bluuebunny/crossref_metadata_2025_split huggingface dataset:
External validation of the Surgical Outcome Risk Tool (SORT) in 3305 abdominal surgery patients in the independent sector in the UK
Authors: Oakland K. , Cosentino D. , Cross T. , Bucknall C. , Dorudi S. , Walker D. 
Published: January 2021

Abstract
Background
Assessing the risk of post-surgical mortality is a key component of pre-surgical planning. The Surgical Outcome Risk Tool (SORT) uses pre-operative variables to predict 30-day mortality. The aim of this study was to externally validate SORT in patients undergoing major abdominal surgery.

Methods
Data were collected from patients treated in five independent hospitals in the UK. Individualised SORT scores were calculated, and area under the receiver operating characteristic (AUROC) and precision-recall curves (PRC) plus 95% confidence intervals (CI) were drawn to test the ability of SORT to identify in-hospital death. Outcomes of patients with a SORT predicted risk of mortality of ≥ 5% (high risk) were compared to those with a predicted risk of < 5% (standard risk).

Results
The study population comprised 3305 patients, mean age 51 years, 2783 (84.2%) underwent elective surgery most frequently involving the colon (24.6%), or liver, pancreas or gallbladder (18.2%). Overall, 1551 (46.9%) patients were admitted to ICU and 29 (0.88%) died. The AUROC of SORT for discriminating patients at risk of death in hospital was 0.899 (95% CI 0.849 to 0.949) and the PRC 0.247. In total, 72 (2.18%) patients were stratified as high risk. There were more unplanned ICU admissions and deaths in this group compared to the standard risk group (25.0% and 3.3%, versus 3.1% and 0.5%, respectively).

Conclusion
We externally validated SORT in a large population of abdominal surgery patients. SORT performed well in patients with lower risk profiles, but underpredicted adverse outcomes in the higher risk group.
Psychometric properties of the Arabic version of the Basic Psychological Needs Satisfaction-Frustration Scale (BPNSFS)
Authors: Zayed Kashef N. , Omara Ehab N. , al-Rawahi Nasser Y. , al-Shamli Ali K. , al-Atiyah Asma A. , al-Haramleh Ahmad A. , Azab Mahmoud S. , al-Khasawneh Ghada M. , Hassan Mohammed A. 
Published: January 2021

Abstract
Background
The aim of this study is to validate the Arabic version of the Basic Psychological Need Satisfaction and Frustration Scale (BPNSFS), and to investigate the extent of its invariance across five Arab countries and gender.

Methods
A back-translated version of the BPNSFS, the second version of the Beck Depression Inventory (BDI-II), and the Warwick-Edinburgh Mental Well-Being Scale (WEMWBS) were administered to a sample consisting of 1082 undergraduate students affiliated with universities in five Arab countries (487 males and 595 females: Mage = 20.04 ± 1.87 years). The data of the BPNSFS were examined for univariate and multivariate normality using Shapiro–Wilk tests and Mardia’s coefficient, respectively. To evaluate and compare the four models with confirmatory factor analysis (CFA), we used the following goodness-of-fit indices: the chi-square value (χ2), comparative fit index (CFI), Tucker-Lewis index (TLI), Root Mean-Square Error of Approximation (RMSEA), and Baysian Information Criterion (BIC). A multi-group CFA [Byrne in Structural equation modeling with EQS: basic concepts, applications, and programming, Routledge, Abingdon, 2013] on the BPNSFS structure to examine its invariance across the five Arab countries and across genders.

Results
The results of confirmatory factor analysis supported the generalizability of the BPNSFS’s six-factor model to the five Arab countries. The relationships between the six psychological needs satisfaction and frustrations and both mental health and symptoms of depression provide additional evidence on the construct validity of the BPNSFS through cross cultural data. The findings of BPNSFS’s measurement invariance across males and females and across the five Arab countries help ensure that the latent means are comparable across these different groups.

Conclusions
The study concluded that the Arabic version of the BPNSFS which measures satisfaction and frustration of the three basic needs (autonomy, competency, and relatedness) is proved to be invariant across the five Arab countries and gender and can be used to compare the basic psychological needs in the Arab context.
Tannin-based extracts of Mimosa tenuiflora bark: features and prospecting as wood adhesives
Authors: Lopes Pedro Jorge Goes , Calegari Leandro , de Medeiros Silva Wagner Alex , Gatto Darci Alberto , de Medeiros Neto Pedro Nicó , de Melo Rafael Rodolfo , Bakke Ivonete Alves , de Avila Delucis Rafael , Missio André Luiz 
Published: January 2021

AbstractMimosa tenuiflora (Willd.) Poir. (MT) is an underutilized plant specie since its wood is mostly used for energy production. Nonetheless, the bark from this forest plant has a high amount of tannins and other valuable compounds. Tannins have high worldwide importance and, because of that, there is an increasing number of researches on biorefinery systems aiming at maximizing their exploitation. The present study evaluated tannins extracted from the MT bark and their use for producing wood adhesives. Three types of powdered tannins were extracted using different solvents: a pure aqueous solution, a 5% sodium hydroxide (NaOH) aqueous solution, and a 5% sodium bisulfite (NaHSO3) aqueous solution. Distilled water, wheat flour, and formaldehyde were also used as a solvent, a glue extender, and a catalyst, respectively. These adhesives were applied for bonding pine wood joints and their shear strengths were determined. All the MT-based adhesives showed high viscosities and, yielded glue lines with similar shear strengths and similar shear deformations if compared to each other. That tannin-based glue incorporated with the tannin extracted using NaOH or NaHSO3 stood out and yielded similar bonding performances if compared to a commercial adhesive applied as a positive control.
Promising improvement of chronic lateral elbow tendinopathy by using adipose derived mesenchymal stromal cells: a pilot study
Authors: Khoury Miguel , Tabben Montassar , Rolón Alejandro U. , Levi Lorena , Chamari Karim , D’Hooghe Pieter 
Published: January 2021

Abstract
Purpose
Study the effect of Adipose derived stromal cells (ASCs) injection as therapeutic procedure on the common extensor tendinopathy.

Methods
Eighteen Tennis players with chronic, recalcitrant LET (who have previously been unsuccessfully treated with nonoperative treatments) underwent clinical evaluation and magnetic resonance imaging (MRI) before intervention. Stromal vascular fraction cells (SVF) were expanded by in vitro culture and ASCs were obtained and characterized by flow cytometry. ASCs were injected into the site of tendinopathy (identified by ultrasound imaging at the origin of the common extensor tendon) on a single occasion followed by physiotherapy. Players underwent serial clinical evaluations during a 12-month period and repeated MRI at 6-month post-injection.

Results
At 6-month clinical evaluation revealed significant improvements compared to baseline in mean Visual Analog Scale (VAS) scores for: (1) maximum pain score (from 6.28 ± 1.65, to 1.0 ± 0.43; p < .001); (2) Mean quick Disabilities of the Arm, Shoulder and Hand (QuickDASH-Compulsory score: 51.38 ± 12.02 to 12.33 ± 4.66; p < .001); (3) QuickDASH-Sport score: 56.94 ± 15.44 to 8.68 ± 8.86; p < .001). Validated MRI scoring system grade of tendinopathy also improved significantly: 4.22 ± 0.26 to 2.22 ± 0.10 (p < .001). At 12-month from injection, VAS maximun pain score further decreased to 0.74 ± 0.44 (p < .001) and QuickDASH-Compulsory score to 5.56 ± 3.58 (p < .001). Average time to return to play tennis was 3,31 ± 0,61 month post-intervention.

Conclusion
Tennis players with recalcitrant LET showed significant clinical improvement and structural repair at the origin of the common tendon origin after injection of autologous ASCs. Results of this study are promising and open a new biological therapeutic modality to treat LET. Even if the results of this pilot study are positive, future well-designed studies, i.e. prospective randomized trials are needed to define the role of cell therapy in treating LET.
Careful medical interview and ultrasonography enabled detection of acute kidney injury and hematoma after lumbar trigger point injection—a case report
Authors: Sato Satoshi , Tachibana Shunsuke , Okazaki Kayoko , Namba Hitoshi , Ichimiya Takahiro , Yamakage Michiaki 
Published: January 2021

Abstract
Background
Trigger point blocks are now widely practiced, especially in pain treatment. Among the complications of lumbar trigger point injection, reports of medically induced kidney injury are very rare, and diagnosis during emergency treatment is rare.

Case presentation
A 78-year-old woman on antiplatelet medication following a stroke was diagnosed with treatable type A aortic dissection at another hospital after undergoing lumbar trigger point injection. On arrival at our hospital, there were no signs of hemodynamic deterioration. Additional careful medical re-interview and ultrasonography by anesthesiologists enabled a definitive diagnosis of acute kidney damage and hematoma caused by lumbar trigger point injection, and aortic dissection surgery was abandoned.

Conclusion
This clinical case demonstrates the importance of awareness of potential kidney injury and hematoma during lumbar trigger point injection.
Whole-body x-ray dark-field radiography of a human cadaver
Authors: Andrejewski Jana , De Marco Fabio , Willer Konstantin , Noichl Wolfgang , Gustschin Alex , Koehler Thomas , Meyer Pascal , Kriner Fabian , Fischer Florian , Braun Christian , Fingerle Alexander A. , Herzen Julia , Pfeiffer Franz , Pfeiffer Daniela 
Published: January 2021

Abstract
Background
Grating-based x-ray dark-field and phase-contrast imaging allow extracting information about refraction and small-angle scatter, beyond conventional attenuation. A step towards clinical translation has recently been achieved, allowing further investigation on humans.

Methods
After the ethics committee approval, we scanned the full body of a human cadaver in anterior-posterior orientation. Six measurements were stitched together to form the whole-body image. All radiographs were taken at a three-grating large-object x-ray dark-field scanner, each lasting about 40 s. Signal intensities of different anatomical regions were assessed. The magnitude of visibility reduction caused by beam hardening instead of small-angle scatter was analysed using different phantom materials. Maximal effective dose was 0.3 mSv for the abdomen.

Results
Combined attenuation and dark-field radiography are technically possible throughout a whole human body. High signal levels were found in several bony structures, foreign materials, and the lung. Signal levels were 0.25 ± 0.13 (mean ± standard deviation) for the lungs, 0.08 ± 0.06 for the bones, 0.023 ± 0.019 for soft tissue, and 0.30 ± 0.02 for an antibiotic bead chain. We found that phantom materials, which do not produce small-angle scatter, can generate a strong visibility reduction signal.

Conclusion
We acquired a whole-body x-ray dark-field radiograph of a human body in few minutes with an effective dose in a clinical acceptable range. Our findings suggest that the observed visibility reduction in the bone and metal is dominated by beam hardening and that the true dark-field signal in the lung is therefore much higher than that of the bone.
Prostate-Only Versus Whole-Pelvic Radiation Therapy in High-Risk and Very High-Risk Prostate Cancer (POP-RT): Outcomes From Phase III Randomized Controlled Trial
Authors: Murthy Vedang , Maitre Priyamvada , Kannan Sadhana , Panigrahi Gitanjali , Krishnatry Rahul , Bakshi Ganesh , Prakash Gagan , Pal Mahendra , Menon Santosh , Phurailatpam Reena , Mokal Smruti , Chaurasiya Dipika , Popat Palak , Sable Nilesh , Agarwal Archi , Rangarajan Venkatesh , Joshi Amit , Noronha Vanita , Prabhash Kumar , Mahantshetty Umesh 
Published: January 2021

PURPOSE We report the clinical outcomes of a randomized trial comparing prophylactic whole-pelvic nodal radiotherapy to prostate-only radiotherapy (PORT) in high-risk prostate cancer. METHODS This phase III, single center, randomized controlled trial enrolled eligible patients undergoing radical radiotherapy for node-negative prostate adenocarcinoma, with estimated nodal risk ≥ 20%. Randomization was 1:1 to PORT (68 Gy/25# to prostate) or whole-pelvic radiotherapy (WPRT, 68 Gy/25# to prostate, 50 Gy/25# to pelvic nodes, including common iliac) using computerized stratified block randomization, stratified by Gleason score, type of androgen deprivation, prostate-specific antigen at diagnosis, and prior transurethral resection of the prostate. All patients received image-guided, intensity-modulated radiotherapy and minimum 2 years of androgen deprivation therapy. The primary end point was 5-year biochemical failure-free survival (BFFS), and secondary end points were disease-free survival (DFS) and overall survival (OS). RESULTS From November 2011 to August 2017, a total of 224 patients were randomly assigned (PORT = 114, WPRT = 110). At a median follow-up of 68 months, 36 biochemical failures (PORT = 25, WPRT = 7) and 24 deaths (PORT = 13, WPRT = 11) were recorded. Five-year BFFS was 95.0% (95% CI, 88.4 to 97.9) with WPRT versus 81.2% (95% CI, 71.6 to 87.8) with PORT, with an unadjusted hazard ratio (HR) of 0.23 (95% CI, 0.10 to 0.52; P < .0001). WPRT also showed higher 5-year DFS (89.5% v 77.2%; HR, 0.40; 95% CI, 0.22 to 0.73; P = .002), but 5-year OS did not appear to differ (92.5% v 90.8%; HR, 0.92; 95% CI, 0.41 to 2.05; P = .83). Distant metastasis-free survival was also higher with WPRT (95.9% v 89.2%; HR, 0.35; 95% CI, 0.15 to 0.82; P = .01). Benefit in BFFS and DFS was maintained across prognostic subgroups. CONCLUSION Prophylactic pelvic irradiation for high-risk, locally advanced prostate cancer improved BFFS and DFS as compared with PORT, but OS did not appear to differ.
MONARCH 3: A randomized phase III study of anastrozole or letrozole plus abemaciclib, a CDK4/6 inhibitor, or placebo in first-line treatment of women with HR+, HER2-locoregionally recurrent or metastatic breast cancer (MBC).
Authors: Goetz Matthew P. , Toi Masakazu , Klise Suzanne , Frenzel Martin , Bourayou Nawel , Di Leo Angelo 
Published: January 2021

TPS624 Background: Abemaciclib (LY2835219), a cell cycle inhibitor of CDK4/CDK6, demonstrated a clinically manageable safety profile and single-agent anti-tumor activity in MBC; all tumor responses were observed in hormone receptor positive (HR+) disease (Tolaney SM, Rosen LS, Beeram M, et al. San Antonio Breast Cancer Symposium, 2014, Abstract P5-19-13). Non-steroidal aromatase inhibitors (NSAI, letrozole and anastrazole), approved in the first-line setting for postmenopausal women with HR+ MBC, are being evaluated in combination with abemaciclib for safety and tolerability in a phase Ib study (NCT02057133) and in the present study (NCT02246621) to assess clinical efficacy. Methods: MONARCH 3 is a randomized, double-blind, placebo-controlled, phase III study of abemaciclib + NSAI vs placebo + NSAI in locoregionally recurrent (not amenable to curative treatment) breast cancer or MBC, with no prior systemic therapy in this disease setting. Patients will be randomized 2:1, and stratified by nature of disease (visceral vs bone-only metastases vs other) and prior (neo)adjuvant endocrine therapy (aromatase inhibitor vs other vs none). Abemaciclib 150 mg or placebo will be given continuously PO every 12 hours until progression, along with anastrozole 1 mg or letrozole 2.5 mg once daily at the investigator’s discretion, and assessments will occur every 28 days. Postmenopausal women with HR+, HER2- disease, a disease-free interval > 12 mos after completion of (neo)adjuvant endocrine therapy, ECOG PS ≤ 1, adequate organ function, and measurable disease or nonmeasurable bone-only disease (RECIST v1.1) are eligible. The primary endpoint is progression-free survival (PFS); a key secondary endpoint is overall survival (OS). The study has 80% power to detect an increase in PFS of approximately 40% (hazard ratio = 0.714). Assuming a median PFS of 10 mos in the control arm, this corresponds to a 4-mo increase in the median PFS. PFS and OS will be hierarchically tested to maintain an overall type I error rate of 2.5%. Enrollment began November 2014; planned enrollment is 450 patients. Clinical trial information: NCT02246621.
Prenatal Exposure to General Anesthesia and Childhood Behavioral Deficit
Authors: Ing Caleb , Landau Ruth , DeStephano David , Miles Caleb H. , von Ungern-Sternberg Britta S. , Li Guohua , Whitehouse Andrew J. O. 
Published: January 2021

BACKGROUND:
Exposure to surgery and anesthesia in early childhood has been found to be associated with an increased risk of behavioral deficits. While the US Food and Drug Administration (FDA) has warned against prenatal exposure to anesthetic drugs, little clinical evidence exists to support this recommendation. This study evaluates the association between prenatal exposure to general anesthesia due to maternal procedures during pregnancy and neuropsychological and behavioral outcome scores at age 10.

METHODS:
This is an observational cohort study of children born in Perth, Western Australia, with 2 generations of participants contributing data to the Raine Study. In the Raine Study, the first generation (Gen1) are mothers enrolled during pregnancy, and the second generation (Gen2) are the children born to these mothers from 1989 to 1992 with neuropsychological and behavioral tests at age 10 (n=2024). In the primary analysis, 6 neuropsychological and behavioral tests were evaluated at age 10: Raven’s Colored Progressive Matrices (CPM), McCarron Assessment of Neuromuscular Development (MAND), Peabody Picture Vocabulary Test (PPVT), Symbol Digit Modality Test (SDMT) with written and oral scores, Clinical Evaluation of Language Fundamentals (CELF) with Expressive, Receptive, and Total language scores, and Child Behavior Checklist (CBCL) with Internalizing, Externalizing, and Total behavior scores. Outcome scores of children prenatally exposed to general anesthesia were compared to children without prenatal exposure using multivariable linear regression models adjusting for demographic and clinical covariates (sex, race, income, and maternal education, alcohol or tobacco use, and clinical diagnoses: diabetes, epilepsy, hypertension, psychiatric disorders, or thyroid dysfunction). Bonferroni adjustment was used for the 6 independent tests in the primary analysis, so a corrected P value <.0083 (P = .05 divided by 6 tests, or a 99.17% confidence interval [CI]) was required for statistical significance.

RESULTS:
Among 2024 children with available outcome scores, 22 (1.1%) were prenatally exposed to general anesthesia. Prenatally exposed children had higher CBCL Externalizing behavioral scores (score difference of 6.1 [99.17% CI, 0.2-12.0]; P = .006) than unexposed children. Of 6 tests including 11 scores and subscores, only CBCL Externalizing behavioral scores remained significant after multiple comparisons adjustment with no significant differences found in any other score.

CONCLUSIONS:
Prenatal exposure to general anesthetics is associated with increased externalizing behavioral problems in childhood. However, given the limitations of this study and that avoiding necessary surgery during pregnancy can have significant detrimental effects on the mother and the child, further studies are needed before changes to clinical practice are made.
You Know What I Know: Interviewer Knowledge Effects in Subjective Expectation Elicitation
Authors: Kerwin Jason T. , Ordaz Reynoso Natalia 
Published: January 2021

Abstract
Directly eliciting individuals' subjective beliefs via surveys is increasingly popular in social science research, but doing so via face-to-face surveys has an important downside: the interviewer's knowledge of the topic may spill over onto the respondent's recorded beliefs. Using a randomized experiment that used interviewers to implement an information treatment, we show that reported beliefs are significantly shifted by interviewer knowledge. Trained interviewers primed respondents to use the exact numbers used in the training, nudging them away from higher answers; recorded responses decreased by about 0.3 standard deviations of the initial belief distribution. Furthermore, respondents with stronger prior beliefs were less affected by interviewer knowledge. We suggest corrections for this issue from the perspectives of interviewer recruitment, survey design, and experiment setup.
What Doctors Want: A Comment on the Financial Preferences of Organized Medicine
Authors: Perera Isabel M. 
Published: January 2021

AbstractOrganized medicine's persistent demand for high payments is one factor that contributes to the rising costs of health care. The profession's long-standing preference for private and fee-for-service practice has pressured payers to increase reimbursement rates in fee-based systems; and it has stalled, thwarted, or otherwise co-opted attempts to contain costs in other payment systems. Yet what doctors want in fact varies. This article revisits classic comparative studies of organized medicine in advanced democracies to highlight two underemphasized findings: (1) physicians' financial preferences can deviate from traditional expectations, and (2) the structure of the organizations that represent doctors can shape whether and how those preferences are expressed. These findings remain relevant today as a discussion of contemporary American health politics illustrates.
Mutant Cx30-A88V mice exhibit hydrocephaly and sex-dependent behavioral abnormalities, implicating a functional role for Cx30 in the brain
Authors: Novielli-Kuntz Nicole M. , Press Eric R. , Barr Kevin , Prado Marco A. M. , Laird Dale W. 
Published: January 2021

ABSTRACT
Connexin 30 (Cx30; also known as Gjb6 when referring to the mouse gene) is expressed in ependymal cells of the brain ventricles, in leptomeningeal cells and in astrocytes rich in connexin 43 (Cx43), leading us to question whether patients harboring GJB6 mutations exhibit any brain anomalies. Here, we used mice harboring the human disease-associated A88V Cx30 mutation to address this gap in knowledge. Brain Cx30 levels were lower in male and female Cx30A88V/A88V mice compared with Cx30A88V/+ and Cx30+/+ mice, whereas Cx43 levels were lower only in female Cx30 mutant mice. Characterization of brain morphology revealed a disrupted ependymal cell layer, significant hydrocephalus and enlarged ventricles in 3- to 6-month-old adult male and female Cx30A88V/A88V mice compared with Cx30A88V/+ or Cx30+/+ sex-matched littermate mice. To determine the functional significance of these molecular and morphological changes, we investigated a number of behavioral activities in these mice. Interestingly, only female Cx30A88V/A88V mice exhibited abnormal behavior compared with all other groups. Cx30A88V/A88V female mice demonstrated increased locomotor and exploratory activity in both the open field and the elevated plus maze. They also exhibited dramatically reduced ability to learn the location of the escape platform during Morris water maze training, although they were able to swim as well as other genotypes. Our findings suggest that the homozygous A88V mutation in Cx30 causes major morphological changes in the brain of aging mice, possibly attributable to an abnormal ependymal cell layer. Remarkably, these changes had a more pronounced consequence for cognitive function in female mice, which is likely to be linked to the dysregulation of both Cx30 and Cx43 levels in the brain.