bluuebunny/crossref_metadata_2025_split huggingface dataset:
Ascorbic acid in urine still compromises urinalysis results
Authors: Nikolac Gabaj Nora , Miler Marijana , Unic Adriana , Milevoj Kopcinovic Lara , Vrtaric Alen , Culej Jelena 
Published: October 2019

Background The aim of this work was to determine the frequency of ascorbic acid-positive urine samples and to evaluate the potential risk on patient safety. Materials and methods A total of  27,856 samples submitted for urinalysis in previous year were retrospectively analysed from the laboratory information system. Urinalysis was done on Iris IQ200 analyzer using 11-parameter iChem Velocity test strips. Risk analysis combined the impact of potentially erroneous results (due to ascorbic acid interference) on patient safety (severity – S) with their frequency (occurrence – O). Potential risk was identified as high, intermediate and low. Results One thousand one hundred and ninety-nine (4.3%) and 1646 (5.9%) samples were mildly (20 mg/dL, 1+) and highly positive (40 mg/dL, 2+) for ascorbic acid, respectively. Severity (S1 to S5) was assigned to four possible errors: false-negative glucose (U-Glc: S2), blood (U-Hb: S5), nitrite (U-Nit: S4) and bilirubin (U-Bil: S1). Based on the frequency of errors, occurrence was categorized as: O2 for U-Glc, and O3 for U-Bil, U-Nit and U-Hb. The risk analysis matrix revealed that false-negative U-Hb was associated with potentially high risk, false-negative U-Nit with intermediate risk, while false-negative U-Glc and U-Bil were associated with low risk on patient safety. Conclusions Positive ascorbic acid can cause potentially high risk for patient safety by missing positive blood in urine.
Organ Donation and the Ars Moriendi
Authors: Doran Stephen 
Published: October 2019

Organ donation is rightly understood as a gift that is a genuine act of love. Organ donation as an act of love requires it to be an act of freedom that honors the integrity of the human person who is in the process of dying. However, the process of organ donation, by necessity, inserts a third party of interest whose primary aim is to assist someone other than the dying person. Caregivers can become “organ focused” instead of “patient focused.” The procurement of organs potentially results in the commodification of the potential organ donor. Furthermore, death is not a momentary event but rather an ontological change in the person where the union of body and soul becomes divided. This Catholic understanding of death is important to assess the impact of organ donation on the process of dying. Family members of organ donors often have traumatic memories associated with the organ donation process, potentially overshadowing the ars moriendi—the art of dying. Summary: While organ donation is an act of love, the donation process can be distraction from the care of the dying patient, who may be treated differently than other dying patients who are not organ donors. A Catholic understanding of death is helpful in assessing the impact of the organ donation process.
Office‐Based Stapes Surgery
Authors: Voizard Béatrice , Maniakas Anastasios , Saliba Issam 
Published: October 2019

ObjectiveThe objective of this study was to provide a proof of concept and to assess the success and safety of stapes surgery for otosclerosis under local anesthesia in an office‐based setting (OBS) as compared with a hospital operating room setting (ORS).Study DesignRetrospective cohort study.SettingWe reviewed all patients who underwent stapes surgery by the same surgeon from October 2014 to January 2017 at our tertiary care center (ORS, n = 36, 52%) and in an OBS (n = 33, 48%).Subjects and MethodsThe surgical technique was identical in both groups. All patients had a temporal bone computed tomography scan and audiogram within the 6 months prior to surgery. Air‐bone gaps (ABGs), bone conduction, and air conduction pure tone average values were calculated. Preoperative results for pure tone average, bone conduction, ABG, and word recognition scores were compared with early (4 months) and late (12 months) follow‐up audiograms. Intra‐ and postoperative complications were compared.ResultsBoth groups were comparable in terms of demographic characteristics and severity of disease. The mean 1‐year postoperative ABG was 5.66 dB (95% CI = 4.42‐6.90) in the ORS group and 6.30 dB (95% CI = 4.50‐8.10) in the OBS group (P =. 55). ABG improved by 24.27 dB (95% CI = 21.40‐27.13) in the ORS group and 23.15 dB (95% CI = 18.45‐27.85) in the OBS group (P =. 68). Complication rates did not differ, although this study remains underpowered.ConclusionsIn this small group of patients, the success of stapes surgery performed in an OBS and its complications were comparable to those of an ORS, thus providing an alternative to patients on long operating room waiting lists.
Assessment of a white matter reference region for 11C-UCB-J PET quantification
Authors: Rossano Samantha , Toyonaga Takuya , Finnema Sjoerd J , Naganawa Mika , Lu Yihuan , Nabulsi Nabeel , Ropchan Jim , De Bruyn Steven , Otoul Christian , Stockis Armel , Nicolas Jean-Marie , Martin Paul , Mercier Joel , Huang Yiyun , Maguire R Paul , Carson Richard E 
Published: October 2019

11C-UCB-J is a positron emission tomography (PET) radioligand that has been used in humans for synaptic vesicle glycoprotein 2A (SV2A) imaging and as a potential synaptic density marker. The centrum semiovale (CS) is a proposed reference region for noninvasive quantification of 11C-UCB-J, due to negligible concentrations of SV2A in this region in baboon brain assessed by in vitro methods. However, in displacement scans with SV2A-specific drug levetiracetam in humans, a decrease in 11C-UCB-J concentration was observed in the CS, consistent with some degree of specific binding. The current study aims to validate the CS as a reference region by (1) optimizing CS region of interest (ROI) to minimize spill-in from gray matter with high radioactivity concentrations; (2) investigating convergence of CS ROI values using ordered subset expectation maximization (OS-EM) reconstruction, and (3) comparing baseline CS volume of distribution ( VT) to nondisplaceable uptake in gray matter, VND. Improving ROI definition and increasing OS-EM iterations during reconstruction decreased the difference between CS VT and VND. However, even with these corrections, CS VT overestimated VND by ∼35–40%. These measures showed significant correlation, suggesting that, though biased, the CS may be a useful estimate of nondisplaceable uptake, allowing for noninvasive quantification for SV2A PET.
Improvement of image quality applying iterative scatter correction for grid-less skeletal radiography in trauma room setting
Authors: Lisson Christoph G , Lisson Catharina S , Vogele Daniel , Strauss Beatrice , Schuetze Konrad , Cintean Raffael , Beer Meinrad , Schmidt Stefan A 
Published: October 2019

Background Iterative reconstruction is well established for CT. Plain radiography also takes advantage of iterative algorithms to reduce scatter radiation and improve image quality. First applications have been described for bedside chest X-ray. A recent experimental approach also provided proof of principle for skeletal imaging. Purpose To examine clinical applicability of iterative scatter correction for skeletal imaging in the trauma setting. Material and Methods In this retrospective single-center study, 209 grid-less radiographs were routinely acquired in the trauma room for 12 months, with imaging of the chest (n = 31), knee (n = 111), pelvis (n = 14), shoulder (n = 24), and other regions close to the trunk (n = 29). Radiographs were postprocessed with iterative scatter correction, doubling the number of images. The radiographs were then independently evaluated by three radiologists and three surgeons. A five-step rating scale and visual grading characteristics analysis were used. The area under the VGC curve (AUCVGC) quantified differences in image quality. Results Images with iterative scatter correction were generally rated significantly better (AUCVGC = 0.59, P < 0.01). This included both radiologists (AUCVGC = 0.61, P < 0.01) and surgeons (AUCVGC = 0.56, P < 0.01). The image-improving effect was significant for all body regions; in detail: chest (AUCVGC = 0.64, P < 0.01), knee (AUCVGC = 0.61, P < 0.01), pelvis (AUCVGC = 0.60, P = 0.01), shoulder (AUCVGC = 0.59, P = 0.02), and others close to the trunk (AUCVGC = 0.59, P < 0.01). Conclusion Iterative scatter correction improves the image quality of grid-less skeletal radiography in the clinical setting for a wide range of body regions. Therefore, iterative scatter correction may be the future method of choice for free exposure imaging when an anti-scatter grid is omitted due to high risk of tube-detector misalignment.
A new instrument for surgical stabilization of multiple rib fractures
Authors: Jian Xiong , Lei Wu , Yuyang Pi , Yongdong Xu 
Published: October 2019

Objective Rib fixation is an effective treatment for patients with multiple rib fractures. We retrospectively evaluated the application of a four-claw titanium plate in patients with rib fractures. Methods Fifty-four patients treated for multiple rib fractures in our hospital from 2012 to 2016 were divided into a surgery group (n = 27) and conservative treatment group (n = 27). The patients’ age, sex, cause of fracture, Injury Severity Score, chest Abbreviated Injury Scale score, number of ventilator days, and length of hospitalization were recorded. Results The mean duration of mechanical ventilation was 4.5 ± 0.7 and 7.9 ± 1.7 days in the surgery and control group, respectively, with a significant difference. The length of intensive care unit stay was also significantly different between the groups (5.9 ± 0.6 vs. 10.6 ± 1.9 days, respectively). The length of hospital stay and recovery time to regular life in the surgery and control group were 11.5 ± 1.9 and 3.9 ± 4.0 days and 38.2 ± 8.3 and 60.8 ± 12.1 days, respectively, both with significant differences. Conclusion A four-claw titanium plate is valuable for patients with multiple rib fractures, allowing easy fixation of broken ribs beneath the scapula, even the second rib.
Rural–urban disparities in caesarean section rates in minority areas in China: evidence from electronic health records
Authors: Kang Lili , Gu Hai , Ye Shangyuan , Xu Biao , Jing Kangzhen , Zhang Ning , Zhang Bo 
Published: October 2019

Objective To assess the rural–urban disparity in caesarean section rates using electronic health records from hospitals located in the Province of Inner Mongolia, which is a minority area in Northeastern China. Methods The study examined the electronic health records of women that gave birth in three major public hospitals between January 2012 and December 2016. Multinomial regression analyses were used to estimate rural–urban disparities in caesarean section rates. Results Data from 61 903 women were examined. Caesarean section rates increased slightly over the study period and the rate was significantly higher in rural compared with urban hospitals (48% versus 38%). This disparity consistently increased over time. Multinomial regression analyses showed that maternal age, ethnicity, health insurance type, employment status, reproductive history and the newborn’s sex were significant risk factors associated with caesarean section rate. Furthermore, stratified analysis of first-time pregnancies, minorities and different age groups showed that the odds of undergoing an emergency caesarean section was lower in the rural hospital, but the odds of undergoing a planned caesarean section was higher in the rural hospital. Conclusions Caesarean section rates have increased in rural areas and the disparity in rural–urban areas has increased substantially over the years.
Posterior Reversible Encephalopathy Syndrome in Children:: A Prospective Follow-up Study
Authors: Darwish Amira Hamed 
Published: October 2019

Aim: To evaluate clinical and radiologic presentation, and neurologic outcome of pediatric posterior reversible encephalopathy syndrome (PRES). Patients and Methods: The study included 24 children (14 males and 10 females) diagnosed with PRES who were prospectively followed for 2 years. They were evaluated using Wechsler Intelligence Scale, electroencephalograph (EEG), and brain magnetic resonance imaging (MRI). Results: The mean age of the studied patients at the time of diagnosis of PRES was 6 years (±2.2). Chemotherapy for cancer represented 66.7% of the causes of PRES in the studied children, followed by renal disorders and immunosuppressive agents for hematopoietic stem cell transplantation. Twenty-seven attacks of PRES were reported as 3 children developed a second attack of PRES. Normal intelligence quotient was found in 95.8% of studied children after PRES. Residual abnormalities in follow-up MRI were demonstrated in 3 children. Epilepsy and residual MRI lesions were reported in 2 of the 3 children with recurrent PRES. Residual lesions in follow-up MRI and epilepsy were more significantly reported after recurrent PRES ( P < .05). Conclusions: Neoplastic, renal disorders and hematopoietic stem cell transplantation represent the main disorders associated with PRES in children. Chemotherapeutic drugs, immunosuppressants, and hypertension are the main risk factors for pediatric PRES. The outcome of pediatric PRES is good, but long-term neurologic sequelae can occur, mainly epilepsy and residual MRI abnormalities. Recurrence of PRES is infrequently reported in children receiving chemotherapeutic or immunosuppressive drugs. Recurrent PRES is a risk factor for long-term neurologic sequelae.
Analysis of reproducibility, evaluation, and preference of the new iC100 rebound tonometer versus iCare PRO and Perkins portable applanation tonometry
Authors: Molero-Senosiaín Mercedes , Morales-Fernández Laura , Saenz-Francés Federico , García-Feijoo Julian , Martínez-de-la-Casa Jose María 
Published: October 2019

Objectives: To analyze the reproducibility of the new iC100 rebound tonometer, to compare its results with the applanation tonometry and iCare PRO and to evaluate the preference between them. Materials and methods: For the study of reproducibility, 15 eyes of 15 healthy Caucasian subjects were included. Three measurements were taken each day in three separate sessions. For the comparative study, 150 eyes of 150 Caucasian subjects were included (75 normal subjects and 75 patients with glaucoma). Three consecutive measurements were collected with each tonometer, randomizing the order of use. The discomfort caused by each tonometer was evaluated using the visual analogue scale. Results: No statistically significant differences were detected between sessions. In the comparison between tonometers, the measurements with iC100 were statistically lower than those of Perkins (−1.35 ± 0.417, p = 0.004) and that iCare PRO (−1.41 ± 0.417, p = 0.002). The difference between PRO and Perkins was not statistically significant ( p = 0.990). The mean time of measurement (in seconds) with iC100 was significantly lower than with Perkins (6.74 ± 1.46 vs 15.53 ± 2.01, p < 0.001) and that PRO (6.74 ± 1.46 vs 11.53 ± 1.85, p < 0.001). Visual analogue scale score with iC100 was lower than Perkins (1.33 ± 0.99 vs 1.73 ± 1.10, p < 0.05). In total, 61.7% preferred iC100 against Perkins. Conclusion: The reproducibility of this instrument has been proven good. iC100 underestimates intraocular pressure compared to applanation tonometry at normal values and tends to overestimate it in high intraocular pressure values. Most of the subjects preferred iC100 tonometer.
The role of cholesterol and cholesterol-driven membrane raft domains in prostate cancer
Authors: Hryniewicz-Jankowska Anita , Augoff Katarzyna , Sikorski Aleksander F 
Published: October 2019

Membrane rafts are heterogeneous and dynamic domains that are characterized by tight packing of lipids. They are enriched in cholesterol, sphingolipids, and certain types of proteins. Among these are various cell signaling proteins, which indicate that rafts play an important role in cell signal transduction pathways, including some involved in cancer development, progression, and invasiveness. Due to their increased cholesterol content, raft domains exhibit lower fluidity than the surrounding membrane. The cell membranes of some solid tumors, such as breast and prostate cancer, contain higher levels of cholesterol, which means larger raft domain can form in those membranes. This may stimulate signaling pathways to promote tumor growth and progression. This review focuses on the known raft-dependent regulatory mechanisms that promote prostate cancer progression.Impact statementProstate cancer remains the most common malignancy and second most frequent cause of cancer-related death in men. Cholesterol levels are usually higher in prostate cancer cells. This affects the cell membrane composition, with cholesterol and sphingolipid-containing raft membrane domains becoming a greater component. In addition to polar lipids, these domains recruit and regulate certain types of protein, including various cell signaling proteins that are critical to cancer cell survival and invasiveness. This suggests that membrane rafts have a regulatory role in tumor progression, making them a potential target in prostate cancer treatment.
Polymorphism of xenobiotic metabolizing gene and susceptibility of epithelial ovarian cancer with reference to organochlorine pesticides exposure
Authors: Sharma Tusha , Banerjee Basu D , Thakur Gaurav K , Guleria Kiran , Mazumdar Darshana 
Published: October 2019

The transformation of ovarian surface epithelial cells, stromal cells, sex cord, or germ cells initiates ovarian malignancy. Epithelial ovarian cancer (EOC) is clinically silent with vague, non-specific symptomatology and is generally diagnosed at an advanced stage, resulting in a high mortality rate. The known main etiological factors are: age at menarche and menopause (early menarche or late menopause), use of oral contraception (estrogen and/or progesterone), family history, genetic factors, inflammation, occupational and environmental exposure. The study is intended to assess the association between blood organochlorine pesticide (OCP) levels and polymorphic status of phase I and phase II metabolizing enzymes (CYP1A1, GSTM1, and GSTT1) in the pathogenesis of epithelial ovarian cancer. The study included 200 subjects in total, of which 100 were epithelial ovarian cancer cases and 100 were controls. Estimation of blood organochlorine pesticide levels was carried out using gas chromatography and significantly high levels of beta-hexachlorocyclohexane (β-HCH), endosulfan-I, endosulfan-II, dichlorodiphenyltrichloroethane (pʹpʹ-DDT), dichlorodiphenyldichloroethylene (pʹpʹ-DDE) were observed in cases as compared to controls ( P-value = 0.029, 0.042, 0.044, 0.039 and 0.037 respectively). For studying the polymorphism of CYP1A1, GSTM1/T1, PCR-RFLP, AS-PCR and multiplexing were performed and the frequency of null deletion of GSTM1/T1 was significantly higher in epithelial ovarian cancer cases. Regression model testing was also performed to check the interactive effect of organochlorine pesticide levels and polymorphic variant of genes keeping CA-125 as the dependent variable and observed a statistically significant role of genotypic/environmental interaction in epithelial ovarian cancer cases in the North Indian population. Impact statement Among pervasive environmental toxins, OCPs are one of the largest and most hazardous classes of contaminants in use around the world. Because these compounds possess the estrogen mimicking properties, the accumulation of these compounds in the human body may be a risk for several hormone-dependent diseases. EOC is hormonally dependent cancer and the mortality rate due to this disease is increasingly prevalent, and it has become imperative to explore the role of OCPs in the disease pathogenesis. The present study highlights the significant association of high OCPs level in the disease pathogenesis. It is also observed that the polymorphism in xenobiotic metabolism enzymes alters the predisposition of OCPs. The synergistic effect of gene polymorphism (CYP1A1, GSTM1, and GSTT1) and non-occupational exposure to OCPs was also assessed considering CA125 level as dependent variable with the risk of EOC and concluded that there exist a potential role of genotypic/environmental interaction in the etiology of EOC.
Mechanical thrombectomy in patients with acute ischemic stroke: A cost-effectiveness and value of implementation analysis
Authors: Heggie Robert , Wu Olivia , White Phil , Ford Gary A , Wardlaw Joanna , Brown Martin M , Clifton Andrew , Muir Keith W 
Published: October 2019

Background Recent clinical trials have demonstrated the efficacy of mechanical thrombectomy in acute ischemic stroke. Aims To determine the cost-effectiveness, value of future research, and value of implementation of mechanical thrombectomy. Methods Using UK clinical and cost data from the Pragmatic Ischemic Stroke Thrombectomy Evaluation (PISTE) trial, we estimated the cost-effectiveness of mechanical thrombectomy over time horizons of 90-days and lifetime, based on a decision-analytic model, using all existing evidence. We performed a meta-analysis of seven clinical trials to estimate treatment effects. We used sensitivity analysis to address uncertainty. Value of implementation analysis was used to estimate the potential value of additional implementation activities to support routine delivery of mechanical thrombectomy. Results Over the trial period (90 days), compared with best medical care alone, mechanical thrombectomy incurred an incremental cost of £5207 and 0.025 gain in QALY (incremental cost-effectiveness ratio (ICER) £205,279), which would not be considered cost-effective. However, mechanical thrombectomy was shown to be cost-effective over a lifetime horizon, with an ICER of £3466 per QALY gained. The expected value of perfect information per patient eligible for mechanical thrombectomy in the UK is estimated at £3178. The expected value of full implementation of mechanical thrombectomy is estimated at £1.3 billion over five years. Conclusion Mechanical thrombectomy was cost-effective compared with best medical care alone over a patient’s lifetime. On the assumption of 30% implementation being achieved throughout the UK healthcare system, we estimate that the population health benefits obtained from this treatment are greater than the cost of implementation. Trial registration NCT01745692.