bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of a novel technique of posterior reconstruction of pubourethralis on ‘early’ return of continence after robot assisted radical prostatectomy (RARP): A comparative study
Authors: Abdul Rouf Malik , Kumar Venkatesh , Agarwal Anshuman , Sharma Mahender , Rawat Suresh Kumar , Taneja Rajesh 
Published: March 2021

Objective: To study the effect of a novel technique of posterior reconstruction of pubourethralis on early return of continence after robot assisted radical prostatectomy (RARP). Materials and methods: The study included 206 patients of organ confined prostate cancer managed at our centre between March 2014 and December 2018.The patients were randomly distributed into two comparable groups with respect to age, height, weight and BMI, with 100 patients in control and 106 patients in study group. After standard excision of the specimen, the posterior reconstruction in the form of Rocco stitch was done in control group while in addition to Rocco stitch pubourethralis was approximated posteriorly in midline at the proposed site of vesicourethral anastomosis in study group. Continence was defined as the need to use 0–1 pad in 24 h. The data was collected on day 0, 3, 7, 15, 30, 90 and 180 after removal of catheter. Results: At day zero, 3,7, 15, 30, 90 and 180 days after catheter removal continence rates (⩽1 pad usage per day) were observed to be 18.8% versus 0%, 22.6% versus 0%, 50.9% versus 5%, 72.6% versus 20%, 84.9 versus 32%, 97.1% versus 83%, and 97.1% versus 91% in the study and control group respectively. Conclusion: Despite small number of patients in this study the results with respect to early return of continence are encouraging in the reconstruction group and there by in favour of this technique .Furthermore the technique is easily reproducible and may be seen as one more additional step to be applied in order to enhance the recovery of continence after RARP. However it is necessary to further validate the efficacy of this procedure through multicenteric controlled trials.
Erectile dysfunction pattern in patients with end stage renal disease on regular dialysis
Authors: Abdelaal Mohamed A , Abouelgreed Tamer Ali , Ibrahim Amal H , Elshater Ahmed I , Sabry Khalid M 
Published: March 2021

Introductions: Evaluating the epidemiology, pattern, and contributing factors of sexual dysfunction in end-stage renal disease (ESRD) patients is the cornerstone in understanding and enhancing these patients’ quality of life. In this study, we aimed to identify the different patterns of erectile dysfunction (ED) among 100 patients undergoing hemodialysis. Materials and methods: A single-center, cross-sectional, study was conducted on 100 patients with ESRD on hemodialysis. Patients were assessed using the International index of erectile dysfunction (IIEF) and Doppler assessment of the penis. Results: A total of 100 patients were included in this study with a mean age of 48.77 ± 9.66 years old. The mean erectile index was 7.10 ± 4.62; while the mean free and total testosterone were 10.07 ± 7.69 and 2.93 ± 1.4 ng/dL, respectively. Overall, 67% of the patients had abnormal hormonal levels. Concerning the penile vasculature, 71% of the patients had arterogenic importance and 19% had venous impotence. The comparative analysis demonstrated that hypertensive patients had lower erectile index ( p = 0.002). In addition, smokers had lower erectile index ( p < 0.001). There was statistical significance between normal hormonal and abnormal hormone level according to erectile index, with lower index in patients with abnormal hormonal level ( p = 0.03). Conclusion: In conclusion, our findings indicate that the most common causes of ED with renal failure were hormonal disturbance, including testosterone, and prolactin. Hypertension and smoking are major contributing factors that should be managed carefully to reduce the risk of ED and improve the quality of life.
Very low risk T1a renal cell carcinoma presenting with pathological fracture caused by a solitary metastases to the contralateral arm
Authors: Sountoulides Petros , Metaxa Linda , Asouhidou Irene , Stavropoulos Marios , Calleary John 
Published: March 2021

Background: Renal Cell Carcinomas are notorious for asynchronous metastases, atypical metastatic sites and late relapses even decades after nephrectomy. It is quite rare though for RCCs to present as metastatic, solitary and symptomatic bone lesions. Even more uncommon is a solitary bone metastasis much larger that the primary tumour caused by a low risk primary T1a RCC which would have otherwise been eligible for active surveillance. Case presentation: An otherwise healthy 68-year-old female was seen by the orthopaedics for right shoulder and upper arm worsening pain. Imaging showed a pathological fracture caused by a 5.5 cm lytic lesion involving the coracoid process and proximal humerus. She underwent proximal humeral replacement and histology of the lesion showed metastatic RCC. Whole body CT scan revealed a primary tumour of the left kidney less than 4cm in diameter. The patient underwent laparoscopic radical nephrectomy and diagnosis of a T1a, clear cell RCC without adverse pathological features was confirmed. She has been on systematic therapy with oral TKIs since and is free from recurrence at 12-months follow up. Conclusions: Even T1a RCCs without adverse pathological features can give rise to distant metastases following unpredictable patterns of spread thereby questioning the safety of active surveillance in healthy and fit patients.
The Frankfurt School and the authoritarian personality: Balance sheet of an insight
Authors: Boucher Geoff 
Published: March 2021

Frankfurt School critical theory is perhaps the most significant theory of society to have developed directly from a research programme focused on the critique of political authoritarianism, as it manifested during the interwar decades of the 20th century. The Frankfurt School’s analysis of the persistent roots – and therefore the perennial nature – of what it describes as the ‘authoritarian personality’ remains influential in the analysis of authoritarian populism in the contemporary world, as evidenced by several recent studies. Yet the tendency in these studies is to reference the final formulation of the category, as expressed in Theodor Adorno and co-thinkers’ The Authoritarian Personality (1950), as if this were a theoretical readymade that can be unproblematically inserted into a measured assessment of the threat to democracy posed by current authoritarian trends. It is high time that the theoretical commitments and political stakes in the category of the authoritarian personality are re-evaluated, in light of the evolution of the Frankfurt School. In this paper, I review the classical theories of the authoritarian personality, arguing that two quite different versions of the theory – one characterological, the other psychodynamic – can be extracted from Frankfurt School research.
Association of Hospital Safety Net Status With Outcomes and Resource Use for Extracorporeal Membrane Oxygenation in the United States
Authors: Gandjian Matthew , Williamson Catherine , Xia Yu , Maturana Carlos , Chervu Nikhil , Verma Arjun , Tran Zachary , Sanaiha Yas , Benharash Peyman 
Published: March 2021

Purpose: Safety net hospitals (SNH) have been associated with inferior surgical outcomes and increased resource use. Utilization and outcomes for extracorporeal membrane oxygenation (ECMO), a rescue modality for patients with respiratory or cardiac failure, may vary by safety net status. We hypothesized SNH to be associated with inferior outcomes and costs of ECMO in a national cohort. Materials and Methods: The 2008-2017 National Inpatient Sample was queried for ECMO hospitalizations and safety net hospitals were identified. Multivariable regression was used to perform risk-adjusted comparisons of mortality, complications and resource utilization at safety net and non-safety net hospitals. Results: Of 36,491 ECMO hospitalizations, 28.2% were at SNH. On adjusted comparison SNH was associated with increased odds of mortality (AOR: 1.23), tracheostomy use (AOR: 1.51), intracranial hemorrhage (AOR: 1.39), as well as infectious complications (AOR: 1.21, all P < .05), with NSNH as reference. SNH was also associated with increased hospitalization duration (β=+4.5 days) and hospitalization costs (β=+$32,880, all P < .01). Conclusions: We have found SNH to be associated with inferior survival, increased complications, and higher costs compared to NSNH. These disparate outcomes warrant further studies examining systemic and hospital-level factors that may impact outcomes and resource use of ECMO at SNH.
Computerized Cognitive Training in Amnestic Mild Cognitive Impairment: A Randomized Clinical Trial
Authors: Duff Kevin , Ying Jian , Suhrie Kayla R. , Dalley Bonnie C.A. , Atkinson Taylor J. , Porter Sariah M. , Dixon Ava M. , Hammers Dustin B. , Wolinsky Fredric D. 
Published: March 2021

Objective: Computerized cognitive training has been successful in healthy older adults, but its efficacy has been mixed in patients with amnestic Mild Cognitive Impairment (MCI). Methods: In a randomized, placebo-controlled, double-blind, parallel clinical trial, we examined the short- and long-term efficacy of a brain-plasticity computerized cognitive training in 113 participants with amnestic MCI. Results: Immediately after 40-hours of training, participants in the active control group who played computer games performed better than those in the experimental group on the primary cognitive outcome (p = 0.02), which was an auditory memory/attention composite score. There were no group differences on 2 secondary outcomes (global cognitive composite and rating of daily functioning). After 1 year, there was no difference between the 2 groups on primary or secondary outcomes. No adverse events were noted. Conclusions: Although the experimental cognitive training program did not improve outcomes in those with MCI, the short-term effects of the control group should not be dismissed, which may alter treatment recommendations for these patients.
Validity and reliability of high-resolution ultrasound imaging for the assessment of regional body composition in stage 5 chronic kidney disease patients undergoing continuous ambulatory peritoneal dialysis
Authors: Geneen Louise J , Kinsella Jodie , Zanotto Tobia , Naish Patrick F , Mercer Thomas H 
Published: March 2021

Background: Accurate measurement of muscle mass is an important research and clinical tool. High-resolution ultrasound (US) has shown potential as a method to assess muscle and fat mass at specific anatomical sites. However, there is limited evidence for the reliability of US to measure muscle size in patients receiving continuous ambulatory peritoneal dialysis (CAPD). Therefore, we examined the validity and reliability of an US method compared to a gold standard comparison for the assessment of a quadriceps muscle in this clinical population. Methods: Twenty people receiving CAPD (mean age = 56.5 ± 16.7 years) at a single dialysis unit were assessed on two occasions, 7 days apart. Measures of the mid-thigh, such as vastus lateralis (VL) anatomical cross-sectional area (ACSA), VL muscle thickness and subcutaneous fat thickness were compared for US reliability and validity compared to magnetic resonance imaging (MRI) measures. Results: US had high validity against gold standard MRI measures, with intraclass correlation coefficients (ICC) equating to VL ACSA of 0.95, VL thickness of 0.99 and fat thickness of 0.98. The US measurements also exhibited high intra-rater reliability (ICCs: VL thickness = 0.98, total muscle thickness = 0.97 and fat thickness = 0.99) in measuring body composition at the mid-VL site in the study population. Conclusions: Valid assessment of regional body composition can be achieved via high-resolution US in patients receiving CAPD. The validity and reliability of the US in repeated measures (in comparison to the gold standard MRI) warrant further investigation in the wider chronic kidney disease population.
Sex-seeking on the internet and mobile-based applications among young people in China: An online survey
Authors: Li Jian , Shan Duo , Liu Peng , Liu Hui , Cai Lingping , Zhang Haichao , Zhang Lei , Zhang Dapeng 
Published: March 2021

The aim of this study was to investigate young people’s risk behaviors in use of social network applications for sexual purposes. Snowball sampling technique was used to recruit participants online. Logistic regressions were performed to examine interrelationships among risk behaviors and sex-seeking platforms (A, B, C, D, and others). The prevalence of online sex-seeking was 22.2% (1156/5199) among people with sexual experience, and the most debut online sex-seeking happened in 15–24 years old in both men and women (79.8%, 590/739 vs 86.1%, 359/417). The risk behaviors varied in different platforms among 730 young people age 15–24 years. Among men, participants seeking sex via B were more likely to engage in concurrent sexual partnership (aOR: 1.64; 95% CI: 1.01–2.66). Participants seeking sex via C were more likely to engage in drug use (aOR: 1.74; 95% CI: 1.01–3.02) and condomless sex (aOR: 1.75; 95% CI: 1.04–2.95). Participants seeking sex via A, C, or D were all less likely to have homosexual behaviors. Among women, participants seeking sex via B were more likely to have condomless sex (aOR: 2.06; 95% CI: 1.10–3.86). The study indicated that emerging of the HIV epidemic in young people might be driven by risk behaviors during online sex-seeking. Effective intervention programs need to target on different social network platforms.
European prosecution between cooperation and integration: The European Public Prosecutor’s Office and the rule of law
Authors: Mitsilegas Valsamis 
Published: March 2021

The article will examine the challenges that the establishment of the European Public Prosecutor’s Office poses for the rule of law – a question which has been underexplored in the policy and academic debate on the establishment of the EPPO, which focused largely on questions of structure and powers of the EPPO and the battle between intergovernmental and supranational visions of European prosecution. The implications of the finally adopted legal framework on the EPPO on the rule of law will be analysed primarily from the perspective of the rule of law as related to EPPO investigations and prosecutions and their consequences for affected individuals – in terms of legal certainty and foreseeability, protection from executive arbitrariness, effective judicial protection and defence rights. The article will undertake a rule of law audit of the EPPO by focusing on three key elements of its legal architecture – the competence of the EPPO, applicable law and judicial review – and the interaction between EU and national levels of investigation and prosecution that the EPPO Regulation envisages. The analysis will aim to cast light on the current rule of law deficit in a hybrid system of European prosecution located somewhere between co-operation and integration.
Vibration behavior of an overhead conductor under updraft winds
Authors: Zhou Qi , Zhao Liangtao , Zheng Chong , Tu Feng 
Published: March 2021

At present, the wind-induced response analysis of an overhead conductor is mainly based on the action of horizontal normal wind. However, for crossing hillsides or extremely strong winds, such a conductor will bear the action of updraft wind, which will change the geometry of the conductor and make its structural dynamic characteristics nonlinear to some extent. In this work, the in-plane and out-of-plane two-dimensional nonlinear equations were established under the action of self-weight and updraft wind. Furthermore, the improved equations of conductor tension and sag were obtained, and the wind-induced vibration response was further investigated. The results showed that the updraft wind caused the nonlinearity of the tension and sag of the overhead conductor, and the nonlinear geometric change significantly affected its resonance response, which exceeded 25% if the wind speed was 50 m/s. In addition, because the proportion of the resonance response in the total wind-induced response was different, the influence of the wind attack angle calculated using the gust response factor method on the gust response factor was slightly larger than that calculated using the the American society of civil engineers method.
Machine Learning Approaches to Determine Feature Importance for Predicting Infant Autopsy Outcome
Authors: Booth John , Margetts Ben , Bryant Will , Issitt Richard , Hutchinson Ciaran , Martin Nigel , Sebire Neil J 
Published: March 2021

Introduction Sudden unexpected death in infancy (SUDI) represents the commonest presentation of postneonatal death. We explored whether machine learning could be used to derive data driven insights for prediction of infant autopsy outcome. Methods A paediatric autopsy database containing >7,000 cases, with >300 variables, was analysed by examination stage and autopsy outcome classified as ‘explained (medical cause of death identified)’ or ‘unexplained’. Decision tree, random forest, and gradient boosting models were iteratively trained and evaluated. Results Data from 3,100 infant and young child (<2 years) autopsies were included. Naïve decision tree using external examination data had performance of 68% for predicting an explained death. Core data items were identified using model feature importance. The most effective model was XG Boost, with overall predictive performance of 80%, demonstrating age at death, and cardiovascular and respiratory histological findings as the most important variables associated with determining medical cause of death. Conclusion This study demonstrates feasibility of using machine-learning to evaluate component importance of complex medical procedures (paediatric autopsy) and highlights value of collecting routine clinical data according to defined standards. This approach can be applied to a range of clinical and operational healthcare scenarios
Morphometric analysis of fibrovascular pigment epithelial detachments treated with ranibizumab and aflibercept
Authors: Karampelas Michael , Syriga Maria , Petrou Petros , Georgalas Ilias , Papaconstantinou Dimitrios , Brouzas Dimitrios 
Published: March 2021

Purpose: To assess fibrovascular pigment epithelial detachments (PED) and their response to two different anti-VEGF agents using optical coherence tomography (OCT) morphometric analysis. Methods: Seventy-three consecutive, treatment-naïve eyes with fibrovascular PED (>125 μm) treated with ranibizumab or aflibercept were retrospectively included. A custom-made software was used to manually segment and calculate PED maximum height, base area, volume and internal reflectivity at baseline, after three injections and 1 year. Results: Visual acuity (VA) change was 2 ETDRS letters ± 7.6 after three injections and 3.2 ETDRS letters ± 10.3 at 1 year. There was no significant difference between VA changes amongst the two drugs. At 1 year, anti-VEGF treatment resulted in a mean reduction of 125 μm in maximum PED height, of 2.26 mm2 in base area and of 0.54 mm3 in volume with a corresponding increase in reflectivity. These changes were more prominent in the aflilbercept group. The observed PED and VA changes at year 1 were strongly correlated with their values at baseline and after three injections. Conclusions: Anti-VEGF treatment resulted in a reduction of all PED dimensions and a corresponding increase in optical reflectivity. Higher, larger and more hypo-reflective PEDs demonstrated a better anatomical response, especially with aflibercept, but this was not correlated with VA.
Intracameral anesthetic mydriatic (ICAM) assisted pediatric cataract surgery
Authors: Kaur Savleen , Korla Shagun , Ram Jagat , Gupta Parul Chawla , Sukhija Jaspreet 
Published: March 2021

Purpose: To assess the efficacy and safety of intracameral mydriatic and anesthetic combination for pupillary dilation in pediatric cataract surgery Methods: This prospective series included children <12 years, with visually significant unilateral or bilateral cataracts planned for cataract surgery with/without intraocular lens implantation. At the beginning of surgery, 0.025 ml of a combination of phenylephrine hydrochloride (0.31%), tropicamide (0.02%), and lidocaine hydrochloride (1%) was injected intracamerally. The efficacy of the combination was tested by achieving capsulorhexis and intraocular lens implantation without additional mydriatics. Results: We recruited 13 patients (16 eyes) with a mean age of 4.1 ± 3.9 years. The mean pupillary diameter changed increased from 1.92 to 5.68 mm after injection of one unit (0.025 ml) of drug ( p < 0.0001). There was a strong positive correlation of the pupillary dilation with axial length ( R = 0.86) and horizontal corneal diameter ( R = 0.81). Seventy-five percent patients had a pupillary diameter >6 mm and surgery could be completed successfully in all cases without additional mydriatics. In all cases, pupil dilated as the surgery progressed. No adverse event to the drug was noted. Conclusions: Intracameral mydriatic-anesthetic combination is an effective and safe way to obtain stable mydriasis in pediatric cataract surgery.
Intraoperative Evaluation of Resection Margins in Breast-Conserving Surgery for In Situ and Invasive Breast Carcinoma
Authors: Koopmansch Caroline , Noël Jean-Christophe , Maris Calliope , Simon Philippe , Sy Marième , Catteau Xavier 
Published: March 2021

Background: The challenge of breast-conserving surgery (BCS) is to remove the entire tumour with free margins and avoid secondary excision that may adversely affect the cosmetic outcome. Consequently, intraoperative evaluation of surgical margins is critical. The aims of this study were multiple. First, to analyse our methodology of intraoperative examination of the resection margins and to evaluate radiological and pathological methods in the assessment of the surgical margins. Second, to evaluate the factors associated with positive margins in our patient population. M&m: The data on the resection margin status of 290 patients who underwent BCS for invasive carcinoma or ductal carcinoma in situ (DCIS) between 2009 and 2016 were reviewed. Results: In the cohort of BCS with invasive carcinoma, the negative predictive value was 97.4% for intraoperative assessment by radiography and 81.8% for intraoperative assessment by pathology. The re-operation rate among cases without intraoperative assessment was 23.6% compared to 7.3% among cases with intraoperative assessment ( P = .003). Margin status was significantly associated with tumour size, histological subtype (invasive lobular carcinoma), and multifocality. In the population of BCS with DCIS, margin status was significantly associated with preoperative localisation and intraoperative margin assessment ( P = .03). Conclusion: There is no statistical difference between pathological and radiological intraoperative assessment. Tumour size, lobular subtype, and multifocality were found to be significantly associated with positive margins in cases with invasive carcinoma, whereas absence of intraoperative margin assessment was significantly associated with positive margins in cases with DCIS. Therefore, intraoperative margin assessment improves the likelihood of complete excision of the lesion.