bluuebunny/crossref_metadata_2025_split huggingface dataset:
Partial Personalization of Medical Treatment Decisions: Adverse Effects and Possible Solutions
Authors: Weyant Christopher , Brandeau Margaret L. 
Published: May 2021

Background Personalizing medical treatment decisions based on patient-specific risks and/or preferences can improve health outcomes. Decision makers frequently select treatments based on partial personalization (e.g., personalization based on risks but not preferences or vice versa) due to a lack of data about patient-specific risks and preferences. However, partially personalizing treatment decisions based on a subset of patient risks and/or preferences can result in worse population-level health outcomes than no personalization and can increase the variance of population-level health outcomes. Methods We develop a new method for partially personalizing treatment decisions that avoids these problems. Using a case study of antipsychotic treatment for schizophrenia, as well as 4 additional illustrative examples, we demonstrate the adverse effects and our method for avoiding them. Results For the schizophrenia treatment case study, using a previously proposed modeling approach for personalizing treatment decisions and using only a subset of patient preferences regarding treatment efficacy and side effects, mean population-level health outcomes decreased by 0.04 quality-adjusted life-years (QALYs; 95% credible interval [crI]: 0.02–0.06) per patient compared with no personalization. Using our new method and considering the same subset of patient preferences, mean population-level health outcomes increased by 0.01 QALYs (95% crI: 0.00–0.03) per patient as compared with no personalization, and the variance decreased. Limitations We assumed a linear and additive utility function. Conclusions Selecting personalized treatments for patients should be done in a way that does not decrease expected population-level health outcomes and does not increase their variance, thereby resulting in worse risk-adjusted, population-level health outcomes compared with treatment selection with no personalization. Our method can be used to ensure this, thereby helping patients realize the benefits of treatment personalization without the potential harms.
Transrectal ultrasound features and biopsy outcomes of transition PI-RADS 5
Authors: Chung Jae Hoon , Park Byung Kwan 
Published: May 2021

Background Transition Prostate Imaging and Reporting and Data System (PI-RADS) 5 is easily detected owing to typical magnetic resonance imaging features. However, it is unclear as to how transition PI-RADS 5 appears on transrectal ultrasound (TRUS). Purpose To assess TRUS features of transition PI-RADS 5 and outcomes of TRUS-guided target biopsy. Material and Methods Between March 2014 and November 2018, 186 male patients underwent TRUS-guided biopsy of PI-RADS 5. Of them, 82 and 104were transition and peripheral PI-RADS 5, respectively. Transition and peripheral PI-RADS 5 were compared according to echogenicity (hyperechoic or hypoechoic) and hypoechoic rim (present or absent). Each tumor was targeted with TRUS based on TRUS features. Significant (Gleason score ≥7) and insignificant (Gleason score 6) cancer detection rates (CDRs) were compared between transition and peripheral PI-RADS 5. Standard reference was biopsy examination. Fisher’s exact test was used for statistical analysis. Results Transition PI-RADS 5 was hyperechoic in 89.0% (73/82) and had a hypoechoic rim in 97.6% (80/82), whereas peripheral PI-RADS 5 was hypoechoic in 99.0% (103/104) and had a hypoechoic rim in 26.9% (28/104) (both, P<0.0001). The significant CDRs of transition and peripheral PI-RADS 5 were 56.1% (46/82) and 65.4% (68/104), respectively ( P=0.2263). However, the insignificant CDRs of these categories were 22.0% (18/82) and 8.7% (9/104), respectively ( P=0.0123). Conclusion Transition PI-RADS 5 tends to have hyperechoic echogenicity and a hypoechoic rim. These findings help to target the transition PI-RADS 5 using TRUS. However, transition PI-RADS 5 is confirmed more frequently as insignificant cancer than peripheral PI-RADS 5.
Identification of adipose tissue-related predictors of the reduction in cardiovascular risk induced by metabolic surgery
Authors: Melchor-López Alberto , Suárez-Cuenca Juan Antonio , Banderas-Lares Diana Zaineff , Peña-Sosa Gustavo De la , Salamanca-García Moisés , Vera-Gómez Eduardo , Hernández-Patricio Alejandro , Gutiérrez-Buendía Juan Ariel , Zamora-Alemán Carlos Ramiro , Alcaráz-Estrada Sofía Lizeth , Ortiz-Fernández Moisés , Montoya-Ramírez Jesús , Gaytán-Fuentes Omar Felipe , Pérez-Cabeza de Vaca Rebeca , Escamilla-Tilch Mónica , Pineda-Juárez Juan Antonio , Téllez-González Mario Antonio , Mondragón-Terán Paul , Rodríguez-Arellano Martha Eunice , Contreras-Ramos Alejandra , García Silvia , Hernández-Muñoz Rolando Efraín 
Published: May 2021

Objectives We aimed to determine whether parameters associated with adipose tissue (adipocyte density and the circulating concentrations of markers of adipose tissue pathology) predict cardiovascular risk (CVR) modification after metabolic surgery (MS). Methods We performed a case–control study of patients with morbid obesity who were candidates for MS. CVR was defined using flow-mediated dilation (FMD) and carotid intima media thickness (CIMT), which were measured during the 9 months following MS. Subgroups of CVR reduction were defined using the following cut-offs: CIMT 10% and/or a two-fold increase in FMD. Results We studied 40 patients with morbid obesity (mean age 44.5 years, 75% women, mean body mass index 46.4 kg/m2) and high prevalences of the metabolically unhealthy obesity phenotype, hypertension, and diabetes mellitus. A significant reduction in CVR was associated with lower vascular endothelial growth factor-A concentration (6.20 vs. 1.59 pg/mL, respectively), low adipocyte density in visceral adipose tissue (100 vs. 80 cells/field), low infiltration with CD68+ cells (18 vs. 8 cells/field) and higher concentrations of lipid peroxidation markers and malondialdehyde (313.7 vs. 405.7 ng/mL). Conclusion The characteristics of adipose tissue and the circulating concentrations of markers of adipose pathology might represent useful predictors of the reduction in CVR following MS. Clinical trial registration number: NCT0356198 ( https://clinicaltrials.gov )
Clinical significance of extra-thyroid 99mTc-pertechnetate uptake before initial radioiodine therapy for differentiated thyroid carcinoma
Authors: Long Bin , Yao Li-Fang , Chen Shou-Cong , Shui Jin , Ye Xue-Mei , Yi He-Qing , Lou Cen 
Published: May 2021

Objective To analyse the clinical characteristics of extra-thyroid 99mTc-pertechnetate uptake in order to explore the effect of the phenomenon on radioactive iodine (RAI) therapy for differentiated thyroid carcinoma (DTC) and its clinical significance. Methods This study retrospectively selected patients with DTC and extra-thyroid 99mTc-pertechnetate uptake. The clinical features, location, location count and extra-thyroid 99mTc-pertechnetate uptake distribution were analysed, combined with the uptake rate, stimulated thyroglobulin (sTg) level, post-therapy whole-body scan and curative effect. Results A total of 38 patients were enrolled in the study and 65 extra-thyroid 99mTc-pertechnetate foci were detected. Thirty-four patients showed abnormal 99mTc-pertechnetate uptake in the lymph nodes (26 of 38; 68.4%), lungs (four of 38; 10.5%) and bones (four of 38; 10.5%). The corresponding uptake rates were 0.2%, 0.2% and 0.8%, respectively. The uptake rate and sTg were significantly positively correlated ( r = 0.36). 131I uptake was found in 36 patients at the 99mTc-pertechnetate uptake site. The number of iodine uptake foci was significantly higher than that of 99mTc-pertechnetate uptake foci. The sTg value and pathological staging significantly differed between the excellent and nonexcellent response groups (Z = –2.947 and Z = –2.348, respectively). Conclusion Extra-thyroid 99mTc-pertechnetate uptake mostly indicated metastases with specific clinical features, which may have prognostic value for the judgment of iodine uptake function and the RAI therapy plan.
Effect of differential hypoxia-related gene expression on glioblastoma
Authors: Lin Chao-Qun , Chen Lu-Kui 
Published: May 2021

Objective Glioblastoma (GB) is a refractory malignancy with a high rate of recurrence and treatment resistance. Hypoxia-related genes are promising prognostic indicators for GB, so we herein developed a reliable hypoxia-related gene risk scoring model to predict the prognosis of patients with GB. Method Gene expression profiles and corresponding clinicopathological features of patients with GB were obtained from the Cancer Genome Atlas (TCGA; n = 160) and Gene Expression Omnibus (GEO) GSE7696 (n = 80) databases. Univariate and multivariate Cox regression analyses of differentially expressed hypoxia-related genes were performed using R 3.5.1 software. Result Fourteen prognosis-related genes were identified and used to construct a risk signature. Patients with high-risk scores had significantly lower overall survival (OS) than those with low-risk scores. The median risk score was used as a critical value and for OS prediction in an independent external verification GSE7696 cohort. Risk score was not significantly affected by clinical-related factors. We also developed a prediction nomogram based on the TCGA training set to predict survival rates, and included six independent prognostic parameters in the TCGA prediction model. Conclusion We determined a reliable hypoxia-related gene risk scoring model for predicting the prognosis of patients with GB.
Comparison of three methods of Müller type C2 and C3 distal femoral fracture repair
Authors: Zhang Yadi , Xing Baorui , Hou Xiuxiu , Li Yunmei , Li Guoliang , Han Guangpu , Li Dongyue 
Published: May 2021

Background We compared the outcomes of three fixation techniques for Müller type C2 and C3 distal femoral fractures. Methods We retrospectively analyzed patients undergoing internal fixation for Müller type C2 and C3 distal femoral fractures via locking plate (Group A), lateral locking condylar plate and medial contoured reconstruction plate (Group B), and lateral locking condylar plate and anterior reconstruction plate (Group C). Knee joint functional recovery and functional outcomes were evaluated 12 months postoperatively. Results Patients included 34 men and 24 women aged 25 to 74 years (mean, 50.3 ± 10.73 years). Operating times were longest in Group B and similar in Groups A and C. Bleeding volume in Group A was smaller than in Group B and similar to that of Group C. Functional outcomes were excellent in 18 (31%) fractures, good in 24 (41%), moderate in 11 (19%), and poor in 5 (9%). Good-to-excellent results were achieved in 56%, 82%, and 83% of patients (Groups A, B, and C, respectively). Groups B and C's outcomes were superior to Group A's outcomes. No significant difference in postoperative complications between the groups existed. Conclusion Lateral locking condylar and anterior reconstruction plating was useful for complex type C distal femoral fractures.
Identification of miRNA-34a and miRNA-155 as prognostic markers for mantle cell lymphoma
Authors: He Jianxia , Xi Yanfeng , Gao Ning , Xu Enwei , Chang Jin , Liu Jie 
Published: May 2021

Objective MicroRNAs (miRNAs) with functional relevance have not been previously identified in mantle cell lymphoma (MCL). Here, we aimed to evaluate the relationships between miR-34a and miR-155-5p and MCL clinicopathology and prognosis. Methods Seventy-five paraffin-embedded tissue samples from patients with MCL who completed at least four cycles of chemotherapy from January 2006 to October 2016, and 27 samples from control patients with reactive lymphoid hyperplasia (RLH), were collected. MiRNA expression levels were measured by qRT-PCR. Results The miR-155-5p levels were significantly higher in patients with MCL than in the controls. The Eastern Cooperative Oncology Group (ECOG) ≥ 2 and Sex-Determining Region Y-Box transcription factor 11 (SOX11) < median value (M) groups presented lower miR-34a expression than the ECOG < 2 and SOX11 ≥ M groups, respectively. MiR-155-5p expression differed between low, intermediate, and high MCL International Prognostic Index risk groups. The AUCs of miR-34a and miR-155-5p were 0.5819 and 0.7784, respectively. The median survival times of the miR-34a ≤ 0.2150 and miR-155-5p > 2.11 groups were shorter than those of the miR-34a > 0.2150 and miR-155-5p ≤ 2.11 groups, respectively. Conclusions Low miR-34a and elevated miR-155-5p levels may be correlated with poor prognosis in MCL.
Size selection of the Ambu AuraOnce laryngeal mask in Chinese men weighing >70 kg: a pilot study
Authors: Chen Jiahui , Chen Chunhuan , Xu Wei , Zhang Xiaoguang 
Published: May 2021

Objective To collect computed tomography data of the laryngeal anatomy of Chinese men and to determine the feasibility of using the size 4 Ambu AuraOnce laryngeal mask (Ambu A/S, Copenhagen, Denmark) in Chinese men weighing >70 kg. Methods This prospective study involved men who underwent surgery from May 2018 to January 2019 at Jinshan Hospital. Pharyngeal and laryngeal parameters were measured by computed tomography. The laryngeal mask insertion success rate, requirement for tracheal tube insertion, laryngeal mask insertion time, fiberoptic bronchoscopy grading, air leakage pressure, and pharyngeal complications were analyzed. Results In a comparison of the size 4 and 5 Ambu AuraOnce devices, the first insertion success rate was 100% and 87% and the three-times insertion success rate was 100% and 93%, respectively, with no significant differences. However, the insertion time was significantly different at 19.6 ± 5.9 versus 31.1 ± 11.2 s, respectively, and the proportions of fiberoptic grading levels were also significantly different. There were no significant differences in the air leakage pressure or pharyngeal complications. Conclusion The size 4 Ambu AuraOnce is more adequate than the size 5 for Chinese men weighing >70 kg, with a shorter insertion time and higher fiberoptic bronchoscopic grading.
Buccal swabs as non-invasive specimens for detection of severe acute respiratory syndrome coronavirus-2
Authors: Gaur Ritu , Verma Dipesh Kumar , Mohindra Ritin , Goyal Kapil , Gupta Shipra , Singla Vidhi , Sahni Vaibhav , Ghosh Arnab , Soni Roop Kishor , Bhalla Ashish , Gauba Krishan , Singh Mini P. 
Published: May 2021

Introduction The current gold standard for detection of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) RNA involves subjecting nasopharyngeal or oropharyngeal swabs to reverse transcription quantitative PCR (RT-qPCR). However, both sample types need to be collected by trained professionals. Using self-collected buccal swabs as an alternative could simplify and accelerate diagnosis of coronavirus disease 2019 (COVID-19). Objective To assess self-collected buccal swab samples as an alternative method for SARS-CoV-2 detection in patients with COVID-19. Methods Buccal swab samples were self-collected by 73 patients with COVID-19. Total RNA was extracted using Qiagen kits. RNA encoding the SARS-CoV-2 Env protein and human RNase P as an internal control was amplified using the TRUPCR® SARS-CoV-2 RT-qPCR kit version 2.1 and a Bio-Rad CFX96 Real-Time Detection System. Result The sensitivity of RT-qPCR from buccal swabs was 58.9% (43/73; 95% confidence interval [CI] 46.77%–70.27%) and that of RT-qPCR from saliva was 62.90% (39/62; 95% CI 49.69%–74.84%) taking positive SARS-CoV-2 RT-qPCR from nasopharyngeal swabs as the gold standard. Conclusion Self-collected buccal swabs are promising alternatives to nasopharyngeal or oropharyngeal swabs for SARS CoV-2 detection.
The microbiological profile of patients with Fournier’s gangrene: A retrospective multi-institutional cohort study
Authors: Cipriani Chiara , Iacovelli Valerio , Sandri Marco , Bertolo Riccardo , Maiorino Francesco , Antonucci Francesco , Micali Salvatore , Rocco Bernardo , Puliatti Stefano , Ferrarese Paolo , Benedetto Giuseppe , Minervini Andrea , Cocci Andrea , Pastore Antonio Luigi , Al Salhi Yazan , Antonelli Alessandro , Morena Tonino , Volpe Alessandro , Poletti Filippo , Celia Antonio , Zeccolini Guglielmo , Leonardo Costantino , Proietti Flavia , Finazzi Agrò Enrico , Bove Pierluigi 
Published: May 2021

Objectives: To evaluate the role of the microbiological profile and of disease-related factors in the management of patients affected with Fournier’s gangrene (FG). Patients and methods: Data regarding patients admitted for FG at nine Italian Hospitals (March 2007–June 2018) were collected. Patients were stratified according to the number of microorganisms documented: Group A – one microorganism; Group B – two microorganisms; Group C – more than three microorganisms. Baseline blood tests, dedicated scoring systems, predisposing risk factors, disease’s features, management and post-operative course were analyzed. UpSet technique for visualizing set intersections in a matrix layout and Cuzick’s nonparametric test for trend across ordered groups were used. Results: Eighty-one patients were available for the analysis: 18 included in Group A, 32 in Group B, 31 in Group C. The most common microorganism isolated was Escherichia coli. In Group B-C, Escherichia coli was often associated to Enterococcus faecalis, Pseudomonas aeruginosa, and Klebsiella pneumoniae. Statistically significant positive association was highlighted among the number of pathogens (Group A vs B vs C) and serum C-reactive Protein ( p < 0.001), procalcitonin ( p = 0.02) and creatinine ( p = 0.03). Scoring systems were associated with the number of microorganisms detected ( p < 0.02). A significant association between the number of microorganisms and the use of VAC therapy and need of a fecal diversion was found ( p < 0.02). The number of microorganisms was positively associated with the length of stay (LOS) ( p = 0.02). Ten weeks after initial debridement, wound closure was achieved in 11 (91.7%), 22 (84.6%) and 20 (80%) patients in Group A, B, and C, respectively, with no differences in overall survival. Conclusion: Polymicrobial infections in FG are positively associated with inflammatory scores, the need for fecal diversion and the LOS. This results may help the counseling and the clinical management of this rare niche of patients.
Every nephron deserves a second chance before nephrectomy in obstructed uropathy due to urolithiasis
Authors: Tonyali Senol , Ortac Mazhar , Dursun Murat 
Published: May 2021

Objective: In this case report, we aimed to present our clinical experience in a patient with hydronephrotic and atrophic kidney due to impacted lower ureteral stone. Case description: A 56-year-old male was admitted to our emergency department with flank pain and nausea. A computed tomography scan revealed a 3 cm stone at the distal ureter, causing severe hydroureteronephrosis. Right kidney parenchyma was extremely thin at the medial zone, and some parenchyma was apparent at the upper and lower poles. We planned renal scintigraphy, but it was impossible to perform quickly due to the active appointment list. The patient’s kidney was assumed to be atrophic/non-functioning; however, given the long waiting list for renal scintigraphy and the patient’s intractable pain, we decided to relieve the patient’s pain with urinary drainage. Nephrostomy insertion was denied because of the extra thin parenchyma. About 40 days later, the patient underwent semi-rigid ureterorenoscopy under spinal anesthesia. It was impossible to place a double J stent to the ureter because of the kinked and extremely dilated ureter. So, we decided to place an open-end 6Fr ureter catheter. DMSA renal scintigraphy showed 33% right kidney and 67% left kidney function. Conclusion: Intractable flank pain might be a predictor of functioning renal parenchyma in hydronephrotic/atrophic kidneys. Renal split function lower than 10% on DMSA scintigraphy might not be an absolute indication of nephrectomy, especially in the obstructed renal unit. Evaluation of renal function after eliminating obstruction might be more reliable.
A Qualitative Review of What Forensic Mental Health Nurses Include in Their Documentation
Authors: Martin Krystle , Ricciardelli Rosemary 
Published: May 2021

Background Documentation of mental health care is a critical component of nursing practice. Despite being identified as playing a critical role, researchers continue to question the quality of nursing documentation and missing and/or inaccurate information. Purpose Our aim is to explore the content of nursing documentation among mental health nurses providing care to forensic inpatients. Methods Using a constructed semi-grounded emergent theme approach for data analysis, we reviewed the types of activities, subjects, and interactions described within nursing notes and identified themes of the content. Results Our results demonstrate that nursing documentation could be categorized into one of seven themes: interactions, food, activities, sleep, mental health, physical health and hygiene. These areas were not consistent with the recommendations from nursing bodies in Canada, specifically the areas of assessment, planning, implementation, and evaluation. Furthermore, missing in the nursing notes is context. Conclusions The discussion highlights the importance of nursing documentation within the context of best practice, bias, and the impact on patient care. We also discuss missing information (context, clinical relevance, and case conceptualization), and suggest that nurses are not injecting this expertise in patient notes. Clinical implications for documentation practices are presented in relation to education and reflective practice.
Domestic Violence Victimization among South Asian Immigrant Men and Women in the United States
Authors: Rai Abha , Choi Y. Joon 
Published: May 2021

Domestic violence is a pernicious social problem in the United States and a cause of national concern. The South Asian culture disempowers individuals experiencing domestic violence from recognizing and reporting victimization. Structural inequities may also discourage reporting victimization. These issues have led to inconsistent findings of domestic violence prevalence rates. Additionally, domestic violence studies with South Asians in the United States have predominantly focused on women, omitting men from this purview of research. The purpose of this study was to examine domestic violence victimization rates as well as their correlates among South Asian immigrant men and women. The sample for this cross-sectional study included 468 South Asians across the 50 U.S. states. Descriptive statistics were used to establish rates of domestic violence victimization. Hierarchical logistic regression was used to examine the correlates of domestic violence victimization. All of the sociodemographic information was added in step 1, and acculturation and gender-role attitudes were added as covariates in step 2. The most prevalent type of domestic violence victimization was physical violence (48%), followed by emotional (38%), economic (35%), verbal (27%), immigration-related (26%), in-laws related (19%), and ultimately sexual abuse (11%). Prevalence rates were higher for women than for men in each type of violence. According to the logistic regression results, education, generational position, family type, and employment were significant correlates of domestic violence victimization. Prior to development of prevention programs by community agencies, it is essential to understand the nature and prevalence of domestic violence experiences among South Asians. The victimization of men in addition to women adds to the novelty of this research study and paves the way for practitioners and scholars to engage in conversations about providing both male and female victims of domestic violence with the needed resources and support. The article will discuss implications for research, practice, and policy.