bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluation of Alt-RAMEC With Facemask in Patients With Unilateral Cleft lip and Palate (UCLP) Using Cone Beam Computed Tomography (CBCT) and Finite Element Modeling—A Clinical Prospective Study
Authors: Singh Shalvi , Batra Puneet , Raghavan Sreevatsan , Sharma Karan , Srivastava Amit 
Published: March 2021

Objective: Evaluate the effects of alternate rapid maxillary expansion and constriction (Alt-RAMEC) protocol on patients with unilateral cleft lip and palate (UCLP) along with maxillary protraction using cone beam computed tomography (CBCT) records and a finite element modeling (FEM) model. Materials and Methods: Twenty-five patients (aged 9-13 years) with UCLP having a GOSLON score 3 were selected for this prospective single-arm cohort study after obtaining necessary informed consent. A 9-week Alt-RAMEC protocol using a custom-made fan-shaped expansion screw was initiated, which was followed by 6-month facemask wear. Pre (T1) and posttreatment (T2) records including CBCT were taken and were evaluated for treatment changes in all 3 dimensions using paired t test. Additionally, a FEM model (ANSYS 15.0) using the Alt-RAMEC protocol was also analyzed for the displacement and stress on various craniofacial structures. Results: Significant forward movement of the maxilla along with clockwise rotation of mandible along with statistically significant increase in lower molar height and upper incisor proclination ( P < .05) was observed. CBCT evaluation showed a statistical significant decrease in buccal alveolar bone thickness and increase in molar inclination ( P < .05). Finite element modeling analysis highlighted that the maximum displacement occurred at the anterior region with stresses radiating till the anterior nasal spine, zygomatic arch, and sphenoid bone. Conclusion: Alt- RAMEC protocol combined with facemask protraction can lead to significant maxillary advancement, with some transient decrease in buccal bone thickness noted thereby warranting long-term studies to further assess its effect on the dentofacial apparatus.
Study on the Risk Factors of Preoperative Deep Vein Thrombosis (DVT) in Patients With Lower Extremity Fracture
Authors: Chang Wenjie , Wang Bin , Li Qiwei , Zhang Yongkui , Xie Wenpeng 
Published: March 2021

Objective: The objective of this work is to discuss and analyze the related factors of lower extremity fracture complicated by preoperative deep vein thrombosis (DVT). Methods: A total of 11,891 patients with closed fractures of lower extremities were selected. By analyzing each patient’s gender, age, presence or absence of diabetes and hypertension, preoperative plasma D-dimer level, and color Doppler ultrasound of the lower extremity vein, the pertinent factors of the patients with lower extremity fractures complicated by preoperative DVT were analyzed. Results: A total of 578 with preoperative DVT were detected, displaying a total incidence of 4.86%. All patients were categorized into either the DVT group or non-DVT group. The results demonstrate that there were statistically significant differences between the 2 groups in age, the presence of diabetes and hypertension, the fracture site, and the preoperative plasma D-dimer level ( P < 0.05). Logistic multivariate analysis revealed that age, the presence of diabetes, and the preoperative plasma D-dimer level of patients were independent risk factors for lower extremity fracture complicated by DVT. Conclusion: Age, the presence of diabetes, the fracture site, and increased D-dimer levels were found to be potential risk factors and indicators for preoperative DVT in patients with lower extremity fractures. In addition, the preoperative plasma D-dimer level has certain guiding significance for the prediction of venous thrombosis after lower extremity fracture, which is conducive to the early prediction and diagnosis of DVT, but it often must be followed with good clinic acumen and examinations.
Subcutaneous ureteral bypass device placement with intraoperative ultrasound guidance, with or without microsurgical ureterotomy, in 24 cats
Authors: Butty Emmanuelle Marie , Labato Mary Anna 
Published: March 2021

Objectives The aim of this study was to describe a method of subcutaneous ureteral bypass (SUB) device placement with intraoperative ultrasound guidance, with or without microsurgical ureterotomy, for the treatment of benign ureteral obstruction(s) in cats. A secondary aim was to describe the complications and outcomes in our population, and compare the two groups with and without ureterotomy. Methods The medical records of cats with benign ureteral obstruction(s) treated with SUB device placement with intraoperative ultrasound guidance between April 2013 and June 2018 were reviewed. Results Twenty-four cats with 30 obstructed ureters had a SUB device placement with intraoperative ultrasound guidance in 26 surgeries. A microsurgical ureterotomy was performed in 14/26 surgeries. Median age was 10.07 years (range 4–16.6). Eleven of 24 cats (46%) had a previous history of chronic kidney disease (CKD). All cats, including two patients with minimal pelvic dilation (⩽4 mm), had a successful intrapelvic placement of the SUB device. Median survival time was 1555 days (4.25 years); this was not significantly different between the two groups ( P = 0.4494). Stone analysis and bacterial culture, where available for review, revealed calcium oxalate in 12/12 and a negative culture in 6/7. The ureterotomy significantly prolonged the procedure duration (180 vs 125 mins) without significantly decreasing the short- and long-term complications ( P = 0.1588 and P = 0.2921, respectively), or the survival time ( P = 0.8437). Conclusions and relevance SUB device placement with intraoperative ultrasound guidance is an effective alternative for the treatment of ureteral obstruction. Ultrasound guidance may be a more accessible option when a trained veterinarian does not have access to fluoroscopy. Microsurgical ureterotomy did not show any advantage and prolonged the anesthesia. Our median survival time emphasizes a good outcome of SUB device placement, even in cats with a previous history of CKD.
Intravitreal injections during COVID-19 outbreak: Protective measures, total duration of care and perceived quality of care in a tertiary retina center
Authors: Denys Paul , Miere Alexandra , Colantuono Donato , Jung Camille , Souied Eric H. 
Published: March 2021

Purpose: To assess patient satisfaction regarding the sudden reorganization of care during the COVID-19 pandemic in the outpatient intravitreal injection (IVI) clinic. Methods: A survey of patients with ongoing IVIs for retinal diseases was carried out between April 23rd and May 12th, 2020. We designed a questionnaire to assess patient satisfaction concerning: personal protective equipment (PPE), social distancing, the perceived quality of care, and the total time spent in the department, using a Likert scale. We also collected the time spent per patients in the outpatient IVI clinic. Results: A hundred and twenty-seven eyes of 108 patients were included. The mean time spent in the IVI outpatient clinic was 31.87 +/− 16.61 min. In our survey, 99.1% of the patients were satisfied (highly satisfied or satisfied) with the new type of care provided, 89.8% with the duration of care, and 93.5% with the PPE. Satisfaction was associated with total time spent in hospital ( p = 0.005), with dissatisfied patients spending about 50% more time in the hospital than satisfied patients (43.91 min vs 30.50 min). Conclusion: Despite the crisis-related adjustment, our survey revealed high patient satisfaction with PPE, quality of care, and total time spent in outpatient IVI clinic.
Predicting 30-day mortality after hip fracture: the G4A calibrated prognostic tool
Authors: Harman Holly , Walton Thomas J , Chan Gareth , Stott Philip , Ricketts David M , Rogers Benedict A 
Published: March 2021

Introduction: Proximal femoral fracture is common with a high mortality (7% mortality at 30 days). Accurate determination of mortality risk allows better consenting, clinical management and expectation management. Our study aim was to develop a prognostic tool to predict 30-day mortality after proximal femoral fracture, among patients treated within a dedicated hip fracture unit. Materials and methods: We collected data from our hospital concerning 2210 patients with 2287 proximal femoral fractures. The clinical parameters of 97 patients who died within 30 days of surgery were analysed. We used logistic regression to determine if the parameters’ relationship with 30-day mortality was statistically significant or not. The statistically significant parameters were used to create a prognostic model for predicting 30-day mortality. Results: The 5 independent predictors of 30-day mortality were gender, age, admission source, preoperative Abbreviated Mental Test Score (AMTS) and American Society of Anesthesiologists Score (ASA). The highest risk was for males >85 years, admitted from institutional care, with low preoperative mental test score and high ASA grade. Using these predictors, we formulated the G4A score. The Hosmer-Lemeshow ‘goodness of fit’ test showed good concordance between observed and predicted mortality rates. Conclusions: We recommend the use of the G4A score to predict 30-day mortality after surgery for proximal femoral fracture, particularly within dedicated hip fracture units. Further research is needed to establish whether the findings of this study are applicable on a national scale.
New formulas to predict the length of a peripherally inserted central catheter based on anteroposterior chest radiographs
Authors: Park Sung-Joon , Chung Hwan Hoon , Lee Seung Hwa , Kim Jeong-Eun , Kim Cherry , Lee Sang Min 
Published: March 2021

Purpose: To develop formulas that predict the optimal length of a peripherally inserted central catheter (PICC) from variables measured on anteroposterior (AP) chest radiography (CXR). Materials and methods: A total of 134 patients who underwent PICC insertion at the angiography suites were included. Clinical information such as patient height, weight, sex, age, cubital crease to inferior carina border length (CCL), and approach side were recorded. The following variables via measurement on AP-CXR were also collected: (1) distance from the T1 to T12 vertebra (DTV), (2) maximal horizontal thoracic diameter (MHTD), and (3) clavicle length (CL). Results: Significant correlations between CCL and the following variables were identified in linear regression analyses: approach side, height, weight, sex, DTV, MHTD, and CL. Multiple regression results motivated the following two formulas: (1) with height data, estimated CCL (cm) = 12.429 + 0.113 × Height + 0.377 × MHTD (if left side, add 2.933 cm, if female, subtract 0.723 cm); (2) without height data, estimated CCL = 19.409 + 0.424 × MHTD + 0.287 × CL + 0.203 × DTV (if left side, add 3.063 cm, if female, subtract 0.997 cm). Estimated final PICC length can be calculated as (Estimated CCL, cm) + 4.0 (distance from inferior carina border to about 2.0 vertebra body unit, cm) − (distance from set cubital crease to designated puncture point, cm). Conclusion: This study suggests new formulas to predict the appropriate PICC length for bedside insertion using previous AP-CXRs. With this formula, ideal positioning of the catheter’s tip can be achieved in the clinical practice, avoiding or minimalizing the exposed catheter out of skin. These formulas may be helpful for patients who cannot undergo intra-hospital transport due to hemodynamic instability or who are concerned about isolation precautions due to any infectious-related contamination.
Factors associated with functional arteriovenous fistula at hemodialysis start and arteriovenous fistula non-use in a single-center cohort
Authors: Chung Edmund YM , Knagge Debbie , Cheung Simone , Sun Jessica , Heath Lauren , McColl Hayden , Guo Henry , Gray Lauren , Srivastava Tarini , Sandy Joshua , McGinn Stella , Fisher Charles 
Published: March 2021

Background: The gold standard of commencing hemodialysis with a functional arteriovenous fistula (AVF) is challenging. We aim to review factors associated with functional AVF at hemodialysis start at a tertiary hospital. Methods: We retrospectively reviewed incident hemodialysis patients or who had AVF creation at a single tertiary hospital from 2011 to 2016. Data was extracted for patient comorbidities, duration from referral to AVF creation and hemodialysis start, estimated glomerular filtration rate (eGFR) at surgical referral, referring nephrologist, events accelerating eGFR decline, and revisions for “failing to mature” AVF to assess factors associated with non-functioning AVF or late AVF creation, using multinomial logistic regression. Results: Two hundred two patients received hemodialysis and 51 had AVF creation but did not dialyze (AVF futility rate 20%). Of these, 133 (66%) commenced hemodialysis with a central venous catheter (CVC) and 69 (34%) with an AVF. Patients with functional AVFs at hemodialysis start were referred earlier than those with non-functional AVFs (median 256 vs 66 days before hemodialysis start, p = 0.001). Age, sex, eGFR at surgical referral, and comorbidities were not predictive of patients with functional AVFs. Events accelerating eGFR decline were associated with an increased incidence of CVC at hemodialysis start (risk ratio (RR) 4.21, 95% confidence interval (CI) 1.96–9.03, p < 0.0001). Referring nephrologists external to our renal unit may be associated with non-functional AVF at hemodialysis start (RR 6.60, 95% CI 1.74–25.13, p = 0.006). Conclusions: We found that functional AVFs required referral a median of 256 days prior to hemodialysis start and events accelerating eGFR decline increase the incidence of CVC at hemodialysis start. Age, sex, eGFR at surgical referral, and comorbidities did not inform the likelihood of timely AVF creation and evaluation of further predictive pre-dialysis factors is necessary to identify patients requiring early AVF creation whilst minimizing the cost of unnecessary procedures.
Citrate-induced local ionized calcium decrease in pediatric hemodialysis settings: An in-vitro study
Authors: Novljan Gregor , Kolar Mitja , Kastelec Lea , Battelino Nina 
Published: March 2021

Background: Citrate is instilled into the dialysis catheter to prevent clotting and to maintain patency between dialysis sessions. A significant amount of citrate leaks from the catheter at the injection time, which decreases the blood ionized calcium concentration (Ca2+) due to chelation. We aimed to evaluate the local impact of concentrated (i.e. 30%) citrate spilling on Ca2+ at the catheter tip in real-time pediatric conditions. Methods: An in-vitro model was constructed, involving an ion-selective electrode (Ca-ISE). A pre-curved catheter and the Ca-ISE were submerged in a glass vessel with the tips positioned adjacent to each other. The vessel was filled with 30 and 80 ml of normal saline with added calcium to simulate normal right atrium size in children and adults, respectively, and normal blood Ca2+. The amount of instilled citrate matched the filling volume of the catheter. Measurements were performed with 4% and 30% citrate solutions. Results: The mean Ca2+ measured at the tip of the catheter was 0.457 and 0.058 mmol/l when using 4% and 30% citrate, respectively ( p < 0.001). The mean Ca2+ recorded in 30 and 80 ml after instilling 30 % citrate was 0.058 and 0.055 mmol/l, respectively ( p = 0.878). Conclusions: The spilling of 30% citrate caused a strikingly greater decrease of Ca2+ at the catheter tip than the standard 4% citrate. The atrial volume did not influence the test results implying similar safety concerns for pediatric and adult patients. The used static experimental setting might have overestimated the spilling effect.
Hypoxia-Inducible Factor 2a Expression Is Positively Correlated With Gleason Score in Prostate Cancer
Authors: Pavlakis Dimitrios , Kampantais Spyridon , Gkagkalidis Konstantinos , Gourvas Victoras , Memmos Dimitrios , Tsionga Aikaterini , Dimitriadis Georgios , Vakalopoulos Ioannis 
Published: March 2021

Background: One of the main factors in response to hypoxia in the tumor microenvironment is the hypoxia-inducible factor (HIF) pathway. Although its role in other solid tumors, particularly renal cell carcinoma, has been sufficiently elucidated, it remains elusive in prostate cancer. The aim of the present study was to investigate the expression of main proteins involved in this pathway and determine the correlation of the results with clinicopathological outcomes of patients with prostate cancer. Methods: The immunohistochemical expression of HIF-1a, HIF-2a and their regulators, prolyl hydroxylase domain (PHD)1, PHD2 and PHD3 and factor inhibiting HIF (FIH), was assessed on a tissue microarray. This was constructed from radical prostatectomy specimens, involving both tumor and corresponding adjacent non-tumoral prostate tissues from 50 patients with localized or locally advanced prostate cancer. Results: In comparison with non-tumoral adjacent tissue, HIF-1a exhibited an equal or lower expression in 86% of the specimens (P = 0.017), while HIF-2a was overexpressed in 52% (P = 0.032) of the cases. HIF-1a protein expression was correlated with HIF-2a (P < 0.001), FIH (P = 0.004), PHD1 (P < 0.001), PHD2 (P < 0.001) and PHD3 (P = 0.035). HIF-2a expression was positively correlated with Gleason score (P = 0.017) and International Society of Urological Pathologists (ISUP) grade group (P = 0.022). Conclusions: The findings of the present study suggest a key role for HIF-2a in prostate cancer, as HIF-2a expression was found to be correlated with Gleason score and ISUP grade of the patients. However, further studies are required to validate these results and investigate the potential value of HIF-2a as a therapeutic target in prostate cancer.
MIR-301b-3p Promotes Lung Adenocarcinoma Cell Proliferation, Migration and Invasion by Targeting DLC1
Authors: Liu Haitao , Ma Xingjie , Niu Niu , Zhao Junjie , Lu Chao , Yang Fan , Qi Weibo 
Published: March 2021

Background: miR-301b-3p is reported in various human cancers for its abnormal expression, while the role and molecular mechanisms in lung adenocarcinoma (LUAD) remain unclear, and this is the focus of the present study. Materials and Methods: TCGA database was consulted to know gene expression in LUAD tissue. CCK-8, colony formation assay and Transwell assay were applied to identify the role of target genes in regulating LUAD cell biological properties. Bioinformatics analysis plus dual-luciferase assay were performed to validate the potential connection between genes. Results: miR-301b-3p and DLC1 were the target genes of this study and respectively differentially up-regulated and down-regulated in LUAD. Functional experiments indicated that miR-301b-3p contributed to cancer cell proliferation, migration and invasion, while this effect was reversed with overexpressed DLC1 which was identified as a direct target of and regulated by miR-301b-3p. Conclusions: Collectively, miR-301b-3p was identified to actively function on LUAD malignant progression by suppressing DLC1 expression. This discovery provides a novel therapeutic strategy for LUAD patients, which helps improve the survival of patients.
Cortical Activity Underlying Gait Improvements Achieved With Dopaminergic Medication During Usual Walking and Obstacle Avoidance in Parkinson Disease
Authors: Orcioli-Silva Diego , Vitório Rodrigo , Nóbrega-Sousa Priscila , Beretta Victor Spiandor , Conceição Núbia Ribeiro da , Oliveira Anderson Souza , Pereira Marcelo Pinto , Gobbi Lilian Teresa Bucken 
Published: March 2021

Background Dopaminergic medication improves gait in people with Parkinson disease (PD). However, it remains unclear if dopaminergic medication modulates cortical activity while walking. Objective We investigated the effects of dopaminergic medication on cortical activity during unobstructed walking and obstacle avoidance in people with PD. Methods A total of 23 individuals with PD, in both off (PDOFF) and on (PDON) medication states, and 30 healthy older adults (control group [CG]) performed unobstructed walking and obstacle avoidance conditions. Cortical activity was acquired through a combined functional near-infrared spectroscopy electroencephalography (EEG) system, along with gait parameters, through an electronic carpet. Prefrontal cortex (PFC) oxygenated hemoglobin (HbO2) and EEG absolute power from FCz, Cz, and CPz channels were calculated. Results HbO2 concentration reduced for people with PDOFF during obstacle avoidance compared with unobstructed walking. In contrast, both people with PDON and the CG had increased HbO2 concentration when avoiding obstacles compared with unobstructed walking. Dopaminergic medication increased step length, step velocity, and β and γ power in the CPz channel, regardless of walking condition. Moreover, dopaminergic-related changes (ie, on-off) in FCz/CPz γ power were associated with dopaminergic-related changes in step length for both walking conditions. Conclusions PD compromises the activation of the PFC during obstacle avoidance, and dopaminergic medication facilitates its recruitment. In addition, PD medication increases sensorimotor integration during walking by increasing posterior parietal cortex (CPz) activity. Increased γ power in the CPz and FCz channels is correlated with step length improvements achieved with dopaminergic medication during unobstructed walking and obstacle avoidance in PD.
Higher prescription of antidepressants and/or anxiolytics among chronic obstructive pulmonary disease patients
Authors: Pelgrim Charlotte E. , van den Heuvel Jan Maurik , Folkerts Gert , Garssen Johan , Maitland-van der Zee Anke H. , Kraneveld Aletta D. 
Published: March 2021

Background: Chronic obstructive pulmonary disease (COPD) is often accompanied by psychiatric problems, such as depression and anxiety, affecting both treatment outcomes and mortality. Evidence for the number of COPD patients using medication for these disorders is sparse. In this study, chronic antidepressant (ATD) and anxiolytic (ANX) drug use – to identify depression and anxiety – among COPD patients was compared with subjects with or without other chronic diseases. Methods: The NControl database containing prescription data of 800 pharmacies including 7 million individuals in The Netherlands was used. Patients of age 55+ years who received frequent prescriptions – at least two/year in 5 out of 6 years – for COPD medication, dermatological drugs, disease-modifying antirheumatic drugs (DMARDs), statins and oral glucose-lowering medication were analyzed for concomitant chronic use of ATDs and ANXs between 1 January 2013 and 1 January 2019. All other subjects aged 55+ years were included as a control group (control group 1). This group was further stratified into a group of subjects that received frequent prescriptions of any kind (control group 2). Results: 15.2% of the patients that receive COPD treatment ( n = 96,319), 15.3% of subjects that are treated for dermatological problems ( n = 62,865), 13.2% of subjects that receive DMARDs ( n = 7900), 11.6% of statins users ( n = 422,376) and 11.4% of oral glucose-lowering medication users ( n = 165,975) are also chronically treated for depression or anxiety, compared with 2.6% (control group 1; n = 3,290,608) and 11.4% (control group 2; n = 757,947). In general, female and 75+ years aged subjects showed a higher risk for using ATDs and ANXs chronically. In the COPD and the dermatological patient group the risk was the highest compared with the other patient groups. Conclusions: The rates of chronic ATD and ANX use and the risk of having depression and/or anxiety are especially high in COPD patients, indicating that psychiatric problems are more common in COPD than in most other chronic diseases. In general, age and gender strongly influence the risk of chronically using ATDs and ANXs. The reviews of this paper are available via the supplemental material section.