bluuebunny/crossref_metadata_2025_split huggingface dataset:
Surgical management of consecutive multisegment thoracic and lumbar tuberculosis: anterior-only approach vs. posterior-only approach.
Authors: Zhao Chen , Luo Lei , Liu Liehua , Li Pei , Liang Lichuan , Gao Yongjian , Luo Fei , Xu Jianzhong , Zhou Qiang 
Published: May 2020

Abstract
Purpose: To compare the efficacy, safety, and technical characteristics of anterior-only and posterior-only approach surgeries for the treatment of consecutive multisegment thoracic and lumbar tuberculosis.Methods: Thirty-five patients who developed consecutive multisegment thoracic and lumbar tuberculosis from September 2012 to May 2016 were retrospectively analyzed. Group A was the posterior-only surgery group, and group B was the anterior-only surgery group. The data on the surgery, deformity correction, functional scores and complications were compared between the two groups.Results: There was no significant difference in the operation time or blood loss between groups A and B (P>0.05). The preoperative average Cobb angle of kyphosis in groups A and B were 36.2±15.2° and 27.9±7.7°, respectively, which significantly decreased to 4.9±11.8° and 10.4±5.6° after the operation, respectively (P<0.05). At the final follow-up, the angles were 7.1±10.5° and 14.6±8.0°, respectively. The correction angle and correction rate in group A (31.3±16.6°, 88.6±43.6%) were greater than those in group B (17.5±4.4°, 64.9±14.0%) (P<0.05). There was no significant difference in the loss angle between groups A and B (P>0.05), but the loss rate in group B (24.0±27.8%) was higher than that in group A (9.6±10.2%) (P<0.05). There was no significant difference in the incidence of complications between the two groups (P>0.05). Conclusion: The posterior-only and anterior-only approaches can lead to satisfactory clinical results in the treatment of patients with consecutive multisegment thoracic and lumbar tuberculosis. With posterior-only surgery, kyphosis can be better corrected, and the correction can be better maintained than with anterior-only surgery.
Magnetic Resonance Imaging and Dynamic X-ray's correlations with Dynamic Electrophysiological Findings in Cervical Spondylotic Myelopathy: a retrospective cohort study.
Authors: Yu Zhengran , Lin Kaiyuan , Chen Jiacheng , Chen Kuan-Hung , Guo Wei , Dai Yuhu , Chen Yuguang , Zou Xuenong , Peng Xinsheng 
Published: May 2020

Abstract
Background
Dynamic somatosensory evoked potentials (DSSEP) can be used to disclose abnormalities of ascending sensory pathways at dynamic positions and diagnose cervical spondylotic myelopathy (CSM). However, radiographic tests including magnetic resonance imaging (MRI) and dynamic X-ray are used much more widely in the management of CSM. Our study aims to clarify the correlations between several radiographic parameters and the DSSEP results, and further determine their reliability with clinical data.
Methods
We retrospectively enrolled 38 CSM patients with surgical intervention. DSSEP tests were performed before surgery. Amplitude ratios of DSSEP N13 and N20 waves at extension and flexion were calculated and recorded as N13_E, N20_E, N13_F, N20_F respectively. Baseline severity was evaluated with the modified Japanese Orthopedic Association (mJOA) score and the Nurick grades. Prognosis was evaluated based on the 2-year recovery rate. Sagittal diameter and transverse areas of the cord and canal were measured and the Spinal cord/Canal Area Ratio were calculated. The compressive ratios at the compressed site (Compression_Ratio), central (Central_Ratio) and 1/4-lateral points (1/4-Lateral_Compression_Ratio), and intramedullary T2 hyperintensity patterns (Ax-CCM types) were also collected from MRI axial images. Dynamic X-rays were used to test for segmental instability of the cervical spine. The correlations between radiologic findings, DSSEP data, and clinical assessments were investigated.
Results
We found that DSSEP N13_E and N13_F correlated with the Compression_Ratio, Central_Ratio, 1/4-Lateral_Compression_Ratio (Pearson, p < 0.05) and Ax-CCM types (ANOVA, p < 0.05) in MRI axial images and cervical segmental instability in dynamic X-ray (t-test, p < 0.05). Apart from the 1/4-Lateral_Compression_Ratio, these radiographic parameters above also correlated with the baseline clinical assessments (Spearman or ANOVA or t-test, p < 0.05) and postoperative recovery rate (Pearson or ANOVA or t-test, p < 0.05).
Conclusions
We found that the preoperative Compression_Ratio, Central_Ratio and 1/4-Lateral_Compression_Ratio in MRI and cervical segmental instability in dynamic X-ray could reflect the dynamic neural dysfunction of the spinal cord. Different Ax-CCM types corresponded to different DSSEP results at extension and flexion, suggesting divergent pathophysiology. These radiographic parameters could help evaluate disease severity and predict postoperative prognosis.
Trial registration:
The trial was retrospectively registered on April 30th, 2020 and the registration number is "[2020]151".
Predictive value of pentraxin-3 on disease severity and prognosis in patients with hemorrhagic fever with renal syndrome
Authors: Du Hong , Hu Haifeng , Wang Pingzhong , Wang Xiaoyan , Zhang Ying , Jiang Hong , Li Jing , Bai Xuefan , Lian Jianqi 
Published: May 2020

Abstract
Background

Pentraxin-3 is an acute-phase protein involved in the processes of inflammatory and infection. This study aimed to analyze the changes of plasma pentraxin-3 prospectively and evaluate its predictive value on disease severity and prognosis in patients with hemorrhagic fever with renal syndrome (HFRS).
Methods

105 patients with HFRS admitted by the Second Affiliated Hospital of Air Force Medical University from October 2012 to December 2014 were randomly enrolled in this study. All patients were divided into a mild-type group (17 cases), a moderate-type group (27 cases), a severe-type group (26 cases) and a critical-type group (35 cases) according to the HFRS criteria for clinical classification. 96 venous blood samples of acute phase and 65 of convalescent phase were collected from patients during hospitalization, while venous blood samples of 27 healthy volunteers were taken as controls. The levels of plasma pentraxin-3 were detected using the enzyme linked immunosorbent assay (ELISA), and which were compared among the acute and convalescent phases in different types of patients, as well as the control group. Spearman correlation analysis was used to evaluate the correlation between pentraxin-3 and conventional laboratory parameters. The predictive effectiveness for prognosis of pentraxin-3 was evaluated by receiver operating characteristic (ROC) curve analysis.
Results

There was no significant difference in gender and age distribution between all types of patients and control group (P > 0.05). In all types of patients, the levels of pentraxin-3 in acute phase were significantly higher than that of control group and convalescent phase of the same type (P < 0.05). The levels of pentraxin-3 increased with the aggravation of the disease, and showed the highest expression in critical-type patients (P < 0.05). Pentraxin-3 was positively correlated with WBC, AST and APTT, and negatively correlated with PLT, ALB and Fib (|rs|>0.500, P < 0.001). Pentraxin-3 showed significant predictive value for the prognosis of patients with HFRS, with the area under ROC curve (AUC) of 0.753 (95%CI: 0.593 ~ 0.914, P = 0.003).
Conclusions

The detection of plasma pentraxin-3 can be beneficial to the evaluation of disease severity and prognosis in patients with HFRS.
Dental Students’ Perceptions of Undergraduate Oral and Maxillofacial Surgery Teaching in an Integrated Curriculum at Kuwait University
Authors: Kamal Mohammad , Abdulwahab Mohammad 
Published: May 2020

Abstract
Background:To evaluate dental students’ perceptions of the undergraduate oral and maxillofacial surgical training teaching curriculum according to a validated questionnaire originally developed by the Association of British Academic Oral Maxillofacial Surgeons (ABAOMS) to assess their self-confidence.Methods:A cross-sectional survey of all 6th-year (n=22) and 7th-year (n=21) dentistry students that was conducted Kuwait University Faculty of Dentistry between 1 and 15 May 2020. A previously implemented and validated questionnaire by ABAOMS was used in the study which is made of 17 questions assessing various areas of the undergraduate OMFS curriculum in the clinical years. The response options to the questionnaire questions were on a Likert scale. Independent sample t-tests were performed to assess the difference in responses between the two groups. Spearman’s Rho correlations were calculated to measure the strength of association between confidence in all aspects of surgical and forceps exodontia. Statistical significance was considered to be a p-value <0.05.Results:A total of 39 questionnaire were completed by the students, with a response rate of 90,90% for the sixth-year students and 90,47% of the seventh-year students. 37 respondents were female (94.9%) reflecting the majority of female students at the faculty. The majority of students expressed that they feel confident that they have enough knowledge to undertake independent practice (61%). General aspects of the questionnaire were answered favourably except for the step of surgical extraction of teeth, in which both classes reported lower level of confidence.Conclusions:This survey revealed the students’ self-confidence undertaking independent practice and preforming basic oral surgery procedures. Students felt comfortable with exodontia using forceps and elevators, root removal, managing acute pericoronitis, managing haemorrhage from a socket, assessing impacted teeth, and recognizing the clinical features of potentially malignant and malignant lesions of the oral cavity. They reported lower level of confidence for performing the steps of surgical procedures. The ABAOMS survey instrument is a useful and thorough tool to assess the self-confidence of the dental students according to their undergraduate oral and maxillofacial surgery teaching.
Radiomics for intracerebral hemorrhage: are all small hematomas benign?
Authors: Zhan Chen-yi , Chen Qian , Zhang Ming-yue , Liu Jin-jin , Xiang Yi-lan , Chen Jie , Zhu Dong-qin , Chen Chao , Xia Tian-yi , Yang Yunjun 
Published: May 2020

Abstract
Background: Radiomics is a valuable tool for predicting hematoma expansion (HE) but has not been used for small intracerebral hemorrhage (ICH). We hypothesized that not all small hematomas are benign and that radiomics could predict HE and short-term outcomes in small hematomas.Methods: We analyzed 313 patients with small ICH who underwent baseline noncontrast CT within 6 h of symptom onset between September 2013 and February 2019. Small ICH was defined as baseline hematoma volume <10 mL. A radiomic score (R-score) was developed in a training (n=218) and validated in a test cohort (n=95). Poor outcome was defined as a Glasgow Outcome Scale score ≤3. The relationship of the R-score with HE and outcomes was investigated using univariate and multivariate analyses. Predictive performance was assessed by the area under the receiver operating characteristic (ROC) curve (AUC).Results: R-score was an independent predictor of HE in the training (odds ratio [OR]: 2.557; 95% CI, 1.455–4.492) and test cohorts (OR, 3.985; 95% CI, 1.051–14.453). In the 3–10 mL subgroup, but not in the <3 ml subgroup, the R-score was independently associated with HE (OR, 4.293; 95% CI, 2.095–8.796) and poor outcome (OR, 1.297; 95%CI, 1.004–1.674) after adjusting for confounders. The R-score achieved good discrimination ability for HE in the training and test cohorts and the 3–10 mL subgroup (AUCs 0.728, 0.717, and 0.740, respectively).Conclusions: Radiomics provides an objective and effective approach for discriminating between benign and malignant course in patients with small ICH, particularly 3–10 mL hematomas.
Increased Expression of KNSTRN in Lung Adenocarcinoma Predicts Poor Prognosis: A Bioinformatics Analysis Based on TCGA Data
Authors: Deng Pengbo , Zhou Rongrong , Zhang Jinghui , An Jian , Cao Liming 
Published: May 2020

Abstract
Background: Available evidence indicates that kinetochore-localized astrin/SPAG5-binding protein (KNSTRN) is an oncogene in skin carcinoma. This study aimed to evaluate the prognostic value of KNSTRN in lung adenocarcinoma (LUAD) underlying the Cancer Genome Atlas (TCGA) database. Methods: The relationship between clinicopathological features and KNSTRN was analyzed with the Wilcoxon signed-rank test and logistic regression. The clinicopathological characteristics associated with overall survival (OS) were evaluated using Cox regression and the Kaplan–Meier method. Gene ontology (GO) analysis, gene set enrichment analysis (GSEA), and single-sample GSEA (ssGSEA) were performed using TCGA data.Results: The KNSTRN expression level was found to be significantly higher in LUAD tissue than in normal lung tissue. Also, it correlated significantly with advanced clinicopathological characteristics. The Kaplan–Meier survival curve revealed a significant relationship of high expression of KNSTRN with poor OS in patients with LUAD. The multivariate Cox regression hazard model demonstrated the KNSTRN expression level as an independent prognostic factor for patients with LUAD. GO and GSEA analyses indicated the involvement of KNSTRN in cell cycle checkpoints, DNA replication, and G2-M checkpoint M phase. Based on ssGSEA analysis, KNSTRN had a positive relationship with Th2 cells and CD56dim natural killer cells. The KNSTRN expression levels in several types of immune cells were significantly different.Conclusion: The findings suggested that the increased expression level of KNSTRN was significantly associated with the progression of LUAD and could also serve as a novel prognostic biomarker for patients with LUAD.
Initial dip predicts renal protective effects after the administration of sodium-glucose cotransporter 2 inhibitors in patients with type 2 diabetes and chronic kidney disease with normoalbuminuria
Authors: Takahashi Kiyohiko , Nakamura Akinobu , Furusawa Sho , Yokozeki Kei , Sugawara Hajime , Yanagisawa Hideyuki , Akikawa Kazumasa , Kikuchi Hideaki 
Published: May 2020

Abstract
Background: We investigated the renoprotective effects of sodium-glucose cotransporter 2 inhibitors (SGLT2is) on renal function in patients with type 2 diabetes and chronic kidney disease (CKD) with normoalbuminuria. Methods: A retrospective review of clinical records of Japanese participants with type 2 diabetes and CKD (estimated glomerular filtration rate [eGFR] < 60 mL/min/1.73 m 2 ) with normoalbuminuria (urine albumin to creatinine ratio < 30 mg/g Cr and/or urinary protein to creatinine ratio < 150 mg/g Cr) was conducted. Participants were categorized into two groups depending on whether they had started using SGLT2is. The main study outcome was a comparison of the change in renal function evaluated by eGFR after 1 year (ΔeGFR + 1 y) between the two groups. Then, we identified predictors that were associated with the outcome. Results: Among the 48 participants, 21 were treated with SGLT2is (SGLT2 group) and 25 were treated with other antidiabetic medications (control group). Although eGFR was significantly decreased at 1 year in the control group, the decline in eGFR was not observed in the SGLT2 group. The change in eGFR was significantly greater in the SGLT2 group than in the control group (ΔeGFR + 1 year, -4.0 [-7.7 to -0.3] mL/min/1.73 m 2 in the control group, 0.9 [-3.9 to 5.7] mL/min/1.73 m 2 in the SGLT2 group; P = 0.0231). Additionally, multiple linear regression analysis showed that an initial dip was an independent factor associated with the worsening of renal function in the SGLT2 group. Conclusions: Although more favorable effects of SGLT2is on renal function were observed in patients with type 2 diabetes and CKD with normoalbuminuria, the higher initial dip was a possible marker of worsening renal function after the initiation of SGLT2is.
Original Scientific Report Anastomosis technique for pancreatojejunostomy and early removal of drainage tubes may reduce postoperative pancreatic fistula
Authors: Kawaida Hiromichi , Kono Hiroshi , Amemiya Hidetake , Hosomura Naohiro , Watanabe Mitsuaki , Saito Ryo , Nakata Yuuki , Shoda Katsutoshi , Shimizu Hiroki , Furuya Shinji , Akaike Hidenori , Kawaguchi Yoshihiko , Sudo Makoto , Matsuda Masanori , Itakura Jun , Fujii Hideki , Ichikawa Daisuke 
Published: May 2020

Abstract
Background Postoperative pancreatic fistula (POPF) is one of the most serious complications after pancreaticoduodenectomy (PD). Various factors have been reported as POPF risks, but the most serious of these is soft pancreas. To reduce POPF occurrences, many changes to the PD process have been proposed. This study evaluates short-term results of anastomosis technique for PD.Methods In total, 120 patients with soft pancreases who had undergone PD at Yamanashi University between January 2012 and December 2019 were analyzed. We divided these patients into two groups: a conventional group (n = 67) and a modified group (n = 53).Results The rate of clinically relevant POPF was significantly lower in the modified group than that in the conventional group (1.9% vs 22.4%, p < 0.001), with there being only one case of POPF in the modified group. There were no cases of POPF-related hemorrhaging in the modified group. On the third day after the operation, the amylase levels in the drainage fluid for the modified group had reduced to one third of those in the conventional group (1696 vs 643 U/L).Conclusions Our novel anastomosis technique for pancreatojejunostomy reduced POPF in PD, especially in cases where the patient had a soft pancreas.
Cervicogenic Headache and the Relationship Between the Position and Movement of the Upper Cervical Spine and Dura
Authors: Sillevis Rob , Shamus Eric , Wyss Karen 
Published: May 2020

Abstract
Background: It has been demonstrated that cervicogenic headaches (CGH) is caused by dysfunction of the upper cervical spine. Due the soft tissue connection between muscle, cervical fascia and dura, this region might contribute to the development of CGH’s. This study evaluated if subjects with CGH have concurrent neural tension signs. The secondary aim of this study was to investigate if there is a correlation between the position of atlas and mobility of atlantoaxial joint in those experiencing cervicogenic headaches compared to a healthy control group.Methods: A convenience sample of 60 subjects were recruited for this study. Each subjected completed self-reported outcome measures, after which the passive neck flexion rotation test, upper limb tension test (ULTT), slump test, and straight leg raise test (SLR) was performed by the physical therapist.Outcomes: There was a significant difference in the passive atlantoaxial rotation to the right between the CGH and the control group p = 0.025. There was a no statistically significance in left rotation. There was no significant relationship between CGH and the ULTT, slump ad SLR with P > 0.05. The position of atlas was significantly related with CGH with P < 0.001 and position of atlas was significantly related to AA motion with p < 0.001Discussion: The results of this study demonstrate that there is a direct relationship between the position of atlas, unilateral restriction in AA rotation, and the presence of CGH’s. The presence of fascial connections between structures of the high cervical spine and the dura motion could result in dural tension and should be considered by physical therapists when managing patients with CGH. The use of the ULTT, Slump test, and SLR test do not appear beneficial identifying those with CGH.
Improving clinical outcomes and patient satisfaction among patients with coronary artery disease: an example of enhancing regional integration between a cardiac centre and a referring hospital
Authors: Veghel Dennis van , Hamad Mohamed Soliman , Schulz Daniela , Cost Bernard , Simmers Timothy , Dekker Lukas 
Published: May 2020

Abstract
Background Value-based healthcare (VBHC) is a promising strategy to increase patient value. For a successful implementation of VBHC, intensive collaborations between organizations and integrated care delivery systems are key conditions. Our aim was to evaluate the effects of a pilot study regarding enhancing regional integration between a cardiac centre and a referring hospital on patient-relevant clinical outcomes and patient satisfaction.Methods The study population consisted of a sample of patients treated for coronary artery disease by use of a coronary artery bypass graft or a percutaneous coronary intervention between 2011 and 2016. Since 2013, the two hospitals have implemented different interventions to improve clinical outcomes and the degree of patient satisfaction, e.g. improvement of communication, increased consultant capacity, and introduction of outpatient clinic for complex patients. To identify intervention effects, logistic regression analyses were conducted. Patients’ initial conditions, like demographics and health status, were included in the model as predictors. Clinical data extracted from the electronic health records and the hospitals’ cardiac databases as well as survey-based data were used.Results Our findings indicate a non-significant increase of event-free survival of patients treated between 2014 and 2016 compared to patients treated between 2011 and 2013 (97.4% vs. 96.7% respectively). This non-significant improvement over time has led to significant better outcomes for patients referred from the study referring hospital compared to patients referred from other hospitals. The level of patient satisfaction (response rate 32.2%;216 out of 669) was improved and reached statistically significant higher scores regarding patient information and education (p=.013), quality of care (p=.007), hospital admission and stay (p=.032), personal contact with the physician (p=.024), and total impression (p=.007).Conclusions This study shows a promising effect of regional integration. An intensified collaboration in the care chain, organized in a structured manner between a cardiac centre and a referring hospital and aiming at high quality, resulted in successful improvement of clinical outcomes and degree of patient satisfaction. The applied method may be used as a starting point of regional integration with other referring hospitals. We encourage others to organize the whole care chain to continuously improve patient-relevant outcomes and patient satisfaction.Trial registration: ISRCTN11311830. Registered 01 October 2018 (retrospectively registered)