bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Validated Calculator to Estimate Risk of Cesarean After an Induction of Labor With an Unfavorable Cervix
Authors: Levine L.D. , Downes K.L. , Parry S. , Elovitz M.A. , Sammel M.D. , Srinivas S.K. 
Published: November 2018

(Am J Obstet Gynecol. 2018;218(2):254.e1–254.e7)
Although >20% of pregnant women undergo induction of labor, there is a limited ability to predict success of induction. While some risk factors of failed induction have been identified, prediction models have been limited to nulliparous women. This study aimed to develop and validate a prediction model for cesarean section to supplement counseling for nulliparous and multiparous women with an unfavorable cervix undergoing induction.
Use of Combined Botulinum Toxin and Physical Therapy for Treatment Resistant Congenital Muscular Torticollis
Authors: Limpaphayom Noppachart , Kohan Eitan , Huser Aaron , Michalska-Flynn Malgorzata , Stewart Sara , Dobbs Matthew B. 
Published: November 2018

Background:
Physical therapy (PT) alone is not always effective for treatment of congenital muscular torticollis (CMT). The adjunctive use of botulinum toxin (BTX) injection into the sternocleidomastoid, followed by PT, could provide correction and avoid more invasive surgery. Aims of the study were to review clinical and caregiver-reported outcomes of children with resistant CMT treated by BTX injection combined with a guided-PT program.

Methods:
Medical records of consecutive children with resistant CMT treated by our protocol between 2010 and 2015 were reviewed. A minimum 2-year follow-up was required. Demographic parameters, numbers of BTX required and pre-BTX and post-BTX head tilt and range of neck rotation were recorded. A univariate analysis test was conducted to identify variables related to the need of repeated BTX injections. A phone interview with the caregivers was done regarding their satisfaction.

Results:
A cohort of 39 patients with treatment resistant CMT were identified that had an average age of 14 (range, 6.5 to 27.6) months at initiation of BTX treatment. Multiple BTX injections were utilized in 21/39 (54%) of patients. No patient required tendon lengthening surgery. At the final evaluation, there was improvement in both head tilt (18.7±6.8 degrees vs. 1.7±2.4 degrees, mean difference (95% CI) 16.9 (14.6-19.3); P<0.001) and range of neck motion (56.0°±11.7 degrees vs. 86.0±3.8 degrees, mean difference (95% CI) 30.0 (26.1-33.9), P<0.001). Pre-BTX parameters were not associated with the requirement of repeated BTX injections (P>0.05). Caregivers were satisfied with the treatment protocol. No untoward effect was observed during the study period.

Conclusions:
The proposed minimally invasive protocol provided correction of resistant CMT and obviated the need for more invasive surgical procedures.

Level of Evidence:
Level IV.
Selection of Patients With Rectal Cancer for Preoperative Chemoradiotherapy: Are T Category and Nodal Status All That Matters?
Authors: Pooni Amandeep , Al-Sukhni Eisar , Milot Laurent , Fruitman Mark , Victor J. Charles , Schmocker Selina , Brown Gina , Kennedy Erin 
Published: November 2018

BACKGROUND:
Although the accuracy of preoperative MRI staging has been established on follow-up histopathologic examination, the reproducibility of MRI staging has been evaluated in studies with expert radiologists reading a large sample of MRI images and therefore is not generalizable to the real-world setting.

OBJECTIVE:
The purpose of this study was to evaluate the interrater reliability of MRI for distance to the mesorectal fascia, T category, mesorectal lymph node status, and extramural depth of invasion for preoperative staging of primary rectal cancer.

DESIGN:
This was a prospective, cross-sectional survey.

SETTINGS:
The study was conducted in Ontario, Canada.

PARTICIPANTS:
Participants included GI radiologists.

INTERVENTIONS:
Participants read 5 preselected staging MRIs using a synoptic report and participated in an educational Webinar.

MAIN OUTCOME MEASURES:
Distance to the mesorectal fascia, T category, extramural depth of invasion, and mesorectal lymph node status for each MRI were abstracted. Data were analyzed in aggregate using percentage of agreement, Fleiss κ, and interclass correlation coefficients to assess interrater reliability.

RESULTS:
Reliability was highest for distance to the mesorectal fascia with an intraclass correlation of 0.58 (95% CI, 0.27–0.80). Kappa scores for T category, mesorectal lymph node status, and extramural depth of invasion were 0.38 (95% CI, 0.23–0.46), 0.41 (95% CI, 0.32–0.49), and 0.37 (95% CI, 0.16–0.82). There was no difference when radiologists were stratified by experience or volume.

LIMITATIONS:
Scores may have been affected by MRI selection, because they were chosen to demonstrate diagnostic challenges for the Webinar and did not reflect a representative sample.

CONCLUSIONS:
Interrater reliability was highest for distance to mesorectal fascia, and therefore, it may be a more reliable criterion than T category, extramural depth of invasion, or mesorectal lymph node status. Combined with the fact that an uninvolved mesorectal fascia is more consistent with the overall goal of rectal cancer surgery, it should be considered as an important MRI criterion for preoperative treatment decision making in the real-world setting. See Video Abstract at http://links.lww.com/DCR/A763.
Impact of the “Weekend Effect” for Hospital Discharges on Readmissions After Elective Colectomy
Authors: Hoang Chau M. , Alavi Karim , Flahive Julie M. , Sturrock Paul R. , Maykel Justin A. , Davids Jennifer S. 
Published: November 2018

BACKGROUND:
Hospital readmissions after elective colectomy are costly and potentially preventable. It is unknown whether hospital discharge on a weekend impacts readmission risk.

OBJECTIVE:
This study aimed to use a national database to determine whether discharge on a weekend versus weekday impacts the risk of readmission, and to determine what discharge-related factors impact this risk.

DESIGN:
This investigation is a retrospective cohort study.

SETTINGS:
Data were derived from the University HealthSystem Consortium,

PATIENTS:
Adults who underwent elective colectomy from 2011 to 2015 were included.

MAIN OUTCOME MEASURES:
The primary outcome measured was the 30-day hospital readmission rate.

RESULTS:
Of the 76,031 patients who survived the index hospitalization, the mean age of the study population was 58 years; half were men and more than 75% were white. Overall, 20,829 (27%) were discharged on the weekend, and the remaining 55,202 (73%) were discharged on weekdays. The overall 30-day readmission rate was 10.5%; 8.9% for those discharged on the weekend vs 11.1% for those discharged during the weekday (unadjusted OR, 0.78; 95% CI, 0.74–0.83). The adjusted readmission risk was lower for patients discharged home without services (routine, without organized home health service) on a weekend compared with on a weekday (adjusted OR, 0.87; 95% CI, 0.81–0.93; readmission rates, 7.4% vs 8.9%, p < 0.001); however, the combination of weekend discharge and the need for home services increased readmission risk (adjusted OR, 1.39; 95% CI, 1.25–1.55; readmission rate, 16.2% vs 8.9%, p < 0.001). Although patients discharged to rehabilitation and skilled nursing facilities were at an increased risk of readmission compared with those discharged to home, there was no additive increase in risk of readmission for weekend discharge.

LIMITATIONS:
Data did not capture readmission beyond 30 days or to nonindex hospitals.

CONCLUSIONS:
Patients discharged on a weekend following elective colectomy were at increased risk of readmission compared with patients discharged on a weekday if they required organized home health services. Further prospective studies are needed to identify areas of intervention to improve the discharge infrastructure. See Video Abstract at http://links.lww.com/DCR/A799.
Double Opposing Triangular Flaps for Circular Skin Defects: Clinical Considerations
Authors: Borgognone Alessandro 
Published: November 2018

Background:
Dealing with circular lesions turns out to be a difficult task. Several techniques are aimed at working out the issue, and there are two main goals to achieve: less distortion of the adjacent tissue and sparing as much healthy tissue as possible.

Methods:
Six patients have been selected in a period of 6 months, the skin lesions or reoperations entailed a residual round gap up to 5 cm as a diameter. The anatomical distribution is representative of the usual experience seen in the clinical setting. The technique introduced is based on the rotation of two opposing triangular flaps facing each other from the circular skin gap. The triangular landmarks of the flaps prevent both the pinch cushioning of the margins, the resection of wedge healthy tissue needed to regularize the surface and a longer scar.

Results:
The six patients’ follow-up has been technically uneventful and subjectively satisfying.

Conclusion:
Double opposing triangular flaps are proposed as a reliable method to deal with circular skin lesions up to 5 cm of diameter.
SURGICAL MANAGEMENT OF TRAUMATIC MACULAR HOLE
Authors: Tang Yi Fan , Chang Andrew , Campbell William G. , Connell Paul P. , Hunyor Alex P. , McAllister Ian L. , Essex Rohan W. ,   for the Australian and New Zealand Society of Retinal Specialists (ANZSRS) Macular Hole Study Group
Published: November 2018

Purpose:
To report the outcomes of eyes receiving surgical management for traumatic macular holes. To describe the preoperative and postoperative optical coherence tomography features of traumatic macular holes and to explore associations between preoperative clinical and optical coherence tomography features, and visual outcome.

Methods:
Retrospective study of patients undergoing vitrectomy for traumatic macular hole and entered into the Australian and New Zealand Society of Retinal Specialists surgical registry. Preoperative clinical data, surgical details, and 3-month postoperative outcomes were recorded prospectively. Longer-term outcomes at 12 months were requested retrospectively, as were preoperative and postoperative optical coherence tomography scans.

Results:
Hole closure was achieved in 91% (21/23) of patients with a single procedure. The average preoperative visual acuity was 20/120. At 3 months postoperatively, the mean visual acuity had improved to 20/70 (P < 0.001), 11/23 (48%) of eyes improved ≥15 letters, and the number of eyes with 20/40 acuity or better increased from 1/23 to 7/23. Eyes with worse visual outcomes (visual acuity < 20/80) had larger holes, worse preoperative acuity, and a greater extent of preoperative ellipsoid band attenuation than those with better postoperative visual acuity.

Conclusion:
Eyes receiving surgical management for traumatic macular hole achieved good anatomical results and approximately half had a substantial improvement in acuity. Ellipsoid band attenuation on preoperative optical coherence tomography and worse preoperative acuity were associated with poorer visual outcomes.
Facial Nerve Stimulation Patterns Associated With Cochlear Implantation in Labyrinthitis Ossificans
Authors: Nassiri Ashley M. , Yawn Robert J. , Dedmon Matthew M. , O’Connell Brendan P. , Holder Jourdan T. , Haynes David S. , Rivas Alejandro 
Published: November 2018

Objective:
To describe and characterize facial nerve stimulation (FNS) patterns in patients with labyrinthitis ossificans who underwent cochlear implantation (CI) for sensorineural hearing loss.

Patients:
Five ears in four patients with labyrinthitis ossificans who underwent CI and subsequently developed FNS.

Interventions:
CI, electrode mapping, and/or explantation to resolve FNS.

Main Outcome Measures:
FNS, postoperative computed tomography imaging, and resolution of FNS.

Results:
Fourteen ears with labyrinthitis ossificans underwent CI over an 11-year period at a single institution; 5 of these ears exhibited postoperative FNS (35.7% incidence). Four cases had involvement of basal electrodes, while all five cases had middle and/or apical electrode stimulation. All cases had resolution of FNS with CI reprogramming, however, the resultant map in two cases provided minimal audiologic benefit and patients became nonusers in that ear.

Conclusions:
FNS arising from all cochlear regions is possible in patients with labyrinthitis ossificans who undergo CI. Mapping and electrode deactivation can resolve symptoms, but resultant audiologic benefit is variable and may lead to explantation.
Single Intravenous High Dose Administration of Prednisolone Has No Influence on Postoperative Impedances in the Majority of Cochlear Implant Patients
Authors: Prenzler Nils Kristian , Kappelmann Christin , Steffens Melanie , Lesinski-Schiedat Anke , Lenarz Thomas , Warnecke Athanasia 
Published: November 2018

Objective:
To evaluate effect of prednisolone on the impedances after cochlear implantation.

Study Design:
Retrospective case series.

Setting:
Tertiary referral center.

Patients and Intervention:
A total of 130 patients underwent cochlear implantation with a Med-El Flex28 synchrony device between 2012 and 2016 and met the inclusion criteria. Only patients with full datasets regarding impedance measurements perioperatively, at first fitting (before and after chronic electric stimulation) and at 3 and 12 months appointments afterward were included. Patients (n = 101) received a single intravenous administration of at least 200 mg prednisolone intraoperatively and control patients (n = 29) did not receive any steroids at all. Patients receiving low dose steroids during surgery were excluded.

Main Outcome Measures:
Mean values for impedances were calculated over all electrode contacts and separately for basal, medial, and apical regions.

Results:
Impedances increased significantly from perioperative measures to first fitting in both groups. Mainly at the basal region of the electrode array, impedances were slightly lower in the steroid group compared with controls. However, the majority of the patients showed increased impedances whether they received steroid treatment or not.

Conclusion:
The present study shows a slight but statistically significant reduction of the mean value of postoperative impedances at the basal electrode contacts in patients receiving a single systemic high dose application of prednisolone. Less than half of the patients showed a decrease in impedances and whether this decrease is clinically relevant remains to be elucidated.
Evidence-based update on the surgical treatment of pediatric tibial shaft fractures
Authors: Cruz Aristides I. , Raducha Jeremy E. , Swarup Ishaan , Schachne Jonathan M. , Fabricant Peter D. 
Published: November 2018

Purpose of review
To describe surgical treatment options for pediatric tibial shaft fractures which are the third most common pediatric long bone fracture. Management of these injuries is dictated by fracture location, fracture pattern, associated injuries, skeletal maturity, and other patient-specific factors. Although most pediatric tibial shaft fractures can be treated nonoperatively, this review provides an update on surgical treatment options when operative intervention is indicated.

Recent findings
Advances in surgical implants and techniques affords a wide range of options for the surgical treatment of pediatric tibial shaft fractures. Flexible intramedullary nailing is gaining wide adoption for acute surgical treatment. Recent studies support cross-sectional imaging for further evaluation and scrutiny of fracture patterns suspicious for intraphyseal or intra-articular extension. Grade I open tibial shaft fractures may be safely treated with irrigation and debridement in the emergency department; however, no high-level comparative studies have been performed to make any definitive conclusions regarding the effectiveness of this treatment strategy.

Summary
Tibial shaft fractures are common injuries in pediatric patients. Management is dictated by fracture location, fracture pattern, associated injuries, patient age, and other patient-specific factors. Surgical intervention is indicated for fractures that are open, irreducible, have failed nonoperative management, are associated with compartment syndrome, or in the multiply injured patient. Surgical treatment options include flexible intramedullary nailing, plate osteosynthesis, external fixation, and rigid intramedullary nailing. Recent literature has shown increased rates of flexible intramedullary nailing. All operative and nonoperative management options can result in complications including compartment syndrome, infection, delayed union, nonunion, malunion, limb length discrepancy, and symptomatic hardware. Most pediatric patients go on to uneventful union with excellent final outcomes and return to full activities.
Identification of a CNGB1 Frameshift Mutation in a Han Chinese Family with Retinitis Pigmentosa
Authors: Xiang Qin , Guo Yi , Cao Yanna , Xiong Wei , Deng Xiong , Xu Hongbo , Li Yu , Du Dongdong , Deng Hao 
Published: November 2018

SIGNIFICANCE
Retinitis pigmentosa (RP) is a severe hereditary retinal disorder characterized by progressive degeneration of rod and cone photoreceptors. This study identified a novel frameshift mutation, c.385delC, p.(L129WfsTer148), in the cyclic nucleotide-gated channel beta 1 (CNGB1) gene of a consanguineous Han Chinese family with autosomal recessive RP (arRP). This expands the spectrum of CNGB1 gene variants in RP cases and possibly refines future genetic counseling.

PURPOSE
The present study sought to identify potential pathogenetic gene mutations in a five-generation consanguineous Han Chinese family with RP.

METHODS
Two members of a five-generation consanguineous Han Chinese pedigree with arRP and 100 normal individuals were enrolled in this study. Exome sequencing was performed on the 70-year-old male proband from a consanguineous family to screen potential pathogenic mutations according to the American College of Medical Genetics and Genomics for the interpretation of sequence variants. Sanger sequencing was performed on the proband, the proband's unaffected son, and 100 normal individuals to verify the disease-causing mutation.

RESULTS
A novel frameshift mutation, c.385delC, p.(L129WfsTer148), with homozygous status in the CNGB1 gene was identified in the proband of the family with arRP, and the mutation with heterozygous status was carried by the asymptomatic son.

CONCLUSIONS
The c.385delC (p.(L129WfsTer148)) mutation in the CNGB1 gene screened by exome sequencing is probably responsible for the RP phenotype in this family. The result expands the spectrum of CNGB1 gene variants in RP cases and possibly refines future genetic counseling.
Evidence of reduced viremia, pathogenicity and vector competence in a re-emerging European strain of bluetongue virus serotype 8 in sheep
Authors: Flannery John , Sanz-Bernardo Beatriz , Ashby Martin , Brown Hannah , Carpenter Simon , Cooke Lyndsay , Corla Amanda , Frost Lorraine , Gubbins Simon , Hicks Hayley , Qureshi Mehnaz , Rajko-Nenow Paulina , Sanders Christopher , Tully Matthew , Bréard Emmanuel , Sailleau Corinne , Zientara Stephan , Darpel Karin , Batten Carrie 
Published: November 2018

SummaryThe outbreak of bluetongue virus (BTV) serotype 8 (BTV-8) during 2006-2009 in Europe was the most costly epidemic of the virus in recorded history. In 2015, a BTV-8 strain re-emerged in France which has continued to circulate since then. To examine anecdotal reports of reduced pathogenicity and transmission efficiency, we investigated the infection kinetics of a 2007 UK BTV-8 strain alongside the re-emerging BTV-8 strain isolated from France in 2017. Two groups of eight BTV-naïve British mule sheep were inoculated with 5.75 log10TCID50 ml−1 of either BTV-8 strain. BTV RNA was detected by 2 dpi in both groups with peak viremia occurring between 5-9 dpi. A significantly greater amount of BTV RNA was detected in sheep infected with the 2007 strain (6.0-8.8 log10 genome copies mL−1) than the re-emerging BTV-8 strain (2.9-7.9 log10 genome copies mL−1). All infected sheep developed BTV-specific antibodies by 9 dpi. BTV was isolated from 2 dpi to 12 dpi for 2007 BTV-8-inoculated sheep and from 5 to 10 dpi for sheep inoculated with the remerging BTV-8. In Culicoides sonorensis feeding on the sheep over the period 7-12 dpi, vector competence was significantly higher for the 2007 strain than the re-emerging strain. Both the proportion of animals showing moderate (as opposed to mild or no) clinical disease (6/8 vs 1/8) and the overall clinical scores (median 5.25 vs 3) were significantly higher in sheep infected with the 2007 strain, compared to those infected with the re-emerging strain. However, one sheep infected with the re-emerging strain was euthanized at 16 dpi having developed severe lameness. This highlights the potential of the re-emerging BTV-8 to still cause illness in naïve ruminants with concurrent costs to the livestock industry.SummaryThe re-emerging Bluetongue virus serotype 8 still presents a threat to naïve ruminants in Europe despite reduced virulence
Leveraging collective regulatory effects of long-range DNA methylations to predict gene expressions and estimate their effects on phenotypes in cancer
Authors: Kim Soyeon , Park Hyun Jung , Cui Xiangqin , Zhi Degui 
Published: November 2018

ABSTRACTDNA methylation of various genomic regions plays an important role in regulating gene expression in diverse biological contexts. However, most genome-wide studies have focused on the effect of 1) methylation in cis, not in trans and 2) a single CpG, not the collective effects of multiple CpGs, on gene expression. In this study, we developed a statistical machine learning model, geneEXPLORER (geneexpression prediction by long-range epigenetic regulation), that quantifies the collective effects of both cis- and trans- methylations on gene expression. By applying geneEXPLORER to The Cancer Genome Atlas (TCGA) breast and lung cancer data, we found that most genes are affected by methylations of as much as 10Mb from promoter regions or more, and the long-range methylation explains 50% of the variation in gene expression on average, far greater than cis-methylation. The highly predictive genes are related to breast cancer, especially oncogenes and suppressor genes. Further, the predicted gene expressions could predict clinical phenotypes such as breast tumor status and estrogen receptor status (AUC=0.999, 0.94 respectively) as accurately as the measured gene expression levels. These results suggest that geneEXPLORER provides a means for accurate imputation of gene expression, which can be further used to predict clinical phenotypes.