bluuebunny/crossref_metadata_2025_split huggingface dataset:
How Well Represented Are Women Orthopaedic Surgeons and Residents on Major Orthopaedic Editorial Boards and Publications?
Authors: Rynecki Nicole D. , Krell Ethan S. , Potter James S. , Ranpura Akash , Beebe Kathleen S. 
Published: June 2019

Abstract

Background
Recent studies indicate that women are substantially underrepresented as orthopaedic surgeons and residents compared with other specialties in medicine and medical school. The reasons for this are multifactorial and not completely understood, but previous studies suggest that women may be attracted to fields in which they have female role models. Given that women interested in academia and research may use female editorship and authorship as a proxy for female representation in orthopaedic surgery, we wanted to examine the proportion of women represented in orthopaedic journals and determine if it reflects the distribution of women in orthopaedic surgery as a field. We further wanted to understand if this representation has changed over time in the setting of a slowly shifting gender landscape within orthopaedic surgery.

Questions/purposes
(1) How are women orthopaedic surgeons and residents represented in orthopaedic journals compared with men? (2) Have these proportions changed in the past two decades in light of relatively new efforts to recruit women to the field of orthopaedic surgery?

Methods
The gender composition of editorial boards and first and last authors were obtained from the 1997, 2007, and 2017 volumes of the following journals: The Journal of Bone & Joint Surgery (JBJS), the Journal of the American Academy of Orthopaedic Surgeons (JAAOS), and Clinical Orthopaedics and Related Research® (CORR®). Gender neutral names were searched to obtain a picture to ensure proper tallies.

Results
The total combined amount of women first and last authors increased from 88 of 1450 (6%) in 1997 to 152 of 1912 (8%) in 2007 to 723 of 5391 (13%) in 2017. Similarly, three of 113 (3%) editorial board members were women in 1997, three of 105 (3%) were women in 2007 and 10 of 107 (9%) editors were women in 2017. Of note, 0 out of 9 editors-in-chief were women.

Conclusions
Based on the current percentage of women orthopaedic surgeons and residents, women are represented equally or in greater numbers as editors and authors in JAAOS, JBJS, and CORR. This may be in part due to women orthopaedic surgeons entering academic medicine at a greater rate than males.

Clinical Relevance
Orthopaedic surgeons serving as mentors to prospective female applicants can cite female representation on editorial boards and as authors as an example of gender parity in the field. Additionally, active orthopaedic surgeons who are women interested in these leadership positions should be encouraged that these opportunities exist, regardless of gender.
Compliance with daily, home-based collection of urinary biospecimens in a prospective, preconception cohort
Authors: Cox Kyley J. , Stanford Joseph B. , Blackburn Brenna E. , Porucznik Christina A. 
Published: June 2019

Background:
Exposures in the periconceptional environment may impact fertility and future health. Assessing time-varying exposures during the periconceptional window requires identifying approximate fertile windows around ovulation. In this prospective cohort study, we instructed women in daily cervical fluid observation and interpretation to identify incipient ovulation; they used this information to time daily urine collection for both partners. Timing and completeness of collection were compared to expert review.

Methods:
One hundred seventy couples planning pregnancy enrolled from community volunteers from 2011 to 2015; women were taught the Peak Day method to identify fertile windows. Both partners collected daily urine specimens from the first day of fertile-quality fluid (estimator of the beginning of fertile window). Men discontinued on the estimated day of ovulation/conception +2 days; women continued through the onset of next menses, or positive pregnancy test at estimated day of ovulation/conception +18 days. We compared dates from samples with participants’ fertility charts to determine proportion correctly collected. Also, expert reviewers judged on which days urine should have been collected, determining investigator-identified sampling days.

Results:
One hundred sixty-nine couples submitted 6,118 urine samples from 284 cycles. Reviewers and participants agreed in 87% of cycles for the date of the beginning of the fertile window ±3 days (65% exact-day agreement); agreement on ovulation date, ±3 days, was 93% (75% exact-day agreement). Five thousand three hundred twenty-nine female samples were expected based on investigator-identified sampling days, and 4,546 were collected, of which 82% were correctly collected on expected days. Fifty-nine percent of male samples were correctly collected relative to investigator-identified sampling days.

Conclusions:
Intensively-scheduled, biologically-triggered, at-home biospecimen collection can successfully be targeted to the periconceptional window and completed in a longitudinal cohort study.
Prosthetic Joint Infection of the Knee Due to Mycobacterium tuberculosis
Authors: Al Soub Hussam , Yacoub Nada , Al Soub Deema 
Published: June 2019

Background
Tuberculous prosthetic joint infection is a rare but serious complication of joint replacement surgery. We report a case of tuberculous prosthetic knee joint infection and review similar cases reported in the literature. The aims of this study were to alert physicians to this rare complication and review the experience of others to improve diagnosis and outcome of this serious complication.

Methods
We report a case and review the literature of all published cases of tuberculous prosthetic knee joint infections in the period between 1950 and 2017.

Results
We found 36 cases reported in the literature, which brings the total number of cases including ours to 37. Majority of cases were reported after the year 2000 and predominantly affecting elderly with a median age of 71 years. Clinical manifestations are nonspecific, with pain and swelling being the most common presenting symptoms (70.5% and 67.5%, respectively). Diagnosis was established by culture or histopathology, which were diagnostic in 89% and 39% of cases, respectively. Management requires the use of antituberculous medication and in some patients in addition surgery. In 35% of patients, medical therapy alone was successful. A 12-month duration of antituberculous drugs is adequate. The outcome is favorable, with survival in 89% of patients.

Conclusions
Tuberculous infection of prosthetic knee joint is a rare but serious complication of total knee replacement surgery. Treatment with antituberculous drugs and surgery in some patients results in favorable outcome.
Risk Factors for Knee Osteoarthritis in Retired Professional Footballers: A Cross-Sectional Study
Authors: Parekh Sanjay M. , Fernandes Gwen S. , Moses Jonathan P. , Fuller Colin W. , Scammell Brigitte E. , Batt Mark E. , Zhang Weiya , Doherty Michael 
Published: June 2019

Objective:
To determine risk factors for 3 knee osteoarthritis (KOA) outcomes, knee pain (KP), radiographic KOA (RKOA), and total knee replacement (TKR) in professional footballers.

Design:
This was a cross-sectional study involving a postal questionnaire, followed by radiographic assessment in a subcohort of responders.

Settings and Participants:
Four thousand seven hundred seventy-five questionnaires were sent to retired professional footballers, who had played in the English football league, and 1207 responded. Of these, 470 underwent knee radiographs.

Assessment of Risk Factors:
Potential factors include age, body mass index (BMI), knee alignment, a history of football-related knee injury, and training hours (during career) were collected through the questionnaire.

Main Outcome Measures:
Knee osteoarthritis outcomes were current KP (pain for most days of the previous month), TKR (self-reported), and RKOA (observed through radiographs).

Results:
Football-related injury was the strongest risk factor for KP [adjusted odds ratio (aOR), 4.22; 95% confidence interval (CI), 3.26-5.48], RKOA [aOR, 2.88; 95% CI, 1.81-4.59], and TKR [aOR, 4.83; 95% CI, 2.87-8.13]. Footballers had a 7% increased risk of RKOA for every 1000 hours trained. Although age and gout were associated with all 3 KOA outcomes, BMI, nodal osteoarthritis (OA), a family history of OA, knee malalignment, and 2D:4D ratio were associated with one or another of these 3 KOA outcomes.

Conclusion:
This study is the first to examine KOA risk factors in retired professional footballers. The study has identified several risk factors, both specific (eg, knee injury and training dose) and nonspecific (eg, age and gout) to footballers. This may be used to develop prevention strategies to reduce the risk of KOA in professional footballers after retirement.
Acute lymphoblastic leukemia with pancreas involvement in an adult patient mimicking pancreatic tumor
Authors: Wang Yinghao , Zhang Xuzhao , Dong Linping , Tang Kezhong , Fang Heqing , Tang Zhe , Zhang Bo 
Published: June 2019

Abstract

Rationale:
Acute lymphoblastic leukemia (ALL) is a malignant disease originating from abnormal proliferation of B or T lymphocytes in bone marrow (BM). Invasion of the pancreas is extremely rare in adults.

Patient concerns:
In this article, we report a case presenting that ALL invades the pancreas, as well as liver, kidney, and duodenum detected by magnetic resonance image. The patient was misdiagnosed as pancreatic tumor at initial since hemogram was unremarkable.

Diagnoses:
The diagnosis of ALL was established based on the endoscopic ultrasonography-guided fine-needle aspiration and bone marrow examination, showing BCR/ABL gene positive.

Interventions:
The patient was actively treated with chemotherapy. Hematological remission was obtained and the lesions in the pancreas disappeared.

Outcomes:
The patient finally died of complication from fungal pneumonia and central nervous system involvement 12 months after diagnosis.

Lessons:
Under the context of infection, persistent or intermittent fever and complete blood count are not significant prognoses of pancreatic involvement for adult with ALL. We hope that this case will help hepatobiliary and pancreatic surgeon to be aware of this kind of disease as pancreatic carcinoma and pancreas involvement by ALL have totally different treatment strategy.
Preoperative assessment of complicated appendicitis through stress reaction and clinical manifestations
Authors: Kang Chun-Bo , Li Wen-Qiang , Zheng Jian-Wei , Li Xiao-Wei , Lin Da-Peng , Chen Xiu-Feng , Wang De-Zhong , Yao Nan , Liu Xue-Kai , Qu Jun 
Published: June 2019

AbstractThis study assessed the severity of the disease through the preoperative clinical manifestations and inflammatory reaction indicators of acute appendicitis, and established a score table to predict complicated appendicitis (CA).The clinical data of 238 patients with acute appendicitis in our hospital were retrospectively analyzed, which included 18 patients with acute simple appendicitis (7.6%), 170 patients with acute purulent appendicitis (72.0%), and 48 patients with acute gangrene and perforation (20.3%). The clinical manifestations and inflammatory reaction indicators were analyzed by univariate logistic regression. Multivariate logistic regression analysis was performed to screen out the independent risk factors of CA. Theβcoefficients of independent risk factors entering the multivariate model were assigned by rounding, and the total score was the sum of values of all factors. Finally, verification and analysis were performed for the predictive model, and the operating characteristic curve (ROC) curve was drawn. Then, the area under the curve (AUC) was compared with the THRIVE scale, and the Hosmer–Lemeshow method was used to evaluate whether the model fitted well.The multivariate logistic regression analysis of independent risk factors was performed, and the values were rounded to the variable assignment based on theβcoefficient values. The plotted ROC and AUC was calculated as 0.857 (P < .001). Using the Hosmer–Lemeshow method, theX2-value was 12.430, suggesting that the prediction model fitted well.The scoring system can quickly determine whether this is a CA, allowing for an earlier and correct diagnosis and treatment. Furthermore, the scoring system was convenient, economical, and affordable. Moreover, it is easy to popularized and promote.
Impact of human immunodeficiency virus infection on mortality of patients who acquired healthcare associated-infection in critical care unit
Authors: Castro-Lima Victor Augusto Camarinha de , Borges Igor C. , Joelsons Daniel , Sales Vivian V.T. , Guimaraes Thais , Ho Yeh Li , Costa Silvia F. , Moura Maria Luisa N. 
Published: June 2019

Abstract
To evaluate 30-day mortality in human immunodeficiency virus (HIV) and non-HIV patients who acquired a healthcare-associated infection (HAI) while in an intensive care unit (ICU), and to describe the epidemiological and microbiological features of HAI in a population with HIV.
This was a retrospective cohort study that evaluated patients who acquired HAI during their stay in an Infectious Diseases ICU from July 2013 to December 2017 at a teaching hospital in Brazil.
Data were obtained from hospital infection control committee reports and medical records. Statistical analysis was performed using SPSS and a multivariate model was used to evaluate risk factors associated with 30-day mortality. Epidemiological, clinical, and microbiological characteristics of HAI in HIV and non-HIV patients and 30-day mortality were also evaluated.
Among 1045 patients, 77 (25 HIV, 52 non-HIV) patients acquired 106 HAI (31 HIV, 75 non-HIV patients). HIV patients were younger (45 vs 58 years, P = .002) and had more respiratory distress than non-HIV patients (60.0% vs 34.6%, P = .035). A high 30-day mortality was observed and there was no difference between groups (HIV, 52.0% vs non-HIV, 54.9%; P = .812). Ventilator-associated pneumonia (VAP) was more frequent in the HIV group compared with the non-HIV group (45.2% vs 26.7%, P = .063), with a predominance of Gram-negative organisms. Gram-positive agents were the most frequent cause of catheter associated-bloodstream infections in HIV patients. Although there was a high frequency of HAI caused by multidrug-resistant organisms (MDRO), no difference was observed between the groups (HIV, 77.8% vs non-HIV, 64.3%; P = .214). Age was the only independent factor associated with 30-day mortality (odds ratio [OR]: 1.05, 95% confidence interval [CI]: 1.01–1.1, P = .017), while diabetes mellitus (OR: 3.64, 95% CI: 0.84–15.8, P = .085) and the Sequential Organ-Failure Assessment (SOFA) score (OR: 1.16, 95% CI: 0.99–1.37, P = .071) had a tendency to be associated with death.
HIV infection was not associated with a higher 30-day mortality in critical care patients with a HAI. Age was the only independent risk factor associated with death. VAP was more frequent in HIV patients, probably because of the higher frequency of respiratory conditions at admission, with a predominance of Gram-negative organisms.
Safety of combining vascular endothelial growth factor receptor tyrosine-kinase inhibitors with chemotherapy in patients with advanced non–small-cell lung cancer
Authors: Lv Wen-wen , Zhang Jin-jie , Zhou Xiao-long , Song Zheng , Wei Chuan-mei 
Published: June 2019

Abstract

Background:
Vascular endothelial growth factor receptor-tyrosine kinase inhibitors (VEGFR-TKIs) have been developed for targeted therapies in non–small-cell lung cancer (NSCLC); moreover, some drug-related toxic reactions among cancer patients have been reported. A meta-analysis of randomized controlled trials (RCTs) to definite the incidence and the risk of grade ≥3 adverse events (AEs), serious and fatal AEs (SAEs and FAEs), with VEGFR-TKIs in advanced/metastatic NSCLC patients was performed.

Methods:
A comprehensive literature search was conducted for the clinical trials published up to December 2017. Qualified studies allotted patients with advanced/metastatic NSCLC to receive either chemotherapy alone or in combination with VEGFR-TKIs. Data were extracted by 2 authors.

Results:
Eighteen RCTs of VEGFR-TKIs plus chemotherapy, involving 8461 advanced NSCLC patients were included. The proportion of patients with grade ≥3 AEs was increased with the addition of VEGFR-TKIs (relative risk, 1.35; 95% confidence interval [CI] 1.19–1.52; incidence, 68.1% vs 50.1%; P < .001). The most common grade ≥3 AEs was neutropenia (24.9% vs 15.4%, P < .001). Addition of VEGFR-TKIs was also related to the increased risk of SAEs (relative risk, 1.34; 95% CI 1.14–1.56; incidence, 37.8% vs 27.9%; P < .001) and FAEs (relative risk, 2.16, 95% CI 1.47–3.19; incidence, 3.4% vs 1.8%). Subgroup analysis suggested there was no difference in the rates of SAEs and FAEs in the second-line settings. No evidence of bias was found between the literatures. The study was registered with PROSPERO (CRD42018099654).

Conclusions:
In comparison with chemotherapy alone, the addition of VEGFR-TKIs in advanced NSCLC patients was related to the increased risk of grades ≥3 AEs, SAEs, and FAEs, especially in the first-line settings. Physicians should be aware of some specific grade ≥3 adverse effect, especially haematologic adverse events, and it is also necessary to monitor cancer patients receiving VEGFR-TKIs.
Central retinal venous occlusion in a child with hyperhomocysteinemia
Authors: Liu Zhengfeng , Pan Xuemei , Jiang Wenjun , Bi Hongsheng 
Published: June 2019

Abstract

Rationale:
To report a rare case of 8-year-old girl patient with central retinal venous occlusion (CRVO) with hyperhomocysteinemia.

Patient concerns:
The patient had a 2-year history on painless visual loss in the left eye.

Diagnoses:
All examination results were within normal limits except plasma homocysteine (HCY). Fluorescein angiography (FA) confirmed peripheral capillary non-perfusion (CNP) in the left eye, and OCT showed macular edema. The girl patient was diagnosed as CRVO.

Interventions:
Based on all of the test results, laser photocoagulation was performed at peripheral capillary non-perfusion (NP). Ranibizumab was injected into virtreous cavity to reduce the macular edema. Oral folic acid, vitamin B12, and vitamin B6 were performed to the girl.

Outcomes:
After 13 months, the girl visual acuity recovered to 20/100 in the left eye.

Lessons:
All eye examinations should be performed in young patients, and they should undergo treatments immediately after is diagnosed as CRVO.
38-year-old woman with nasal congestion
Authors: Xiao Zhixian , Zhou Li , Xu Lian , Liang Fangqi , Tian Li , Jiang Luyun , Ren Guowei , Deng Jianhong 
Published: June 2019

Abstract

Introduction:
Benign fibrous histiocytoma (BFH) is a mesenchymal tumor composed of fibroblasts and histiocytes, which normally occurs in the bone tissue and/or the skin of the limbs. BFH of the nasal septum is rare worldwide.

Patient concerns:
A 38-year-old female patient attended our clinic with congestion in her right nasal cavity.

Diagnoses:
Endoscopic examination revealed a mass within the right nasal passage. Immunohistochemical staining demonstrated cells labeled with VIM (+), CD68PGM1 (+), CD34 (–), Actin (–), PCK (–), EMA (–), Desmin (–), SMA (–), S-100 (–), P63 (–), ALK-1 (–), beta-catenia (+), and KI67 (+). Clinical and histopathological examinations showed that the mass was a septum-originated BFH.

Interventions:
For the treatment of BFH of the nasal septum, the mass was removed endoscopically using a transnasal approach.

Outcomes:
No recurrence was observed over 30 months of follow-up.

Conclusion:
To prevent the recurrence wide local resection with histological clear margin and long-term follow-up with an endoscope are necessary.
The dominant models of KCNJ11 E23K and KCNMB1 E65K are associated with essential hypertension (EH) in Asian
Authors: Zhancheng Wang , Wenhui Ji , Yun Jiang , Lingli Wang , Huijun Huang , Yan Shen , Jin Li 
Published: June 2019

Abstract

Background:
The K+ channel, subfamily J, member-11 (KCNJ11) E23K and β1 subunit of large-conductance Ca2+-activated K+ channel (KCNMB1) E65K polymorphisms were shown to be associated with the risk of essential hypertension (EH). However, the results were inconclusive with relatively small sample size. Thus, we carried out a meta-analysis to investigate the genetic association between KCNJ11 E23K and KCNMB1 E65K polymorphisms and essential hypertension risk.

Methods:
Relative studies were collected using PubMed, Web of Science, the Cochrane Library databases, Chinese National Knowledge Infrastructure and Embase databases. Pooled odds ratios with 95% confidence intervals were used to assess the strength of associations.

Results:
The dominant models of KCNJ11 E23K (P = .006, OR [95%CI] = 0.45 [0.25, 0.79]) and KCNMB1 E65K (P = .04, OR [95%CI] = 0.91 [0.83, 1.00]) were significantly associated with essential hypertension risk. No significant association was detected between the allelic and recessive models of KCNJ11 E23K and KCNMB1 E65K and the susceptibility of EH. Subgroup analysis stratified by ethnicity showed that the dominant model of KCNMB1 E65K was associated with EH risk in Asian population (P = .003, OR [95%CI] = 0.83 [0.74, 0.94]), but not in Caucasian (P = .74, OR [95%CI] = 1.02 [0.89, 1.18]).

Conclusions:
The dominant model of KCNJ11 E23K and KCNMB1 E65K might be susceptible factors for essential hypertension. To confirm this result, large-scale case-control studies with more subjects are necessary.
Primary pulmonary artery sarcoma with deep vein thrombosis
Authors: Li Xin , Qi Quan , Liang Fuxiang , Zhang Xuxia , Dong Shuai , Song Bing 
Published: June 2019

Abstract

Rationale:
Pulmonary artery sarcomas (PAS) are easily misdiagnosed as thromboembolic disease of pulmonary arteries, because of rarity and presenting with nonspecific signs, symptoms, or imaging findings.

Patient concerns:
A 26-year-old man was admitted to the department of invasive technology with fever and dyspnea. Blood tests showed inflammatory activity, a slight increase of D-dimer and Fibrin Degradation Product. A chest enhanced computed tomography (CT) scanning revealed multiple filling defects occurred in the main trunk of both pulmonary arteries and branches of the left pulmonary artery

Diagnoses:
It was initially diagnosed with pulmonary embolism (PE) and deep vein thrombosis (DVT), but was eventually diagnosed with pulmonary artery sarcoma that was confirmed by biopsy.

Interventions:
The transcatheter thrombolysis therapy, inferior vena cava filter implantation, and operation were performed.

Outcomes:
The Organized mass was removed by the operation and was pathologically diagnosed as pulmonary artery sarcoma, the patient received postoperative chemotherapy according to the recommendation of oncology department.

Lessons:
Coagulation markers have been reported to differentiate PAS from PE, but this case suggested that PAS can be associated with DVT and abnormal coagulation-fibrinolysis system.