in theater followed by orchidopexy. In the 112 patients who underwent a bilateral orchidopexy, the time from onset of symptoms to surgery was significantly shorter at a median (IQR) of 13 (9–26) h, compared to 144 (40–264) h in the 194 patients who had an orchidectomy (p < 0.0001). The odds of presenting with a right -sided testicular torsion increases by 6% (p = 0.047) for every 1-year increase in age.

Conclusion
This study shows that there is a significant association between the pre-surgery duration of symptoms and the testicular salvage rate. Testicular salvage is possible beyond 72 h from the onset of symptoms, although the salvage rate reduces from 75% within 24 h to 3.6% beyond 72 h. In addition, it also shows that older patients tend to present with right-sided torsion.
Towards behaviour based testing to understand the black box of autonomous cars
Authors: Utesch Fabian , Brandies Alexander , Pekezou Fouopi Paulin , Schießl Caroline 
Published: July 2020

Abstract
Background
Autonomous cars could make traffic safer, more convenient, efficient and sustainable. They promise the convenience of a personal taxi, without the need for a human driver. Artificial intelligence would operate the vehicle instead. Especially deep neural networks (DNNs) offer a way towards this vision due to their exceptional performance particularly in perception. DNNs excel in identifying objects in sensor data which is essential for autonomous driving. These networks build their decision logic through training instead of explicit programming. A drawback of this technology is that the source code cannot be reviewed to assess the safety of a system. This leads to a situation where currently used methods for regulatory approval do not work to validate a promising new piece of technology.

Objective
In this paper four approaches are highlighted that might help understanding black box technical systems for autonomous cars by focusing on its behaviour instead. The method of experimental psychology is proposed to model the inner workings of DNNs by observing its behaviour in specific situations. It is argued that penetration testing can be applied to identify weaknesses of the system. Both can be applied to improve autonomous driving systems. The shadowing method reveals behaviour in a naturalistic setting while ensuring safety. It can be seen as a theoretical driving exam. The supervised driving method can be utilised to decide if the technology is safe enough. It has potential to be developed into a practical driving exam.