bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Burden of Preventable Adverse Drug Events on Hospital Stay and Healthcare Costs in Japanese Pediatric Inpatients: The JADE Study
Authors: Iwasaki Hitoshi , Sakuma Mio , Ida Hiroyuki , Morimoto Takeshi 
Published: February 2021

Background: Adverse drug events (ADEs) are a burden to the healthcare system. Preventable ADEs, which was ADEs due to medication errors, could be reduced if medication errors can be prevent or ameliorate. Objective: We investigated the burden of preventable ADEs on the length of hospital stay (LOS) and costs, and estimated the national burden of preventable ADEs in pediatric inpatients in Japan. Methods: We analyzed data from the Japan Adverse Drug Events (JADE) study on pediatric patients and estimated the incidence of preventable ADEs and associated extended LOS. Costs attributable to extended LOS by preventable ADEs were calculated using a national statistics database and we calculated the effect of preventable ADEs on national cost excess. Results: We included 907 patients with 7377 patient-days. Among them, 31 patients (3.4%) experienced preventable ADEs during hospitalization. Preventable ADEs significantly increased the LOS by 14.1 days, adjusting for gender, age, ward, resident physician, surgery during hospitalization, cancer, and severe malformation at birth. The individual cost due to the extended LOS of 14.1 days was estimated as USD 8258. We calculated the annual extra expense for preventable ADEs in Japan as USD 329 676 760. Sensitivity analyses, considering the incidence of preventable ADEs and the length of hospital stay, showed that the expected range of annual extra expense for preventable ADEs in Japan is between USD 141 468 968 and 588 450 708. Conclusion: Preventable ADEs caused longer hospitalization and considerable extra healthcare costs in pediatric inpatients. Our results would encourage further efforts to prevent and ameliorate preventable ADEs.
BRAF, MEK and EGFR inhibition as treatment strategies in BRAF V600E metastatic colorectal cancer
Authors: Ros Javier , Baraibar Iosune , Sardo Emilia , Mulet Nuria , Salvà Francesc , Argilés Guillem , Martini Giulia , Ciardiello Davide , Cuadra José Luis , Tabernero Josep , Élez Elena 
Published: February 2021

Introduction: BRAF driver mutations are found in up to 15% of patients with colorectal cancer (CRC) and lead to constitutive activation of BRAF kinase and sustained RAS/RAF/MEK/ERK pathway signaling. BRAF mutations define a sub-population characterized by a poor prognosis and dismal median survival. Following successful outcomes with BRAF inhibition in BRAF mutant metastatic melanoma, this approach was evaluated in metastatic colorectal cancer (mCRC). The development and combination of targeted therapies against multiple signaling pathways has proved particularly successful, with improved survival and response rates. Areas covered: This review addresses the development of therapeutic strategies with inhibitors targeting MAPK/ERK and EGFR signaling in BRAF V600E mutated mCRC, focusing on encorafenib, binimetinib and cetuximab. A pharmacological and clinical review of these drugs and the therapeutic approaches behind their optimization are presented. Expert opinion: Exploiting knowledge of the mechanisms of resistance to BRAF inhibitors has been crucial to developing effective therapeutic strategies in BRAF-V600E mutant mCRC. The BEACON trial is a successful example of this approach, using encorafenib and cetuximab with or without binimetinib in patients with previously treated BRAF V600E mutant mCRC, showing an impressive improvement in clinical outcomes and tolerable toxicity compared with chemotherapy, establishing a new standard of care in this setting.
Comparison of the effectiveness of celiac versus common hepatic artery injection for the detection of hepatocellular carcinoma and of the feeding artery on cone-beam computed tomographs obtained during hepatic angiography
Authors: Hotta Akihiro , Ishikawa Masaki , Tachikake Toshihiro , Matsuura Noriaki , Toyota Naoyuki , Awai Kazuo 
Published: February 2021

Background Cone-beam computed tomography (CBCT) has been widely used during transcatheter arterial chemoembolization for hepatocellular carcinoma. Purpose To evaluate the sensitivity of CBCT for the detection of hepatocellular carcinomas and the tumor feeders by comparing celiac artery (CA) and common hepatic artery (CHA) injection. Material and methods We retrospectively enrolled 30 patients (52 hepatocellular carcinoma lesions) who had undergone CBCT-assisted transcatheter arterial chemoembolization. In 17 procedures (28 hepatocellular carcinomas) we acquired CBCT scans using CA injections (CBCT-CA) and in 18 (24 hepatocellular carcinomas) we used CHA injections (CBCT-CHA). Of the 30 patients, 5 underwent CBCT-CA and CBCT-CHA at different transcatheter arterial chemoembolization procedures. We performed inter-group comparisons of the detectability of hepatocellular carcinoma, the feeding artery, the intrahepatic artery branch order, and the tumor-to-liver contrast. Results CBCT-CA detected all 28 hepatocellular carcinomas and 27 of their feeders (96.4%); CBCT-CHA identified 22 of 24 hepatocellular carcinomas (91.7%) and 21 of their feeders (95.5%). There was no significant inter-group difference in the detectability of hepatocellular carcinoma lesions (p = 0.21) or feeding arteries (p = 0.69). CBCT-CHA was superior for the assessment of the tumor-to-liver contrast and the intrahepatic artery branch order (both: p < 0.01). Conclusion CBCT-CA and CBCT-CHA were equally useful for the detection of hepatocellular carcinoma and of the feeding artery, although CBCT-CHA yields better visualization of hepatocellular carcinoma and the hepatic artery. Thus CA injection seems sufficient for lesion and vessel detection when the insertion of an angiographic catheter into the CHA is difficult.
Comparison between turbo spin-echo and echo planar diffusion-weighted imaging of the female pelvis with 3T MRI
Authors: Yoshizako Takeshi , Yoshida Rika , Asou Hiroya , Nakamura Megumi , Kitagaki Hajime 
Published: February 2021

Background Echo-planar imaging (EPI)-diffusion-weighted imaging (DWI) may take unclear image affected by susceptibility, geometric distortions and chemical shift artifacts. Purpose To compare the image quality and usefulness of EPI-DWI and turbo spin echo (TSE)-DWI in female patients who required imaging of the pelvis. Material and Methods All 57 patients were examined with a 3.0-T MR scanner. Both TSE- and EPI-DWI were performed with b values of 0 and 1000 s/mm2. We compared geometric distortion, the contrast ratio (CR) of the myometrium to the muscle and the apparent diffusion coefficient (ADC) values for the myometrium and lesion. Two radiologists scored the TSE- and EPI-DWI of each patient for qualitative evaluation. Results The mean percent distortion was significantly smaller with TSE- than EPI-DWI ( p = 0.00). The CR was significantly higher with TSE- than EPI-DWI ( p = 0.003). There was a significant difference in the ADC value for the uterus and lesions between the EPI- and TSE-DWI ( p < 0.05). Finally, the ADC values of cancer were significantly different from those for the uterus and benign with both the two sequences ( p < 0.05). The scores for ghosting artifacts were higher with TSE- than EPI-DWI ( p = 0.019). But there were no significant differences between TSE- and EPI-DWI with regard to image contrast and overall image quality. Conclusion TSE-DWI on the female pelvis by 3T MRI produces less distortion and higher CR than EPI-DWI, but there is no difference in contrast and image quality.
“They Are Not Mixing With Others”: Finnish Lecturers’ Perspectives on International Students’ (Mis-)Encounters in Higher Education
Authors: Mendoza Carlos , Dervin Fred , Yuan (袁梅) Mei , Layne Heidi 
Published: February 2021

Purpose: Meeting “others,” especially so-called “local” students, is usually seen as a sign of success for intercultural learning and integration in research on study abroad and internationalization of higher education. Previous studies have focused on how international students themselves describe their (mis-)encounters. In this article, the authors consider lecturers’ voices about this phenomenon. Lecturers have an influence on the students’ experiences since they spend a lot of time together in and outside class. Design/Approach/Methods: Using a thematic analysis and social network analysis of interview data with lecturers, and a critical perspective toward the dichotomy of “local” versus “international” students, a university in Finland, a popular destination thanks to its positive image in global education, serves as a case study. Findings: The article identifies privileges, limits, and (missed) opportunities of encounters, as shared by the lecturers in focus group discussions. Furthermore, the lecturers created hierarchies in the way they described the encounters between different kinds of students. Some signs of pluralizing both local and international students were also found in some lecturers’ discourses. Originality/Value: The article ends with recommendations for institutions regarding the lecturers’ problematic role of gatekeepers in student encounters and the limiting categories used in institutions of higher education to refer to students.
Implementing Telemedicine Visits in an Underserved Ophthalmology Clinic in the COVID-19 Era
Authors: Adeli Mona , Bloom William R. 
Published: February 2021

Introduction: Many of the potential barriers to providing telehealth services already disproportionately impact vulnerable populations. The purpose of this study was to assess the incorporation of synchronous ophthalmology telemedicine visits in a tertiary university-based ophthalmology clinic for low-income and uninsured patients in the COVID-19 era. Methods: The records of 18 patients who were due for an in-person visit in the medically underserved patient clinic at our institute were reviewed. Patients considered high risk of ocular morbidity progression were approved to proceed with an in-person visit. Patients with non-urgent visit indications were attempted to be contacted by telephone to be offered a telemedicine telephone visit as an alternative to a postponed in-person office visit. Results: Clinical triage by an attending ophthalmologist determined that 17 patients (94.4%, n = 18) had visit indications appropriate for evaluation by telemedicine. Six patients (35.3%, n = 17) were successfully contacted and offered a telemedicine visit as an alternative to a postponed in-person office visit. All 6 patients accepted, scheduled, and completed a telemedicine visit. Eleven patients (64.7%, n = 17) were not able to be successfully contacted to offer and schedule either a telemedicine visit or a postponed in-person office visit. Patients who were not able to be successfully contacted were on average younger in age and more likely to be female, Hispanic/Latino, from Latin America, with a preferred language of Spanish. Conclusions: Synchronous ophthalmology telemedicine visits can be successfully incorporated in a tertiary university-based setting for low-income and uninsured patients. The primary barrier to providing telemedicine visits in this population was the ability to successfully contact patients to offer and schedule these visits.
Clinical Outcomes, Survivorship, and Return to Sport After Arthroscopic Capsular Repair With Suture Anchors for Adolescent Multidirectional Shoulder Instability: Results at 6-Year Follow-up
Authors: Mitchell Brendon C. , Siow Matthew Y. , Carroll Alyssa N. , Pennock Andrew T. , Edmonds Eric W. 
Published: February 2021

Background: Multidirectional shoulder instability (MDI) refractory to rehabilitation can be treated with arthroscopic capsulolabral reconstruction with suture anchors. To the best of our knowledge, no studies have reported on outcomes or examined the risk factors that contribute to poor outcomes in adolescent athletes. Purpose: To identify risk factors for surgical failure by comparing anatomic, clinical, and demographic variables in adolescents who underwent intervention for MDI. Study Design: Case series; Level of evidence, 4. Methods: All patients 20 years or younger who underwent arthroscopic shoulder surgery at a single institution between January 2009 and April 2017 were evaluated. MDI was defined by positive drive-through sign on arthroscopy plus positive sulcus sign and/or multidirectional laxity on anterior and posterior drawer tests while under anesthesia. A 2-year minimum follow-up was required, but those whose treatment failed earlier were also included. Demographic characteristics and intraoperative findings were recorded, as were scores on the Single Assessment Numeric Evaluation (SANE), Pediatric and Adolescent Shoulder Survey (PASS), and short version of the Disabilities of the Arm, Shoulder and Hand (QuickDASH). Results: Overall, 42 adolescents (50 shoulders; 31 female, 19 male) were identified as having undergone surgical treatment for MDI with minimum 2-year follow-up or failure. The mean follow-up period was 6.3 years (range, 2.8-10.2 years). Surgical failure, defined as recurrence of subluxation and instability, was noted in 13 (26.0%) shoulders; all underwent reoperation at a mean of 1.9 years (range, 0.8-3.2 years). None of the anatomic, clinical, or demographic variables tested, or the presence of generalized ligamentous laxity, was associated with subjective outcomes or reoperation. Number of anchors used was not different between shoulders that failed and those that did not fail. Patients reported a mean SANE score of 83.3, PASS score of 85.0, and QuickDASH score of 6.8. Return to prior level of sport occurred in 56% of patients. Conclusion: Adolescent MDI refractory to nonsurgical management appeared to have long-term outcomes after surgical intervention that were comparable with outcomes of adolescent patients with unidirectional instability. In patients who experienced failure of capsulorrhaphy, results showed that failure most likely occurred within 3 years of the index surgical treatment.
Gold particles from Kamchatka: A brief look at gold biogeochemical cycling in a distinct environment
Authors: Rea Maria Angelica D. , Brugger Joël , Etschmann Barbara , Okrugin Victor , Shuster Jeremiah 
Published: February 2021

AbstractKamchatka is a peninsula located on the far eastern side of Russia and is a geologically active region within the Pacific Ring of Fire. Placer gold particles were obtained from a stream located in the Yelizovsky District and were compared to particles from regions at similar latitudes. Russian gold particle surface textures and morphologies were characterised optically and using electron microscopy, and bacteria occurring on the surface of particles were inferred from detected amplicon sequence variants (ASVs). The gold particles contained remarkably variable gold surface textures with an average 70% of surface area containing clay-filled concavities. Particle morphologies, interpreted from axis ratios, suggested that these particles were transported from primary sources. Proteobacteria constituted 60% of all the detected ASVs from the particles. Within this phylum, Gammaproteobacteria was the most dominant class. This study contributes to the understanding of gold biogeochemical cycling in a distinct bioclimatic environment.
Control Performance Evaluation of Serial Urology Manipulator by Virtual Prototyping
Authors: Shi Hu , Li Jiajie , Guo Lianjie , Mei Xuesong 
Published: February 2021

AbstractProstatic hyperplasia and tumor are common diseases, and the minimally invasive surgery inserting the instruments through the urethra into the prostate is commonly conducted. Taking the robotic manipulator for such surgery into consideration, this paper analyses the workspace of the end effector, and proposes the distribution error of the fixed point and the tracking error of manipulator end effector on the cone bottom surface of the workspace as the basis for control implementation of the manipulator. The D-H coordinate system of the manipulator is established and the trajectory planning of the end effector in the Cartesian space is carried out. The digital model was established, and dynamics simulation was performed in Solidworks and Matlab/Simulink environment to guide the manipulator design. Trajectory mapping and synchronization control between virtual model and the actual manipulator are realized based on digital twin technique. The virtual manipulator can reflect the real-time state of the manipulator with data interaction by comparing the dynamics simulation results with the motor current values obtained by experiment. Experiment was carried out with PD feedback control and Newton–Euler dynamics based feedforward control to get the trajectory tracking characteristic of each motor, errors of the fixed point and tracking performance of the end effector of the manipulator. The results show that compared with PD feedback control, feed forward control implementation can achieve a reduction of 30.0% in the average error of the fixed point of the manipulator and a reduction of 33.3% in the maximum error.
Persumed sympathetic Ophthalmia after scleral buckling surgery: case report
Authors: Hosseini Seyedeh Maryam , Shoeibi Nasser , Azimi Zadeh Mahdieh , Ghasemi Mahdi , Abrishami Mojtaba 
Published: February 2021

Abstract
Background
Scleral buckling (SB) is usually considered an extraocular operation premeditated to have a low risk of sympathetic ophthalmia (SO). Here we report a rare case of presumed SO in a young female patient following SB.

Case presentation
A nineteen-year-old female patient was referred for visual loss in her left eye due to macula off inferior long-standing rhegmatogenous retinal detachment (RRD). The best corrected visual acuity (BCVA) was 20/400 in the left eye. SB with 360 degrees encircling band, an inferior segmental tire with one spot cryoretinopexy at the break site, and subretinal fluid drainage was performed. BCVA was improved to 20/80 and the retina was totally attached 1 week after the operation. The patient referred to the hospital 6 weeks later with severe visual loss in both eyes as counting finger 1 m. Patient examination indicated bilateral multifocal serous retinal detachment (SRD) and vitreous cells. The patient, diagnosed with SO, received intravenous corticosteroid pulse therapy and mycophenolate mofetil for treatment. The inflammation was controlled and SRD resolved after a 5-day intravenous treatment without being relapsed after 6 months. Consequently, BCVA became 20/20 and 20/50 in the right and left eye, respectively, after 6 months. The findings of systemic workup were negative for any extraocular disease or systemic involvement.

Conclusion
Since SB is a procedure without manipulating intraocular tissues, it is considered to impose a low risk for SO. This report presented SO occurrence after successful SB. Some factors may induce SO, including inciting the choroid and retinal pigment epithelium with cryoretinopexy or perforating for drainage.
Comprehensive analysis of immunoglobulin and clinical variables identifies functional linkages and diagnostic indicators associated with Behcet’s disease patients receiving immunomodulatory treatment
Authors: Cheng Linlin , Li Yang , Wu Ziyan , Li Liubing , Liu Chenxi , Liu Jianhua , Dai Jiayu , Zheng Wenjie , Zhang Fengchun , Tang Liujun , Yu Xiaobo , Li Yongzhe 
Published: February 2021

AbstractBackgroundBehcet’s disease (BD) is a relapsing systemic vascular autoimmune/inflammatory disease. Despite much effort to investigate BD, there are virtually no unique laboratory markers identified to help in the diagnosis of BD, and the pathogenesis is largely unknown. The aim of this work is to explore interactions between different clinical variables by correlation analysis to determine associations between the functional linkages of different paired variables and potential diagnostic biomarkers of BD.MethodsWe measured the immunoglobulin proteome (IgG, IgG1–4, IgA, IgA1–2) and 29 clinical variables in 66 healthy controls and 63 patients with BD. We performed a comprehensive clinical variable linkage analysis and defined the physiological, pathological and pharmacological linkages based on the correlations of all variables in healthy controls and BD patients without and with immunomodulatory therapy. We further calculated relative changes between variables derived from comprehensive linkage analysis for better indications in the clinic. The potential indicators were validated in a validation set with 76 patients with BD, 30 healthy controls, 18 patients with Takayasu arteritis and 18 patients with ANCA-associated vasculitis.ResultsIn this study, the variables identified were found to act in synergy rather than alone in BD patients under physiological, pathological and pharmacological conditions. Immunity and inflammation can be suppressed by corticosteroids and immunosuppressants, and integrative analysis of granulocytes, platelets and related variables is likely to provide a more comprehensive understanding of disease activity, thrombotic potential and ultimately potential tissue damage. We determined that total protein/mean corpuscular hemoglobin and total protein/mean corpuscular hemoglobin levels, total protein/mean corpuscular volume, and plateletcrit/monocyte counts were significantly increased in BD compared with controls (P < 0.05, in both the discovery and validation sets), which helped in distinguishing BD patients from healthy and vasculitis controls. Chronic anemia in BD combined with increased total protein contributed to higher levels of these biomarkers, and the interactions between platelets and monocytes may be linked to vascular involvement.ConclusionsAll these results demonstrate the utility of our approach in elucidating the pathogenesis and in identifying novel biomarkers for autoimmune diseases in the future.