bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical outcomes of patients with multivessel coronary artery disease treated with robot-assisted coronary artery bypass graft surgery versus one-stage percutaneous coronary intervention using drug-eluting stents
Authors: Su Chieh-Shou , Shen Ching-Hui , Chang Keng-Hao , Lai Chih-Hung , Liu Tsun-Jui , Chen Kuan-Ju , Lin Tzu-Hsiang , Chen Yu-Wei , Lee Wen-Lieng 
Published: October 2019

Abstract
A number of studies have reported on treatment outcomes of coronary stenting (PCI) for multivessel coronary artery diseases (MVD), and compared them with the conventional coronary artery bypass grafting (CABG). However, the clinical outcomes of robot-assisted CABG (R-CABG) in comparison with PCI in MVD patients have not been investigated.
We recruited retrospectively MVD patients receiving R-CABG and PCI with drug-eluting stents for all vessels in one stage between January 2005 and December 2013 at our institution with at least 3 years of outcomes were retrospectively recruited and analyzed.
A total of 638 MVD patients were studied. Among them, 281 received R-CABG, and 357 received PCI. Similar complete revascularizations were achieved in both groups (R-CABG: 40.2%, PCI: 41.5%, P = .751). The residual stenosis was 4.1 ± 4.4 in the R-CABG group, and comparably 3.5 ± 3.7 in the PCI group (P = .077). Patients in the R-CABG group were younger, with more severe coronary artery disease (CAD) and had more background risk factors. The in-hospital and long-term mortalities as well as the incidence of TLR, myocardial infarction (MI), stroke were all similar between groups. But the incidence of TVR and any revascularization were lower in the R-CABG group. The long-term mortality was predicted by age, left ventricular ejection fraction, and chronic kidney disease, but not by the revascularization modality, completeness of revascularization, nor residual SYNTAX scores. The last 3 factors were not predictors of long-term TLR, TVR, MI, and stroke.
The in-hospital and long-term survival rates of MVD were similar for both the R-CABG and PCI groups. But the R-CABG group had rates of TVR and any revascularization lower than PCI. Revascularization modality, completeness of revascularization, and residual SYNTAX scores were not predictors of in-hospital and long-term mortalities, MI, and stroke in real-world practice. R-CABG was associated with lower rates of TLR and TVR, and is likely a safe and effective treatment and an alternative choice of PCI for MVD patients who have low surgical risks.
Increased risk of appendectomy in patients with asthma
Authors: Kim So Young , Oh Dong Jun , Park Bumjung , Park Il-Seok , Choi Hyo Geun 
Published: October 2019

Abstract
The study aimed to expand previous data regarding an association between asthma and appendectomy in children compared with the population of all ages.
The Korean Health Insurance Review and Assessment Service—National Sample Cohort from 2002 through 2013 was used. In all, 22,030 participants who underwent appendectomy were matched for age, sex, income, region of residence, hypertension, diabetes, and dyslipidemia with 88,120 participants who were included as a control group. In both the appendectomy and control groups, previous history of asthma was investigated. Appendectomy for appendicitis was identified based on a surgical code (International Classification of Disease-10 [ICD-10]: K35). Asthma was classified using an ICD-10 code (J45 and J46) and medication history. The crude and adjusted odds ratios (ORs) and 95% confidence intervals (CIs) of asthma for appendectomy were analyzed using conditional logistic regression analysis. Subgroup analyses were conducted according to age and sex.
Approximately 15.2% (3358/22,030) of individuals in the appendectomy group and 13.3% (11,749/88,120) of those in the control group had asthma (P < .001). The appendectomy group demonstrated a higher adjusted odds of asthma than the control group (adjusted OR 1.18, 95% CI 1.13–1.23, P < .001). This result was consistent in the subgroups divided according to age and sex.
The odds for asthma were higher in the appendectomy group than in the control group.
Gait turning patterns in chronic ischemic stroke males and its relationship to recovery
Authors: Kusumaningsih Widjajalaksmi , Triangto Kevin , Salim Harris 
Published: October 2019

Abstract

Introduction:
Impaired turning patterns have been considered as 1 factor which potentially leads to disability in chronic stroke patients. Mobility comprises 80% of the chief disability, and would eventually lead to falls. Expanded Timed Up and Go (ETUG) is an effective mobility assessment method. It utilizes video recording to analyze the conventional Time Up and Go (TUG) Test components, which includes turning pattern analysis.

Methods:
Six healthy males without stroke history and 21 chronic ischemic stroke males (divided into subjects with or without the presence of flexor synergy pattern subgroups) capable of independent ambulation were recruited from Neurology and Medical Rehabilitation Department outpatient clinic. ETUG tests were recorded for each subject and were analyzed thoroughly using a computer program.

Results:
Timed Up and Go time was significantly different between the 3 groups (P = .001). As compared to control, and synergy absent group, median turning time was highest in chronic stroke patients with presence of flexor synergy by 2786 ms (P = .002), but was not significantly different in percentage ETUG (14%, P = .939). Further analysis revealed that Brunnstrom stage and number of steps taken for turning significantly affect TUG duration. Other factors such as hemiparetic side, or body height were not significantly associated.

Discussion:
The presence of flexor synergy would significantly affect turning time, this would then correlate to the disability of shifting body's center of gravity, as a part of the Stroke core set of International Classification of Functioning, Disability, and Health (ICF).Therefore, stroke patients need to have early ambulatory training regarding pivoting motion rather than solely focusing on straight walking. Instead of hemiparetic side, it is possible that overall turning time is affected by coordination and orientation capability, signifying the importance of cortical plasticity.
Spontaneous cerebellar hemorrhage with severe brainstem dysfunction through minimally invasive puncture treatment by locating the simple bedside
Authors: Wang Jing , Wu Qing-Yuan , Du Cui-Ping , Liu Jin , Zhang Hua , Wang Jun-Yan , Xue Wei , Chen Sheng-Li 
Published: October 2019

Abstract
This study aims to evaluate the feasibility and effectiveness of minimally invasive puncture treatment by positioning the simple bedside for spontaneous cerebellar hemorrhage.
From January 2017 to March 2018, the investigators applied simple bedside positioning to perform the intracranial hematoma minimally invasive surgery for 21 patients with cerebellar hemorrhage.
For these 21 patients, the bleeding amount and Glasgow Coma Scale (GCS) score before the operation were 18.5 ± 5.0 cc and 9.5 ± 3.3, respectively; 24 hours after the operation, the GCS score was 11.0 ± 4.6. Five patients died within 7 days of the operation and the head computed tomography (CT) was re-examined. It was found that the average bleeding amount was 3.4 ± 0.9 cc, the operation success rate was 76.2%, and the accurate puncture rate was 100%. Six months later, the Modified Rankin Scale (MRS) score was 2.5 ± 2.0. The postoperative recovery was good. The situation shows that patients with favorable outcomes (MRS score 0–2) accounted for 38.1% (8/21), and the fatality rate was 33.3% (7/21).
The efficacy of the intracranial hematoma minimally invasive surgery by positioning the simple bedside for spontaneous cerebellar hemorrhage with severe brainstem dysfunction is good.
The 100 most-cited articles on prenatal diagnosis
Authors: Zhang Meilian , Zhou Yu , Lu Yanfang , He Suhui , Liu Min 
Published: October 2019

Abstract

Background:
The number of citations a published article receives can be used to demonstrate its impact on a field of study. The objective of this study was to identify and characterize the 100 most-cited research articles (T100) published on prenatal diagnosis.

Methods:
The Web of Science (WOS) database was searched for papers on prenatal diagnosis published between 1900 and 2018. The 100 most-cited original articles and reviews were recorded. Each eligible paper was reviewed for authors, journal name, year of publication, country, institution, total citations, citation density, H-index, research field, article type, and keywords.

Results:
The T100 were published between 1972 and 2015 with a mean of 332.7 citations per paper (range: 196–1254). Most of the T100 were published between 1990 and 2005, in 35 journals led by New England Journal of Medicine (n = 14) followed by Lancet (n = 10), and Proceedings of The National Academy of Sciences of the United States of America (n = 8). Studies on method application, which promotes field development, were the majority article type. The team of Lo YM featured prominently in the field, and the United States of America, United Kingdom, and Hong Kong, China were the leading countries/regions. Frequency of cooperation was also highest among these 3 regions. Hierarchical cluster analysis produced 4 groups of keywords.

Conclusion:
Our analysis provides a historical perspective on scientific progress in prenatal diagnosis and may assist clinicians and researchers in assessing the quality of research over the past 50 years. It also provides concise information to guide future research.
Immunohistochemistry of immune checkpoint markers PD-1 and PD-L1 in prostate cancer
Authors: Sharma Meenal , Yang Zhiming , Miyamoto Hiroshi 
Published: October 2019

Abstract
Recent availability of immune checkpoint inhibitors has facilitated research involving programmed cell death protein 1 (PD-1) and its ligand, programmed death-ligand 1 (PD-L1). However, the incidence and clinical implication of PD-1 and PD-L1 expression in prostate cancer remain poorly understood. The current study aimed to determine the status of PD-1/PD-L1 expression in prostate cancer specimens and its prognostic significance.
We immunohistochemically stained for PD-1 and PD-L1 in our tissue microarray (TMA) consisting of radical prostatectomy specimens. The expression of PD-1/PD-L1 was designated as positive when moderate to strong staining or weak staining was seen in at least 1% or 10%, respectively, of tumor cells and/or associated immune cells. We then evaluated the relationship between the expression of each protein and clinicopathological features available for our patient cohort.
PD-1 and PD-L1 were positive in 3 (1.5%) and 1 (0.5%) of 201 non-neoplastic prostate tissues, and also in 17 (7.7%) and 29 (13.2%) of 220 prostate cancers, respectively. PD-1 and PD-L1 were also expressed in tumor-infiltrating lymphocytes/macrophages in 172 (78.2%) and 33 (15.0%) cases, respectively. PD-L1 expression in tumor cells was more often seen in high pT stage (pT2: 10.8% vs pT3/4: 20.4%; P = .072; pT2/3a: 11.4% vs pT3b/4: 31.6%; P = .013) or lymph node-positive (pN0: 10.1% vs pN1: 27.3%; P = .086) cases, whereas PD-1 expression in tumor cells was not significantly associated with pT/pN stage. In addition, there were no statistically significant associations between PD-1/PD-L1 expression in tumor cells or tumor-infiltrating lymphocytes/macrophages versus patient age, preoperative prostate-specific antigen level, or Gleason score. Kaplan–Meier analysis coupled with log-rank test further revealed no significant associations between PD-1/PD-L1 expression in tumor cells (P = .619/P = .315), tumor-infiltrating lymphocytes/macrophages (P = .954/P = .155), or either or both of them (P = .964/P = .767) versus disease recurrence after radical prostatectomy.
PD-1/PD-L1 expression was detected in a subset of prostate cancers. In particular, PD-L1 expression was considerably up-regulated in nonorgan-confined tumors. However, PD-1/PD-L1 expression in our TMA was found to be not very helpful in predicting tumor recurrence in prostate cancer patients who underwent radical prostatectomy.
Religious values of physicians affect their clinical practice
Authors: Kørup Alex Kappel , Søndergaard Jens , Lucchetti Giancarlo , Ramakrishnan Parameshwaran , Baumann Klaus , Lee Eunmi , Frick Eckhard , Büssing Arndt , Alyousefi Nada A. , Karimah Azimatul , Schouten Esther , Wermuth Inga , Hvidt Niels Christian 
Published: October 2019

Abstract

Background:
Observational studies indicate that religious values of physicians influence clinical practice. The aim of this study was to test prior hypotheses of prevalence of this influence using a meta-analysis design.

Methods:
Based on a systematic literature search we performed individual participant data meta-analysis (IPDMA) on data based on 2 preselected questionnaires. Ten samples from 7 countries remained after exclusion (n = 3342). IPDMA was performed using a random-effects model with 2 summary measures: the mean value of the scale “Religiosity of Health Professionals”; and a dichotomized value of the question “My religious beliefs influence my practice of medicine.” Also, a sensitivity analysis was performed using a mixed-models design controlling for confounders.

Results:
Mean score of religiosity (95% confidence interval [CI]) was significantly lower in the European subgroup (8.46 [6.96–9.96]) compared with the Asian samples India (10.46 [9.82–10.21]) and Indonesia (12.52 [12.19–12.84]), whereas Brazil (9.76 [9.54–9.99]) and USA (10.02 [9.82–10.21]) were placed in between. The proportion of the European physicians who agreed to the statement “My religious beliefs influence my practice of medicine” (95% CI) was 42% (26%–59%) compared with Brazil (36% [29%–43%]), USA (57% [54%–60%]), India (58% [52%–63%]), and Indonesia (91% [84%–95%]).

Conclusions:
Although large cross-cultural variations existed in the samples, 50% of physicians reported to be influenced by their religious beliefs. Religiosity and influence of religious beliefs were most pronounced in India, Indonesia, and a European faith-based hospital. Education regimes of current and future physicians should encompass this influence, and help physicians learn how their personal values influence their clinical practice.
Can people self-select an exercise intensity sufficient to enhance muscular strength during weight training?
Authors: de Oliveira Segundo Victor Hugo , Piuvezam Grasiela , de Azevedo Kesley Pablo Morais , de Medeiros Humberto Jefferson , Leitão José Carlos , Knackfuss Maria Irany 
Published: October 2019

AbstractBackground:Previous studies have reported that self-selection of the training intensity can be an interesting strategy to improve adherence in aerobic exercise programs. However, its effectiveness with weight training has not been systematically reviewed and remains unclear. In this study, we will describe a systematic review protocol that aims to investigate if people are able to self-select an intensity during weight training sufficient to enhance muscular strength.Methods:This protocol is guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols. In this study, we will search the following electronic databases: PubMed, Science Direct, Scopus, Web of Science and SPORTDiscus. Intervention studies with at least one weight training session performed at self-selected intensity, with people from both genders and all age ranges will be included. The Downs & Black checklist will be used for methodological quality assessment. Two experienced reviewers will independently perform the selection of studies, data extraction, and evaluation of the methodological quality.Conclusion:This will be the first systematic review describing the results of weight training intervention studies with self-selected intensity. This study will provide high-quality and reliable evidence for health professionals and may direct methodological recommendations for further studies.PROSPERO registration number:CRD42019120323
Frozen embryo transfer at the cleavage stage can be performed within the first menstrual cycle following the freeze-all strategy without adversely affecting the live birth rate
Authors: Song Jingyan , Xiang Shan , Sun Zhengao 
Published: October 2019

Abstract
Thus far, all clinical trials evaluating the efficacy of embryo transfer strategies have selectively delayed the first frozen embryo transfer (FET) by at least 1 menstrual cycle. Nevertheless, this approach, which is based solely on clinical experience, may create unnecessary psychological stress on infertile patients who are anxious to conceive as soon as possible. This study aimed to investigate whether the time interval between oocyte retrieval and subsequent FET affects reproductive outcomes.
We implemented a large retrospective cohort study in a single assisted reproductive technology (ART) unit at a university-based hospital, including 1540 autologous FET cycles performed in freeze-all cycles. The beginning of the FET was classified as either ‘cycle 1’ (performing FET within the first menstrual cycle) or ‘cycle ≥2’ (performing FET after one or more menstrual cycles). Live birth rate (LBR) was the primary outcome of our study.
The mean interval for ‘cycle 1’ and ‘cycle ≥2’ FETs was 25.72 ± 5.10 days and 75.33 ± 24.85 days, respectively (P < .001). The type of controlled ovarian hyperstimulation (COH) and endometrial preparation protocols differed significantly between groups (P = .008 and P = .004, respectively). However, FET groups were similar in many ways. Univariate analysis showed that there was no significant difference in LBR between the different cycles (33.1% after ‘cycle 1’ FET vs 34.2% after ‘cycle ≥2’ FET, P = .68). To evaluate whether LBR remained unchanged after adjustment for potential confounders, we performed multivariate logistic regression. FET timing had no significant impact on LBR in the first FET (odds ratio [OR]: 1.06, 95% confidence interval [CI]: 0.80–1.39).
In accordance with the present study, it might not be necessary for clinicians to wait more than 1 menstrual cycle before performing FET. This allows us to reduce otiose deferment in FET, without adversely affecting reproductive outcomes.
Paget's disease of bone: updates for clinicians
Authors: Hsu Emory 
Published: October 2019

Purpose of review
To provide clinicians an overview to the diagnosis, treatment, and management of Paget's disease, including recent guideline recommendations, with comparison of the Endocrine Society Clinical Practice Guideline (JCEM 2014) with the new Clinical Guideline review endorsed by the International Osteoporosis Foundation, the American Society of Bone and Mineral Research, the European Calcified Tissues Society, and the United Kingdom Bone Research Society (JBMR 2019).

Recent findings
Radionuclide bone scans are recommended for assessing the extent of Paget's disease. Bisphosphonates remain the mainstay for therapy with evidence of reducing symptomatic bone pain. One 5 mg intravenous dose of zoledronic acid is the current standard therapy for Paget's disease.

Summary
Paget's disease of the bone is characterized by focal increased bone remodeling activity, resulting in sclerotic or lytic lesions and poor bone quality at one or more sites. Patients may be symptomatic with bone pain, or may be asymptomatic, and identified through unexplained elevations in serum alkaline phosphatase. Diagnosis is through plain film imaging, with radionuclide bone scan to determine the extent. A single dose of IV zoledronic acid typically results in extended suppression of bone turnover and amelioration of bone pain. There remains a lack of evidence regarding efficacy of this treatment with regards to other complications of Paget's, but in general, bisphosphonate treatment is recommended.
Older Adults With Subjective Cognitive Decline Worry About the Emotional Impact of Cognitive Test Results
Authors: Wong Sara , Smith Samantha , Jacova Claudia 
Published: October 2019

Introduction:
Older adults with subjective cognitive decline (SCD) would benefit from routine cognitive testing as they are twice as likely to develop dementia. Worries about concerning test results may diminish participation. The current study aimed to characterize the pattern of worries among older adults with and without SCD.

Methods:
Adults 50 years or above completed the Attitudes Around Cognitive Testing questionnaire on Mechanical Turk.com or in a primary care setting. Mechanical Turk.com is an online crowdsourcing site where requesters (eg, researchers) post jobs (eg, surveys or tasks) and workers (eg, respondents) choose which jobs to do for pay. Respondents were asked about perceived cognitive decline and about different types of worries they anticipated having if they received concerning test results.

Results:
We report data for 393 respondents (online: n=296, primary care: n=97), mean age of 63 years, age range of 50 to 91 years, and 60% endorsing SCD. Compared with No SCD, those with SCD anticipated a higher number of worries centered disproportionately on worries of becoming depressed, ashamed or embarrassed, feeling “stupid” and unable to do things, and being put in a nursing home. We observed this SCD pattern of worries in both samples.

Discussion:
Individuals with SCD worry about the emotional consequences of cognitive testing. This at-risk group would benefit from interventions focused on these concerns to increase patient engagement with cognitive tests.
The Sensitivity of PCR combined with the Specificity of Toxin Enzyme Immunoassay: Could an Ultra-sensitive Single Molecule Counting Technology Offer a Standalone Solution for Diagnosis of Clostridioides difficile Infection?
Authors: Perry Michael , Graham Lee , Perry Lauren , Parida Sweta , Katzenbach Phoebe , Baptista Jose , Sandlund Johanna , Anderson Bethan , Copsey Sarah , Scotford Selina , Morris Tefor 
Published: October 2019

Background
Clostridioides difficile infection (CDI) continues to cause significant morbidity and avoidable mortality worldwide. Results from an ultra-sensitive toxin immunoassay (Singlulex Clarity C. diff toxins A/B assay) were compared with those of various other diagnostic and reference methods/algorithms for the detection of C. difficile.

Methods
293 residual clinical stool samples were tested using the Singulex assay. In total, 188 samples were tested by GDH and 239 were tested by PCR. All toxin B PCR (Serosep EntericBio C. difficile assay) positive samples (n=168) and prospectively tested GDH samples (n=97) were also tested using membrane-type toxin EIA (MT-EIA; Techlab Tox A/B Quik Chekò). Culture (alcohol shock and Brazier’s media; Oxoid) and ribotyping (capillary electrophoresis using Bidet et al. primers) information was available for 205 samples.

Results
The positive percent agreement (PPA) and negative percent agreement (NPA) of the Singulex Clarity C. diff toxins A/B assay compared with: GDH; toxin EIA; PCR; GDH/toxin EIA; GDH/toxin EIA/PCR; PCR/toxin EIA and culture were – 61% & 92%; 97% & 50%; 69% & 90%; 100% & 51%; 81% & 77%; 96% & 65%; and 69% AND 52% respectively.

Conclusions
The Singulex Clarity C. diff toxins A/B assay had high PPA compared to toxin EIA and multistep algorithms ending with toxin EIA, and high NPA compared to PCR and a multistep algorithm ending with PCR. The Singulex Clarity assay has the potential to be used as a standalone test for CDI diagnosis; additional clinical studies are required and will soon be underway.