bluuebunny/crossref_metadata_2025_split huggingface dataset:
Disease trajectories, place and mode of death in people with head and neck cancer: Findings from the ‘Head and Neck 5000’ population-based prospective clinical cohort study
Authors: Mayland Catriona R , Ingarfield Kate , Rogers Simon N , Dey Paola , Thomas Steven , Waylen Andrea , Leary Sam D , Pring Miranda , Hurley Katrina , Waterboer Tim , Pawlita Michael , Ness Andy R 
Published: February 2020

Background: Few large studies describe initial disease trajectories and subsequent mortality in people with head and neck cancer. This is a necessary first step to identify the need for palliative care and associated services. Aim: To analyse data from the Head and Neck 5000 study to present mortality, place and mode of death within 12 months of diagnosis. Design: Prospective cohort study. Participants: In total, 5402 people with a new diagnosis of head and neck cancer were recruited from 76 cancer centres in the United Kingdom between April 2011 and December 2014. Results: Initially, 161/5402 (3%) and 5241/5402 (97%) of participants were treated with ‘non-curative’ and ‘curative’ intent, respectively. Within 12 months, 109/161 (68%) in the ‘non-curative’ group died compared with 482/5241 (9%) in the ‘curative’ group. Catastrophic bleed was the terminal event for 10.4% and 9.8% of people in ‘non-curative’ and ‘curative’ groups, respectively; terminal airway obstruction was recorded for 7.5% and 6.3% of people in the same corresponding groups. Similar proportions of people in both groups died in a hospice (22.9% ‘non-curative’; 23.5% ‘curative’) and 45.7% of the ‘curative’ group died in hospital. Conclusion: In addition to those with incurable head and neck cancer, there is a small but significant ‘curative’ subgroup of people who may have palliative needs shortly following diagnosis. Given the high mortality, risk of acute catastrophic event and frequent hospital death, clarifying the level and timing of palliative care services engagement would help provide assurance as to whether palliative care needs are being met.
Diagnostic Accuracy of Dual-Energy CT in Detection of Acute Pulmonary Embolism: A Systematic Review and Meta-Analysis
Authors: Abdellatif Waleed , Ebada Mahmoud Ahmed , Alkanj Souad , Negida Ahmed , Murray Nicolas , Khosa Faisal , Nicolaou Savvas 
Published: February 2020

Purpose: In this systematic review and meta-analysis, we aimed to investigate the accuracy of dual-energy computed tomography (DECT) in the detection of acute pulmonary embolism (PE). Methods: We searched Medline (via PubMed), EBSCO, Web of Science, Scopus, and the Cochrane Library for relevant published studies. We selected studies assessing the accuracy of DECT in the detection of PE. Quality assessment of bias and applicability was conducted using the Quality of Diagnostic Accuracy Studies-2 tool. Meta-analysis was performed to calculate mean estimates of sensitivity, specificity, positive likelihood ratio (PLR), and negative likelihood ratio (NLR). The summary receiver operating characteristic (sROC) curve was drawn to get the Cochran Q-index and the area under the curve (AUC). Results: Seven studies were included in our systematic review. Of the 182 patients included, 108 patients had PEs. The pooled analysis showed an overall sensitivity and specificity of 88.9% (95% confidence interval [CI]: 81.4%-94.1%) and 94.6% (95% CI: 86.7%-98.5%), respectively. The pooled PLR was 8.186 (95% CI: 3.726-17.986), while the pooled NLR was 0.159 (95% CI: 0.093-0.270). Cochran-Q was 0.8712, and AUC was 0.935 in the sROC curve. Conclusion: Dual-energy computed tomography shows high sensitivity, specificity, and diagnostic accuracy in the detection of acute PE. The high PLR highlights the high clinical importance of DECT as a prevalence-independent, rule-in test. Studies with a larger sample size with standardized reference tests are still needed to increase the statistical power of the study and support these findings.
Risk Factors for Seizures and Epilepsy in Children With Congenital Heart Disease
Authors: Ghosh Suman , Philip Joseph , Patel Nikita , Munoz-Pareja Jennifer , Lopez-Colon Dalia , Bleiweis Mark , Winesett Steven Parrish 
Published: February 2020

Objectives: To identify potential risk factors for pre- and postoperative seizures and epilepsy in children with congenital heart disease. Methods: Retrospective cohort study of neonates and infants <3 months of age with congenital heart disease who underwent cardiopulmonary bypass from November 24, 2006, until June 1, 2015. Children with seizures were classified based on time of occurrence into early preoperative, early postoperative, and late postoperative. Children with recurring seizures 30 days after cardiac surgery met criteria for epilepsy. Results: 247 patients completed follow-up; 2.4% had seizures early preoperation and 1.6% early postoperation. Late postoperative epilepsy occurred in 5.3% of the cohort. The majority of seizures in the late postoperative epilepsy group started after 1 year of age (mean 1.53 years, range = 0.18-4.7 years). One of the 13 patients with epilepsy had a seizure during their intensive care unit hospitalization. Potential risk factors for seizures included brain injury ( P < .001), high-risk surgery (Society of Thoracic Surgeons-European Association for Cardio-Thoracic Surgery score ≥3, P = .024), and low birth weight ( P < .04). Infants with stroke were more likely to develop epilepsy ( P = .04). Presence of seizures was associated with increased length of stay ( P < .001). Conclusions: Our study suggests an association between children with congenital heart disease diagnosed with stroke in the neonatal/infancy period and the development of epilepsy. These children may not have prior early pre- and postoperative seizures. Risk factors for seizures include brain injury, high-risk surgery, and lower birth weight. Seizures were associated with an increased length of stay but did not necessarily lead to subsequent epilepsy.
Wellness Program Nonparticipation and Its Association With Employee Turnover
Authors: Jenkins Kristi Rahrig , Sherman Bruce W. 
Published: February 2020

Purpose: This study examines the association between nonparticipation in wellness activities and employee turnover risk. Design: Retrospective, cross-sectional analysis. Setting: Large university in the Midwestern United States. Participants: Employees with continuous employment during 2016 and complete human resources and wellness program data (n = 34 405). Methods: Demographic, health risk assessment (HRA), and wellness program participation data were collected in 2016 and paired with administratively recorded turnover status from 2017. For the multivariate analyses, logistic regression models were used. Results: There were statistically significant associations between various socioeconomic and demographic characteristics (gender, age, race, wage, union and faculty status, and health score) with turnover status. Also, all 3 participation levels (participated in the HRA only, participated in the HRA and wellness programming, and participated in wellness programming only) had lower odds of experiencing turnover compared to nonparticipants (participated in the HRA only [adjusted odds ratio, AOR: 0.89; confidence interval, CI: 0.80-0.99], participated in wellness program(s) only [AOR: 0.77; CI: 0.62-0.95] and participated in both the HRA and program(s) [AOR: 0.82; CI: 0.74-0.91], respectively). Conclusion: Employee participation in wellness program activities appears to represent a measure of engagement with work. Nonparticipation in these programs is associated with increased risk of employment turnover in the subsequent year.
LncRNA KCNQ1OT1 attenuates sepsis-induced myocardial injury via regulating miR-192-5p/XIAP axis
Authors: Sun Fangyuan , Yuan Weifang , Wu Hao , Chen Gang , Sun Yuxia , Yuan Lin , Zhang Wei , Lei Ming 
Published: February 2020

Myocardial dysfunction is a prime cause of death in sepsis. This study is to delve into the function of lncRNA KCNQ1OT1 in myocardial injury induced by sepsis. Sepsis-induced myocardial injury model in rat was initiated by intraperitoneally injecting of LPS (10 mg/kg) in vivo, and cardiomyocyte H9c2 was treated with LPS to mimic sepsis in vitro. KCNQ1OT1 and miR-192-5p expressions were detected by qRT-PCR. The cell viability was probed with CCK-8 experiment and the apoptosis of the cardiomyocytes was tested using flow cytometry analysis. Western blot was operated to determine apoptosis-related proteins expressions. ELISA was used to evaluate the levels of TNF-α, IL-6, and IL-1β. Bioinformatics analysis, RT-PCR, dual luciferase reporter assay, and RNA immunoprecipitation experiment were utilized to detect the interrelation of genes. Herein, we proved that KCNQ1OT1 was considerably down-regulated, whereas miR-192-5p was markedly increased in myocardial tissues of septic rats. KCNQ1OT1 interrelated with miR-192-5p, and negatively modulated its expression levels. Overexpression of KCNQ1OT1 or the transfection of miR-192-5p inhibitors greatly facilitated the viability and impeded the apoptosis of H9c2 cardiomyocytes. miR-192-5p paired with the 3ʹUTR of XIAP, and repressed its protein expression, and XIAP was modulated positively by KCNQ1OT1. In conclusion, our work indicates that down-regulation of KCNQ1OT1 advances cardiac injury through regulating miR-192-5p/XIAP axis during sepsis.Impact statementSepsis-induced cardiomyopathy remains to be a major challenge to health care systems around the globe. There are no known therapies currently available that can cure the disease. This study provides convincing evidence that KCNQ1OT1 could attenuate sepsis-mediated myocardial injury. We further demonstrate that the beneficial function of KCNQ1OT1 was achieved by regulating the miR-192-5p/XIAP axis. We therefore found a new mechanism of cardioprotective effect of KCNQ1OT1, one which also offers a novel theoretical basis for the therapy of sepsis-induced cardiomyopathy.
Radiation Exposure in Posterior Lumbar Fusion: A Comparison of CT Image-Guided Navigation, Robotic Assistance, and Intraoperative Fluoroscopy
Authors: Wang Erik , Manning Jordan , Varlotta Christopher G. , Woo Dainn , Ayres Ethan , Abotsi Edem , Vasquez-Montes Dennis , Protopsaltis Themistocles S. , Goldstein Jeffrey A. , Frempong-Boadu Anthony K. , Passias Peter G. , Buckland Aaron J. 
Published: February 2020

Study Design: Retrospective clinical review. Objective: To assess the use of intraoperative computed tomography (CT) image-guided navigation (IGN) and robotic assistance in posterior lumbar surgery and their relationship with patient radiation exposure and perioperative outcomes. Methods: Patients ≥18 years old undergoing 1- to 2-level transforaminal lateral interbody fusion in 12-month period were included. Chart review was performed for pre- and intraoperative data on radiation dose and perioperative outcomes. All radiation doses are quantified in milliGrays (mGy). Univariate analysis and multivariate logistic regression analysis were utilized for categorical variables. One-way analysis of variance with post hoc Tukey test was used for continuous variables. Results: A total of 165 patients were assessed: 12 IGN, 62 robotic, 56 open, 35 fluoroscopically guided minimally invasive surgery (MIS). There was a lower proportion of women in open and MIS groups ( P = .010). There were more younger patients in the MIS group ( P < .001). MIS group had the lowest mean posterior levels fused ( P = .015). Total-procedure radiation, total-procedure radiation/level fused, and intraoperative radiation was the lowest in the open group and highest in the MIS group compared with IGN and robotic groups (all P < .001). Higher proportion of robotic and lower proportion of MIS patients had preoperative CT ( P < .001). Estimated blood loss ( P = .002) and hospital length of stay ( P = .039) were lowest in the MIS group. Highest operative time was observed for IGN patients ( P < .001). No differences were observed in body mass index, Charlson Comorbidity Index, and postoperative complications ( P = .313, .051, and .644, respectively). Conclusion: IGN and robotic assistance in posterior lumbar fusion were associated with higher intraoperative and total-procedure radiation exposure than open cases without IGN/robotics, but significantly less than MIS without IGN/robotics, without differences in perioperative outcomes. Fluoro-MIS procedures reported highest radiation exposure to patient, and of equal concern is that the proportion of total radiation dose also applied to the surgeon and operating room staff in fluoro-MIS group is higher than in IGN/robotics and open groups.
Assessment of Disability Related to Hip Dysplasia Using Objective Measures of Physical Performance
Authors: Scott Elizabeth J. , Willey Michael C. , Mercado Arthur , Davison John , Wilken Jason M. 
Published: February 2020

Background: Lower extremity physical performance measures (PPMs), which can objectively quantify functional ability, are an attractive adjuvant to patient-reported outcome (PRO) instruments. However, few tests have been validated for use in hip instability. Purpose: To evaluate 4 different PPMs for their ability to differentiate between young adults with hip dysplasia indicated for treatment with periacetabular osteotomy (PAO) and asymptomatic controls and to test inter- and intratest reliability and relationship with popular hip PRO instruments. Study Design: Cohort study (diagnosis); Level of evidence, 2. Methods: A total of 24 symptomatic patients aged 15 to 39 years (100% female) with hip dysplasia (lateral center-edge angle <25°) indicated for treatment with PAO completed the visual analog scale (VAS) for pain, Hip disability and Osteoarthritis Outcome (HOOS) Pain subscale, HOOS Short Version (HOOS PS), International Hip Outcome Tool Short Version (iHOT-12), modified Harris Hip Score (mHHS), Patient Reported Outcome Measurement Information System (PROMIS) physical function (PF) and pain interference (PI), and 4 physical function tests: (1) self-selected walking speed (SSWS), sit-to-stand 5 times (STS5), (3) 4-square step test (FSST), and (4) timed stair ascent (TSA). A further 21 young, asymptomatic adults aged 18 to 39 years (91% female) also underwent testing. Between-group comparisons were made with unpaired t test with Bonferroni-Holm correction. Inter- and intrarater reliability was assessed in 38 participants by repeating PPMs at a second visit and using 2 raters. Spearman rank correlation coefficients were used to determine associations between PPMs and PRO instruments. Results: Significant differences between patients with hip dysplasia and controls were observed for all PRO instruments (HOOS Pain, 47.8 vs 99.2; HOOS PS, 61.9 vs 99.2; iHOT-12, 32.2 vs 99.2; mHHS, 54.5 vs 90.6; PROMIS PF, 41.4 vs 65.6; and PROMIS PI, 62.0 vs 39.1 [all P < .001]), and all PPMs (SSWS, 1.21 vs 1.53 m/s; STS5, 10.85 vs 5.95 s; FSST, 6.59 vs 4.03 s [all P < .001]; and TSA, 4.58 vs 3.29 s [ P = .002]). All 4 PPMs demonstrated excellent intra- and intertest reliability (intraclass correlation coefficient, 0.83-0.99). STS5, FSST, and TSA were correlated highly ( r > 0.5) with physical function PRO instruments, including PROMIS PF, mHHS, and iHOT-12. Conclusion: Patients with symptomatic hip dysplasia demonstrated significant impairment on functional testing compared with asymptomatic controls, and performance measure testing demonstrated excellent test-retest reliability. Timed stair ascent and sit-to-stand testing in particular were correlated strongly with physical function PRO instruments. PPMs may be a viable and well-received adjuvant to PRO instrument administration for patients with nonarthritic hip conditions, and investigation of the ability of PPMs to assess surgical outcomes for hip dysplasia is warranted.
Meniscal Injury Does Not Significantly Affect the Dimensions of the Intact Meniscus in the Opposite Compartment of the Knee
Authors: Yoon Kyoung Ho , Song Sang Jun , Lee Hee Sung , Park Cheol Hee 
Published: February 2020

Background: Meniscal allograft transplant requires precise matching of the size of the allograft with the dimensions of the recipient knee. Estimation of contralateral meniscal size on magnetic resonance imaging (MRI) has been considered the ideal method to measure menisci before transplant. We questioned whether a contralateral intact meniscus with meniscal injury in the opposite compartment could be used as a reference to determine allograft size. Our question was derived from knowledge of meniscal injury influencing structures of the opposite compartment of the knee, including the meniscus. Purpose: To compare meniscal dimensions between intact meniscus with meniscal injury in the opposite compartment and normal meniscus with a normal opposite compartment. Study Design: Cross-sectional study; Level of evidence, 3. Methods: This observational, cross-sectional study was performed between 2016 and 2017. The control group consisted of 200 knees with normal medial and lateral menisci. The medial intact group consisted of 150 cases of medial intact meniscus with injured lateral meniscus, and the lateral intact group consisted of 150 cases of lateral intact meniscus with injured medial meniscus. All patients were male. Mean age, height, and weight did not differ among groups. We investigated meniscal dimensions on MRI, including anteroposterior and mediolateral lengths, distance between the anterior and posterior horns (AHPH distance), and widths and heights of the anterior and posterior horns and midbody. Results: Most medial meniscal dimensions were similar between the control and medial intact groups, but the AHPH distance was smaller in the medial intact group ( P < .001). Likewise, most lateral meniscal dimensions were similar between the control and lateral intact groups, but the AHPH distance was smaller in the lateral intact group ( P < .001). Conclusion: Most dimensions of the intact meniscus with meniscal injury in the opposite compartment were similar to those of the normal meniscus with normal opposite compartment. Measuring the dimensions of the contralateral intact meniscus with meniscal injury in the opposite compartment on MRI can be an appropriate method to determine meniscal allograft size.
Can the distal tibial insertion of the anterolateral ligament be palpated to identify lesions in anterior cruciate ligament tears?
Authors: Cavaignac Etienne , Murgier Jérôme , Thomas Pierre , Courtot Louis , Marot Vincent 
Published: February 2020

Background: It has been established that the anterolateral ligament (ALL) plays a role in controlling the rotational stability of the knee. We have demonstrated that ALL injuries can be identified by ultrasound. In most instances, the injury is tibial. The objective of this study was to evaluate the correlation between acutely painful palpation of the distal insertion of the ALL and the lesion as observed on ultrasound. Methods: We conducted a prospective single center study with 130 patients (89 men and 41 women). The mean age was 27.2 ± 8.3 years and the subjects had unilateral ACL injury for less than one month. On average, the distal insertion was palpated 8.8 ± 3.2 days after the trauma to determine the pain status of the ALL. An ultrasound was performed preoperatively by a surgeon trained in ultrasound diagnosis. All assessments were conducted in a double blind method (the surgeon did not know the clinical status of the ALL). We measured the correlation between the ALL ultrasound injury assessment and pain on palpation of the distal insertion using the intra-class correlation coefficient with a 95% confidence interval. The correlation between the preoperative pivot shift grade in the operating room and the ultrasound injury assessment was also examined. This study was approved by the ethics committee. Considering that the objective could not be quantified, the number of subjects required was determined by recruitment for 1 year. Results: The consistency between painful palpation of the distal insertion of the ALL and the ultrasound injury assessment was good with a 95% confidence interval of the ICC at 0.801 (95% CI: 0.730, 0.855) The sensitivity of this clinical test was 92% (95% CI: 88-97), specificity, 88 (95% CI: 82-93), the positive predictive value, 88% (95% CI: 82-94) and the negative predictive value, 92% (95% CI: 87 -97). The consistency between the pivot shift grade in the operating room and the injury on ultrasound was good, ICC = 0.850 (95% CI: 0.794, 0.891) Conclusion: The diagnostic value of painful palpation of the distal insertion of the ALL in identifying ALL injury was excellent. This structure is involved in the rotational stability of the knee. Therefore, assessment by palpation is adapted to the specific management of knee trauma.
Chronic anterior instability with hyperlaxity treated by arthroscopy using the Trillat technique with endobutton fixation: results for 14 cases
Authors: Valenti Philippe , Cartaya Marco , Werthel Jean-David 
Published: February 2020

Background: Recurrent anterior instability associated with hyperlaxity remains a difficult challenge. In 1954, Trillat proposed osteoclasis of the coracoid process in order to make it more distal and more medial to place the conjoint tendon just in front of the humeral head. The conjoint tendon lowers and reinforce the stabilizing action of the subscapularis muscle in abduction. This open surgery technique has provided satisfactory results in patients with chronic anterior glenohumoral instability associated with massive irreparable rotator cuff tears. We hypothesized that this procedure could be arthroscopy-assisted with the use of an endobutton to treat anterior glenohumoral instability with hyperlaxity without engaging bone defects. Methods: This is a prospective study on 14 patients (9 females, 5 males; average age 25 years) who underwent surgery between 05/2014 and 12/2016. These were patients with anterior instability with hyperlaxity (external rotation > 85° / positive sulcus sign and no associated bone lesions). Arthroscopic surgery consisted of an antero-inferior capsuloplasty with Bankart repair combined with coracoid osteoclasis and fixation with an endobutton with a self-locking mechanism. The results were evaluated using SSV, Walch-Duplay, Rowe and Constant scores. Standard X-rays and a CT scan with 3D reconstructions were also performed at follow-up. Results: With an average follow-up of 26 months (24 to 32 months), no recurrent instability was reported, but persistent apprehension was found in 2 cases. The average Walch-Duplay score was 85 points, Rowe 89 points, the SSV 91% and adjusted Constant score 95.8%. The average VAS score was 0.8 points. The mean preoperative active anterior elevation of 178° decreased to 165° postoperatively and similarly, external rotation with the elbow at side decreased from 90° to 57°. At the last follow-up, all osteotomies healed. No complications were reported. Conclusion: Arthroscopy-assisted Trillat technique with the use of an endobutton appears to be a reliable technique for the treatment of hyperlaxity associated with chronic anterior glenohumoral instability without bone defect. Stabilization and adjustment of coracoid osteoclasis are provided by the endobutton; lowering and medial placement of the coracoid causes lowering of the subscapularis muscle by the conjoint tendon in abduction and thereby reinforces anterior capsuloplasty. Longer follow-up is required to confirm the reliability of this technique.