bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinico-radiologic features and therapeutic strategies in tumefactive demyelination: a retrospective analysis of 50 consecutive cases
Authors: Vakrakou Aigli G. , Tzanetakos Dimitrios , Evangelopoulos Maria-Eleptheria , Argyrakos Theodore , Tzartos John S. , Anagnostouli Maria , Andreadou Elissavet , Koutsis Georgios , Velonakis Georgios , Toulas Panagiotis , Gialafos Elias , Dimitrakopoulos Antonios , Psimenou Erasmia , Stefanis Leonidas , Kilidireas Constantinos 
Published: May 2021

Aims: Our goal was to expand the spectrum of clinico-radiologic characteristics and the possible therapeutic choices in patients with tumefactive demyelinating lesions (TDLs). Methods: A retrospective analysis of 50 patients with at least one TDL was performed at an academic neurology center (2008–2020). Results: Our cohort comprised mostly women (33/50) with a mean age of 38 years at TDL onset. The mean follow-up time was 76 months. The mean Expanded Disability Status Scale score at TDL onset and at the latest neurological evaluation was 3.7 and 2.3, respectively. We subcategorized the patients into seven groups based mainly on the clinical/radiological findings and disease course. Group A included patients presenting with a Marburg-like TDL ( n = 4). Groups B and C comprised patients presenting with monophasic ( n = 7) and recurrent TDLs ( n = 12), respectively. Multiple sclerosis (MS) patients who subsequently developed TDL ( n = 16) during the disease course were categorized as Group D. Group E comprised patients who initially presented with TDL and subsequently developed a classical relapsing–remitting MS without further evidence of TDL ( n = 5). Groups F ( n = 2) and G ( n = 4) involved MS patients who developed TDL during drug initiation (natalizumab, fingolimod) and cessation (interferon, fingolimod), respectively. Regarding long-term treatments applied after corticosteroid administration in the acute phase, B-cell-directed therapies were shown to be highly effective especially in cases with recurrent TDLs. Cyclophosphamide was spared for more aggressive disease indicated by a poor response to corticosteroids and plasma exchange failure. Conclusion: Tumefactive central nervous system demyelination is an heterogenous disease; its stratification into distinct groups according to different phenotypes can establish more efficient treatment strategies, thus improving clinical outcomes in the future.
Patient-Tailored Decision Support System Improves Short- and Long-Term Glycemic Control in Type 2 Diabetes
Authors: Augstein Petra , Heinke Peter , Vogt Lutz , Kohnert Klaus-Dieter , Salzsieder Eckhard 
Published: May 2021

Background: The increasing prevalence of type 2 diabetes mellitus (T2D) and specialist shortage has caused a healthcare gap that can be bridged by a decision support system (DSS). We investigated whether a diabetes DSS can improve long- and/or short-term glycemic control. Methods: This is a retrospective observational cohort study of the Diabetiva program, which offered a patient-tailored DSS using Karlsburger Diabetes-Management System (KADIS) once a year. Glycemic control was analyzed at baseline and after 12 months in 452 individuals with T2D. Time in range (TIR; glucose 3.9-10 mmol/L) and Q-Score, a composite metric developed for analysis of continuous glucose profiles, were short-term and HbA1c long-term measures of glycemic control. Glucose variability (GV) was also measured. Results: At baseline, one-third of patients had good short- and long-term glycemic control. Q-Score identified insufficient short-term glycemic control in 17.9% of patients with HbA1c <6.5%, mainly due to hypoglycemia. GV and hyperglycemia were responsible in patients with HbA1c >7.5% and >8%, respectively. Application of DSS at baseline improved short- and long-term glycemic control, as shown by the reduced Q-Score, GV, and HbA1c after 12 months. Multiple regression demonstrated that the total effect on GV resulted from the single effects of all influential parameters. Conclusions: DSS can improve short- and long-term glycemic control in individuals with T2D without increasing hypoglycemia. The Q-Score allows identification of individuals with insufficient glycemic control. An effective strategy for therapy optimization could be the selection of individuals with T2D most at need using the Q-Score, followed by offering patient-tailored DSS.
Knowledge, attitudes and perceptions of radiology healthcare workers during the COVID-19 pandemic
Authors: Ooi Jolene Wei Ling , Er Amanda Tse Wern , Chong Choon Ming , Tsai Koh Tzan , Chong Mei Choo 
Published: May 2021

Background: Medical imaging is vital in the diagnostic workup and evaluation of patients suspected or confirmed to have COVID-19; hence, radiology healthcare workers (HCWs) were an essential part of the early containment response to the pandemic. Radiology services are facing rising demands to introduce stricter infection control measures, and staff are expected to adhere to the new protocols while coping with a surge in patients. Objectives: This study aims to identify the knowledge, attitudes and perceptions (KAPs) of radiology HCWs at a single site with regard to workplace preparedness during the COVID-19 pandemic. Methods: A 26-item questionnaire was conducted with radiographers, radiology nurses, and support staff who had direct patient contact. Questions were concerned with involvement in managing suspected or positive COVID-19 patients, knowledge of infection control measures, and attitudes and perceptions in relation to working during the pandemic. Results were analysed using t-tests, chi-square tests, and Spearman’s rank-order correlation, with statistical difference set at p<0.05. Results: Radiology HCWs self-reported significantly better knowledge of infection control measures and positive work attitudes. Those who had received the flu vaccine had significantly better perceptions of working during the pandemic. Suggested improvements included better organisational structure and more resources, better staff compliance and vigilance, better education, and a clearer focus on staff wellbeing. Conclusion: The findings indicate favourable KAPs among radiology HCWs in Singapore with regard to workplace preparedness during the pandemic, but efforts towards sustainability must be considered. Formulating policies to nurture motivated and resilient HCWs during a pandemic is advocated to foster a resilient workforce that is prepared for the next pandemic.
Long-term outcome of sexual function in sickle cell disease men with ischemic priapism: A systematic review
Authors: Attar Firas S , Mohammad Majed A , Almoamin Haithem HA 
Published: May 2021

Purpose: The purpose of this study was to have an accurate estimate about the sexual function of sickle cell disease adult men with previous history of recurrent attacks of ischemic priapism in childhood. We assessed the studies for their precise documentation for the erectile function in this group of patients. Materials and methods: We performed a systematic review of the literature by querying PubMed, Medline, and Cochrane. We included original studies on adult patients with sickle cell disease and history of ischemic priapism. Results: We identified 15,057 publications, of which 10 met the study inclusion criteria. The incidence of erectile dysfunction was reported up to 69.20% in one study. Conclusion: More extended prospective studies are required as multicenter studies to find the exact incidence of erectile dysfunction in men with sickle cell disease and priapism. Level of evidence: Level of evidence is not applicable for this systematic review.
Chest CT versus RT-PCR for the detection of COVID-19: systematic review and meta-analysis of comparative studies
Authors: Karam Mohammad , Althuwaikh Sulaiman , Alazemi Mohammad , Abul Ahmad , Hayre Amrit , Alsaif Abdulmalik , Barlow Gavin 
Published: May 2021

Objectives To compare the performance of chest computed tomography (CT) scan versus reverse transcription polymerase chain reaction (RT-PCR) as the reference standard in the initial diagnostic assessment of coronavirus disease 2019 (COVID-19) patients. Design A systematic review and meta-analysis were performed as per the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. A search of electronic information was conducted using the following databases: MEDLINE, EMBASE, EMCARE, CINAHL and the Cochrane Central Register of Controlled Trials. Setting Studies that compared the diagnostic performance within the same patient cohort of chest CT scan versus RT-PCR in COVID-19 suspected patients. Participants Thirteen non-randomised studies enrolling 4092 patients were identified. Main outcome measures Sensitivity, specificity and accuracy were primary outcome measures. Secondary outcomes included other test performance characteristics and discrepant findings between both investigations. Results Chest CT had a median sensitivity, specificity and accuracy of 0.91 (range 0.82–0.98), 0.775 (0.25–1.00) and 0.87 (0.68–0.99), respectively, with RT-PCR as the reference. Importantly, early small, China-based studies tended to favour chest CT versus later larger, non-China studies. Conclusions A relatively high false positive rate can be expected with chest CT. It is possible it may still be useful to provide circumstantial evidence, however, in some patients with a suspicious clinical presentation of COVID-19 and negative initial Severe Acute Respiratory Syndrome Coronavirus 2 RT-PCR tests, but more evidence is required in this context. In acute cardiorespiratory presentations, negative CT scan and RT-PCR tests is likely to be reassuring.
Consanguinity: A Form of Social Capital Among the Muslims of Char Areas in Barpeta District, Assam
Authors: Begum Gulrukh 
Published: May 2021

Information on the dynamics of consanguinity is always important for public health strategy. It provides a direct roadmap for healthcare providers and health policymakers to make people aware of the consequences of consanguinity. The present study aims to investigate the attitude of the Muslim people practising consanguinity in the char (river island) areas of Barpeta district in Assam. It intends to seek a cultural explanation behind the practice of consanguinity. The study was conducted cross-sectionally among the Muslims living in different villages of the temporary, semi-permanent and permanent river islands of Barpeta district in Assam. A total of 556 married couples were included in the study. Of these, 103 couples are consanguineous and the rest 453 are non-consanguineous. To study the prevalence of congenital disorders, a sample of 153 males and 121 female inbred children of the consanguineous couples and 701 male and 571 female children of the non-consanguineous parents have been included in the study. The prevalence of consanguineous marriage in the chars was found to be 18.53% and the average coefficient of inbreeding was 0.05996796. Of the consanguineous marriages, the most favoured type was between the first cousins (63.11%), followed by half first-cousin marriages (12.62%). Altogether 14.60% of inbred were found to have some type of congenital disorder against 0.31% non-inbred. In the chars of Barpeta, it is not only ignorance but poor economic condition is also a reason behind the practise of consanguinity. Consanguineous marriage provides means of escaping the expenditure incurred in dowry or bridewealth payment. With seasonal floods, river erodes their village and crops completely every year. Family remains the sole source of stability and security. Consanguineous marriage therefore forms a sort of social capital as they are a source of secured and stable married life in the most hostile ecological settings where these people are living. Social security is of utmost priority behind these marriages in the char.
Using Trust as a Resource for Social Value Creation: A Case of JanaJal
Authors: Kulshrestha Reeti , Sahay Arunaditya , Sengupta Subhanjan 
Published: May 2021

Research question: With the help of an instrumental research case on a social enterprise in India that provides a solution to those with none or limited access to fresh drinking water, this study aims to explore how trust helps create social value. Links to theory: At the theoretical level, the study draws upon ‘trust’ and ‘social value’ literature to examine how a social entrepreneur utilized trust as an enabler to creating social value. Phenomenon studied: The case developed deeper understanding of the phenomena of ‘trust helps creating social value’. Type of the case: It is an instrumental research case study that helps explore the phenomenon and draws connections between trust and social value creation if any. Case context: The case context is making affordable drinking water available to all, especially the community of people who are deprived of it. Findings: Conducting a series of in-depth interviews with the founder, we developed a better understanding of how the social entrepreneur used trust as a resource to create social value in the context of affordable drinking water. The findings showed how the protagonist (founder) worked on gaining trust of his beneficiaries and stakeholders to create social value. Findings also revealed the enablers and deterrents of trust in social value creation. Discussions: Our study shows how trust as a resource creates social value. In the context of our study, it contributes on how a social entrepreneur is creating social value not only by making affordable drinking water accessible to all but also deliver other social value creation benefits. The study brings out legitimacy, technology and social network as its enablers. The study also intends to fill the knowledge gap on how firms create social value by building trust with stakeholders and beneficiaries. Since little is known about trust even at the level of beneficiaries and stakeholders, our study aims to develop a better understanding of the phenomenon.
Consistency and Reliability of Ankle Stress Radiography in Patients With Chronic Lateral Ankle Instability
Authors: Choi Ji Hye , Choi Kug Jin , Chung Chin Youb , Park Moon Seok , Sung Ki Hyuk , Lee Kyoung Min 
Published: May 2021

Background: Ankle stress radiographs are important tools for evaluating chronic lateral ankle instability. The consistency of a patient’s ankle condition as it affects the reliability of ankle stress radiographs has never been evaluated. Purpose: To investigate the consistency and reliability of ankle stress radiographs in patients with chronic lateral ankle instability without an ankle injury during the study period. Study Design: Cohort study (diagnosis); Level of evidence, 3. Methods: Included were patients with chronic lateral ankle instability who underwent 2 repeated ankle stress radiographs between January 2014 and July 2019; those with an ankle injury during the study period were excluded. The tibiotalar tilt angle on varus stress radiographs and anterior translation of the talus on anterior drawer stress radiographs were measured at initial presentation and final follow-up examination. Interobserver reliability and consistency of ankle stress radiographs were analyzed using the intraclass correlation coefficient (ICC). Results: A total of 45 patients (mean ± standard deviation age, 36.4 ± 13.4 years; 18 men and 27 women; follow-up duration, 9.1 ± 3.2 months) were included. The mean ± standard deviation tibiotalar tilt angle and anterior talar translation at initial presentation were 10.8° ± 5.2° and 6.9 ± 2.7 mm, respectively. The interobserver reliabilities of the tibiotalar tilt angle and anterior talar translation were excellent (ICC = 0.926 [95% CI, 0.874-0.959] and 0.911 [95% CI, 0.766-0.961], respectively). The consistency between the initial and final radiographs was good for tibiotalar tilt angle (ICC = 0.763 [95% CI, 0.607-0.862]) and poor for anterior talar translation (ICC = 0.456 [95% CI, 0.187-0.660]). Conclusion: Although the interobserver reliability of the radiographic measurements was excellent, the consistency of the ankle stress radiographs was not as acceptable. Surgeons need to be cautious when deciding whether to operate on a patient with chronic lateral ankle instability based on a single ankle stress radiograph.
Magnitude and Determinants of Adverse Perinatal Outcomes in Tefera Hailu Memorial Hospital, Sekota Town, Northern Ethiopia
Authors: Seyoum Eshetu , Bekele Alemayehu , Tsegaye Adino Tesfahun , Birhanu Simon 
Published: May 2021

Background Of 133 million births globally, 3.7 million died in the neonatal period and 3 million are stillborn. The perinatal mortality rate in Ethiopia is 46 per 1000 pregnancies. However, area-specific information is limited in this regard. Therefore, this study aimed to determine the magnitude and determinants of adverse perinatal outcomes in Northern Ethiopia. Method An institution-based cross-sectional study was conducted by reviewing the medical records of mothers who gave birth between September 2015 and August 2016. The completeness and consistency of data were checked. Descriptive statistics were computed. A multinomial logistic regression model was fitted to identify determinants of adverse perinatal outcomes. Odds ratio with 95%CI was used and variables that had a P-value of < 0.05 in the final model were considered statistically significant. Result The magnitude of adverse perinatal outcomes was 214/799(27.47 %). Out of that, 10.8% had a perinatal mortality outcome, and 16.7% had a perinatal morbidity. Not using modern contraceptives(AOR = 1.7, 95% CI: 1.1-2.7), labor induction or augmentation(AOR = 3.0, 95% CI: 1.2-7.8), obstetric complications(AOR = 2.2, 95% CI: 1.1-4.5), attending antenatal care(AOR = 0.4, 95% CI: 0.2-0.8), primigravida (AOR = 0.5, 95% CI: 0.3-0.9), had no history of medical illness(AOR = 0.5, 95% CI: 0.3-0.8), and urban residency(AOR = 1.9, 95% CI, 1.1-2.9) were the significant determinants of perinatal outcome. Conclusion The magnitude of adverse perinatal outcomes was considerable and 1 in 5 neonates either had morbidity conditions or died. Improving family planning utilization, ANC, referral linkage, and management of obstetric complications could help to reduce the undesirable consequences of perinatal outcomes.
A Bibliometric Analysis of the Top 100 Cited Papers in Retinal Detachment
Authors: Asahi Masumi George , Pakhchanian Haig , Doepker Christine , Raiker Rahul , Gallemore Ron P. 
Published: May 2021

Purpose: This work aimed to identify and analyze the most frequently cited articles in retinal detachment (RD). Methods: Institute for Scientific Information’s Web of Science index (Thomas Scientific) was used to identify the top 100 most cited articles on RD between 1900 and 2019. Data from the top 100 most cited articles that met inclusion criteria were analyzed based on title, citation frequency, authorship, institution, journal, year of publication, and country of origin. Results: The top 100 articles in RD were cited 88 to 480 times. Steven K. Fisher was the most cited individual, with the University of California system being the most cited organization. Sixty-four percent of the top 100 articles originated from the United States and were published in the American Journal of Ophthalmology, Ophthalmology, and Archives of Ophthalmology at frequencies of 36%, 24%, and 11%, respectively. The top funding agencies included the US Department of Health and Human Services, the National Institutes of Health, and the National Eye Institute at 29%, 28%, and 27%, respectively. The top-cited article, which assessed the role of the retinal pigment epithelium by histologic and electron microscopic analysis of RDs in eyes of owl monkeys, was by Machemer and Laqua in the American Journal of Ophthalmology. Conclusions: This bibliometric analysis provides researchers and clinicians with a detailed overview of the most cited manuscripts in RD. Such analyses may guide researchers and funding agencies on important research areas in the field.
The Effect of Obstructive Sleep Apnea Treatment and Severity on Choroidal Thickness in Patients With Central Serous Chorioretinopathy
Authors: Azad Amee D. , Davila Jose R. , Rayess Nadim , Cao Michelle , Mruthyunjaya Prithvi , Pan Carolyn K. 
Published: May 2021

Purpose: This work aimed to analyze the association of obstructive sleep apnea (OSA) with choroidal thickness (CT) in patients with central serous chorioretinopathy (CSC). Methods: We identified patients in the Stanford Research Repository with a diagnosis of CSC and OSA. Age- and sex-matched controls with either CSC or OSA only were also identified. CT was measured at 5 points (subfoveal, and 1500 and 3000 µm nasal and temporal) by 2 graders. In addition to OSA treatment and severity, we also investigated the association of Oxygen Desaturation Index and nocturnal oxygen saturation nadir with subfoveal CT (SFCT). Results: A total of 57 patients and 72 eyes met the study inclusion criteria. The mean SFCT was significantly different across the 3 groups: OSA-only was the thinnest, followed by CSC with OSA, and CSC-only was the thickest (194.2 μm, 295.1 μm, and 357.8 μm, respectively, P < .001). SFCT was thicker in CSC with OSA compared with those with only OSA ( P < .05). OSA treatment status and OSA severity did not show a significant difference in SFCT in multivariable modeling. Nocturnal oxygen saturation nadir was positively associated with SFCT, but this did not reach significance.. Conclusions: SFCT is significantly different in patients with OSA alone, CSC with OSA, and CSC alone. While OSA treatment status did not demonstrate a significant difference in SFCT in this study, future studies should evaluate patients for OSA in patients known to have CSC and atypically thin CT to further investigate the novel metrics leveraged in this study.
Sulcus-Deepening Trochleoplasty for Trochlear Dysplasia
Authors: Ignozzi Anthony J. , Hyde Zane , Dart Scott E. , Diduch David R. 
Published: May 2021

Background: Patients who are refractory to initial management of trochlear dysplasia, which consists of bracing and physical therapy, may be candidates for trochleoplasty. Indications: Indications for trochleoplasty include Dejour classification type B or D trochlear dysplasia, supratrochlear spur height ≥7 mm, and a positive J sign on examination. Technique Description: The thick shell sulcus-deepening trochleoplasty technique involves removing the supratrochlear spur by creating a 5-mm–thick osteochondral shell with underlying cavity, dividing the thick shell into medial and lateral leaflets, and securing the leaflets with absorbable sutures. This establishes a new trochlear groove that is flush with the anterior cortex of the femur. Results: A review of 21 studies with length of follow-up from 8.8 months to 15 years found postoperative dislocation was present in 0% to 15% of patients and the patient satisfaction ranged from 81.0% to 94.4%. A prospective study with a minimum 2-year follow-up found no cases of recurrent dislocation, no progression of radiographic arthritis, 84.8% of patients returned to sport, and the patient satisfaction was a 9.1/10. Discussion/Conclusion: Sulcus-deepening trochleoplasty for trochlear dysplasia provides patellar stability and excellent patient satisfaction.