bluuebunny/crossref_metadata_2025_split huggingface dataset:
Preoperative Albumin-to-Fibrinogen Ratio Predicts Postoperative Pneumonia in Patients with Esophageal Squamous Cell Carcinoma: A Retrospective Study
Authors: Zhang Peng , Zhao Song 
Published: December 2020

Abstract
Background: Postoperative pneumonia is the most common postoperative complication in patients with esophageal cancer. Prediction of postoperative pneumonia by establishing a preoperative physiological function parameter model can help patients make adequate preoperative preparation, reduce treatment costs, and improve prognosis and quality of life. The purpose of this study was to investigate the relationship between albumin, fibrinogen, albumin-to-fibrinogen ratio(AFR) , and other preoperative laboratory tests and postoperative pneumonia in patients with esophageal cancer after esophagectomy.Methods: Retrospective analysis was performed on 177 consecutive patients who underwent esophagectomy in the Department of Thoracic Surgery, The First Affiliated Hospital of Zhengzhou University from December 2018 to December 2019.Postoperative pneumonia was defined according to the revised Uniform Pneumonia Score(rUPS).Patients were divided into pneumonia and non-pneumonia groups for comparison of baseline data, perioperative indicators, and laboratory examination data.(Receiver operating characteristic)ROC curve analysis was used to evaluate the efficacy, sensitivity and specificity of AFR, and Youden’s index was used to calculate the cut-off values of AFR and other laboratory tests data. Univariate and multivariate logistic regression analyses were used to assess the risk factors for postoperative pneumoniaResults: Of the 177 patients, 32 (18%) developed postoperative pneumonia. The AUC value predicted by AFR using ROC curve analysis was 0.767, 65.6% sensitivity and 83.4% specificity. Multivariate logistic regression analysis showed that albumin (P=0.013), creatinine (P=0.01), and AFR (P=0.016) were independent risk factors for postoperative pneumonia.Conclusion: Preoperative AFR can effectively predict the occurrence of postoperative pneumonia in patients with esophageal cancer
Comparing Female Permanent Contraception Options in High Resource Countries: A Systematic Review
Authors: Gormley Rebecca , Vickers Brian , Cheng Brooke , Norman Wendy V 
Published: December 2020

Abstract
Background: Multiple options for permanent or long-acting contraception are available, each with adverse effects and non-contraceptive benefits. A comprehensive comparison of methods to support decision-making for people seeking to end their fertility and their healthcare providers is needed. We aimed to understand what is known from high quality studies about the comparability of options for permanent contraception. We sought studies comparing these methods of permanent or long-acting contraception: laparoscopic tubal ligation, hysteroscopic tubal occlusion, bilateral salpingectomy, and levonorgestrel-releasing intrauterine contraception (LNG-IUC), for effectiveness, adverse events, tolerability, patient recovery, non-contraceptive benefits and healthcare system costs among females in high resource countries seeking to permanently avoid conception. Methods: We followed PRISMA guidelines, searched EMBASE, Pubmed (Medline), Web of Science, and screened retrieved articles to identify additional relevant studies. We extracted data on population, interventions, outcomes, follow-up, health system costs, and study funding source. We assessed risk of bias using the Newcastle-Ottawa Scale, excluding studies with high risk of bias. Due to considerable heterogeneity, we performed a narrative synthesis. Results: Our search identified 6,612 articles. We reviewed the full text of 154 studies, yielding 35 studies which met inclusion criteria. We excluded 10 studies with high risk of bias, retaining 25 at low or medium risk for bias in our synthesis. Most studies assessed hysteroscopic tubal occlusion and/or laparoscopic tubal ligation. Most comparisons reported on effectiveness and adverse events, with fewer reporting tolerability, patient recovery, non-contraceptive benefits, and healthcare system costs. No comparisons reported accessibility, eligibility, or follow-ups required. We found inconclusive evidence comparing the effectiveness of hysteroscopic tubal occlusion to laparoscopic tubal ligation. All studies reported adverse events. All forms of tubal interruption reported a protective effect against cancers. Tolerability appeared greater among tubal ligation patients compared to hysteroscopic tubal occlusion patients. No medium or high-quality studies compared LNG-IUC to other methods.Conclusions: High-quality studies comparing outcomes relevant for those seeking female permanent contraception are needed to support informed decision-making. Research is needed to directly compare surgical forms of permanent contraception, such as tubal ligation or removal, with alternative options, such as intrauterine contraception.Systematic review registration: PROSPERO [CRD42016038254].
New Stent for Transapical Mitral Valve Replacement in Acute Swine Experiment
Authors: Zou Yu , Teng Peng , Ma Liang 
Published: December 2020

Abstract
Background: Many patients with mitral regurgitation are denied open-heart surgery due to high risk. Transcatheter mitral valve replacement offers an alternative treatment. This study aimed to test the feasibility of a new self-expanding valved stent for transcatheter mitral valve replacement via apex in an acute animal model.Methods: Eight porcine experiments were performed in the acute study. A left thoracotomy was performed. The new self-expanding transcatheter valved stent was deployed under fluoroscopic guidance within the native mitral annulus via apex. Hemodynamic data, before and after implantation, were recorded. Mitral annulus diameter and valve area were measured using echocardiography. Transvalvular and left ventricular outflow tract pressure gradient were measured invasively. Results: Seven animals underwent successful transapical mitral valve replacement; the implantation was unsuccessful in one animal. The mean procedure time, defined from placing the purse-string to tightening the purse-string, was 17.14 ± 7.86 min. Hemodynamic data before and after transapical mitral valve replacement showed no difference in statistical analysis. The mean diameter and mean functional area of the self-expanding device after implantation were 2.58 ± 1.04 cm and 2.70 ± 0.26 cm2, respectively. Trace to mild central and paravalvular leak was detected in 7 valves. Mean pressure gradient across the self-expanding device was 2.00 ± 0.82 mm Hg; the corresponding gradients across the LVOT were 3.28± 1.11 mm Hg. Postmortem examinations confirmed precise device positioning in 7 animals with no signs of LVOT obstruction.Conclusion: Transcatheter mitral replacement of the new valved stent was confirmed feasible in acute preclinical models. The new stent reveals optimal design parameters.
Open Aortic Valve Replacement Followed by Open Adrenalectomy In A Patient With Symptomatic Pheochromocytoma and Critical Aortic Stenosis: A Case Report
Authors: Feinstein Igor , Lee Tiffany , Khan Sameer , Raleigh Lindsay , Mihm Fred 
Published: December 2020

Abstract
Background: Pheochromocytoma is a rare medical condition caused by catecholamine-secreting tumor cells. Operative resection can be associated with significant hemodynamic fluctuations due to the nature of the tumor, as well as associated post-resection vasoplegia. To allow for cardiovascular recovery before surgery, patients require pre-operative alpha-adrenergic blockade, which would be limited in the setting of co-existent severe aortic stenosis. In this report, we describe a patient with severe aortic stenosis and symptomatic pheochromocytoma. Case presentation: A 51-year-old man with severe aortic stenosis (valve area 0.8 cm2) was found to have a highly active 4x4 cm left adrenal pheochromocytoma. Alpha-adrenergic blockade for his pheochromocytoma was limited by syncope in the setting of his aortic stenosis. Open aortic valve replacement (AVR) was performed, followed by adrenalectomy the next day. The perioperative course for each surgical procedure was hemodynamically volatile, exacerbated by severe alcohol withdrawal. During the adrenalectomy, cardiogenic and vasoplegic shock developed immediately after securing the vascular supply to his tumor. This shock was refractory to vasopressin and methylene blue, but responded well to angiotensin II and epinephrine. After both surgeries were completed, his course was further complicated by severe ICU psychosis, ileus, fungal bacteremia, pneumonia/hypoxic respiratory failure and atrial fibrillation. He ultimately recovered and was discharged from the hospital after 38 days. Conclusion: To our knowledge, this is the first report of surgical AVR and pheochromocytoma resection in a patient with critical aortic stenosis. The appropriate order and timing of surgeries when both these conditions co-exist remains controversial.
A Poorly Prognostic Case of Renal Dialysis in a 20-Year Case Series of Adult Coronary Sinus Atrial Septal Defect Repair at New Tokyo Hospital
Authors: Sugimori Haruhiko , Nakao Tatsuya , Ikegaya Yuki , Iwahashi Daisuke , Tsuda Shoich , Kume Nao , Nakamura Sunao 
Published: December 2020

Abstract
Background: Isolated coronary sinus atrial septal defect (ASD) is defined as a coronary sinus unroofed in the terminal portion without a persistent left superior vena cava and other anomalies. This defect is rare and part of a wide spectrum of unroofed coronary sinus syndromes. Recently, several reports have described this finding. We searched the hospital’s database to determine the incidence of this defect, and to raise awareness of this condition, we discussed the findings from five patients with coronary sinus ASD who underwent surgical repair. Case presentation: The patients were three women and two men with an age range of 63–77 years. All patients underwent transthoracic echocardiography and computed tomography, and one underwent magnetic resonance imaging. In two patients, the defect was found unexpectedly intraoperatively; left-to-right shunting was apparent in the other three patients preoperatively. The pulmonary-to-systemic blood flow ratio ranged from 1.42 to 3.1 following cardiac catheterization, and oxygen saturation step-up was seen on the right side of the heart. Valvular regurgitation was seen in 4/5 patients with the mitral, tricuspid, and aortic valves involved in different combinations and to different degrees. Right atrial and ventricular dilation were seen in 4/5 patients; three patients had left atrial dilation. Three patients experienced atrial fibrillation, and one of these also experienced paroxysmal ventricular contractions. All patients underwent surgical repair, and some underwent multiple procedures. One patient who had previously undergone kidney transplantation died approximately 1 year postoperatively; the remaining four patients are currently experiencing good activities of daily living without symptoms. Conclusions: Coronary sinus ASD (Kirklin and Barratt–Boyes type IV unroofed coronary sinus syndrome) comprised 1.3% of adult congenital heart surgeries and 0.07% of adult open-heart surgeries in our hospital from 1999 to 2019. Our hospital performs cardiac surgery mainly for patients with acquired cardiac disease, and coronary sinus ASD is rare. Early diagnosis and, in symptomatic patients (especially those with blood access shunts, which may overload the heart), early surgical repair are important. The poorly prognostic case in our series is noteworthy, as similar cases have not been reported previously.
Lymphoepithelial carcinoma in the body of the tongue: The first case report
Authors: Sawako Ono , Marunaka Hidenori , Yanai Hiroyuki , Kawai Hotaka , Takabatake Kiyofumi , Nakano Keisuke , Nishida Kenji , Taniguchi Kohei , Toji Tomohiro , Nagatsuka Hitoshi , Yoshino Tadashi 
Published: December 2020

Abstract
Background

Lymphoepithelial carcinoma (LEC) of the tongue is a rare subtype of squamous cell carcinoma. Histologically, it is an undifferentiated carcinoma with rich lymphocyte and plasma cell infiltration. The most common location for LEC in the head and neck is the salivary glands, and LEC of the oral cavity is extremely rare1.
Conclusions

The first case report of LEC in the body of the tongue is presented. In addition, a review of the literature was performed, and the relationship between LEC and Epstein-Barr virus infection was considered.
Mental disorder and PTSD in Syria during wartime: a nationwide crisis
Authors: Kakaje Ameer , Zohbi Ragheed Al , Aldeen Osama Hosam , Makki Leen , Alyousbashi Ayham , Alhaffar Bahaa Aldin 
Published: December 2020

Abstract
Background: Syria has experienced war since 2011, leaving over 80% under the poverty line and millions being displaced. War and its retaliations have significantly impacted the mental health of Syrians. This study evaluates the post-traumatic stress disorder (PTSD), and the severity of the mental distress caused by war and other factors such as low social support. This study also evaluates other variables and compares the findings with multiple studies of Syria and refugees.Methods: This is a cross-sectional study that included people who lived in Syria from different governorates. Online surveys were distributed into multiple online groups and included Kessler 10 (K10) questionnaire, the Screen for Posttraumatic Stress Symptoms (SPTSS) tool, the Multidimensional Scale of Perceived Social Support, and demographic and war-related questionnaires.Results: Our study included 1951 participants, of which, 527 (27.0%) were males and 1538 (78.8%) aged (19-25) years. Among participants, 44% had likely severe mental disorder, 27% had both likely severe mental disorder and full PTSD symptoms, 36.9% had full PTSD symptoms, and only 10.8% had neither positive PTSD symptoms nor mental disorder on the K10 scale. Around 23% had low overall support. Half of the responders were internally displaced, and 27.6% were forced to change places of living three times or more due to war. Around 86.6% of the responders believed that the crisis was the main reason for their mental distress. Those with high SPTSS and K10 scores were found to take more days off from work or school due to negative feelings and having somatic symptoms. Moreover, the number of times changing places of living due to war, educational level, and being distressed by war noise were the most important factors for more sever PTSD and mental distress. No differences in PTSD and mental disorder prevalence were noted in governorates and type of job. A strong correlation (r=0.623) was found between SPTSS and K10 scores. Conclusion: The conflict in Syria has left the population at a great risk for mental distress which was more severe compared to Syrian refugees elsewhere. Many measures with an emphasis on mental health are needed to aid the people against a long-term avoidable suffering.
Test re-test reliability of single and multijoint strength properties in female Australian footballers
Authors: Kadlec Daniel , Jordan Matthew J. , Snyder Leanne , Alderson Jacqueline , Nimphius Sophia 
Published: December 2020

Abstract
Purpose: To examine the test re-test reliability of isometric maximal voluntary contractions (MVC) of hip adduction (ADDISO), hip abduction (ABDISO), and multijoint leg extension (SQUATISO) in sub-elite female Australian footballers. Methods: Data were collected from 24 sub-elite female Australian footballers (age: 22.6±4.5 y; height: 169.4±5.5 cm; body mass: 66.6±8.0 kg; 4.5±4.4 y sport-specific training; 2.5±2.0 y unstructured resistance training) from the same club on two non-consecutive days. Participants performed 3 isometric MVCs of ADDISO, ABDISO and SQUATISO. The SQUATISO was performed at 140° knee flexion with a vertical trunk position and ADDISO and ABDISO measures were performed in a supine position at 60° of knee flexion and 60° hip flexion. Reliability was assessed using paired T-tests and the intraclass correlation coefficient (ICC) with 95% confidence intervals (CI), typical error (TE) and coefficient of variation (CV%) with 95% CI. Results: SQUATISO peak force (ICC: .95; CV%: 4.1), ABDISO for left, right and sum (ICC: .90 – .92; CV%: 5.0 – 5.7), and ADDISO for left, right and sum (ICC: .86 - .91; CV%: 6.2 – 6.9) were deemed acceptably reliable based on predetermined criteria (ICC ≥ .8 and CV% ≤ 10). Conclusion: SQUATISO, ABDISO and ADDISO tests demonstrated acceptable reliability for the assessment of peak force in sub-elite female Australian footballers, suggesting these assessments are suitable for muscle strength testing and monitoring adaptations to training.
3D simulation of radiographic projections to test and reduce the effect of pelvic tilt on the accuracy of cross-table lateral radiography
Authors: Xu Jie , Su Baohua , Zhang Wenhui , Sun Hao , Li Deng , Cai Zhiqing , Chen Meiyi , Qiu Meiling , Ma Ruofan 
Published: December 2020

Abstract
Background: Cross-table lateral (CL) radiography is a convenient and feasible method to assess cup version angle (VA) after total hip arthroplasty; However, pelvic tilt (PT) may contribute to its measurement inaccuracy. How PT affects CL radiographic measurements have not been well studied. We sought (1) to determine the effect of the PT on cup version measurement on CL radiography and (2) to develop a method for reducing measurement errors caused by the PT. Methods: We used 3D technique to construct standard model and capture CL radiography simulation. A linear regression model was created to analyze the relationship between PT and VA. CL radiography and computed tomography (CT) were performed for the enrolled patients after surgery. The consistency between CL and CT measurements were verified by intra-class correlation coefficient (ICC). Results: There was a high correlation between the VA and PT. For each 1-degree increased in the PT, the VA decreased by 0.76° (R²=0.995, p<0.001). Based on the data, we created a corrective formula to convert the radiographic measurements into values approximating the actual VA under a natural pelvic position. The VA measurements corrected by our equation was in high agreement with the CT-measured values with reference to the corresponding PT (ICC=0.988, p<0.001), which was in sharp contrast to that without PT control (ICC=0.454, p=0.203). Conclusions: The PT may contribute to cup version measurement inaccuracies on CL radiography. Our mathematical algorithm can serve as a reliable method to improve the accuracy of CL radiography.
Prevalence of postural musculoskeletal symptoms among dental students in United Arab Emirates.
Authors: Hashim Raghad , Salah Afraa , Mayahi Fatemeh , Haidary Saeedeh 
Published: December 2020

Abstract
Background The main purpose of this study was to assess the prevalence of neck, shoulder, and low-back pain and to explore factors associated with musculoskeletal pain (MSP) among dental students at Ajman University and Ras Al Khaimah College of Dental Sciences in United Arab Emirates (UAE). Method This cross-sectional study was conducted among dental students using an online questionnaire, which was a modified version of the Standardized Nordic questionnaire, focused on neck, shoulder and low-back pain in the past week and the past year. Results Two hundred and two students (out of 368) responded to the questionnaire. The prevalence of MSP in at least one body site in the past week, and in the past year was 48.5% and 68.3% respectively. Factors significantly associated with MSP in at least one body site at any time were having history of trauma (P = 0.009), lack of exercise (P = 0.001), longer clinical sessions (P = 0.000), and higher BMI (P = 0.010). Conclusion The prevalence of MSP among dental students in the UAE is high. Careful attention from dental colleges is needed to increase students’ awareness of this problem. This study contributed to better understanding of MSP among dental professionals.
Association of ultra-processed food consumption with cardiovascular mortality in the US population: long-term results from a large prospective multicenter study
Authors: Zhong Guo-Chao , Gu Hai-Tao , Peng Yang , Wang Kang , Wu You-Qi-Le , Hu Tian-Yang , Jing Feng-Chuang , Hao Fa-Bao 
Published: December 2020

Abstract
Background: Ultra-processed foods have now become dominant in the global food system. Whether their consumption is associated with cardiovascular mortality remains controversial. Moreover, data on ultra-processed foods and cardiovascular outcomes are scarce in the US population. We aimed to examine the association of ultra-processed food consumption with cardiovascular mortality in a US population. Methods: A population-based cohort of 91891 participants was identified from the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial. Dietary data were collected through a validated 137-item food frequency questionnaire. Ultra-processed foods were defined by the NOVA classification. Cox regression was used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) for cardiovascular mortality. Restricted cubic spline regression was used to test nonlinearity. Subgroup analyses were conducted to identify the potential effect modifiers. Results: After an average follow-up of 13.5 years (1236049.2 person-years), 5490 cardiovascular deaths were documented, including 3985 heart disease deaths and 1126 cerebrovascular deaths. In the fully adjusted model, participants in the highest vs. the lowest quintiles of ultra-processed food consumption had higher risks of death from cardiovascular disease (HRquintile 5 vs. 1, 1.50; 95% CI, 1.36–1.64) and heart disease (HRquintile 5 vs. 1, 1.68; 95% CI, 1.50–1.87) but not cerebrovascular disease (HRquintile 5 vs. 1, 0.94; 95% CI, 0.76–1.17). A nonlinear dose–response pattern was observed for overall cardiovascular and heart disease mortality (all Pnonlinearity<0.05), with a threshold effect observed at ultra-processed food consumption of 2.4 servings/day and 2.3 servings/day, respectively; below the thresholds, no significant associations were observed for these two outcomes. Subgroup analyses showed that the increased risks of mortality from ultra-processed foods were significantly higher in women than in men (all Pinteraction<0.05). Conclusions: High consumption of ultra-processed foods is associated with increased risks of overall cardiovascular and heart disease mortality. These harmful associations may be more pronounced in women. Our findings need to be confirmed in other populations and settings.