bluuebunny/crossref_metadata_2025_split huggingface dataset:
Discrepancy rates of preliminary and final reports for after-hours pediatric teleradiology interpretations
Authors: Pfeifer Cory M , Dinh Mary L 
Published: February 2021

Background Children’s hospitals often do not have a high enough volume to justify providing radiologist staffing overnight, leading to hospitals employing teleradiology services to offer preliminary reports. There is limited literature related to discrepancies between preliminary teleradiology pediatric radiologists and final interpretations. Purpose The purpose of this study is to examine discrepancy rates for teleradiologists preliminarily interpreting pediatric exams at a children’s hospital. Material and Methods Eight thousand seven hundred seventy-eight consecutive preliminary reports issued by pediatric teleradiologists were reviewed. The hospital utilized a system in which local onsite radiologists rated the preliminary reports of teleradiologists following the interpretations as part of standard operating procedure. Discrepancies were also rated according to whether the discrepancy was actionable (judged to alter patient management by the final rater) or not. Rates were stratified by modality, preliminary teleradiologist reader, and final rater and compared to each using a normal approximation. The mean discrepancy rates were compared using a z test for proportions. Linear regression was applied to the effect of years of radiologist experience on the total and actionable discrepancy rates. Results The overall actionable discrepancy rate was 1.6%, similar to inter-observer discrepancy rates reported in other studies. There were no significant differences in the actionable discrepancy rates among teleradiologists. There was no correlation between years of experience and discrepancy rate for either the teleradiologists or the final raters. Conclusion Pediatric subspecialty teleradiologists issue reports that mirror discrepancy rates typical of radiologists who issue reports for emergent adult studies. Years of radiologist experience is not a predictor of discrepancy rate.
Risk Factors for Discharge to a Non-Home Destination and Reoperation Following Outpatient Total Hip Arthroplasty (THA) in Medicare-Eligible Patients
Authors: Gordon Adam M. , Malik Azeem Tariq , Khan Safdar N. 
Published: February 2021

Introduction: The Centers for Medicare and Medicaid Services removed total hip arthroplasty (THA) from the inpatient-only (IO) list in January 2020. Given this recommendation, we analyzed Medicare-eligible patients undergoing outpatient THA to understand risk factors for nonroutine discharge, reoperations, and readmissions. Materials and Methods: The 2015-2018 American College of Surgeons–National Surgical Quality Improvement Program database was queried using Current Procedural Terminology code 27130 for Medicare eligible patients (≥ 65 years of age) undergoing outpatient THA. Postoperative discharge destination was categorized into home and non-home. Multivariate logistic regression models were used to evaluate risk factors associated with non-home discharge disposition. Secondarily, we evaluated rates and risk factors associated with 30-day reoperations and readmissions. Results: A total of 1095 THAs were retrieved for final analysis. A total of 108 patients (9.9%) experienced a non-home discharge postoperatively. Patients were discharged to rehab (n = 47; 4.3%), a skilled care facility (n = 47; 4.3%), a facility that was “home” (n = 8; 0.7%), a separate acute care facility (n = 5; 0.5%), or an unskilled facility (n = 1; 0.1%). Independent factors for a non-home discharge were American Society of Anesthesiologists Class >II (odds ratio [OR] 2.74), operative time >80 minutes (OR 2.42), age >70 years (OR 2.20), and female gender (OR 1.67). Eighteen patients (1.6%) required an unplanned reoperation within 30 days. A total of 40 patients (3.7%) required 30-day readmissions, with 35 readmissions related to the original THA procedure. Independent risk factors for 30-day reoperation were COPD (OR 5.85) and HTN (OR 5.24). Independent risk factors for 30-day readmission were HTN (OR 4.35) and Age >70 (OR 2.48). Discussion: The current study identifies significant predictors associated with a non-home discharge, reoperation, and readmission in Medicare-aged patients undergoing outpatient THA. Conclusion: Providers should consider preoperatively risk-stratifying patients to reduce the costs associated with unplanned discharge destination, complication or reoperation.
Increasing trend of serum antimullerian hormone level after long term follow up of endometrioma resection
Authors: Haghgoo Ameneh , Shervin Adel , Chaichian Shahla , Ghahremani Mehran , Mehdizadeh Kashi Abolfazl , Akhbari Farnaz 
Published: February 2021

Background: Endometriosis is a chronic disease mostly affecting women at reproductive age. Some evidence suggests that surgery of ovarian endometrioma may have a detrimental effect on ovarian reserve. The aim of this study was to evaluate the changes of serum antimullerian hormone (AMH) levels in patients with endometrioma after cystectomy. Methods: A prospective study was performed at Nikan hospital on 58 patients with endometrioma who underwent laparoscopic cystectomy. Of them, 30 had unilateral endometrioma and 28 had bilateral endometrioma. Complete excision was done, pelvic endometriosis implants as well as deep infiltrative endometriosis was resected. Sutures were made for the closure of ovarian parenchyma and bleeding control. We did not use any hot energy devices such as cautery on ovaries for ablation, coagulation or resection of endometrioma. Serum AMH levels were measured preoperatively, 3, 9, and 15 months postoperatively. Results: Serum AMH levels decreased significantly from the preoperative sample (2.98 ± 2.47 ng/ml) to 3 months after laparoscopy (1.07 ± 1.06 ng/ml), then gradually increased 9 months (1.47 ± 1.16 ng/ml) and 15 months (1.95 ± 1.85 ng/ml) after surgery, without returning to the preoperative levels during the follow-up time of study. Conclusion: There is a fluctuation pattern in AMH levels from preoperative to 15-month follow-up after endometrioma surgery using only suture for ovarian hemostasis. Firstly, there is decline in AMH level 3 months after surgery, then an increasing trend was observed gradually up to 15 months after surgery. Controlled studies are needed to compare the effects of various cystectomy methods on the ovarian reserve after endometrioma surgery
Treatment of displaced fractures of the patella: Tension band wiring technique with the one-end or both-ends K-wire bending fixation method
Authors: Huang Po-Hua , Hsu Chi-Hsiang , Hsu Shan-Ling , Liu Hao-Chen 
Published: February 2021

Purpose: Tension band wiring technique has been widely used for treating patellar fracture. Conventional techniques are associated with some complications and several modifications have been introduced to increase stabilization. The purpose of this study was to compare two different fixation techniques, the one-end and both-ends Kirschner wire bending fixation methods. Methods: We retrospectively reviewed patient data from 2013 to 2017, including the age, sex, body height, body weight, BMI, lesion of injury, trauma mechanism, fracture displacement and classification, type of fixation, fracture healing duration, length of follow-up, clinical results and complications. The surgical outcome was assessed using the pain score (VAS), Lysholm knee score, and knee joint ROM. Plain radiographs were used to evaluate radiographic outcomes and assess the fracture union duration and hardware complications. We performed statistical analysis to compare these two different fixation techniques. Results: There were no significant differences between the two groups in terms of demographic data, fracture healing duration, level of the K-wires, distance between the K-wires, or length of the K-wires over the patella length (all p > 0.05). There were significant differences in the VAS score, K-wire migration, flexion degree, ROM, and Lysholm score (all p < 0.001) between the two different fixation methods. Conclusion: The both-ends K-wire bending fixation method has a lower complication rate and results in a better clinical outcome than the one-end K-wire bending fixation method. This revised technique can effectively control both ends of the K-wires, thus eliminating the possibility of K-wire migration and improving the fixation stability.
In Vitro Effects of Fluoride, Hydroxyapatite, and Bromelain-Containing Toothpaste Types on Surface Roughness of Different Restorative Materials
Authors: Telatar Gül Yıldız , Bedir Fatih 
Published: February 2021

Aim: To examine the effects of fluoride, hydroxyapatite, and bromelain-containing toothpaste types on the surface roughness of nanohybrid, nanofilled, flowable, and bulk-fill composites; conventional, light-curing, and low-viscosity glass ionomers; and compomers. Materials and Methods: A total of 160 specimens were fabricated using nanohybrid, nanofilled, flowable, and bulk-fill composites; conventional, light-curing, and low-viscosity glass ionomers; and compomers. Each material group was divided into four subgroups ( n = 5) as follows: Control (C), fluoride toothpaste (FT), bromelain toothpaste (BT), and hydroxyapatite toothpaste (HT). Surface roughness values of all specimens were examined using an optical profilometer and a scanning electron microscope at 500, 1,000, and 3,500 magnifications. Results: The highest average roughness value (Ra; µm) was obtained from the conventional glass ionomer material ( P < .001). While the mean Ra value was 0.155±0.116 µm at baseline, it was 0.262±0.203 µm in the fluoride group, 0.237±0.192 µm in the hydroxyapatite group, 0.260±0.293 µm in the bromelain group, and 0.198± 0.187 µm in the control group ( P < .001). Conclusion: We have found that brushing with various types of toothpaste containing fluoride, bromelain, and hydroxyapatite may not result in obtaining different surface roughness values from different types of restorative materials. Differences in surface roughness values of restorative materials may be found at different magnifications under scanning electron microscope.
The Top 100 Most Cited Articles on Anterior Cruciate Ligament Reconstruction: A Bibliometric Analysis
Authors: Tang Ning , Zhang Wenchao , George Daniel M. , Su Yang , Huang Tianlong 
Published: February 2021

Background: The concept of anterior cruciate ligament (ACL) reconstruction (ACLR) has become widely accepted, gaining increased attention in recent years and resulting in many research achievements in this field. Purpose: The aim of this study was to determine which original articles on ACLR have been most influential in this field by identifying and analyzing the characteristics of the 100 most cited articles. Study Design: Cross-sectional study. Methods: Articles on ACLR were identified via the Thomson ISI Web of Science database on November 30, 2019. The 100 most cited articles were identified based on inclusion and exclusion criteria. The data extracted from each article for the subsequent analysis included title, date of publication, total citations, average citations per year (ACY), journal name, first author, institutions, themes, level of evidence, and keywords. Results: The total number of citations was 29,629. The date of publication ranged from 1975 to 2015. A majority of the articles originated from the United States (58%) and were published in the 1990s (32%) and 2000s (48%). The mean ACY was 18.43 ± 9.51. Of the selected articles, nearly one-half were published in the American Journal of Sports Medicine (42%). The most prolific co-author and first author were Freddie H. Fu (n = 13) and K. Donald Shelbourne (n = 5), respectively. The most productive institution was the University of Pittsburgh (14%). Material comparison (19%) and technique comparison (16%) were the 2 most popular themes. More than one-quarter of articles were level 4 evidence (37%). Moreover, the keywords ACL, ACL reconstruction, ACL rupture, knee joint, knee injuries, and human showed the highest degree of centrality. Conclusion: By analyzing the characteristics of articles, this study demonstrated that ACLR is a growing and popular area of research, with the focus of research varying through timeline trends. Studies on anatomic reconstruction and biomechanics might be areas of future trends.
Risk of intracerebral haemorrhage from hypertension is greatest at an early age
Authors: Stanton Robert , Demel Stacie L , Flaherty Matthew L , Antzoulatos Eleni , Gilkerson Lee A , Osborne Jennifer , Behymer Tyler P , Moomaw Charles J , Sekar Padmini , Langefeld Carl , Woo Daniel 
Published: February 2021

Introduction The risk of intracerebral haemorrhage (ICH) associated with hypertension (HTN) is well documented. While the prevalence of HTN increases with age, the greatest odds ratio (OR) for HTN as a risk for ischemic stroke is at an early age. We sought to evaluate if the risk for ICH from HTN was higher in the youngest patients of each race. Patients and methods The Ethnic/Racial Variations of ICH (ERICH) study is a prospective multicenter case-control study of ICH among whites, blacks, and Hispanics. Participants were divided into age groups based on race-specific quartiles. Cases in each race/age group were compared to controls using logistic regression (i.e., cases and controls unmatched). The probability of ICH among cases and controls for each race were compared against independent variables of HTN, quartile of age and interaction of quartile and age also using logistic regression. Results Overall, 2033 non-lobar ICH cases and 2060 controls, and 913 lobar ICH cases with 927 controls were included. ORs were highest in the youngest age quartile for non-lobar haemorrhage for blacks and Hispanics and highest in the youngest quartile for lobar haemorrhage for all races. The formal test of interaction between age and HTN was significant in all races for all locations with the exception of lobar ICH in whites (p = 0.2935). Discussion Hypertension is a strong independent risk factor for ICH irrespective of location among persons of younger age, consistent with the hypothesis that first exposure to HTN is a particularly sensitive time for all locations of ICH.
Delayed-Onset Propionibacterium acnes Endophthalmitis in the Absence of Capsular Complex Following Scleral-Fixated Intraocular Lens: A Case Report
Authors: Gonzalez-Gonzalez Luis A. , Prensky Colin J. , Orlin Anton 
Published: February 2021

Purpose: This work reports a case of delayed-onset Propionibacterium acnes endophthalmitis in a patient with scleral-fixated intraocular lens (IOL), successfully treated with intravitreal antibiotics and steroids. Methods: Patient underwent complete ophthalmic examinations over 2 years. Vitreous cultures, optical coherence tomography, anterior segment and fundus photographs, and fluorescein angiogram were performed. Results: A 78-year-old man with dislocated IOL underwent IOL removal and scleral-fixated AO60. He did well for 2 months but returned 9 months later with vision loss. Examination revealed low-grade inflammation and multiple IOL opacities. Vitreous culture grew P acnes. He was treated with intravitreal clindamycin followed by dexamethasone for macular edema without IOL explantation. A year after treatment no inflammation or macular edema was noted. Conclusion: To our knowledge, this is the first case of P acnes endophthalmitis following scleral sutured IOL. Treatment with intravitreal injections alone, without IOL explantation, was effective, possibly because of the absence of capsular complex.
American Society of Hematology 2021 guidelines for management of venous thromboembolism: prevention and treatment in patients with cancer
Authors: Lyman Gary H. , Carrier Marc , Ay Cihan , Di Nisio Marcello , Hicks Lisa K. , Khorana Alok A. , Leavitt Andrew D. , Lee Agnes Y. Y. , Macbeth Fergus , Morgan Rebecca L. , Noble Simon , Sexton Elizabeth A. , Stenehjem David , Wiercioch Wojtek , Kahale Lara A. , Alonso-Coello Pablo 
Published: February 2021

Background:Venous thromboembolism (VTE) is a common complication among patients with cancer. Patients with cancer and VTE are at a markedly increased risk for morbidity and mortality.Objective:These evidence-based guidelines of the American Society of Hematology (ASH) are intended to support patients, clinicians, and other health care professionals in their decisions about the prevention and treatment of VTE in patients with cancer.Methods:ASH formed a multidisciplinary guideline panel balanced to minimize potential bias from conflicts of interest. The guideline development process was supported by updated or new systematic evidence reviews. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach was used to assess evidence and make recommendations.Results:Recommendations address mechanical and pharmacological prophylaxis in hospitalized medical patients with cancer, those undergoing a surgical procedure, and ambulatory patients receiving cancer chemotherapy. The recommendations also address the use of anticoagulation for the initial, short-term, and long-term treatment of VTE in patients with cancer.Conclusions:Strong recommendations include not using thromboprophylaxis in ambulatory patients receiving cancer chemotherapy at low risk of VTE and to use low-molecular-weight heparin (LMWH) for initial treatment of VTE in patients with cancer. Conditional recommendations include using thromboprophylaxis in hospitalized medical patients with cancer, LMWH or fondaparinux for surgical patients with cancer, LMWH or direct oral anticoagulants (DOAC) in ambulatory patients with cancer receiving systemic therapy at high risk of VTE and LMWH or DOAC for initial treatment of VTE, DOAC for the short-term treatment of VTE, and LMWH or DOAC for the long-term treatment of VTE in patients with cancer.
Blueschist mylonitic zones accommodating syn-subduction exhumation of deeply buried continental crust: the example of the Rocca Canavese Thrust Sheets Unit (Sesia–Lanzo Zone, Italian Western Alps)
Authors: Roda Manuel , Zucali Michele , Corti Luca , Visalli Roberto , Ortolano Gaetano , Spalla Maria Iole 
Published: February 2021

AbstractThe Rocca Canavese Thrust Sheets Unit (RCTU) is a subduction-related mélange that represents the eastern-most complex of the Sesia–Lanzo Zone (SLZ), bounded by the Periadriatic (Canavese) Lineament that separates the Alpine subduction complex from the Southalpine domain. The RCTU is limited to the south by the Lanzo Massif (LM) and to the east by the Eclogitic Micaschists Complex (EMC). Particularly the tectonic contact area of the RCTU, adjacent to the neighbouring SLZ and the LM is characterised by a 100–200-m-thick mylonitic to ultra-mylonitic zone (MZ) that was active under blueschist-to greenschist-facies conditions. Despite the dominant mylonitic structure, some rocks (garnet-bearing gneiss, garnet-free gneiss and orthogneiss) still preserve pre-mylonitic parageneses in meter-sized domains. The scarcity of superposed structures and the small size of relicts impose a detailed microstructural analysis supported by chemical investigation to reconstruct the tectono-metamorphic history of the MZ. Therefore, we integrated the classical meso- and microstructural analysis approach with a novel quantitative technique based on the Quantitative X-Ray Map Analyzer (Q-XRMA), used to classify rock-forming minerals starting from an array of X-ray elemental maps, both at whole thin section and micro-domain scale, as well as to calibrate the maps for pixel-based chemical analysis and end-member component maps, relevant for a more robust conventional geothermobarometer application as well for calculating reliable PT pseudosections. Pre-Alpine relicts are garnet and white mica porphyroclasts in the garnet-bearing gneiss and biotite and K-feldspar porphyroclasts in garnet-free gneiss and orthogneiss, respectively, providing no PT constraints. The Alpine evolution of the MZ rocks, has been subdivided in three deformation and metamorphic stages. The first Alpine structural and metamorphic equilibration stage (D1 event) occurred at a pressure of ca. 1.25–1.4 GPa and at a temperature of ca. 420–510 °C, i.e. under blueschist-facies conditions. The D2 event, characterised by a mylonitic foliation that is pervasive in the MZ, occurred at ca. 0.95–1.1 GPa and ca. 380–500 °C, i.e. under epidote-blueschist-facies conditions. The D2 PT conditions in the MZ rocks are similar to those predicted for the blocks that constitute the RCTU mélange, and they overlap with the exhumation paths of the EMC and LM units. Therefore, the RCTU, EMC and LM rocks became coupled together during the D2 event. This coupling occurred during the exhumation of the different tectono-metamorphic units belonging to both continental and oceanic lithosphere and under a relatively cold thermal regime, typical for an active oceanic subduction zone, pre-dating Alpine continental collision.
Discovery of vanoxerine dihydrochloride as a CDK2/4/6 triple-inhibitor for the treatment of human hepatocellular carcinoma
Authors: Zhu Ying , Ke Kun-Bin , Xia Zhong-Kun , Li Hong-Jian , Su Rong , Dong Chao , Zhou Feng-Mei , Wang Lin , Chen Rong , Wu Shi-Guo , Zhao Hui , Gu Peng , Leung Kwong-Sak , Wong Man-Hon , Lu Gang , Zhang Jian-Ying , Jiang Bing-Hua , Qiu Jian-Ge , Shi Xi-Nan , Lin Marie Chia-mi 
Published: February 2021

Abstract
Background
Cyclin-dependent kinases 2/4/6 (CDK2/4/6) play critical roles in cell cycle progression, and their deregulations are hallmarks of hepatocellular carcinoma (HCC).

Methods
We used the combination of computational and experimental approaches to discover a CDK2/4/6 triple-inhibitor from FDA approved small-molecule drugs for the treatment of HCC.

Results
We identified vanoxerine dihydrochloride as a new CDK2/4/6 inhibitor, and a strong cytotoxicdrugin human HCC QGY7703 and Huh7 cells (IC50: 3.79 μM for QGY7703and 4.04 μM for Huh7 cells). In QGY7703 and Huh7 cells, vanoxerine dihydrochloride treatment caused G1-arrest, induced apoptosis, and reduced the expressions of CDK2/4/6, cyclin D/E, retinoblastoma protein (Rb), as well as the phosphorylation of CDK2/4/6 and Rb. Drug combination study indicated that vanoxerine dihydrochloride and 5-Fu produced synergistic cytotoxicity in vitro in Huh7 cells. Finally, in vivo study in BALB/C nude mice subcutaneously xenografted with Huh7 cells, vanoxerine dihydrochloride (40 mg/kg, i.p.) injection for 21 days produced significant anti-tumor activity (p < 0.05), which was comparable to that achieved by 5-Fu (10 mg/kg, i.p.), with the combination treatment resulted in synergistic effect. Immunohistochemistry staining of the tumor tissues also revealed significantly reduced expressions of Rb and CDK2/4/6in vanoxerinedihydrochloride treatment group.

Conclusions
The present study isthe first report identifying a new CDK2/4/6 triple inhibitor vanoxerine dihydrochloride, and demonstrated that this drug represents a novel therapeutic strategy for HCC treatment.