bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Distinct Epidemiologic Pattern of Precancerous Lesions of Esophageal Squamous Cell Carcinoma in a High-risk Area of Huai'an, Jiangsu Province, China
Authors: Pan Da , Su Ming , Zhang Ting , Miao Caiyun , Fu Lingmeng , Yang Ligang , Song Guang , Raine Philip J. , Wang Shaokang , Sun Guiju 
Published: April 2019

Abstract
Better understanding of esophageal precancerous lesions (EPL) can inform prevention strategies for esophageal squamous cell carcinoma (ESCC). Here, a cross-sectional epidemiologic study based on the Early Diagnosis and Early Treatment Project of Esophageal Cancer database from 2011 to 2017 was performed to fully investigate and characterize the epidemiology of EPL in rural Huai'an District. Data of 11,518 participants ages 35–75 years were collected through face-to-face interviews by questionnaire. Participants underwent a routine endoscopy examination, tissues were biopsied, and diagnosed according to the histologic criteria of dysplasia. Unconditional univariate and multivariate logistic regression analyses were performed to obtain crude and adjusted odds ratios and corresponding 95% confidence intervals, respectively. A total of 667 subjects were diagnosed with EPL. Factors associated with an increased risk of EPL included: drinking shallow well water and surface water, irregular diet, excessive smoking, exposure to secondhand smoke, consumption of corn, corn flour, pickled food, fried food, and hot food, and having a history of digestive system diseases. In addition, liquor use, but not other alcohol types, contributed to risk of EPL. Consumption of deep well water and vegetables, fruits, and animal livers were associated with lower EPL risk. This study suggested a completely distinct pattern that alcohol use plays only a minor role in EPL and excessive tobacco use shows a significant association in rural Huai'an District, while eating habits and environmental exposure may be the dominant factors. This work may be promising to provide scientific evidence to support primary prevention of ESCC in this region.
Does Small Vessel Disease Burden Impact Collateral Circulation in Ischemic Stroke Treated by Mechanical Thrombectomy?
Authors: Eker Omer Faruk , Rascle Lucie , Cho Tae-Hee , Mechtouff Laura , Derex Laurent , Ong Elodie , Berthezene Yves , Nighoghossian Norbert 
Published: April 2019

Background and Purpose—
The development of leptomeningeal collateral artery network might be adversely affected by small vessel wall alteration. We sought to determine whether small vessel disease (SVD) burden may impact collateral development in patients treated by mechanical thrombectomy for anterior circulation acute ischemic stroke.

Methods—
The patients admitted in our center for anterior circulation acute ischemic stroke and (1) treated by mechanical thrombectomy with or without thrombolysis and (2) who underwent a baseline magnetic resonance imaging were included in the study. The SVD burden and the pial collaterality were assessed through the cerebral SVD score (severe when ≥1) and the Higashida score (favorable when ≥ 3) on magnetic resonance imaging and digital subtraction angiography, respectively. Any association between the cerebral SVD score and the collaterality were assessed through comparative and regression analyses.

Results—

Between January 2013 and March 2018, 240 patients met the inclusion criteria (68.7±16.1 years old; 49.2 % female). The cerebral SVD scores were of 0 in 125 (52.1%), 1 in 74 (30.8%), 2 in 30 (12.5%), and 3 in 11 (4.6%) patients. Hundred and thirty-six patients (58.1%) presented a favorable collaterality score. The favorable collaterality subgroup presented a significantly higher proportion of female (79%), lower baseline National Institutes of Health Stroke Scale (
P
<0.001), and higher Diffusion-Weighted Imaging-Alberta Stroke Program Early CT Scores (
P
<0.001). The regression analyses showed no impact of the cerebral SVD score on the collaterality pattern (odds ratio, 1.11, 95% CI, 0.82–1.50;
P
=0.51).

Conclusions—
In patients with anterior circulation acute ischemic stroke, collateral flow status does not seem to be influenced by SVD burden.
Climate Scientists’ Wide Prediction Intervals May Be More Likely but Are Perceived to Be Less Certain
Authors: Løhre Erik , Juanchich Marie , Sirota Miroslav , Teigen Karl Halvor , Shepherd Theodore G. 
Published: April 2019

AbstractThe use of interval forecasts allows climate scientists to issue predictions with high levels of certainty even for areas fraught with uncertainty, since wide intervals are objectively more likely to capture the truth than narrow intervals. However, wide intervals are also less informative about what the outcome will be than narrow intervals, implying a lack of knowledge or subjective uncertainty in the forecaster. In six experiments, we investigate how laypeople perceive the (un)certainty associated with wide and narrow interval forecasts, and find that the preference for accuracy (seeing wide intervals as “objectively” certain) versus informativeness (seeing wide intervals as indicating “subjective” uncertainty) is influenced by contextual cues (e.g., question formulation). Most important, we find that people more commonly and intuitively associate wide intervals with uncertainty than with certainty. Our research thus challenges the wisdom of using wide intervals to construct statements of high certainty in climate change reports.
Development of a mass spectrometry method for 1,25-dihydroxy vitamin D3 using immunoextraction sample preparation
Authors: Ivison Fiona M , Hinchliffe Edward , Howarth Neil , Pickersgill Mandy , Tetlow Lesley 
Published: April 2019

Background 1,25-Dihydroxy vitamin D3 (DHVD) is the active metabolite of vitamin D, required to maintain blood calcium concentrations. Measurement has proved challenging as it circulates in picomolar concentrations and must be differentiated from other dihydroxyvitamin D species. Clinically, it is essential to be able to determine the cause of hypercalcaemia, which may be due to DHVD excess. Methods The liquid chromatography-mass spectrometry (LCMS) assay which has been developed uses immunoextraction of 0.5 mL serum followed by Amplifex™ derivatization of the dried eluent, with the analysis using the SCIEX 6500+ instrument taking a run time of 11 min. Results The limit of quantitation was determined (15 pmol/L) and the method is linear up to at least 600 pmol/L. Repeatability ranged from 6.1% at 23 pmol/L to 2.5% at 172 pmol/L and intermediate imprecision was 15.6% at 26 pmol/L to 8.3% at 173 pmol/L. The method is unaffected by icterus, haemolysis or lipaemia. Good performance was achieved with the samples from the vitamin D external quality assessment scheme, demonstrating a negative bias compared with the all lab trimmed mean (average –13.8%) and the specific method group (average –7.75%). A negative bias was observed across the concentration range found in 78 patient samples in comparison to a commercial radioimmunoassay (mean –47.8%). This was not unexpected and is likely due to better specificity of the mass spectrometry assay and the lack of a commutable standard reference calibrator. Conclusions We have developed a sensitive and robust LCMS method for the analysis of DHVD in serum, utilizing immunoextraction and derivatization to provide specificity.
Association of novel biomarkers with major clinical outcomes in a cohort of patients with atherosclerotic renovascular disease
Authors: Vassallo Diana , Alderson Helen , Vuilleumier Nicolas , Ritchie James , Green Darren , Pagano Sabrina , Virzi Julien , Chrysochou Constantina , Kalra Philip A 
Published: April 2019

IntroductionIn this study, we investigate whether the addition of biomarkers to a model based on traditional risk factors improves risk prediction and patient selection for revascularization in atherosclerotic renovascular disease.MethodsPatients in the Salford Renovascular Study who had the following biomarkers analysed on a baseline sample were included in this study: FGF-23, Cystatin C, kidney injury molecule-1, myeloperoxidase, neutrophil gelatinase-associated lipocalin, N-terminal prohormone of brain natriuretic peptide (NT-proBNP), high-sensitivity Troponin T and anti-apolipoprotein A1 IgG. Cox proportional hazards models and net reclassification index were used to study the effects of either individual or a panel of biomarkers on predicting death, end-stage kidney disease and cardiovascular events.ResultsA total of 112 patients were followed up for a median 59.9 months (IQR 33.6–86.9). In total, 75 patients died, 21 reached end-stage kidney disease and 36 suffered a cardiovascular event. Only NT-proBNP maintained a statistically significant association with all end-points (death: HR 1.62 [95% CI 1.26–2.10], P < 0.0005; end-stage kidney disease: HR 1.51 [95% 1.19–1.91], P = 0.001; cardiovascular event: HR 1.56 [95% CI 1.23–1.97], P < 0.0005). Risk reclassification improved with addition of all biomarkers as a panel to the base model. Only patients with NT-proBNP concentrations above 300 ng/L gained benefit from revascularization with regard to all adverse end-points compared with medically managed patients.ConclusionsNT-proBNP is independently associated with increased risk for all adverse events in atherosclerotic renovascular disease. Novel biomarkers may have an incremental risk predictive value when used in combination with traditional risk factors, and NT-proBNP may have value in patient selection for revascularization. Given the small size of this study, larger multicentre studies are required to validate these findings.
Pediatric Obstructive Sleep‐Disordered Breathing: Updated Polysomnography Practice Patterns
Authors: Friedman Norman R. , Ruiz Amanda G. , Gao Dexiang , Jensen Alexandria , Mitchell Ron B. 
Published: April 2019

ObjectiveTo assess the current practice patterns of pediatric otolaryngologists in managing obstructive sleep‐disordered breathing 6 years following the 2011 publication of the clinical practice guideline “Polysomnography for Sleep‐Disordered Breathing prior to Tonsillectomy in Children.”Study DesignCross‐sectional survey.SettingAmerican Society of Pediatric Otolaryngology (ASPO) members.Subjects and MethodsAn electronic survey to assess ASPO members’ adherence to polysomnography guidelines prior to tonsillectomy.ResultsForty percent (170 of 427) of ASPO members completed the survey, with 73% in academic practice and 27% in private practice. Snoring represented, on average, 48% of the respondents’ practices. The percentage of respondents who requested a polysomnogram prior to tonsillectomy ≥90% of the time was 55% (n = 94) for Down syndrome, 41% (n = 69) for a child <2 years old, and 29% (n = 49) for obese children. A total of 109 (73%) and 112 (75%) respondents admit at least 90% of the time for a child with Down syndrome and for a child <3 years of age, respectively, but only 52 (35%) have a similar practice for an obese child. Only 37% adhere to the inpatient admission recommendation for children with documented obstructive sleep apnea on polysomnogram.ConclusionThe current polysomnogram practice patterns for responding pediatric otolaryngologists are not aligned with the clinical practice guideline of the American Academy of Otolaryngology—Head and Neck Surgery Foundation. The threshold for overnight observation when a preoperative polysomnogram has not been performed may be too low. A campaign is necessary to educate clinicians who take care of children with obstructive sleep‐disordered breathing and to obtain more evidence to further define best practice.
Air Pollution and Angioedema
Authors: Kedarisetty Suraj , Jones Evan , Tint Derrick , Soliman Ahmed M. S. 
Published: April 2019

ObjectiveTo identify environmental factors that may precipitate angioedema.Study DesignCase series with chart review.SettingAn urban tertiary care medical center.Subjects and MethodsAfter institutional review board approval was obtained, a chart review of all patients who presented to Temple University Hospital with angioedema from January 2012 to December 2014 was performed. Patient demographics and hospital course were gathered. Environmental data on the dates of presentation, including precipitation, humidity, and air pollution, were obtained from regional Environmental Protection Agency online data banks and used for statistical analysis.ResultsIn total, 408 patients, representing 450 episodes of angioedema, met the inclusion criteria for the study. Most patients were female (58%), African American (74%), and on an angiotensin‐converting enzyme inhibitor (ACE‐I) upon presentation (61%). Days with unhealthy levels of air pollution were associated with an increased likelihood of angioedema presentation (odds ratio [OR], 1.82; confidence interval [CI], 1.01‐3.30;P=. 046). Subgroup analysis revealed that elevated ground‐level ozone was the primary air pollutant significantly associated with angioedema presentations (OR, 4.95; CI 1.92‐12.76;P=. 0009). Higher ground‐level ozone was also associated with ACE‐I angioedema presentations (P=. 017) but not with non‐ACE‐I angioedema presentations (P=. 86). Air quality was not predictive of angioedema severity or need for intubation.ConclusionAngioedema is a complex, multifactorial disease resulting in potentially life‐threatening complications. This is the first study to demonstrate that higher levels of air pollution, specifically ground‐level ozone, are associated with significantly increased rates of angioedema episodes, although not severity.
Utility of Magnetic Resonance Imaging in Differentiating Cerebrospinal Fluid Leak from Middle Ear Effusion
Authors: Breen Joseph T. , Edwards Colin R. , Cornelius Rebecca S. , Hazenfield J. Michael , Kohlberg Gavriel D. , Samy Ravi N. , Pensak Myles L. 
Published: April 2019

ObjectiveTo demonstrate the clinical utility, sensitivity, and specificity of standard magnetic resonance imaging (MRI) sequences in differentiating temporal bone cerebrospinal fluid leaks from all other middle ear effusions.Study DesignRetrospective imaging review.SettingAcademic medical center.SubjectsPatients with cerebrospinal fluid leaks or other middle ear effusions who also underwent MRI.MethodsPatients were assigned to cerebrospinal fluid leak and other effusion cohorts based on clinical course, findings at surgery/myringotomy, and beta‐2 transferrin fluid analysis. Reviewers blinded to the clinical outcome examined T1‐weighted, T2‐weighted, diffusion‐weighted, fluid‐attenuated inversion recovery (FLAIR), and 3‐dimensional (3D) acquired T2‐weighted MRI sequences. For each sequence, fluid imaged in the temporal bone was graded as either similar or dissimilar in signal intensity to cerebrospinal fluid in the adjacent subarachnoid space. Signal similarity was interpreted as being diagnostic of a leak. Test characteristics in predicting the presence of a leak were calculated for each series.ResultsEighty patients met criteria (41 leaks, 39 other effusions). The 3D T2 series was 76% sensitive and 100% specific in diagnosing a leak, and FLAIR was 44% sensitive and 100% specific. The T1‐weighted (73% sensitive, 69% specific), T2‐weighted (98% sensitive, 5.1% specific), and diffusion‐weighted (63% sensitive, 66% specific) series were less useful.ConclusionsMRI, with attention to 3D T2 and FLAIR series, is a noninvasive and highly specific test for diagnosing cerebrospinal fluid leak in the setting of an indeterminate middle ear effusion.
Is growth improving employment quality in India? Evidence of widening subnational inequality
Authors: Moktan Anamika 
Published: April 2019

One of the biggest challenges faced by India today is to generate quality employment. Even in areas of rapid per capita income growth, typified by the Gujarat model of neoliberal state-sponsored technological development, there is a substantial and increasing decent work deficit. Across India more generally, the decent work deficit is, in fact, growing along several dimensions, leading to ‘growth without development’ or ‘non-inclusive growth’. This article analyses quality of employment in India across subnational spaces – among states and between rural and urban locations – using three International Labour Organisation decent work dimensions: ‘employment opportunity’, ‘social security benefits’ and ‘social dialogue’. The analysis is based on published government data, for the period 1993–1994 to 2011–2012 – the period covered by the liberalisation experiment. The conclusion is that economic growth has not contributed significantly to employment quality. Although employment opportunity is significantly higher in the developed states, coverage of social security benefits and scope for social dialogue among regular salaried/wage workers are significantly less in these areas than in underdeveloped regions. Indeed, employment opportunity is significantly higher in rural areas, and the condition of workers in urban areas is not significantly better than in rural locations. Furthermore, over time, the difference in quality of employment across subnational spaces has either increased or remained stagnant. JEL Codes: J00, J81, J21, 018.
Does the Use of Magnetic Resonance Imaging Scan in Occult and Suspected Metastatic Pathological Neck of Femur Fractures Affect the Choice of Surgical Intervention?
Authors: Budair Basil , Al-Tibi Mohammad , Boutefnouchet Tarek 
Published: April 2019

Background: Magnetic resonance imaging (MRI) is often employed as the diagnostic modality of choice in occult and suspected pathological femoral neck fractures. We evaluated the clinical utility of MRI scan in this patient population. Method: Retrospective observational analysis of cases with a radiologically occult or suspected metastatic pathological neck of femur fracture. Results: From a total of 894 femoral neck fractures treated in our institution, 100 patients had and MRI scan pre-operatively for either occult fracture or suspected fracture secondary metastatic disease. Magnetic resonance imaging confirmed the presence of 13 simple fractures. A total of 14 patients had pathological features suggestive of metastasis, of which 12 were clearly visible on plain radiographs. Surgical plan did not change after MRI for any of these pathological fractures. Conclusion: Results of this study demonstrate that an MRI scan had an impact on treatment selection only when a simple but radiographically occult fracture is suspected and but not in the context of suspected metastatic pathological fractures.
Surgical Repair of Distal Triceps Tendon Injuries: Short-term to Midterm Clinical Outcomes and Risk Factors for Perioperative Complications
Authors: Waterman Brian R. , Dean Robert S. , Veera Shreya , Cole Brian J. , Romeo Anthony A. , Wysocki Robert W. , Cohen Mark S. , Fernandez John J. , Verma Nikhil N. 
Published: April 2019

Background: Few large-scale series have described functional outcomes after distal triceps tendon repair. Predictors for operative success and a comparative analysis of surgical techniques are limited in the reported literature. Purpose: To evaluate short-term to midterm functional outcomes after distal triceps tendon repair in a broad patient population and to comparatively evaluate patient-reported outcomes in patients with and without pre-existing olecranon enthesopathy while also assessing for modifiable risk factors associated with adverse patient outcomes and/or revision surgery. Study Design: Case series; Level of evidence, 4. Methods: This study was a retrospective analysis of 69 consecutive patients who underwent surgical repair of distal triceps tendon injuries at a single institution. Demographic information, time from injury to surgery, mechanism of injury, extent of the tear, pre-existing enthesopathy, perioperative complications, and validated patient-reported outcome scores were included in the analysis. Patients with a minimum of 1-year follow-up were included. Results: The most common mechanisms of injury were direct elbow trauma (44.9%), extension/lifting exercises (20.3%), overuse (17.4%), and hyperflexion or hyperextension (17.4%). Eighteen patients were identified with pre-existing symptomatic enthesopathy, and 51 tears were caused by an acute injury. A total of 36 complete and 33 partial tendon tears were identified. Bone tunnels were most commonly used (n = 30; 43.5%), while direct sutures (n = 23; 33.3%) and suture anchors (n = 13; 18.8%) were also used. Perioperative complications occurred in 21.7% of patients, but no patients experienced a rerupture at the time of final follow-up. No statistically significant relationship was found between patient age ( P = .750), degree of the tear ( P = .613), or surgical technique employed ( P = .608) and the presence of perioperative complications. Conclusion: Despite the heightened risk of perioperative complications after primary repair of distal triceps tendon injuries, the current series found favorable functional outcomes and no cases of reruptures at short-term to midterm follow-up. Furthermore, age, surgical technique, extent of the tear, and mechanism of injury were not associated with adverse patient outcomes in this investigation. Pre-existing triceps enthesopathy was shown to be associated with increased complication rates.
Rare Bosworth Fracture-Dislocation Variant of an Irreducible Distal Fibula Dislocation of the Ankle Without Fibula Fracture
Authors: Wenxian Png , Mehta Kinjal Vidyut 
Published: April 2019

Background: Irreducible fracture-dislocations of the ankle are rare orthopedic emergencies that should not be missed. The Bosworth fracture-dislocation is a rare fracture where an incarcerated fibula fragment remains locked behind the posterior lateral tubercle of the tibia. We present a case describing a variation of a Bosworth injury, with a dislocation of an intact distal fibula with an associated medial malleolus fracture. Methods: Our patient is a 55-year old male who presented to the emergency department with a left ankle injury after being involved in a road traffic accident. Radiographs show a posterior dislocation of an intact distal fibula associated with a fracture of the medial malleolus and disruption of the ankle mortise. Results: An attempt to reduce the dislocation at the emergency department under sedation was unsuccessful. The patient was subsequently taken to the operating theatre for manipulation and reduction and application of an external fixator. Definitive fixation was performed successfully a week later. Conclusion: A high index of suspicion is critical for diagnosing a Bosworth fracture-dislocation, as this diagnosis is commonly missed. Early diagnosis and proper surgical anatomic reduction are important to prevent chronic ankle instability and evolution towards ankle arthritis. Level of Evidence: Level IV, case study.