bluuebunny/crossref_metadata_2025_split huggingface dataset:
Changes in the Oral Health-Related Quality of Life in Infants With Cleft Lip and/or Palate Before and After Surgical Treatment
Authors: López Ramos Roxana Patricia , Victorio Daniel José Blanco , Ramos Gilmer Torres , Pajuelo Mónica J. , Abanto Jenny 
Published: February 2021

Objective: To assess oral health-related quality of life (OHRQoL) changes before and after the primary surgical treatment in infants with cleft lip and/or palate (CL/P). Design: Quasi-experimental study. Methods: A total of 106 infants with CL/P younger than 2 years undergoing primary surgical treatment in the Plastic Surgery Service of the Instituto Nacional de Salud del Niño in Peru. The parent/caregiver answered a questionnaire about OHRQoL named the Peruvian version of the Early Childhood Oral Health Impact Scale (P-ECOHIS) in the pretreatment (baseline) and follow-up post-treatment. The total score of P-ECOHIS and their 2 sections (child impact and family impact) in the baseline and each follow-up period post-treatment scores were assessed. As well as, the type of the CL/P on OHRQoL, standardized effect sizes (ES) based on mean total change scores (difference between baseline and 12th month) were analyzed. Results: Improvements in infant’s OHRQoL after treatment were reflected in each follow-up period P-ECOHIS score compared to the baseline score. The total P-ECOHIS scores decreased significantly from 28.07 (baseline) to 7.7 (12th month; P < .0001), as did the individual domain scores ( P < .0001). There were significant differences in the baseline and follow-up post-treatment scores of infants who reported improvement of the OHRQoL ( P < .0001). The ES was large (3.79). The cleft lip had an improvement in the OHRQoL at 12th month post-treatment ( P < .0001). Conclusions: Primary surgical post-treatment resulted in significant improvement of the infant’s OHRQoL with CL/P.
Risk Reduction and Perioperative Complications in Patients With Diabetes and Multiple Medical Comorbidities Undergoing Charcot Foot Reconstruction
Authors: Lyons Madeline , McGregor Patrick Cole , Pinzur Michael S. , Adams William , Wilkos-Prostran Lynette 
Published: February 2021

Background: Modern patient safety programs focus on medical optimization of patients prior to surgery, regional anesthesia when possible, and hospitalist-orthopedic co-management during the perioperative period. Methods: Eighty-five consecutive patients with diabetes and multiple medical comorbidities underwent surgical reconstruction for acquired deformities secondary to Charcot foot arthropathy with circular ring fixation between 2016 and 2019. All patients participated in a standardized risk reduction program that included medical optimization prior to surgery, regional anesthesia whenever possible, and hospitalist-orthopedic co-management during the perioperative period. Charts were retrospectively reviewed for medical comorbidities, complications, and length of stay. The American College of Surgeons (ACS) National Surgical Quality Improvement Program (NSQIP) Risk Calculator was used to retrospectively calculate their predicted perioperative risk. Results: On multivariable analysis, longer lengths of stay were associated with low preoperative hemoglobin values (rate ratio [RR], 1.36; P = .01) and congestive heart failure (RR, 1.42; P = .02). There were 22 (26%) complications, though only 10 (12%) were serious. These included acute kidney injury ( n = 6), sepsis ( n = 2), 1 cardiac event, and 1 pulmonary embolism. Overall, the accuracy of predicting a complication using the ACS NSQIP Risk Calculator was 74% (95% CI, 63%-85%), which was comparable to the accuracy of predicting a complication using only patients’ congestive heart failure and pin-tract infection statuses ( c = 74%, 95% CI, 62%-86%). Discussion: Medical optimization of patients with diabetes and multiple medical comorbidities prior to elective complex reconstruction orthopedic surgery allows the surgery to be performed with a predictable risk for perioperative complications. Preoperative anemia and congestive heart failure are associated with longer hospitalizations in this patient group. The ACS NSQIP Risk Calculator appears to be a reliable predictor of complications during the perioperative period. This study demonstrates that reconstructive surgery in this complex patient population can be accomplished with a reasonable exposure to perioperative risk. Level of Evidence: Level IV, retrospective case series.
The Selection of Treatment Modality for Breast Ductal Carcinoma In Situ: Experience From a Single Institution
Authors: You Kai-yun , Bi Zhuo-fei , Ma Yu-jia , Mao Yong-lin , Zou Wei-liang , Liu Yi-min , Yao He-rui 
Published: February 2021

Purpose: Although breast conservation surgery(BCS) followed by adjuvant radiotherapy is now the mainstream treatment method for breast ductal carcinoma in situ(DCIS), mastectomy is still performed in some patients who refuse to undergo radiation. However, the most effective treatment method for these patients is still unknown. In the current study, we aimed to compare the survival rates between mastectomy and BCS plus adjuvant radiotherapy in patients with DCIS. Materials and Methods: We performed a retrospective study of 333 patients with DCIS from May 2004 to December 2016. There were 209 patents who were treated with BCS and adjuvant radiotherapy, while the remaining of 124 patients underwent mastectomy. The disease-free survival (DFS) and local recurrence-free survival(LRFS) rates were compared between the 2 treatment groups. Cox proportional hazards regression was performed to explore factors associated with DFS and LRFS. Results: The 10-year local recurrence(LR) rates in the mastectomy and BCS plus adjuvant radiotherapy groups were 2.6% and 7.5%, respectively. There was no difference in the LR rate between the 2 groups. Furthermore the DFS rate was also similar between the mastectomy and BCS plus adjuvant radiotherapy groups. Based on the multivariable analysis, age and tumor grade were significantly correlated with the LRFS and DFS rates. In the subgroup analysis based on the factors of age and tumor grade, patients with a tumor grade of III who underwent mastectomy had better LRFS and DFS rates compared to those who received BCS plus radiotherapy. Conclusion: In patients with DCIS, the long-term efficacy was similar between mastectomy and BCS followed by adjuvant radiotherapy. However, in the subgroup of patients with grade III tumors, mastectomy seems to offer a better LRFS and DFS than BCS plus radiotherapy.
Use of magnetic resonance venography for inferior petrosal sinus sampling
Authors: Tokairin Kikutaro , Osanai Toshiya , Fujima Noriyuki , Ishizaka Kinya , Motegi Hiroaki , Ishi Yukitomo , Kameda Hiraku , Sugiyama Taku , Kazumata Ken , Nakayama Naoki 
Published: February 2021

Background: Inferior petrosal sinus (IPS) sampling (IPSS) is a transvenous interventional procedure performed to diagnose Cushing’s disease. The reported IPSS failure rate is approximately 10% because IPS catheter delivery is conducted blindly and is challenging because of IPS anatomical variations. This study aimed to evaluate the usefulness of preprocedural magnetic resonance venography (MRV) for assessing IPS access routes before IPSS. Methods: Nineteen consecutive patients who underwent IPSS at a single university hospital in Japan were retrospectively studied. A preprocedural MRV protocol optimized to visualize the IPS before IPSS was established and utilized in the eight most recent cases. An IPSS procedure was considered successful when bilateral IPS catheterization was accomplished. Patient demographics, IPSS success rate, and radiation dose required during IPSS were compared between two groups: MRV group ( N = 8) and no-MRV group ( N = 11) before IPSS. Results: There were no significant differences in age, sex, and IPSS success rates between the groups. The average radiation dose was 663.6 ± 246.8 (SD) mGy and 981.7 ± 389.5 (SD) mGy in the MRV group and no-MRV group, respectively. Thus, there was a significant reduction in radiation exposure in the MRV group ( p = 0.044). Catheterization of the left IPS was unsuccessful in only one patient in the MRV group owing to IPS hypoplasty, as found on the MRV. Conclusions: Hypoplastic IPSs occur in patients and can complicate IPSS. Preprocedural MRV assessment is useful for understanding venous anatomy and preventing unnecessary intravenous catheter manipulation during IPSS, which involves blind manipulation around the IPS.
Radioembolization With Holmium-166 Polylactic Acid Microspheres: Distribution of Residual Activity in the Delivery Set and Outflow Dynamics During Planning and Treatment Procedures
Authors: Drescher Robert , Seifert Philipp , Gühne Falk , Aschenbach René , Kühnel Christian , Freesmeyer Martin 
Published: February 2021

Purpose: To evaluate the microsphere outflow dynamics and residual Ho-166 activity during and after transarterial radioembolization planning and treatment procedures, and to assess the distribution and predilection sites of residual activity in the proprietary delivery set and the microcatheter. Materials and Methods: Fifteen planning and 12 therapeutic radioembolization procedures were performed with poly-l-lactic acid microspheres loaded with Ho-166. The amount and distribution of residual activity was assessed by dose calibrator measurements and SPECT imaging. The activity flow profile from the microcatheter was assessed dynamically. For planning procedures, different injection methods were evaluated in order to attempt to decrease the residual activity. Results: The median residual activities for planning and treatment procedures using standard injection methods were 31.2% (range 17.3%–44.1%) and 4.3% (range 3.5%–6.9%), respectively. Planning residual activities could be decreased significantly with 2 injection methods similar to treatment procedures, to 17.5% and 10.9%, respectively ( P = 0.002). Main predilection sites of residual microspheres were the 3-way stopcock and the outflow needle connector. During treatment procedures, more than 80% of the injected activity is transferred during the first 3 injection cycles. Conclusion: After treatment procedures with holmium-loaded microspheres, mean residual activity in the delivery set is reproducibly low and between reported values for glass and resin microspheres. The majority of microspheres is transferred to the patient during the second and third injection cycle. An estimated residual waste of 3% to 4% may be included in the treatment activity calculation. For planning procedures, a modified injection technique should be used to avoid high residual activities.
Are restricted mean survival time methods especially useful for noninferiority trials?
Authors: Freidlin Boris , Hu Chen , Korn Edward L 
Published: February 2021

Background: Restricted mean survival time methods compare the areas under the Kaplan–Meier curves up to a time [Formula: see text] for the control and experimental treatments. Extraordinary claims have been made about the benefits (in terms of dramatically smaller required sample sizes) when using restricted mean survival time methods as compared to proportional hazards methods for analyzing noninferiority trials, even when the true survival distributions satisfy proportional hazardss. Methods: Through some limited simulations and asymptotic power calculations, the authors compare the operating characteristics of restricted mean survival time and proportional hazards methods for analyzing both noninferiority and superiority trials under proportional hazardss to understand what relative power benefits there are when using restricted mean survival time methods for noninferiority testing. Results: In the setting of low-event rates, very large targeted noninferiority margins, and limited follow-up past [Formula: see text], restricted mean survival time methods have more power than proportional hazards methods. For superiority testing, proportional hazards methods have more power. This is not a small-sample phenomenon but requires a low-event rate and a large noninferiority margin. Conclusion: Although there are special settings where restricted mean survival time methods have a power advantage over proportional hazards methods for testing noninferiority, the larger issue in these settings is defining appropriate noninferiority margins. We find the restricted mean survival time methods lacking in these regards.
Commoning Against the Corona Crisis
Authors: Lijster Thijs , De Tullio Maria Francesca 
Published: February 2021

The Covid-19 crisis has highlighted the ‘precarity’ of human life in general, and particularly that of certain groups in society. It has debunked the myth of the autonomous, self-sufficient individual, and shows the extent to which we always already live ‘in common’, thereby also emphasizing the necessity of commons (of care, nurture, and economic resources). This research explores what role commons, as an antidote to precarity and a form of resistance against governmental precarization, can play in the current situation. We start by analyzing the relationship between precarity and commons in light of the Covid-19 crisis. On the basis of participant observation in Naples (Italy) we will describe the commoning activities during the pandemic, their governmental invisibilization, and the way in which they could be institutionally recognized as a vital action of care and solidarity, also beyond the emergency. Finally, in the last part, we draw on the work of Roberto Esposito, and his use of the terms community and immunity, arguing that precisely because of the impossibility of fully immunizing ourselves from the virus (and from each other) we have to consider ourselves as part of a community, bound not by shared properties but by a shared obligation.
Trace elements in patients with aortic valve sclerosis
Authors: Al-Taesh Hataw , Çelekli Abuzer , Sucu Murat , Taysi Seyithan 
Published: February 2021

Background: Aortic valve sclerosis (AVSc) is defined as the thickening and calcification of aortic valve cusps, in the absence of obstruction of ventricular outflow. AVSc is linked with a clear imbalance in some trace elements. Aims: The objective of this study was to investigate the relationship between AVSc and serum levels of iron (Fe), zinc (Zn), selenium (Se), and copper (Cu). Additionally, this research aimed to explore the clinical significance of human serum zinc, selenium, copper, and iron concentrations as a potential new biomarker for AVSc patients and to clarify the pathophysiological role in individuals at risk of developing AVSc. Patients and methods: The study included 40 subjects with AVSc (25% male and 75% female) who were compared with a healthy control group with the same gender ratio. AVSc was based on comprehensive echocardiographic assessments. Blood samples were taken and Zn and Cu concentrations were determined through the use of atomic absorption spectroscopy. Se was measured using an inductively coupled plasma mass spectrometry device and Fe was measured using a Beckman Coulter instrument. Results: There was a significant difference in the prevalence of diabetes, blood pressure levels, and body mass index between the patients and the healthy subjects ( p < 0.05). The differences between the serum Fe, Se, and Cu levels of the AVSc patients and the healthy subjects ( p > 0.05) were recorded. The serum Zn of AVSc patients when compared was significantly lower compared with that of the control group ( p < 0.01). Conclusion: Patients with AVSc had an imbalance in some of the trace elements in their blood. The patient group’s valves had higher serum Cu levels and lower serum Se, Zn, and Fe concentrations compared with the healthy group’s valves. In the valve patients as compared, AVSc had a high prevalence of obesity, hypertension, and diabetes.
Circular RNA‐HIPK3 regulates human pulmonary artery endothelial cells function and vessel growth by regulating microRNA‐328‐3p/STAT3 axis
Authors: Hong Liuqing , Ma Xiaoying , Liu Jiyuan , Luo Yinzhu , Lin Jincai , Shen Ying , Zhang Liyan 
Published: February 2021

The proliferation and migration of pulmonary artery endothelial cells are the pathological basis of pulmonary vascular remodeling with pulmonary hypertension. Recent studies have shown that circular RNA (circRNA) regulates biological processes in various vascular diseases, including pulmonary arterial hypertension. It has been reported that circRNA regulates the vascular endothelial cells’ function. Therefore, circRNA may have crucial roles in human pulmonary artery endothelial cells (hPAECs) proliferation, migration, and tube formation in pulmonary arterial hypertension. In this study, we aimed to discover the role and mechanism of circular RNA HIPK3 (circHIPK3) in the proliferation and migration of pulmonary hypertension hPAECs. First, we used platelet‐derived growth factor—stimulated hPAECs as a cellular model of pulmonary arterial hypertension. The results showed that platelet‐derived growth factor promoted hPAECs proliferation, migration, and tube formation. Notably, platelet‐derived growth factor upregulated the expression of circHIPK3 in hPAECs and regulated their proliferation, migration, and angiogenesis. Mechanistically, we confirmed miR‐328‐3p was copiously pulled down by circHIPK3 in hPAECs. Luciferase reporter and RNA immunoprecipitation assays further indicated the cytoplasmic interactions between circHIPK3 and miR‐328‐3p. Subsequently, we found that circHIPK3 might increase the expression of STAT3 by sponging miR‐328‐3p. Collectively, our results demonstrated that the circHIPK3‐miR‐328‐3p‐STAT3 axis contributed to the pathogenesis of pulmonary arterial hypertension by stimulating hPAECs proliferation, migration, and angiogenesis. The circHIPK3 has an accelerated role in pulmonary arterial hypertension development, implicating the potential values of circHIPK3 in pulmonary arterial hypertension therapy.
Adolescents’ and young adults’ experiences of a prototype cancer smartphone app
Authors: Hanghøj Signe , Boisen Kirsten A , Hjerming Maiken , Pappot Helle 
Published: February 2021

Objective Smartphone cancer-related apps have been shown to meet some of the needs of adolescents and young adults (AYAs) during their cancer trajectory. However, there is a lack of apps evaluated by AYAs; thus, the quality of many of these apps has been contested. The aim of this study was to investigate the usefulness of a cancer smartphone app called Kræftværket. The AYA participants reflected on their first experiences of the app and whether it was a relevant and useful tool during and after their cancer trajectory. Methods A total of 20 AYA cancer patients aged 16-29 years (n = 10 on treatment, n = 10 in follow up) were provided with a prototype of the Kræftværket app during a 6-week test period (April-May 2018). After the test period, n = 17 participated in focus group interviews, which were analyzed thematically. Results The following themes were found: Sharing personal information (anonymity, safe communication, tough topics, videos and YouTube clips, tracking statistics); Normalcy (Seeing oneself reflected in in others, not alone, general and specific communities); Need for interaction (response from the app, information provided by the app, the app should give more back); and An everyday tool (integrating the app into daily routines, competition between app and Facebook group, temporary needs). Conclusions The app was perceived to be most relevant at disease onset. During the treatment period, both diagnosis-specific information and communities were requested. There was a call for a clearer distinction between the purpose of the app and other Facebook communities and for a notification function.
Relationship of Anterior Cruciate Ligament Volume and T2* Relaxation Time to Anterior Knee Laxity
Authors: Wang Hsin-Min , Shultz Sandra J. , Ross Scott E. , Henson Robert A. , Perrin David H. , Schmitz Randy J. 
Published: February 2021

Background: High anterior knee laxity (AKL) has been prospectively identified as a risk factor for anterior cruciate ligament (ACL) injuries. Given that ACL morphometry and structural composition have the potential to influence ligamentous strength, understanding how these factors are associated with greater AKL is warranted. Hypothesis: Smaller ACL volumes combined with longer T2* relaxation times would collectively predict greater AKL. Study Design: Cross-sectional study; Level of evidence, 3. Methods: College-aged active male (n = 20) and female (n = 30) participants underwent magnetic resonance imaging (MRI) and AKL testing. T2-weighted MRI scans were used to assess ACL volumes, and T2* relaxation times were used to assess ACL structural composition. AKL was measured via a commercial knee arthrometer. Forward stepwise linear regression with sex and weight (first step; suppressor variables) as well as ACL volume and T2* relaxation time (second step; independent variables) was used to predict AKL (dependent variable). Results: After initially adjusting for sex and weight ( R 2 = 0.19; P = .006), smaller ACL volumes combined with longer T2* relaxation times collectively predicted greater AKL ( R 2 = 0.52; P < .001; R 2 Δ = 0.32; P Δ < .001). A smaller ACL volume was the primary predictor of greater AKL ( R 2 Δ = 0.28; P < .001), with a longer T2* relaxation time trending toward a significant contribution to greater AKL ( R 2 Δ = 0.04; P = .062). After adjusting for ACL volume and T2* relaxation time, sex (partial r = 0.05; P = .735) and weight (partial r = 0.05; P = .725) were no longer significant predictors. Conclusion: AKL was largely predicted by ACL volume and to a lesser extent by T2* relaxation time (and not a person’s sex and weight). These findings enhance our understanding of how AKL may be associated with a structurally weaker ACL. The current study presents initial evidence that AKL is a cost-effective and clinically accessible measure that shows us something about the structural composition of the ACL. As AKL has been consistently shown to be a risk factor for ACL injuries, work should be done to continue to investigate what AKL may tell a clinician about the structure and composition of the ACL.