bluuebunny/crossref_metadata_2025_split huggingface dataset:
Does the Position of Cage Affect the Clinical Outcome of Lateral Interbody Fusion in Lumbar Spinal Stenosis?
Authors: Qiao Guangxi , Feng Min , Liu Jian , Wang Xiaodong , Ge Miao , Yang Bin , Yue Bin 
Published: August 2020

Study Design: A retrospective study. Objective: This study aims to identify the ideal cage position in lateral lumbar interbody fusion (LLIF) and to investigate if the posterior instrumentation would affect the indirect decompression. Methods: Patients underwent 2-stage surgeries: stage I was LLIF and stage II was percutaneous pedicle screws fixation after 1 week. Anterior disc height (ADH), posterior disc height (PDH), left and right foraminal height (FH), and segmental angle (SA) were measured on lateral computed tomography reconstructions. The cross-sectional area of the thecal sac (CSA) was determined by the outlined area of the thecal sac on a T2-weighted axial magnetic resonance imaging. The patients were subgroups according to the cage position: the anterior (cage located at the anterior 1/3 of disc space) and posterior groups (cage located at the posterior 2/3 of disc space). P values <.05 were considered significant. Results: This study included 46 patients and 71 surgical levels. After stage I LLIF, significant increase in ADH, PDH, bilateral FH was found in both 2 subgroups, as well as the CSA (all Ps < .01). SA increased 2.84° ± 3.2° in the anterior group after stage I LLIF and increased 0.81° ± 3.1° in the posterior group ( P = .013). After stage II surgery, SA was similar between the anterior and posterior groups ( P = .20). Conclusion: The anteriorly placed cage may provide better improvement of anterior disc height and segmental angle after stand-alone LLIF surgery. After the second stage posterior instrumentation, the cage position would not affect the segmental angle or foraminal height.
Does Time From Injury to Surgery Affect Outcomes After Surgical Repair of Partial and Complete Proximal Hamstring Ruptures?
Authors: Shambaugh Braidy C. , Wuerz Thomas H. , Miller Suzanne L. 
Published: August 2020

Background: No previous study has compared the outcomes of repair for partial and complete proximal hamstring ruptures at various intervals after the injury. Purpose: The primary aim was to determine whether time from injury to surgery affected outcomes after primary repair of partial and complete proximal hamstring ruptures. The secondary aim was to assess patients’ experiences from initial evaluation to finding a treating surgeon. Study Design: Cohort study; Level of evidence, 3. Methods: Records from 2007 to 2016 from a single surgeon’s practice were reviewed. A total of 124 proximal hamstring repair procedures in 121 patients were identified. There were 92 patients who completed questionnaires: a custom survey, the standard Lower Extremity Functional Scale (LEFS), a custom LEFS, the standard Marx activity scale, a custom Marx activity scale, and the University of California Los Angeles (UCLA) activity score. Results were analyzed for partial and complete repair procedures performed at ≤3 weeks, ≤6 weeks, and >6 weeks after the injury. Results: The mean follow-up was 43 months (median, 38 months). Of 93 repair procedures reviewed, 51% (9/28 partial; 38/65 complete), 79% (16/28 partial; 57/65 complete), and 22% (12/28 partial; 8/65 complete) were performed at ≤3 weeks, ≤6 weeks, and >6 weeks, respectively. At those various intervals, no statistical difference was found in standard LEFS, custom LEFS, standard Marx, custom Marx, or UCLA scores. Female sex, older age, and body mass index >30 kg/m2 were negative predictors of outcome measures. When repaired >6 weeks after the injury, a greater percentage of patients reported weakness of the operative leg compared with the contralateral side (partial tears: 6.3% vs 25%, respectively; complete tears: 24.6% vs 50%, respectively) in addition to greater sitting intolerance (partial tears: 0% vs 25%, respectively; complete tears: 7.1% vs 12.5%, respectively). Patients repaired >6 weeks after the injury visited, on average, 2.6 practitioners before an evaluation by the treating surgeon compared with 1.6 treated surgically at ≤6 weeks ( P = .008). Conclusion: Patients with proximal hamstring repair performed in the acute and chronic settings can expect successful outcomes but may experience more subjective weakness and difficulty with prolonged sitting when the repair is performed >6 weeks after the injury. Patients faced challenges in receiving the correct diagnosis and referral to an appropriate treating surgeon, emphasizing the need for an increased awareness of the injury.
Survival and quality of life after early discharge in low-risk pulmonary embolism
Authors: Barco Stefano , Schmidtmann Irene , Ageno Walter , Anušić Toni , Bauersachs Rupert M. , Becattini Cecilia , Bernardi Enrico , Beyer-Westendorf Jan , Bonacchini Luca , Brachmann Johannes , Christ Michael , Czihal Michael , Duerschmied Daniel , Empen Klaus , Espinola-Klein Christine , Ficker Joachim H. , Fonseca Cândida , Genth-Zotz Sabine , Jiménez David , Harjola Veli-Pekka , Held Matthias , Iogna Prat Lorenzo , Lange Tobias J. , Lankeit Mareike , Manolis Athanasios , Meyer Andreas , Münzel Thomas , Mustonen Pirjo , Rauch-Kroehnert Ursula , Ruiz-Artacho Pedro , Schellong Sebastian , Schwaiblmair Martin , Stahrenberg Raoul , Valerio Luca , Westerweel Peter E. , Wild Philipp S. , Konstantinides Stavros V. 
Published: August 2020

IntroductionEarly discharge of patients with acute low-risk pulmonary embolism requires validation by prospective trials with clinical and quality-of-life outcomes.MethodsThe multinational Home Treatment of Patients with Low-Risk Pulmonary Embolism with the Oral Factor Xa Inhibitor Rivaroxaban (HoT-PE) single-arm management trial investigated early discharge followed by ambulatory treatment with rivaroxaban. The study was stopped for efficacy after the positive results of the predefined interim analysis at 50% of the planned population. The present analysis includes the entire trial population (576 patients). In addition to 3-month recurrence (primary outcome) and 1-year overall mortality, we analysed self-reported disease-specific (Pulmonary Embolism Quality of Life (PEmb-QoL) questionnaire) and generic (five-level five-dimension EuroQoL (EQ-5D-5L) scale) quality of life as well as treatment satisfaction (Anti-Clot Treatment Scale (ACTS)) after pulmonary embolism.ResultsThe primary efficacy outcome occurred in three (0.5%, one-sided upper 95% CI 1.3%) patients. The 1-year mortality was 2.4%. The mean±sdPEmb-QoL decreased from 28.9±20.6% at 3 weeks to 19.9±15.4% at 3 months, a mean change (improvement) of −9.1% (p<0.0001). Improvement was consistent across all PEmb-QoL dimensions. The EQ-5D-5L was 0.89±0.12 at 3 weeks after enrolment and improved to 0.91±0.12 at 3 months (p<0.0001). Female sex and cardiopulmonary disease were associated with poorer disease-specific and generic quality of life; older age was associated with faster worsening of generic quality of life. The ACTS burden score improved from 40.5±6.6 points at 3 weeks to 42.5±5.9 points at 3 months (p<0.0001).ConclusionsOur results further support early discharge and ambulatory oral anticoagulation for selected patients with low-risk pulmonary embolism. Targeted strategies may be necessary to further improve quality of life in specific patient subgroups.
A Fast Route Towards Freestanding Single-Crystalline Oxide Thin Films by Using YBa2Cu3O7-x as a Sacrificial Layer
Authors: Chang Yao-Wen , Wu Ping-Chun , Yi Jhih-Bang , Liu Yu-Chen , Chou Yi , Chou Yi-Chia , Yang Jan-Chi 
Published: August 2020

AbstractResearchers have long been seeking multifunctional materials that can be adopted for next-generation nanoelectronics, and which, hopefully, are compatible with current semiconductor processing for further integration. Along this vein, complex oxides have gained numerous attention due to their versatile functionalities. Despite the fact that unbounded potential of complex oxides has been examined over the past years, one of the major challenges lies in the direct integration of these functional oxides onto existing devices or targeted substrates that are inherently incompatible in terms of oxide growth. To fulfill this goal, freestanding processes have been proposed, in which wet etching of inserted sacrificial layers is regarded as one of the most efficient ways to obtain epitaxial high-quality thin films. In this study, we propose using an alternative oxide, YBa2Cu3O7 (YCBO), as a sacrificial layer, which can be easily dissolved in light hydrochloric acid in a more efficient way, while protecting selected complex oxides intact. The high epitaxial quality of the selected complex oxide before and after freestanding process using YBCO as a sacrificial layer is comprehensively studied via a combination of atomic force microscopy, X-ray diffraction, transmission electron microscopy, and electrical transports. This approach enables direct integration of complex oxides with arbitrary substrates and devices and is expected to offer a faster route towards the development of low-dimensional quantum materials.
Nano-clays as Potential Pseudo-antibodies for COVID-19
Authors: Abduljauwad Sahel N. , Habib Taimur , Ahmed Habib-ur-Rehman 
Published: August 2020

AbstractDespite several efforts, the development of an effective vaccine for COVID-19 may take a much longer time. Traditional/natural medicine, already experienced by humans, could be an earlier solution. Considering the research team’s experience in using nano-clays as high-affinity material for cancer metastasis, melanoma treatment, and bone regeneration, we propose to use these nano-clays for the prevention/treatment of COVID-19. Owing to high affinity, nano-clays would capture the viruses before the latter get engaged with human hACE2. In this study, molecular-level simulations and modeling of the interaction of coronavirus spike and hACE2 proteins were performed with and without nano-clays. The results showed a very high level of affinity/cohesiveness among SARS-CoV-2 spike and nano-clays as compared to the one between the former and hACE2. We premise that these nano-clays since already being used as drug carriers could also be injected as “clays-alone” medicine. Recommendations have also been provided for future in vitro and in vivo studies.
binomialRF: interpretable combinatoric efficiency of random forests to identify biomarker interactions
Authors: Rachid Zaim Samir , Kenost Colleen , Berghout Joanne , Chiu Wesley , Wilson Liam , Zhang Hao Helen , Lussier Yves A. 
Published: August 2020

AbstractBackgroundIn this era of data science-driven bioinformatics, machine learning research has focused on feature selection as users want more interpretation and post-hoc analyses for biomarker detection. However, when there are more features (i.e., transcripts) than samples (i.e., mice or human samples) in a study, it poses major statistical challenges in biomarker detection tasks as traditional statistical techniques are underpowered in high dimension. Second and third order interactions of these features pose a substantial combinatoric dimensional challenge. In computational biology, random forest (RF) classifiers are widely used due to their flexibility, powerful performance, their ability to rank features, and their robustness to the “P > > N” high-dimensional limitation that many matrix regression algorithms face. We propose binomialRF, a feature selection technique in RFs that provides an alternative interpretation for features using a correlated binomial distribution and scales efficiently to analyze multiway interactions.ResultsIn both simulations and validation studies using datasets from the TCGA and UCI repositories, binomialRF showed computational gains (up to 5 to 300 times faster) while maintaining competitive variable precision and recall in identifying biomarkers’ main effects and interactions. In two clinical studies, the binomialRF algorithm prioritizes previously-published relevant pathological molecular mechanisms (features) with high classification precision and recall using features alone, as well as with their statistical interactions alone.ConclusionbinomialRF extends upon previous methods for identifying interpretable features in RFs and brings them together under a correlated binomial distribution to create an efficient hypothesis testing algorithm that identifies biomarkers’ main effects and interactions. Preliminary results in simulations demonstrate computational gains while retaining competitive model selection and classification accuracies. Future work will extend this framework to incorporate ontologies that provide pathway-level feature selection from gene expression input data.
Characteristics and outcomes of patients with dyspnoea as the main symptom, assessed by prehospital emergency nurses- a retrospective observational study
Authors: Kauppi Wivica , Herlitz Johan , Magnusson Carl , Palmér Lina , Axelsson Christer 
Published: August 2020

Abstract
Background
Dyspnoea (breathing difficulty) is among the most commonly cited reasons for contacting emergency medical services (EMSs). Dyspnoea is caused by several serious underlying medical conditions and, based on patients individual needs and complex illnesses or injuries, ambulance staff are independently responsible for advanced care provision. Few large-scale prehospital studies have reviewed patients with dyspnoea. This study aimed to describe the characteristics and final outcomes of patients whose main symptom was classified as dyspnoea by the prehospital emergency nurse (PEN).

Methods
This retrospective observational study included patients aged > 16 years whose main symptom was dyspnoea. All the enrolled patients were assessed in the south-western part of Sweden by PENs during January and December, 2017. Of 7260 assignments (9% of all primary missions), 6354 fulfilled the inclusion criteria. Analysis was performed using descriptive statistics, and the tests used were odds ratios and Kaplan-Meier analysis.

Results
The patients mean age was 73 years, and approximately 56% were women. More than 400 different final diagnostic codes (International Statistical Classification of Diseases and Related Health Problems [ICD]-10th edition) were observed, and 11% of the ICD-10 codes denoted time-critical conditions. The three most commonly observed aetiologies were chronic obstructive pulmonary disease (20.4%), pulmonary infection (17.1%), and heart failure (15%). The comorbidity values were high, with 84.4% having previously experienced dyspnoea. The overall 30-day mortality was 11.1%. More than half called EMSs more than 50 h after symptom onset.

Conclusions
Among patients assessed by PENs due to dyspnoea as the main symptom there were more than 400 different final diagnoses, of which 11% were regarded as time-critical. These patients had a severe comorbidity and 11% died within the first 30 days.
Association of household income with home-based rehabilitation and home help service utilization among long-term home care service users
Authors: Tsuchiya-Ito Rumiko , Ishizaki Tatsuro , Mitsutake Seigo , Hamada Shota , Yoshie Satoru , Iijima Katsuya , Tamiya Nanako 
Published: August 2020

Abstract
Background
To examine the association of household income with home-based rehabilitation and home help services in terms of service utilization and expenditures.

Methods
A secondary data analysis of cross-sectional design was conducted using long-term care (LTC) insurance claims data, medical claims data, and three types of administrative data. The subjects comprised LTC insurance beneficiaries in Kashiwa city, Japan, who used long-term home care services in the month following care needs certification. Household income was the independent variable of interest, and beneficiaries were categorized into low-income or middle/high-income groups based on their insurance premiums. Using a two-part model, the odds ratios (ORs) and 95% confidence intervals (CIs) for the utilization of home-based rehabilitation and home help services in the month following care needs certification were estimated using logistic regression analysis, and the risk ratios (RRs) of service expenditures were estimated using a generalized linear model for gamma-distributed data with a log-link function.

Results
Among 3770 subjects, 681 (18.1%) used home-based rehabilitation and 1163 (30.8%) used home help services. There were 1419 (37.6%) low-income subjects, who were significantly less likely to use (OR: 0.813; 95%CI: 0.670–0.987) and spend on (RR: 0.910; 95%CI: 0.829–0.999) home-based rehabilitation services than middle/high-income subjects. Conversely, low-income subjects were significantly more likely to use (OR: 1.432; 95%CI: 1.232–1.664) but less likely to spend on (RR: 0.888; 95%CI: 0.799–0.986) home help services than middle/high-income subjects.

Conclusion
Household income was associated with the utilization of long-term home care services. To improve access to these services, the LTC insurance system should examine ways to decrease the financial burden of low-income beneficiaries and encourage service utilization.
Interleukin-8 is not a predictive biomarker for the development of the acute promyelocytic leukemia differentiation syndrome
Authors: Yamamoto de Almeida Luciana , Pereira-Martins Diego Antonio , Lima Ana Sílvia Gouvêa , Baggio Márcia Sueli , de Araujo Koury Luisa Corrêa , Lange Ana Paula , Bassi Sarah Cristina , Scheucher Priscila Santos , Rego Eduardo Magalhães 
Published: August 2020

Abstract
Background
Differentiation syndrome (DS) is the main life-threatening adverse event that occurs in acute promyelocytic leukemia (APL) patients treated with all-trans retinoic acid (ATRA). Cytokine imbalances have been reported to play role during the developing of acute promyelocytic leukemia differentiation syndrome (APL-DS). However, the relationship between the plasma cytokine levels and their prognostic value for the prediction of DS developing in patients with APL during the treatment with ATRA and anthracyclines has not been previously reported.

Methods
In this study, we followed an APL cohort (n = 17) over 7 days of ATRA therapy in DS (n = 6) and non-DS groups (n = 11). Interleukin (IL)-1β, IL-6, IL-8, IL-10, IL-12p70 and TNF-α were measured in the peripheral blood plasma from 17 patients with APL and 11 healthy adult controls by using the cytometric bead array method.

Results
In non-DS patients, IL-8 plasma levels were significantly reduced in the seventh day of ATRA treatment (34.16; 6.99 to 147.11 pg mL− 1 in D0 vs. 10.9; 0 to 26.81 pg mL− 1 in D7; p = 0.02) whereas their levels did not discriminate between DS and non-DS development during the entire induction period (all p > 0.05 in D0, D3, and D7). No significant differences were found in IL-6 levels between groups (p > 0.05 in D0-D7). Other cytokines tested were all undetectable in patients with APL or healthy controls.

Conclusions
We demonstrated that the modulation of IL-8 following ATRA treatment may occur regardless of the development of DS and, therefore, does not appear to be a predictive biomarker to monitor the APL-DS.
Ab-externo drainage with continuous anterior chamber infusion for non-resolving exudative retinal detachment: a case report
Authors: Simunovic Matthew P. , Shao Emily H. , Osaadon Perach 
Published: August 2020

Abstract
Background
Drainage of exudative retinal detachment may be necessary for either therapeutic or diagnostic purposes (or both). Here, we describe an external drainage technique for non-resolving vision-threatening exudative retinal detachment which combines the advantages of internal drainage (widefield viewing and intraocular pressure control using continuous anterior chamber infusion) with those of external drainage (drainage of sub-retinal fluid without vitrectomy).

Case presentation
To illustrate this technique, we present a 13-year-old girl with macula-off exudative retinal detachment secondary to Vogt-Koyanagi-Harada syndrome, which was unresponsive to aggressive medical management. External drainage was undertaken using widefield viewing and chandelier illumination. Intraocular pressure was maintained with an anterior chamber infusion. Near-complete drainage of sub-retinal fluid was achieved, and retinal reattachment was maintained at 6 months postoperatively, with a corresponding improvement in visual acuity from 20/63 to 20/40.

Conclusions
External drainage under chandelier-assisted viewing at the surgical microscope with anterior chamber infusion offers the ergonomic and optical advantages of the surgical microscope and widefield visualisation, continuous IOP control and drainage of sub-retinal fluid without the need for pars plana vitrectomy.
Social determinants of mental health care systems: intensive community based Care in the Veterans Health Administration
Authors: Bhalla Ish P. , Stefanovics Elina A. , Rosenheck Robert A. 
Published: August 2020

AbstractBackgroundSince deinstitutionalization in the 1950s–1970s, public mental health care has changed its focus from asylums to general hospitals, outpatient clinics and specialized community-based programs addressing both clinical and social determinants of mental health. Analysis of the place of community-based programs within a comprehensive health system such as the Veterans Health Administration (VHA) may illuminate the role of social forces in shaping contemporary public mental health systems.MethodsNational VHA administrative data were used to compare veterans who exclusively received outpatient clinic care to those receiving four types of specialized community-based services, addressing: 1) functional disabilities from severe mental illness (SMI), 2) justice system involvement, 3) homelessness, and 4) vocational rehabilitation. Bivariate comparisons and multinomial logistic regression analyses compared groups on demographics, diagnoses, service use, and psychiatric prescription fills.ResultsAn hierarchical classification of 1,386,487 Veterans who received specialty mental health services from VHA in Fiscal Year 2012, showed 1,134,977 (81.8%) were seen exclusively in outpatient clinics; 27,931 (2.0%) received intensive SMI-related services; 42,985 (3.1%) criminal justice services; 160,273 (11.6%) specialized homelessness services; and 20,921 (1.5%) vocational services. Compared to those seen only in clinics, veterans in the four community treatment groups were more likely to be black, diagnosed with HIV and hepatitis, had more numerous substance use diagnoses and made far more extensive use of mental health outpatient and inpatient care.ConclusionsAlmost one-fifth of VHA mental health patients receive community-based services prominently addressing major social determinants of health and multimorbid substance use disorders.